CEA mRNA在大肠癌患者微转移早期预测中的意义

目的:大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEA mRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法:应用逆转录多聚酶链式反应(RT-PCR)法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEA mRNA水平。结果:(1)大肠癌患者术前外周血CEA mRNA阳性率26.7%(16/60),引流静脉血阳性率48.3%(29/60),引流静脉血明显高于外周静脉血(P0.05)。(2)大肠癌引流静脉血中CEA mRNA在肿瘤大于5厘米者、Dukes C期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。(3)手术前后引流静脉血CEAm RNA阳性率具有显著差异(P0.05),外周血CEA mRNA阳性率无显著差异。结论:大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEA mRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

622例肺癌患者远处转移临床特征的回顾性分析

目的:探讨不同病理类型IV期原发性支气管肺癌的远处转移特点。方法:回顾性分析我科收治的622例诊断明确、资料完整的IV期肺癌患者,比较不同病理类型肺癌患者各器官远处转移发生率,并进行统计学分析。结果:622例IV期肺癌患者中,鳞状细胞癌188例(30.2%),腺癌275例(44.2%),小细胞癌130例(20.9%),大细胞癌5例(0.8%),腺鳞癌14例(2.3%)。平均年龄55.4岁,男女比例为2.60:1,高发年龄为40~60岁。各器官远处转移发生率从高到低依次为:骨267例(42.9%),胸膜212例(34.1%),双肺162例(26.0%),脑148例(23.8%),肝132例(21.2%),肾上腺53例(8.5%),心包50例(8.0%),皮下转移6例(1.0%),肌肉3例(0.5%),眼球和脊髓各1例(0.2%)。单器官转移共283例(45.5%),多器官转移共339例(54.5%),最多为6个器官远处转移。结论:不同病理类型肺癌有各自不同的远处转移特点及临床特征,应选择相应的检查并制定针对性治疗方案。     

In vitro studies to prove the effect of sera of eosinophilia in colony formation

Serum samples from four patients with reactive eosinophilia and two patients with eosinophilic leukaemia were compared with normal sera with respect to formation of eosinophil colonies after addition of the sera to mononuclear cells from peripheral blood of healthy subjects. Supernatants from ConA stimulated guinea-pig spleen cells and human lymphocytes were tested in a similar way. Grown colonies were placed on glass slides and after staining with luxol fast blue the percentage of eosinophils was counted. The serum samples of the patients with reactive eosinophilia produced the greatest number of eosinophil colonies while supernatants of spleen and lymphocytes produced the greatest number of eosinophilic granulocytes. Our findings suggest the existence of a factor stimulating eosinophil colonies in the tested serum fractions. Beyond that an indication is given for a substance in the supernatants of spleen and lymphocyte suspensions which stimulates more intensively the maturing into eosinophilic granulocytes than the formation of colonies.     

CEAmRNA在大肠癌患者微转移早期预测中的意义

目的：大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEAmRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法：应用逆转录多聚酶链式反应（RT-PCR）法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEAmRNA水平。结果：（1）大肠癌患者术前外周血CEAmRNA阳性率26．7％（16／60）,引流静脉血阳性率48.3％（29／60）,引流静脉血明显高于外周静脉血（P〈0．05）。（2）大肠癌引流静脉血中CEAmRNA在肿瘤大于5厘米者、DukesC期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。（3）手术前后引流静脉血CEAmRNA阳性率具有显著差异（P〈O．05）,外周血CEAmRNA阳性率无显著差异。结论：大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEAmRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

