Complete atrioventricular septal defect: a clinicopathologic study of 35 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the autopsy characteristics, pathologic type, malfomation and genetic characteristics of complete atrioventricular septal defect (CAVSD).</p><p><b>METHODS</b>Thirty five cases of CAVSD were collected from Maternal and Child Hospital of Haidian District during Jan.2003 to Jan.2015. Autoptic material, clinical history and chromosome examination were reviewed.</p><p><b>RESULTS</b>Among 35 cases of CAVSD between 18-38 gestational weeks, there were 26 cases with CAVSD A (74.3%, 26/35), 1 case with CAVSD B (2.8%, 1/35) and 8 cases with CAVSD C (22.8%, 8/35). Only CAVSD malformation was seen in 4 cases (11.4%, 4/35). Multiple malformations were seen in 31 cases (88.6%, 31/35). Combined malformations most frequently occurred in cardiovascular, respiratory and locomotor system. Among 15 cases with chromosome examination, chromosome aberrations was found in 13 cases (13/15) and trisomy-21 was found in 11 cases (11/15).</p><p><b>CONCLUSIONS</b>CAVSD is a rare disease and CAVSD A is the most common type. CAVSD is usually combined with other malformations and chromosome aberrations.</p>

Clinicopathologic study of 25 cases of placental chorioangioma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.</p><p><b>METHODS</b>Twenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.</p><p><b>RESULTS</b>The average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.</p><p><b>CONCLUSIONS</b>Placental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.</p>

Congenital pulmonary airway malformation of lung in fetus: a clinicopathological analysis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the etiology, pathogenesis, clinicopathologic characteristics, prognosis and treatment of congenital pulmonary airway malformation (CPAM).</p><p><b>METHODS</b>Eighteen cases of CPAM were enrolled into the study. The clinical history, autopsy findings and immunohistochemical results were evaluated, with review of literature. The pathogenetic mechanism, pathologic features and differential diagnosis of CPAM were studied.</p><p><b>RESULTS</b>Histologic examination showed that 2 cases were classified as Stocker type I, 12 cases as type II, and 4 cases as type III. The lesion was unilateral and involved single lobe in 13 cases. The remaining 5 cases had bilateral diseases. Of the 18 cases studied, 12 cases showed single organ involvement and 6 cases had malformations affecting multiple organs. The associated malformations included cardiac anomalies (4 cases), polycystic kidney with gastrointestinal atresia (1 case) and nuchal cystic hygroma with hydrothorax (1 case).</p><p><b>CONCLUSIONS</b>CPAM is a rare pulmonary disorder. The etiology of this non-neoplastic condition is unknown. Imaging analysis is a valuable tool to suggest CPAM, while definite diagnosis requires pathologic examination. The overall prognosis is determined by the presence of associated malformations, fetal hydrops and pulmonary hypoplasia.</p>

Application of p16 and Ki67 protein in diagnosis of cervical lesions / 中国基层医药

Objective To investigate the diagnosis value of p16 combined with Ki67 protein in cervical lesions.Methods Totally 1 542 women with previous liquid-based cytology smear result of abnormality underwent a colposcopy-directed biopsy excision procedure.Biopsy specimens were detected by p16 and Ki67 immunostaining alongside hematoxylin and eosin (H&E) staining.A four-semiquantitative class was used to describe the immunohistochemical results.Results Biopsy results revealed 1 542 women included 473 women with negative for dysplasia (NEG),629 women with cervical intraepithelial neoplasia (CIN) Ⅰ,206 women with CIN Ⅱ,206 women with CINⅢ and 28 women with cervical squamous cell carcinoma (SCC).The averageage of this study population was 34.47 years.CINs mainly occurred in women aged 20-29 years and 30-39 years.The positive rates of p16 in NEG,CIN Ⅰ,CIN Ⅱ,CINⅢ and SCC were 15.22％,60.25％,98.06％,99.51％,100.00％ respectively,and the positive rates of Ki67 were 12.05％,63.12％,96.12％,98.06％,100.00％ respectively.p16 expression and Ki-67 expression significantly increased with disease progression (p16:r =0.758,P =0.000 ; Ki67:r =0.773,P =0.000).Expression level of p16 was positively related with Ki-67 (r =0.774,P =0.000).The positive expression rates of p16 and Ki-67 of NEG were significantly lower than those of CIN and SCC (p16:x2 =1 127.46,P =0.000;Ki67:x2 =1 316.85,P =0.000).The positive expression rates of p16 and Ki-67 were markedly higher in CIN Ⅰ than those in CINⅡ,CINⅢⅢ and SCC (p16:x2 =500.19,P =0.000;Ki67:x2 =603.23,P=0.000).Conclusion Women aged 20-39 years are key subjects for cervical cancer screening.p16 and Ki67 immunohistochemistry is important in the ancillary diagnosis of cervical lesions.

