Co-existing squamous cell carcinoma and chronic myelomonocytic leukemia with ASXL1 and EZH2 gene mutations:A case report

BACKGROUND Chronic myelomonocytic leukemia(CMML),a rare clonal hematopoietic stem cell disorder characterized by myelodysplastic syndrome and myeloproliferative neoplasms,has a generally poor prognosis,and easily progresses to acute myeloid leukemia.The simultaneous incidence of hematologic malignancies and solid tumors is extremely low,and CMML coinciding with lung malignancies is even rarer.Here,we report a case of CMML,with ASXL1 and EZH2 gene mutations,combined with non-small cell lung cancer(lung squamous cell carcinoma).CASE SUMMARY A 63-year-old male,suffering from toothache accompanied by coughing,sputum,and bloody sputum for three months,was given a blood test after experiencing continuous bleeding resulting from a tooth extraction at a local hospital.Based on morphological results,the patient was diagnosed with CMML and bronchoscopy was performed in situ to confirm the diagnosis of squamous cell carcinoma in the lower lobe of the lung.After receiving azacitidine,programmed cell death protein 1,and platinum-based chemotherapy drugs,the patient developed severe myelosuppression and eventually fatal leukocyte stasis and dyspnea.CONCLUSION During the treatment and observation of CMML and be vigilant of the growth of multiple primary malignant tumors.

Inhibitory effect of celecoxib combined with cisplatin on growth of human tongue squamous carcinoma Tca8113 cell xenograft tumor

Objective:The aim of this study was to observe the inhibitory effect of application of COX-2 inhibitor,celecoxib,combined with cisplatin on the growth of human tongue squamous carcinoma Tca8113 cell xenograft by animal experiment.Methods:The nude mice were transplanted subcutaneously with Tca 8113 cells,and then were administrated with celecoxib,cisplatin or celecoxib combined with cisplatin respectively,and were sacrificed after 35 days.The weight of xenograft was measured to calculate the tumor inhibition rate.The histological change was studied under light and electron microscope.The COX-2 protein expression was observed by immunohistological staining.And the COX-2 mRNA expression was determined by RT-PCR.Results:Celecoxib,the COX-2 inhibitor,could not only inhibit the growth of Tca8113 cell xenograft tumor and COX-2 protein expression,but also enhance the inhibitory effect cisplatin on xenograft tumor growth significantly.The tumor inhibition rates of celecoxib group,cisplatin group and celecoxib plus cisplatin group were 15.63%,37.50% and 82.81% respectively that was statistically significant compared to control group(P < 0.01).The combined application of celecoxib and cisplatin could inhibit tumor growth more significantly than that of separated application(P < 0.01).The inhibitory effect of celecoxib on COX-2 mRNA expression of Tca 8113 cell was weaker and not significant(P = 0.073).Conclusion:Celecoxib can not only inhibit xenograft tumor growth in nude mice,but also enhance the inhibitory effect of CDDP on Tca 8113 transplanted tumor growth in nude mice.The mechanism maybe related to inhibition of COX-2 protein expression,which offers beneficial reference to further explore the mechanism between inhibition of COX-2 enzyme activity and prevention of head and neck tumor.

Multiple distant metastasis of tongue squamous cell carcinoma after surgical operation and radiotherapy——a case report and literature review

This article reported a 36-year male patient with tongue squamous cell carcinoma who showed negative cervical lymphadenopathy by clinical examination but cervical lymph node metastases diagnosed by pathological examination. The patient underwent tongue tumor resection and left forearm radial skin flap repair, and then received 50 Gy 3-D conformal radiotherapy and chemotherapy combining 5-fluorouracil with carboplatin. One year after the operation, although the patient showed no tumor recurrence in primary site and no metastasis of cervical lymph nodes, metastasis occurred in several tissues including spine, ribs, mandible, skeletal muscles of upper extremity as well as lymph nodes of the mediastinum and lung hilum, which caused the patient to die quickly. According to the literature, we conclude that distant metastasis of tongue squamous cell carcinoma was less common, but once it occurs, the prognosis of the patient is extremely poor.

