扩散加权成像在宫颈癌诊断中的应用及与病理相关性分析

目的:分析宫颈癌扩散加权成像特征及与病理相关性。方法:选取100例宫颈癌患者为观察组,100例健康志愿者为对照组,均接受磁共振检查。观察组患者均行病理学检查,并测定微血管密度。观察宫颈癌磁共振特征,并分析其与病理相关性。结果:1.磁共振共确诊宫颈癌97例,诊断符合率为97.0%。与病理分期比较,磁共振分期正确84例,正确率为84%。2.观察组宫颈癌病变区ADC值平均为(0.893±0.098)s/mm2,显著低于对照组的(1.623±0.132)s/mm2,差异具有统计学意义(P0.05)。病理分期Ⅲ、Ⅳ其病变ADC值及MVD值显著低于Ⅰ、Ⅱ期病变,差异具有统计学意义(P0.05)。经pearson相关分析,宫颈癌ADC值与MVD值间呈显著负相关(r=-0.502,P=0.011)。结论:在宫颈癌的诊断中,磁共振具有很高应用价值。宫颈癌病变于扩散加权成像呈高信号,其ADC值显著低于正常宫颈组织,且与MVD呈显著负相关。     

C/EBPα在非小细胞肺癌中的表达及其与微血管密度的关系

目的:探讨C/EBPα在非小细胞肺癌(non-small cell lung cancer,NSCLC)组织中的表达及其与肿瘤微血管密度(microvessel density,MVD)的关系.方法:应用免疫组织化学EnVision法检测40例手术切除的NSCLC组织及其配对的40例距肿瘤＞5 cm以上癌旁正常肺组织中C/EBPα蛋白的表达,并分析C/EBPα在NSCLC中的表达与其临床病理特征的关系.采用CD34标记肺癌组织中的肿瘤微血管,分析C/EBPα的表达与肿瘤MVD的关系.结果:NSCLC组织中C/EBPα的阳性表达率明显低于癌旁正常肺组织(P＜0.05).C/EBPα与NSCLC患者的年龄、性别、TNM分期及有无淋巴结转移均无关(P＞0.05),与NSCLC组织的分化程度及病理类型有关(P＜0.05).在NSCLC组织中,C/EBPα蛋白表达阳性组MVD明显低于C/EBPα蛋白表达阴性组(P＜0.05).结论:C/EBPα在NSCLC中的低表达可能通过调节MVD介导NSCLC的发生和发展.     

骨肉瘤中血管生成拟态与HIF-1α蛋白的关系及临床意义

目的检测骨肉瘤中血管生成拟态(vasculogenic mimicry,VM)和缺氧诱导因子-1α(HIF-1α)的关系及临床意义,旨在探寻影响骨肉瘤进展及预后的有效指标。方法采用CD34和PAS套染法检测108例骨肉瘤及28例骨软骨瘤中VM、微血管密度(Microvessel density,MVD)及HIF-1α表达水平差异,并分析其与骨肉瘤患者临床病理因素及5年存活率之间的关系。结果骨肉瘤组织中VM、HIF-1α过表达及MVD≥22的阳性率分别为62.96%(68/108)、57.41%(62/108)和58.33%(63/108),骨软骨瘤中分别为0%(0/28)、32.14%(9/28)和28.57%(8/28)(P<0.05);VM、HIF-1α过表达及MVD与骨肉瘤分级、远处转移及软组织浸润和Enneking分期有关(P<0.05),与患者年龄、性别、部位、肿瘤大体、组织学类型和直径无关(P>0.05);骨肉瘤中VM、HIF-1α过表达与MVD之间呈正相关(P<0.05);VM阳性、HIF-1α过表达及MVD≥22组患者5年存活率分别为8.82%(6/68)、8.06%(5/62)和3.17%(2/63);VM阴性、HIF-1α低表达及MVD<22组分别为87.5%(35/40)、78.26%(36/46)和86.67%(39/45)(P<0.05);Cox多因素分析提示VM、HIF-1α、MVD、远处转移、软组织浸润和Enneking分期是影响骨肉瘤患者预后的独立危险因素(P<0.05)。结论 VM可能是判断骨肉瘤预后的新指标,联合检测VM、HIF-1α及MVD对骨肉瘤的侵袭、转移及预后判断有重要意义。     

