Runx3在溃疡性结肠炎中的表达

目的:观察Runx3在溃疡性结肠炎(UC)粘膜组织中的表达,探讨抑癌基因RUNX3在溃疡性结肠炎发病机制中的调控作用.方法:选取经过临床表现、内镜、病理等方法共同确诊的溃疡性结肠炎活检的石蜡标本和结肠癌手术切除标本残端的正常组织石蜡标本,用免疫组织化学的方法检测Runx3蛋白在68例UC及50例对照结肠粘膜组织中的表达情况.结果:Runx3在UC及对照组结肠粘膜组织中均有表达,两者之间的差异无统计学意义(P＞0.05). Runx3的表达与UC患者的性别、年龄及病变严重程度之间无显著性相关(P＞0.05).结论:Runx3作为一个转录因子在溃疡性结肠炎的发病机制中可能通过非直接的方式发挥其重要作用.     

IBS症状在溃疡性结肠炎缓解期中的发生情况及影响因素

目的：探讨肠易激综合征（IBs）症状在溃疡性结肠炎缓解期中的发生情况及影响因素。方法：采用问卷调查的形式对来我院就诊的124例溃疡性结肠炎（UC）患者进行调查和随访,对在缓解期的75例患者根据IBS症状的发生情况进行症状评估、心理状态评分,探讨1BS症状在缓解期溃疡性结肠炎患者中的发生情况以及影响因素。结果：溃疡性结肠炎缓解期患者IBS症状的发生率为43％,且女性缓解期溃疡性结肠炎患者出现IBS症状的比例（57％）显著高于男性患者（30％）,而症状达到IBS诊断标准的患者焦虑或者抑郁评分明显高于未达IBS诊断标准者（P〈0．000）。结论：溃疡性结肠炎缓解期患者IBS症状的发生率较高,与患者的心理及精神状态有着密切的关系。     

朊蛋白在结肠癌及结肠炎组织中的表达及其临床意义

目的：观察朊蛋白（PrPc）在正常结肠粘膜、结肠炎及结肠癌组织中的表达,并探讨其临床意义。方法：采用免疫组织化学法分别检测PrPc在正常结肠组织、结肠炎及结肠癌组织（各40例）中的表达,并分析其在结肠癌及结肠炎组织中的表达与患者性别、分化程度、TNM分期、淋巴结转移及炎症程度等临床特征间的关系。结果：PrPc在正常结肠及结肠癌组织中均有表达,在结肠炎中表达较低,在结肠癌组织中阳性表达率为60％（24／40）,明显高于正常结肠组织的35％（14／40）及结肠炎组织的30％（12／40）（P〈0．05）。轻度结肠炎中PrPc的阳性表达率明显高于重度结肠炎,结肠癌中PrPc的表达与患者的肿瘤分级、分期显著相关（P〈0．05）。结论：PrPc在结肠癌中的表达增高,在结肠炎中表达较低,可作为临床判断结肠癌恶性程度及结肠炎炎症程度的重要参考指标。     

溃疡性结肠炎合并肿瘤性息肉的危险因素分析

目的:探讨溃疡性结肠炎合并肿瘤性息肉的流行病学、发病机制的特点以及危险因素.方法:选择我院2008年6月至2012年3月收治的25例溃疡性结肠炎合并肿瘤性息肉(观察组)、25例散发性肿瘤性息肉(对照一组),25例大肠息肉癌变患者为研究对象(对照二组)的临床资料进行回顾性分析,对各组患者息肉标本及临床危险因素进行分析.结果:观察组结肠镜下形态学特点、组织学分型与对照一组存在显著性统计学差异(P＜0.05),而与对照二组患者无统计学差异(P＞o.05).观察组与对照一组的临床危险因素比较,其中性别、年龄、BMI指数、病理分型、息肉直径大小、P53阳性和其他因素(有原发性硬化性胆管炎、结直肠癌家族史)存在统计学差异,与对照二组危险因素仅有性别存在统计学差异.结论:溃疡性结肠炎合并肿瘤性息肉患者在病理组织类型特点与危险因素与息肉癌变者更为相近,临床诊断治疗过程中应给予高度重视.     

