PROTEÇÃO MIOCÁRDICA CIRURGIA CARDIOVASCULAR INCOR - HC - FMUSP INCOR - HC - FMUSP.
tmmu.edu.cnaammt.tmmu.edu.cn/Upload/PaperUpLoad/357d728b-defd-421d...HC] 24.85±1.36...
Transcript of tmmu.edu.cnaammt.tmmu.edu.cn/Upload/PaperUpLoad/357d728b-defd-421d...HC] 24.85±1.36...
书书书
!"#$
:10005404(2014)20211305!"
Carfilzomib#$%&'()*+,-./01234
!
"
1,#$%
1,&'(
1,)*+
1,,-.
2,/
0
1 (400016!"
,!"#$%&'()*#+
:,-.$
1,/0
.$
2)
[56
] %&
12
carfilzomib(CFZ)3456789:;<=>?@AB
。'(
BALB/cCDEFGHCDI
-J
C26KL
,MN56789OP
,Q
40R
BALB/CCDSTAUVWXYZ[\]
(HC)、CFẐ_]
(CP)、CFZ`
a]
(CT)、789]
(CC),b]
10R
。cdefg
、h9g?ijklm
,GHn)
5、12o
CP、CT]Ypqrst
CFZ,)
19ouvwxy
。zgCD
、{-<
、569g
,dg56h|
,ELISAX}d~����~����Ⅱ��
,qRTPCR
�
Westernblot}d{-<
ATF2、pATF2、MAFbx�
MuRFl�
mRNA�����
。)*
CD9g�{-<9g
HC]
>CP]
>CT]
>CC]
(P<005),569g�h|
CC]
>CT]
>CP]
(P<005);~���
、~����Ⅱ,{-
<
ATF2、MuRFl�
MAFbxmRNA?��9
HC]
>CP]
>CT]
>CC]
(P<005),�
pATF2�
ATF2���
CP]
>CT
]
>HC]
>CC]
(P<005)。)+
CFZ3456789CD:;<=>����B
pATF2�4�����~�
�����
、�B�����h���56����
。
[789
] 56789
;Carfilzomib;� ¡
ATF2;��~������
;�����h��
[:;<1=>
] R730.6;R966;R977.3 [?@ABC
] A
[DEFG
] ¢
£
,Email:tanglihua6969@sina.com
[HIJK
] http://www.cnki.net/kcms/detail/51.1095.R.20140821.1521.037.html(20140821)
CarfilzomibamelioratesskeletalmuscleconsumptioninmicewithcancercachexiaanditsmolecularmechanismWangQiang1,ZhengYueyong1,PengXudong1,KangQingjie1,DengDawei2,TangHua1(1DepartmentofGastrointestinalSurgery,2DepartmentofHepatobiliarySurgery,theFirstAffiliatedHospitalofChongqingMedicalUniversity,Chongqing,400016,China)
[Abstract] Objective Tostudytheroleofcarfilzomib(CFZ)intheameliorationofskeletalmuscleconsumptionincancercachexiaanditsassociatedmechanism.Methods Cancercachexiamodelwasinducedbyinjectingmurinecolon26adenocarcinomacellsintomaleBALB/cmiceintraperitoneally.BALB/cmiceweredividedinto4groupsrandomly,includingahealthycontrolgroup(HC),aCFZpreventiongroup(CP),aCFZtreatmentgroup(CT)andacancercachexiagroup(CC).Atdifferenttimepoints,foodintake,bodyweightandspontaneousactivityweredetected.FollowingadministrationofCFZintraperitoneallytwiceaweektoCPandCTgroupsonthedays5and12aftertumorcellsinjection,respectively,allmiceweresacrificedonday19.Mousebody,tumorentityandgastrocnemiusmuscleontheleftsidewereaccuratelyweighedandthevolumeoftumorsweremeasured.TheserumlevelsofreninandangiotensinⅡ weredetectedbyELISA.ThemRNAandproteinlevelsofATF2,pATF2,MAFbxandMuRFlweredetectedbyrealtimePCRandWesternblotting.Results ComparedwiththeCCgroup,theweightofmousebodyandgastrocnemiusmusclewerebothincreasedintheCPgroupandCTgroup(P<005),whichwerestilllowerthanthatoftheHCgroup(P<005).ThetumormassandvolumeoftheCTgroupweregreaterthanthatoftheCPgroup,lessthanthatoftheCCgroup(P<005).ComparedwiththeCCgroup,thelevelsofreninandangiotensinⅡ intheserumandthemRNAandproteinexpressionofATF2,MuRFlandMAFbxingastrocnemiusmuscleoftheCPandCTgroupweredecreased,however,theratioofpATF2toATF2wereincreased.TheaboveresultshadstatisticalsignificancebetweentheCPgroupandtheCTgroup(P<005).Conclusion CFZamelioratesskeletalmuscleconsumptionincancercachexiamice,whichmayberelatedtotheinhibitionofpATF2degradationresultinginsynthesisblockofreninangiotensinsystemandthesuppressionofubiquitinproteasomepathwayandtumorgrowth.
