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Objective@#To investigate the clinicopathologic features, differential diagnosis and biological behavior of pleomorphic leiomyosarcoma (PLMS) and dedifferentiated leiomyosarcoma (DLMS).@*Methods@#Forty-nine cases were collected from November 2007 to December 2016, including eight that diagnosed at Fudan University Shanghai Cancer Center, and 41 consultation cases. The clinical findings and pathologic features were reviewed. Immunophenotype was obtained in 33 cases and follow-up information was available in 38 cases.@*Results@#There were 22 males and 27 females with ages ranging from 24 to 83 years (mean 52.5 years). Fifteen cases occurred in extremities, 14 in deep body cavity, 11 in the trunk, 4 in the head and neck, 2 in the bladder, and 1 each in the inguinal region, perineum and femoral vein, respectively. Tumor sizes ranged from 3 to 30 cm (mean 9.1 cm). The tumors were composed of at least small foci of typical leiomyosarcoma (LMS) and areas of high-grade pleomorphic/undifferentiated sarcoma. The typical LMS component showed the characteristic morphology of smooth muscle differentiation and was low to intermediate grade in most cases. Pleomorphic areas were mainly composed of atypical spindle and polygonal cells admixed with variable large, bizarre atypical cells and multinuclear giant cells, mostly mimicking undifferentiated pleomorphic sarcoma. The pleomorphic and leiomyosarcomatous areas were usually intermixed, but the demarcation may be distinct or gradual in some cases. The classical LMS component was positive for at least one myogenic marker: α-SMA in 97.0%(32/33), desmin in 72.7%(24/33), H-caldesmon in 90.9% (20/22), MSA in 14/16, and calponin in 15/15 of cases. The pleomorphic sarcoma component was reactive for at least one myogenic marker in 87.9% (29/33) of cases, usually showing focal and less intense immunoreactivity than classical LMS component: α-SMA was positive in 81.8%(27/33), desmin in 48.5%(16/33), H-caldesmon in 72.7% (16/22), MSA in 12/16, and calponin in 11/15 of cases. Based on staining for muscle markers in the pleomorphic component, 29 cases were designated as PLMS, 4 as DLMS. Ki-67 index ranged from 15% to 70% (mean 40%). Follow-up data was available in 38 cases (77.6%), of which 11 patients (28.9%) died of disease, 12 patients were alive with unresectable or recurrent disease, 14 patients were alive with no evidence of disease and another one died of unrelated cause. The median disease-free and overall survival was 6 and 10 months respectively. Twelve patients exhibited local recurrence and 11 developed metastases. The median interval to progression was 8 months.@*Conclusions@#The identification of areas of typical LMS is crucial for accurate diagnosis of PLMS and DLMS. Both PLMS and DLMS show more aggressive behavior and poorer prognosis than ordinary LMS.
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Objective@#To investigate the clinicopathologic and genetic features, pathologic diagnosis and differential diagnosis of angiofibroma of soft tissue(AFST).@*Methods@#The clinicopathologic characteristics of 24 cases diagnosed at Fudan University Shanghai Cancer Center from 2011 to 2017 were analyzed; immunohistochemical staining and interphase fluorescence in situ hybridization (FISH) were performed, and the literatures were also reviewed.@*Results@#There were 15 male and 9 female (male∶female=1.7∶1.0) patients with age of onset ranging from 8 to 68 years (mean, 45 years). Fourteen cases occurred in extremities, including upper limbs (n=3) and lower limbs (n=11); seven cases were in the trunk, and 1 case each was in the temporal region, retroperitoneum and liver, respectively. Clinically, the tumors usually presented as a slowly growing painless mass. Tumor sizes ranged from 0.8 to 14 cm (mean 4.6 cm). Microscopically, most lesions were well-circumscribed, with fibrous capsules. Few cases infiltrated the surrounding fibrofatty tissue focally. The tumors were mainly composed of sparse short spindle cells and numerous small, branching, thin-walled blood vessels distributed in amyxoid, fibromyxoid or collagenous matrix, often accompanied by medium-sized, round or irregular and ecstatic vessels at the tumor periphery.By immunohistochemistry, all tested cases expressed vimentin (5/5), and showed variable positivity for EMA (2/4), ER (1/2), PR (2/3), α-SMA (1/18)and desmin (1/10). Ki-67 proliferation index were all less than 5%. CD34, CD31 and ERG staining clearly outlined the contours of blood vessels in the stroma. Four cases were tested for NCOA2 gene rearrangement by FISH, of which three were positive. Follow-up data was available in 17 patients (range, 3 to 69 months; mean, 30 months) were all free of disease.@*Conclusions@#Soft tissue angiofibroma is a benign fibroblastic neoplasm characterized by a prominent and complex vasculature set in a myxoid-to-collagenous stroma, and cytogenetically a distinctive NCOA2 gene rearrangement. Caution should be exercised for the possibility of potentially misinterpretation of AFST as vascular tumors and other myxoid soft tissue tumors.
