幽门螺杆菌感染性胃癌组织中cyclinD1、MMP-9的表达及其临床意义

目的:探讨幽门螺杆菌(HP)感染性胃癌组织中细胞周期蛋白D1(cyclinD1)、基质金属蛋白酶-9(MMP-9)的表达及其临床意义。方法:选取2016年12月到2018年6月期间在兰州大学第一医院接受治疗的胃癌患者80例,收集其手术切除的病理组织。采用C-14呼气试验和改良Giemsa染色检测患者HP感染的情况,采用免疫组化法检测胃癌组织中cyclinD1、MMP-9表达情况。分析HP感染、cyclinD1、MMP-9表达与胃癌患者临床病理特征的关系,并分析胃癌患者HP感染与cyclinD1、MMP-9表达的相关性。结果:80例胃癌患者HP感染阳性56例(70.00%),阴性24例(30.00%)。有淋巴结转移、浸润深度为T3+T4的胃癌患者的HP感染阳性率高于无淋巴结转移、浸润深度为T1+T2的胃癌患者(P0.05)。80例胃癌患者cyclinD1阳性表达45例(56.25%),阴性表达35例(43.75%),MMP-9阳性表达65例(81.25%),阴性表达15例(18.75%),TNM临床分期为III+IV期、分化程度为低分化、有淋巴结转移、浸润深度为T3+T4的胃癌患者的cyclinD1、MMP-9阳性表达率明显高于TNM临床分期为I+II期、分化程度为中高分化、无淋巴结转移、浸润深度为T1+T2的胃癌患者(P0.05)。HP感染阳性患者的cyclinD1阳性表达率和MMP-9阳性表达率均明显高于HP感染阴性患者(P0.05)。Pearson相关分析显示,胃癌患者HP感染与cyclinD1、MMP-9表达均呈正相关(P0.05)。结论:胃癌患者的HP感染情况与淋巴结转移、浸润深度有关,cyclinD1和MMP-9的表达与TNM临床分期、分化程度、淋巴结转移、浸润深度有关,且胃癌患者HP感染与cyclinD1、MMP-9表达均呈正相关。     

胃癌组织中Bag-1蛋白表达特点及与临床病理学特征、预后的关系

目的:探讨Bc1-2相联系的抗凋亡基因1(Bag-1)蛋白在胃癌组织中的表达及与患者临床病理学特征、预后的关系。方法:选取病理科收集的79例胃癌组织及30例癌旁组织,标本收集时间2010年2月至2013年12月,采用免疫组化SP染色检测两组标本中的Bag-1蛋白表达水平,并分析Bag-1蛋白表达与胃癌患者临床病理学、预后的关系。结果:胃癌组织中的Bag-1蛋白阳性表达率65.82%显著的高于癌旁组织的13.33%(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05);Bag-1蛋白阳性和阴性表达的患者1年以及2年生存率相差不大,差异无统计学意义(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05)。结论:胃癌组织中的Bag-1蛋白高表达,并且与患者的胃癌临床分期和淋巴结转移以及预后有关。     

BRMS1与乳腺癌腋窝淋巴结微转移的临床研究

目的:探讨BRMS1的表达与乳腺癌腋窝淋巴结微转移的关系.方法:采用连续切片和CK-19联合检测86例腋窝淋巴结转移阴性的所有淋巴结微转移灶的情况,术后随访其复发情况,免疫组化检测乳腺癌组织中BRMS1的表达并分析其与淋巴结微转移及术后复发率的关系.结果:86例乳腺癌腋窝淋巴结转移阴性的689淋巴结中有48粒(6.97％)检测到微转移,其中阳性病例22例(25.58％),BRMS1的表达阴性的乳腺癌患者腋窝淋巴结微转移病例率(43.24％)和术后复发率(54.05％)远高于BRMS1表达阳性的乳腺癌患者(12.24％,8.16％),差异具有显著性,且呈明显的负相关.结论:BRMS1与腋窝淋巴结微转移密切相关,可以成为乳腺癌腋窝淋巴结微转移分子指标,并对乳腺癌的分期、预后、治疗具有重要的指导意义.     

