Fine needle aspiration cytology in the diagnosis of bone lesions

OBJECTIVE: Fine needle aspiration cytology (FNAC) in combination with radiological examination has recently gained clinical recognition for evaluating skeletal lesions. We evaluated our experience with the use of FNA in diagnosing bone lesions with emphasis on areas of difficulty and limitations. MATERIALS AND METHODS: Over a period of 5 years FNA was performed in 66 cases of bone lesions. Aspirations were done by cytopathologists using 22-gauge needle. Out of 66 cases unsatisfactory aspirate was obtained in 12 cases. Cytohistological correlation was available in 19 cases. RESULTS: Adequate aspirates were categorized into neoplastic (27 cases) and non-neoplastic (27 cases) lesions. Of the 27 neoplastic aspirates, 20 were malignant (12 primary, 8 metastatic deposits) and 7 were benign. In the malignant group osteosarcoma was correctly diagnosed in 3 cases while other 3 were labeled as sarcoma NOS because of lack of osteoid. Metastatic deposits were sub-typed in 6 cases; from renal cell carcinoma (3 cases), proststic adenocarcinoma, follicular carcinoma thyroid, and squamous cell carcinoma. Neoplastic group comprised of 6 cases of cysts and 21 cases of chronic osteomyelitis. Thirteen cases were diagnosed as tuberculous osteomyelitis. CONCLUSIONS: FNA is a frequent indication in metastases in the bone where distinct cytologic features can even identify an unknown primary. However, diagnosis of primary tumours of the bone is limited by precise subtyping of the tumours. FNA has emerged as a cost effective tool for initial diagnosis of both neoplastic and non-neoplastic lesions of the bone.     

Epstein-Barr病毒的免疫调控与逃逸机制北大核心CSCD

EB病毒(Epstein-Barr Virus,EBV)属于γ疱疹病毒科,是第一个被发现与人类肿瘤相关的DNA病毒。EB病毒通过激活Toll样受体(Toll like receptors,TLRs)信号通路,诱导I型干扰素的大量释放和功能性的自噬机制,从而引起机体的免疫应答。然而,相对于其他疱疹病毒,EB病毒已进化出更为精细且错综复杂的机制来破坏和逃逸宿主的免疫系统,如限制自身蛋白表达、活化宿主的泛素-蛋白酶体系统、干扰或逆转自噬与泛素化修饰等。这些机制会引发EB病毒在宿主体内的持续性感染,导致宿主免疫功能失调,引发EB病毒相关疾病(如鼻咽癌、传染性单核细胞增多症等)。因此,研究EB病毒特异性的免疫调控机制不仅对深入理解EB病毒的潜伏性感染和致癌性至关重要,而且还将为EB病毒诱发的相关疾病的免疫预防与治疗鉴定出新的潜在靶点。此文主要阐述了EB病毒调控宿主免疫应答和逃逸先天免疫应答的分子机制。     

nm23-H1调控肿瘤侵袭转移分子机制研究进展

侵袭转移是恶性肿瘤的重要生物学特征,也是导致肿瘤患者治疗失败和死亡的主要原因。研究表明,nm23基因家族与肿瘤的发生、发展及转移密切相关。其中,nm23-H1是被发现的第一个人类nm23基因,与肿瘤侵袭转移关系极为密切。现将nm23-H1基因调控肿瘤侵袭转移分子机制的研究进展作一综述。     

surv iv in 及B c l-2 基因在非小细胞 肺癌中的表达和相关性

目的：探讨Survivin基因的表达在肺癌发生、发展中的作用及其Bcl-2蛋白表达的相互关系。方法：应用PT-PCR检测Sur-vivin mRNA的表达。结果：表达阴性的肺癌病人总生存率明显高于阳性表达的病人,并且其表达与患者年龄、性别、吸烟史、组织类型、肿瘤分化、大小及纵隔淋巴结转移无显著相关。免疫组化显示,肿瘤细胞胞浆和胞核中Survivin阳性表达分别为70％和80％,胞浆和胞核同时阳性为54％,Survivin在胞浆中的免疫活性与肿瘤分期有关（P=0．019）,与患者生存期无关。在所有类型的肺癌中,鳞状细胞癌中的Survivin明显增高。用免疫组织化学链霉菌抗生物素蛋白过氧化酶法（SP法）检测Bcl-2蛋白的表达。Bcl-2在鳞癌中的阳性表达率为最高。结论：Survivin基因在非小细胞肺癌中表达上调,提示其通过抑制细胞凋亡,在肺癌癌变发生、发展中起重要作用,可能成为肺癌基因治疗的新靶点,其阳性表达亦预示肿瘤有较高的侵袭性和不良预后,Survivin基因与凋亡抑制基因Bc12的共同表达可能在肺癌中起协同作用。     

When plant teratomas turn into cancers in the absence of pathogens

Habituated calli have long been classified as neoplasms together with tumors from different origins. The general opinion is that habituation is a reversible process with an epigenetic basis. This is probably true in most cases examined. However, we show here that there might be several degrees of habituation, which can be considered as steps of a neoplastic progression leading to cancerisation in the absence of an introduced oncogenic pathogen. Cell rejuvenation, loss of the capacity to organize meristematic centers, and loss of totipotency are proposed to define plant cancer through this neoplastic progression of a callus.
Habituated tissues share many morphological and biochemical similarities with so-called vitreous shoots from micropropagation. Vitrification and hyperhydric malformations of shoots raised in vitro may be considered as steps of another neoplastic progression, which leads to cancerisation also in the absence of introduced oncogenic pathogens. In this case death of the whole organism occurs either through direct apex necrosis or indirectly, from the loss of the capacity for the primary meristems to function normally, which gives rise to completely anarchic structures. As in the animal kingdom, carcinogenesis in plants is the final result of a multistep process involving the irreversible conversion of a stem cell to a terminal-differentiation-resistant cell.     

