口腔鳞癌组织细胞凋亡相关蛋白Fas/FasL的表达研究

目的　研究调亡相关蛋白Fas、FasL在口腔鳞状细胞癌组织中的表达及意义。方法　应用免疫组织化学方法检测 10例正常口腔粘膜、 38例口腔鳞癌组织及肿瘤浸润淋巴细胞 (TIL)和 11例转移淋巴结中Fas、FasL的表达。结果　Fas在正常口腔粘膜中广泛表达 ;鳞癌组织表达明显下调 (P <0 .0 5 ) ;Fas表达与口腔鳞癌分化程度有关 ;淋巴结转移癌中Fas表达减弱。FasL在正常口腔粘膜不表达 ;鳞癌组织表达明显上调 (P <0 .0 5 ) ;FasL表达与口腔鳞癌分化程度无关 (P >0 .0 5 ) ;有淋巴结转移者FasL阳性表达率高于无转移者 (P <0 .0 5 )。TIL细胞Fas、FasL阳性表达率为 81.6 %和 84 .2 % .。Fas、FasL在口腔鳞癌的表达有明显相关性 (P <0 .0 5 )。结论　Fas表达与口腔粘膜上皮细胞的自然分化成熟衰老及口腔鳞癌的形成和肿瘤的恶性度有关。FasL的表达上调可能是口腔鳞癌组织免疫反攻击的体现 ,对促进肿瘤的发生发展及转移有重要作用。     

微小RNAmiR-21和miR-31在13腔鳞癌组织中的表达及意义

目的：检测口腔鳞癌中微小RNA miR-21和miR-31的表达,探讨其与肿瘤发展的关系。方法：应用实时荧光定量PCR的方法检测72例口腔鳞癌,38例正常口腔粘膜miR-21和miR-31的表达,统计学分析其表达与肿瘤临床分期和病理分型的关系。结果：①口腔鳞癌组织与对照组比较,微小RNA miR-21和miR-31的表达都有显著增高（P〈0.05）,其中miR-21的增高更为显著（P〈0.001）。②统计学分析表明,miR-21的表达在晚期鳞癌组织较早中期鳞癌组织增高更为显著（P〈0.01）,在低分化鳞癌组织较中、高分化鳞癌组织增高更为显著（p〈0.001）;MiR-31的表达水平在不同肿瘤临床分期和病理分型鳞癌组织中无明显差异（P〉0.05）。结论：miR-21和miR-31在口腔鳞癌发生发展过程中表达有明显增高,其中miR-21表达水平可作为潜在的口腔鳞癌临床分期分级和预后的指标。     

MACC1和C-Met在口腔白斑和口腔鳞状细胞癌中的表达及意义

目的:探讨分析MACC1和C-Met在正常口腔黏膜、口腔白斑及口腔鳞状细胞癌中的表达及其临床意义。方法:采用免疫组化SP法检测20例口腔黏膜、20例上皮异常增生白斑、50例口腔鳞癌组织中的MACC1、C-Met蛋白的表达情况,采用X2和spearman等级相关分析对结果进行判定。结果:MACC1、C-Met蛋白在异常增生型白斑和口腔鳞癌中的阳性表达率分别为50%、76%,35%、66%,均明显高于正常口腔黏膜(17.6%,5.0%),差异均有统计学意义(P0.05)。MACC1和C-Met蛋白表达与口腔鳞癌的分期、淋巴结转移及分化程度密切相关(P0.05)。Spearman等级相关分析显示口腔白斑及口腔鳞癌中MACC1和C-Met的表达呈现正相关(P0.05)。结论:MACC1和C-Met在上皮不典型增生性白斑和口腔鳞癌中高表达,二者在口腔黏膜白斑的癌变和口腔鳞癌的发生发展中可能起重要作用。     