以肠道外症状为首发表现的结肠癌47例临床分析

目的:分析以肠道外症状为首发表现的结肠癌临床特征,旨在提高结肠癌诊治水平.方法:收集我院1994年1月至2008年1月间以肠道外症状为首发表现的结肠癌47例,对其临床特点进行回顾性分析.结果:47例以肠道外症状为首发表现的结肠癌中位发病年龄为65岁;贫血症状多见,占78.7％(37/47),长期低热3例,肝转移瘤4例,肺转移瘤2例,皮肌炎1例;肿瘤多发生于右半结肠,占74.5％(35/47);病理类型:乳头状腺癌为主,占61.7％(29/47);Dukes分期:B期占44.7％(21/47),C期占42.6％(20/47);结肠镜是重要诊断方法,结肠镜与钡灌肠有互补优势;手术是主要治疗手段,综合治疗可延长患者生存期.结论:以肠道外症状为首发表现的结肠癌以贫血多见,病变多位于右半结肠,结肠镜是主要确诊方法,以手术为主的综合治疗可改善患者预后.     

复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的临床研究

目的:观察复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的疗效.方法:第一阶段将102例轻、中度溃疡性结肠炎患者随机分成A组(34例)、B组(34例)和C组(34例),分别服用美沙拉嗪片、复方嗜酸乳杆菌、美沙拉嗪+复方嗜酸乳杆菌治疗12周后观察3组临床疗效,缓解率及缓解时间.第二阶段将各组缓解者随访1年,观察3组维持时间及复发率.结果:3组临床疗效评价,临床缓解时间、缓解率比较无显著性差异见(P＞0.05),3组患者维持临床缓解时间、复发率比较差异无显著性意义(P＞0.05).所以由中国株嗜酸乳杆菌,日本株嗜酸乳杆菌、粪链球菌和枯草杆菌等四种菌粉组成的复方片剂是值得推荐的维持治疗缓解期UC的有效药物;两者联合用药并未增效,联合使用复方嗜酸乳杆菌片和美拉沙嗪作为溃疡性结肠炎的联合维持治疗是没有必要的.结论:复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的疗效与美拉沙嗪比较无差异,没有必要联合使用复方嗜酸乳杆菌片和美拉沙嗪作为溃疡性结肠炎的联合维持治疗.     

宝鸡地区80 例结肠癌患者发病危险因素研究

目的:探讨宝鸡地区结肠癌患者的发病的高风险因素,为减少宝鸡地区结肠癌的发病率和死亡率采取有效措施提供理论依据。方法:对我院收治的80例结肠癌患者的病史资料进行统计分析,通过收集同期入院的非癌结肠疾病患者作为对照资料,对危险因素进行详细对比,通过单因素分析和Logistics回归分析,得出高风险影响因素。结果:流行病学研究表明,结肠癌发病率随着年龄的增加显著上升,且在发病患者中,男性患者显著多于女性患者(P0.05)。而结肠癌的病灶分布部位表明,乙状结肠癌发病率最高;单一风险因素的研究表明,低膳食纤维饮食、糖尿病史、高血压史、结肠癌家族史、以及结肠炎史都显著影响结肠癌的发病率(P0.05);Logistics多因素分析表明低膳食纤维饮食、糖尿病史、高血压史和结肠癌家族史是结肠癌的主要危险因素(P.0.05)。结论:高血压、糖尿病、结肠癌家族病史以及低膳食纤维饮食是宝鸡地区结肠癌患病的主要风险因素。为控制宝鸡地区结肠癌的发病率,需要针对性的对结肠癌高危人群进行理论指导和及时的筛查与对应干预措施。     