肺癌患者外周血血小板在肺癌血行转移中的作用研究

目的：观察肺癌患者外周血血小板对肺癌分期和血行转移的影响。方法：选择在我院呼吸科初诊的原发性肺癌患168例,分析其外周血小板计数与肺癌病理类型和分期的关系,并在模拟流体状态下,体外研究活化血小板对培养的肺癌细胞和内皮细胞相互作用的影响。结果：肺腺癌中外周血血小板计数增高现象最为明显,占37.09%（23/62）（P〈0.05）,鳞癌占22.64%,小细胞癌占22.70%,其他占14.20%。其中有远处血行转移者血小板增多（20.24%）较无明显转移者（7.14%）相差显著（P〈0.01）。同时体外研究显示流体状态对肺癌细胞粘附存在影响,而活化血小板增强了肺癌细胞与内皮细胞的相互作用。结论：血小板活化与肺癌尤其是肺腺癌的血行转移密切相关;活化血小板增强了肺癌细胞与内皮细胞的相互作用是血小板促进肺癌血行转移的重要机制之一。     

HPV+/-宫颈癌患者临床特点与预后的对比分析

目的:探讨HPV阴性与HPV阳性宫颈癌的临床特点及其和预后的关系。方法:选取住院手术的HPV呈阴性与阳性的宫颈癌患者各86例,且两组患者在年龄、FIGO临床分期相近。分析两组患者的年龄、肿瘤临床分期、病理分型、原发肿瘤大小、分化程度、基层浸润深度、淋巴结转移、治疗方案情况及其5年RFS和总生存时间。结果:两组间宫颈癌患者肿瘤分化程度、肌层浸润深度、淋巴结转移间差异有统计学意义(P0.05)。HPV阳性组和HPV阴性组随访时间分别为63(13~87)个月、61(9~90)个月,5年总生存率分别为70.4%和61.3%,平均总生存时间分别为(73.15±2.74)月和(62.72±3.03)月,差异有统计学意义(p0.05)。HPV阴性组和HPV阳性组5年RFS分别为52.3%和66.4%,平均RFS为(51.57±4.62)月和(58.83±3.46)月,差异有统计学意义(p0.05)。结论:HPV阴性宫颈癌瘤体倾向于低分化,易发生局部侵犯和淋巴结转移,其临床预后较差。     

T lymphocyte control of human eosinophilic granulopoiesis. Clonal analysis in an idiopathic hypereosinophilic syndrome

The idiopathic hypereosinophilic syndrome (HES) comprises a heterogeneous group of disorders with unknown pathogenesis characterized by persistent peripheral blood and bone marrow eosinophilia and eosinophilic infiltrates of multiple organs leading to severe organ dysfunction. In the present study, T lymphocyte clones were randomly established from the blood of a patient with HES and propagated in culture with mitogen and interleukin 2. Whereas 28 of 29 clones were able to stimulate myeloid colony formation when co-cultured with normal bone marrow cells in a double-layer micro-agar culture system, one third of these clones preferentially stimulated pure eosinophil colonies (up to 98% of all colonies). This pattern differed markedly (p less than 0.001) from the pattern of release of hemopoietic factors by 126 T cell clones established from four other individuals. Eosinophil colony stimulation was due to the release of a lineage-specific eosinophilic colony-stimulating factor (Eo-CSF) by these clones after appropriate stimulation. Production of Eo-CSF in vitro was inhibited by hydrocortisone or cyclosporin A. All Eo-CSF-producing clones had the T4+8-phenotype and were capable of producing in addition interleukin 2 and interferon-gamma. Southern blot analysis of the T cell receptor beta-chain rearrangement of the Eo-CSF-producing clones showed a different rearrangement pattern for each clone. These studies suggest a reactive T cell-mediated eosinophilia as the pathogenetic mechanism in this case of HES and, for the first time, point to a biologic relevance of a lymphokine-induced stimulation of hemopoiesis.     