3112)
36¤)
20¥
2014¦
10§
30̈ )
©
ª
#
%
&
&
«
J Third Mil Med Univ Vol.36,No.20
Oct.30 2014
[Keywords] cancercachexia;carfilzomib;phosphoATF2;reninangiotensinsystem;ubiquitinproteasomepathway
Correspondingauthor:TangHua,Email:tanglihua6969@sina.com
56789
(cancercachexia,CC)¬�®��
¯°±²³�´µ¶·¸�¹ºk:;<]»¼½
(�¾¿�ÀÁ]»¼½
),ÂÃĹ*ÅÆ�ÇÈZ
ÉÊ�ËÌÍÎÏÊ
[1]。�ÐÑWÒ
,�
50% ~80%�7k56ÓÔj�56789
[2-3],ÕÖ
30%�
56ÓÔ×GvØ56789
,�³¬JÙyÚ
[2]。
Û�
,ÜÝZÞ
,¿�*ßÏà�`a56789�á
â
,®��¯°±²³�µ¶·¸ãä789W
å
[1]。Ìæ
,çÒ56789�j�AB
,èéê�
`aëì
,íîï56789�_`ð�!%ñò
。
56789óôÉʬõö:;<÷ø
,Õ^n
³ù
。ú¦ûü
,�����h���ý�4567
898þ%ÿY:;<��9
[4]。��~����
��í��9��4ð�!ô!"
,~����Ⅱ�
ý×G#l�����h��ý�4��9
[5-6]。�
� ¡¸$#lÌÍ
2(phosphorylationofactivatingtranscriptionfactor,pATF2)
�ý�B��W%
[7],
pATF2i�&�����h�4
。Carfilzomib(CFZ)
¬*H���h�B'
[8],�ý�B]»��
��hlk
,()�ý�B56��
[9-10]。Ìæ
,y
ûü*+�12���h�B'
CFZ�,�B
pATF2�4
,%-�.3456789�/�
。
1 LMNO<
1.1 12
0kú1�
BALB/cCD
,6~82
,h9g
20~22g,SPF3
,45Ø!"#$%&67m89:
。CDI-JKL;
Colon26(C26)&!"#$%&5667<=>
。MAFbx�
MuRFl?h
(SantaCruz@A
);ATF2�
pATF2?h
(Epitomics@A
);GAPDH�B?
