Clinicopathological Features and Prognosis of Patients Newly Diagnosed With Lung Adenocarcinoma With Both EGFR Mutation and C-MET Amplification / 中国医学科学院学报

Objective To explore the clinicopathological features and prognosis of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification.Methods The pathological sections were reviewed.EGFR mutation was detected by amplification refractory mutation system-quantitative real-time polymerase chain reaction,and C-MET amplification by fluorescence in situ hybridization.The clinicopathological features and survival data of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification were analyzed retrospectively.Results In 11 cases of EGFR mutation combined with C-MET amplification,complex glands and solid high-grade components were observed under a microscope in 10 cases except for one case with a cell block,the tissue structure of which was difficult to be evaluated.The incidence of lung adenocarcinoma in the patients with EGFR mutation combined with C-MET amplification at clinical stage Ⅳ was higher than that in the EGFR mutation or C-MET amplification group (all P<0.001),whereas the difference was not statistically significant between the EGFR mutation group and C-MET amplification group at each clinical stage (all P>0.05).There was no significant difference in the trend of survival rate between EGFR gene group and C-MET amplification group (χ2=0.042,P=0.838),while the survival of the patients with EGFR mutation combined with C-MET amplification was worse than that of the patients with EGFR mutation (χ2=246.72,P<0.001) or C-MET amplification (χ2=236.41,P<0.001).Conclusions The patients newly diagnosed with lung adenocarcinoma with EGFR mutation plus C-MET amplification demonstrate poor histological differentiation,rapid progress,and poor prognosis.The patients are often in the advanced stage when being diagnosed with cancer.Attention should be paid to this concurrent adverse driving molecular event in clinical work.With increasing availability,the inhibitors targeting C-MET may serve as an option to benefit these patients in the near future.

Correlation of monitoring the renal pelvic pressure in RIRS and the morbidity of postoperative fever / 局解手术学杂志

Objective To investigate the clinical significance of monitoring the renal pelvic pressure( RPP) and regulating the manual perfusion pressure in flexible ureteroscope holmium laser lithotripsy. Methods A total of 189 patients with upper urinary tract calculi treated by RIRS in our hospital were retrospectively analyzed from August 2014 to August 2017. The renal pelvic pressure was monitored during RIRS in 136 cases( monitored group) whereas no monitoring occurred in the rest 53 cases( unmonitored group) . The monitored group was divided into two sub-groups of 49 cases named high-pressure group(the cumulative time of renal pelvis pressure upon 40 cmH2O≥1 min) and 87 ca-ses named low-pressure group respectively. The morbidity of postoperative fever ( T≥38. 5℃) was evaluated statistically between monitored group and unmonitored group,meanwhile between high-pressure group and low-pressure group. Results Postoperative fever did not correlate to age,sex,involved kidney,and postoperative urinary tract infection. Whether renal pelvic pressure was monitored or not,infection calculi, duration of operation and whether the cumulative time of renal pelvis pressure upon 40cmH2O≥1 min contributed to postoperative fever. The rate of postoperative fever in unmonitored group was higher than monitored group while the same between high-pressure group and low-pres-sure group,with statistically significant difference(P<0. 05). Conclusion Monitoring the intraoperative RRP and regulating the manual perfusion pressure during RIRS has positive significance in postoperative recovery and contribute to reducing postoperative fever.

Relationship of EpCAM expression and DNA copy number alteration in colorectal carcinoma cells / 临床与实验病理学杂志

Purpose To investigate the clinical pathology significance of epithelial cellular adhesion molecule (EpCAM, CD326) expression in colorectal carcinoma cells. Methods Flow cytometry and immunofluorescence assay were used to detect EpCAM expression in 55 cases of fresh colorectal cancer tissues and adjacent normal mucosa. The percentage of positive cells (PPC) and mean fluorescence index (MFI) were calculated. Correlation of EpCAM expression with DNA ploidy change and its value were investigated in the early diagnosis of colorectal cancer. Results The values of PPC and MFI were significantly higher in colorectal carcinoma tissue than that in the normal colorectal tissue [(PPC: (83.48 ± 7.07)％ vs (43.56±5.29)％, t =39.22, P＜0.001. MFI: 28.90(19.60-45.89) vs4.89(3.79-6.28), Z=-6.45, P＜0.001) ]. There were also significant differences (P＜0.01) in the values of PPC and MFI between invasive type and ulcer types, between well-and moderately-differentiated and poorly-differentiated cancers, between Dukes stages A + B and C + D, (between pTNM stages I+ II and III + IV, between pTl + T2 and pT3 + T4, and between pNO and pNl. DNA content analysis showed that DNA polyploid was detected in 39 of 55 colorectal carcinoma (70.90％ ). The DNA index (DI) and ploid were correlated with differentiation degree and Dukes stages, but uncorrelated with lymph node metastasis. At the same time, in the EpCAM positive cases, DI was increased with increased expression of EpCAM (r = 0.668, P =0.000) and the proliferation index of cells in S phase ratio(Sphase fraction, SPF) (r1 =0.664, P1 =0.000, r2 =0.651, P2 = 0.000 ). Conclusion EpCAM expression is obviously upregulated in colorectal carcinoma, and it is closely correlated with the invasion, metastasis and proliferation of tumor cells. The combination of EpCAM expression and DNA content analysis provides references to the early diagnosis and prognosis evaluation in colorectal carcinoma.