涎腺粘液表皮样癌中hMLH1、hMSH2与p53基因的表达及意义

目的:探索hMLH1、hMSH2基因在涎腺粘液表皮样癌中的表达及其与p53表达的关系.方法:采用免疫组织化学S-P法对涎腺粘液表皮样癌及正常涎腺组织石蜡切片进行hMLH1、hMSH2及p53表达的检测.结果:(1)hMLH1、hMSH2及p53在癌组织中表达阳性率均显著高于正常组织(P＜0.01).(2)hMLH1、hMSH2的表达与癌的分化程度、患者年龄、性别、肿块大小、浸润深度以及有无淋巴结转移均无关(P＞0.05).(3)hMLH1、hMSH2基因均与p53表达呈正相关.结论:检测hMLH1、hMSH2、p53将有助于判断涎腺粘液表皮样癌的恶性程度和相关的生物学行为.     

四种错配修复基因蛋白在结直肠癌中的表达及临床意义

目的:分析hMLH1、hMSH2、hMSH6和hPMS2四种错配修复基因蛋白在结直肠癌中的表达及其临床意义。方法:随机选取2013年1月至2015年12月广州医科大学附属第三医院结直肠癌患者标本177例,采用免疫组织化学法检测hMLH1、hMSH2、hMSH6和hPMS2蛋白的表达情况,并分析蛋白表达与临床参数间关系。结果:177例结直肠癌组织中,hMLH1蛋白的缺失率为6.2%(11/177),hMSH2蛋白的缺失率为4.0%(7/177),hMSH6蛋白的缺失率为1.7%(3/177),hPMS2蛋白的缺失率为8.0%(14/177),四者之和占所有结直肠癌病例的19.8%(35/177)。四种错配修复基因蛋白表达缺失均与肿瘤发生部位有关(P0.05),另外,hMLH1及hPMS2蛋白的表达缺失还与肿瘤分化程度相关(P0.05),hMSH6蛋白的表达缺失还与肿瘤浸润深度相关(P0.05);而缺失均与年龄、性别、淋巴结转移和远处转移无关(P0.05)。结论:错配修复蛋白的表达在部分结直肠癌组织中出现缺失现象,且与肿瘤部位及分化程度密切相关。hMLH1、hMSH2、hMSH6和hPMS2四种基因的突变,为临床判断预后及拟定治疗方案提供一个有参考价值的依据。     

错配修复蛋白hMSH2、hMLH1在涎腺粘液表皮样癌中的表达

目的:探讨人类错配修复基因2 the human mutS homolog 2(hMSH2)人类错配修复基因1human mutL homolog 1(hMLH1)在涎腺粘液表皮样癌(salivary gland mucoepidermoid carcinoma-SMEC)表达水平及临床病理意义。重点研究人类错配修复基因2和人类错配修复基因1与目标肿瘤发生的相关性。方法:采用HE染色方法筛选共计47例典型病例,采用免疫组织化学染色分析37例SMEC、10例正常组织涎腺中hMSH2、hMLH1的表达水平,结合计算机辅助高清晰图像分析处理技术做出综合评价。结果:hMLH1的表达与SMEC分化呈负相关(P0.05);hMLH1的低表达或表达缺失在低分化的SMEC中较普遍,在中分化和高分化中表达逐步增强;hMSH2的表达与SMEC分化不相关(P0.05)。结论:hMSH2、hMLH1异常表达与涎腺黏液表皮样的发生、演进存在相关性,以hMLH1、hMSH2为切入点为涎腺黏液表皮样癌治疗与预防提供参考依据。     