溃疡性结肠炎患者外周血C 反应性蛋白、血清降钙素原及白细胞介素-6 水平及临床意义

目的:分析溃疡性结肠炎(Ulcerative colitis,UC)患者血清降钙素原(Procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)及白细胞介素-6(Interleukin-6,IL-6)水平与病情严重程度的关系。方法:选择2013年5月-2015年5月在我院就诊的溃疡性结肠炎患者91例作为研究对象,另选择同期在我院接受健康体检的志愿者69例作为对照组。检测并比较两组研究对象血清降钙素原(PCT)、C反应性蛋白(CRP)及白细胞介素-6(IL-6)的水平,并分析PCT,CRP及IL-6水平与溃疡性结肠炎的相关性。结果:溃疡性结肠炎患者PCT水平为(1.24±0.23)ng/m L,对照组PCT水平为(0.12±0.10)ng/m L,溃疡性结肠炎患者PCT水平显著高于对照组,差异具有统计学意义(P0.05);溃疡性结肠炎患者CRP水平为(105.27±19.93)mg/m L,对照组CRP水平为(7.62±2.97)mg/m L,溃疡性结肠炎患者血清CRP水平显著高于对照组,差异具有统计学意义(P0.05);溃疡性结肠炎患者IL-6水平为(248.15±35.60)ng/m L,对照组IL-6水平为(144.05±20.26)ng/m L,溃疡性结肠炎患者血清IL-6水平显著高于对照组,差异具有统计学意义(P0.05)。溃疡性结肠炎患者血清PCT,IL-6及CRP水平之间均呈正相关关系(r=0.301,0.468,0.413,P0.01)。结论:溃疡性结肠炎患者血清PCT,CRP及IL-6水平均显著高于健康人群,其水平变化与患者病情严重程度有关。因此,我们在临床实践中应予以重视。     

复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的临床研究

目的:观察复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的疗效。方法:第一阶段将102例轻、中度溃疡性结肠炎患者随机分成A组(34例)、B组(34例)和C组(34例),分别服用美沙拉嗪片、复方嗜酸乳杆菌、美沙拉嗪+复方嗜酸乳杆菌治疗12周后观察3组临床疗效,缓解率及缓解时间。第二阶段将各组缓解者随访1年,观察3组维持时间及复发率。结果:3组临床疗效评价,临床缓解时间、缓解率比较无显著性差异见(P>0.05),3组患者维持临床缓解时间、复发率比较差异无显著性意义(P>0.05)。所以由中国株嗜酸乳杆菌,日本株嗜酸乳杆菌、粪链球菌和枯草杆菌等四种菌粉组成的复方片剂是值得推荐的维持治疗缓解期UC的有效药物;两者联合用药并未增效,联合使用复方嗜酸乳杆菌片和美拉沙嗪作为溃疡性结肠炎的联合维持治疗是没有必要的。结论:复方嗜酸乳杆菌对轻中度溃疡性结肠炎诱导和维持缓解作用的疗效与美拉沙嗪比较无差异,没有必要联合使用复方嗜酸乳杆菌片和美拉沙嗪作为溃疡性结肠炎的联合维持治疗。     

肠道菌群及其代谢产物 与结肠腺瘤性息肉相关性的研究进展

结肠癌(colorectal cancer,CRC)是常见的消化道恶性肿瘤,其发病率和病死率都极高。从结肠息肉发展到结肠癌一般需要10～15年,且大多遵循息肉-腺瘤-癌症的发展过程,结肠腺瘤性息肉(colorectal adenomatous polyps,CAP)被认为是结肠癌的癌前病变。有研究显示肠道菌群的改变与肠道腺瘤性息肉样变及癌症的发生发展有密切的相关性。根据肠道菌群在不同病理状态下的富集程度,可以进一步分析其与结肠病变之间的关系。本文就肠道菌群的构成,CAP患者粪便和腺瘤组织中肠道菌群富集的改变,以及肠道菌群代谢产物对CAP患者的影响等内容进行综述,为结肠腺瘤性息肉的早期诊断和治疗提供依据。     

Inducible nitric oxide synthase activity in colon biopsies from inflammatory areas: correlation with inflammation intensity in patients with ulcerative colitis but not with Crohn's disease

