口腔白斑组织癌变标志性基因筛查

口腔黏膜白斑病（oral leukoplakia,OLK）是最常见的口腔粘膜的癌前病变．OLK恶性转化率高达43%,因此加强其风险调查和监测对于该病的预防和治疗具有重要意义．本研究采用美国SuperArray公司的肿瘤基因芯片（OHS-802）检测口腔正常组织、OLK组织和口腔鳞状细胞癌（oral squamous cell carcinoma, OSCC)组织的肿瘤相关基因表达差异,旨在筛查与口腔黏膜白斑病发生和癌变相关的表达阳性基因,为探究OLK的发生及癌变机制奠定基础．将“正常组织→OLK组织→OSCC组织”连续递增2倍以上或递减2倍以上的基因确定为OLK组织癌变的标志性基因．SuperArray基因芯片、RT-PCR法和实时定量PCR结果显示,仅有3个基因（ACP-2、BCL-2、SOCS-3）表达水平连续下调2倍以上,有6个基因（CLK-3、CTNNB-1、FKBP-8、GDF-15、NF-1、XRCC-1）表达连续上调2倍以上．进一步经RT-PCR和实时定量PCR验证,其结果与SuperArray结果一致．本研究结果提示,ACP-2等9个基因可能是口腔正常黏膜组织经OLK转变为癌组织的驱动基因,可作为OLK组织、OSCC组织和口腔正常黏膜组织诊断的分子标志．     

食管鳞癌与腺癌差异基因表达的对比分析

目的：研究食管鳞癌（esophageal squamous cell carcinoma,ESCC）与食管腺癌（esophageal adenocarcinoma,EAC）的基因差异表达,探讨ESCC与EAC发生发展的基因学基础。方法：选取8例ESCC和8例EAC组织抽提mRNA,应用cDNA芯片技术通过芯片杂交、生物信息学处理,找出两者间差异表达基因。结果：采用BioStarH-40芯片发现差异表达基因541条,差异表达基因占13．8％,其中表达增强309条（显著增强73条）,表达降低232条（显著降低61条）。结论：ESCC与EAC基因表达比较,差异有统计学意义,这些差异可能在两类肿瘤不同的生物学行为中起重要作用。     

LC3和beclinl在口腔黏膜癌变过程中不同时期的变化及其意义

目的检测微管相关蛋白1轻链3(microtubule-assaiated protein 1 light chain 3,LC3)和自噬基因beclin1在口腔黏膜癌变过程不同时期的特点及表达趋势,探讨其在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)发生进展中的意义。方法采用免疫组织化学方法对19例口腔正常黏膜、9例单纯增生颊黏膜、14例异常增生颊黏膜、15例原位癌阶段颊黏膜及38例OSCC标本进行LC3及beclin1检测。结果 OSCC组LC3和beclin1阳性率显著低于正常口腔黏膜组、单纯增生组、异常增生组及原位癌组;原位癌组LC3和beclin1阳性率较上皮异常增生组虽有升高但无明显差异;LC3和beclin1在OSCC中的表达无相关性。结论 LC3和beclin1在口腔黏膜癌变的过程中表达下调,在原位癌阶段自噬活性有所增加,癌变完成后自噬能力显著降低;自噬活性的改变可能与口腔鳞癌的发生、发展相关。     

角质形成细胞生长因子(KGF)在喉粘膜良性、癌前及恶性病变中的mRNA水平分析

利用原位杂交的方法检测KGFmRNA在正常喉粘膜上皮（N）、慢性非特异性炎症（IF）、不典型增生（DYS）及鳞癌（SCC）中的转录水平,探讨KGF在喉粘膜良性及恶性病变中的分布和可能的作用。结果表明,KGFmRNA不仅在间质中的成纤维细胞中表达,少量的炎细胞及血管内皮细胞中亦表达,而且从N、IF、DYS到SCC、KGFmRNA转录水平逐渐增强;上皮细胞及肿瘤性上皮细胞不表达KGFmRNA,KGFmRNA在分化差的SCC周围间质中表达较分化好的SCC周围间质增多。结论：KGF在上皮与间充质细胞的交互作用中发挥着重要的作用,对维持喉粘膜正常结构、代谢及喉癌的发生发展具有重要意义。     