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。     

人口腔鳞癌组织中HIF—1a和NF—κB的表达及意义

目的：探讨缺氧诱导因子（HIF—1a）和核因子-κB（NF—κB）口腔鳞癌中的表达及相互关系,研究它们的表达与肿瘤临床病理指标的联系。方法：应用SP染色法检测HIF—1a和NF—κB在49例口腔鳞癌组织、10例正常口腔黏膜组织中的阳性率。结果在口腔鳞癌中HIF—1a和NF—κB的阳性表达率分别为80．0％和78．4％,其阳性率及表达等级均显著高于正常对照组（P〈0．05）,在中-低分化组和有淋巴结转移组中的表达显著高于高分化组和无淋巴结转移组（P〈0．05）。HIF—1a表达与NF—κB表达成等级正相关（r=0．45,P〈0．05）。结论：HIF-1a或NF—κB与口腔鳞癌生物学行为有密切关系,二者的联合检测,有助于口腔鳞癌恶性程度和生物学特性的判断。     

中国地鼠口腔颊囊黏膜癌变过程凋亡相关基因caspase-3、caspase-9、Bax、Bcl-2的表达

目的探讨凋亡相关基因caspase-3、caspase-9、Bax、Bcl-2在中国地鼠口腔正常黏膜、上皮单纯增生、上皮异常增生和鳞状细胞癌组织中的表达及其意义。方法采用免疫组织化学法、RT-PCR检测正常中国地鼠口腔黏膜上皮、单纯增生上皮、异常增生上皮和鳞癌组织中caspase-3、caspase-9、Bax、Bcl-2蛋白及mRNA的表达。结果在口腔黏膜癌变过程中,鳞癌组织中抑制凋亡蛋白Bcl-2表达明显高于口腔正常黏膜、上皮单纯增生、上皮异常增生(P0.05);异常增生上皮caspase-3、caspase-9、Bax表达均明显高于正常组(P0.05),但随着增生程度的加重,caspase-3、caspase-9、Bax表达明显降低(P0.05)。相关性分析显示,鳞癌组织中Bcl-2与Bax、caspase-3、caspase-9呈负相关(P0.05)。RT-PCR结果表明,与正常组织相比,鳞癌组织中Bcl-2高表达,而caspase-3、caspase-9、Bax的mRNA表达显著下调(P0.05)。结论本实验在中国地鼠鳞癌组织中caspase-3、caspase-9、Bax表达降低而Bcl-2表达上升,揭示了caspase-3、caspase-9、Bax、Bcl-2表达与口腔鳞癌的发生、发展密切相关,可以为口腔颊囊黏膜癌的基因治疗提供一些线索或并为评价OSCC的生物学特征及预后提供参考。     

人肺鳞癌和腺癌组织中c-erbB-2癌基因蛋白表达与细胞增殖及预后的关系

用S－P免疫组织化学方法,用c－erbB－2多克隆抗体及PCNA单克隆抗体对50例肺鳞癌和30例腺癌组织石蜡包埋标本进行检测。结果显示：c－erbB－2染色总阳性率为46．25％,鳞癌阳性率为40％,腺癌阳性率为56．67％,两者之间无显著性差异。伴有淋巴结转移的肺癌组织中c－erbB－2阳性表达率较高（66．67％）,并且与肺癌预后有关。PCNA表达阳性级别与患者的术后生存期呈负相关（P＜0．05）,与c－erbB－2表达阳性级别呈正相关（P＜0．05）。本研究提示,用免疫组织化学方法检查,c－erbB－2蛋白和PCNA共同表达可作为临床判断肺鳞癌和腺癌预后的较好指标之一。     