(CDEFG�8�H@A
);Westernblot
I�J'K
(LMo@A
);���~����ⅡELISAJ
'K
(BIOFINE@A
);RealtimePCRI�J'K
(TaKaRa@
A
);õ8
(TaKaRa@A
);CFZ(Selleck@A
)。
1.2 3456789:;<=>?@A
40RCDSTAUVWXYZ
4]
:[\]
(HC)、CFẐ_]
(CP)、CFZ`a]
(CT)、789]
(CC),b]
10R
。N
OkP°
12
,YpwíU��¥�
C26I-JKLQR
0.1mL(
S
1×106ßKL
)GHØ
CP、CT、CC]CD�TUVE
F
,HC]CDGHWh|��àX�
,GHY+
0.5hZµ
[
。\?EF56)]^cd56h|
。56h|_`@a
:
V=ab2/2,a、bbW56��c�dc
。ef6CDefg¼
½
,gålm3h
、ijjkWWå
,ÂÕh9gF�-�[\
]��_&lm)
,n¹o789¥
。
1.3 BCDEF
bop)cdCDefg
、h9g
、ij
、qrst
。GH
n)
5o
CP]f6CDuvqrst
CFZ2.0mg/kg(b2
2w
)[11]^_
;)
12o¹o789
,CT]uvqrst
CFZ2.0mg/kg(
b2
2w
)̀a
,HC]�
CC]uvWh|�àX
�
。)
19owxy~
,<zx{
1hnY|~�
,}~Ø
-80℃
���"
;���uvCD
,Y|{-<�56]»
,zgC
D
、56
、T�{-<9g
,dg56h|
;{-<]»��R
��}
,n{Ø
-80℃�~
。
1.4 RealtimePCRGFHIJK
ATF2、MAFbx、MuRFImRNA
LM
îw{-<]»
RNA,d
RNA�c��c
,·¸$Ï[
cDNA。�"
SYBRGreenRealtimePCRMasterMix��J'
K
,ý·¸$�
cDNAZO�¹º���O
,��õ8�W
1。10μL�Oh�
:2μLcDNA,0.3μL�、F�õ8
,5μL�Ï
�Ñ
,2.4μL���
;�O��Z
:95℃^�k
1min,95℃�
k
5s,60℃ ¡
15s,72℃¢£
15s,¤¥
40w
。/�¦Ì
mRNA�IíW%���"
2-ΔΔCt_`@a
。!§
3w67
。
P
1 QRSTUVW
¦Ì õ8¨©
ATF2��
5′GCCCTTCCTCTCCTCAACCA3′F�
5′AGTCCTAACCAATCCACTGCCA3′MAFbx
��
5′GAAGAGAGCAGTATGGGGTCAC3′F�
5′CTTGAGGGGAAAGRGAGACG3′MuRF1
��
5′GGAACACGAAGACGAGAAAATC3′F�
5′TGGCTATTCTCCTTGGTCACTC3′GAPDH
��
5′GGTGAAGGTCGGTGTGAACG3′F�
5′CTCGCTCCTGGAAGATGGTG3′
1.5 WesternblotGF
ATF2、pATF2、MAFbx、MuRF1NOLM
Q
0.5g{-<]Ȼo
RIPA«4R¬
,|:
、w��
Rnd��9�c
(BCAX
),"
10%SDSPAGEY|®¯°
,
PVDF±¸±
,5%�À²³´µ
,�
ATF2(1∶2000)、pATF2(1∶2000)、MAFbx(1∶1500)
�
MuRF1(1∶1500)、GAPDH(1∶1000)
?h¶·
4℃¸
,TBSTR¹±
,º�IOB?¶
·n¹±
,¡&j�X»¼
。!§
3w67
。
1.6 ELISAGFP*QR7PSTURⅡVW
½4
-80℃~�xy
,¾¿xÀÁ
,ª~�xy?³(
�cxÀÁ
("ØNÂxÀÃÄ�bßÅc�xÀÁý?bß
ÆyÇÈ
2ߧÉ
),�zÊ
,¹Ë
,»Ì
,ÍÞ�On
,�x
Î
450nmÏ�ШdgÑÉ��Òc�
[D(450)]。ÓÔx
ÀÃÄ?dÕÑÆy�
D(450)�ÕgÆy9�Sg
。
4112)
36¤)
20¥
2014¦
10§
30̈ )
©
ª
#
%
&
&
«
J Third Mil Med Univ Vol.36,No.20
Oct.30 2014
1.7 XYZ5[
_gÐÑ" 珋x±sWÖ
,�"
SPSS19.0�_�
,Ë]�
Ø�"ÙÌ�ÚlYÛ
,]ÜÝÝ�Ø�"
SNKq}7
。
2 XY
2.1 CFZ\]^_`abD89cd?ef
GH
5dn
CC]
、CP]
、CT]CDUVEF�\?56
,
12dn
CC]gåh9g»ÞF�
、gåef¼½
、ij�ßà
�áÕjk
、ijk�àlm¼½
、qr³âW789Wå
。
�
CFZã^n
,)
19oCDh9g�{-<9g
HC]ä
CP]ä
CT]ä
CC]
(P<005);Õ
CFZ�»Þ�B56��
�
,3]f6CD56h|�9g
CP]å
CT]å
CC]
(P<005);
ðh�W
2。f6CDefgæ�
HC]»Þ�ç
,Ì
]ܿ�һlm
(P>0.05)�è©g
。
P
2 QZ[\]
19̂_`)a
、bc,)a
、%&)ad`efg
(n=10,珋x±s)
]p h9!