食管鳞癌与腺癌差异基因表达的对比分析

目的:研究食管鳞癌(esophageal squamous cell carcinoma,ESCC)与食管腺癌(esophageal adenocarcinoma,EAC)的基因差异表达,探讨ESCC与EAC发生发展的基因学基础。方法:选取8例ESCC和8例EAC组织抽提mRNA,应用cDNA芯片技术通过芯片杂交、生物信息学处理,找出两者间差异表达基因。结果:采用BioStarH-40芯片发现差异表达基因541条,差异表达基因占13.8%,其中表达增强309条(显著增强73条),表达降低232条(显著降低61条)。结论:ESCC与EAC基因表达比较,差异有统计学意义,这些差异可能在两类肿瘤不同的生物学行为中起重要作用。     

NOB1在食管鳞状细胞癌中的表达及临床意义

目的研究NOB1基因在食管鳞状细胞癌（Esophageal squamous cell carcinoma,ESCC）中的表达及临床意义。方法利用免疫组织化学SP法检测59例ESCC及其相应（50例）的远端正常食管黏膜组织中NOB1的表达。结果 ESCC中NOB1的阳性率为71%,正常食管黏膜鳞状上皮中的阳性率为26%,两组比较,差异有统计学意义（P〈0.05）。NOB1的表达与ESCC的分化程度及淋巴结转移相关,与患者的性别,年龄以及肿瘤浸润深度无关。结论 NOB1在ESCC中表达升高,可能在ESCC发生发展过程中起重要作用。     

食管癌Egr-1基因表达及其与细胞凋亡的关系

目的：研究早期生长反应基因-1（Egr-1基因）和Bcl-X1蛋白在人食管癌变过程中的表达及与细胞凋亡的关系。方法：应用原位杂交、免疫组织化学和TUNEL法检测66例食管鳞状细胞癌及癌旁粘膜、上切缘粘膜中Egr-1mRNA和蛋白、凋亡相关蛋白Bcl-X1和原位细胞凋亡。结果：食管上皮和食管癌细胞Egr-1基因原位杂交、Bcl-X1.蛋白免疫组化阳性物定位于细胞浆,Egr-1蛋白免疫组化阳性产物、TUNEL法阳性信号定位于细胞核。在食管癌变过程中,细胞凋亡发生率和凋亡指数逐渐升高;Egr-1mRNA及蛋白在食管粘膜上皮非典型增生中呈高表达。在癌组织,Egr-1阳性表达时凋亡指数显著高于其阴性表达;而Bcl-X1.阳性表达时凋亡指数显著低于其阴性表达。结论：细胞凋亡发生在食管癌变的全过程。Egr-1mRNA和蛋白在食管癌前病变呈高表达;Egr-1阳性鳞癌的凋亡指数显著升高;Egr-1有促进凋亡的作用。Egr-1的表达和细胞凋亡在食管癌变过程中可能有重要生物学意义。     