微小RNA miR-21和miR-31在口腔鳞癌组织中的表达及意义

目的:检测口腔鳞癌中微小RNA miR-21和miR-31的表达,探讨其与肿瘤发展的关系。方法:应用实时荧光定量PCR的方法检测72例口腔鳞癌,38例正常口腔粘膜miR-21和miR-31的表达,统计学分析其表达与肿瘤临床分期和病理分型的关系。结果:①口腔鳞癌组织与对照组比较,微小RNA miR-21和miR-31的表达都有显著增高(P0.05),其中miR-21的增高更为显著(P0.001)。②统计学分析表明,miR-21的表达在晚期鳞癌组织较早中期鳞癌组织增高更为显著(P0.01),在低分化鳞癌组织较中、高分化鳞癌组织增高更为显著(p0.001);MiR-31的表达水平在不同肿瘤临床分期和病理分型鳞癌组织中无明显差异(P0.05)。结论:miR-21和miR-31在口腔鳞癌发生发展过程中表达有明显增高,其中miR-21表达水平可作为潜在的口腔鳞癌临床分期分级和预后的指标。     

原发性口腔鳞癌组织及血清中内皮抑素表达的意义

目的：探讨原发性口腔鳞癌患者组织和血清中内皮抑素表达及与肿瘤分期、分级的关系。方法：采用免疫组化方法检测36例口腔鳞癌和12例正常口腔粘膜组织中内皮抑素表达情况。ELISA法检测36例口腔鳞癌患者术前血清内皮抑素水平,14例健康者血清做对照。结果：内皮抑素主要见于肿瘤组织细胞质。正常口腔粘膜中内皮抑素表达率为7.15%,口腔鳞癌组织中内皮抑素阳性率为76.44%,其中G1、G2、G3级阳性率分别为47.21%、79.17%、90.90%,病理分级间比较差异有统计学意义（P〈0.05）。口腔鳞癌患者血清中内皮抑素水平（49.62±1.72）ng/mL显著高于健康对照者（5.60±0.37）ng/mL（P〈0.05）,TNM分期III、IV期肿瘤患者血清内皮抑素水平显著高于I和II期（P〈0.05）。结论：口腔鳞癌患者组织和血清中内皮抑素表达显著升高,并与肿瘤分期、分级相关,检测内皮抑素表达有助于判断口腔鳞癌恶性程度。     

EGFR在晚期声门上型喉鳞癌组织中的表达及其临床意义

目的:研究表皮生长因子受体(epidermalgrowth factorreceptor,EGFR)在晚期声门上型喉鳞癌组织中的表达情况及其与临床各相关因素的关系,探讨EGFR能否作为判断晚期声门上喉鳞癌患者预后的预测性指标。方法:收集我院2004年1月~2008年4月共52例晚期(Ⅲ期、Ⅳ期)声门上型喉鳞癌患者手术后切除的肿瘤组织,应用免疫组化技术检测EGFR表达情况,运用统计学方法,结合临床资料分析其与肿瘤分期、淋巴结转移、病理分化程度、生存率及术后放疗对预后的影响等临床病理特征的关系。结果:EGFR在晚期声门上型喉鳞癌组织中存在阳性表达,阳性表达物质呈棕黄色,表达率为76.92%(40/52),其中过表达率为44.23%。EGFR的表达与晚期声门上型喉鳞癌患者的年龄、性别、吸烟无关,与浸润程度(P=0.005),淋巴结转移数目(P=0.018),TNM分期(P=0.003),病理分化程度(P=0.011)有关。单因素分析得出EGFR表达程度、T、N分期以及病理分化程度是影响无复发生存时间的危险因素(P0.05),T、N分期、病理分化程度是影响总生存时间的危险因素(P0.05)。多因素分析显示只有肿瘤浸润程度(T分期)和淋巴结转移(N分期)是影响无复发生存时间和总生存时间的独立预后因素。EGFR的阴性表达组与阳性表达组的3年、5年生存率不具有统计学差异(P0.05)。结论:EGFR在晚期声门上型喉鳞癌组织中存在过表达,证实了EGFR的过度表达与肿瘤的侵袭、转移相关,检测其表达水平对晚期喉癌的个体化治疗、靶向治疗有重要参考价值。但EGFR尚不能作为晚期声门上型喉鳞癌行手术及术后辅助放疗患者对无复发生存时间和总生存时间的预测指标。     

Overexpression and clinicopathological significance of homeobox gene Quox-1 in oral squamous cell carcinoma