Summary. Nitric oxide synthase (NOS) activities are responsible for the enzymatic conversion of L-arginine into NO and L-citrulline. Relatively low amounts of NO are produced in intestinal epithelial cells or are released from nerve endings. The effects of NO production are related to the maintenance of epithelial integrity and permeability. A pathological role of an increased NO production has been suggested to play a role in models of experimental colitis. In humans, NOS activity in colon mucosa from patients with ulcerative colitis is clearly increased when compared with the activity of the control group. In contrast, an increase of NOS activity in the colon mucosa from patients with Crohn's disease remains controversial. In the present work, we have measured NOS activity in colon biopsies originating from the control group (n = 16), from patients with ulcerative colitis (n = 23) and Crohn's disease (n = 17) using the radiochemical method of the conversion of L-[guanido-¹⁴C] arginine into radioactive L-citrulline. In the control group, NOS activity was mainly of the inducible type (88% of total NOS activity) since it was characterised by its insensibility to the absence of calcium in the assay medium. In colon biopsies originating from patients with ulcerative colitis, inducible NOS activity was increased 3 fold (p < 0.005) and in patients with Crohn's disease, inducible NOS activity was increased 5 fold (p < 0.005). Correlations between NOS activity in colon biopsies and the intensity parameters of the disease i.e. Truelove index, endoscopic score and histo-logical parameters were evidenced in patients with ulcerative colitis. In contrast, in patients with Crohn's disease, the high inducible NOS activity was not correlated with any intensity parameters of the disease. From these data, we concluded that although inducible NOS activity was increased several fold in colon biopsies originating from patients with both ulcerative colitis and Crohn's disease, a correlation between this activity and the severity of bowel inflammation was not found in either cases. Received August 7, 1999     

Serum antibodies to EpCAM in healthy donors but not ulcerative colitis patients

Purpose: The gastrointestinal carcinoma-associated antigen epithelial cell adhesion molecule (EpCAM) has been a target for passive and active immunotherapy of gastrointestinal carcinoma patients. The antigen is expressed by both tumor and normal tissues. The immunogenicity of EpCAM in colorectal cancer patients has been described previously. The purpose of this study was to evaluate humoral and cellular immune responses of healthy individuals and ulcerative colitis patients to EpCAM and to relate immune responses to colonic tissue expression of EpCAM. Methods: An inhibition radioimmunoassay was used to detect anti-EpCAM serum antibodies. Anti-EpCAM antibodies of a healthy donor were expressed by phages and sequenced. ³H-thymidine incorporation assay was used for detection of lymphoproliferative responses to stimulation with EpCAM. EpCAM tissue expression was determined by immunohistochemistry. Results: We detected anti-EpCAM serum antibodies in 4 of 10, and EpCAM-specific lymphoproliferation responses in 1 of 10 healthy volunteers. The majority of anti-EpCAM antibodies derived from a healthy donor were germline-encoded. In contrast, none of the 23 patients with ulcerative colitis showed serum antibodies to EpCAM (P=0.005). Antigen expression was greatly reduced and altered in ulcerative colitis patients, whereas colon from healthy individuals and uninvolved colon of colorectal cancer patients expressed high levels of EpCAM. Conclusion: The results of these studies suggest an association between EpCAM antibody production and colonic EpCAM expression in healthy individuals and patients with ulcerative colitis. Decreased and altered colonic EpCAM expression in ulcerative colitis patients may be related to the disease induction, based on the previously demonstrated adhesion function of this molecule. Healthy individuals with anti-EpCAM immune responses and high risk for developing colorectal carcinoma are prime candidates for prophylactic immunization against EpCAM.Emma E. Furth and Jian Li contributed equally     

Ubiquitin ligase A20 regulates p53 protein in human colon epithelial cells

Background

Intestinal polyps may further develop into colon cancer; the pathogenesis is not clear. The p53 gene is an important anti-cancer gene in the body, which is suppressed in cancer. The ubiquitin E3 ligase A20 (A20) plays a role in regulating the activities of epithelial cells. This study was designed to investigate the role of the colon polyp epithelium-derived A20 in the pathogenesis of colon cancer.

Results

Eighty-eight colon cancer patients and 136 colon polyp patients were recruited into this study. Human colon cancer tissue, the epithelium of adenomas polyp and hyperplastic polyp showed high levels of A20, which had a positive correlation with the cancerous tendency of colon polyps. The levels of A20 were much higher in the adenomas and hyperplastic polyps than that in the inflammatory polyps; the latter showed less cancerous tendency. A20 bound p53 to form complexes in colon cancer tissue and colon polyps. Over expression of A20 suppresses P53 protein levels in the HEK293 cells.