人癌细胞线粒体DNA控制区序列特征分析

为了探讨癌细胞mtDNA控制区序列的变化特征, 采用PCR产物限制性片段长度多态性(PCR-RFLP)分析与直接测序相结合的方法,对比分析6株人癌细胞系、 6例癌患者及4例健康成人白细胞mtDNA控制区序列。发现第16519位T→C、16 534位A→G、46位T→G和49位A→C突变, 在癌细胞系和癌患者白细胞mtDNA中分别占50%(3/6)和33.3%(2/6), 健康成人白细胞mtDNA中未见此类型突变;第16 278位C→T突变,在癌细胞系mtDNA中占50%(3/6),显著高于正常人群mtDNA中此位点的多态性变异。表明癌细胞和癌患者白细胞mtDNA重链复制起点及其 相邻D环区的特征性突变可能与细胞癌变/或癌的易感性有关。 Abstract：　To explore the sequence feature of mitochondrial DNA(mtDNA) control region in human carcinoma cells, polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and direct sequence techniques were used to analyze the sequence of mtDNA control region of 6 human carcinoma cell lines versus white blood cells which from 6 tumor patients and 4 normal adults. The T to C mutation at np 16 519, A to G mutation at np 16 534, T to G mutation at np 46, and A to C mutation at np 49 was found in 50% (3/6 cases) of carcinoma cell lines and in 33.3%(2/6 cases) of tumor patients, but it was not found in normal adults. The C to T mutation at np 16 278 was found in 50%(3/6 cases) of carcinoma cell lines, it was significantly higher than that of the polymorphism of normal population. These findings suggest that the typical mutation in the starting area of heavy-strand replication and the first half of D-loop region might probably be associated with carcinogenesis or susceptibility of carcinoma.     

人癌细胞线粒体DNA控制区序列特征分析

为了探讨癌细胞mtDNA控制区序列的变化特征, 采用PCR产物限制性片段长度多态性(PCR-RFLP)分析与直接测序相结合的方法,对比分析6株人癌细胞系、 6例癌患者及4例健康成人白细胞mtDNA控制区序列。发现第16519位T→C、16 534位A→G、46位T→G和49位A→C突变, 在癌细胞系和癌患者白细胞mtDNA中分别占50%(3/6)和33.3%(2/6), 健康成人白细胞mtDNA中未见此类型突变;第16 278位C→T突变,在癌细胞系mtDNA中占50%(3/6),显著高于正常人群mtDNA中此位点的多态性变异。表明癌细胞和癌患者白细胞mtDNA重链复制起点及其 相邻D环区的特征性突变可能与细胞癌变/或癌的易感性有关。 Abstract：　To explore the sequence feature of mitochondrial DNA(mtDNA) control region in human carcinoma cells, polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and direct sequence techniques were used to analyze the sequence of mtDNA control region of 6 human carcinoma cell lines versus white blood cells which from 6 tumor patients and 4 normal adults. The T to C mutation at np 16 519, A to G mutation at np 16 534, T to G mutation at np 46, and A to C mutation at np 49 was found in 50% (3/6 cases) of carcinoma cell lines and in 33.3%(2/6 cases) of tumor patients, but it was not found in normal adults. The C to T mutation at np 16 278 was found in 50%(3/6 cases) of carcinoma cell lines, it was significantly higher than that of the polymorphism of normal population. These findings suggest that the typical mutation in the starting area of heavy-strand replication and the first half of D-loop region might probably be associated with carcinogenesis or susceptibility of carcinoma.     

鼻咽癌组织中蛋白酶ICH的表达及其与bcl-2的表达关系

探讨蛋白酶ＩＣＨ１ 与凋亡基因ｂｃｌ２ 的关系及在鼻咽癌发生中的作用。应用免疫组化方法对４６例鼻咽癌组织中ＩＣＨ１ （ＩＣＨ１Ｌ和ＩＣＨ１Ｓ） 和ｂｃｌ２ 的表达进行观察。结果发现１１ 例良性病变中２ 例ＩＣＨ１Ｌ阳性, １ 例ＩＣＨ１Ｓ阳性。４６ 例鼻咽癌中１６ 例ＩＣＨ１Ｌ阳性, ２２ 例ＩＣＨ１Ｓ阳性, 阳性率分别为３４８％ 和４７８％ , 各组织学分型间无明显差异（Ｐ＞ ００５）。癌细胞ＩＣＨ１ 表达较良性病变增加, 但ＩＣＨ１Ｌ与良性病变比较无显著性差异 （Ｐ＞ ００５）。良性鼻咽上皮ｂｃｌ２ 阴性。４６ 例鼻咽癌中３８ 例ｂｃｌ２ 阳性, 阳性率为８２６％ , ｂｃｌ２ 表达与组织分型也无明显关系 （Ｐ＞ ００５）。ＩＣＨ１Ｌ与ｂｃｌ２ 呈反向表达关系。提示ＩＣＨ１ 和ｂｃｌ２ 表达异常可能与鼻咽上皮的癌变有关。ｂｃｌ２ 对ＩＣＨ１Ｌ表达可能有影响。     

