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Purpose To analyze the correlations between PD-L1 expression and clinicopathological factors and their prognostic values in esophageal squamous cell carcinoma (ESCC) patients.Methods PD-L1 expression in the primary tumors from 253 patients with ESCC was evaluated using tissue microarray and immunohistochemistry (IHC).PD-L1 positivity was defined as positive staining of 1％ and 5％ tumor cells.Survival curves were constructed by using the Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.Results Overall,tumoral PD-L1 expression was potentially associated with favorable DFS and OS.When the patients were stratified into stage Ⅰ + Ⅱ (60.9％,154/253) and stage Ⅲ + Ⅳa (39.1％,99/253),the prognostic role was not consistent.In patients with stage Ⅰ + Ⅱ disease,tumoral PD-L1 expression was associated with better DFS and OS upon multivariate analysis (1％ as the cutoff:P =0.046 and 0.021,5％ as the cutoff:P=0.011 and0.004).However,PD-L1 expression was not correlated with prognosis in patients with stage Ⅲ + Ⅳa disease (1％ as the cutoff:P =0.586 and 0.682,5％ as the cutoff:P =0.807 and 0.620).Conclusion The prognostic role of tumoral PDL expression is variable in different stages of ESCC,and tumoral PDL expression is an independent favorable predictor in ESCC patients with Stage Ⅰ-Ⅱ disease,but not in stage Ⅲ-Ⅳa or lymph node metastasis.
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Objective@#To investigate the clinical features, immunohistochemical and differential diagnosis of desmoplastic fibroblastoma.@*Methods@#The clinical data and pathology features of 7 cases of desmoplastic fibroblastoma were collected and immunohistochemical study were carried out in all cases with a review of the literatures.@*Results@#There were 2 males and 5 females, with age ranging from 31 to 71 years (average and mean age were 59 and 61 years, respectively). The tumors were located in extremities and abdomen (left toe and right toe, right foot back, left leg and right thigh, right forearm and left hepatic lobe). Clinically, the tumors presented as slow growing painless masses of long standing duration. Grossly, the tumors were well-circumscribed with firm, white to gray cut-off surface. Tumor size ranged from 1.2 to 4.0 cm in maximum diameter (average 3.0 cm). Microscopically, 2 cases were located in dermis, 4 cases were located in subcutaneous and 1 case was located in liver parenchyma. It was composed of spindle-shaped or stellate cells with a fibroblastic or myofibroblastic appearance, and sparsely scattered in densely fibrous or fibromyxoid background. There was small vascular component in tumor background. At high magnification, the tumor cells were medium size with abundant cytoplasm, and the nucleus were small and always with small nucleoli. In some cases, the tumor cells were slightly larger with enlarged nuclei, but without cellular atypical and mitosis. Immunohistochemical study showed that the tumor cells were strongly positive for vimentin, desmin, S-100 protein and CD34, but CKpan was negative. α-SMA showed focal positive in one case. Ki-67 index ranged from 1% to 2%. Four cases were followed-up (ranged from 11 to 21 months, average 16.5 months) and the patients had no recurrence after surgery.@*Conclusions@#Desmoplastic firoblastoma is a rare soft benign tumor. The differential diagnosis includes other benign or low-grade fibroblastic/myofibroblastic lesions.
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To investigate the clinicopathological features as well as prognosis of early esophageal squamous cell neoplasm (ESCN) treated with endoscopic resection (ER).Methods 368 patients were collected from 2007 to 2013.Clinicopathological features including invasion depth and margin were evaluated.Survival curves were constructed by using the Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.Results There were 252 males and 116 females with a median age of 61 (16-84) years.Patient numbers of hyperplasia,low grade intraepithelial neoplasia,high grade intraepithelial neoplasia,m1,m2,m3,sm1 and sm2 were 47(12.8％),61 (16.6％),61 (16.6％),54(14.7％),38(10.3％),63(17.1％),12(3.3％) and 32(8.7％),respectively.The cumulative overall 1-year,3-year,and 5-year rates of survival in the metachronous esophageal lesions were 4.1％,12.9％ and 32.6％,respectively.The incidence of lymph node/distant metastasis was 1.54％ in m3,6.25％ in sm2,and 0 in other subgroups.The overall 1-year,3-year,and 5-year survival rates were 99.5％,97.3％,and 87.5％,respectively.Significant difference was identified between sm2 and non-sm2 patients in metastatic rate (P =0.021),however,no significant difference existed between m3 patients and sm2 patients (P =0.252).Metachronous esophageal lesion and survival between sm2 and non-sm2 patients demonstrated no statistical difference (P =0.401 and P =0.634).Conclusion ER is an effective and relatively safe treatment for superficial ESCN.The procedure is still appropriate in selecting sin2 patients.It is necessary to monitor the second primary cancer in sm2 patients during follow-up.