The expression and clinicopathological significance of Quox-1 gene was studied in oral squamous cell carcinoma (OSCC). Immunocytochemistry and western blot analysis were used to examine the different expressions of Quox-1 protein in 114 OSCC specimens, 34 oral epithelial dysplasia specimens, and 16 normal oral mucosa specimens. RT-PCR and virtual Northern Blot were also used to examine the expression of Quox-1 mRNA. It was found that Quox-1 was not expressed in normal epithelium. However, as dysplastic lesions progressed Quox-1 expression increased (p < 0.01), and Quox-1 expression was not significantly different between severe dysplasia and highly differentiated OSCCs (p > 0.05). As the degree of differentiation decreased, Quox-1 positivity increased in OSCC (p < 0.01), and the rate of Quox-1 (81.58%) positivity in OSCC was higher than that in normal oral mucosa (p < 0.01). Our findings imply that the positive expression of Quox-1 is correlated with the histological classification of OSCCs. Thus, the expression of Quox-1 in OSCC may serve as a significant predicting factor of proliferative status and malignant degree, and it may also be a biological detection marker of oral mucosas initial cancer and of OSCC.     

Anxa2, Stat3 在口腔鳞状细胞癌中的表达及意义

目的:探讨膜联蛋白A2(Anxa2)和细胞信号转导和转录激活因子3(Stat3)在口腔鳞癌组织中的表达及其临床意义。方法:选择口腔鳞癌石蜡标本80例为实验组,20例正常口腔黏膜组织为对照组。应用免疫组织化学法检测Anxa2和Stat3蛋白的阳性表达,并进行结果判定,采用x2和Spearman等级相关分析法分析二者表达差异性及其相关性。结果:Anxa2、Stat3在病例组中的阳性表达率,分别为81.3%(65/80)、87.5%(70/80),明显高于对照组中的表达率,25.0%(5/20)、30.0%(6/20),且差异有统计学意义(P0.05),Anxa2和Stat3蛋白表达水平与口腔鳞癌的分期、淋巴结转移及分化程度有密切关系。Spearman等级相关分析Anxa2和Stat3在口腔鳞癌组织中蛋白的表达呈正相关(r=0.302,P0.01)。结论:Anxa2、Stat3在OSCC的发生和转移过程中均具有重要的作用,且二者间也有相互作用的关系。     

FURTHER OBSERVATIONS ON THE OCCURRENCE OF NEXUSES IN BENIGN AND MALIGNANT HUMAN CERVICAL EPITHELIUM

An estimate is made of the frequency of occurrence of nexuses ("gap junctions") in a spectrum of human cervical epithelia, ranging from normal to malignant, since a deficiency of nexuses may be important in abnormal cell-to-cell communication in malignant tissues. The normal cervical epithelium has approximately ten nexuses per cell in the basal layer of proliferating cells and 200 nexuses per cell in the more differentiated intermediate zone. Nexuses are rare between invasive malignant epithelial cells (carcinoma cells). In many areas of cell proliferation near the edge of the tumor mass, fewer than one nexus per cell is present. However, up to four nexuses per cell can be found in some well differentiated regions of invasive carcinoma. Preinvasive malignant epithelia (severe dysplasia and carcinoma-in situ) have as few nexuses as invasive carcinoma. In abnormal but benign epithelia (squamous metaplasia and mild dysplasia), nexuses are abundant. The data indicate that a decrease in number of nexuses correlates with the severity of the morphological alteration in the dysplastic epithelium. Also the deficiency of nexuses in groups of carcinoma cells can occur many cell generations before the development of invasion of the malignant epithelium into the connective tissue. The diminution of nexuses before invasion suggests that a deficiency of nexuses may be one of the important factors in eventually permitting the development of the diffusely infiltrating type of invasion which is characteristic of highly malignant tumors such as squamous carcinomas.     