Rspo1、LGR5、NF-κB/p65在胃癌中的表达及其临床意义

目的 通过检测特异性顶部盘状底板反应蛋白1(Rspo1)、富含亮氨酸的重复G蛋白偶联受体5(LGR5)与核转录因子κB/p65(NF-κB/p65)在人胃癌中的表达水平及与临床病理因素及预后之间的关系,并分析三者在胃癌发生发展中发挥的作用。方法 免疫组织化学SP法测定Rspo1、LGR5及NF-κB/p65在115例胃癌组织标本及20例正常组织标本中的表达。结果 Rspo1、LGR5、NF-κB/p65在胃癌中表达较正常组织增高;Rspo1、LGR5、NF-κB/p65的表达与浸润深度、TNM分期、淋巴结及远处转移有关,同时Rspo1表达与肿瘤大小、LGR5表达与肿瘤大小及分化程度有关;胃癌组织中Rspo1与LGR5、NF-κB/p65的表达呈正相关;Kaplan-Meier分析显示Rspo1、LGR5和NF-κB/p65表达阳性组3年生存率均低于阴性组;单因素Cox分析提示肿瘤大小、分化程度、浸润深度、淋巴结转移、远处转移、Rspo1、LGR5、NF-κB/p65阳性是影响胃癌患者预后的危险因素;多因素Cox分析提示淋巴结转移、远处转移、Rspo1及LGR5阳性是影响胃癌患者预后的独立危险因素。结论 Rspo1、LGR5、NF-κB/p65的表达与胃癌的发生发展有关;Rspo1-LGR5在激活Wnt/β-catenin通路的同时可能激活NF-κB通路,二者对胃癌发展有协同作用。     

Beclin1与p53在唾液腺多形性腺瘤和癌在唾液腺多形性腺瘤中的表达及与临床病理因素的关系研究

目的:探讨自噬体相关基因Beclin1与p53基因在唾液腺多形性腺瘤(PA)和癌在唾液腺多形性腺瘤(CPA)中的表达及其与临床病理因素的关系。方法:选择2013年1月至2017年8月于我院手术切除的PA标本45例作为PA组,CPA标本32例作为CPA组,正常腮腺组织30例作为对照组,应用免疫组化SP法对三组Belin1与p53基因表达情况进行检测,分析CPA组Beclin1、p53表达情况与临床病理因素关系及Beclin1、p53表达的相关性。结果:三组Beclin1、p53阳性表达率存在统计学差异,CPA组Beclin1阳性表达率低于PA组和对照组,CPA组和PA组p53阳性表达率高于对照组,且CPA组高于PA组(P0.05)。CPA组Beclin1、p53表达情况与TNM分期、淋巴结转移有关,TNM分期为III-IV期患者Beclin1阳性表达率低于I-II期患者,p53阳性表达率高于I-II期患者,淋巴结转移患者Beclin1阳性表达率低于无淋巴结转移患者,p53阳性表达率高于无淋巴结转移患者,差异均有统计学意义(P0.05),CPA组Beclin1、p53表达情况与年龄、性别、肿瘤直径、侵袭性无关(P0.05)。经Spearman相关性分析可得,CPA患者Beclin1和p53的表达呈负相关关系(r=-0.839,P=0.000)。结论:PA及CPA中存在Beclin1异常低表达,p53异常高表达,CPA患者Beclin1、p53表达情况与TNM分期、淋巴结转移有关,且两者表达呈负相关。     