Skp2和P27在食管鳞状细胞癌中表达及其临床意义

目的:研究S期激酶相关蛋白2(Skp2)与细胞周期素抑制因子P27在人食管鳞状细胞癌中蛋白冰平的表达差异,分析二基因的相互关系及其与食管鳞癌浸润深度、组织学分级、淋巴结转移等临床病理因素间的关系,探讨Skp2和P27在食管鳞癌发生发展过程中的作用及其临床意义.方法:应用免疫组化检测49例食管鳞癌及其切缘正常组织中Skp2和P27的表达,用PearsonX<'2>检验分析二者的表达在两组间是否有差别;用Pearson X<'2>检验和Fisher's确切概率法分析Skp2和P27表达与食管鳞癌患者性别、年龄、临床分期、病理组织学分级、淋巴结转移等临床病理因素间的关系;用Pearson相关系数分析食管鳞癌中Skp2和P27两者表达的相关性;结果:Skp2在食管鳞癌及其切缘正常粘膜组织中的阳性表达率分别为57.1%和20.0%,(P<0.05).P27在食管鳞癌及其切缘正常粘膜组织中的阳性表达率分别为51.0%和85.0%,(P<0.05).Skp2和P27的表达与临床分期、组织学分级、淋巴结转移显著相关,与患者性别、年龄无显著相关,且二者在食管鳞癌中表达呈显著负相关.结论:食管鳞癌中Skp2基因在蛋白水平高表达,在切缘正常粘膜组织中低表达,P27蛋白表达与Skp2蛋白表达之间呈负相关.Skp2和P27表达与食管鳞癌肿瘤临床分期、组织学分级、淋巴结转移等临床病理因素密切相关.     

食管组织和外周血中代谢和DNA修复相关基因的表达谱分析

目的:研究代谢酶和DNA修复相关基因在食管组织和外周血中的表达谱.方法:收集93例淮安地区食管癌病例的食管癌旁正常组织和外周血,采用实时荧光定量RT-PCR方法定量分析食管正常组织和外周血中的代谢酶和修复酶共计11个基因的mRNA水平.结果:11个代谢酶和修复酶基因在食管组织和外周血的表达水平有明显差异,食管组织中GSTPI＞NQOI、MGMT＞hMLH1、hMSH2、hOGG1、XRCC1、XPD,XPA、CYP2E1＞MTHFR;在外周血中GSTP1＞hMLH1、hMSH2、XPA、MGMT＞hOGG1、NQO1、CYP2E1、XRCC1、XPD＞MTHFR.食管组织基因表达水平与外周血相应基因的表达之间未发现有统计学意义的直线相关关系.结论:代谢酶和修复酶基因在食管组织和外周血的表达谱相似,但基因表达水平有差异,本分析为这些基因的研究提供了基础数据的支持.外周血和食管组织在肿瘤易感性和肿瘤发生相关的生物标志物研究中具有不同的应用价值.     

抑癌基因PTEN在食管癌中的表达

目的　研究抑癌基因PTEN在食管癌组织的表达 ,探讨PTEN与食管癌发生发展之间的关系。方法　应用免疫组织化学SABC法对食管癌及癌旁食管粘膜PTEN的表达进行检测。结果　PTEN在食管鳞癌 (4 8 2 2 % )中的表达率明显低于癌旁正常食管粘膜组织 (90 6 3% ) ,有显著性差异 (P <0 0 1)。而且从食管鳞癌Ⅰ至Ⅲ级PTEN表达率逐渐降低 ,鳞癌Ⅰ至Ⅲ级PTEN的表达率分别是 :78 5 7%、 6 0 0 %、 2 7 2 7% ,有显著性差异 (P <0 0 1)。结论　从癌旁正常食管鳞状上皮组织 ,到Ⅰ～Ⅲ级食管鳞癌组织的PTEN表达依次降低 ,表明PTEN在食管癌的发生以及进展过程中有表达缺失。     