Comparative analysis of DNA quantitative cytology and TCT in cervical cancer screening / 中国基层医药

Objective To compare the cytology diagnostic accuracy of DNA quantitative cytology and thinprep cytology test(TCT) in cervical cancer screening for exploring effective method in cervical cancer screening.Methods TCT and DNA quantitative cytology were carried out in 7 470 women.Women with positive results additionally underwent high risk human papillomavirus (HPV) detection.Positive cytologic diagnosis included atypical squamous cells(ASC) or above in TCT and DNA index 2.5 or above in DNA quantitative cytology.Results The positive rate was 13.0％ in method of DNA quantitative cytology and 13.7％ in method of TCT in 7 470 cases.Positive rate of the two methods had no significant difference in cervical cancer screening(x2 =1.813,P =0.178).There was significant difference in positive rate of TCT between cases with DNA index≥2.5,＜4.5,heteroploid cells more than 3 or DNA index≥4.5 and cases with DNA index≥2.5,＜4.5,heteroploid cells less than 3.Every grade of TCT abnormality had abnormal DNA index.Abnormality of DNA index had an increasing trend with the severity of TCT.Infection rate of high risk HPVs had significant difference in different grades of DNA index (x2 =62.648,P =0.000).Conclusion Combination of DNA quantitative cytology and TCT is an effective method in cervical cancer screening,which can reduce misdiagnosis,guide cervical biopsy and suggest infection of high risk of HPVs.

Expression and clinicopathologic significance of CD44v6/CD24 in ovarian serous carcinomas / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the expression and clinicopathologic significance of cancer stem cell markers CD44v6 and CD24 in ovarian serous carcinoma tissues.</p><p><b>METHODS</b>One hundred and two cases of ovarian carcinoma diagnosed during the period from June, 2001 to December, 2010 were retrieved from archival files. The histology slides were reviewed and a two-tier system for grading of ovarian serous carcinoma was applied. The expression of CD44v6 and CD24 was detected by immunohistochemistry using EnVision method. The relationship between CD44v6/CD24 expression and various clinicopathologic parameters was analyzed.</p><p><b>RESULTS</b>There were 46.1% (47/102) and 59.8% (61/102) cases expressing CD44v6 and CD24, respectively. Both CD44v6 and CD24 expression showed positive correlation with higher histopathologic grade (P = 0.003 and P < 0.05, respectively). CD24 expression also correlated with the presence of lymph node metastasis (P < 0.05). There was no statistically significant relationship between the expression of these two markers (χ(2) = 0.394, P = 0.530). The age of the patients, histopathologic grade, clinical stage and nodal status correlated with progression-free survival time (P < 0.05). CD44v6 expression and histopathologic grade correlated with the overall survival time (P < 0.05). Patient age was an independent poor prognostic factor by multivariate analysis.</p><p><b>CONCLUSIONS</b>CD44v6 expression, age older than 50 years, high clinical stage and presence of lymph node metastasis are associated with poor prognosis in patients with ovarian serous carcinoma. The two-tier system for grading of ovarian serous carcinoma is useful in predicting survival; and high tumor grade represents an important poor prognostic indicator for ovarian serous carcinoma.</p>

Clinicopathologic features of fetal nuchal cystic hygroma: report of 40 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathogenesis, pathologic features and prognosis of fetal nuchal cystic hygroma.</p><p><b>METHODS</b>Forty autopsied cases of fetal nuchal cystic hygroma were collected during January 2003 to December 2012. The clinical history, pathologic changes and immunohistochemical (EnVision method) findings were reviewed, and the pathogenesis and pathologic characteristics were analyzed.</p><p><b>RESULTS</b>Of the 40 cases, 16 (40.0%) showed single malformation and 24 (60.0%) were associated with multiple malformations in other organs and/or systems.Nineteen cases were septated and 21 were not. The associated malformations occurred in the respiratory system, skeletal system and urinary system.In the cases of combined malformations of umbilical cord, 3 were single umbilical artery malformations and 1 was torsion and stricture of umbilical cord.Four cases had chromosomal analysis, and all were trisomy-21.</p><p><b>CONCLUSIONS</b>Fetal nuchal cystic hygroma is a rare disease. The etiology is unknown, but it is not neoplastic.Lymphangioma is divided into 3 types:capillary lymphangioma, cavernous lymphangioma and cystic hygroma according to their expansile growth pattern. The overall prognosis is determined by any co-existing chromosomal anomalies, associated malformations and the time of diagnosis of the cystic hygroma.</p>