Alterations in metastatic properties of hepatocellular carcinoma cell following H-ras oncogene transfection

AIM: To demonstrate the relationship between H-ras oncogene and hepatocellular carcinoma (HCC) metastasis. METHODS: Activated H-ras oncogene was transfected into SMMC 7721, a cell line derived from human HCC, by calcium phosphate transfection method. Some metastasis-related parameters were detected in vitro, including adhesion assay, migration assay, expression of collagenase IV(c IV ase) and epidermal growth factor receptor (EGFR). RESULTS: The abilities of H-ras-transfected cell clones in adhesion to laminin (LN) or fibronectin (FN), migration, c IV ase secretion increased markedly, and the expression of EGFR elevated moderately. More importantly, these alterations were consistent positively with the expression of p21, the protein product of H-ras oncogene. CONCLUSION: H-ras oncogene could induce the metastatic phenotype of HCC cell in vitro to raise its metastatic potential.

Effect of 5-Aza-2'-deoxycytidine on the P16 tumor suppressor gene in hepatocellular carcinoma cell line HepG2

INTRODUCTIONHepatocellular carcinoma (HCC) is one of the mostcommon human malignancies worldwide[1,2], and isclosely associated with infection of HBV and HCVand contamination of aflatoxin B1[3-6]. Althoughthe molecular mechanisms of hepatocarcinogenesisremain poorly understood, an increasing number ofgenetic abnormalities have been recognized[7-10],for example, the p16 gene[11,12] the p53gene[13-18], the E-cadherin gene[19], and the c-mycgene[20].

Blockage of IGF-1R signaling sensitizes urinary bladder cancer cells to mitomycin-mediated cytotoxicity

A major problem which is poorly understood in the management of bladder cancer is low sensitivity to chemotherapy and high recurrence after transurethral resection. Insulin-like growth factor 1 receptor (IGF-1R) signaling plays a very important role in progression, invasion and metastasis of bladder cancer cells. In this study, we investigated whether IGF-1R was involved in the growth stimulating activity and drug resistance of bladder cancer cells. The results showed: The mRNAs of IGF-1, IGF-2 and IGF-1R were strongly expressed in serum-free cultured T24 cell line, whereas normal urothelial cells did not express these factors/receptors or only in trace levels; T24 cell responded far better to growth stimulation by IGF-1 than did normal urothelial cells; blockage of IGF1R by antisense oligodeoxynucleotide (ODN) significantly inhibited the growth of T24 cell and enhanced sensitivity and apoptosis of T24 cells to mitomycin (MMC). These results suggested that blockage of IGF-IR signaling might potentially contribute to the treatment of bladder cancer cells which are insensitive to chemotherapy.

自噬蛋白Beclin-1与N-myc下游调控基因2在食管鳞状细胞癌中的表达及其临床意义

目的探索自噬蛋白Beclin-1和N-myc下游调控基因2(NDRG2)在食管鳞状细胞癌(ESCC)中的表达,并探讨两种蛋白作为ESCC预后分子标志物的临床价值。方法采用免疫组织化学染色检测Beclin-1与NDRG2在121例ESCC组织中的表达,通过Pearson相关分析两者表达与临床病理参数的关系。根据Beclin-1与NDRG2的表达情况将所有患者分为2组,高、低表达组的生存概率通过Kaplan-Meier曲线计算,Log-rank检验用于生存分析的比较。采用Cox比例风险模型进行单因素和多因素分析,确定ESCC患者的独立预后因子。结果免疫组织化学染色分析显示Beclin-1蛋白在121例ESCC及癌旁组织中的阳性表达率分别为40.5%(49/121)和59.5%(68/121),差异有统计学意义(χ^(2)=5.973,P=0.015)。NDRG2蛋白在ESCC组织中的阳性表达率亦明显低于癌旁组织,差异有统计学意义(46.3%vs.61.2%;χ^(2)=5.385,P=0.020)。Beclin-1低表达者有更为频繁的淋巴结转移(χ^(2)=6.158,P=0.013)和更晚的TNM分期(χ^(2)=4.538,P=0.033),而NDRG2低表达与更晚的T分期(χ^(2)=6.607,P=0.010)和TNM分期(χ^(2)=5.744,P=0.017)相关。Kaplan-Meier曲线显示,Beclin-1低表达与高表达患者的3年总体生存(OS)率分别为44.3%和60.9%,差异有统计学意义(χ^(2)=5.696,P=0.017)。NDRG2低表达者的预后亦明显低于NDRG2高表达者,3年OS率分别为43.9%和59.2%(χ^(2)=9.004,P=0.003)。单、多因素Cox比例风险模型分析表明,Beclin-1低表达(HR=1.727,95%CI:1.017~2.934,P=0.043)、NDRG2低表达(HR=1.671,95%CI:1.023~2.730,P=0.040)与TNMⅡ~Ⅲ期(HR=3.823,95%CI:2.133~6.852,P<0.001)是ESCC患者预后不良的独立预测因素。结论Beclin-1和NDRG2表达在ESCC中明显下调,且与患者不良预后相关,其可能是预测ESCC患者生存的预后标志物。

