目的 探讨Kruppel样因子5(KLF5)及其下游基因在乳癌组织中的表达,分析其与乳癌病理特点的相关性及在预测乳癌肺转移中的临床意义.方法 应用免疫组织化学方法,检测乳癌肺转移乳癌组织(35例)、乳癌无肺转移乳癌组织(35例)、乳腺良性肿瘤组织(20例)及乳癌肺转移原发灶癌旁正常组织(20例)KLF5、肿瘤坏死因子-α诱导蛋白2(TNFAIP2)和β-连环蛋白(β-catenin)表达,分析各因子表达与乳癌肺转移病人临床病理特征间的关系,Kaplan-Meier生存分析模型分析各因子表达与乳癌病人5年无远处转移生存率(DFS)及总生存率(OS)的相关性,单因素卡方检验和多因素二元Logistic回归模型分析KLF5、TNFAIP2和β-catenin对乳癌肺转移风险的预测价值.结果 乳癌肺转移组KLF5(χ2=25.881,P<0.01)、TNFAIP2(χ2=23.669,P<0.01)和β-catenin(P=0.002)阳性表达明显高于其他3组,乳癌肺转移组KLF5、TNFAIP2、β-catenin表达与组织学分级、脉管内癌栓有关(P=0.001～0.048);与年龄、分子亚型、ER、PR、HER-2、Ki67及生存状态无关(P>0.05).Kaplan-Meier生存分析显示,乳癌病人KLF5、TNFAIP2和β-catenin表达与DFS(χ2=5.371～7.084,P<0.05)、OS(χ2=4.152～7.670,P<0.05)显著相关.单因素和多因素分析表明,KLF5表达是乳癌发生肺转移的独立危险因素(HR=3.246,95％CI=1.197～12.046,P=0.034).结论 KLF5、TNFAIP2和β-catenin在乳癌肺转移乳癌组织中高表达且KLF5可能为预测乳癌肺转移风险的分子标志物.

患者男，38岁。因左腹股沟肿物于2015年10月入青岛大学医学院第二附属医院。曾于2008年无明显诱因左侧前臂出现散在红斑及皮下小结节，不久整个上肢变粗、肿胀，伴有皮温略升高，无疼痛及表皮破溃，临床在局麻下行前臂皮肤活检，当地医院诊断为“炎性肉芽肿”，患者服中药治疗。2010年左侧下肢外伤后肿胀增粗，左小腿肤色变暗变黑，皮温升高，表皮无破溃，未行处置。2015年10月发现左侧腹股沟肿物，时有疼痛，无发热、畏寒，伴盗汗，体质量减轻约10 kg。体检：左前臂及左小腿粗大、红肿，似橡皮肿，病变表面皮肤皱缩（图1），左下肢皮肤多发散在红斑，直径0．5～2．0 cm，左腹股沟触及多枚肿大淋巴结，质韧，无触痛，活动尚可。 B型彩超示：双侧腹股沟、双侧腋窝、双颈部及右侧锁骨上区多发肿大淋巴结，直径0．5～2．5 cm，部分淋巴结内部结构紊乱，血流信号极丰富，不除外淋巴瘤。临床再次行腹股沟淋巴结活检，并会诊当地医院皮肤活检病理切片。

目的观察TTF-1、Napsin A、CK7、P63和CK5/6在肺活检标本中不同肺肿瘤内的差异表达结果,探讨它们在各类型肺癌鉴别诊断中的价值,寻找最经济有效的抗体组合。方法 209例肺穿刺活检和支气管镜检标本中,原发肺癌202例,转移性腺癌7例。原发癌中,非小细胞癌162例,其中腺癌（AC）102例,鳞状细胞癌（SCC）55例,大细胞癌（LCC）5例;小细胞癌（SCLC）40例。通过免疫组织化学染色,观察TTF-1、Napsin A、CK7、P63和CK5/6在肿瘤中的表达情况。结果判定：阳性瘤细胞数≥10%为阳性,阳性瘤细胞数〈10%为阴性。结果 TTF-1在小细胞癌中表达率最高为97.5%（39/40）,在鳞状细胞癌中表达率最低为3.6%（2/55）。TTF-1和Napsin A在肺腺癌具有较高特异性,分别为96%、100%,而CK7具有较高敏感性（100%）;P63在鳞状细胞癌具有较高特异性（96%）,而CK5/6具有较高敏感性（95%）。结论肺活检取材较少的小标本,在鉴别低分化腺癌与低分化鳞状细胞癌、小细胞癌与低分化鳞状细胞癌较困难时,辅助免疫组织化学染色,联合应用TTF-1、Napsin A、P63和CK5/6,是一组最经济有效的抗体组合,同时也有助于对肺原发性腺癌与转移性腺癌的鉴别。

