目的：探讨荧光原位杂交技术（FISH）检测乳腺癌Her2/neu的扩增情况，比较FISH法与免疫组织化学（IHC）法检测结果的一致性。方法：收集乳腺癌患者手术切除的肿瘤标本50例。经石蜡包埋，组织切片后，应用FISH法检测Her2/neu扩增情况，IHC法检测Her2/neu蛋白表达情况，并对两种检测方法的结果进行统计学分析。结果：50例标本中FISH阳性17例，FISH阴性33例，FISH阳性率34%（17/50）。 50例标本中IHC（~）14例，IHC(0~+)36例，IHC蛋白表达率28%(14/50)。FISH法与IHC法检测结果的总符合率为82%(41/50)(K=0.581)。结论：FISH法具有较高的稳定性与可靠性，临床开展FISH法检测Her2/neu基因扩增情况作为IHC法的补充, 可以更加准确和客观地对乳腺癌患者的治疗和预后进行评价。
Objective To explore the expression of tumor necrosis factor (TNF) mRNA, TNF and TNFR in the gallbladder mucosa which developed from hyperplasia, dysplasia to carcinoma, and to further discuss the relationship between TNF and pathogenesis of gallbladder carcinoma. Methods In situ hybridization and immunohistochemistry were used to determine TNF mRNA, TNF protein and TNFR protein expression in hyperplasia, dysplasia and carcinoma of gallbladder. Results ①No one of 20 cases of gallbladder hyperplasia was found to express TNF mRNA, while 4 of 20 (20%) cases of dysplasia and 18 of 20 (90%) cases of carcinoma were found to express TNF mRNA (P＜0.05). ②For the expression of TNF mRNA in mononuclear cells (MNC), positive staining was found in 15% of gallbladder hyperplasia, 85% of dysplasia and 90% of carcinoma, respectively (P＜0.05). The cell numbers of positive staining MNC were 4.85±1.50, 6.00±2.71 and 9.33±3.07, respectively (P＜0.05). ③In gallbladder carcinoma, the cell number of carcinoma and MNC with positive TNF mRNA expression was correlated with clinical stage (P＜0.05). The higher the clinical stage, the more the positive staining cell numbers. The positive staining cell numbers of carcinoma in stage Ⅰ-Ⅲ and Ⅳ-Ⅴ were 9.13±4.39 and 14.80±4.02, respectively (P＜0.01), and the positive staining cell numbers of MNC were 7.13±2.53 and 11.10±2.23, respectively (P＜0.05). ④The cell numbers of carcinoma and MNC with TNF mRNA expression increased with tumor size. In tumors with diameter over 2 cm and less than 2 cm, the positive staining cell numbers of carcinoma were 14.00±4.20 and 8.83±4.96, respectively (P＜0.05), and that of MNC were 10.50±2.54 and 7.00±2.83, respectively (P＜0.05). ⑤The region of TNF protein expression was similar to that of TNF mRNA, but TNF protein expression was more frequent and wider than that of TNF mRNA. ⑥The tumor necrosis factor receptor was expressed in tumoral vascular endothelial cells and MNC in all cases of carcinoma, but was negatively stained in mucosa epithelial cells and tumor cells of all cases. ⑦There was positive linear correlation in TNF mRNA between tumor cell and MNC (r=0.687, P＜0.01), same as that in TNF protein expression (r=0.742, P＜0.01); and there was positive linear correlation in tumor cell between TNF mRNA and TNF protein expression (r=0.847, P＜0.01), same as that in MNC (r=0.643, P＜0.01). Conclusion The TNF mRNA and TNF protein expression are increasing during the development of gallbladder mucosa epithelial from hyperplasia, dysplasia to carcinoma, and increasing with tumor stage. It suggests that TNF may contribute to carcinogenesis of gallbladder carcinoma induced by gallstone, and related to the progression of gallbladder carcinoma.
ObjectiveTo study the expression of HOX A9 mRNA and its clinicopathological significance in the benign and malignant lesions of pancreas. MethodsIn situ hybridization for HOX A9 mRNA was used on routine paraffinembedded sections. ResultsThe positive rate and scoring mean of HOX A9 mRNA expression was significanfly lower in pancreatic carcinoma (49%, 3.3±2.1) than that in chronic pancreatitis (95%, 5.4±0.8) and pericancerous tissues (80%, 4.6±1.2), the negative case of HOX A9 mRNA in chronic pancreatitis and pericancerous tissues showed middle or severelyatypical hyperplasis of the ductal epitheli. The positive rate and scoring mean of HOX A9 mRNA expression was significantly higher in the cases of welldifferentiation (63%, 4.0±2.2) or without metastasis (64%, 4.1±2.2) than that in the ones of poorlydifferentiation (32%, 2.6±2.3) or with metastasis (32%, 2.7±2.2). ConclusionThe expression of HOX A9 mRNA might be related the carcinogenesis, progress, biological behaviors, and prognosis of pancreatic carcinoma. The assay of HOX A9 mRNA expression in the benign lesions of pancreas might have important clinical values in the prevention and earlystage finding of the pancreatic carcinoma.