IARS2在胃癌预后中的临床应用

为检测IARS2和MYO5B在胃癌组织中的表达并探讨IARS2表达与胃癌患者临床病理特征及预后的关系,本研究使用荧光定量PCR (quantitative polymerase chain reaction, qRT-PCR)及Western blotting检测30例胃癌组织和癌旁组织中IARS2和MYO5B的表达,使用线性回归分析两者m RNA表达相关性。使用免疫组化方法检测86对胃癌组织及癌旁组织中IARS2蛋白的表达情况,根据免疫组化IARS2表达情况将胃癌患者分为IARS2阳性组和阴性组,比较两组患者临床病理特征及预后情况。结果发现,较之癌旁组织,IASR2在胃癌组织中显著高表达(p<0.05),而MYO5B在胃癌组织中显著低表达(p<0.05),且两者表达负相关(r=0.5768, p=0.0008)。免疫组化显示IASR2阳性细胞在胃癌组织中的阳性率为70.9%。IASR2高表达提示更高的胃癌淋巴结转移(p=0.041)和TNM分期(p=0.004)及更低的患者术后5年总生存率(p=0.000 6)。研究提示IARS2在胃癌组织中高表达,可作为评估胃癌预后的标志物。     

~(125)Ⅰ标记的Flt4多抗检测荷瘤小鼠前哨淋巴结的探讨

目的探讨125I标记的Flt4多抗(125I-Flt4PcAb)对荷瘤小鼠前哨淋巴结(sentinel lymph node,SLN)的检测,为应用Flt4PcAb进行SLN特异性定位提供实验依据。方法建立BALB/c裸小鼠后肢荷瘤模型,7周后应用125I-Flt4PcAb检测肿瘤的SLN,健侧作为对照,切取窝淋巴结探测γ射线的每分钟计数率(count per minute,Cpm),并进行HE及角蛋白免疫组化染色;分析不同状态淋巴结摄取125I-Flt4PcAb的特点。结果BALB/c裸小鼠后肢皮下注射Tca-8113细胞悬液,移植瘤成功率达100%;患侧70枚窝淋巴结中,HE染色3枚(4.3%)出现肿瘤转移;角蛋白免疫组化染色为5枚(7.1%);125I-Flt4PcAb摄取方面,肿瘤转移淋巴结、反应性增生淋巴结和正常淋巴结之间均有显著差异(P<0.05)。结论BALB/c裸小鼠后肢皮下注射Tca-8113细胞悬液可成功致瘤,但淋巴结转移率低;免疫组化染色较HE染色检测肿瘤转移更敏感;125I-Flt4PcAb能够检测到荷瘤鼠的SLN,肿瘤转移淋巴结对125I-Flt4PcAb的摄取下降。     

胃癌患者Sox2蛋白和CTHRC-1蛋白的表达与肿瘤发展密切相关

本研究选取病理科收集的自2016年1月至2016年12月的90例术后胃癌组织标本(胃癌组)、45例癌旁组织标本(对照组),采用免疫组化染色法检测两组标本中的Y框蛋白(Sox2)、胶原三股螺旋重叠蛋白-1表达,并分析其与肿瘤TNM分期、淋巴结转移、浸润深度、分化程度的关系,采用Spearman秩相关检验检测两种蛋白的相互关系,试图探讨胃癌患者癌组织中性别决定区Y框蛋白(Sox2)、胶原三股螺旋重叠蛋白-1(CTHRC-1)的表达及其相关性。研究结果表明:胃癌组的Sox2蛋白阳性表达率63.33%显著低于对照组的93.33%(p<0.05),胃癌组的CTHRC-1蛋白阳性表达率78.89%显著高于对照组的24.44%(p<0.05);胃癌组的Sox2蛋白阳性表达与胃癌的分化程度、发生淋巴结转移具有相关性(p<0.05);胃癌组的CTHRC-1蛋白阳性表达与胃癌的淋巴结转移、TNM分期、肿瘤浸润深度具有显著的相关性(p<0.05);胃癌组的Sox2蛋白与CTHRC-1蛋白呈显著的负相关表达(Spearman相关系数r=-0.322, p=0.002<0.05)。本研究的初步结论表明:胃癌组织中Sox2蛋白低表达和CTHRC-1蛋白高表达,并且与肿瘤发展密切相关,且二者表达呈负相关。     

