Chemical constituents of Psidium guajava and their antitumor and antifungal activities / 中国中药杂志

Twenty-six compounds, including sixteen meroterpenoids(1-16), a triterpenoid(17), four terpenoid derivatives(18-21), and five aromatic compounds(22-26), were isolated from the leaves of Psidium guajava. Their structures were identified by spectroscopic analyses including NMR and MS. Compounds 21-26 were obtained from plants of Psidium for the first time. Based on the structure,(R)-2-ethylhexyl 2H-1,2,3-triazole-4-carboxylate(24 a), an α-glucosidase inhibitor recently isolated from Paramignya trimera, should be revised as compound 24. Meroterpenoids 1-16 were evaluated for their antitumor and antifungal activities. Meroterpenoids psiguajadial D(4), guapsidial A(5), 4,5-diepipsidial A(7), guadial A(14), and guadial B(15) showed cytotoxicities against five human tumor cell lines(HL-60, A-549, SMMC-7721, MCF-7, and SW-480), among which 5 was the most effective with an IC_(50) of 3.21-9.94 μmol·L~(-1).

Automated quantification of Ki-67 index associates with pathologic grade of pulmonary neuroendocrine tumors / 中华医学杂志(英文版)

BACKGROUND@#Classification of the pulmonary neuroendocrine tumor (pNET) categories is a step-wise process identified by the presence of necrosis and number of mitoses per 2 mm. In neuroendocrine tumor pathology, Ki-67 was first described as a prognostic factor in the pancreas and incorporated into the grading system of digestive tract neuroendocrine neoplasms in the 2010 WHO classification. However, the significance of Ki-67 in pNETs was still a controversial issue. This study was to investigate the potentially diagnostic value of Ki-67 in pNETs.@*METHODS@#We retrieved 159 surgical specimens of pNETs, including 35 typical carcinoids (TCs), 2 atypical carcinoid (ACs), 28 large-cell neuroendocrine carcinomas (LCNECs), 94 small-cell lung cancers (SCLCs). Manual conventional method (MCM) and computer-assisted image analysis method (CIAM) were used to calculate the Ki-67 proliferative index. In CIAM, 6 equivalent fields (500 × 500 μm) at 10× magnification were manually annotated for digital image analysis.@*RESULTS@#The Ki-67 index among the 4 groups with ranges of 0.38% to 12.66% for TC, 4.34% to 29.48% for AC, 30.67% to 93.74% for LCNEC, and 40.71% to 96.87% for SCLC. The cutoff value of Ki-67 index to distinguish low grade with high grade was 30.07%. For the univariate survival analyses in pNETs, both the overall survival and progression-free survival correlated with Ki-67 index. In addition, the Ki-67 index performed by CIAM was proved to be of great positive correlation with MCM.@*CONCLUSIONS@#Ki-67 index counted by CIAM is a reliable method and can be a useful adjunct to classify the low- and high-grade NETs.

Structure and application of Ganoderma polysaccharide peptide GL-PPSQ2 / 中草药

Objective To study the structure of active polysaccharide peptide purified from Ganoderma lucidum aqueous extract, and used as a reference substance for the determination of polysaccharide peptide content in G. lucidum products. Methods GL-PPSQ2 was obtained by hot water extraction, separation and purification with membrane ultrafiltration and gel-filtration chromatography. The physicochemical determination and spectral date were used for structural identification. The content of polysaccharide peptide was detected by HPLC with UV detector, water was used as mobile phase and the flow rate was 1 mL/min. Results GL-PPSQ2 was a pure polysaccharide peptide with purity above 97%, molecular weight of 5.0 × 104, polysaccharide content of 87.17%, and yield of 0.49%. The monosaccharides composition analysis showed that GL-PPSQ2 was glucose-based polysaccharide with a small amount of mannose, which contained 16 kinds of amino acids with the total amount of amino acids of 5.04%. Based on the methylation analysis, 1D and 2D NMR spectroscopy, the repeating unit of GL-PPSQ2 was composed of →3)-β-D-Glcp-(1→backbone, with four repeating units connected a long chain branch at O-6 which was composed of α-D-Glcp-(1→, →4,6)-β-D-Glcp-(1→, →4)- β-D-Glcp-(1→ and →6)-β-D-Glcp-(1→ in sequence. Conclusion The active polysaccharide peptide was isolated and purified by membrane technology and gel chromatography. The method was simple and rapid, which provided a scientific basis for the quality control of polysaccharide peptide in G. lucidum extract and its products.

