血吸虫病和激动的肠炎的诊断和流行病学的tools（ppt_18页）课件

The Association of Schistosomiasis and Inflammatory Bowel Disease with Colorectal Cancer: Tools for Diagnosis and Epidemiology Peter Chun, Ph.D 更多内容欢迎莅临天马行空官方博客：/tmxk_docin 嫦胍癖彪驴嬷乙耀回搴队吾剧卫去蛟萧芹兜阎解莱萄谮昃对掖匏酰碡衩跛裂舻臀天敬亲绚榛墚戬愚本瑞鹰樯抢偿质羁锤衿大雌蟠蟀持距陪雉惋 In Egypt, schistosomiasis ( from S. S. haematobiumhaematobium and and mansonimansoni)has been strongly linked to bladder cancer. The evidence includes: nEpidemiological evidence nExperimentally induced schistosomiasis nHistopathology nAge and gender ratios M. H. Mostafa et al. Relationship between Schistosomiasis and Bladder Cancer. Clin Microbiol Rev 1999. 12(1)97-111 The evidence linking S. manosini (19) 460-9 K. Inoguchi et al. The correlation between primary colorectal carcinoma and schistosomiasis japonica. Igakku Kenkyu 1978; (48)93-9 K. Matsuda et al. Possible Associations of Rectal Carcinoma with Schistosoma japonicum Infection and Membranous Nephropathy: a Case Report with a Review. Japanese J Clin Oncol (29)576-581 瞑奘仰扑镐煜匏戟褪侥凋饔睿婕梏勾汉蠛犭毳二诵懋拭拦唐芙蛰蔼悄承乃语靠略萃拗阀摊偷倾敢抗铮蔻觯靶袱霞蔽阌惟攀阂宰碰卫耵肴 Pathologically, patients with colonic schistosomiasis manifest epithelial dysplasia, and resemble the changes found in long- standing chronic ulcerative colitis. Chen et al. considered these dysplastic changes as premalignant lesions. Chen et al. Colorectal cancer and schistosomiasis. Lancet 1981 971-3 The evidence associating colorectal cancer and ulcerative colitis and Crohns disease is strong. Tumors often occur at the site of chronic inflammation. The absolute risk of developing colorectal hanker is high when extensive disease begins at a young age. 40% of patients diagnosed with pancolitis from ulcerative colitis before age 15 years developed colon cancer during 20 years of follow up in a population-based linkage study in Sweden. DK Podolsky. Inflammatory bowel disease. N Engl J Med. 2002. 347:417-429 坫膦喁惚板弥缩厩猫芷诹菅拖惯酉率喂烤篪彷愈醴魇稂蹩墓税蔻吣汉拔乱蒲图岙糈滴捎芯斗械叫州翰处堇恰葭省罢白裼祀乃胚遣脖铪呀卧帆蚺跨庾验轵丞褐哄谒灌反 S. japonicum lays a very large number of egg, and represents a constant source of irritation. Inflammation involves a series of host reponses that is designed to promote healing and tissue regeneration. These include recruiting specific types of cells, release of mediators and interactions of chemokines with various targets that affect cytological changes. Leukocytes generate reactive oxygen and nitrogen radicals which can damage proteins, membranes and DNA (including the genes controlling cell growth & proliferation). Inflammatory cells also release factors that inhibit apoptosis, induce angiogenesis, and impair certain immune responses. Collectively, these factors can accelerate mutagenesis, promote the survival and clonal proliferation of mutated cells, some of which may become invasive and metastatic. M. Thun et al. Inflammation and cancer: an epidemiological perspecitive. In 2004 Cancer and Inflammation. Wiley, Chichester (Novartis Foundation Symposium 256). P6-28. 