【Abstract】Objective To study the relationship of the expression of CD44v6 mRNA and nm23H1 mRNA with the clinical pathology parameter and prognosis of breast cancer, and to investigate the correlation of the expression of CD44v6 mRNA and nm23H1 mRNA. Methods In situ hybridization and CSA immunohistochemistry method were used to detect the expression of CD44v6 mRNA and nm23H1 mRNA in 94 cases of breast cancer. Results The positive expression of CD44v6 mRNA and the negative expression of nm23H1 mRNA were positively correlated with the grading, clinical stage, lymph node metastasis, and recurrence and prognosis of breast cancer. CD44v6 mRNA expression and nm23H1 mRNA were negatively correlated in breast cancer. Patients who had positive expression of CD44v6 mRNA and negative expression of nm23H1 mRNA had a higher lymph node metastatic rate and a lower survival rate. Conclusion Several genes were involved in the occurrence and development of breast cancer in which the expression of CD44v6 mRNA has synergistic action in negative regulation with that of nm23H1 mRNA. Combined detection of the expression of these two mRNA is helpful to judge the metastasis, recurrence and prognosis of breast cancer.
Objective To investigate the association of the expression of CD15 mRNA with the invasion and prognosis of hepatocellular carcinoma (HCC) and the expression of nm23H1 mRNA. Methods In situ hybridization and immunohistochemistry methods were used to detect the expression of CD15 mRNA and protein nm23H1 mRNA in HCC.Results In 99 cases of HCC, the positive rate of CD15 mRNA,its protein and nm23H1 mRNA were 38.4%, 36.4% and 76.8%, respectively. The expression of CD15 mRNA was consistent with its protein and negatively correlated with the expression of nm23H1 mRNA. The expression of CD15 mRNA and its protein, nm23H1 mRNA were associated with the invasiveness and metastasis of HCC and the prognosis of HCC patients. Conclusion The detection of CD15 expression could be a new pathological biology index to judge the metastasis and prognosis of HCC.
Effect of radical operation on expression of interleukin-2(IL-2)mRNA and production of IL-2 were markedly reduced preoperatively and four weeks after operation,expression of IL-2 mRNA significantly enhanced,but it was still lower than that in the normal group.Production of IL-2 nearly reached normal level,When PBL was activated by phytohemagglutinin(PHA),expresseion of IL-2 mRNA and production of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 mRNA and production of IL-2 are dificient in gastric cancer patients,and radical surgery will help them to recover and they can also be improved through activation with PHA.
Objective To investigate surgical strategy for the treatment of muscular ventricular septal defect （MVSD） in infants with multiple ventricular septal defects（VSD）. Methods Clinical data of 46 infants with multiple VSD who underwent surgical repair in Shanghai Children’s Medical Center from January 2010 to April 2012 were retrospectively analyzed. There were 24 males and 22 females with their age of 8±6 months and body weight of 6.1±1.9 kg. All the patients received one-stage surgical repair，among whom MVSD of 10 patients was not found and repaired during the surgery. MVSD was repaired by surgical suture in 19 patients，hybrid repair under direct vision in 12 patients，and hybrid repair via the right ventricle in 5 patients. All the patients were regularly followed up after discharge by chest X-ray，ECG and color Doppler echocardiography to observe the closure of MVSD and the presence of residual shunt. Results All the 46 patients with multiple VSD survived their surgery without perioperative death. Three patients undergoing hybrid repair under direct vision received delayed sternal closure. One patient undergoing hybrid repair under direct vision had postoperative cardiac dysfunction. All the 46 patients were followed up for 1-17 months. Twenty-three patients had residual shunt of varying degrees during follow-up，and most of the MVSD of patients with residual shunt were ＜4 mm，who were receiving further follow-up and evaluation. Conclusion Appropriate surgical strategies can be applied according to specific surgical views during the operation for the treatment of MVSD in infants with multiple VSD，and satisfactory clinical outcomes can be achieved.
Abstract: Objective To summarize the clinical experiences of onestage hybrid operation for treating typeB aortic dissection and aortic aneurysm involving distal aortic arch, explore the indication for this special technique and analyze shortterm followup results. Methods From October 2008 to May 2010, 16 consecutive patients received onestage hybrid operation in Fu Wai Hospital for aortic dissection or aortic aneurysm involving distal aortic arch. There were 12 males and 4 females. Their age ranged from 38.0 to 67.0 years (54.0±9.2 years). There were 14 patients of typeB aortic dissection, 1 patient of thoracic aortic aneurysm involving the aortic arch, and 1 patient of penetrating aortic ulcer. Among them, 10 were acute ones and 6 were chronic ones. Brachiocephalic artery bypass using neck incision with retrograde endovascular stent graft implantation was used. Four patients received bypass from the left common carotid artery to the left subclavian artery; 11 patients underwent bypass from the right common carotid artery to the left common carotid artery; and 1 patient had both of the bypasses. Intensive care unit(ICU) stay, hospital stay， and incidence of complications were closely monitored after operation. Computed tomography(CT) and general condition of the bypass grafts and its blood flow were followed up at three months and one year after operation. Results No death or severe complications occurred perioperatively. All onestage surgeries were technically successful with stent grafts implanted. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleakage of the stent grafts. One patient had mild paraplegia and recovered soon after treatment. Ventilation time of these patients was 2.010.0 hours (5.3±2.7 hours). The ICU stay was 0.0-2.0 days (1.1±0.4 days) and hospital stay was 4.0-7.0 days (5.3±0.8 days). The expenditure of blood products was 0.0-1 016.5 RMB (134.5±281.8 RMB). All patients were followed up with a followup period of 3.0 to 26.0 months (130±5.1 months). All patients recovered to normal social life. Enhanced CT scanning at three months and one year after operation showed no endoleakage or translocation of the stent grafts and 100% patency of the bypass grafts. There was no obvious change of the distal part of the dissection except some thrombosis formation in nine patients. Conclusion Onestage hybrid operation is safe and effective in shortening the duration of the operation and hospital stay, reducing the surgical trauma and sufferings of the patients, and lowering the risk of staged operations with satisfactory shortterm results. This special technique may expand the indications of simple endovascular repair. The mid and longterm results still need to be followed up.