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Purpose To investigate the pathological morphology and diagnostic parameters in the high-grade primary neuroendocrine carcinoma (NECa) of the uterus.Methods The clinical manifestations,pathological morphology,and immunohistochemical features of 25 uterine high-grade primary NECa cases were analyzed,and the relevant literatures were reviewed.Results The age of the 25 patients ranged from 24 to 72 years (mean age,44 years).Clinically,most of them complained of the vaginal bleeding or occupying lesions.84％ cases displayed typical neuroendocrine architectures histologically,and neurosecretory granules were observed in the electron microscopy examination.The nucleus of the small-cell type and large-cell type NECa were typical.Additionally,the mitosis number was more than 20/10 HPF in 64％ cases,10 to 20/10 HPF in 28％ cases,and less than 10/10 HPF in 8％ cases.Furthermore,highgrade NECa was often accompanied with apoptosis (72％) and necrosis (92％).The diagnosis included 13 cases of small-cell carcinoma,5 cases of combined small-cell carcinoma (1 with cervical intraepithelial neoplasia 3,1 with squamous cell carcinoma,and 1 with adenocarcinoma),4 cases of large-cell NECa,and 3 cases of combined large-cell NECa (2 with squamous cell carcinoma,and 1 with adenocarcinoma).The neuroendocrine markers were positive with Syn (96％),CgA (70.5％) and CD56 (78.6％).76.9％ cases demonstrated CKpan positivity,with small foci or linetype of cytoplasmic immunostaining.The proliferation index of Ki-67 was ranged from 60％ to 90％.In this study,13 patients received the uterus excision with adjuvant chemotherapy,and 5 cases died within 2 years.Conclusion High-grade NECa of the uterus is rare,and the terminology is similar to that of the digestive tract and lung.Yet,the diagnostic parameters are slightly different to some extent.The therapy is the surgical resection followed by adjuvant chemotherapy.
ABSTRACT
Objective To observe the level of reduced glutathione(GSH) and oxidized glutathione(GSSG)in a mouse bone cell line MC3T3-E1 cells exposed to fluoride.Methods MTT method was used to detect cell viability of M C3T3-E1 cells exposed to varying concentrations and periods of fluoride [F-concentration:0(control),0.5,1.0,2.0,4.0,8.0,12.0,20.0 mg/L; F-periods:1,2,4 and 10 days].The Xevo TQ MS was employed to test the levels of GSH,GSSG and glutamine (Gln).Results The MC3T3-E1 cell viability was significantly higher in the 2 mg/L group(0.57 ± 0.05) 1 day after the exposure compared to the respective control(0.49 ± 0.03,P ＜0.01); conversely,cell viability was markedly lower in the 8 mg/L(0.49 ± 0.07) and 12 mg/L(0.47 ± 0.09)groups 4 days after the exposure in comparison to the control(0.63 ± 0.06,P ＜ 0.05 or P ＜ 0.01).The cell viability in the 8 mg/L group(1.52 ± 0.29) 10 days after the exposure was significantly higher than that in the control group (0.86 ± 0.23,P ＜ 0.01),however,the value in the 20.0 mg/L group (0.54 ± 0.07) was significantly lower(P ＜0.01).The level of cell GSH decreased significantly in the 20 mg/L groups 2 days[(13.92 ± 4.63)μmol/L]and 10 days [(0.53 ± 0.30)μmol/L]after exposure compared to the respective comtrols [(26.42 ± 3.67),(24.85 ± 5.68)μmol/L,all P ＜ 0.01].The level of cell GSSG markedly increased in the 2 mg/L group 2 days [(1.12 ± 0.62)μ mol/L]and the 8 mg/L group 4 days [(2.13 ± 0.62)μ mol/L]after exposure compared to the controls[(0.55 ± 0.22),(1.46 ± 0.46)μmol/L,all P ＜ 0.05].The similar change was observed in the 8 mg/L group[(2.97 ± 1.30)μmol/L] 10 days after exposure compared to the control [(1.35 ± 0.50)μmol/L,P ＜ 0.05].The level of Glndecreased significantly in the 2 mg/L group[ (62.80 ± 17.4l)μ mol/L] 4 days and in the 8 and 20 mg/L groups 10 days[ (122.26 ± 19.51), (19.38 ± 8.11)μmol/L] after exposure compared to the controls [ (83.28 ±14.32), ( 147.15± 16.95) μmol/L , all P ＜ 0.05 or P ＜ 0.01 ]. Conclusions Fluoride exposure can significantly promote the changes of GSH, GSSG and Gln levels in the osteoblast, thus affecting the intracellular redox equilibrium.