基于生物信息学分析筛选舌鳞癌的关键基因

目的:利用生物信息学方法筛选舌癌的关键基因,探讨其与舌癌进展相关的潜在功能和通路机制。方法:分析微阵列数据集GSE13601,筛选出差异表达基因。利用注释、可视化和集成发现数据库(DAVID)进行基因本体论(GO)及京都基因和基因组百科全书(KEGG)通路分析。利用STRING数据库构建蛋白质相互作用网络、癌症基因组图谱数据库(TCGA)测序数据评估舌癌关键基因的表达。结果:共筛选出101个差异表达基因及20个关键基因,进一步研究发现,MYH2、MYLPF、NEB、ACTN2、DES、TMP2等关键基因影响舌癌患者的生存率,并且MYH2、MYLPF、ACTN2、DES、TPM2、TNNC1、MYL1、MYH7和TNNI2等基因的表达与舌癌的临床分期相关。结论:MYH2、MYLPF、NEB、ACTN2、DES、TMP2、MYL1、TNNC1、MYH7和TNNI2可能参与舌癌的发生、发展,具备成为舌癌潜在生物标志物和治疗靶点的潜力。

Detailed deletion mapping of loss of heterozygosity on 9p13-23 in laryngeal squamous cell carcinoma by microsatellite analysis

Background This study was designed to investigate the hot spots of microsatellite loss of heterozygosity (LOH) on 9p13-23 in laryngeal squamous cell carcinoma and to find out the correlation between the incidence of microsatellite LOH and the clinicopathological parameters Methods Tumor tissues were obtained from paraffin embedded sections with microdissection Genomic DNA was extracted from tumor tissues and peripheral blood lymphocytes with the phenol-chloroform Polymerase chain reaction (PCR) amplification and denaturing gel electrophoresis were carried out in a set of 42 squamous cell carcinoma (SCC) of larynx and corresponding peripheral blood lymphocytes using 13 highly polymorphic microsatellite markers on 9p13-23 The correlation was analyzed between microsatellite LOH at the high frequency on 9p13-23 and clinicopathological parameters in the patients with squamous cell carcinoma of larynx KH*2/5DResults Of the 42 laryngeal cancers, 41 (97 6%) showed LOH in at least one of the microsatellite markers tested on 9p13-23 The most frequently deleted marker was D9S162 in 17 of the 19 (89 5%) informative samples The marker D9S171, which is located on 9p21, had LOH detected in 12 of the 15 informative cases (80 0%) LOH at the D9S1748 marker (closest to the p16 gene locus) was detected in 18 of the 36 informative cases (50 0%) Allelic deletion mapping revealed two minimal regions of LOH encompassing markers D9S161-D9S171 on 9p21 and IFNA-D9S162 on 9p22-23 Multiple LOH (≥4) on 9p21-23 was found more frequently in the patients under 60 years, with supraglottic SCC or cervical lymph node metastasis than those over 60 years, with glottic SCC or without cervical lymph node metastasis ( P <0 01 or 0 01, 0 05, respectively) On the contrary, there was no correlation between T stages or pathologic classification and the frequency of LOH on 9p21-23 in 42 SCC of Larynx Conclusions These findings imply the presence of at least two putative tumor suppressor genes on 9p13-23 in laryngeal SCC Multiple genetic alterations are probably implicated in supraglottic SCC with cervical lymph node metastasis in younger patients