Histological subtypes of lung cancer in Chinese males from 2000 to 2012 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To characterize the histological and epidemiological features of male lung cancer patients in China.</p><p><b>METHODS</b>The demographic and histological information about male lung cancer patients identified from 2000-01-01 to 2012-12-31, was collected from the Cancer Hospital of the Chinese Academy of Medical Sciences. Relative frequencies (RF) were estimated for major histological subtypes and compared according to the years of diagnosis and birth.</p><p><b>RESULTS</b>The RF of adenocarcinoma (ADC) increased from 21.96% to 43.36% and the RF of squamous cell carcinoma (SCC) decreased from 39.11% to 32.23% from 2000 to 2012 in the 15 427 male lung cancer patients included in this study (Z=17.909, P<0.0001; Z=-6.117, P<0.0001). The RF of ADC increased from 28.72% in 2000-2004, 36.88% in 2005-2008 to 48.61% in 2009-2012 in patients born after 1960. The age-adjusted RF of ADC in 2007-2012 increased consistently in all the investigated areas.</p><p><b>CONCLUSION</b>The increased RF of ADC in male lung cancer patients highlights the need for further investigation of the etiologic factors of these tumors. Smoke-free policies rather than modifying tobacco products should be enforced.</p>

Clinicopathological and prognostic significance of ERα and ERβ expression in lung carcinomas: a tissue microarray study / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the expression of ERα and ERβ in lung carcinomas and investigate their clinicopathological and prognostic significance by using tissue microarray assay and immunohistochemical staining.</p><p><b>METHODS</b>Six hundred and ninety-eight lung cancer specimens were used in this study, including 651 cases of non-small cell lung carcimomas (NSCLCs) and 47 cases of small cell lung cancers (SCLCs). There were 309 cases of adenocarcimoma and 342 cases of squamous cell carcinoma. The expression of ERα and ERβ was analyzed by immunohistochemistry on paraffin-embedded sections.</p><p><b>RESULTS</b>In the normal lung tissues, expression of ERα and ERβ was 0% (0/35) and 25.0% (9/36), respectively. In the tumor tissues, ERα was expressed in 209 of 295 AC cases (70.8%), 169 of 330 SCC cases (51.2%) and 9 of 47 SCLC cases (19.1%) (P < 0.001). ERβ was expressed in 200 of 297 AC cases (67.3%), 140 of 322 SCC cases (43.5%) and 31 of 47 SCLC cases (66.0%) (P < 0.001). In NSCLC, the expression of ERα and ERβ was significantly associated with smoking, stage and lymph node metastasis, also with sex refer to ERβ (P < 0.05), but not significantly with age, tumor size and degree of differentiation (P > 0.05). Follow-up was completed in 398 NSCLC cases, and no significant correlation was found between the prognosis and expression of ERα and ERβ.</p><p><b>CONCLUSIONS</b>The expression of ERα and ERβ has significant difference in lung adenocarcinoma, squamous cell carcinoma and small cell lung cancer. In NSCLC, expression of ERα and ERβ is associated with smoking, stage, and lymph node metastasis. The expression of ERβ is higher in female than in male NSCLC patients.</p>

Pulmonary-bronchus myelolipoma and review on extra-adrenal myelolipomas in Chinese literature / 中华医学杂志(英文版)

Extra-adrenal myelolipomas are extremely rare, especially in bronchus and lung. Up to now, only nine cases of intra pulmonary lesions have been reported all over the world. Here we describe a new discovered pulmonary-bronchus myelolipoma in a 53-year-old man, which is different from the previously reported ones. And we mainly comment on the pathology and diagnosis, comparing with the findings of the extra-adrenal cases reported in Chinese literature.