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Background and purpose:Epidermal growth factor receptor (EGFR) gene mutation is the most important predictive factor for determining the effectiveness of EGFR tyrosine kinase inhibitors (TKIs) for non-small cell lung cancer (NSCLC). This study aimed to determine the clinical application value of mutation-speciifc immu-nohistochemistry forEGFR mutation detection in NSCLC.Methods:Mutation-specific immunohistochemistry and ampliifcation refractory mutation system (ARMS) were used simultaneously to detectEGFR gene mutation status in 290 lung cancer specimens. The sensitivity, speciifcity, positive predictive value (PPV) and negative predictive value (NPV) of mutation-speciifc immunohistochemistry for detectingEGFR gene mutations were evaluated. The consistency was analyzed between mutation-speciifc immunohistochemistry results and ARMS results.Results:With ARMS testing as the gold standard, when a cutoff value of score 1+ was used as positive by immunohistochemistry, the sensitivity of mutation-speciifc immunohistochemistry forEGFR gene mutation was 72.92%, speciifcity 95.20%, positive predictive value 93.75% and negative predictive value 78.08%. The accuracy of immunohistochemistry was obviously different when variousEGFR gene mutations were detected. The sensitivity of immunohistochemistry for exon 19 deletion was only 55.55%, but speciifcity was above 99%. When immunohistochemistry score was 1+, the sensitivity for L858R mu-tation was 90.27%, whereas speciifcity was 95.86%. When immunohistochemistry score was 2+ or 3+, the speciifcity for L858R mutation was 98.63%-100%. The results of mutation-speciifc immunohistochemistry were ifnely correlated with mutation status determined by ARMS assay (P<0.001, Kappa value: 0.612-0.864). Mutation-speciifc immunohis-tochemistry can directly determineEGFR gene mutation abundance at the cellular level.Conclusion:Mutation-speciifc immunohistochemistry could be an effective supplemental method toEGFR molecular tests.
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<p><b>OBJECTIVE</b>To study the clinicopathological characteristics of hepatic angiomyolipoma (HAML) and to evaluate the correlation between clinicopathological parameters and tumor subtypes.</p><p><b>METHODS</b>Retrospective analysis of clinicopathological features was conducted in 182 cases of HAML.</p><p><b>RESULTS</b>HAML patients were predominantly female (M:F=1:4) and most commonly presented with non-specific symptoms. The median age at diagnosis was 46 years, ranged from 17 to 77 years. Tumor diameter was ranged from 0.3 to 32.0 cm with an average of 5.0 cm. Majority of the tumor was epithelioid type (112/165, 67.9%). Extramedullary hematopoiesis, multinucleated giant cells, intranuclear inclusions, nucleolus, cellular atypia, invasive growth pattern, multiple masses, hyperpigmentation and purpura-like changes mostly occurred in the epithelioid type (P<0.05). Extramedullary hematopoiesis was commonly seen in HAML, the significance of which was still uncertain.</p><p><b>CONCLUSIONS</b>Most of HAML are epithelioid type, characterized by a proliferation of predominantly epithelioid cells, in which extramedullary hematopoiesis is commonly seen. Some morphologic features that may predict malignant such as necrosis, mitotic figures, and tumor emboli are only found in the epithelioid HAML. Mitotic activity, tumor necrosis, tumor thrombus, giant cells, periportal invasion, multiple lesions and tumors size over 10 cm are closely related with tumor recurrence and metastasis.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Angiomyolipoma , Diagnosis , Pathology , Epithelioid Cells , Cell Biology , Gastrointestinal Neoplasms , Diagnosis , Pathology , Giant Cells , Pathology , Necrosis , Neoplasm Recurrence, Local , Prognosis , Retrospective StudiesABSTRACT
