42例食道癌手术切除率相关因素分析

目的 :对影响食管癌手术切除率的相关因素作临床分析。方法 :1985年5月至1999年8月 ,外科手术探查42例食道癌 ,对其中13例未能手术切除病例的相关因素作临床研究。结果 :手术切除率为69 %(29/42) ,认为影响手术切除率的主要相关因素一是病程长 ,平均吞咽困难病程为4～7mo,Ⅲ、Ⅳ及T4 病例所点比率大 ;二是切除率与癌肿病变长度及部位有密切关系。结论 :宣传普及食管癌疾病知识 ,发现早期病人 ,合理筛选手术病人方可提高手术切除率。对T4 外侵邻近器官病例 ,如能同时切除受侵器官者 ,为增加手术切除率 ,提高外科手术治疗效果 。

EFFECTS OF MUTATION AND EXPRESSION OF PTEN GENEmRNA ON TUMORIGENESIS AND PROGRESSION OFEPITHELIAL OVARIAN CANCER

Objective To investigate the mutation and expression of tumor suppressor gene-PTEN mRNA and explore their roles in tumorigenesis and progression of ovarian cancer. Methods Mutated exon 5 of PTEN gene was examined in normal ovary(n = 5), ovarian cyst (n =5), ovarian borderline tumor (n = 9), epithelial ovarian cancer(n = 60), and ovarian cancer cell line (n = 1)by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). mRNA expression of PTEN gene was evaluated in corresponding tissues and cell line by reverse transcription polymerase chain reaction(RT-PCR). The mutation and mRNA expression of PTEN gene were compared with clini-copathological features of ovarian cancer. Results Mutated exon 5 of PTEN gene was detected only in 5(7.1%)cases of epithelial ovarian cancer. mRNA expression level of PTEN gene in ovarian borderline tumor or ovarian cancer was lower than that in normal ovary or ovarian cyst(P < 0.05). The level of PTEN gene mRNA expression was negatively correlated with clinicopathological staging of ovarian cancer, whereas positively correlated with histological differentiation (P < 0.05). mRNA expression level of PTEN gene in ovarian endometrioid cancer was significantly lower than that in ovarian serous or mucinous cancer (P < 0.05=. Conclusions Mutation of PTEN gene occurs in ovarian cancer. Down-regulated expression of PTEN is probably an important molecular event in tumorigenesis of ovarian cancer. Abnormal expression of PTEN gene is involved in progression of ovarian cancer. Reduced expression of PTEN gene is closely associated with tumorigenesis and pathobiological behaviors of ovarian endometrioid cancer.

Tumor suppressor gene p16 and Rb expression in gastric cardia precancerouslesions from subjects at a high incidence area in northern China

AIM:To further understand the molecular basis for gastric cardia carcinogenesis and to provide etiological clues. METHODS: Endoscopic mucosa biopsy and histopathological examinations were made on 37 subjects from a high incidence area for both esophageal and gastric cardia carcinomas in northern China. All the biopsy samples were fixed in 850 ml. (-1)L alcohol and embedded in paraffin. Each block contained one piece of tissue and was serially section at 5 microm. Immunohistochemistry (ABC) was carried out on these gastric cardia samples to determine the alterations of p16 and Rb. RESULTS: Based on the histopathlogical examination there were 11 cases of chronic superficial gastritis, 12 cases of chronic atrophic gastritis and 14 cases of dysplasia. The immunostaining demonstrated different levels of unclear immunostaining of p16 and Rb in normal gastric cardia tissue and the tissues with different severity of lesions. With the lesions progressing, the positive immunostaining rates for p16 protein had a decreasing tendency. In contrast, the positive immunostaining rate for Rb protein had an increasing tendency. There was a significant negative relationship between the two parameters. Changes of p16 was CSG 11(100%), CAG 7(58%), DYS 4(29%) and changes of Rb was CSG 2(18%), CAG 8(67%) and DYS 12(86%), (P【0.05). CONCLUSION: The alterations of p16 and Rb protein may play a role in the early stages of gastric cardia carcinogenesis.

Possibility of non-invasive diagnosis of gastric mucosal precancerous changes

AIM: To assess the possibility of non-invasive screening of atrophic chronic gastritis for preventing further development of gastric cancer.METHODS: One hundred and seventy-eight consecutive Helicobacter pylori ( H pylori)-positive dyspeptic patients after detection of serum levels of pepsinogen-1 (PG-1) and gastrin-17 (G-17) by enzyme immunoassay were proposed for endoscopy and histology. The serologic and morphologic results were compared with estimating the sensitivity, specificity and prognostic values of the tests.RESULTS: There was statistically significant reverse dependence between the grade of stomach mucosal antral or corpus atrophy and the proper decreasing of serum G17 or PG1 levels. The serologic method was quite sensitive in the diagnosis of non-atrophic and severe antral and corpus gastritis. Also, it was characterized by the high positive and negative prognostic values.CONCLUSION: Detection of serum G-17 and PG1 levels can be offered as the screening tool for atrophic gastritis. The positive serologic results require further chromoendoscopy with mucosal biopsy, for revealing probable progressing of atrophic process with development of intestinal metaplasia, dysplasia or gastric cancer.

Efficacy of dynamic contrast enhanced-MRI in distinguishing benign and malignant breast lesions

Objective: The aim of the study was to discuss the diagnostic value of dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in distinguishing malignant tumors of breast from benign lesions. Methods: A DCE-MRI study was performed on 18 benign lesions, 16 malignant tumors and 2 borderline lesions of breast (mean age 51.7 years). The seven items including shape, marginal feature, spreading signs, time-signal intensity curve, maximum slope of increase (MSI), signal enhancement ratio (SER) and signal enhanced extent (SEE) were compared between patients with benign lesions and those with malignant tumors. Results: Shape, marginal feature, spreading signs, time-signal intensity curve, SEE and SER between the benign and malignant groups of breast represented significantly difference except MSI. The 36 cases with breast lesion displayed sensitivity, specificity, accuracy for diagnosing malignant tumor of breast using the scoring method was 93.8%, 83.3% and 88.2%, respectively. Conclusion: DCE-MRI combined with morphology and dynamic enhanced feature of breast lesion has well efficacy to differentiate malignant tumor from benign lesions.