Dendritic cells are dysfunctional in patients with operable breast cancer

Background: Dendritic cells (DCs) play a crucial role in presenting antigens to T lymphocytes and inducing cytotoxic T cells. DCs have been studied in patients with breast cancer to define the factors leading to failure of an effective systemic and locoregional anticancer host response. Methods: Purified DCs were obtained from peripheral blood (PB) and lymph nodes (LNs) of women with operable breast cancer, using immunomagnetic bead selection. The stimulatory capacity of DCs in the allogeneic mixed leukocyte reaction (MLR) and autologous T cell proliferation test (purified protein derivative (PPD) as stimulator), the expression of surface markers on DCs and the production of cytokines in vitro by DCs from patients with operable breast cancer and from healthy donors (controls) were studied. Results: 70–75% purified DCs were isolated from PB and LNs. PBDCs and LNDCs from patients with operable breast cancer demonstrated a reduced capacity to stimulate in an MLR, compared with PBDCs from normal donors (p<0.01). Autologous T cell proliferation in patients had a decreased ability to respond to PPD, when compared with controls (p<0.01). However, T cells from patients responded as well as control T lymphocytes in the presence of control DCs. PBDCs and LNDCs from patients expressed low levels of HLA-DR and CD86, and induced decreased interleukin-12 (IL-12) secretion in vitro, compared with DCs from normal donors (p<0.01). Conclusion: These data suggest a defective DC function in patients with operable breast cancer. Switched-off DCs in patients with early breast cancer and decreased IL-12 production may be important factors for progressive tumour growth.     

Toll-like receptor 2 is expressed on the intestinal M cells in swine

The Toll-like receptor (TLR) 2 binds a wide variety of microbial cell wall components. In this study, we investigated the expression pattern of TLR2 in adult swine gut-associated lymphoid tissues using real-time quantitative PCR, Western blotting, immunohistochemistry, and flow cytometric analysis. The mRNA for TLR2 was preferentially expressed in the mesenteric lymph nodes (MLNs) and Peyer's patches (Pps) of adult swine. Expression in these two tissues was approximately 15- and 9-fold higher than that of spleen, respectively. Western blotting further confirmed that the TLR2 protein was highly expressed in the MLNs and Pps. Interestingly, TLR2-expressing cells were found not only in immune cells, such as T cells and B cells, but also in membranous (M) cells. In addition, double immunostaining for TLR2 and cytokeratin 18 revealed that TLR2 was strongly expressed not only in the cytoplasm but also in the apical membrane of the pocket-like M cells. These results indicate that TLR2 on the MLNs and Pps enable the host defense to respond to a variety of cell wall components. Furthermore, the potential function of TLR2 as a pattern recognition receptor and its cellular distribution suggest that TLR2 plays an important role in ligand-specific transcytosis and transport in M cells.     

蛙心包淋巴孔的发现

首次报道蛙心包淋巴孔 ,揭示心包腔淋巴转归途径。本实验应用扫描电镜和透射电镜观察心包淋巴孔的超微结构 ,并使用计算机图象处理技术对淋巴孔作定量分析。结果发现 ,正常蛙心包腔面有一些散在分布的心包淋巴孔和少量淋巴窦。构成淋巴孔的间皮细胞常出现粗大的胞质突起 ,伸入淋巴孔 ,形成瓣膜状结构。淋巴孔的平均直径为 0 72±0 33μm ,平均分布密度是 3 57± 2 0 7个 /0 0 1mm2 ;心包间皮淋巴窦的面积是 995 0 8±2 2 1 74μm2 /0 0 1mm2 。蛙心肌无血管 ,其血供仅由心腔内血液直接进入心肌的小梁间隙。心包脏层未发现有淋巴孔。结果表明 :间皮淋巴窦是心包膜正常“漏出”的形态依据。心包淋巴孔的发现 ,证明心包腔淋巴引流途径的存在。淋巴引流对于心肌组织间液的平衡 ,清除组织间液蛋白质 ,防止心肌间质水肿 ,有重要意义     