A Role for the Endothelial Glycocalyx in Regulating Microvascular Permeability in Diabetes Mellitus

Diabetic angiopathy is a major cause of morbidity and mortality in diabetes mellitus. Endothelial dysfunction and associated alterations in blood flow, pressure and permeability are widely accepted phenomena in the diabetic milieu and are understood to lead to microangiopathy. Despite the clinical importance of diabetic microangiopathy, the mechanisms of pathogenesis remain elusive. In particular, much is yet to be understood about the nature of the putative increased permeability with respect to diabetes. Microvessel permeability is intrinsically difficult to measure and a surrogate (solute or solvent flux) is usually reported, the measurement of which is hampered by haemodynamic factors, such as flow rate, hydrostatic pressure gradient, solute concentration and surface area available for exchange. Very few studies describing the measurement of permeability with respect to diabetes have controlled for all these factors. As a result, the nature of the increased microvessel permeability in diabetes mellitus and indeed its causes are poorly understood. Recent studies have shown that hyperglycaemia can alter the glycocalyx structure, and parallel findings have shown that the apparent increase in permeability demonstrated in hyperglycaemia may be due to an increase in the permeability of the vessels to water, and not an increase in protein permeability, an effect attributable to altered glycocalyx. This review focuses on the current understanding of microvascular permeability in terms of the endothelial glycocalyx- fibre-matrix theory, those methods used to determine permeability in the context of diabetes, and the more recent developments in our understanding of elevated microvascular permeability in the diabetic circulation.     

不同性质甲状腺结节与微血管密度关系的研究

目的:探讨不同性质甲状腺结节与微血管密度关系,提高认识.方法:分别选取甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织,病理切片行常规HE染色及免疫组化SP染色.在高倍视野(×400)下选取5个血管着色密集区进行计数并取其平均数,MVD值=(n1 +n2+n3+n4+n5)/5.结果:(1)甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织平均MVD值分别为(65.54±19.21)个/HP、(54.54±11.76)个/HP、(47.85± 10.92)个/HP、(21.82±7.43)个/HP,甲状腺乳头状癌MVD值显著高于甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织(P＜0.05).甲状腺腺瘤、结节性甲状腺肿MVD值显著高于正常甲状腺组织(P＜0.05).(2)伴有淋巴结转移的甲状腺乳头状癌患者MVD值显著高于不伴有淋巴结转移者(P＜0.05);男性甲状腺乳头状癌患者MVD值显著高于女性患者(P＜0.05);＞40岁及≤40岁甲状腺乳头状癌患者MVD值间无统计学差异(P＞0.05).结论:甲状腺乳头状癌MVD值显著高于甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织,且伴有淋巴结转移的甲状腺乳头状癌患者MVD值显著高于不伴有淋巴结转移者.     

脊髓组织内微血管过氧化物酶组织化学染色方法的实验研究

本文以正常及损伤脊髓组织为材料,对内源性过氧化物酶染色显示微血管的方法进行了实验研究。结果,组织用10％缓冲福尔马林4℃固定6—12小时,或微波固定40～120秒,冰冻切片30～50μm、DAB-NiCl显示血管最好。该方法不用灌注,对血管无扩张、破裂作用,无人为改变,可以定量或半定量判定组织器官活体时的血液循环,可用于正常及损伤脊髓组织内微血管形态学研究和定量分析。     

周细胞覆盖率与胃癌侵袭相关性的分析

目的:探讨周细胞在胃癌血管周围的覆盖率是否可以作为判断胃癌预后的一个指标。方法:利用免疫组织化学双染的方法同时标记内皮细胞(抗CD34抗体)和周细胞(抗α-SMA抗体),检测48例胃癌石蜡标本当中微血管壁周细胞覆盖率(microvessel pericyte coverage index,MPI),应用SPSS11.5统计软件分析MPI与胃癌患者性别、年龄、肿瘤大小、浸润深度、淋巴结转移、临床分期、以及脉管内是否有癌栓等临床病理参数之间的关系。结果:MPI与胃癌的分化程度呈正相关(P=0.002),与脉管内是否有癌栓呈负相关(P=0.002),而与患者年龄、性别、肿瘤大小、浸润深度、临床分期、淋巴结转移等无关(P均0.05)。结论:利用免疫组织化学双染的方法可以清晰标记胃癌的微血管结构,血管的不成熟即周细胞覆盖率低成为胃癌患者预后差的重要因素。     