(g){-<9g
(mg)69g
(g)6h|
(cm3)HC
]
24.85±1.36 137.5±13.29 - -CP
] 22.50±1.36a 110.8±13.70a 2.26±0.36a 2.54±0.41a
CT] 20.38±0.81ab 102.93±9.80ab 3.38±0.40ab 3.90±0.48ab
CC] 17.24±0.90abc 74.57±6.37abc 4.87±0.39abc 5.47±0.48abc
a:P<005,g
HC6hi
;b:P<005,g
CP6hi
;c:P<005,g
CT6hi
2.2 ELISAGF]^P*QRDPSTURⅡLM
jk
Ié�ê
1。+
CC]9~����~����ⅡW%�
�»ÞïØ
HC]
、CP]�
CT]
,Õ
CP]
、CT]��Yp�
CC]�ç
55.01%、34.77%(P<005);CP]
、CT]~���
�ⅡYp�
CC]�çë
46.40%、31.43%(P<005);Ñ]Ü
��_&lm
(P<005)。
2.3 RealtimePCRGF]^HIJ
ATF2、MAFbxD
MuRF1mRNALMjk
�
HC]�Ø
,f6CD�{-<¦Ì
ATF2、MAFbx�
MuRF1mRNAW%g»Þìï
(P<005)。�
CC]I�
,CP]CD{-<¦Ì
ATF2、MAFbx�
MuRF1mRNAW%gYp
�çë
33.97%、68.59%、51.65% (P<005),CT]CD�{
-<¦Ì
ATF2、MAFbx�
MuRF1mRNAW%gYp�çë
14.14%、38.05%、31.78%(P<005,ê
2)。
!"
#!
$%
&!
&%
'!
(%
)!
*+
!
"
!"
#$
%&,-./'
01( 12( 13( 11(
4
45
456
7(+
)++
8+
9+
$+
(+
+
)*
+,
"!
-.
%&,-.//
01( 12( 13( 11(
4
45
456
:
;
(0
(0
a:P<005,g
HC6hi
;b:P<005,g
CP6hi
;c:P<005,g
CT6hi
;
1 QZ[\hijk
(A)dhlmnkⅡ(B)Popq
2.4 ]^HIJ
ATF2、pATF2、MAFbxD
MuRF1N
O<LMjk
Ié�W
3、ê
3。�
CC]�Ø
,CP]�
CT]CD�{
-<]»
ATF2、MAFbx�
MuRF1���9W%gæF�
(P<005),
í¬
pATF2���9W%���ï
(P<005);CT]
�
ATF2、pATF2、MAFbx�
MuRF1��9W%���
CP]Ç
ìï
(P<005)。pATF2�
ATF2���
,CC]�
HC]
、CP]
、CT]ç
(P<005),í¬
HC]�
CT]lmà�_&ñò
(P>005)。
P
3 QZ[\bc,
ATF2、pATF2、MAFbx、MuRF1rs)t
uPoa
(n=3,珋x±s)]p
ATF2 pATF2 MuRF1 MAFbx pATF2/ATF2HC
]
0.228±0.066 0.147±0.026 0.185±0.110 0.146±0.019 0.646±0.040CP
] 0.351±0.023a 0.285±0.088a 0.425±0.010a 0.298±0.015a 0.816±0.66a
CT] 0.484±0.036ab 0.339±0.015ab 0.699±0.034ab 0.471±0.020ab 0.704±0.060b
CC] 0.6158±0.043abc0.259±0.020abc 0.743±0.022abc 0.559±0.011abc 0.421±0.025ab
a:P<005,g
HC6hi
;b:P<005,g
CP6hi
;c:P<005,g
CT6hi
!