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<p><b>OBJECTIVE</b>To detect the presence of ROS1 fusion gene in pulmonary adenocarcinoma and its clinicopathologic parameters.</p><p><b>METHODS</b>Fluorescence RT-PCR was used to detect the presence of ROS1 fusion gene in 369 surgical resection samples of pulmonary adenocarcinoma with known EGFR mutation status. The presence of ROS1 fusion gene in correlation with clinicopathologic features was analyzed. Sixteen positive and 20 negative samples by RT-PCR were further confirmed by direct sequencing.</p><p><b>RESULTS</b>ROS1 fusion gene was detected in 16 of 369 lung adenocarcinoma samples (4.3%). The presence of ROS1 fusion gene was not correlated to gender, age, smoking history, tumor site, size, histological subtype, tumor differentiation, T staging, lymph node metastasis, TNM staging and EGFR mutation (P > 0.05). The frequency of ROS1 fusion gene was similar in female and male patients, 4.4% (8/183) vs 4.3% (8/186), P > 0.05. The presence of ROS1 fusion gene in patients of ≤ 60 years of age was higher than that in patients of > 60 years, 5.1% (10/195) vs 3.4% (6/174), P > 0.05. The rate of ROS1 fusion gene of non-smokers was a slight higher than that of smokers, 4.4% (14/318) vs 3.9% (2/51), P > 0.05. Both positive and negative cases were confirmed by direct sequencing in all cases.</p><p><b>CONCLUSIONS</b>ROS1 fusion gene occurs more frequently in younger and non-smoking patients of pulmonary adenocarcinoma, and may coexist with EGFR mutations. ROS1 fusion gene seems to define a distinct subset of pulmonary adenocarcinoma.</p>
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Objective To investigate the expression,clinicopathological significance and correlation of S100A4,EGFR and PI3K in lung adenocarcinoma.Methods Immunohistochemical method (EnVision two steps) was used to detect the expression of S100A4,EGFR and PI3K proteins in 84 lung adenocarcinoma tissue samples and 30 normal lung tissue samples.The relationship of S100A4,EGFR and PI3K expression with clinicopathologic factors,post-operative five-year survival and the correlations among the three proteins were analyzed.Results The positive expression rates of S100A4,EGFR and PI3Kin lung adenocarcinoma tissues were higher than those in normal tissues,respectively [(69.0 ％,58/84) vs (6.7 ％,2/30),(64.3 ％,54/84) vs (16.7 ％,5/30),(52.4 ％,44/84) vs (13.3 ％,4/30),P ＜ 0.01].The expression of S100A4,EGFR and PI3K proteins were positively correlated with the differentiated degree,lymph node metastasis,clinical stages,and five-year survival (P ＜ 0.05),but not correlated with other clinicopathologic factors (P ＞ 0.05).The expression of S100A4 was positively correlated with EGFR and PI3K in lung adenocarcinoma (P ＜ 0.01),and the expression of EGFR was positively correlated with PI3K (P＜ 0.01).Conclusions S100A4,EGFR and PI3K were closely related with the occurrence,development,metastasis and prognosis of lung adenocarcinoma.S100A4 might be an important marker in estimating biological behavior and metastasis tendence of lung adenocarcinoma.S100A4 may be correlated with EGFR and PI3K.
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Objective To investigate the expression and significance of S100A4 protein and Ecadherin in coloreetal carcinoma. Methods S-P immunohistochemical method was used to detect the expression of S100A4 and E-cadherin in 87cases with colorectal carcinoma and 87 cases with adjacent colorectal tissue, and the expression of S100A4 and E--cadherin were analyzed with relation to clinicopathologic factors and post-operative five-year survival. Results There was no expression for S100A4 protein in glandular epithelium of adjacent colorectal tissues. The positive expression rate of S100A4 was 64.4 %(56/87) in colorectal carcinoma. There was a significant difference between eolorectal carcinoma and adjacent group(P ＜0.01). The expression of S100A4 was positively correlated with the clinical stages, lymph node metastasis and five-year survival (P ＜0.05), but not with other clinicopathalagic factors (P ＞0.05). There was 100 % expression for E-cadherin in adjacent colorectal tissues. The positive expression rate of Ecadherin was 62.1%(54187) in colorectal carcinoma. There was a significant difference between colorectal carcinoma and adjacent group (P ＜0.01). The expression of E-cadherin was positively correlated with the clinical stages, lymph node metastasis, tumor site and five-year survival (P ＜0.05), hut not with other clinicopathologic factors (P ＞0.05). The expression of S100A4 was negatively correlated to E-cadherin in colorectal carcinoma without statistical meaning(r =-0.087, P ＞0.05). Conclusion S100A4 and E-cadherin are closely related with colorectal cancer invasion, metastasis and prognosis; S100A4 might be an important predictor of the clinicopathologic features and prognosis of eolorectal carcinoma.