细胞周期调控因子的表达与肺癌预后关系的研究

应用细胞周期调控因子P^27kipl,Rb单克隆抗体和CDK4多克隆抗体,对54例肺鳞状细胞癌的纤支镜活镜标本和10例正常肺组织进行免疫组织化学染色研究。结果发现：54例肺鳞癌中,P^27kipl阳性表达率为928/54）51.9%。表达水平与患预后呈正相关。P^27kipl表达是影响肺癌患预后的主要因素。CDK4阳性表达率（26/54）为48.1%,Rb阳性表达率（33/54）为61.1%。表达水平与患预后呈正相关。结果表明：P^27kipl低表达可作为判断肺鳞癌患预后差的一个独立的有效标记指标,CDK4表达对鉴别良恶性病变有一定意义,Rb表达可作为判断肺鳞癌预后的有意义指标。     

用原位末端标记方法观察细胞凋亡在正常喉粘膜、炎症、癌前和癌变中的作用

为了观察凋亡与喉粘膜癌变的关系,本实验应用原位末端标记（ＩＳＥＬ）方法检测喉粘膜正常（ｎｏｒｍａｌｌａｒｙｎｇｅａｌｍｕｃｏｓａ,Ｎ）、炎症（ｉｎｆｌａｍｍａｔｉｏｎ,ＩＦ）、不典型增生（ｄｙｓｐｌａｓｉａ,ＤＹＳ）及鳞癌（ｓｑｕａｍｏｕｓｃｅｌｃａｒｃｉｎｏｍａ,ＳＣＣ）中细胞凋亡情况。标记后的凋亡细胞通过计数以凋亡指数（ＡＩ）表示。结果表明：ＤＹＳ组的凋亡指数（ＡＩ）在所有病变中最高;ＤＹＳ及ＳＣＣ组的ＡＩ值较正常Ｎ及ＩＦ组明显增多,且有显著性差异（Ｐ＜００５）;对ＳＣＣ的计数显示,ＡＩ值随着ＳＣＣ的分化程度下降有逐渐减少的趋势。ＳＣＣ转移组与非转移组的ＡＩ值间无显著性差异（Ｐ＞００５）。结论：细胞凋亡在喉粘膜癌前病变和癌变中发挥着重要作用,与喉癌的发生发展密切相关     

No mutations found in exon 2 of gene p16CDKN2A during rat tongue carcinogenesis induced by 4-nitroquinoline-1-oxide

The medium-term tongue carcinogenesis assay is a useful model for studying oral squamous cell carcinomas phase by phase. The present study aimed to investigate mutations in exon 2 of gene p16CDKN2A during rat tongue carcinogenesis induced by 4-nitroquinoline 1-oxide (4NQO) using direct DNA-sequencing method. A total of 30 male Wistar rats were treated with 4-nitroquinoline 1-oxide (4NQO) in drinking water for 4, 12, and 20 weeks at 50 ppm dose. Ten animals were used as negative control. No histopathological changes in tongue epithelia were observed among controls or in the group treated for 4 weeks with 4NQO. Following 12-week treatment, hyperplasia and epithelial dysplasia were found in mild and moderate forms. At 20 weeks, the tongue presented moderate and/or severe oral dysplasia and squamous cell carcinoma, with squamous cell carcinoma in the majority of animals. No mutations were found in any experimental period evaluated that corresponded to normal oral mucosa, hyperplasia, dysplasia and squamous cell carcinomas. Taken together, our results suggest that p16CDKN2A mutations in exon 2 are not involved in the multistep tongue carcinogenesis of Wistar rats induced by 4NQO.     