明胶酶及肿瘤抑制基因pten在喉鳞状细胞癌中表达的研究

目的探讨喉鳞癌中明胶酶MMP-2、MMP-9及肿瘤抑制基因PTEN的表达及其相关性.方法应用S-P免疫组化法检测68例喉鳞癌、9例异型增生及15例正常喉粘膜的MMP-2、MMP-9及PTEN蛋白表达.结果(1)MMP-2、MMP-9阳性表达率:喉鳞癌中分别为73.53%、79.41%,均显著高于异型增生表达率(44.44%、22.22%)及正常喉粘膜表达率(13.33%、20.00%),P<0.05;伴淋巴结转移的喉鳞癌组分别为96.88%、100%,显著高于未转移组52.78%、61.11%,P<0.01.T3-T4期MMP-9的表达(100%)高于T1-T2期(53.33%),P<0.01.(2)PTEN在异型增生喉上皮中高表达率66.67%,显著高于正常喉上皮(13.33%)P<0.01,喉鳞癌中高表达率44.12%,阴性表达率为22.06%,总异常率(66.17%)与正常组(13.33%)间差异显著,P<0.05.PTEN高表达率在伴淋巴结转移组(25.00%)低于未转移组(61.11%),P<0.05;与组织学分级负相关(P<0.01).(4)喉鳞癌中MMP-2与MMP-9表达间呈正相关,二者分别与PTEN表达呈负相关.结论MMP-2、MMP-9表达增强及PTEN表达减弱对喉鳞癌的浸润转移起促进作用且相互协同,是喉鳞癌侵袭的重要标志物,其中PTEN异常是一早期事件.     

子宫内膜异位症中hMLH1、hMSH2基因启动子区的甲基化研究

目的：探讨错配修复基因1（hMLH1）、错配修复基因2（hMSH2）启动子区甲基化与子宫内膜异位症的关系。方法：采用甲基化特异性PCR方法检测23例子宫内膜异位症组织和20例正常子宫内膜中hMLH1、hMSH2基因启动子区的甲基化状态。结果：hMLH1基因在子宫内膜异位症中的甲基化率为39％（9/23）,在正常子宫内膜组织中的甲基化率为5％（1／20）,两者比较,差异有统计学意义（P〈0．05）;hMSH2基因在子宫内膜异位症中的甲基化率为8％（2／23）,在正常子宫内膜组织中的甲基化率为5％（1／20）,两者比较,无明显差异（P〉0．05）。结论：hMLH1基因启动子区甲基化可能与子宫内膜异位症发病有关;hMSH2基因启动子区甲基化与子宫内膜异位症之间不存在显著联系。     

脑胶质瘤MGMT、hMLH1和hMSH2基因启动子甲基化状态研究

目的：探讨脑胶质瘤患者O6-甲基鸟嘌呤-DNA甲基转移酶基因MGMT和错配修复基因hMLH1、hMSH2启动子CpG岛甲基化状态,及其在烷化剂化疗中的意义。方法：采用甲基化特异性PCR（MSP）方法检测39例脑胶质瘤和6例正常脑组织MGMT、hMLH1和hMSH2基因启动子区的甲基化状态,免疫组化方法测定蛋白表达。结果：脑胶质瘤患者组织MGMT、hMLH1和hMSH2基因启动子区甲基化发生率分别为46.2%、10.3%和20.5%,3种基因启动子未甲基化模式与其对应蛋白表达模式相似,并与患者性别、年龄、病理类型和病理分级无明显相关性。回顾性分析患者资料,显示39例脑胶质瘤患者中,MGMT基因甲基化的患者生存期显著高于MGMT基因未甲基化患者（P〈0.05,Log-rank检验）。结论：MGMT及错配修复基因甲基化是脑胶质瘤发生过程中常见的分子事件,可能与肿瘤的发生有关;检测MGMT、hMLH1和hMSH2基因启动子甲基化状态,在判断脑胶质瘤患者预后和预测烷化剂化疗耐药性中可能具有重要意义。     