乙醛脱氢酶1在喉鳞状细胞癌中的表达及临床病理意义

目的探讨乙醛脱氢酶1在喉鳞状细胞癌中的表达及临床病理意义。方法采用免疫组化Elivision法及原位杂交法对2007年6月-2009年1月间我院收治的86例喉鳞状细胞癌患者的癌组织及其正常喉组织进行ALDH1蛋白及mRNA检测,结合临床病理特征进行相关性分析和无病生存期分析。结果 ALDH1蛋白在喉正常组织中低表达,在喉鳞癌组织中不同程度表达,喉癌组织中ALDH1mRNA的表达和蛋白的表达基本一致。ALDH1蛋白的表达与患者年龄、喉癌的部位、浸润范围、临床分期无明显相关性(P0.05);有淋巴结转移患者ALDH1蛋白表达高于淋巴结阴性患者,具有统计学意义(P0.05);5年生存率ALDH1阳性患者明显低于ALDH1阴性患者(P0.05)。结论 ALDH1在喉鳞癌组织中的高表达与淋巴结转移有关,ALDH1阳性表达可作为喉鳞癌患者预后判断的指标。     

EMT标志分子Vimentin在胃癌中的表达和临床意义

目的:探讨EMT标志分子Vimentin在胃癌中的表达和临床意义。方法:利用免疫组化染色的方法检测Vimentin在120例胃癌及其相应癌旁组织中的表达,统计分析Vimentin的表达水平与年龄、性别、组织学类型、TNM分期、淋巴结转移等临床病理特征间的相关性。结果:Vimentin在胃癌中的表达阳性率为55.8%,远高于相应癌旁组织的22.5%(P0.01),进一步分析研究发现Vimentin的表达水平在Ⅲ和Ⅳ期的胃癌中(TNM分期)的表达明显高于Ⅰ和Ⅱ期的胃癌,差异具有统计学意义(P=0.009),在发生淋巴结转移胃癌中表达明显高于未发生淋巴结转移的胃癌,差异具有统计学意义(P0.000)。结论:Vimentin在胃癌中高表达,其表达水平与TNM分期、淋巴结转移密切相关,提示Vimentin在胃癌的转移过程中可能发挥重要作用。     

Ratio between Negative and Positive Lymph Nodes Is Suitable for Evaluation the Prognosis of Gastric Cancer Patients with Positive Node Metastasis

Objective

To date, there is no consensus to evaluate the most appropriate category of the nodal metastasis for precise predication the prognosis of gastric cancer patients with positive node metastasis after curative surgery.

Methods

We retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 299 gastric cancer patients with positive node metastasis after curative surgery for evaluation the optimal category of the nodal metastasis.

Results

With the univariate and multivariate survival analyses, the depth of primary tumor invasion was identified as the independent predicators with the OS of 299 gastric cancer patients with nodal metastasis postoperatively, as were the number of positive lymph nodes (PLNs), the number of negative lymph nodes (NLNs), and the ratio between negative and positive lymph nodes (RNPL). The RNPL was identified to be more suitable for predication the OS of gastric cancer patients with positive node metastasis than the ratio between positive and dissected lymph nodes (RPDL) by using the stratum procedure of survival analysis. Besides, we found both PLNs and NLNs were independently correlated with OS of gastric cancer patients with nodal metastasis when RNPL, instead of RPDL, was controlled in the partial correlation model.

Conclusions

RNPL, a new category of the nodal metastasis, was suitable for predication the OS of gastric cancer patients with nodal metastasis after curative resection, as were the PLNs, and NLNs.     

Ex vivo localization and immunohistochemical detection of sentinel lymph node micrometastasis in patients with colorectal cancer can upgrade tumor staging