Relationship between levels of Skp2 and P27 in breast carcinomas and possible role of Skp2 as targeted therapy

Estrogen receptor-negative breast carcinomas are more aggressive and are unresponsive to anti-estrogens. Thus, they clearly require new therapies targeted against specific genes and proteins actively engaged in the pathophysiology of cancer. The S-phase kinase-associated protein Skp2 is required for the ubiquitin-mediated degradation of the cdk-inhibitor p27 and is a bona fide proto-oncoprotein. We attempted to explore whether Skp2 may be a potential specific therapeutic target in the subset of aggressive breast carcinomas by investigating the possible relationship between expression of Skp2 and p27 proteins and estrogen receptor (ER). Immunohistochemical analysis of tumor tissues was employed to determine the expression of Skp2, p27, and ER proteins in 82 cases of primary breast carcinoma. Higher levels of Skp2 were detected more frequently in ER-negative tumors and tumors metastatic to the axillary lymph nodes. The expression of p27 was inverse with the histologic grade. Statistical analysis showed that the percentage of high Skp2 expressors was significantly greater in the group with low p27 expression than in the group with high p27 expression. The current study, together with the results from a previous study, demonstrated the existence of a subtype of high-grade, negative ER breast carcinomas with high Skp2 and low p27 levels. This implies that Skp2 may be a potential specific therapeutic target in a subset of aggressive breast carcinomas. Thus far, there is no specific therapy for the ER-negative and HER-2/neu resistant groups, which are among the subset of aggressive tumors.     

肿瘤旋磁治疗机的基本原理与临床初步应用

ZCX-Ⅱ型旋磁治疗机由上下两对磁头组成,下磁头由电动马达驱动,而上磁头则是在下磁头耦合力的作用下而发生同步旋转,以达到人体组织纤维与磁力线发生相对运动,从而产生磁生物学效应的目的,属国际首创。随机选择的32例临床放弃治疗的晚期恶性肿瘤患者,使用ZCX-Ⅱ型肿瘤旋磁治疗机,采用不同的治疗参数进行治疗。结果观察,症状完全缓解率达28.1%,部分缓解率达65.6%,总有效率为93.8%1,年生存率为28.1%。治疗后所有患者的临床症状和体征均可得到不同程度的改善和缓解,且无任何严重地毒副作用。文中介绍了该设备的基本原理、使用方法和临床疗效,并对其临床相关问题进行简要讨论。     

[F]Fluorodeoxyglucose positron emission tomography in advanced thyroid cancer

In recent years, [¹⁸F]Fluorodéoxyglucose-PET imaging has emerged as an important oncological imaging modality. In metastatic thyroid carcinoma (M1), [¹⁸F]FDG-PET has been shown to have a high sensitivity in non iodine-avid metastases and/or dedifferentiated tumours and may therefore provide real-time prognostic information. The use of [¹⁸F]FDG-PET is more controversial in M0 patients with low residual serum Tg values but is very sensitive in aggressive histotypes such as tall cell variants of papillary thyroid carcinomas.     

胃癌患者血清IL-17、IL-6和TGF-β1水平及其临床意义

目的:探讨胃癌患者外周血中白介素17(IL-17)、白介素6(IL-6)和转化生长因子-β1(TGF-β1)的表达水平及其临床意义。方法:选择2009年1月~2010年1月我院收治的50例胃癌患者(观察组)及同期50例健康对照者(对照组)为研究对象,采用ELISA法检测和比较其外周血中IL-17、IL-6和TGF-β1的水平,并分析胃癌患者外周血中IL-17、IL-6和TGF-β1水平与其临床病理特征之间的相关性。结果:观察组患者外周血中IL-17、IL-6和TGF-β1的水平分别为(8.51±2.68)pg/ml、(7.81±5.41)pg/ml和(1093.42±831.21)pg/ml,均明显高于健康对照组(P0.01)。胃癌患者的血清IL-17、TGF-β1的水平与其年龄、性别、临床分期、有无淋巴结转移、分化程度、肿瘤部位及大小均无明显相关性(P0.05);而血清IL-6的水平与肿瘤的大小相关(P0.05),但与其他临床病理特征无关(P0.05);血清IL-17水平与IL-6、TGF-β1的水平均无明显相关性(P0.05)。结论:血清IL-17、IL-6和TGF-β1水平的升高与胃癌的发生有关,但IL-6和TGF-β1可能不是血清中IL-17生成的诱导因子。