Conclusions

A20 may play an important role in the cancerous tendency of colon polyposis.     

IL-23 in inflammatory bowel diseases and colon cancer

Studies in recent years have identified a pivotal role of the cytokine IL-23 in the pathogenesis of inflammatory bowel diseases (IBD: Crohn´s disease, ulcerative colitis) and colitis-associated colon cancer. Genetic studies revealed that subgroups of IBD patients have single nucleotide polymorphisms in the IL-23R gene suggesting that IL-23R signaling affects disease susceptibility. Furthermore, increased production of IL-23 by macrophages, dendritic cells or granulocytes has been observed in various mouse models of colitis, colitis-associated cancer and IBD patients. Moreover, in several murine models of colitis, suppression of IL-12/IL-23 p40, IL-23 p19 or IL-23R function led to marked suppression of gut inflammation. This finding was associated with reduced activation of IL-23 target cells such as T helper 17 cells, innate lymphoid cells type 3, granulocytes and natural killer cells as well as with impaired production of proinflammatory cytokines. Based on these findings, targeting of IL-23 emerges as important concept for suppression of gut inflammation and inflammation-associated cancer growth. Consistently, neutralizing antibodies against IL-12/IL-23 p40 and IL-23 p19 have been successfully used in clinical trials for therapy of Crohn´s disease and pilot studies in ulcerative colitis are ongoing. These findings underline the crucial regulatory role of IL-23 in chronic intestinal inflammation and colitis-associated cancer and indicate that therapeutic strategies aiming at IL-23 blockade may be of key relevance for future therapy of IBD patients.     

Leiden mutation (as genetic) and environmental (retinoids) sequences in the acute and chronic inflammatory and premalignant colon disease in human gastrointestinal tract.

BACKGROUND: Tumor, calor, dolor, pallor and functio laesa are together involved in the different acute and chronic inflammatory processes. The processes involved in the inflammation are determined by differently acquired and hereditary factors. Recently the presence of a new genetic marker (Leiden point mutation) was found in Crohn's disease and ulcerative colitis. On the other hand, the GI mucosal integrity was proven on gastrointestinal mucosal damage to be produced by different chemicals, xenobiotics, drugs. In human observations, the serum level of retinoids (vitamin A, lutein, zeaxanthin, alpha-, beta-carotene) was proven in patients with chronic gastrointestinal inflammatory bowel disease. The aims of this study were (1) to measure the prevalence of Leiden mutation; (2) to identify the changes in the serum retinoid level in patients with Helicobacter pylori infection of the stomach (n=24), hepatitis C infection (n=75), ileitis terminalis (Crohn's disease; n=49), ulcerative colitis (n=35), colon polyposis (n=59) and adenocarcinoma in colon polyps (n=9), and 57 healthy persons were used in the control group; (3) to compare the directions of the changes in the measured parameters in the acute (H. pylori and hepatitis C infections), chronic (ileitis terminalis, ulcerative colitis) GI inflammatory diseases and in colon polyposis without and with malignisation. METHODS: The Leiden mutation was measured by the method of polymerase chain reaction, the retinoid level in the patient's serum was measured by high liquid cromathografic method (HPCL). RESULTS: (1) It has been found that the prevalence of Leiden mutation increased significantly in patients with ileitis terminalis (P<0.001), ulcerative colitis (P<0.001), colon polyposis (P<0.001) and with colon polyps with malignisation (P<0.01). (2) Serum level of vitamin A and zeaxantin were decreased significantly in all group of patients except for the group with H. pylori infections. (3) alpha- and beta-carotenes were found to be practically at the same level as those in the control groups, except in patients of colon polyps with malignisation. (4) The vitamin A, lutein, zeaxantin, alpha- and beta-carotenes were decreased in patients with ileitis terminalis. CONCLUSIONS: (1) The essential role of retinoids (carotenoids) as environmental factors are suggested for keeping GI mucosal integrity in human healthy subjects and patients. (2) Leiden mutation, as a genetic marker, can be used in the screening of patients with ileitis terminalis, ulcerative colitis and colon polyposis (without and with malignisation). (3) An opposite direction can be found between the increased prevalence of Leiden mutation and decrease of serum levels of retinoids in group of patients with ileitis terminalis, ulcerative colitis and colon polyposis (without and with malignisation).     