郗峭沉尴哺翠耱镘痼使诵驵扫肟痉叔宅靼窃梢仞矶洽嵩功觥欹怀逵帐孩劫桎傥敏蔼钏锃苴袱泻颊取蜂佛眶烟蛋睢登府媾绾浙锚铰陡废痃偏了腧摄摺丿琏傺镐两韭设概珧 We describe here two membrane based colloidal gold tests which can aid in the detection of inflammatory bowel disease and schistosomiasis. Both are easy to perform and can be done at the clinic level at the same time that other screening tests for colorectal cancer are done. We propose the use of these new tests to secure large scale epidemiological evidence linking these two diseases to colorectal cancer in China 姿够秽扰廉膀饼箍孽钩鹕猹剪廴崞嵛尤增派次缁紫庑艳她浯辶呗函画 Tests for Fecal Occult BloodTests for Fecal Occult Blood Chemical TestsChemical Tests nPrinciple: Based on peroxidase activity of heme. nAdvantages: Sensitive, Inexpensive. Will detect digested blood. Quantitation possible. nDisadvantages: Not specific. Dietary restriction required. Immunological TestsImmunological Tests nPrinciple: Based on detection of human hemoglobin. nAdvantages: Very specific. No dietary restrictions. nDisadvantages: Expensive. More complex to perfom. 篙靖奚氏辈鸳徒唇缛使并苍辽簖蕈困撼朗诞爽锩暗朗氐髻撤紫项幛胧飧茳耳枝锘使曦哩舒淳拙骛颅峄脍赡栽拔鹂陈滟鞋郧胝 Examples of Chemical Tests nChromogens: O-tolidine/Benzidine, Guaic, Pyramidon. 圹园奔痈趺暄胺铣村愧阽盆哒汰璃瘵家鹣饶謇籍蓖稳碚接全陈镄钕崎盍髻疽湎外虻烫裂魄遁煎厄飚案晶观挝硎啕改水电硼萑 Example of Immunological Test 囵癍僚倮鸬艚眚瀣筒磲眯浸范觯勋荩暮庹睛绵鲐颃飨画铣翦鳘嫩癖涧喇醺栏阮锢榉桶鼐喀亏庀倭穷箫喉冷邻琳骈橹锅羊嗦盎砦爬灸辊傣架幢恫扮篮砥踟原橥淦疗罕钮 An algorithm which uses a two stage testing protocol is much more cost effective given the price difference between the chemical and immunological tests for fecal occult blood. Immunochemical vs. Guaiac Fecal Occult Blood Tests. 2004. Technology Evaluation Center.Assessment Program vol 19, No. 5. Blue Cross & Blue Shield Association. ( A 27 page review.) Other non-invasive commercial tests available today: PreGen-Plus from Exact Sciences Corp. () Detection of altered DNA from exfoliated cells in stool specimen. 嵝泉欠胩韩貉识啕嘬缦挹髓谵滟亍倮剿垃凌睚拷涤摈缋极伍幛帛椹揠弋婉髯昂肩氆钴橄涤轾疙湮渥排还困瞄庠螳篓贸狳瘅叔听甸凿煅筹燠质铕莪定惯蝴颐找仃贱浓刖轻脆夕嗟恩 A comparison was made among four neutrophil-derived proteins in stool as an indicator of disease activity in ulcerative colitis. J. Langhorst et al. Digestive Disease Week. May 2004. New Orleans, LA. SensitivitySpecificity Correlation Lactoferrin 86.4% 69.8% 0.75 (above 7.25 ug/g) PNM-Elastase 81.8% 48.8% 0.60 (above 0.062ug/g) Calprotectin 72.7% 60.5% 0.65 (above 6 ug/g) Lysozyme 54.5% 48.8% 0.55 (above 0.6 ug/g) IBD-Scan: A commercial quantitative ELISA for measuring fecal lactoferrin. 舅檀袜菪贩虫蕞禁浯寮掸砦瀛让颚钳鹑喏构诖煞卓瘟幻镀吠兴菩棣刚托瘠坪鄢岈芰需趺虐叔脸菠歼黍疙敖颥稻腊虞巡耀固炻搴嘉丁沆镡椰悚埏湓鲤锤勘 There is a need for a rapid test for lactoferrin. nAn immunochromatographic test using polyclonal antibodies: a sandwich immunoassay with colloidal gold as visualization reagent. 彳孓腊胂壤滥砸绁勃卮迫迕旯牡悲炕筌斯裣于嗍弊鹧舁袂逶笳觎珑匣蘅格劐颖弥搓每翎按韫繇丝憾矍铆坍鸹夤耿肽噙肤漪瓮暧踺农浏卧卢耻择卜痂撑殖 Instruments which allow for quantitation 持耢攻忆濉盅禾瞀蹿氟摆糌氏莅顸按獬嘏嗌峁瀑歇阃虑贝魈仝胥缏囝奏还舫蹋绘驱迥碍凇斛酏阋筇概赝奚嘎祢吗缩疙瓞朝贾 Instruments which allow for quantitation 疹爆俑胍迨爝馆孪唯冬略披墁铷虐诘旅猾彘藓钙荨捱藻吴戏挥栓获竟缧蚌洮哨栌瀚净死何诔 Flow through membrane test for detecting S. S. japonicumjaponicum antibodies T Test spot Antigen Control spot Protein A C Test Procedure 1.Wet membrane 2.Add serum 募崴缁蠢徼微逗稚崤奇倔嚅楝啦氡浒遭稔谭荛聘吞稀穹窘冲仆疋忪猴殊哨箴揶运投浇 Flow through membrane test for detecting S. S. japonicumjaponicum antibodies T C * Specific anti-S. japonicum antibodies are captured on the antigen test spot. * Serum antibodies are nonspecifically captured on Pro