食管鳞状细胞癌中HDGF、VEGF表达与微血管形成的关系

目的:研究食管鳞状细胞癌中肝癌衍生生长因子(HDGF)、血管内皮生长因子(VEGF)的表达及其与微血管形成的关系。方法:通过免疫组化SABC法检测和比较68例食管鳞癌、20例切缘正常组织中HDGF、VEGF的表达和CD34标记的微血管密度(MVD),分析HDGF和VEGF表达之间的关系及其与食管鳞癌患者临床病理因素和食管癌组织MVD值的关系。结果:食管鳞癌组织中HDGF(63.2%)和VEGF(72.1%)的阳性表达率均明显高于切缘正常粘膜组织(15.0%、20.0%)(P0.05),食管鳞癌组织和切缘正常粘膜组织中的MVD值分别为35.48±5.75和13.50±2.1(P0.05)。食管鳞癌组织HDGF的阳性表达率仅与其临床分期明显相关(P0.05),而VEGF的阳性表达率与其淋巴结转移、临床分期均显著相关(P0.05),二者在食管鳞癌组织中的表达呈显著正相关(P0.05)。食管鳞癌组织中HDGF、VEGF阳性表达组MVD值均明显高于HDGF、VEGF阴性表达组(P0.05)。结论:HDGF可能通过诱导VEGF的产生,从而促进血管生成,参与食管鳞癌的发生、发展及转移。     

Age at diagnosis of cancer as predictor of mutation occurrence in families suspected of HNPCC

Analysis of significance of age at cancer diagnosis as a factor allowing identification of a subgroup of patients with a high frequency of hMSH2 and hMLH1 mutations among families that fulfil suspected HNPCC criteria was performed. DNA from thirty-one unrelated patients affected by colorectal cancer from families matching the above criteria were studied by direct sequencing for occurrence of hMSH2 and hMLH1 gene mutations. Seven unequivocal constitutional mutations were detected: five in the hMLH1 gene and two in the hMSH2 gene. Additionally, one hMLH1 alteration of unknown significance was found. All seven mutations were found in a subgroup of 19 patients with cancer diagnosed before the age of 50 years. In a subgroup of 12 patients with cancer diagnosed at an older age only one case with hMLH1 alteration of unknown significance was detected. Our results indicate that early age at cancer diagnosis seems to be a crucial pedigree factor in discrimination of patients with hMSH2 or hMLH1 mutations among families suspected of HNPCC and matching criteria I of ICG-HNPCC.     

实时荧光定量RT-PCR对胃癌组织中hMLH1 mRNA的检测及其临床意义

目的:探讨DNA错配修复基因hMLH1在胃癌组织中的表达水平及其临床意义.方法:应用实时荧光定量逆转录聚合酶链反应(RT-PCR)技术对40例胃癌患者的癌组织、40例癌旁胃炎组织及21例慢性胃炎患者的慢性胃炎组织中hMLH1 mRNA进行定量检测,以三磷酸甘油醛脱氢酶基因(hGAPDH)为内参照.结果:胃癌组织、癌旁胃炎组织、慢性胃炎组织中hMLH1 mRNA的相对含量分别是7.23±1:11.91,3.80±5.13,2.01±1.25,三组相比差异有统计学意义(F=3.272,P=0.042),胃癌组织中hMLH1mRNA含量明显高于其他两组,癌旁胃炎组织中含量明显高于非胃癌惠者慢性胃炎组织中的含量(P＜0.05);除hMLH1 mRNA含量在有、无淋巴结转移的胃癌组织中有显著差异(P＜0.05)外,hMLH1 mRNA在胃癌组织中含量受肿瘤直径、浸润深度影响不大(P＞0.05).结论:胃癌组织和癌旁慢性胃炎组织与慢性胃炎组织相比存在hMLH1 mRNA转录差异,这种基因的转录差异可能与胃癌的发生有关,而与胃癌的发展关系不显著.     