Immunohistochemical detection of early-stage carcinogenesis of oral leukoplakia by increased DNA-instability and various malignancy markers

The degree of DNA instability as determined by immunohistochemical staining with anti-single-stranded DNA antibody after acid hydrolysis (the DNA instability test) was used as a marker of malignancy. The test was applied to tissues of oral leukoplakia assessed histopathologically as hyperplasia (38 cases), mild (12 cases), moderate (11 cases) and severe (8 cases) dysplasia, and invasive squamous cell carcinoma (SCC, 20 cases). Tissues were subjected to immunohistochemical staining for proliferating cell nuclear antigen (PCNA), p53, DNA-fragmentation factor 45 (DFF45), analysis of various AgNORs parameters, and triple immunostaining for vascular endothelial growth factor (VEGF), CD34, and PCNA. The DNA instability test was positive in 20 (100%) SCC cases, 8 (100%) severe dysplasia cases, 8 (72.7%) moderate dysplasia cases, 6 (50.0%) mild dysplasia cases, and 9 (23.7%) hyperplasia cases, indicating malignancy. The proportion of lesions positive for PCNA, p53, DFF45, and values of AgNORs parameters steadily increased from hyperplasia to mild, moderate and severe dysplasia, and SCC, especially in those showing positive DNA instability test, indicative of malignancy. Based on these results, 44.9% of leukoplakia were malignant tissues, namely carcinoma in situ. The proportion of PCNA-positive vascular endothelial cells in the vicinity of VEGF-positive epithelial lesion was significantly higher than that of negative DNA instability lesions, as revealed by immunohistochemical triple staining for VEGF, CD34, and PCNA. Our results suggest that increased DNA instability, enhanced proliferative activity, p53 mutation, and induction of DFF45 and VEGF may allow cancer cell proliferation, enhance their survival by escaping apoptosis, and provide abundant nutrients during early-stage carcinogenesis of oral leukoplakia.     

Early progression stage of malignancy of uterine cervical dysplasia as revealed by immunohistochemical demonstration of increased DNA-instability

The degree of DNA-instability as revealed by the immunohistochemical staining with anti-single-stranded DNA antibody after acid hydrolysis (DNA-instability test) was used as a marker of malignancy. This was applied to mild dysplasia (42 cases), moderate dysplasia (43 cases), severe dysplasia (27 cases), squamous cell carcinoma in situ (CIS) (21 cases), invasive squamous cell carcinoma (SCC) (31 cases) and normal (7 cases) human uterine cervix. The expression of tumour suppressor gene p53 and oncogene bcl-2 was detected immunohistochemically. Proliferative activity was evaluated by PCNA immumohistochemistry and the quantitative analysis of the number, mean area, the largest area and maximum shape irregularities of AgNOR in a nucleus were performed for all these cases. The distribution of numeric chromosomal aberrations of chromosome 17 was also investigated in some of these cases. The results showed that 31 SCC (100%), 21 CIS (100%), 21 severe dysplasia (77.77%), 28 moderate dysplasia (65.11%), and 14 mild dysplasia (33.33%) were positively stained by the DNA-instability test diffusely or sporadically, indicating their malignancy. Reflecting the malignant character, these cases showed a remarkable increase in the PCNA-index with the loss of polarity of PCNA positive cell distribution and also an increase in number, mean and largest sizes and maximum shape irregularity of AgNOR dots. The mean chromosome index for chromosome 17, p53 and bcl-2 immunostaining positivity were also found to be significantly increased in moderate and severe dysplasia and in cancerous cases in comparison to normal and mild dysplasia cases. Moreover, the DNA-instability-test positive dysplasia cases showed statistically significant increased values of PCNA-index, AgNOR parameters, mean chromosome index, p53 and bcl-2 expression in comparison to those of DNA-instability-test negative dysplasia cases. In conclusion, some mild dysplasia (33.33%) and most of the moderate (65.11%) and severe dysplasia (77.77%) were regarded as malignant in nature, existing at an early stage of progression of malignancy.     