舌鳞状细胞癌关键基因的筛选及其潜在治疗药物的预测

目的通过生物信息学方法筛选舌鳞状细胞癌的关键基因,并预测其潜在的治疗药物。方法从GEO数据库中下载GSE34105和GSE13601数据集,并利用limma包筛选DEGs。DAVID数据库对DEGs进行GO及KEGG富集分析。STRING数据库构建PPI网络,并在Cytoscape中进行可视化。“CytoHubba”筛选Hub基因,并利用TCGA数据库、HPA数据库及RT-qPCR进行验证。最后,在Cellminer数据库中筛选Hub基因潜在的治疗药物。结果共筛选出192个DEGs,其中上调基因84个,下调基因108个。GO富集分析显示,DEGs主要涉免疫反应、细胞外基质分解等生物学过程;KEGG富集分析显示,DEGs主要富集在EMC-受体相互作用信号通路。筛选出IFIT3、OAS2作为Hub基因。预测出布加替尼、艾沙佐米柠檬酸盐及硼替佐米等19种可能靶向作用于舌鳞状细胞癌的药物。结论通过生物信息学方法筛选出两个Hub基因,并预测其潜在的治疗药物,为研究舌鳞状细胞癌的分子机制及开发治疗药物提供理论基础。

舌鳞癌隐匿性颈淋巴结转移的特点及其对患者预后的影响

背景与目的:舌鳞癌隐匿性颈淋巴结转移有一定的规律性,且影响预后。本研究的目的是分析舌鳞癌隐匿性颈淋巴结转移的特点及其对患者预后的影响,为选择性肩胛舌骨肌上颈清扫提供临床依据。方法:收集1990～1996年间在我院住院行手术治疗的164例舌鳞癌患者的资料,分析舌鳞癌隐匿性颈淋巴结转移的特点及其对患者预后的影响。结果:164例舌鳞癌隐匿性颈淋巴结转移率为25.71%,最常见的转移部位是同侧的Ⅱ区,其次分别为同侧的Ⅰ和Ⅲ区,82.98%隐匿性转移的颈淋巴结位于以上3个区域,大多数隐匿性转移的颈淋巴结在首次手术治疗后2年内(33/36)被发现。经统计学分析,显性颈淋巴结转移和隐匿性颈淋巴结转移与无转移组之间患者的预后有显著性差异(log-rank,P<0.01),而显性转移组与隐匿性转移组患者的预后之间无显著性差异(log-rank,P>0.05)。结论:同侧的Ⅰ～Ⅲ区是舌鳞癌隐匿性颈淋巴结转移的常见区域,对较易发生隐匿性颈淋巴结转移的cN0舌鳞癌患者可行选择性肩胛舌骨肌上颈清扫术。隐匿性颈淋巴结转移影响cN0舌鳞癌患者的预后。

舌鳞状细胞癌预后因素的探讨

目的 :探讨影响舌鳞癌预后的有效因素。方法 :对 12 1例舌鳞癌患者进行回顾研究 ,应用Cox比例风险模型对 13个与舌鳞癌术后生存率有关的指标进行回归分析。结果 :只有原发灶的切缘状态和颈淋巴结转移情况才是影响舌鳞癌术后生存率的独立指标 (P <0 0 5 )。结论 :对原发灶和颈转移淋巴组织的彻底手术切除是提高舌鳞癌患者生存率的关键。