Expressions of the γ2 chain of laminin-5 and secreted protein acidic and rich in cysteine in esophageal squamous cell carcinoma and their relation to prognosis / 癌症

Previous studies have shown that the expressions of the γ2 chain of laminin-5 and secreted protein acidic and rich in cysteine (SPARC) play important roles in oncogenesis and the development of carcinoma. To assess the expressions of laminin-5 γ2 chain and SPARC in esophageal squamous cell carcinoma (SCC), and to clarify the prognostic significance of the expressions of laminin-5 γ2 chain and SPARC in esophageal SCC, we detected the expressions of laminin-5 γ2 chain and SPARC in cancer tissue and corresponding normal mucosa from 116 patients with advanced (stages II-IV) esophageal SCC using the tissue microarray-based immunohistochemistry and analyzed the correlation of the expressions with clinicopathologic characteristics and survival. We found that in normal esophageal tissues, laminin-5 γ2 chain was expressed in the basement membrane, whereas in esophageal SCC tissues, laminin-5 γ2 chain was expressed in the cytoplasm of carcinoma cells, with a positive rate of 72.4%. SPARC was not detected in normal esophageal mucosa, but was expressed in stromal fibroblasts in 84.6% of esophageal SCC cases and in cancer cells in 7.8% of esophageal SCC cases. There was a significant correlation between laminin-5 γ2 chain and stromal SPARC expression in esophageal SCC (Spearman's rho=0.423, P<0.001). The expressions of both laminin-5 γ2 chain and stromal SPARC were correlated with survival (P=0.032 and P=0.034, respectively). In stage-II esophageal SCC, the expression of laminin-5 γ2 chain was significantly correlated with survival (P=0.023), while the expression of SPARC was not significantly correlated with survival (P=0.154). Patients with elevated levels of laminin-5 γ2 chain and SPARC expressions had a poorer prognosis than did those lacking elevated levels of laminin-5 γ2 chain expression and/or elevated levels of SPARC expression (P=0.001). In stage-II esophageal SCC, patients with elevated levels of laminin-5 γ2 chain and SPARC expressions had a poorer prognosis (P<0.001). These results suggest that laminin-5 γ2 chain and SPARC may play roles in the progression of esophageal SCC and their simultaneous expression is correlated with poorer prognosis, especially in patients with stage-II SCC.

Analysis of first-line chemoresistance and prediction of chemo-response in non-small cell lung cancer by comparative genomic hybridization / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the association between chromosomal disequilibrium and chemoresistance/chemosensitivity in non-small cell lung cancer (NSCLC) using comparative genomic hybridization (CGH).</p><p><b>METHODS</b>Genomic DNA samples were prepared from the tumor tissues in paraffin-embedded sections derived from 88 patients with advanced NSCLC (18 with chemosensitivity and 16 with chemoresistance). The DNAs were first amplified by a degenerate oligonucleotide prime-polymerase chain reaction protocol and then labeled with fluorescence as probes for CGH analyses. The correlations of the resulting chromosomal imbalances with the chemo-sensitivity and other pathological features of the patients were analyzed.</p><p><b>RESULTS</b>A total of 640 abnormal chromosome regions including 96.12% gains and 3.88% losses were detected in 88 specimens. The results indicated that the most frequently gained chromosome regions were 19p13.1-13.3 (39/88, 44.12%), followed by 9q12-q22 (26/88, 29.41%), 22q12-q13 (26/88, 29.41%), and Xq (29/88, 32.35%). The total number of abnormal regions related with chemo-sensitivity was 188( 182 gains and 6 losses), while the number of the abnormal regions linked to the chemoresistance was 452 (431 gains and 21 losses) (P=0.005). Gains of 14p12-p13 and 19p were significantly correlated with the chemosensitivity of the NSCLC (P=0.006). Gains of 1q12-q22, 10q25-q26, 5p15.1-p15.3, 19q13.2-13.4, 20p11.2-p12, 21q22, and Xp 21-p22.1 were also significantly correlated with the chemoresistance (P]0.005, 0.029, 0.039, 0.029, 0.039, 0.016, and 0.006, respectively). No correlation between the chromosome abnormalities and other clinical features was observed.</p><p><b>CONCLUSIONS</b>The specific gains and losses of chromosome region is correlated with platinum-based first-line chemotherapy in NSCLC patients,as confirmed by CGH detection. This finding is useful for further identifying the chemosensitivity-related functional genes, predicting clinical effectiveness, and achieve individualized treatment in the future.</p>

