超声造影定量分析联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效的预测价值

摘要 目的：探讨超声造影定量分析联合血清甲胎蛋白（AFP）、血管内皮生长因子受体-2（VEGFR-2）、可溶性T细胞免疫球蛋白粘蛋白分子3（sTim-3）对原发性肝癌肝动脉化疗栓塞（TACE）治疗疗效的预测价值。方法：选择2020年1月至2022年10月海军军医大学第二附属医院收治的原发性肝癌患者94例。行TACE治疗2个月,采用改良的实体瘤疗效评价标准评估患者疗效,根据不同疗效分为疗效不良组（n=32）和疗效良好组（n=62）。所有患者均行超声造影检查,比较两组超声造影定量分析参数、治疗前血清AFP、VEGFR-2、sTim-3水平,采用受试者工作特征（ROC）曲线分析超声造影定量分析参数联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效的预测价值。结果：经TACE治疗,62例患者疗效良好、32例患者疗效不良,治疗有效率为65.96%。疗效良好组术前超声造影达峰时间、等增强开始时间显著长于疗效不良组（P<0.05）。疗效良好组术前血清AFP、VEGFR-2、sTim-3水平显著低于疗效不良组（P<0.05）。ROC曲线分析结果显示,超声造影定量分析联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效预测的曲线下面积（AUC）为0.950,灵敏度为84.85%,特异度为82.12%,高于各指标单独检测。结论：超声造影定量分析参数、血清AFP、VEGFR-2、sTim-3水平可预测原发性肝癌患者TACE治疗的疗效,且联合诊断的预测效能更高。     

基于上转磷光颗粒的AFP免疫层析定量检测

目的：建立了上转磷光免疫层析快速定量检测AFP的方法,用于原发性肝癌的诊断。方法：利用上转磷光标记的双抗夹心免疫层析技术检测血清中AFP的含量。将AFP单克隆抗体分别标记上转磷光颗粒并包被硝酸纤维膜,制成免疫层析检测试纸。评价该试纸的灵敏度、特异性和精密度。并通过临床50例血清样本,探讨上转磷光技术与化学发光检测方法的一致性。结果：该方法能在20min内完成,检测灵敏度达5ng/ml。浓度范围从5-1000ng/ml作标准曲线,呈现较好的线性。通过三组平行实验探讨其精密度,变异系数都在10%以内。应用于其它肿瘤标志物如CEA、CA199、AFU和NSE的检测,无交叉反应。与化学发光相比,决定系数R2=0.9692,一致性较好。结论：该方法简便、快速、廉价,可以实现定量,尤其适合基层门诊和体检现场使用。     

胃肝样腺癌的临床病理特征

目的探讨胃肝样腺癌（hepatoid adenocarcinoma of the stomach,HAS）的临床病理学特点、发生机制和免疫组化特征,以提高诊断水平。方法收集并分析5例胃肝样腺癌的临床特征和病理资料,采用HE染色、免疫组化方法,并复习文献。结果组织学胃肝样腺癌具有管状腺癌、粘液性癌和肝样分化腺癌的移行过渡,肿瘤细胞呈小梁状、巢团状,间质为丰富的血窦。免疫表型胃肝样腺癌AAT（5／5）、ACT（5／5）、CEA（5／5）、AFP（4／5）均为阳性,Heppar1灶性阳性（2／5）。结论胃肝样腺癌是一种少见的高度恶性、侵袭性强的特殊类型胃癌,组织学呈肝细胞样腺癌,免疫表型AFP、AAT和ACT阳性有助诊断。     

甲种胎儿球蛋白(AFP)定性定量酶联免疫试盒剂的研制

甲胎蛋白是一种癌胚相关蛋白,它在胎儿血清中含量每毫升数毫克之多,在正常人血清中低于25μg/ml,在原发性肝细胞癌者血清中甲胎蛋白的阳性率和滴度都很高,所以血清中甲胎蛋白的检测是诊断肝癌的特异指标。本方法采用双抗体夹心法原理,可定性及定量检测血清和血浆标本中甲胎蛋白含量,并配制AFP系列标准,为原发性肝癌的早期诊断及普查具有重要的临床意义。     

Carcinogenic mechanisms: A critical review and a suggestion that oncogenesis may be adaptive ontogenesis

The precise mechanism(s) whereby normal cells become malignant are not known with any degree of certainty. However, many mechanisms have been proposed on the basis of available experimental evidence as interpreted by the proposer. These fall into two main groups and are based upon changes in genetic structure (somatic mutation hypotheses) or in genetic expression (epigenetic hypotheses). Yet a third group embodies elements of the first two. The more important of all these proposals are critically reviewed and yet another hypothesis is ventured.In this hypothesis, the induction of neoplasia is envisaged as embodying (a) initiation of preferentially partly-differentiated and resting stem cells and (b) promotion of the initiated cells, through mitosis and further differentiation and by adaptations of normal ontogenic mechanisms, into a variety of novel phenotypes which are malignant or potentially so. Cancer-specifying genes, altered chromosomes, de-differentiations and interrupted re-differentiations are not considered to be causally involved, although the last three of these can be present as epiphenomena. Evidence cited in support of this proposal appears to show a general absence from cancer cells of any single property, including an abnormality in genetic constitution or in cellular expression, which is specific to malignancy. Malignancy is thus envisaged as abnormal expressions of the genetic potential of the zygote. Some practical and theoretical implications of this concept are discussed.     