Objective:To study the clinicopathologic features of IgG4-related pulmonary inflammatory pseudotumor (IRPIP), and its correlations with CD4+T lymphocytes and interleukin-10 (IL-10) expression,and to investigate the immunopathological factors in the disease of IgG4-related pulmonary inflammatory pseudotumor .Methods: Expressions of IL-10, CD3, CD20, CD4, CD8 were examined by immunohistochemistry in 17 cases of IgG4-related pulmonary inflammatory pseudotumor tissues and 15 cases of IgG4-nonrelated pulmonary inflammatory pseudotumor tissues ( INPIP) .To analyze the differences of these indexes expression between IRPIP and INPIP.Results: In group of IRPIP, the CD4+T lymphocytes number and the ratio of CD 4+T lymphocytes number/CD8+T lymphocytes number were all apparently higher than those in the group of INPIP (P=0.006,0.023,respectively).The cells numbers of CD3,CD8,IL-10 positive expression in IRPIP were higer than those in INPIP ,and the cells number of CD20 positive expression in IRPIP was lower than that in INPIP,but these differences all had no statistical significance (P>0.05).In IRPIP,the number of IgG4+plasmacytes was positively related to the number of IL-10+cell (r=0.517),the correlation had statistical significance (P=0.033). Conclusion:The number of CD4+T lymphocytes increased in addition to the increased number of IgG 4+plasmacytes in the lesion back-ground of IRPIP,and the number of IgG4+plasmacytes was positively related to the number of IL-10+cells.It is suggested that the increased number of Th 2 lymphocyte and the increased secretion of cytokine IL-10were are immunopathological factors participated in the disease of IRPIP .
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<p><b>OBJECTIVE</b>To study the clinical features, pathologic findings and prognosis of patients with dysplastic nodules of liver (DN) and early hepatocellular carcinomas (eHCC).</p><p><b>METHODS</b>One hundred and forty-five archival cases previously diagnosed as DN or eHCC or well-differentiated HCC during the period from 2000 to 2009 were retrieved and reevaluated with the new diagnostic criteria by two experienced pathologists, according to International Consensus Group for Hepatocellular Neoplasia (ICGHN) 2008. Immunohistochemical study (EnVision method) for CD34, HSP70, glutamine synthetase, glypican 3 and Ki-67 was carried out. The original diagnosis and diagnosis after review were compared and correlated with the survival data of the patients, with statistical analysis.</p><p><b>RESULTS</b>With the new criteria, 16 cases were diagnosed as low-grade DN, 50 cases as high-grade DN, 72 cases as DN with microinvasion, 7 cases as advanced HCC. Slide review showed no diagnostic discrepancy in 112 cases (77.2%). Amongst the 33 (22.8%) underdiagnosed cases, there were 7 cases of advanced HCC initially diagnosed as DN or DN with microinvasion and 26 cases of eHCC initially diagnosed as high-grade DN. Kaplan-Meier analysis showed that the diagnosis of high-grade DN or early HCC carried no statistically significant difference in overall survival (P = 0.778, 0.677) or disease-free survival (P = 0.949, 0.700) in all patients and in patients with no history of HCC. The co-existence of advanced HCC in patients with DN or eHCC significantly correlated with overall survival (P = 0.004) but not with disease-free survival (P = 0.079).</p><p><b>CONCLUSIONS</b>The new diagnostic criteria by ICGHN 2008 are useful in delineating high-grade DN and eHCC. The overall survival and disease-free survival of patients with eHCC or high-grade DN undergoing hepatectomy show no statistically significant difference. Patients with DN or eHCC have better prognosis than patients with advanced HCC, though there is still a high risk of tumor recurrence.</p>