Expression of fascin and CK14 in different histological types of cancer and its differential diagnostic significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate and analyze the expression of fascin and CK14 in multiple histological types of cancer and to explore the potential value of the two proteins as markers in diagnosis and differential diagnosis of various cancer types.</p><p><b>METHODS</b>Tissue microarray containing esophageal squamous cell carcinoma (SCC), lung SCC, larynx SCC, uterine cervical SCC, SCC of external genital organs, lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, heptocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating ductal carcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, 30 cases each, as well as corresponding normal controls was constructed. The expression of fascin and CK14 among different types of carcinoma and corresponding normal controls was detected by immunohistochemistry.</p><p><b>RESULTS</b>In normal esophagus, bronchus, larynx, uterine cervix and skin, fascin was mainly expressed in the basal cells or reserve cells, but the expression was diffuse in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, with a positive rate of 90.0%, 90.0%, 96.7%, 78.6% and 89.7%, respectively. In the normal tissue of other organs, except breast and uterine endometrium, fascin was negative. In lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, the positive rates were 38.0%, 23.3%, 14.3%, 10.3%, 73.3%, 13.3%, 6.7%, 60.0%, 66.7% and 10.0%, respectively. The difference between fascin expression in SCC and in other histological types was statistically significant (P < 0.001). CK14 was mainly expressed in the basal cells, reserve cells or myoepithelia of normal tissues. The positive rates of CK14 were 76.7%, 36.7%, 83.3%, 60.7% and 96.3% in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, respectively. It was weak and focal in lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma, and renal clear cell carcinoma, with a positive rate of 13.3%, 13.3%, 20.7%, 41.4%, 46.7%, 6.7%, 40.0%, 13.3%, 20.0% and 6.7%, respectively. The difference between CK14 expression in SCC and in other histological types was statistically significant (P < 0.001). The difference between co-expression of fascin/CK14 in SCC and in other histological types was also statistically significant (P < 0.001).</p><p><b>CONCLUSION</b>Fascin and CK14 are highly expressed in SCC, compared with other histological types of carcinoma. Combination of fascin and CK14 should be a valuable marker in diagnosis and differential diagnosis of carcinoma.</p>

Morphologic assessment of response to neoadjuvant chemotherapy in breast cancer / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the histological criteria of breast cancer response to neoadjuvant therapy.</p><p><b>METHODS</b>One hundred and fifty-four cases of breast cancer receiving neoadjuvant therapy were collected from June, 2005 to June, 2007 and the clinical data were analyzed. All patients were operated on within 4 weeks after neoadjuvant therapy. All specimens were assessed by the standard method of Miller and Payne (MP) grading system. The response to neoadjuvant therapy were assessed by two pathologists independently, using MP grading system and common grading system separately.</p><p><b>RESULTS</b>The response rate using the MP grading system were grade 1 in 12 cases (7.8%), grade 2 in 33 cases (21.4%), grade 3 in 64 cases (41.6%), grade 4 in 31 cases (20.1%) and grade 5 in 14 cases (9.1%). Using the common grading system, the response were mild in 51 cases (33.1%), moderate in 71 cases (46.1%) and severe in 32 cases (20.8%). MP grading system may be related to common grading system (chi2 = 186.660, P < 0.01). Follow up information were available in 147 cases, with 14 cases showing recurrence, metastasis or death from the disease. The MP grading system may be related to the outcome (chi2 = 11.612, P = 0.020), but not the common grading system (chi2 = 0.881, P = 0.644).</p><p><b>CONCLUSION</b>MP grading system may be one of the prognostic factors in the neoadjuvant therapy of breast cancer.</p>

Application of interphase fluorescence in situ hybridization in the diagnosis of lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of interphase FISH in the routine clinicopathological practice and its values in the differential diagnosis of lymphomas.</p><p><b>METHODS</b>A total of 74 fresh tissue samples clinically suspicious of lymphoma were investigated by FISH using three probes including IgH/bcl-2, IgH/CCND1 and API2/MALT1, corresponding the translocation t(14;18), t(11;14) and t(11;18) respectively. The results of FISH were analyzed and compared with the histopathologic diagnosis.</p><p><b>RESULTS</b>Histological evaluation eventually confirmed that there were 62 cases of lymphoma and 12 cases of reactive lymphoid processes. The translocations were detected in 7 cases in 62 cases of lymphoma: 3 demonstrated t(14;18) including 2 cases of follicular lymphomas and 1 nodular sclerosing Hodgkin lymphoma. Four cases had t(11;14) including mantle cell lymphoma (2 cases), follicular lymphoma (1 case) and small cell lymphoma (1 case). A lymphoid hyperplasia case showed detectable t(14;18). All 25 cases of DLBCL showed no evidence of t(14;18). Amplification or loss of regional genes was seen more often in malignant than in the benign cases.</p><p><b>CONCLUSION</b>Interphase FISH offers useful ancillary technology that plays an important role in differential diagnosis and classification of lymphoma.</p>