NUMB在口腔白斑和鳞癌中的表达变化及意义

目的:研究NUMB在口腔白斑和鳞癌中的表达及意义。方法:采用免疫组织化学法检测88例口腔正常黏膜、口腔白斑及口腔鳞癌石蜡包埋组织中NUMB蛋白的表达。结果:NUMB在口腔正常黏膜(95.7%)、口腔白斑(75%)及口腔鳞癌(4.7%)中均有阳性表达但是表达频率依次降低。NUMB在各个组中的阳性表达率具有统计学差异(P0.05)。结论NUMB阳性表达率随口腔组织恶性程度增高而减少的趋势提示该基因可能在口腔正常黏膜到口腔白斑再到口腔鳞癌的转化中起作用,NUMB有可能成为早期发现癌变的分子生物学标志之一。     

ATM mRNA在食管癌组织中的表达及其临床意义

目的探讨共济失调性毛细血管扩张症突变基因(Ataxia-telangiectasia mutated,ATM)mRNA在食管鳞状细胞癌组织中的表达及其临床意义。方法应用原位分子杂交方法检测52例食管正常黏膜、45例食管上皮内瘤变组织及63例食管癌组织ATM mRNA的表达。结果食管正常黏膜、食管上皮内瘤变及食管癌组织中ATM mRNA表达率分别为26.9%(14/52)、44.4%(20/45)及63.5%(40/63),食管癌组织中ATM mRNA表达率明显高于正常黏膜及上皮内瘤变(P≤0.05),ATM mRNA表达率与食管癌组织分级呈负相关(r=-0.312,P=0.013);食管正常黏膜和食管上皮内瘤变ATM mRNA表达率无明显差异(P=0.07),食管癌组织中ATM mRNA表达与患者年龄、性别、肿瘤浸润深度、淋巴结转移、临床分期及其它临床病理因素无关(P0.05)。结果 ATM mRNA在食管癌组织中异常表达,有望成为食管癌治疗的新靶点。     

Apoptosis and mitosis in oral and oropharyngeal epithelia: evidence for a topographical switch in premalignant lesions

Abstract. Apoptosis (programmed cell death) may play a part in carcinogenesis. The mucosa of the oral cavity, a common site for the development of dysplasia and squamous cell carcinoma, is ideal for the study of carcinogenesis in vivo. Earlier work suggested that apoptosis falls with the development of carcinoma, and that carcinogenesis is preceded by topographical changes in apoptosis. To explore these hypotheses, 72 paraffin sections were obtained: 15 normal (N), nine mild dysplasia (D), 15 severe dysplasia/carcinoma in situ (CIS), 30 squamous cell carcinoma (SCC: power analysis suggested 15 per group). Apoptotic (AI) and mitotic (MI) indices and AI/MI ratio were calculated (1000 cells/slide). These, with age, sex, alcohol and smoking habits, and anatomical subsite, were entered into a regression model with histological group as dependent. Vertical cell position (cp) was plotted, and resultant frequency curves were compared. MI significantly increased (mean N 0.39, 95% confidence interval 0–0.35; D 0.63, 0.23–0.98; SCC 0.86, 0.51–1.21, P <0.0001) and AI/MI significantly decreased (D 0.54, 0.20–0.86; SCC 0.28, 0.05–0.61, P <0.05) progressing from D, through CIS, to SCC. However, after inclusion of all variables, only MI remained significant ( P <0.0001). Peak incidence of mitosis shifted downwards in CIS relative to N and D, whilst peak apoptosis shifted upwards. Thus, programmed cell death remains static as mitosis increases in carcinogenesis of the oral cavity. However, there is an alteration in the topographical relationship of these events in CIS which may make homeostatic mechanisms involving apoptosis less efficient.     