ABSTRACT: BACKGROUND: It is not clear if sentinel lymph node (SLN) mapping can improve outcomes in patients with colorectal cancers. The purpose of this study was to determine the prognostic values of ex vivo sentinel lymph node (SLN) mapping and immunohistochemical (IHC) detection of SLN micrometastasis in colorectal cancers. METHODS: Colorectal cancer specimens were obtained during radical resections and the SLN was identified by injecting a 1% isosulfan blue solution submucosally and circumferentially around the tumor within 30 min after surgery. The first node to stain blue was defined as the SLN. SLNs negative by hematoxylin and eosin (HE) staining were further examined for micrometastasis using cytokeratin IHC. RESULTS: A total of 54 patients between 25 and 82 years of age were enrolled, including 32 males and 22 females. More than 70% of patients were T3 or above, about 86% of patients were stage II or III, and approximately 90% of patients had lesions grade II or above. Sentinel lymph nodes were detected in all 54 patients. There were 32 patients in whom no lymph node micrometastasis were detected by HE staining and 22 patients with positive lymph nodes micrometastasis detected by HE staining in non-SLNs. In contrast only 7 SLNs stained positive with HE. Using HE examination as the standard, the sensitivity, non-detection rate, and accuracy rate of SLN micrometastasis detection were 31.8% (7/22), 68.2% (15/22), and 72.2%, respectively. Micrometastasis were identified by ICH in 4 of the 32 patients with HE-negative stained lymph nodes, resulting in an upstaging rate 12.5% (4/32). The 4 patients who were upstaged consisted of 2 stage I patients and 2 stage II patients who were upstaged to stage III. Those without lymph node metastasis by HE staining who were upstaged by IHC detection of micrometastasis had a significantly poorer disease-free survival (p = 0.001) and overall survival (p = 0.004). CONCLUSION: Ex vivo localization and immunohistochemical detection of sentinel lymph node micrometastasis in patients with colorectal cancer can upgrade tumor staging, and may become a factor affecting prognosis and guiding treatment.     

结直肠癌淋巴结微转移灶的临床病理研究

摘要目的：探讨结直肠癌淋巴结微转移灶的特点及其临床病理意义。方法：对我院2001年1月-2006年10月收治的56例无组织学淋巴结转移的结直肠癌患者的650个淋巴结进行微转移灶的免疫组织化学和组织学检测,并分析微转移灶与患者临床病理特征之间的关系。结果-通过对41,zm厚淋巴结连续切片进行观察,连续切片五片的微转移灶检出率较一片和两片的的微转移灶检出率显著升高（P〈0．05）。按解剖部位分组的患者微转移灶阳性率1组有66．67％（16／24）,2组有60％（9／15）,3组有41．2％（7／17）,无显著性差别（P〉0．05）。微转移灶与无组织学淋巴结转移的结直肠癌患者的肿瘤浸润深度（P=0．013）和肿块大小（P=0．037）存在显著性相关,但有微转移灶和无微转移灶的无组织学淋巴结转移的结直肠癌患者总体生存状况比较无显著差异（P〉0．05）。结论：微转移灶在无组织学淋巴结转移的结直肠癌淋巴结中较常见,与肿瘤大小和浸润深度有关,但与患者的预后无显著相关性。     

Postmastectomy Radiotherapy Improves Disease-Free Survival of High Risk of Locoregional Recurrence Breast Cancer Patients with T1-2 and 1 to 3 Positive Nodes

Objectives

The indications for post-mastectomy radiotherapy (PMRT) with T1-2 breast cancer and 1-3 positive axillary lymph nodes is still controversial. The purpose of this study was to investigate the role of PMRT in T1-2 breast cancer with 1-3 positive axillary lymph node.

Methods

We retrospectively reviewed the file records of 79 patients receiving PMRT and not receiving PMRT (618 patients).

Results

The median follow-up was 65 months. Multivariate analysis showed that PMRT was an independent prognostic factor of locoregional recurrence-free survival (LRFS) (P = 0.010). Subgroup analysis of patients who did not undergo PMRT showed that pT stage, number of positive axillary lymph nodes, and molecular subtype were independent prognostic factors of LRFS. PMRT improved LRFS in the entire group (P = 0.005), but did not affect distant metastasis-free survival (DMFS) (P = 0.494), disease-free survival (DFS) (P = 0.215), and overall survival (OS) (P = 0.645). For patients without PMRT, the 5-year LRFS of low-risk patients (0–1 risk factor for locoregional recurrence) of 94.5% was significantly higher than that of high-risk patients (2-3 risk factors for locoregional recurrence) (80.9%, P < 0.001). PMRT improved LRFS (P = 0.001) and DFS (P = 0.027) in high-risk patients, but did not improve LRFS, DMFS, DFS, and OS in low-risk patients.

