论著

TAP 水平与乳腺癌分子分型、临床病理特征的相关性分析

Relationship between TAP level and molecular typing and clinicopathological features of breast cancer

:359-366
 
       目的  探讨TAP水平与乳腺癌分子亚型及临床病理参数之间的相关性。方法  以2021年3月—2025年1月期间收治的150例乳腺癌病例为样本,采用静脉采血方式测定TAP凝聚物表面积指标,通过免疫组织化学EnVision双步染色技术,对雌激素受体(ER)、雄激素受体(AR)、孕激素受体(PR)、Ki-67及p53等表达水平进行分析,采用荧光原位杂交(FISH)对人表皮生长因子受体2(HER2)基因扩增状态进行检测。结果  150例患者中,TAP强阳性131例,TAP弱阳性15例,TAP阴性4例,TAP阳性率97.33%。免疫表型:ER阴性43例,ER阳性107例;AR阳性133例,AR阴性17例;PR阴性60例,PR阳性90例;p53阳性73例,p53阴性77例;HER2强阳性41例,HER2弱阳性89例,HER2阴性20例;Ki-67增殖指数≥20% 116例,Ki-67增殖指数<20% 34例。FISH对65例免疫组织化学检测结果为HER2(2+ )的乳腺癌病例进行基因扩增状态分析,其中阳性7例,阴性58例。Ki-67高增殖组TAP表达水平显著高于低增殖组(P<0.05);不同临床分期患者TAP表达水平存在差异(P<0.05);三阴型、HER2阳性型、Luminal A型和Luminal B型的患者之间的TAP表达水平存在差异(P<0.05),各分子分型(HER2阳性型、三阴型、Luminal A型和Luminal B型)与其对应非分型组的TAP表达均无统计学差异(均P>0.05)。结论  TAP在乳腺癌中广泛表达,且与Ki-67增殖指数、临床分期呈正相关。虽然不同分子分型间TAP表达存在总体差异,但具体亚型对比未显示显著性,后期需扩大样本量验证。
       Objective  To explore the relationship between tumor abnormal protein(TAP)level and molecular typing and clinicopathological features of breast cancer.Methods  A total of 150 breast cancer cases admitted from March 2021 to January 2025 were enrolled in this study.The surface area of TAP condensates was measured using venous blood samples.The expression levels of estrogen receptor(ER),androgen receptor(AR),progesterone receptor(PR),Ki-67,and P53 were analyzed via immunohistochemistry(IHC)using the EnVision two-step staining technique.The amplification status of the human epidermal growth factor receptor 2(HER2+)gene was determined using fluorescence in situ hybridization(FISH).Results  Among 150 patients,131 cases were strongly positive,15 cases were weakly positive and 4 cases were negative,with a positive rate of 97.33%.Immunophenotype:ER positive in 107 cases and ER negative in 43 cases,133 cases were  positive for AR and  17 cases were negative,PR was positive in 90 cases and negative in 60 cases,73 cases were positive for p53 and 77 cases were negative.HER2 is strongly positive in 41 cases,weakly positive in 89 cases and negative in 20 cases.There were 116 cases with Ki-67 proliferation index ≥ 20% and 34 cases with Ki-67 proliferation index < 20%.Sixty-five cases of breast cancer HER2(2 )were detected in the later stage.by FISH,of which 7 cases were positive and 58 cases were negative.The expression level of TAP in patients with high Ki-67 proliferation index was higher than that in patients with low Ki-67 proliferation index(P<0.05).The expression level of TAP in patients with different clinical stages was different(P<0.05).There were differences in TAP expression levels among patients with triple negative type,HER2 positive type,Luminal A type and Luminal B type(P<0.05).There was no statistical difference in TAP expression between each molecular type(triple negative type,HER2 positive type,Luminal A type and Luminal B type)and its corresponding non-typing group(all P>0.05).Conclusions  TAP is widely expressed in breast cancer,and it is positively correlated with Ki-67 proliferation index and clinical stage.Although there is a general difference in TAP expression among different molecular typing,the comparison of specific subtypes shows no significance,and it needs to be verified by expanding the sample size 
论著

12例结肠粪性溃疡穿孔诊治分析

Clinical analysis of stercoral perforation of colon in twelve patients

:25-27
 
目的 探讨结肠粪性穿孔的发病原因、临床特点、诊断和治疗方法。方法 回顾性分析广州市第一人民医院2012年1月—2015年1月收治的12例结肠粪性穿孔病人的临床资料。结果 本组病人共12例,均因腹膜炎体征行剖腹或腹腔镜探查术,术中根据Maurer标准诊断为结肠粪性溃疡穿孔。本组病人术后治愈出院10例,治愈率为83.3%,2例80岁以上病人因感染中毒性休克、多器官功能衰竭分别于术后第2天及第3天在重症监护病房死亡,死亡率为16.7%,术后主要合并症为肺炎(10例,83.3%)及胸腔积液(12例,100%)。结论 在临床工作中,了解结肠粪性穿孔发生的危险因素,及时进行有针对性的辅助检查,快速手术干预是降低病死率的关键。
Objective To explore the causes, clinical characteristics, diagnosis and treatment of stercoral perforation of colon. Methods The clinical data of 12 cases of stercoral perforation of colon from Jan 2012 to Jan 2015 were retrospectively analyzed. Results There were twelve patients who were diagnosed stercoral perforation of colon according to accurate diagnostic criteria during the open or laparoscopic operation. Of the 12 cases, 10 cases (83.3%) were cured, 2 cases (16.7%) died because of septic shock and multiple organ failure in the intensive care unit. After operation 10 cases (83.3%) had pulmonary infection and 12 cases (100%) had pleural effusion. Conclusion The key of improve the prognosis of stercoral perforation of colon depends on the full understanding of risk factors, proper preoperative examination and prompt surgical procedures.
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