Objective To investigate the expressions of CD44+/CD24-/low phenotype in human triple-negative breast cancer and the relationship of CD44+/CD24-/low with clinic pathological features and prognosis in the triple-negative breast cancer.Methods 53 paraffin specimens of triple negative breast cancer patients were collected from January 2008 to December 2009. 53 paraffin specimens from non-triple negative breast cancer patients of same period corresponding clinical staging were randomly selected.The expression of CD44+/CD24-/low phenotype between the triple negative breast cancer patients and non-triple negative breast cancer patients by immunohistochemical technique for CD44 and CD24 staining were statistically analyzed so as to explore the relationship of CD44+/CD24-/low with clinic pathological features and prognosis in the triple-negative breast cancer.Results The positive rate of CD44+/CD24-/low in the triple-negative breast cancer of 54.7%.Discoveried that the proportion of CD44+/CD24-/low cells in the triple negative breast cancer patients group was significantly higher than those of in the non-triple negative breast cancer patients. The patients with gradeⅢ were 15 patients (28.3% ) in the TNBC group,and were 5 patients (9.4% ) in the NTNBC group (P<0.05) .In TNBC group, significant differences(P<0.05) were observed in recurrence 24.5% , systemic organ metastases 17% in the CD44+/CD24-/low (+) higher than in the CD44+/CD24-/low (-).In TNBC group, significant differences(P<0.05) were observed in the 5-year OS 62% , DFS 51% in the CD44+/CD24-/low (+) lower than in the&nbsp;CD44+/CD24-/low(-).Conclusion The recurrence , distant metastasis and poor prognosis of triple-negative breast cancer was associated with the elevated expression of CD44+/CD24-/low.

Objective To investigate the expression of nuclear factor kappa B( NF-κB),tumor necrosis factor α( IL-6) and Interleukin-8( IL-8) in human esophageal carcinoma tissues and their clinical action. Methods 48 samples of esophageal cancer tissues and corresponding samples of paracancerous normal esophageal tissues were collected,and. NF-κB,IL-6 and IL-8 were detected by immunohistochemistry SABC method. The correlation between the expression of NF-κB、IL-6 and IL-8 with the clinical pathologic features of esophageal cancer was analyzed. Results The positive expressions rates of NF-κB in esophageal carcinoma and adjacent normal esophageal tissues turned out to be 79. 2% and 45. 8% respectively,IL-675. 0% and 41. 7% and IL-8 83. 3% and 52. 1%. The difference was significant for all groups( P < 0. 05). The expression of NF-κB was closely associated with the expressions of IL-6 and IL-8 respectively. In addition,the expressions of NF-κB and IL-8 was correlated with lymphnode metastasis and stageing,IL-6 were with vascular invasion,lymphnode metastasis and stageing. Conclusions Highly expressed NF-κB and its induced inflammation factors had close relationship with clinical pathologic features of esophageal cancer,which suggest that the pathway of NF-κB play an important role in carcinogenesis and development of esophageal cancer.

目的探讨乳腺癌中LRP、GST-π、TOPOⅡ的表达及临床意义,以期为选择化疗方案提供参考,获得更有效的化疗效果.方法应用免疫组化SABC法,对80例乳腺癌的主要耐药指标LRP、GST-π、TOPOⅡ进行检测,并结合临床分期进行研究.结果乳腺癌中LRP表达率为80.00%(64/80),临床Ⅱ、Ⅲ期表达率显著高于Ⅰ期,GST-π表达率为65.00%(52/80),临床Ⅲ期表达率显著高于Ⅰ、Ⅱ期.TOPOⅡ表达率为55.00%(44/80),临床Ⅲ期表达率显著低于Ⅰ、Ⅱ期.LRP与GST-π间有明显相关性,说明它们对肿瘤耐药起作用具有一定的协同性.LRP、GST-π与TOPOⅡ间无明显相关性,说明它们各自的表达从不同方面对肿瘤耐药起作用.结论乳腺癌联合检测LRP、GST-π、TOPOⅡ对化疗药物的选择具有指导作用,对预后的判断有参考价值.

肿瘤细胞多药耐药的形成是化疗成功的一大障碍.肿瘤耐药性主要包括4个方面:①多药耐药(MDR1)基因过度表达介导的,称为典型多药耐药;②由拓扑异构酶Ⅱ(DNA topoisomerase Ⅱ,TOPOⅡ)介导的,称为不典型多药耐药;③谷胱甘肽S转移酶的表达;④肺耐药蛋白(lung resistance protein,LRP)的表达.我们采用免疫组织化学法对80例乳腺癌LRP、TOPOⅡ进行检测,现报告如下.

目的:探讨穿刺细胞学检查在乳腺疾病中的应用价值.方法:1800例乳腺疾病患者做针吸穿刺细胞学检查,并对其中778例做病理对照.结果:在有病理对照的778例中,共诊断乳腺癌168例,漏诊9例,诊断符合率94.7%,诊断良性疾病590例,漏诊27例,诊断符合率95.5%.