Conclusions

PMRT is beneficial in patients with high risk of locoregional recurrence breast cancer patients with T1-2 and 1 to 3 positive nodes.     

Measurement of mRNA of 11 biomarkers by RT-PCR to detect lymph node involvement in cervical cancer

Lymph node metastases are a major prognostic factor in cervical carcinomas. The aim of this study was to characterize the expression of 11 markers in cervical tumors and negative lymph nodes and to determine which ones could be helpful for improving the specificity of molecular diagnosis of nodal involvement. Using TaqMan RT-PCR, we studied the expression of CK19, MUC1, HER1-HER4, VEGF, VEGF-C, uPA, MMP9, and PRAD1 in uterine cervical tumors and in histologically nonmetastatic lymph nodes of 8 patients diagnosed with locally advanced cervical cancer. We observed that CK19, MUC1, HER1-HER3, uPA, and VEGF had a significantly higher expression in cervical tumors than in the negative nodes, whereas VEGF-C expression level was higher in the negative nodes than in the tumors. PRAD1 harbored similar expression levels in the tumors and in the negative nodes. Interestingly, 1 of the 4 patients who presented a clinical recurrence, showed elevated HER1, HER2, uPA, and VEGF in the histologically negative nodes. Our results suggest that CK19, MUC1, HER1-3, uPA, and VEGF are biomarkers that have a higher expression in tumoral cervical tissues compared with the negative lymph nodes and could be useful to diagnose nodal involvement in uterine cervical carcinoma. Our results should encourage us in continue to investigate a greater number of patients, including patients with histologically involved nodes.     

Prognostic Model Based on Systemic Inflammatory Response and Clinicopathological Factors to Predict Outcome of Patients with Node-Negative Gastric Cancer

Prognostic models are generally used to predict gastric cancer outcomes. However, no model combining patient-, tumor- and host-related factors has been established to predict outcomes after radical gastrectomy, especially outcomes of patients without nodal involvement. The aim of this study was to develop a prognostic model based on the systemic inflammatory response and clinicopathological factors of resectable gastric cancer and determine whether the model can improve prognostic accuracy in node-negative patients. We reviewed the clinical, laboratory, histopathological and survival data of 1397 patients who underwent radical gastrectomy between 2007 and 2013. Patients were split into development and validation sets of 1123 and 274 patients, respectively. Among all 1397 patients, 545 had node-negative gastric cancer; 440 were included in the development set, 105 were included in the validation set. A prognostic model was constructed from the development set. The scoring system was based on hazard ratios in a Cox proportional hazard model. In the multivariate analysis, age, tumor size, Lauren type, depth of invasion, lymph node metastasis, and the neutrophil—lymphocyte ratio were independent prognostic indicators of overall survival. A prognostic model was then established based on the significant factors. Patients were categorized into five groups according to their scores. The 3-year survival rates for the low- to high-risk groups were 98.9%, 92.8%, 82.4%, 58.4%, and 36.9%, respectively (P < 0.001). The prognostic model clearly discriminated patients with stage pT1-4N0M0 tumor into four risk groups with significant differences in the 3-year survival rates (P < 0.001). Compared with the pathological T stage, the model improved the predictive accuracy of the 3-year survival rate by 5% for node-negative patients. The prognostic scores also stratified the patients with stage pT4aN0M0 tumor into significantly different risk groups (P = 0.004). Furthermore, the predictive value of this model was validated in an independent set of 274 patients. This model, which included the systemic inflammatory markers and clinicopathological factors, is more effective in predicting the prognosis of node-negative gastric cancer than traditional staging systems. Patients in the high-risk group might be good candidates for adjuvant chemotherapy.     

基于医疗数据信息集成系统的3D打印技术在肺癌手术中的应用

目的:探讨基于医疗数据信息集成系统的3D打印技术在治疗肺癌中的应用。方法:2014年10月~2015年10月收治的符合肺癌临床路径,进入医疗数据信息集成系统,并接受320排螺旋CT扫描三维重建,3D打印出实体1:1大小的患侧肺血管及肺病灶模型,术前制定手术方案且模拟手术过程的42例非小细胞肺癌(NSCLC)患者,经电视胸腔镜应用内镜缝合切割器切除病灶,术中快速冰冻切片明确诊断,行肺段切除术,肺叶切除术。观察术中肺血管与3D打印符合程度。记录手术时间、术中出血量、切除淋巴结数量、有无术中死亡、病理结果、并发症、引流时间和引流量及术后生存情况。结果:术中证实95%以上的肺血管可被3D打印出来。手术时间(51.4±18.1)min,术中出血量(40.2±20.3)mL。切除淋巴结(7.1±2.8)枚。无术中死亡。术后病理回报示肺鳞癌13例,肺腺癌29例。病理分期:T1aN0M0 12例,T1aN1M0 10例,T1bN0M0 3例,T1bN1M0 3例,T2aN0M0 2例,T2aN1M0 12例。术后患者无严重并发症,其中肺感染6例、肺膨胀不全6例、房颤5例,所有患者经积极后痊愈;术后引流时间(3.0±1.2)d,引流量(200.7±66.1)mL/d。42例随访2~12个月,中位随访时间8.0月,40例无瘤生存,术后6个月发生转移脑转移2例,分别于术后7和10个月死亡。结论:基于医疗数据信息集成系统的3D打印技术可以应用于肺癌手术。     

Prognostic value of serum and tumor tissue CA 72-4 content in gastric cancer

To date no general agreement has been reached regarding the prognostic significance of CEA, CA 19-9 and CA 72-4 as serum markers in gastric cancer, and only scattered information is available on the predictive value of marker expression in tumor tissue. Therefore, a longitudinal study was designed to analyze the presurgical serum and tumor tissue content of CA 72-4, CEA and CA 19-9 in 166 patients at different stages of gastric cancer, and to evaluate the possible correlation with clinicopathological features in respect to prognostic information on relapse-free survival. The results obtained showed that 48.4% of patients with tumor recurrence had positive presurgical CA 72-4 levels compared to approximately 24% of patients who remained free of disease. Furthermore, the median presurgical serum CA 72-4 levels were significantly elevated in relapsing patients. Serosa and lymph node involvement as well as positive presurgical serum CA 72-4 levels had independent prognostic value in predicting recurrence. A significant association between disease-free survival and lymph node involvement, depth of invasion and tumor tissue content of CA 72-4 was also demonstrated. We may therefore conclude that CA 72-4 antigen can be considered the marker of choice in the follow-up of gastric cancer patients and may be used as a prognostic indicator of relapse.     

CD40 signal expression in gastric cancer tissue and its correlation with prognosis of gastric cancer patients

CD40 signaling plays a critical role in the survival rate of gastric cancer patients. Tumour samples were collected from 73 patients with who were diagnosed as gastric cancer in general surgery department in the 1st affiliated hospital of Suzhou University between September 2002 and July 2003. All patients had not received radiotherapy and chemotherapy before operation. These patients include 46 male and 27 female. Here we show that CD40 is constitutively expressed in the human gastric carcinoma tissues, and CD40 protein and mRNA positive expression in gastric cancer tissues closely correlated with lymph node metastasis and tumour TNM stage. CD40 positive expression in gastric cancer patients with lymph node metastasis was markedly higher than that in gastric cancer patients without lymph node metastasis. CD40 positive expression in stage III-IV gastric cancer patients was markedly higher than that in stage I-II gastric cancer patients. Moreover, CD40 expression closely correlated with prognosis of gastric cancer patients. Therefore, CD40 was taken as grouping variable, and lymph node metastasis and clinical staging were taken as stratification variables, respectively, further analysis showed that prognosis in gastric cancer patients with lymph node metastasis and CD40 positive expression was markedly worse than that in gastric cancer patients without lymph node metastasis and CD40 negative expression (P = 0.0076). These results suggest that CD40 signaling plays a critical role in the survival of gastric cancer patients.