局部晚期鼻咽癌患者外周血VEGF检测及意义

目的:研究血管内皮生长因子(vascular endothelium growth factor,VEGF)在局部晚期鼻咽癌患者外周血中的表达相,探讨VEGF与局部晚期鼻咽癌预后的关系,研究是否能预测局部晚期鼻咽癌患者的预后,或作为局部鼻咽癌治疗的靶分子,为寻找局部晚期鼻咽癌放化疗疗效的分子生物学评价指标提供依据。方法:选择57例局部晚期鼻咽癌患者,收集外周血标本,酶联免疫吸附实验(enzym-linked immunosorbent assay,ELISA)检测外周血中VEGF蛋白水平。结合临床病理特征和随访资料进行分析。结果:(1)局部晚期鼻咽癌患者外周血VEGF表达水平均与复发率、远处转移率有关(P0.05)。(2)局部晚期鼻咽癌患者外周血VEGF的表达水平与性别和年龄无关(P0.05)。(3)局部晚期鼻咽癌患者外周血VEGF的表达水平与生存率有关(P0.05)。结论:局部晚期鼻咽癌患者外周血中VEGF的表达水平对复发率、远处转移率和生存率有影响,提示VEGF在局部晚期鼻咽癌的侵袭转移中可能起协同作用;VEGF检测对筛选较高鼻咽癌转移风险的患者可能有更大的临床价值。     

胃癌组织中HER2、PD-L1的表达与临床病理特征的相关性

目的:检测胃癌组织中人表皮生长因子受体2(HER2)、程序性死亡因子1配体(PD-L1)的表达,并分析其与胃癌患者临床病理特征的相关性。方法:采用分层整群抽样回顾性分析的方法抽取我院2016年1月至2018年12月经手术病理诊断为胃癌的100例原发性胃癌患者,全部患者术后均经病理组织切片免疫组化染色检测其HER2、PD-L1表达,对比不同性别、年龄、肿瘤大小、肿瘤部位、分化程度、病理类型等临床病理特征胃癌患者HER2、PD-L1的表达,分析二者与胃癌患者临床病理特征的相关性。结果:100例胃癌患者中男女比例为2.8:1,年龄60岁占比高,肿瘤大小多超过4 cm,WHO分型以分化不良与分化较好为主,肿瘤部位主要位于胃下2/3,浸润深度多为T4,TNM分期集中在Ⅰ～Ⅲ期,多伴淋巴结转移,几乎无远处转移,多存在脉管侵犯,部分有神经侵犯。100例胃癌患者胃癌组织HER2表达阴性、弱阳性、强阳性检出率分别为42.00%、31.00%、27.00%;PD-L1阴性、阳性检出率分别为57.00%、43.00%。胃癌组织HER2阳性表达、PD-L1阳性表达均高于癌旁正常胃组织,差异有统计学意义(P0.05)。胃癌组织中HER2表达与疾病分化程度呈负相关(r0,P0.05),PD-L1的表达与肿瘤分化程度、浸润深度、与远处转移均呈显著正相关(r0,P0.05)。结论:HER2的阳性表达可能提示胃癌患者较低的恶性程度,PD-L1的高表达可能提示胃癌患者存在远处转移、浸润深度深、恶性程度高。HER2和PD-L1有望成为胃癌患者诊断参考指标及药物干预的靶点。     

Tumor necrosis factor in solid tumors: increased blood levels in the metastatic disease.

TNF, a cytokine produced by macrophages, is able either to exert an antitumor activity, or to determine severe clinical complications, such as cachexia and septic shock. Increased blood levels of TNF have been described in cancer patients. The present study was performed to better define TNF secretion in patients with solid tumors. The study included 48 cancer patients (lung cancer: 22; colon cancer: 11; breast cancer: 10; renal cancer: 5), and among them 27 showed distant organ metastases. TNF serum levels were measured by IRMA method. The control group comprised 40 healthy subjects. TNF levels were also evaluated in relation to those of SIL-2R, whose increase seems to be associated with an unfavorable prognosis in cancer. High levels of TNF were seen in 27/48 (56%) patients. Mean levels of TNF were significantly higher in cancer patients than in controls. Moreover, within the cancer group, TNF mean values were significantly higher in metastatic patients than in those without metastases; the highest levels were observed in patients with visceral lesions as dominant metastasis sites. Finally, patients with high TNF concentrations showed significantly higher mean levels of SIL-2R than those with normal values. This study shows that the neoplastic metastatic disease is associated with an exaggerated TNF secretion.     