"
#
$%&
$%'
(%&
(%)
)%&
)
!*+$,-.!!"#$%
/#& #0& #*& ##&
1
12
123
4
5
6
&
7
8
$
(
)
9!+2:,-.!!"#'%
/#& #0& #*& ##&
1
12
123
7;&
7%)
8%&
8%)
$%&
$%)
(%&
(%)
)%&
)
9<-+(,-.!!"#'%
/#& #0& #*& ##&
1
12
123
&( &( &(
a:P<005,g
HC6hi
;b:P<005,g
CP6hi
;c:P<005,g
CT6hi
;
2 QZ[\
ATF2(A)、MAFbx(B)d
MuRF1(C)mRNAtuPopq
5112)
36¤)
20¥
2014¦
10§
30̈ )
©
ª
#
%
&
&
«
J Third Mil Med Univ Vol.36,No.20
Oct.30 2014
!!"#$%&$!'(
)
*
!+!",$-&$!.(
)
*
!/01,.-22!.(
)
3
!/4#5672$!.(
)
*
!849:;-)&!.(
)
*
. $ ) 2
1:HC6
;2:CP6
;3:CT6
;4:CC6
;
3 QZ[\bc,
ATF2、pATF2、MAFbx、MuRFld
GAPDHrs)Popq
3 v!
56789ýî¥Zh9gï!F�
、<ð]»
(ñ¾³ñÀÁ]»
)¹ºk=>Z»ÞÉÊ
,()ñ
�òf
、�5
、ó~
、ËôõÆ�ö÷WWå
[1],ã+
ø%Yc�¼ùÓÔ��l9g
,øîÓÔ��~)
Ü
。:;<÷ø������h��
、iú½�h�
�
、û|Í#l������
、üýoþ���
(ÿ!
���
)���¦9"(�����WÌ���
,í
56789j�
、j#�$%AB&Ý'³�(
。
CFZ¬*Hê�³�·k���h�B'
[9]。
CFZ�ý'gÐ)k��B*+]».���]»,
������hlk
,()�ý'g�)ÜÐ)k
�B-D./6��
[10,12]。¸$#lÌÍ
2(ATF2)¬*Hl¡��
1¸$ÌÍ
[13],+O#0#F
,@l
k1a
pATF2�ý�B2Ëë¦Ì
(3��
)W%
。
��~������+56789�j�
、j#9ö
4&�!ô!"
[5-6],@9~����Ⅱ�ý#l+
:;<9ÉmkW%������h���5G�
E3MuRFl�
MAFbx��4:;<
[14]。��¬~�
���6¸¡Z~����Ⅰ�H�ÌÍ
,~���
�Ⅰ+¸¡��!"F1[~����Ⅱ。DeschW
[7]«7
,cAMP�O8�IÏØ��¦Ì9:;<
cAPM�O8�I��
,�
pATF2=IÏØ
cAPM�O8�I��
,�ý>?k�B��W%
。��
�h�B'�ý34~����Ⅱõö�@ï~A�
~�!N
[15]。í¬
,���h�B'¬,�ý�B�
�~�������3456789B�«7
。
y67ûüjå
,CCCD&Ø560#!"
,
ATF2W%g�ª
,�����h��lk�C�D¹
pATF2�4
,pATF2/ATF2��F�
;()�
ELISA}djå
,~����~����ⅡW%g&Ø
pATF2F��»Þ�ï
;MuRF1�
MAFbx�
mRNA���W%���ï�í:;<�4�ª
;Ìæ
CCCDh9g
、{-<9g¼½
,569g�h|�ª
。
�
CFZ̀an
,ATF2W%�ç
,�����h��l
k��B
pATF2�4
,EÕ
pATF2/ATF2���
ï
;()~����~����ⅡW%g�ç
,{-<
MuRF1�
MAFbxW%=F�
;CDh9g»Þ�ª
,
{-<9g��
,ijklmgÒ»îï
,56h|�
9g»ÞF�
。îÖ
CFZ�ý3456789¹Y
。
()+56��F¥uv^_"G
,.é»Þ�ª
。
��ÌZF¥56HfC�íAhO#0#½
,ATF2W%½
;CFZF¥»Þ�B56��?
