子宫颈癌放疗的康复护理

目的：探讨子宫颈癌放射治疗的康复护理方法。方法：采用科普宣传、康复期指导、放射治疗前康复指导、并发症护理和出院后康复指导等方法对放射治疗的患者进行护理。结果：科学的康复护理使患者均能耐受高剂量放射治疗,提高了患者的生存质量,5年生存率明显提高。结论：科学护理是宫颈癌患者放射治疗期和康复期的重要手段。     

青藤碱抑制人宫颈癌的研究

目的：研究青藤碱（sinomenine,SIN）对宫颈癌Hela细胞增殖的影响及其机制,为SIN在宫颈癌的预防和治疗上提供实验依据。方法：不同浓度SIN分别处理体外培养的人宫颈癌细胞系Hela细胞后,采用噻唑蓝（Mar）法检测处理24h、48h、72h后Hela细胞的增殖活性,流式细胞仪测定细胞周期和细胞凋亡。结果：1．0．1、0．2、0．4、0．625、1．25、2．5mmml／L SIN处理Hela细胞24h、48h、72h后,细胞增殖明显受到抑制,呈时间和剂量依赖性特点;2．流式细胞仪细胞周期分析表明,SIN处理组G1期细胞比例明显增加,S期细胞比例明显减少,两组比较有统计学意义;3．细胞凋亡分析表明,SIN处理组细胞凋亡率较对照组升高,呈时间和剂量依赖性特点;结论：SIN在体外能有效抑制宫颈癌细胞生长,其机制可能与其阻滞细胞周期、诱导细胞凋亡有关,SIN有望应用于宫颈癌的辅助治疗。     

未绝经宫颈癌患者肿瘤组织中环氧合酶2的表达及其临床意义

目的探讨环氧合酶2(COX-2)在宫颈癌组织中的表达与月经周期的关系及其临床意义。方法选取47例未绝经宫颈癌手术病人,病史结合子宫内膜HE染色观察判断患者所处月经周期时段,采用免疫组织化学SP法检测宫颈癌组织中COX-2及增殖细胞核抗原(PCNA)的表达,计算机图像分析COX-2免疫染色密度值及PCNA标记指数(LI)。结果宫颈癌组织中COX-2表达阳性者增生期表达强于分泌期(P<0.05),但阳性率无显著性差异(P>0.05),COX-2阳性癌组织中PCNALI高于阴性者,差异有显著性(P<0.01)。有淋巴结转移者COX-2的表达高于无转移者(P<0.05),宫颈癌组织中COX-2的表达与FIGO临床分期、组织分化程度无显著相关性(P>0.05)。结论未绝经宫颈癌患者肿瘤组织中COX-2的表达在增生期较分泌期明显增加,并参与调节肿瘤的生长、转移。     

High TMPRSS4 expression is a predictor of poor prognosis in cervical squamous cell carcinoma

Objective The aim of this study was to clarify the clinical role of TMPRSS4 expression in cervical squamous cell carcinoma (CSCC) and to investigate the role of TMPRSS4 in predicting outcomes of patients with CSCC. Methods The retrospective study enrolled 87 patients diagnosed with CSCC between 2004 and 2006. TMPRSS4 expression in CSCC was assessed by immunohistochemistry, and data on clinical variables were collected by retrospective chart review. The impact of TMPRSS4 expression on 5-year disease-free survival (DFS) and 5-year overall survival (OS) was assessed by Kaplan–Meier analysis and Cox proportional hazards modeling. Results The high expression of TMPRSS4 was 63.2% in 87 patients with CSCC, and 17.5% in 40 patients with benign cervical disease (P < 0.001). High TMPRSS4 expression was significantly associated with tumor grade (P = 0.005), lymph node metastasis (P = 0.004), and deep cervical stromal invasion (P = 0.025). Patients with high expression of TMPRSS4 had shorter OS and DFS than those with low expression (P = 0.0205 and P = 0.0318, respectively). In multivariate Cox regression analysis, high expression of TMPRSS4 was a potential prognostic indicator for OS (P = 0.041) and DFS (P = 0.015). Conclusion Our findings suggest that TMPRSS4 might play an important role in the progression of CSCC. TMPRSS4 could be a potential prognostic marker of CSCC.     