Assessment of the potential uses of liposomes for lymphoscintigraphy and lymphatic drug delivery failure of 99m-technetium marker to represent intact liposomes in lymph nodes

The in vivo fate of subcutaneously injected neutral SUV liposomes in rats was examined using a membrane marker, ^99mTc, and an aqueous marker, ¹²⁵I-labelled poly(vinyl pyrrolidone). Liposomes with entrapped ¹²⁵I-labelled poly(vinyl pyrrolidone) were labelled with ^99mTc by the SnCl₂ method [2]. ^99mTc-radioactivity was localized several-fold more in the primary and secondary regional lymph nodes than ¹²⁵I-labelled poly(vinyl pyrrolidone)-radioactivity. Similarly, ^99mTc-radioactivity appeared and was subsequently cleared from the circulation much more rapidly than ¹²⁵I-labelled poly(vinyl pyrrolidone). The gel chromatography of the lymph node homogenate revealed that 60–70% of ¹²⁵I-labelled poly(vinyl pyrrolidone)-radioactivity was in the liposome fractions, whereas only 3% of ^99mTc-radioactivity was co-eluted with liposomes. Thus, the two markers have different fates in the lymphatics, and the presence of all ^99mTc-radioactivity does not represent the 60–70% of intact liposomes present in lymph nodes. Using the aqueous marker ¹²⁵I-labelled poly(vinyl pyrrolidone), the lymphnode localization of positive, negative and neutral small unilamellar vesicles was studied, and it was found that ¹²⁵I-radioactivity was more localized from negative liposomes than from positive liposomes, which in turn was more localized than that from neutral liposomes. Thus, these findings differ from those reported earlier [2], where the authors used ^99mTc as a liposomal marker. In vitro studies showed that liposomes of preparations containing 20 mol% cholesterol became ‘leaky’ to low-molecular-weight drugs, for example, methotrexate (M_r 454) to a much greater extent than with a large-molecular-weight substance, ¹²⁵I-labelled poly(vinyl pyrrolidone) (M_r 30 000–40 000), when incubated with rat lymph at 37°C. Using the two markers ^99mTc and ¹²⁵I-labelled poly(vinyl pyrrolidone) it was found that the localization of both radioactivities was reduced in lymph nodes draining λ-carrageenan-treated footpads. In conclusion, it is suggested that liposomes can be used for the delivery of drugs to diseased lymph nodes, and it would be worthwhile examining the possibilities of using alternative methods of labelling liposomes with ^99mTc rather than using the SnCl₂ technique [2], or using other radionuclides as markers for γ-scan imaging.     

64排多层螺旋CT对直肠癌淋巴结转移的诊断研究

目的:通过对直肠癌患者原发肿瘤周围脂肪间隙内淋巴结的影像学分析,来评价64排增强螺旋CT对直肠癌淋巴结转移的诊断价值。方法:收集我院经术后病理证实的102例直肠癌患者的临床及影像学资料进行回顾性分析,通过多平面成像,记录直肠周围脂肪间隙内淋巴结的CT表现,包括淋巴结大小、边缘及强化程度。以病理结果为准确定转移性和非转移性淋巴结,采用双盲法。结果:单因素分析结果显示淋巴结大小、边缘及强化方式与阳性率有显著的相关性(P0.05),多因素分析结果显示各相关因素有显著诊断意义的是淋巴结大小、边缘及强化方式,其敏感性分别为94.7%、87.6%、56.9%,特异性分别为69.3%、51.6%、62.3%。结论:综合分析原发肿瘤周围脂肪间隙内淋巴结的表观情况,有助于提高对淋巴结转移的判断。     