Morphology of hypoxia following cryoablation in a prostate cancer murine model: Its relationship to necrosis, apoptosis and, microvessel density

The aim of this study is to investigate the tumor tissue changes in terms of hypoxia and demonstrate its relationship to vascularity and apoptosis following therapeutic cryoablation in a prostate tumor murine model. Total 67 male C57BL/J6 mice were assigned into sham-operation group and cryoablation group. Murine prostate tumors (RM-9) were inoculated subcutaneously in a right hind leg and treated with cryotherapy. Of 30 mice, tumor volumes were measured for 12 days following operation. Of 37 mice, tumor tissues were harvested in 24 h following operation, and histological/molecular changes were analyzed. Hematoxylin and eosin or immunohistochemical staining were utilized to quantify tumor necrosis, hypoxia (pimonidazole), vascularization (CD31), and apoptosis (cleaved caspase-3). The results showed that cryoablated tumors demonstrated significant delayed growth following treatment compared to controls. Pathological analysis revealed that the severity of hypoxia increased in the cryoablation arm compared to controls. Necrotic and apoptotic populations were also found to be increased in the cryoablation arm (P = 0.028 and 0.021). Hypoxia demonstrated a positive correlation with necrosis (r = 0.520, P = 0.001) and apoptosis (r = 0.474, P = 0.003), while showing negative correlation with microvessel density (MVD) (r = −0.361, P = 0.021). We concluded that in the peripheral areas from the cryoneedle impact site, strong hypoxic responses were found, which may play important role in tumor freezing injury. To our knowledge, this is the first report describing cryoablation-mediated changes of hypoxia at a molecular level in the prostate cancer murine model.     

胃癌中TAMs与血管生成及转移相关性的分析

目的：研究胃癌中肿瘤相关巨噬细胞（tumor associated macrophages,TAMs）的表达及其与肿瘤血管生成的关系,进而分析其与转移的相关性。方法：利用免疫组化双染方法同时标记TAMs（抗CD68抗体）和内皮细胞（抗CD34抗体）,检测90例胃癌中TAMs、微血管密度（microvessel density,MVD）。结果：①TAMs与胃癌的大小、淋巴结转移、远处转移呈显著正相关（P均〈0.05）;②MVD与胃癌的远处转移呈显著正相关（P均〈0.05）;③在胃癌组织中TAMs与MVD的表达呈显著的正相关（r=0.325,P=0.002）。结论：TAMs可能通过促进胃癌血管的生成,进而促进胃癌细胞发生血管内渗,最终实现胃癌细胞的转移。     

多孔自凝固磷酸钙/纤维蛋白1∶1比例血管化的分析研究

目的:观察复合纤维蛋白的多孔自凝固磷酸钙的理学性能及体内血管化情况,探讨其各组份对材料生物学特性的影响,为其临床应用提供实验数据.方法:1)采用凝固时间测定和电镜观察材料表面和断面等方法对复合支架材料构造和理学性能进行分析;2)将24只新西兰白兔随机分为3组,每组8只,分别在每只实验兔腰背筋膜下植入1:1、CPC两种比例材料各一枚.术后2、4、8周进行取材,对材料及其周围组织进行组织学观察、微血管情况定量分析.结果:1)CPC/FG复合支架材料以1∶1(g/ml)混合后,与单纯的CPC相比,初凝时间延长,而终凝时间没有明显的统计学差异;电镜观察发现多孔自凝固磷酸钙复合了纤维蛋白胶之后,纤维蛋白胶分布均匀贯穿多孔自凝固磷酸钙晶体之间,并将其紧密相连;2)术后2周材料外周可见幼稚的微血管.1∶1组高于CPC组(P＜0.05).4周微血管密度达到高峰,相对于2周时有明显差异.1∶1组高于CPC组(P＜0.05).8周时微血管密度相对4周没有显著差异.各组微血管密度与4周时没有明显变化(P＞0.05).结论:复合支架材料具有合适的凝固时间和较好的结构,纤维蛋白胶及其降解产物影响复合材料在体内的微血管密度,使复合材料血管化能力提高,其可作为细胞载体和骨缺损修复支架材料应用于临床和实验中.