目的 探讨血管生成相关因子：癌基因HER2、缺氧诱导因子（HIF）和血管内皮细胞生长因子（VEGF）在乳腺癌组织中的表达及其与血行转移的相关性。方法 应用免疫组织化学技术（SP法）检测51例乳腺浸润性导管癌组织中HER2、HIF-1α、VEGF蛋白的表达并随访其术后5年内远处血行转移的情况。结果 51例乳腺浸润性导管癌组织中HER2、HIF-1a和VEGF表达均彼此相关。单因素分析显示44例乳腺浸润性导管癌中HER2、VEGF、淋巴结转移和临床肿瘤分期与癌的远处血行转移相关，HIF-1α表达与远处血行转移不相关（P>0.05）。23例淋巴结阴性乳腺癌中，仅VEGF表达与其远处血行转移密切相关（P<0.05）。结论 乳腺浸润性导管癌组织中HER2可能通过HIF-1α途径调节VEGF蛋白的表达，参与乳腺癌血管的生成。VEGF表达可作为术后预测血行转移的指标之一，HER2过度表达和HIF-1α表达不能预测远处血行转移。

目的 探讨白细胞浸润和新生血管与下肢静脉性溃疡的关系。方法 采用不同体位下肢血常规白细胞计数和免疫组织化学法测定微血管密度，比较溃疡组、无溃疡组和对照组的白细胞计数和微血管密度。结果 溃疡组中，患肢下垂位血白细胞计数比平卧位减少237%，与其他组相比差异有统计学意义（P<0.05）；患肢皮肤中白细胞和微血管密度比其他组明显升高，差异有统计学意义（P<0.01）；白细胞与微血管密度呈显著正相关（rE0.73，P<0.05）。结论 白细胞浸润和新血管生成是下肢静脉性溃疡发生发展的重要因素。

Tumor progression largely depends on blood supply and neovessel formation, and angiogenesis is emerging as a promising target for cancer therapy. Vascular endothelial growth factor (VEGF), a major proangiogenic molecule, stimulates angiogenesis via promoting endothelial proliferation, urvival and migration. VEGF has been found to be up-regulated in various types of tumors and to be associated with tumor progression and poor prognosis. Inhibition of VEGF or its signaling pathway has been shown to suppress tumor angiogenesis and tumor growth. In the present study, we tested the antiangiogenic and antitumor effects of soluble VEGF receptor-1 [soluble Flt (sFlt)-1] on the growth of follicular thyroid carcinoma (FTC). We constructed a 293 embryonic kidney cell line (293-Flt1-3d) that expresses sFlt-1, which is composed of the first three extracellular domains of Flt-1. The 293-Flt1-3d cells inhibited the in vitro growth of human umbilical vein endothelial cells in a paracrine manner. The in vivo antitumor and antiangiogenic activities of the 293-Flt1-3d cells were tested. When 293-Flt1-3d cells were inoculated at a site remote to the FTC-133 tumor transplant, the growth of FTC-133 tumors were inhibited by 70.37%, as compared with the control treatment with 293 cells expressing control gene LacZ. Immunohistochemical analysis of microvessel densities in treated tumors demonstrated that 293-Flt1-3d cells robustly suppressed intratumoral angiogenesis. Our data suggest that a mammalian cell-mediated approach could effectively deliver sFlt-1 gene therapy and inhibit tumor angiogenesis and tumor growth.

Despite the availability of effective treatments for Graves' disease, there are patients who are unable to tolerate, or choose not to accept, current therapies (oral medication, radioactive iodine, or surgery). In this study, we have examined the use of thyroid arterial embolization as an option for patients who suffer from Graves' disease and who fit into one of the preceding patient groups. Selective arteriography, followed by embolization of thyroid arteries, was performed using Seldinger's technique in 22 patients with Graves' disease. Six of the patients received both arterial embolization and surgery at 2-3 wk after embolization. No serious complications were noted in any patient. In those who were treated with only interventional embolization, 14 of 22 (63.6%) became euthyroid and remained in this state for the duration of the study. The remaining 2 patients required a maintenance dose of antithyroid drug therapy (tapazole, 5-10 mg/d; or propylthiouracil, 50-100 mg/d). Patients were followed for a median time of 27 months (range, 6-50). At the end of the follow-up period, all 22 patients were euthyroid, the size of thyroid gland had decreased by one third to one half its original volume, but 2 patients continued to require antithyroid drugs. Histologic analysis of thyroid tissue from 6 patients who had embolization followed by surgery showed that embolization blocked both the superior and inferior thyroid arteries plus most of their branches. Evidence of chemical inflammation, necrosis, and fibrosis were observed in embolized thyroid tissue. The average diameter of capillary network within the body of the thyroid adjacent to superior and inferior artery was 0.12-0.25 mm, with the smallest ones ranging from 0.04-0.11 mm. The diameter of the capillaries in the isthmus ranged from 0.13-0.15 mm. The average diameters of the superior and inferior arteries were 2-5.5 and 3-3.75 mm, respectively, measured using radiographs from angiography. Based on the measured diameters of arteries, the appropriate size of embolizing granules can be selected, and complete embolization of the majority of the thyroid glands was achieved with a high frequency of therapeutic success. Histological examination of the thyroid tissue and clinical follow-up after embolization indicate that this procedure is an effective, minimally invasive, and safe method for the treatment of Graves' disease patients who cannot, or choose not to, accept current therapies.