Analysis of O6-methylguanine-DNA methyltransferase methylation status in sporadic colon polyps

Background/aimThe aim of our study was to check how MGMT methylation status together with known factors influenced the risk of colon cancer development.Materials and methodsWe examined patients with colon polyps. Information concerning gender, age, lifestyle, diet, anthropometry and medical information, including cancer and family history of cancer, was analyzed. Polymorphism variety of MGMT gene was investigated in another study. Genetic analysis for MGMT methylation assessment was performed for polyp tissue samples from 143 patients.ResultsPositive methylation MGMT status was found in 55 patients. There was no correlation between gender and MGMT methylation status (p = 0.43). We did not find correlation between patients younger and older than 60 (p = 0.87). There was no correlation between smoking and MGMT methylation status (p = 0.36). We did not find correlation between BMI and MGMT methylation status (p = 0.86). We did not find correlation between MGMT methylation status and colon cancer in familial history (p = 0.45).ConclusionOur study showed no correlations between methylation status of MGMT polymorphisms and clinical features like age, gender, polyp localization, smoking status, or obesity. It has been shown previously that MGMT methylation status may show nonspecific methylation in colon polyps. Gene methylation status in adenoma tissues has also been associated by other authors with the adenoma's size, histology, and degree of atypia. In our study, we evaluated the gene methylation status in colon polyps and found no association with adenoma characteristics. The present study showed no correlation for MGMT methylation in polyps in different regions of colon.     

miR27a对结肠癌细胞增殖和侵袭能力的影响

目的:检测mi R196a、mi R146a、mi R27a和mi R200a在结肠癌患者中的表达情况,研究差异mi RNA对结肠癌细胞功能的影响。方法:用PCR检测mi R196a、mi R146a、mi R27a和mi R200a在结肠癌患者癌组织中的表达情况;用转染技术高表达和低表达mi R27a后,检测结肠癌细胞的增殖能力和侵袭能力。结果:结肠癌组mi R27a的表达水平与正常组和大肠炎组相比显著增加(P0.05);mi R27a mimics转染组结肠癌细胞的增殖速度和侵袭能力显著增高(P0.05),且mi R27a inhibitors转染组结肠癌细胞的增殖速度和侵袭能力明显降低,差异具有统计学意义(P0.05)。结论:结肠癌患者mi R27a的表达水平显著增高,且mi R27a能增强结肠癌细胞的增殖能力和侵袭能力。     

Fascin在结肠癌中表达的临床病理学研究

目的:Fascin是一种肌动蛋白结合蛋白,在多种上皮性肿瘤中高表达并与肿瘤侵袭有关。在本研究中观察fascin在结肠癌中表达及探讨其临床病理意义,为其在结肠癌早期诊断和预后预测方面的应用提供依据。方法:应用免疫组织化学技术检测Fascin在结肠肿瘤中的表达,并分析其表达的结肠癌临床病理意义。结果:Fascin在癌旁肠粘膜、腺瘤、腺癌中表达有显著性差异,其中癌旁肠粘膜组和腺瘤组阳性表达率无显著性差异(X2=0.344,P0.05),腺癌组阳性表达率显著高于癌旁粘膜组(X2=8.492,P0.0,1),腺癌组阳性表达率显著高于腺瘤组(X2=7.450,P0.01)。Fascin表达与结肠癌患者的年龄、性别、肿瘤浸润肠壁深度、淋巴结转移、分化程度无显著相关性,而在中-晚期病例(III/IV期)中的表达率显著高于早期病例(P0.05)。Fascin表达阳性病例的生存期显著高于Fascin表达阴性病例(P0.022)。结论:Fascin表达与结肠癌发生和预后密切相关,可能作为结肠癌早期诊断和预后的标志物。