pATF2�4�
E~����Ⅱ��»Þ¼½
,MuRF1¾
MAFbx�
W%¼½
,Ìæ{-<�4¼½
。±²F¥ã^56
789ð�»Þ!"�Iì
[1]。
��J
,CFZ3456789:;<=>��
��B
pATF2�4
,K��B���W%ý��~
����Ⅱ�L�
,EÕ
MuRF1�
MAFbxW%F�
;
()���×G�B
MuRF1�
MAFbxlk?56�
���
。Ìæ
,CFZ�M[Z^_�`a56789
ØN�G8
。í¬56789¬*ßËÌÍÎÏÙ
,
CFZ3456789�¹Y¬,O�@PQR��'
�¹*Å�ûü
。
wx?@
:
[1]FearonK,StrasserF,AnkerSD,etal.Definitionandclassificationofcancercachexia:aninternationalconsensus[J].LancetOncol,2011,12(5):489-495.
[2]vonHaehlingaS,AnkerSD.Cachexiaasmajorunderestimatedunmetmedicalneed:factsandnumbers[J].IntJCardiol,2012,161(3):121-123.
[3]KumarNB,KaziA,SmithT,etal.Cancercachexia:traditionaltherapiesandnovelmolecularmechanismbasedapproachestotreatment[J].CurrTreatOptionsOncol,2010,11(3/4):107-117.
[4]PolgeC,HengAE,JarzaguetM,etal.MuscleactinispolyubiquitinylatedinvitroandinvivoandtargetedforbreakdownbytheE3ligaseMuRF1[J].FASEBJ,2011,25(11):3790-3802.
[5]RajanV,MitchWE.Ubiquitin,proteasomesandproteolyticmechanismsactivatedbykidneydisease[J].BiochimBiophysActa,2008,1782(12):795-799.
[6]DuJ,HuZ,MitchWE.Cellularsignalsactivatingmuscleproteolysisinchronickidneydisease:atwostageprocess[J].IntJBiochemCellBiol,2005,37(10):2147-2155.
[7]DeschM,HackmayerG,TodorovVT.IdentificationofATF2asatranscriptionalregulatorofreningene[J].BiolChem,2012,393(1/2):93-100.
[8]KhanML,StewartAK.Carfilzomib:anovelsecondgenerationproteasomeinhibitor[J].FutureOncol,2011,7(5):607-612.
[9]DemoSD,KirkCJ,AujayMA,etal.AntitumoractivityofPR171,anovelirreversibleinhibitoroftheproteasome[J].CancerRes,2007,67(13):6383-6391.
[10]JakubowiakAJ.Evolutionofcarfilzomibdoseandscheduleinpatientswithmultiplemyeloma:ahistoricaloverview[J].CancerTreatRev,2014,40(6):781-790.
6112)
36¤)
20¥
2014¦
10§
30̈ )
©
ª
#
%
&
&
«
J Third Mil Med Univ Vol.36,No.20
Oct.30 2014
[11]DasmahapatraG,LemberskyD,SonMP,etal.ObatoclaxinteractssynergisticallywiththeirreversibleproteasomeinhibitorcarfilzomibinGCandABCDLBCLcellsinvitroandinvivo[J].MolCancerTher,2012,11(5):1122-1132.
[12]MansourMA,AljoufiMA,AlHosainiK,etal.Possibleroleofselective,irreversible,proteasomeinhibitor(carfilzomib)inthetreatmentofrathepatocellularcarcinoma[J].ChemBiolInteract,2014,215:17-24.
[13]GozdeckaM,BreitwieserW.TherolesofATF2(activatingtranscriptionfactor2)intumorigenesis[J].BiochemSocTrans,2012,40
(1):230-234.[14]YoshidaT,TabonyAM,GalvezS,etal.Molecularmechanismsand
signalingpathwaysofangiotensinIIinducedmusclewasting:potentialtherapeutictargetsforcardiaccachexia[J].IntJBiochemCellBiol,2013,45(10):2322-2332.
[15]LiS,WangX,LiY,etal.Bortezomib,aproteasomeinhibitor,attenuatesangiotensinIIinducedhypertensionandaorticremodelinginrats[J].PLoSOne,2013,8(10):e78564.