MMP2和MMP9在粘膜内胃癌中表达及其临床病理意义

目的:观察基质金属蛋白酶(MMP)家族成员MMP2和MMP9在粘膜内胃癌中的表达及其与淋巴结转移的相关性。方法:研究病例为病理诊断为粘膜内胃癌的档案病例,应用免疫组织化学技术检测MMP2和MMP9在粘膜内胃癌中表达的临床病理意义,特别是与淋巴结转移的相关性。结果:临床病理分析结果显示有淋巴结转移的IMGC病例肿块直径要显著大于无淋巴结转移的IMGC。有淋巴结转移IMGC中低分化腺癌发生率要显著高于无淋巴结转移组。有淋巴结转移IMGC中淋巴管侵犯发生率要显著高于无淋巴结转移组。免疫组化结果显示,MMP2在正常胃粘膜上皮和粘膜内胃癌中的阳性表达率分别是7%和43.93%,有显著性差异(P0.01),MMP9在正常胃粘膜上皮和粘膜内胃癌中的阳性表达率分别为和23%和48.48%,无显著性差异(P0.05)。MMP9在淋巴结转移组中的阳性率(87.5%)显著高于无淋巴结转移组(36%),在有淋巴管侵犯病例中的表达率(83.3%)显著高于无淋巴管侵犯的病例(30%),差异均有统计意义(P0.05);而MMP2的表达与有无淋巴结转移及淋巴管侵犯均无显著相关性(P0.05)。结论:MMP9可能作为预测粘膜内胃癌是否有淋巴结转移的标志物,但需要结合组织分化、肿块大小和淋巴管侵犯等临床病理特点综合判断。MMP2可能与粘膜内胃癌的发生有关而作为早期诊断的指标。     

MRI在直肠癌术前N分期中的应用价值研究

目的：分析直肠癌直肠系膜内淋巴结的MRJ表现,评价MRI在直肠癌术前N分期中的应用价值。方法：对2011年8月至2012年2月经手术治疗并经病理证实的116例直肠癌病例行术前MRI检查,观察和记录每个淋巴结的大小、边缘以及信号,以病理学诊断转移淋巴结阳性为标准进行分组,由2位影像科医生采用双盲法阅片并达成一致。结果：MRI诊断直肠周围淋巴结转移的各项诊断标准具有统计学意义,其中淋巴结短轴直径与转移相关性的统计结果为（P〈0．05,r=0．210）,淋巴结边缘与转移相关性的统计结果为（P〈0．05,r=0．180）,淋巴结信号与转移相关性的统计结果为（P〈0．05,r=0．209）。Logistic回归分析显示淋巴结大小诊断淋巴结转移的可信度最高,Wals值为13．180。结论：综合分析直肠周围淋巴结大小,边缘、信号对诊断淋巴结转移有较大作用,其中以淋巴结大小的作用最为显著。     

腹腔镜下头侧中间入路治疗直肠癌患者的近期疗效及对第253组淋巴结的清扫效果分析

摘要 目的：分析头侧中间入路对腹腔镜直肠癌患者的近期疗效及第253组淋巴结的清扫效果。方法：2017年6月到2020年6月选择在江苏省中医院诊治的80例直肠癌作为研究对象,根据手术入路方式的不同分为中间组42例与外侧组38例。所有患者都给予腹腔镜直肠癌根治术治疗,中间组采用头侧中间入路,外侧组给予外侧入路,记录与随访近期疗效及第253组淋巴结的清扫效果。结果：所有患者手术过程顺利,吻合后系膜、肠管均无张力;中间组的第253组淋巴结清扫时间少于外侧组(P<0.05),两组的第253组淋巴结清扫数量对比差异无统计学意义(P>0.05)。两组的手术时间、术中出血量对比差异无统计学意义(P>0.05),中间组的术后肛门首次排气时间、术后拔除引流管时间、术后住院时间显著少于外侧组(P<0.05)。中间组术后9个月的肠梗阻、吻合口漏、吻合口出血、切口感染等并发症发生率为4.8 %,显著低于外侧组23.7 %(P<0.05)。所有患者术后随访9个月,中间组的复发率为2.4 %,显著低于外侧组的15.8 %(P<0.05)。结论：头侧中间入路在腹腔镜直肠癌患者中的应用能提高第253组淋巴结的清扫效率,促进患者康复,减少术后并发症的发生,降低近期复发率。