Gene expression profile and mutational analysis of DNA mismatch repair genes in carcinoma prostate in Indian population

DNA mismatch repair (MMR) plays a role in promoting genetic stability by repairing DNA replication errors, inhibiting recombination between nonidentical DNA sequences, and participating in responses to DNA damage. Although the role of MMR in prostate carcinogenesis remains unclear, MMR deficiency in Carcinoma Prostate (Pca) could prove to be clinically significant. Thus, the present study investigated the gene expression profile of six major MMR genes, viz. hMLH1, hMSH2, hPMS1, hPMS2, hMSH3, and hMSH6, and polymorphism in hMLH1 and hMSH2 in Pca in Indian population. Further, correlation with clinicopathological parameters was evaluated to establish their role as a potential prognostic marker. A significant downregulation of hMLH1, hMSH2, and hPMS2 expression was observed in Pca compared to benign prostatic hyperplasia (BPH). A greater loss of hPMS2 protein in poorly differentiated tumors was demonstrated, which was in concordance with a significant inverse correlation of hPMS2 gene expression with the Gleason score indicating its significance as a marker for Pca progression. An important association of hMLH1-93G>A polymorphism with the risk of Pca was also identified. The results of the present study suggest that an altered MMR has important biological and clinical significance in Pca in Indian population.     

The frequency of hereditary defective mismatch repair in a prospective series of unselected colorectal carcinomas

A comprehensive analysis of somatic and germline mutations related to DNA mismatch-repair (MMR) genes can clarify the prevalence and mechanism of inactivation in colorectal carcinoma (CRC). In the present study, 257 unselected patients referred for CRC resection were examined for evidence of defective DNA MMR. In particular, we sought to determine the frequency of hereditary defects in DNA MMR in this cohort of patients. MMR status was assessed by testing of tumors for the presence or absence of hMLH1, hMSH2, and hMSH6 protein expression and for microsatellite instability (MSI). Of the 257 patients, 51 (20%) had evidence of defective MMR, demonstrating high levels of MSI (MSI-H) and an absence of either hMLH1 (n=48) or hMSH2 (n=3). All three patients lacking hMSH2, as well as one patient lacking hMLH1, also demonstrated an absence of hMSH6. DNA sequence analysis of the 51 patients with defective MMR revealed seven germline mutations-four in hMLH1 (two truncating and two missense) and three in hMSH2 (all truncating). A detailed family history was available for 225 of the 257 patients. Of the seven patients with germline mutations, only three had family histories consistent with hereditary nonpolyposis colorectal cancer. Of the remaining patients who had tumors with defective MMR, eight had somatic mutations in hMLH1. In addition, hypermethylation of the hMLH1 gene promoter was present in 37 (88%) of the 42 hMLH1-negative cases available for study and in all MSI-H tumors that showed loss of hMLH1 expression but no detectable hMLH1 mutations. Our results suggest that, although defective DNA MMR occurs in approximately 20% of unselected patients presenting for CRC resection, hereditary CRC due to mutations in the MMR pathway account for only a small proportion of patients. Of the 257 patients, only 5 (1.9%) appear to have unequivocal evidence of hereditary defects in MMR. The epigenetic (nonhereditary) mechanism of hMLH1 promoter hypermethylation appears to be responsible for the majority of the remaining patients whose tumors are characterized by defective DNA MMR.     

Endometrial Cancer as a Familial Tumor: Pathology and Molecular Carcinogenesis (Review)

Some cases of endometrial cancer are associated with a familial tumor and are referred to as hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome). Such tumors are thought to be induced by germline mutation of the DNA mismatch repair (MMR) gene, but many aspects of the pathology of familial endometrial cancer are unclear and no effective screening method has been established. However, the pathology of endometrial cancer with familial tumor has been progressively clarified in recent studies. At present, about 0.5% of all cases of endometrial cancers meet the clinical diagnostic criteria for HNPCC. A recent analysis of the three MMR genes (hMLH1, hMSH2 and hMSH6) revealed germline mutations in 18 of 120 cases (15.0%) of endometrial cancer with familial accumulation of cancer or double cancer, with a frameshift mutation of the hMSH6 gene being the most common. Many cases with mutation did not meet the current clinical diagnostic criteria for HNPCC, indicating that familial endometrial cancer is often not diagnosed as HNPCC. The results suggest that the hMSH6 gene mutation may be important in carcinogenesis in endometrial cancer and germline mutations of the MMR gene may be more prevalent in cases associated with familial accumulation of cancer. An international large-scale muticenter study is required to obtain further information about the pathology of endometrial cancer as a familial tumor.Key Words: HNPCC, Endometrial cancer, DNA mismatch repair gene, hMLH1, hMSH6.     