人乳头瘤病毒与宫颈癌前病变的相关性研究

目的：探讨人乳头瘤病毒感染与宫颈癌前病变两者之间的相关性。方法：选择2009年11月～2011年12月来我院就诊的220例宫颈病变患者为研究对象,将患者分成4组,即炎症组、CINl组、CIN2组和CIN3组,各组进行人乳头瘤病毒检出率及病毒载量的比较。结果：炎症组、CINl、CIN2和CIN34组人乳头瘤病毒的检出率分别为67．2％、80％、87．3％和91．4％且4组之间比较差异有显著统计学意义（P〈O．001）。炎症组HPV感染的阳性率与CIN组比较显著降低（P〈0．005）,宫颈癌前病变各组HPV感染呈阳性的病毒载量差异有统计学意义（P〈0．05）。结论：宫颈癌前病变的严重程度和感染高危型HPV病毒载量呈正相关,随着感染高危型HPV病毒载量越高,宫颈癌前病变的程度越严重。     

Seasonality in the Incidence of Cervical Carcinoma in Teenagers and Young Adults in Northern England, 1968–2005

Infection with human papillomavirus is an established risk factor for cervical carcinoma. However, the role of other environmental factors is less well established. To further investigate whether other agents may be involved, the authors have analyzed seasonal variation in cervical cancer with respect to month of birth and separately month of diagnosis. All 85 cases diagnosed in 15–24-yr-olds during the period 1968–2005 were extracted from the specialist population-based Northern Region Young Persons' Malignant Disease Registry. The chi-square heterogeneity test was used to assess overall nonuniform variation in month of birth and separately month of diagnosis. Poisson regression analysis was used to fit sinusoidal (harmonic) models to the data using month of birth and month of diagnosis in separate models. Based on month of birth, there was statistically significant heterogeneity (p?=?.03) and a significant sinusoidal pattern, with an incidence peak involving births in the autumn months (p?=?.03). Based on month of diagnosis, there was marginally significant heterogeneity (p?=?.06). The evidence of seasonal variation around time of birth for cervical carcinoma is highly novel and suggests possible early etiological involvement of environmental factors. (Author correspondence: Richard.McNally@ncl.ac.uk)     

SIRT1在宫颈癌细胞耐药中的作用及其机制研究

摘要目的：探讨沉默交配型信息调节因子2同源蛋白1（silentmatingtypeinformationregulation2homologyl,SIRTl）在宫颈癌化疗耐药中的作用及其机制。方法：体外培养人宫颈癌Hela细胞系和宫颈癌Hela／MMC耐药细胞亚系,westernblotting检测MMC对Hela和Hela／MMC细胞内SIRTl蛋白表达的影响;MTT法检测MMC及Nicotinamide对Hela和Hela／MMC细胞增殖的影响;AnnexinV-PI试验检测Hela／MMC细胞凋亡的亡的情况;RT—PCR方法检测耐药相关蛋白P—gP的mRNA表达情况。结果：正常情况下,Hela／MMC细胞中SIRTl的表达显著高于Hela细胞（P〈0．05）,MMC处理的Hela／MMC细胞中SIRTl的表达显著高于未经MMC处理（P〈0．05）。Nicotinamide对Hela和Hela／MMC细胞具有相似的生长抑制作用,Nicotinamide可使MMC诱导的Hela／MMC细胞凋亡增加,同时降低细胞内P-gP的mRNA表达（P〈0．05）。结论：SIRTl表达下调能显著减轻Hela／MMC细胞对MMC的耐药性,其作用可能与P—gp有关。     