补骨脂乙素对舌鳞状细胞癌Tca8113细胞增殖的抑制作用和凋亡诱导作用及其机制

目的:观察补骨脂乙素(IBC)对人舌鳞状细胞癌Tca8113细胞增殖和凋亡的影响,并阐明其可能的作用机制。方法:将体外培养的Tca8113细胞分为对照组(0μmol·L-1)和不同浓度IBC组(10、20、40及80μmol·L-1)。通过MTT法检测细胞增殖抑制率,流式细胞术检测细胞凋亡率,Western blotting法检测各组细胞中Akt、p-Akt、Erk、p-Erk、Bax、Bcl-2和Caspase-3蛋白的表达水平。结果:MTT法检测,随着IBC浓度的增加和作用时间的延长,Tca8113细胞的增殖抑制率逐渐增加,12、24和48h半数抑制浓度(IC50)分别为(285.13±8.97)、(132.40±7.76)和(58.56±5.93)μmol·L-1,不同时间点IC50比较差异有统计学意义(P<0.05)。流式细胞术检测,与对照组(1.69%±0.65%)比较,作用48h后20和40μmol·L-1 IBC组细胞凋亡率(分别为8.21%±2.32%和22.45%±1.18%)明显升高(P<0.05)。Western blotting法检测,与对照组比较,作用48h后20和40μmol·L-1 IBC组细胞中Bcl-2、p-Akt和p-Erk表达水平明显降低(P<0.05),Bax表达水平明显升高(P<0.05);Akt和Erk蛋白表达水平无明显变化(P>0.05);与对照组比较,作用48h后40μmol·L-1 IBC组Tca8113细胞中Caspase-3蛋白表达水平明显升高(P<0.05)。结论:IBC可抑制Tca8113细胞的增殖并诱导细胞凋亡,Akt和Erk通路可能是其诱导肿瘤细胞凋亡的途径。

食管鳞癌组织中NDRG1 mRNA和蛋白的表达

目的:探讨食管鳞癌组织中NDRG1mRNA和蛋白的表达情况及其与临床病理因素的关系。方法:分别采用RT PCR和免疫组织化学SP法检测49例食管鳞癌组织(分化程度Ⅰ级14例,Ⅱ级23例,Ⅲ级12例;有淋巴结转移21例,无淋巴结转移28例)、23例癌旁不典型增生黏膜组织及49例正常食管黏膜组织中NDRG1mRNA和蛋白的表达。结果:食管鳞癌组织中NDRG1mRNA相对含量低于癌旁不典型增生黏膜组织及正常食管黏膜组织(P<0.05或0.01);不同分化程度的食管鳞癌组织之间NDRG1mRNA相对含量差异无统计学意义(P>0.05);伴淋巴结转移的食管鳞癌组织与无淋巴结转移的食管鳞癌组织NDRG1mRNA相对含量差异无统计学意义(P>0.05)。癌旁不典型增生组织及食管鳞癌组织中NDRG1蛋白()阳性率(3/23和4/49)均低于正常黏膜组织的43/49(P<0.01);食管鳞癌组织中NDRG1蛋白表达与癌组织的分级及有、无淋巴结转移无关(P均>0.05)。结论:食管鳞癌组织中NDRG1mRNA和蛋白表达降低,其低表达可能与食管鳞癌发生有关。

早期舌鳞癌复发原因及预后因素的分析

背景与目的:早期舌癌的治疗效果理想,但复发是影响早期舌癌治疗效果的重要因素。本研究回顾性分析227例早期舌癌的临床资料,探讨早期舌癌复发的主要原因及影响预后的因素。方法:收集中山大学肿瘤防治中心1992-2003年首治的227例早期舌鳞癌患者的临床资料,Kaplan-Meier法对各影响因素进行生存率分析并计算生存率,log-rank法比较各因素不同水平生存分布的差异。Cox回归模型进行多因素分析,影响复发不同因素间比较用卡方检验。结果:高分化鳞癌组复发率为19.3%,中高低分化鳞癌组复发率为39.2%,二者的差异具有统计学意义(P=0.004),综合治疗组复发率为15%,单纯手术组复发率为28%,二者的差异具有统计学意义(P=0.014)。复发组及非复发组3年及5年生存率分别为40.7%、87.3%及25.9%、80.3%,二者的差异具有统计学意义(P=0.000)。行颈清扫组及未行颈清扫组3年及5年生存率分别为为76.4%、75.0%及68%、61.2%,二者的差异具有统计学意义(P=0.023);≥45岁组及<45岁组3年及5年生存率分别为75.6%、78%及59.5%、66.1%,二者的差异具有统计学意义(P=0.021)。结论:病理分级及是否进行综合治疗是影响早期舌癌复发的原因,患者的年龄、是否行颈清扫、是否复发是影响早期舌癌预后的因素,年龄及是否复发是影响预后的独立因素。