脑胶质瘤患者组织和血清MGMT、hMLH1和hMSH2基因启动子甲基化状态检测

目的探讨脑胶质瘤患者组织和血清中MGMT、hMLH1和hMSH2基因启动子CpG岛甲基化发生率及相关性。方法甲基化特异性PCR（MSP）检测39例脑胶质瘤组织样本及32例预处理的脑胶质瘤血清样本中MGMT、hMLH1和hMSH2基因启动子区的甲基化状态。结果脑胶质瘤组织MGMT、hMLH1和hMSH2基因启动子区甲基化发生率分别为46．2％、10．3％和20．5％,肿瘤组织中至少有一种基因甲基化的发生率为64．1％（25／39）;在脑胶质瘤患者外周循环血液中检测到了相关基因甲基化系列,并且与组织中基因甲基化发生率明显相关。结论MGMT、hMLH1和hMSH2基因启动子甲基化是脑胶质瘤发生过程中常见的分子事件,血清中相关基因DNA甲基化检测有可能为脑胶质瘤诊断和个体化化疗提供一种稳定的无创性检测指标。     

Muir-Torre phenotype has a frequency of DNA mismatch-repair-gene mutations similar to that in hereditary nonpolyposis colorectal cancer families defined by the Amsterdam criteria.

Muir-Torre syndrome (MTS) is an autosomal dominant disease defined by the coincidence of at least one sebaceous skin tumor and one internal malignancy. About half of MTS patients are affected by colorectal cancer. In a subgroup of MTS patients the disease has an underlying DNA mismatch-repair (MMR) defect and thus is allelic to hereditary nonpolyposis colorectal cancer (HNPCC). The purpose of this study was to examine to what extent germ-line mutations in DNA MMR genes are the underlying cause of the MTS phenotype. We ascertained 16 MTS patients with sebaceous skin tumors and colorectal cancer, and we examined their skin and visceral tumors for microsatellite instability. All the patients exhibited high genomic instability in at least one tumor. The search for germ-line mutations in the hMSH2 and hMLH1 genes in 13 of the MTS patients revealed truncating mutations in 9 (69%): eight mutations in the hMSH2 gene and one in the hMLH1 gene. This is the first systematic search for germ-line mutations in patients ascertained on the basis of sebaceous skin tumors. Our results indicate that (1) MTS patients exhibit significantly more mutations in the hMSH2 gene than in the hMLH1 gene; and (2) the subpopulation of MTS patients who are also affected by colorectal cancer, irrespective of family history and age at onset of tumors, may have a likelihood for an underlying DNA MMR defect similar to that for patients with a family history fulfilling the strict clinical criteria for HNPCC.     

ERK_2在食管鳞状细胞癌组织中的表达及临床意义

目的研究ERK2在食管鳞状细胞癌组织中的表达及临床意义。方法应用免疫组化S-P法检测食管正常黏膜、癌旁组织及食管癌组织中ERK2表达状况。结果食管正常黏膜、癌旁组织及食管癌组织中ERK2表达率分别为20.0%(4/20)、45.7%(16/35)及86.2%(81/94),食管癌组织中ERK2表达率明显高于正常黏膜及癌旁组织组(P<0.05)。正常黏膜组和癌旁组织组ERK2表达率无明显差异(P>0.05),食管癌组织中ERK2表达与患者年龄、性别、肿瘤浸润深度、组织分化、淋巴结转移、临床分期及其它临床病理因素无关(P>0.05)。结论ERK2过表达在食管癌发生中起重要作用,单独检测ERK表达可能无助于判断患者的预后。