兰州市门诊病人人乳头瘤病毒（HPV）感染与宫颈病变相关性分析

目的：了解兰州市门诊病人人乳头瘤病毒（HPV）感染情况、年龄分布及与宫颈病变相关性,免疫组化法测不同宫颈病变组中P16表达,了解P16在筛查宫颈癌及其癌前病变中的作用。方法：收集兰州市2009年10月至2011年3月782例门诊女病人,核酸分子快速导流杂交基因芯片技术（HyBrimax）对宫颈脱落细胞行HPV分型检测,分析门诊病人中HPV感染状况及年龄分布。部分细胞学异常或高危HPV阳性者阴道镜下宫颈活检,病理检查宫颈病变程度及与HPV感染相关性,免疫组化法检测宫颈组织中P16蛋白表达情况。结果：兰州市门诊782例病人中,HPV阳性率28.64%（224/782）,21种亚型检测出17种,排在前5位亚型分别为HPV16、HPV58、HPV68、HPV52、HPV33,各年龄组间HPV感染差异有统计学意义（P〈0.05）,21-30岁之间感染占37.42%。117例病检组织中,HPV在正常/炎症、CINⅠ、CINⅡ-Ⅲ、ICC组中阳性率分别为35.55%、65.60%、88.46%、100%,各组间HPV感染差异有统计学意义（P〈0.01）,同时P16表达依次增高,阳性率分别为22.22%、56.25%、84.61%、100%,组间差异有统计学意义（X2=36.124,P=0.001）。结论：兰州市门诊病人HPV感染阳性率为28.64%,各年龄组间感染差异有统计学意义,随宫颈病变加重,HPV检出率及P16蛋白表达均增高,二者联合检测有助于早期诊断及治疗。     

Synergistic antitumor activity of reversine combined with aspirin in cervical carcinoma in vitro and in vivo

A recent report showed that reversine treatment could induce murine myoblasts dedifferentiation into multipotent progenitor cells and inhibit proliferation of some tumors, and other reports showed that apoptosis of lung adenocarcinoma cells could be induced by aspirin. The aim of the present study was to evaluate the synergistic antitumor effects of reversine and aspirin on cervical cancer. The inhibition rate of reversine and aspirin on cervical cancer cell lines’ (HeLa and U14) was determined by MTT method, cell cycle of HeLa and U14 cells was analyzed by FACS, mitochondrial membrane potential of HeLa and U14 was detected using a JC-1 kit. HeLa and U14 colony formation was analyzed by soft agar colony formation assay. The expression of caspase-3, Bcl-2/Bax, cyclin D1 and p21 was detected by qRT-PCR and Western Blotting. Moreover, tumor weight and tumor volume was assessed using a murine model of cervical cancer with U14 cells subcutaneously (s.c.) administered into the neck, separately or combined with drug administration via the intraperitoneal (i.p.) route. The inhibition rate of cells in the combination group (10 μmol/L reversine, 10 mmol/L aspirin) increased significantly in comparison to that when the drugs were used alone (P < 0.05); moreover, this combination could synergistically inhibit the proliferation of five cervical cancer cell lines (HeLa, U14, Siha, Caski and C33A). In the therapeutic mouse model, tumor weight and tumor volume of cervical cancer bearing mice was more reduced when compared with the control agents (P < 0.05) in tumor-bearing mice. The combination of reversine and aspirin exerts synergistic growth inhibition and apoptosis induction on cervical cancers cells.     

TSHR蛋白在宫颈癌的表达及其与HPV-16感染的关系

目的研究促甲状腺激素受体（TSHR）在子宫颈癌组织的表达及其与乳头瘤病毒（HPV－16）的关系。方法应用免疫组织化学链霉菌抗生物素过氧化物酶（SP）法检测79例子宫颈癌和30例子宫颈炎组织HPV－16与TSHR蛋白表达。79例癌症患者中病理分级〈Ⅱ级33例,≥Ⅱ级46例;病理分期〈Ⅱ期56例,≥Ⅱ期23例;无淋巴结转移66例,有淋巴结转移13例;肿瘤大小〈3cm44例,肿瘤大小≥3cm35例。结果HPV－16在子宫颈癌表达率55．70％明显高于宫颈炎5％（P〈0．05）,TSHR在子宫颈癌表达率68．35％明显高于宫颈炎26．67％（P〈0．05）。HPV－16表达与肿瘤的大小、肿瘤分级、分期、淋巴结转移不相关。TSHR表达与肿瘤的大小呈正相关,P〈0．05,与肿瘤分级、分期及淋巴结转移不相关。HPV－16与TSHR在宫颈癌表达呈正相关。结论HPV感染对宫颈癌病变起到强烈的预警作用。TSHR不仅在甲状腺滤泡上皮细胞表达,在子宫颈癌细胞也表达,TSHR过表达能促进宫颈细胞的异常增殖,其异常功能可能是恶性肿瘤特定的临床表型。HPV与TSHR在子宫颈癌变过程中起协同作用。