基因表达谱芯片发现36条喉鳞癌相关基因

目的 :研究探讨喉鳞癌发生、发展中相关基因群的表达和初步功能。 方法 :按微矩阵排列的 40 96种全长基因 PCR产物制成 Bio Door40 96型微矩阵表达谱芯片 ;采用条件优化的一步法抽提喉鳞癌及正常组织总 RNA,用 Qiagen公司 Oligotexm RNA离心柱分离纯化两种组织的 m RNA;经逆转录合成荧光分子 (Cy3/ Cy5 )掺入的 c DNA一链制备表达谱探针 ,芯片杂交和严格洗片后 ,用 Scan Array30 0 0荧光扫描仪扫描芯片荧光信号图像 ,利用计算机分析肿瘤及正常组织中差异表达的基因。对所获得的基因进行分子生物信息学分析。结果 :在 40 96种基因中 ,喉鳞状细胞癌与正常组织间存在差异表达的基因。在所检测的 4对临床标本中 ,发现有差异表达的基因 36条 (0 .88% )。生物信息学分析显示 ,该 36条差异表达基因与肿瘤的发病机制可能存在相关性。结论 :喉鳞状细胞癌的发生、发展中存在多基因表达调控的改变 。

胸苷酸合成酶基因多态性及其蛋白表达与食管鳞状细胞癌淋巴结转移的关系

背景与目的:胸苷酸合成酶(thymidylatesynthase,TS)是DNA合成的关键酶。TS基因5′非编码区(untranslatedregion,UTR)串联重复序列和G/C单核苷酸多态性(singlenucleotidepolymorphism,SNP)可能导致酶表达或活性的改变,从而改变个体对肿瘤的易感性及预后。本实验的目的是探讨TS5′-UTR多态性与食管鳞状细胞癌(esophagealsquamouscellcarcinoma,ESCC)淋巴结转移的关系,并探讨此多态性对TS蛋白表达的影响。方法:从232例ESCC患者和348例健康对照的外周血中提取白细胞DNA,分别用PCR和PCR-RFLP方法检测TS5′UTR28bp串联重复序列和G/CSNP的基因型。51例患者的术后切除组织采用免疫组织化学染色的方法(S-P法)检测肿瘤组织中的TS蛋白的表达情况。结果:5′UTR的3G/3G,3G/3C,3C/3C,2R/3G,2R/3C,2R/2R和其它基因型频率在健康对照组分别为17.5%,17.3%,29.3%,12.9%,17.8%,3.7%,1.5%和在病例组中分别为16.0%,16.0%,29.3%,13.8%,17.6%,4.3%,3.0%;3G,3C,2R和其它等位基因型频率在健康对照组中分别为32.8%,47.0%,19.5%,0.7%和在病例组中分别为31.2%,46.8%,20.5%,1.5%。与3G/3G基因型相比,2R/3G基因型显著增加淋巴结转移的危险性(年龄和性别校正OR=11.53,95%CI=2.67～49.74)。TS表达水平与患者的性别、年龄、淋巴结转移和临床病理分期无关,而与TS5'UTR基因型密切相关(P<0.05)。结论:TS5′UTR重复序列及SNP多态性与ESCC淋巴结转移有关,而TS蛋白表达水平与淋巴结转移无关。