Therapy for oral squamous cell carcinoma by tegafur and streptococcal agent OK-432 in combination with radiotherapy: Association of the therapeutic effect with differentiation and apoptosis in the cancer cells

Twenty patients with oral squamous cell carcinoma having mainly stage II or III lesions without distant metastasis, were treated with tegafur and streptococcal agent, OK-432, in combination with radiotherapy. As a consequence, 16 cases among the treated 20 cases showed complete remission by this therapy alone. Especially, we have found that the squamous cell carcinoma arising in non-keratinizing oral epithelium rather than in keratinizing oral epithelium has better response to this therapy. Among the 16 cases with complete remission (CR) by the current therapy, 10 cases were histopathologically diagnosed as well-differentiated squamous cell carcinoma and six cases as moderately differentiated squamous cell carcinoma. When we examined immunohistochemically the expres-sion of various antigens such as proliferating cell nuclear antigen (PCNA), p53 and LeY or the presence of DNA fragmentation by nick-end labelling in the biopsy materials taken at the first visit to our clinic from 20 patients treated with the current therapy, the CR group showed a significantly increased LeY expres-sion level ( p< 0.05) and DNA fragmentation rate ( p< 0.05) as compared with the partial response (PR, n= 3) + no change (NC, n= 1) group. On the other hand, the CR group with respect to PCNA expression level was significantly decreased as compared with the PR + NC group ( p< 0.05). From these findings, it can be considered that the therapy for oral squamous cell carcinoma by UFT and OK-432 in combination with radiotherapy is very effective, which may be associated with differentiation or apoptosis in oral squamous carcinoma cells. In addition, we present the clinical findings and results of immunohistochemical staining for the biopsy materials obtained from four CR cases treated with the current therapeutic method.     

P16、P27蛋白在食管鳞状细胞癌中的表达及意义

目的为探讨P16、P27蛋白在食管鳞状上皮、增生上皮和癌变上皮中表达状况及其与鳞状细胞癌发生、进展和转移的相关性.方法采用SP免疫组织化学方法,检测72例(其中活检标本13例)食管癌组织中P16、P27蛋白的表达情况.结果 P16、P27在食管癌和增生性上皮均有阳性表达,但两者相比均无统计学意义(P>0.05),在正常上皮组均无阳性表达;P16、P27在高分化鳞癌组阳性表达率均显著高于低分化鳞癌组(P<0.05);P16、P27在伴有淋巴结转移的食管癌组与不伴有淋巴结转移组比较差异显著(P<0.05).P16在原发食管癌组阳性表达率和淋巴结转移癌中比较具有显著性差异(P<0.05).结论 P16、P27基因蛋白在食管癌组织中的表达与病理分化程度有关;P16的表达与转移癌的形成有关;P16、P27表达与患者性别、年龄、肿瘤发生部位、浸润深度无明显相关性.     

p27蛋白和Cyclin E在食管鳞状细胞癌的表达及意义

目的　探讨 p2 7和CyclinE在食管鳞状上皮和鳞癌细胞中的表达特点及意义。方法　收集正常食管鳞状上皮粘膜组织和不典型增生的食管粘膜组织共 41例 ,食管鳞状细胞癌组织 73例 ,采用S P免疫组织化学方法进行染色。结果　CyclinE和 p2 7在正常鳞状上皮中无阳性表达 ;不典型增生上皮组阳性率分别为 3 3 3 3 % ( 7/ 2 1)和 2 3 80 % ( 5 / 2 1) .在鳞癌中CyclinE和 p2 7阳性率分别为 5 3 42 % ( 3 9/ 73 )和 2 7 40 % ( 2 0 / 73 ) .经统计 ,CyclinE与癌组织分化程度有关 ,低分化组阳性率明显高于中、高分化组 (P <0 0 5 ) ;而p2 7在高分化组阳性率明显高于低分化组 (P <0 0 5 ) ;两者差异显著 (P <0 0 5 )。结论　p2 7和CyclinE表达与食管鳞癌的生物学行为有关。CyclinE过表达是食管鳞癌恶性度较高的指标 ,而p2 7过表达是恶性度较低的指标