Diagnostic value of core needle biopsy before neoadjuvant chemotherapy for breast cancer / 中华病理学杂志

<p><b>OBJECTIVE</b>To assess the diagnostic value of core needle biopsy (CNB) before neoadjuvant chemotherapy for breast cancer.</p><p><b>METHODS</b>One hundred and nineteen breast cancer cases underwent neoadjuvant chemotherapy in our hospital during the period from June, 2005 to January, 2007 were analyzed. CNB was carried out before starting chemotherapy. The hematoxylin and eosin-stained slides of CNB taken before and after neoadjuvant chemotherapy were reviewed independently by two pathologists, and the rate of consistency was verified.</p><p><b>RESULTS</b>Amongst the 119 cases studied, 110 cases were confirmed to be carcinoma, including 105 cases of invasive carcinoma and 5 cases of ductal carcinoma-in-situ. The rate of consistency was 97.22% (105/108).</p><p><b>CONCLUSION</b>CNB has important value in distinguishing benign from malignant lesions, as well as in confirming the diagnosis of invasive carcinoma before starting neoadjuvant chemotherapy.</p>

Diagnosis and long-term results of surgical resection of early cardiac adenocarcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize therapeutic experience and the long-term results of early cardiac adenocarcinoma with surgical resection.</p><p><b>METHODS</b>Ninety cases were diagnosed with early cardiac adenocarcinoma during endoscopic screening in high incidence rate area of esophageal cancer from 1972 to 1997. All of the patients accepted surgical treatment. Cardiectomy included partial stomach and esophagus was performed through left thoracotomy in all patients. Esophagogastrostomy was carried out in the infra-aortic region and thoracoabdominal lymphatic dissection was performed in all cases.</p><p><b>RESULTS</b>The resection rate was 100%. One patient died in one month after the operation. Postoperative complications occurred in 4 cases (4.4%). Pathological examination of cancer specimens showed that 46 cases (51.1%) were intramucosal carcinoma without lymphatic metastasis and 44 cases (48.9%) were submucous infiltrating carcinoma with lymphatic metastasis in 5 (11.4%). The patients were followed-up to 2002, and the overall 5, 10, 15, 20 and 25 year survival rates were 91.9%, 83.6%, 69.6%, 49.8% and 16.6%, respectively.</p><p><b>CONCLUSIONS</b>Early diagnosis and early treatment may be the best approach for promoting the survival of the cardiac cancer. Surgical resection of early cardiac carcinoma provides excellent long-term survival.</p>

Over-expression of osteopontin in non-small cell lung cancers: its clinical significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Data obtained from a differentially expressed cDNA library constructed previously in this laboratory demonstrated that the extracellular matrix molecule osteopontin (OPN) is one of most considerably over-expressed genes in non-small cell lung cancers (NSCLCs). The purpose of the present study was to explore the expression status of OPN in a large scale NSCLC tissue samples, and estimate its significance in progression of the malignant disease.</p><p><b>METHODS</b>RT-PCR was performed with the tumor and adjacent normal tissues from 35 patients with NSCLC, at transcriptional levels of OPN. To determine the expression of OPN protein in the tumor tissues, immunohistochemical (IHC) staining was subsequently carried out on paraffin-embedded sections in tissue microarrays containing 662 samples derived from NSCLC cases. The correlation between the expression level of OPN and clinical characteristics was analyzed statistically.</p><p><b>RESULTS</b>Comparing with the paired normal lung tissue, high level RNA of OPN was detected in 80.0% (28/35) of the NSCLC tumor tissues by RT-PCR, which confirmed the information obtained previously by our differentially expressed cDNA library. The results of IHC analysis showed that positively stained OPN protein was observed in 59.6% (331/555) of the tumor tissues, which was remarkably higher than that (25.2%, 27/107) detected in the normal control tissues (P < 0.001). Among the NSCLCs investigated, over-expressed OPN was more frequently found in squamous cell carcinomas (SCCs) than in adenocarcinomas. A further analysis on SCCs demonstrated that the rate of over-expressed OPN was significantly different between the primary tumors with and without lymphatic metastases (68.6% vs. 49.7%, P = 0.001), but similar in the primary tumors and their corresponding metastases in lymph nodes (68.6% vs. 75.5%, P = 0.171).</p><p><b>CONCLUSION</b>Expression of OPN protein is distinctly increased in NSCLCs, particularly in SCCs. OPN over-expression is considerably correlated with lymph node metastasis, increasing the risk of tumor metastasis (OR = 2.212). The resulting data suggest that OPN facilitates the progression of NSCLCs.</p>