Pathological and haematological responses of cats experimentally infected with Toxocara canis larvae

Responses of eight adult cats to one or two infections with larvae of Toxocara canis were studied up to 39 days post infection (DPI). Clinically, all cats remained normal throughout the study. The major necropsy finding was multifocal, white to grey nodules mainly within the liver, lungs and kidneys; live larvae were found in liver nodules. Histologically, the nodules were eosinophilic granulomas. Granulomas containing a larval section were observed mainly within the liver. All infected cats had variably severe, eosinophilic arteritis and bronchiolitis and medial hypertrophy and hyperplasia of the pulmonary arteries. No inflammatory eye lesions were detected. Circulating eosinophil levels increased in all infected cats; peak values of 15,790 and 10,050 eosinophils microliters-1 were observed at 25 or 32 DPI in cats receiving a single or double infection, respectively. Bone marrow of all infected cats exhibited marked eosinophilic hyperplasia which did not correlate with the level of circulating eosinophilia. Thus, infection of cats by the larvae of T. canis causes disseminated eosinophilic and granulomatous disease with marked pulmonary artery and airway lesions.     

Circulating dendritic cells in early and advanced cancer patients: diminished percent in the metastatic disease

Despite the well demonstrated fundamental role of dendritic cells (DC) in generating antitumor immunity in experimental conditions, to date there are only few preliminary studies which investigate the percent of DC in the peripheral blood of cancer patients. Several cell surface markers have now been described which are specific to cultured DC, however their expression in vivo is still controversial. Recently, however, two DC subsets, consisting of immature and mature DC, have been shown to be present in peripheral blood, which can be recognized as CD123+ and CD11c+ cells, respectively. On this basis, we decided to investigate the presence of both mature and immature DC in the peripheral blood of early or advanced cancer patients. The study included 40 solid tumor patients, 18 of whom had a locally limited disease, while the other 22 showed distant organ metastases. CD123+ and CD11c+ cells were detected by FACS using monoclonal antibodies, and expressed as the percent of total leukocytes. The control group consisted of 50 healthy subjects. The mean percent of both CD123+ and CD11c+ cells was significantly lower in cancer patients than in controls. Moreover, the mean percent of both DC subsets was significantly lower in metastatic patients than in the non-metastatic ones. This study, demonstrating significantly lower percents of both immature and mature DC in the peripheral blood of cancer patients, particularly in those with distant organ metastases, suggests that DC deficiency may play a role in inducing cancer-related immunosuppression. Therefore, the demonstration of a diminished percent of DC in peripheral blood may represent a new interesting biological marker predicting a poor prognosis in human neoplasms, as with lymphocytopenia, the unfavourable prognostic significance of which has been well demonstrated.     

Increases in mRNA and Protein Levels of the Genes for the Actin-Binding Proteins Profilin,Fascin, and Ezrin Promote Metastasis in Non-Small Cell Lung Cancer

The actin-binding proteins profilin, fascin, and ezrin were tested for involvement in metastasis of non-small cell lung cancer (NSCLC). The levels of the PFN1, FSCN1, and EZR mRNAs and respective proteins were determined by real-time PCR and Western blotting; tumor and adjacent normal lung tissue samples were obtained from 46 NSCLC patients. Patients with lymphatic metastasis had higher expression levels of the profilin, fascin, and ezrin mRNAs and the profilin and fascin proteins. Both mRNA and protein expression levels increased in patients with distant metastasis. The molecules may serve as predictors to evaluate the prognosis in NSCLC.     

Dopamine beta-hydroxylase deficiency

Idiopathic chronic eosinophilic pneumonia (ICEP) is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm³. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than lymphocyte counts in the bronchoalveolar lavage. ICEP is a rare disorder of unknown cause. Its exact prevalence remains unknown. ICEP may affect every age group but is rare in childhood. It is twice as frequent in women as in men. One third to one half of the ICEP patients have a history of asthma. The mainstay of treatment of ICEP is systemic corticosteroids. Response to oral corticosteroid therapy is dramatic and has led to the consideration of corticosteroid challenge as a diagnostic test for ICEP. Nevertheless, relapses or development of severe asthma are frequent when tapering or withdrawing treatment. Long-term oral corticosteroid therapy is necessary in up to half of the patients.     