明胶酶在舌鳞癌发生、演进中的表达和意义

【目的】通过检测明胶酶在口腔正常黏膜、白斑、白斑癌变和鳞癌组织中的表达,探讨其在舌鳞癌的发生和演进中的变化和作用。【方法】应用免疫组织化学的方法检测14例口腔正常黏膜、22例白斑、7例白斑癌变和59例舌鳞癌组织中明胶酶(MMP-2和MMP-9)蛋白的表达。【结果】①MMP-2在口腔正常黏膜、白斑、白斑癌变和舌鳞癌组织中阳性率分别为29%、50%、86%和83%;MMP鄄9在口腔正常黏膜、白斑、白斑癌变和舌鳞癌组织中阳性率分别为50%、100%、100%和83%。②正常黏膜组织中MMP-2的阳性率明显低于白斑癌变(P=0.016)和舌鳞癌组织(P=0.000);白斑组织中MMP-2的阳性率明显低于舌鳞癌组织(P=0.001);白斑癌变组织中MMP鄄2的阳性率明显低于伴有淋巴结转移的舌鳞癌组织(P=0.019);舌鳞癌组织中无淋巴结转移组的阳率明显低于伴有淋巴结转移组(P=0.006)。③正常黏膜组织中MMP-9的阳性率明显低于白斑(P=0.021)和白斑癌变组织(P=0.016);白斑和白斑癌变组织中MMP-9的阳性率低于无淋巴结转移的舌鳞癌(P=0.002和0.007);舌鳞癌组织中无淋巴结转移组的阳率明显低于伴有淋巴结转移组(P =0.033)。【结论】明胶酶在舌鳞癌发生和演进过程中表达明显增加,并可能在这一过程中起着重要作用。

喉鳞状细胞癌组织中Survivin基因与p15和p16基因表达的关系

目的 探讨抑凋亡基因Survivin(SVV)在喉鳞状细胞癌 (laryngealsquamouscellcarcinomas,LSCC)中的表达意义及与抑癌基因p15、p16表达的关系。 方法 采用免疫组化链酶卵白素 生物素复合体 (strepavidin biotincomplex ,SABC)方法检测了 4 8例LSCC组织及 2 4例癌旁组织、2 4例正常喉黏膜组织SVV、p15、p16蛋白的表达并进行统计分析。 结果 SVV蛋白在正常喉黏膜中不表达 ,4 8例LSCC组织中 2 7例SVV蛋白阳性表达 ,占 5 6 3% ,2 4例癌旁组织中 6例SVV蛋白阳性表达 ,占 2 5 0 % SVV蛋白在LSCC组织与癌旁组织中的表达以及SVV在癌旁组织与正常喉黏膜中的表达差异均有显著性 (P <0 0 5 )。SVV蛋白表达与LSCC的发生部位、TNM分期、病理分级、淋巴结转移及预后有关 (P <0 0 5 )。p16蛋白强阳性组、p16蛋白弱阳性组及 p16蛋白阴性组的SVV蛋白阳性率差异有显著性 (P <0 0 0 1) ,且表达呈正相关 (C =0 5 2 )。p15蛋白阳性组与 p15蛋白阴性组的SVV蛋白阳性表达差异无显著性。结论SVV基因在LSCC的发生发展中起重要作用 ,并对LSCC的早期诊断、预后判断有意义。SVV的过度表达与 p16抑癌作用的失去可能在LSCC的发病机制中有协同作用。

舌鳞癌颈淋巴结转移的MRI诊断

背景与目的明确有无颈部淋巴结转移对舌癌的治疗与预后评价意义重大,单纯触诊诊断淋巴结转移的准确率难以令人满意,MRI越来越多地用于颈部淋巴结转移的评价。本研究旨在分析舌鳞癌颈淋巴结转移的MRI特点及规律,探讨MRI在诊断舌鳞癌颈部淋巴结转移中的作用。方法对92例舌鳞癌患者共448个颈部淋巴结区进行MRI鄄病理对照分析。结果448个淋巴结区中,166区(37.1%)病理为淋巴结转移,其中Ⅱ区最常受累,Ⅰ、Ⅱ区MRI诊断的假阳性率及假阴性率均较高。舌体鳞癌颈部淋巴结各区转移率与舌根鳞癌比较无统计学差异。76个淋巴结区有明确的淋巴结中央坏死,病理证实均为转移淋巴结。包膜外侵犯34区,MRI上淋巴结边缘不规则,周围脂肪带模糊、不完整,其中2例包绕颈内动脉。以淋巴结最小直径≥8mm,或中央坏死作为MRI诊断转移淋巴结的标准,敏感性79.5%,特异性90.4%,准确性86.4%。结论舌鳞癌颈部淋巴结转移以Ⅱ区最高,淋巴结的大小、有无中央坏死及边缘是否规则可作为MRI诊断的主要依据。MRI对于Ⅲ、Ⅳ及Ⅴ区诊断的淋巴结转移诊断准确性高,但对Ⅰ、Ⅱ区淋巴结转移诊断价值有限。