LaminB1蛋白在食管鳞癌组织中表达的形态学观察

目的探讨laminB1蛋白在食管鳞癌患者的癌组织及上切缘正常粘膜上皮中表达的形态变化。方法制备组织切片原位核基质,应用免疫组化的方法检测核基质制备前后正常粘膜上皮及癌组织中laminB1的表达;同时提取组织核基质蛋白,应用Westen blot检测核基质蛋白中laminB1的表达。结果正常食管粘膜上皮及食管鳞癌组织核基质制备前后laiminB1表达的阳性率分别为:正常粘膜上皮93.3%、正常粘膜上皮核基质86.7%、癌组织96.7%、癌核基质86.7%。正常粘膜上皮laminB1表达阳性细胞从基底层至颗粒层逐渐减少,制备核基质后正常粘膜上皮核基质laminB1表达阳性细胞数目减少、强度明显减弱,阳性细胞集中于基底层,多数细胞整个胞核着色。癌组织laminB1表达阳性细胞散在分布,无规律;癌核基质laminB1表达阳性强度减弱,阳性颗粒在核周较集中。癌核基质laminB1表达的阳性强度比正常粘膜上皮核基质高,差异有显著性(x2=5.042,P<0.05)。Western blot检测显示正常粘膜核基质的laminB1条带比癌核基质弱。结论laminB1蛋白在食管正常粘膜上皮及食管鳞癌组织中广泛存在。制备核基质后,laminB1蛋白在癌核基质的表达比正常粘膜上皮核基质强;且癌核基质中laminB1的分布与正常粘膜上皮核基质存在差异。     

H－ras在颊粘膜正常、良性、癌前及恶性变上皮中的表达：免疫组织化学定量研究

本文通过建立图象分析方法对免疫组织化学反应结果进行定量,检测观察Ｈ－ｒａｓ在口腔颊粘膜上皮在正常（Ｎ）、慢性炎症（ＩＦ）、癌旁上皮（ＥＡＣ）和鳞癌（ＳＣＣ）的变化过程中的表达并进行分析。结果显示Ｈ－ｒａｓ在ＳＣＣ组中,以中等分化的ＳＣＣ无论是Ｈ－ｒａｓ表达的量还是细胞阳性率都较高。此外,组织学观察显示,Ｈ－ｒａｓ在处于分化末期但尚未角化的正常上皮细胞中有较高的表达。本文结果显示了Ｈ－ｒａｓ的过表达与上皮细胞的会化程度密切相关。本研究还显示,所采用的阳性区域透光值、平均总透光值及阳性反应区域与阴性反应区域比值可靠并有相关性。这进一步说明了用免疫组化定量方法检测Ｈ－ｒａｓ癌基因表达的精确和可靠性。     

Altered expression of integrins and basement membrane proteins in malignant and pre-malignant lesions of oral mucosa

Integrins are transmembrane receptors that regulate cell-cell and cell-extracellular matrix (ECM) contact. In epithelial tissues, they interact with ECM components of the basement membrane (BM) to maintain the homeostasis and the architecture of the tissue. This interaction controls several cell functions such as adhesion, migration, proliferation, differentiation, and therefore has a key role in cancer development and metastasis. We studied the expression of integrins and ECM components of the BM by immunohistochemistry in frozen specimens of malignant squamous cell carcinoma (SCC), pre-malignant lesions of the oral mucosa (leucoplakia) and oral lichen planus. In invasive SCC, we observed altered polarity and distribution of alpha2beta1, alpha6beta4 and alpha3beta1 integrins, whereas in the in situ carcinoma alpha6beta4 and alpha3beta1 patterns only were altered. Immunostaining for ECM components such as Laminin-1 (Ln-1), Ln-5, and Collagen IV (Coll IV) was discontinuous and interrupted in invasive SCC, whereas it was normal in the in situ carcinoma. In both pre-malignant lesions and lichen planus specimens, integrins were expressed in a polarized manner in the presence of a normal BM, whereas were abnormally distributed in those tissues with altered staining patterns of the ECM components. In conclusion, we suggest that abnormal re-distribution of alpha3beta1 and alpha6beta4 integrins and expression of ECM components such as Ln-5 could play an important role in SCC invasion and metastasis.