目的:探讨ΔNp63和Ki67在膀胱移行上皮癌(transitional cell carcinoma of bladder,TCCB)中的免疫组化表达及与膀胱癌病理分级、临床病理分期和预后的相关性。方法:随机选择2006～2007年间56例TCCB和12例正常膀胱黏膜病理切片用SP免疫组化行ΔNp63和Ki67检测,将结果与病理分级、分期和预后进行分析。结果:ΔNp63和Ki67在膀胱移行细胞癌中的阳性表达率明显高于正常膀胱黏膜(Plt;005)。ΔNp63和Ki67在低分化、浸润性癌组织中的阳性表达率明显高于高分化、浅表性癌组织,在膀胱癌的病理分级和临床分期之间表达差异有统计学意义(Plt;005)。ΔNp63和Ki67在复发病例中的阳性表达率显著高于初发病例(Plt;005)。采用Spearman等级相关性分析对ΔNp63和Ki67在TCCB中的表达进行比较,ΔNp63与Ki67呈正相关,rs′为0316,且Plt;005。结论:ΔNp63和Ki67与膀胱癌的临床病理分级和分期及预后密切相关,随膀胱癌分化程度的降低和浸润程度的增加而增强。ΔNp63和Ki67在TCCB的进展中可能有相互协同作用,ΔNp63可能通过促进细胞增殖发挥促癌作用,联合检测ΔNp63和Ki67可以作为判断TCCB的预后的肿瘤标记物。
ObjectiveTo evaluate the safety and feasibility of laparoscopic hepatectomy. Methods A total of 25 patients with hepatocellular carcinoma or liver hemangioma received laparoscopic hepatectomy, and perioperative results were analyzed. ResultsOnly one patient was converted to open hepatectomy because of massive hemorrhage. Blood loss of all patients during operation ranged from 100-1 200 ml with an average of 400 ml. The total blood volume of transfusion was 200-1 000 ml (mean 400 ml) in 14 patients. The operative time was 0.8-4.0 h (mean 2.3 h). All patients had no complications such as bile leakage and infection, and discharged from hospital in 5-10 d (mean 8 d) after operation. ConclusionLaparoscopic hepatectomy is safe and feasible to some liver diseases, but should be used with caution for the patients with tumor diameter over 9 cm and hepatic large vessels invaded by cancer.