Cytokine-mediated apoptosis of granulocytes eosinophilicus in eosinophilia

The influence of recombinant forms of cytokincs (IL-5, IL-3 and eotaxin) on programmed destruction of eosinophils obtained from patients with diseases associated with high eosinophilia of blood (malignant diseases of system of blood, opisthorchosis) was studied in vitro. It was shown that all examined categories of patients irrespective of their nosology demonstrated a low level of spontaneous apoptosis of eosinophils. Cultivation of cosinophils isolated from peripheral blood of the patients with invasion O. felineus in vitro with r-IL-5, r-IL-3 and r-eotaxin decreased the number of eosinophilic cells undergoing apoptosis in comparison with spontaneous one. At the same time, incubation of eosinophils obtained from the patients with malignant diseases of system of blood, associated with cosinophilic syndrome, with r-IL-5, r-IL-3 and r-eotaxin allowed to ascertain the absence of sensitivity of eosinophilic cells to the antiapoptotic effect of these cytocines.     

Hematological characteristics of rats spontaneously developing eosinophilia.

Hematological and genetic characteristics of newly found eosinophilic rats were studied. Hematologically, high blood eosinophil counts started at 6 weeks of age. Almost all 10-week-old rats had eosinophilia with individual counts above 500/microliter and 5 to 100 times the normal level. Proliferating eosinophils had normal morphology. An increase in lymphocyte counts was observed at 5 weeks of age, one week earlier than the onset of eosinophilosis. In bone marrow, proliferation of eosinophils was also observed at 8 weeks of age and thereafter progressed, suggesting a role in the pathogenesis of eosinophilia in this rat. The results of genetic cross experiments revealed the disease to be hereditary. The spontaneously eosinophilic rat therefore warrants attention as a model for studying the underlying mechanisms of human and animal eosinophilia.     

3.0 T高分辨磁共振在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值

摘要 目的：研究3.0 T高分辨磁共振（MRI）在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值。方法：将我院从2018年1月～2019年12月收治的直肠癌患者120例纳入研究。所有患者均接受3.0 T高分辨MRI检查,以术后病理结果为金标准,分析其对术前T N分期、环周切缘有无累及淋巴结转移的评估价值。结果：直肠癌术前3.0 T高分辨MRI T分期与病理结果一致性较高,检验结果显示Kappa值=0.543,P值=0.000。直肠癌术前3.0 T高分辨MRI N分期与病理结果一致性较高,检验结果显示Kappa值=0.519,P值=0.000。以术后病理结果为金标准,直肠癌术前3.0 T高分辨MRI诊断环周切缘累及的灵敏度、特异度、准确度、阴性预测值、阳性预测值分别为92.50%（37/40）、93.75%（75/80）、93.33%（112/120）、96.15%（75/78）、88.10%（37/42）。直肠癌淋巴结转移者MRI边缘模糊、肠周围脂肪信号不均匀占比较无淋巴结转移者更高,且短径较无淋巴结转移者更长（均P＜0.05）。结论：3.0 T高分辨MRI在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值较高,具有一定的临床应用价值。     

Eosinophilia in a patient with cyclical vomiting: a case report

BACKGROUND: Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. CASE PRESENTATION: The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7-10 days, with each episode lasting for 1-3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. CONCLUSIONS: The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3), granulocyte macrophage colony stimulating factor (GM-CSF) and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.     

Clinical evaluation of CA 15.3 in the post-operative follow-up of breast cancer patients

In 265 patients operated for breast carcinoma the monoclonal antibody serum test CA 15.3 was predictive of metastatic diffusion of the disease. Its level increased in cases of distant metastasis with no significant difference between multiple and single sites (p = 0.014). The concentration of the marker was higher in 21 (23.8%) patients without nodal involvement and in 19 (27.5%) with nodal involvement (p = 0.193). Our study suggests that CA 15.3 may be an aid in the follow-up of patients with metastatic diffusion of breast cancer.