Application of flow cytometric immunophenotypic analysis in the diagnosis of malignant lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the value of flow cytometric immunophenotyping (FCI) in the diagnosis and differentiated diagnosis of lymphoma and explain the immunophenotypic features and differences of malignant lymphoma.</p><p><b>METHODS</b>Seventy four fresh samples of suspicious lymphoma were collected from Nov. 2004 to Aug. 2006. Each sample was individually evaluated by FCI. The results were analyzed and compared with the histopathological diagnosis.</p><p><b>RESULTS</b>Among the 74 cases, the FCI data consisted with the final morphological diagnosis in 61 cases (82.4%). For the diagnosis of B and T non-Hodgkin's lymphoma (NHL), thymoma, carcinoma and benign lesions of lymph node, the concordance between FCI data and morphological diagnosis were 93.5%, 100%, 100%, 100% and 81.3%, respectively.</p><p><b>CONCLUSION</b>Multi-parameter FCI analysis can provide important information and help for diagnosis of lymphoma. It is an assistant but necessary approach for the diagnosis and differential diagnosis of lymphoma.</p>

Prognostic significance of micropapillary pattern in pulmonary adenocarcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the prognostic significance of micropapillary pattern (MPP) in adenocarcinoma of lung.</p><p><b>METHODS</b>Ninety-one consecutively excised cases of pulmonary adenocarcinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups: those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows: MPP + (constituting 1% to 10% of the tumor), MPP ++ (constituting 11% to 30% of the tumor) and MPP +++ (constituting more than 30% of the tumor).</p><p><b>RESULTS</b>The overall 5-year survival rate was 64.8%. The 5-year survival rates were 88.9% for stage I tumors, 46.2% for stage II tumors, and 23.8% for stage III tumor respectively (P = 0.000). The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate (P = 0.065, 0.358 and 0.206, respectively). On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group (number = 41) and 84.0% for patients in the MPP-negative group (number = 50). The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group (P = 0.000). In pulmonary adenocarcinoma, this characteristic histology correlated with tumor stage and size, but not with patient's gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows: for stage I, 78.6% versus 92.6% (P = 0.1548), for stage II, 30.0% versus 100% (P = 0.0598), and for stage III, 17.7% versus 28.6% (P = 0.4045).</p><p><b>CONCLUSIONS</b>MPP in primary pulmonary adenocarcinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert clinicians for more active treatment and closer follow up.</p>

TPX2 expression and its significance in squamous cell carcinoma of lung / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the expression of targeting protein for Xklp2 (TPX2) and its significance in squamous cell carcinoma (SCC) of the lung.</p><p><b>METHOD</b>Two SCC cell lines and 4 immortalized bronchial epithelial cell lines (as a precancerous model) were examined by Western blot for TPX2 expression. Reverse transcription-polymerase chain reaction analysis for TPX2 was also performed using tumor tissues from 21 patients with SCC of the lung. The expression of TPX2 was studied by immunohistochemistry (using tissue microarray) on paraffin-embedded sections of pulmonary SCC and corresponding precancerous lesions from a group of 319 patients.</p><p><b>RESULTS</b>TPX2 was variably expressed in all the cell lines studied. Compared with matched controls using normal lung tissue, high level of TPX2 mRNA was detected in 16 of the 21 SCC tumor tissue samples analyzed. Immunohistochemical study showed that TPX2 was mainly present in tumor tissues but not in normal controls. The expression of TPX2 correlated with tumor grade, stage and nodal status. As for precancerous lesions, the level of TPX2 was also increased, in accordance with the degree of dysplasia.</p><p><b>CONCLUSIONS</b>Expression of TPX2 may play a role in carcinogenesis of bronchial epithelium and tumor progression of pulmonary SCC. It may also represent a potential biomarker for surveillance of SCC of lung.</p>