(yz
:20140417;{|
:20140518)
(lm
nop
)
!"#$
:10005404(2014)20211701}~N��
��������hl��&
1�
qrs
,Utu
,vwk
,xyz
,{
|
,}
~
,�
�
,!�(
(225001ST UV
,UV%&WX#&+r�.$
)
[789
] �EÆ~�ZE6
;+56
;̧.6
[:;<1=>
] R739.41 [?@ABC
] B
[DEFG
] �YZ
,̄[
:(0514)87373565,Email:zhanghengzhu@sina.com
[HIJK
] http://www.cnki.net/kcms/detail/51.1095.R.20140916.1649.004.
html(20140916)
�EÆ~�ZE6
(epithelioidhemangioendothelioma,EHE)
¬*Hj8\øç
,í]^_`�çc7k56
。EHE�+¶ÚÑÿaj�
,bc�Øde�×]»
,@wZfE�
gã
,=��Ø/
、h
、:
、+
、,-7
、ij
、:k
、�lsjW
ÿa
。åmn+o`�
1pqZ¸.k
EHE,IÏI�rs«
t3F
。
1 ���M
ÓÔ
,uk
,44v
,Ì
“�§fw
5dx
ӯ
2013¦
1§
18¨o+
。o+)ÙsýyzÆfwZó
,�j!
,ñ7:{
|
,àeh}~
。��ÓÔ
20¦U�º���%*�
,18¦U
jå/k56
,º¡a?9G`a
,6¦U�jå
“ËjhI
�
”(ðh`a³�
),à56��8�
。o+�h
:r��(
,
��ÉW%W�
,�
3.0mm,��t��
,de<�<��
�c
。�ÿ
CT�C��Ö
:Ýh���ËjCI�¼
,b%Ô
�
6mm,�CnC¡³Ò»
。ÝhËj¸.��
,/k1t
³��
;fq
MRI��
:T������QRI�¼
,%C�
34mm×31mm×35mm,Z�� sî
T1îT2QR¼
,2¡�
% �5QR¼
。¢�¦£�;
、¢�C+?T¤��û¡Q
RI�¼
。�Cn�ËjI�¥1C¡Ò»
(ê
1A)。IÏÓ
Ô��8�?¼¥&ÐÑ
,¦Å`�ZqZ¸.6
,®96?
§�¨8³©*
。ª«ÓÔqZ8�
,¬a.OÒ»
,®¯
�`a
。o+
10dnÓÔ+¶°Fº]q+56%*�
,�9
�56±²³Ì
,~´*µ
,9¶·¸�û¡
,ÿY±¹º»
Æ
,56��c+]»¼H½�
,�9¾��}«tîÖ7k
56
。�n8àîÖZ
:¿FÖËÀ;g~Áv
,2¡6KL
�1
,L�1
,L9�
,À;�
“ÅÆÆ
”IM
,ÇZ6^
C~�
(ê
1C)。ÈÉ]¡Ié
(ê
1D):CKpan、CD31、CD34(Ç
+),AFP、CK19、CK20、CK5/6、CK7、D240、F8、GFAP、P63、S100、TTF1、Villin、NapsinA、P40(
Ç
),Ki67(�
<5% +)。I
Ê
:̧.k�EÆ~�ZE6
,IÏ8�
,+/kèé6jÀ
。
�nÓÔfwÒ»34
,àËÌ
、ÍÎ
、ÏÐWÂjÙ
。bÍ`
�
:qZ¸.k�EÆ~�ZE6
,Z/k¸.
。3ߧnÑ`
§�fq
MRI�C��îÖ
:T���;��
T1QR¼
,è�
C¡?§jÊÒ
,x8Àè�Ò»Ó�
(ê
1B)。/UÓÔÒ
%TÔ9
。
! "
# $
A:���"��
MRI;B:���"��
MRI;C:HE����
(×400);D:
��6�
CD34(+)(SP×400);
1 �G�%&���������
MRIP�/��(����
2 v!
EHE¬*HB��ý�EÆKLZÉÊ�~�ZE56
,
&
WeissW
[1]Ø
1982¦wîgÂÕÖZ
EHE,@�8&º
(��
2128�
)
7112)
36¤)
20¥
2014¦
10§
30̈ )
©
ª
#
%
&
&
«
J Third Mil Med Univ Vol.36,No.20
Oct.30 2014