甲胎蛋白携带药物靶向治疗肿瘤

甲胎蛋白(alpha fetoprotein,AFP)是一种在胎儿发育时期高表达的蛋白质,它又是一种穿梭蛋白质,能够将营养物质输送给胚胎细胞.相似的是,在肝癌等恶性肿瘤发展时期,肿瘤细胞也高表达AFP及其受体,它们通过AFP受体摄取AFP及其运载的物质.因此,可以将AFP与抗癌药物结合,选择性攻击肿瘤细胞.AFP与药物...     

血清HCG, AFP联合超声检查对前置胎盘植入类型的相关性分析

目的:探讨超声对植入胎盘诊断的敏感性及特异性及血清AFP、HCG和不同胎盘植入类型的相关性。方法:选取孕晚期前置胎盘产妇208例,按孕周1:1匹配,选取入无前置胎盘无胎盘植入的产妇208例为对照组。产前对所有研究对象进行胎盘超声学检查,根据术后病理将胎盘植入类型分为粘连性胎盘、植入性胎盘和穿透性胎盘组。同时测定产前、产后3 d、产后4 w血清AFP和HCG水平。结果:208例前置胎盘最终病理确诊胎盘植入67例,占32.21%(其中粘连性胎盘组31例、植入性胎盘组19例、穿透性胎盘组17例),产前超声诊断62例。超声对胎盘植入诊断总的敏感性86.56%,特异性97.16%。对照组、前置胎盘并胎盘植入组、单纯胎盘前置组胎盘厚度平均(2.34±0.63)cm、(3.27±0.78)cm、(2.42±0.61)cm,差异有统计学意义(P0.05)。粘连性胎盘植入组、植入性胎盘组、穿透性胎盘组产前、产后3 d、产后4 w各时间点血清AFP、β-HCG均明显高于对照组和前置胎盘组,差异有统计学意义(P0.05)。穿透性胎盘组产前、产后3 d、产后4 w各时间点血清AFP、β-HCG高于粘连性胎盘组和植入性胎盘组,差异有统计学意义(P0.05)。结论:超声对穿透性胎盘植入诊断具有较高的特异性和敏感性,但对粘连性胎盘植入诊断的敏感性和特异性不高,血清AFP和HCG水平和胎盘植入类型有一定关系,联合检测有助于胎盘植入类型的诊断。     

Amyloids and prions in plants: Facts and perspectives

Amyloids represent protein fibrils that have highly ordered structure with unique physical and chemical properties. Amyloids have long been considered lethal pathogens that cause dozens of incurable diseases in humans and animals. Recent data show that amyloids may not only possess pathogenic properties but are also implicated in the essential biological processes in a variety of prokaryotes and eukaryotes. Functional amyloids have been identified in archaea, bacteria, fungi, and animals, including humans. Plants are one of the most poorly studied groups of organisms in the field of amyloid biology. Although amyloid properties have not been shown under native conditions for any plant protein, studies demonstrating amyloid properties for a set of plant proteins in vitro or in heterologous systems in vivo have been published in recent years. In this review, we systematize the data on the amyloidogenic proteins of plants and their functions and discuss the perspectives of identifying novel amyloids using bioinformatic and proteomic approaches.     

西安市1995-2008年检出脊髓灰质炎疫苗病毒的急性弛缓性麻痹病例流行病学分析

分析脊髓灰质炎(脊灰)病毒(PV)的急性弛缓性麻痹(AFP)病例流行病学特征,提高对疫苗衍生脊灰病毒(VDPVs)和循环的疫苗衍生脊灰病毒(cVDPVs)的认识,增加AFP病例监测系统敏感性。对西安市1995-2008年检出的PV阳性AFP病例进行流行病学分析。对疫苗变异PV采用VP1基因核苷酸序列测定方法进行分子生物性状分析。西安市1995-2008年共检出PV13株,检出率4.29%。分离到的PV以II、III型为主,AFP病例散在发生,无聚集性。未全程免疫儿童(全程免疫儿童,年龄以≤1岁儿童为主(84.62%)。麻痹残留率高达84.62%。脊灰相关病例(VAPP)的发生危险性为0.24/100万。型内特征鉴定有1株为疫苗变异PV,经VP1基因核苷酸序列测定未达到VDPV的分类标准。维持无脊灰阶段,存在着VDPV和发生cVDPVs的可能,在保持高水平脊髓灰质炎疫苗(OPV)免疫覆盖率的同时,高质量的AFP病例流行病学监测和病毒学监测工作,具有重要的现实意义。     

肠道病毒B组山东地方株的基因型分布

为明确源自急性弛缓性麻痹(AFP)病例的HEV-B组病毒山东地方株的基因型分布,探讨其优势基因型的变迁与疾病暴发之间的关系,本研究对山东省1994年~2008年AFP监测系统分离到的HEV-B组病毒进行了VP1区核酸扩增和序列测定。序列测定结果显示HEV-B山东地方株共包括29种基因型,其中CVA 1种(CVA9),CVB 5种(CVB1~5),ECHO 20种以及新型肠道病毒EV73、75、97。其中ECHO11、CVB3、ECHO6、ECHO14、ECHO25是AFP监测系统中最常分离到的B组病毒。同源性比较显示,相同血清型HEV-B山东地方株型内核苷酸同源性最小75.4%,最大99.6%,与原型株核苷酸同源性最小73.8%,最大85.2%,但氨基酸变异不大。研究表明,不同基因型病毒具有不同的时间循环模式,相同基因型毒株内部根据其遗传距离的远近又可划分为不同的基因亚型,从而帮助确定HEV的传播途径和传播范围。