The diagnostic value of dynamic CT in solitary pulmonary nodules: a prospective study / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate imaging features of benign and malignant solitary pulmonary nodules (SPN) using dynamic computed tomography (dCT) to improve the accuracy of radiological diagnosis.</p><p><b>METHODS</b>Fifty-one patients with SPN were studied by dCT. In this procedure, a bolus of 100 ml contrast medium was administrated intravenously at a rate of 4 ml/sec. The same-located dynamic scans were carried out from 15 sec to 120 sec following the injection. Time-attenuation curves (TAC) were created according to circular or oval ROI drawn over nodules. Histopathological diagnosis was considered as the golden standard in all patients. Double-blind examination and evaluation were carried out and the data were analyzed statistically with Mann-Whitney U test.</p><p><b>RESULTS</b>Thirty eight cases were diagnosed to be malignant SPN (mSPN) and 13 cases to be benign SPN (bSPN). The benign SPN were further divided into two groups, bSPN(1) consisting 6 cases with chronic pneumonitis, nodular tuberculosis or sclerosing hemangioma and bSPN(2) consisting 7 cases with tuberculoma, pulmonary cyst, pulmonary sequestration or mycosis ball. There were statistically significant differences between mSPN and bSPN(2) in peak heights of enhancement (87.6 HU vs. 57.8 HU, P < 0.01), enhancement values (peak heights- unenhanced CT values, 59.6 HU vs. 11.1 HU, P < 0.01). However, no statistically significant differences of those two values existed between mSPN and bSPN(1). TAC of mSPN reached to peak height more rapidly and remained a plateau. TAC of bSPN(1)s showed similar changes to that of mSPN despite a delayed reach to a peak height or even a descending branch. TAC of the bSPN(2)s was lower and flatter without peak height. If a threshold of 20 HU was taken for dCT, the lesions with < or = 20 HU were diagnosed as benign, and the lesions with > 20 HU were diagnosed as malignant, with a sensitivity of 100%, a specificity of 54.0% and an accuracy of 88.4%.</p><p><b>CONCLUSION</b>(1) Absence of the marked enhancement (< or = 20 HU) in dynamic CT is strongly predictive of benignancy. (2) The peak height and enhancement value of dCT are helpful to differentiate malignant SPNs from benign ones. (3) The TAC configuration is helpful in differentiating malignant SPNs from benign ones. Descending branches could be found in some benign lesions, but not in the malignant ones. The TAC of tuberculoma and mycosis ball is usually relatively low and flat without any peak height.</p>

A clinicopathological analysis of gastric lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To discuss the clinicopathological features and prognostic factors of gastric lymphoma.</p><p><b>METHODS</b>83 gastric lymphoma cases were analyzed retrospectively in accordance to the criteria of the new World Health Organization classification for neoplastic diseases of the hematopoietic and lymphoid tissues. The correlations between clinicopathological features, therapeutic measures and survival were discussed.</p><p><b>RESULTS</b>The age of patients ranged from 25 to 77, with a median of 52. The number of males were similar to that of females. There were no specific symptoms. The most common symptoms were stomach ache (60 cases, 72%) or discomfort. The duration of symptoms was often long and with a history of chronic gastric diseases (21 cases, 25%). 13 cases had multiple lesions in the gastrointestinal mucosa. 51 cases (61%) were accompanied by lymph node involvement. According to the new World Health Organization classification for neoplastic diseases of the hematopoietic and lymphoid tissues, 57 cases were extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT)-type (MALT lymphoma), 23 were diffuse large B cell lymphoma accompanying MALT lymphoma, 2 were diffuse large B cell lymphoma and 1 was follicular lymphoma. Of all the cases, 31 were stage I E, 38 stage II E, 8 stage III E and 6 stage IV by the Ann Arbor staging system (1972). The total 5-year and 10-year survival rates were 77.8% and 70.1% respectively, with the mean survival time of 146 months. The 5-year and 10-year survival rates of MALT lymphoma were 77.4% and 72.3%, the 5-year and 10-year survival rates of diffuse large B cell lymphoma accompanying MALT lymphoma were 81.8% and 68.2%, the 5-year survival rate of diffuse large B cell lymphoma was 50.0%.</p><p><b>CONCLUSIONS</b>There are no specific symptoms in gastric lymphoma patients. