幽门螺杆菌感染与胃癌侵袭转移及COX-2和MMP-9表达的关系

目的:探讨COX-2和MMP-9在胃癌组织中的表达及其与幽门螺杆菌感染和胃部转移侵袭的关系.方法:采用快速尿素酶试验及Warthin-Starry银染色法检测45例胃癌标本中幽门螺杆菌感染情况,采用免疫组织化学法检测COX-2和MMP-9在胃癌组织中的表达,对其与幽门螺杆菌感染和胃癌患者临床病理特征的相关性进行分析.结果:①幽门螺杆菌感染组胃癌中浆膜侵袭和淋巴结转移卒均高于无幽门螺杆菌感染组(P<0.05).②胃癌浆膜侵袭组和淋巴结转移组中COX-2、MMP-9蛋白表达阳性率均分别显著高于无胃癌浆膜侵袭组、淋巴结转移组(P<0.05).③幽门螺杆菌感染与COX-2和MMP-9表达具有相关性.结论:幽门 螺杆菌感染能够增加胃癌的侵袭转移能力,其机制可能与COX-2和MMP-9表达增加有关.     

PCNA、P27蛋白在老年胃癌中的表达及其临床意义

目的：探讨增殖细胞核抗原（PCNA）和P27蛋白（P27）在老年胃癌中表达及其临床意义。方法：采用免疫组织化学SP法检测58例老年胃癌组织中PCNA、P27蛋白表达情况,分析它们与老年胃癌临床生物学行为的关系。结果：PCNA在老年胃癌组中的阳性表达率明显高于对照组的阳性表达率,P27在老年胃癌组中的阳性表达率明显低于对照组的阳性表达率。PCNA蛋白阳性表达与老年胃癌是否有浆膜浸润、组织分化程度、淋巴结转移以及TNM分期密切相关（P〈0.01）,而P27蛋白阳性表达与老年胃癌类型、是否有浆膜浸润、组织分化程度、淋巴结转移以及TNM分期密切相关（P〈0.01）。老年胃癌组织中PCNA、P27的表达呈负相关（r=-0.536,P〈0.05）。结论：P27表达下调、PCNA表达增强在老年胃癌的发生、发展过程中具有重要的作用,且两者具有相互作用。     

人胃癌组织中herg1基因和HERG1蛋白过度表达的临床病理意义的研究

目的探讨herg1基因及其表达的HERG1蛋白在胃癌中的表达情况,研究其与胃癌间的相关性。方法应用免疫组化方法（SP法）,RT—PCR技术及Westernblot方法对64例胃癌组织标本及对应正常胃粘膜组织中的herg1基因及HERG1蛋白的表达进行检测,并进行回顾性随访。结果（1）RT—PCR分析胃癌组织中herg1基因mRNA阳性率为100％（64／64）,正常组织中为0％（0／64）。（2）Western blot方法检测胃癌组织中HERG1蛋白表达阳性率为100％（64／64）,正常组织中为0％（0／64）。（3）免疫组化分析HERG1蛋白在胃癌组织的阳性率为81．25％（52／64）,与其病理类型无关,而在正常组织中未见明显表达,在伴有淋巴结转移或肝转移的胃癌herg1的阳性表达率为100％（10／10）,无转移者为78％（42／54）。Hegrl基因的表达与胃癌的淋巴转移、肝转移有相关性（P〈0．01）。结论Herg1基因和HERG1蛋白的过度表达参与了胃癌的发生发展过程,同时提示该基因和蛋白的检测可以预测胃癌组织的侵袭、转移倾向,为建立肿瘤转移的分子标志提供了理论和实验依据。     

RegIV和CCL7在胃癌中的表达及相关性分析

目的:研究再生基因4(RegIV)和趋化因子CCL7在胃癌中的表达及相关性。方法:选择2010年3月至2014年3月在我院接受手术治疗的胃癌患者72例作为研究对象。对比RegIV及CCL7在胃癌组织以及癌旁正常组织中的阳性表达情况,分析不同病理参数对RegIV及CCL7阳性表达的影响,RegIV与CCL7表达的相关性及影响RegIV及CCL7在胃癌中表达的危险因素。结果:胃癌组织的RegIV阳性率及CCL7阳性率均显著高于癌旁正常组织,差异均有统计学意义(均P0.05)。有浆膜浸润、有淋巴结转移以及TNM分期为Ⅲ~Ⅳ期者的RegIV与CCL7阳性表达率均显著高于无浆膜浸润、无淋巴结转移以及TNM分期为0~Ⅱ期者,差异均有统计学意义(均P0.05)。经Spearman法分析相关性可知,RegIV与CCL7表达呈正相关。根据Logistic回归分析法可知,有浆膜浸润、有淋巴结转移以及TNM分期为Ⅲ~Ⅳ期均为RegIV及CCL7在胃癌中表达的危险因素。结论:RegIV与CCL7均可在胃癌组织中呈现出较高的阳性表达,且二者与患者临床预后有密切关系,在临床治疗过程中值得关注与重视。     

基质金属蛋白酶- 9, 组织抑制因子- 1 在进展期 胃癌中的表达与意义

目的：研究基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）及其组织抑制因子-1（tissue inhibitor of metallopmteinase—1,TMP-1）在进展期胃癌中的表达情况,探讨二者的表达与胃癌侵袭转移闻的关系及二者间的联系。方法：应用免疫组化方法检测70例进展期胃癌标本中MMP-9,TIMP-1的表达,并进行回顾性随访。结果：馒反肌层以上者MMP-9的阳性表达（66．67％）明显高于肿瘤局限于粘膜、粘膜下者（20％P〈0.01）。MMP-9阳性表达与胃癌的淋巴转移与肝转移有相关性（P〈0．01）。TIMP-1的表达随胃癌浸润深度增加而减少,当肿瘤突破浆膜时TIMP-1的表达呈现陡降趋势（P〈0．01）。结论：MMP-9的过阳性表达和TIMP-1的表达失衡可能与胃癌转移行为有关。TIMP-1可能抑制胃癌的浸润转移。     

进展期胃癌的脾门淋巴结转移相关因素的研究

目的:探讨进展期胃癌脾门淋巴结(10组)转移的相关临床病理因素.方法:回顾分析了(2008-2011年)75例胃癌根治术伴10组淋巴结切除的进展期胃癌病例.分析了临床病理学因素和10组淋巴结转移的相关性.结果:本研究结果提示10组淋巴结转移的阳性率为52％.胃下部癌的转移率(20％)相对较低(P=0.000),大弯侧肿瘤的转移率高达76.2％.病灶的侵润深度及病理TNM分期与10组淋巴结阳性率密切相关,组织学类型或分化程度与10组淋巴结转移无统计学相关.病灶小于3 cm病例的10组淋巴结转移的阳性率为0％,而大于9 cm或Borrmann-Ⅳ的肿瘤患者的10组淋巴结转移的阳性率为100％.结论:10组淋巴结转移的高危因素包括:1.中上部胃癌;2.肿瘤位于胃大弯侧;3.大于3 cm; 4.侵达胃壁浆膜层.含以上高危因素的进展期胃癌根治手术中,建议常规行术中快速冰冻检查10组淋巴结是否存在转移;含2个以上高危因素的进展期胃癌建议行脾切除术,或如果技术条件具备应行保留脾的10组淋巴结清扫术以便最终获得R0切除.     

淋巴结转移阴性的胃癌患者临床病理特征及生存探讨

目的:探讨淋巴结转移阴性胃癌患者的临床病理特征以及预后影响因素。方法:收集2000年1月至2009年1月我院收治的胃癌患者325例,其中经病理检查显示淋巴结转移阴性的105例患者作为阴性组(LN-组),另229例阳性患者作为阳性组(LN+组),比较两组的临床病理特征及临床预后。结果:LN-组的肿瘤直径、浸润深度及术后化疗与LN+组比较差异显著(P0.05);LN-组的5年生存率为76.2%,显著高于LN+组的43.2%(P0.05)。未透浆膜的LN-患者3年、5年生存率显著高于浸透浆膜者,术后化疗的LN-患者5年生存率显著高于未化疗者(P0.05),肿瘤直径5 cm的LN-患者3、5年生存率显著高于≥5 cm者(P0.05)。单因素分析显示浸润深度、肿瘤大小及术后化疗与LN-胃癌患者的预后具有密切关系(P0.05)。COX多因素分析显示浸润深度是影响LN-胃癌患者临床预后的独立因素(P0.05)。结论:淋巴结转移阴性胃癌患者的病灶多位于中下部,男性多于女性,发病年龄多在60岁以内,肿瘤直径多不超过5 cm,浸润深度多未浸透浆膜,临床预后优于淋巴结转移阳性胃癌患者,浸润深度是影响淋巴结转移阴性胃癌患者临床预后的独立因素。     

银染PCR—SSCP方法检测胃癌微小卫星DNA不稳定性

应用银染PCR-SSCP方法检测30例常规石蜡包埋胃癌组织第2、5、17号染色体4个位点的微小卫星DNA不稳定性(MIN)。结果发现11例阳性病例(36.7％),其中出现4、3、2个及单个位点异常分别为1(3％)、2(6％)、5(16.7％)和3例(10％)。4个位点中,以D5S107发生率最高(33.3％),其次为D2S123(30％)、D17S250(16.7％)、D2S119(12％)。提示MIN是胃癌病变中常见的分子遗传学事件,MIN的出现可能是胃癌发生的又一重要机制。银染PCR-SSCP是一简便、快速、灵敏、有效的检测MIN的方法。     

荧光素酶标记人胃癌细胞裸鼠原位移植模型的建立

目的建立荧光素酶标记人胃癌原位异种移植模型。方法将萤火虫荧光素酶作为标记基因导入人胃癌MGC803细胞,建立稳定表达荧光素酶的细胞,将其接种裸鼠胃壁浆膜下,建立胃癌裸鼠原位肿瘤模型。用活体荧光成像系统检测肿瘤的发生发展,并进行小动物超声影像和病理学分析。结果裸鼠原位成瘤率为100%,活体荧光成像观察发现在接种第7天,就可以观察到肿瘤发光。21 d后肿瘤进入对数生长期,28 d后肿瘤出现明显坏死,平均荧光光子数呈现下降趋势。超声成像发现小鼠胃部有直径为8.39 mm,面积为28.92 mm2瘤块。结论荧光素酶标记可以实时监测原位异种移植人胃癌生长状况。     

腺病毒载体介导p53基因转移抑制人胃腺癌细胞增殖

采用携带P53基因的腺病毒载体系统Ad－P53进行胃癌的体外实验性治疗,以通过腺病毒感染胃癌细胞后P53基因在癌细胞中高效表达,来抑制胃癌细胞增殖,从而为胃癌术后复发的治疗找到、条有效的途径。用Ad－p53基因综染人胃癌S3C－7901细胞后,进行X－gal染色测定腺病毒转染效率;用P53特异引物扩增转染后的7901细胞外源性P53基因;IX：IZ法用一对引物对Ad－P53转染细胞进行EI区基因检测。结果表明,七MOI大于25时腺病毒转染效率即可达100％。腺病毒EI区基因检测：Ad－P53、Ad－IncXi和PBS感染组均未见阳性扩增带。与Ad一beZ和PB…     

用于胃癌检测的漫反射光谱

胃癌正严重地威胁人类的健康,为了开发一种可以诊断早期胃癌的新型光学检测技术,建立了一套简便的组织体漫反射光谱检测装置.首先,根据组织体的光学特性,介绍光谱检测方法的基本原理.然后,利用组织癌变导致的组织体光学特性变化,建立漫反射光谱检测的实验装置.最后,利用该实验装置分别获取正常胃组织和胃癌组织的漫反射光谱.实验结果表明:癌变和正常胃组织的漫反射光谱在可见光区域有明显差别,特别是在波长为500 nm和630 nm处,但是漫反射光谱检测无法分辨来自组织不同层的光谱信息.这些结果说明漫反射光谱检测装置可用于胃癌的辅助检测.     

Diagnosis of early gastric cancer based on fluorescence hyperspectral imaging technology combined with partial‐least‐square discriminant analysis and support vector machine

This study investigated the feasibility of using fluorescence hyperspectral imaging technology to diagnose of early‐stage gastric cancer. Fluorescence spectral images of 76 patients who were pathologically diagnosed as non‐atrophic gastritis, premalignant lesions and gastric cancer were collected. Fluorescence spectra at 100‐pixel points were randomly extracted after binarization. Diagnostic models of non‐atrophic gastritis, premalignant lesions and gastric cancer were constructed through partial‐least‐square discriminant analysis (PLS‐DA) and support vector machine (SVM) algorithms. The prediction effects of PLS‐DA and SVM models were compared. Results showed that the average spectra of normal, precancerous and gastric cancer tissues significantly differed at 496, 546, 640 and 670 nm, and regular changes in fluorescence intensity at 546 nm were in the following order: normal > precancerous lesions > gastric cancer. Additionally, the effect of the diagnostic model established by SVM is significantly better than PLS‐DA which accuracy, specificity and sensitivity are above 94%. Experimental results revealed that the fast diagnostic model of early gastric cancer by combining fluorescence hyperspectral imaging technology and improved SVM was effective and feasible, thereby providing an accurate and rapid method for diagnosing early‐stage gastric cancer.      

Study on gastric cancer blood plasma based on surface-enhanced Raman spectroscopy combined with multivariate analysis

A surface-enhanced Raman spectroscopy (SERS) method combined with multivariate analysis was developed for non-invasive gastric cancer detection. SERS measurements were performed on two groups of blood plasma samples: one group from 32 gastric patients and the other group from 33 healthy volunteers. Tentative assignments of the Raman bands in the measured SERS spectra suggest interesting cancer-specific biomolecular changes, including an increase in the relative amounts of nucleic acid, collagen, phospholipids and phenylalanine and a decrease in the percentage of amino acids and saccharide in the blood plasma of gastric cancer patients as compared with those of healthy subjects. Principal components analysis (PCA) and linear discriminant analysis (LDA) were employed to develop effective diagnostic algorithms for classification of SERS spectra between normal and cancer plasma with high sensitivity (79.5%) and specificity (91%). A receiver operating characteristic (ROC) curve was employed to assess the accuracy of diagnostic algorithms based on PCA-LDA. The results from this exploratory study demonstrate that SERS plasma analysis combined with PCA-LDA has tremendous potential for the non-invasive detection of gastric cancers.     

A novel urine analysis technique combining affinity chromatography with Au nanoparticle based surface enhanced Raman spectroscopy for potential applications in non‐invasive cancer screening

Modified nucleoside in urine samples is one of the most common biomarkers for cancer screening. Therefore, we developed a novel detection method for modified nucleoside detection in human urine. In this work, the modified nucleoside from real cancer patient's urine samples was first separated and purified using the affinity chromatography (AC) technology relying on its specific adsorption capacity. Then, surface‐enhanced Raman spectroscopy (SERS) technology with the capability of single molecular detection was used to sensitively characterize the biomolecular features of modified nucleoside. A total of 141 high‐quality SERS spectra of urinary modified nucleoside can be obtained from 50 gastric cancer patients and 43 breast cancer patients, as well as 48 healthy volunteers. Using principal component analysis combined with linear discriminant analysis (PCA‐LDA), the diagnostic sensitivities for identifying gastric cancer vs normal, breast cancer vs normal, gastric cancer vs breast cancer were 84.0%, 76.7% and 82.0%, respectively, and the corresponding diagnostic specificities for each combination were 95.8%, 87.5% and 90.7%, respectively. These results show that this novel method based on urinary modified nucleoside detection combining AC and SERS technologies holds promising potential for developing a specific, non‐invasive and label‐free tool for cancer screening.      

用组织光学特性鉴别诊断人离体的正常膀胱和膀胱癌组织

研究正常人膀胱和膀胱癌组织在Kube lka-Munk二流模型下对476.5 nm,514.5 nm和808 nm波长的激光的光学特性的差异。采用双积分球系统和Kube lka-Munk二流模型进行测量研究。实验结果表明,正常膀胱和膀胱癌组织在Kube lka-Munk二流模型下对476.5 nm,514.5 nm和808 nm波长的每一个波长的激光的吸收、散射、总衰减、有效衰减系数都有非常显著性的差异(P<0.01)。膀胱癌组织对476.5 nm,514.5 nm和808nm波长的激光的吸收系数明显地较正常膀胱组织对相应波长的激光的吸收系数要大(P<0.01),膀胱癌组织对476.5 nm和514.5 nm波长的激光的散射系数明显地较正常膀胱组织对相应波长的激光的散射系数要小(P<0.01),而膀胱癌组织对808 nm波长的激光的散射系数明显地较正常膀胱组织对同一波长的激光的散射系数要大(P<0.01)。膀胱癌组织对476.5 nm,514.5 nm和808 nm波长的激光的总衰减系数明显地较正常膀胱组织对相应波长的激光的总衰减系数要大(P<0.01),膀胱癌组织对476.5 nm,514.5 nm和808 nm波长的激光的有效衰减系数明显地较正常膀胱组织对相应波长的激光的有效衰减系数要大(P<0.01)。提示使用双积分球系统和Kube lka-Munk二流模型来确定离体的正常膀胱组织和膀胱癌组织对476.5 nm,514.5 nm和808nm波长的激光的光学特性的差异鉴别诊断病变的膀胱组织是一个有效的方法。     

Gastric cancer detection based on blood plasma surface-enhanced Raman spectroscopy excited by polarized laser light

We have recently applied surface-enhanced Raman spectroscopy (SERS) for blood plasma analysis for non-invasive nasopharyngeal cancer detection and obtained good preliminary results. The aim of this study was to develop a more robust SERS spectroscopy based blood plasma analysis method for non-invasive gastric cancer detection. The effect of different laser polarizations (non-polarized, linear-polarized, right-handed circularly polarized, and left-handed circularly polarized) on blood plasma SERS spectroscopy was explored for the first time. Silver nanoparticles as the SERS-substrate were directly mixed with blood plasma to enhance the Raman scattering of various biomolecular constituents. High quality SERS spectra were obtained using a fiber optic probe and a dispersive type near infrared Raman system. Blood plasma samples from gastric cancer patients (n=32) and healthy subjects (n=33) were analyzed. The diagnostic performance for differentiating gastric cancer plasma from normal plasma was evaluated. Principal component analysis combined with linear discriminant analysis (LDA) of the obtained spectral data was used to develop diagnostic algorithms. Classification results obtained from cross-validation of the LDA model based on the four spectral data sets of different laser polarizations demonstrated different diagnostic sensitivities and specificities: 71.9% and 72.7% for non-polarized laser excitation, 75% and 87.9% for linear-polarized laser excitation, 81.3% and 78.8% for right-handed circularly polarized laser excitation, 100% and 97% for left-handed circularly polarized laser excitation. The results from this exploratory study demonstrated that plasma SERS spectroscopy with left-handed circularly polarized laser excitation has great promise of becoming a clinically useful diagnostic tool for non-invasive gastric cancer detection.     

Upregulation of plasma C9 protein in gastric cancer patients

Gastric cancer is one of the leading causes of cancer‐related deaths worldwide. Current biomarkers used in the clinic do not have sufficient sensitivity for gastric cancer detection. To discover new and better biomarkers, protein profiling on plasma samples from 25 normal, 15 early‐stage and 21 late‐stage cancer was performed using an iTRAQ‐LC‐MS/MS approach. The level of C9 protein was found to be significantly higher in gastric cancer compared with normal subjects. Immunoblotting data revealed a congruent trend with iTRAQ results. The discriminatory power of C9 between normal and cancer states was not due to inter‐patient variations and was independent from gastritis and Helicobacter pylori status of the patients. C9 overexpression could also be detected in a panel of gastric cancer cell lines and their conditioned media compared with normal cells, implying that higher C9 levels in plasma of cancer patients could be attributed to the presence of gastric tumor. A subsequent blind test study on a total of 119 plasma samples showed that the sensitivity of C9 could be as high as 90% at a specificity of 74%. Hence, C9 is a potentially useful biomarker for gastric cancer detection.     

hTERT methylation and expression in gastric cancer

Gastric cancer is the second most prevalent cause of cancer death worldwide. DNA methylation is a common event in gastric carcinogenesis. hTERT seems to be the rate-limiting determinant of telomerase activation, which is responsible for stability and life span. hTERT hypermethylation has been associated with telomerase expression. In the present study, we investigated the promoter methylation status and hTERT protein expression in gastric cancer and normal mucosa samples. One hundred and nine gastric cancer and 53 normal mucosa samples were investigated through methylation-specific PCR. Immunohistochemistry was analysed using peroxidase in 55 gastric cancer and 18 normal gastric mucosa samples. This is the first study evaluating hTERT methylation status in gastric carcinogenesis. We did not observe hTERT protein expression in normal gastric mucosa. Moreover, hTERT expression was observed in 80% of tumours and was associated with gastric cancer (p?<?0.0001). Partial methylation was the most frequent pattern in gastric samples, even in normal mucosa. The frequency of specimens presenting hypermethylation was significantly higher in tumours than in normal mucosa samples (p?=?0.0002), although the presence of hypermethylated promoter was not associated with a higher frequency of hTERT expression. A low correlation between hTERT protein expression and methylation was verified in gastric cancer samples. There was a clear difference in the frequency of hTERT expression and methylation within tumoral and non-tumoral tissues. Methylation status and telomerase expression may be useful for the diagnosis of gastric cancer and may have an impact on the anti-telomerase strategy for cancer therapy.     

Combining near-infrared-excited autofluorescence and Raman spectroscopy improves in vivo diagnosis of gastric cancer

This study aims to evaluate the diagnostic utility of the combined near-infrared (NIR) autofluorescence (AF) and Raman spectroscopy for improving in vivo detection of gastric cancer at clinical gastroscopy. A rapid Raman endoscopic technique was employed for in vivo spectroscopic measurements of normal (n=1098) and cancer (n=140) gastric tissues from 81 gastric patients. The composite NIR AF and Raman spectra in the range of 800-1800 cm(-1) were analyzed using principal component analysis (PCA) and linear discriminant (LDA) to extract diagnostic information associated with distinctive spectroscopic processes of gastric malignancies. High quality in vivo composite NIR AF and Raman spectra can routinely be acquired from the gastric within 0.5s. The integrated intensity over the range of 800-1800 cm(-1) established the diagnostic implications (p=1.6E-14) of the change of NIR AF intensity associated with neoplastic transformation. PCA-LDA diagnostic modeling on the in vivo tissue NIR AF and Raman spectra acquired yielded a diagnostic accuracy of 92.2% (sensitivity of 97.9% and specificity of 91.5%) for identifying gastric cancer from normal tissue. The integration area under the receiver operating characteristic (ROC) curve using the combined NIR AF and Raman spectroscopy was 0.985, which is superior to either the Raman spectroscopy or NIR AF spectroscopy alone. This work demonstrates that the complementary Raman and NIR AF spectroscopy techniques can be integrated together for improving the in vivo diagnosis and detection of gastric cancer at endoscopy.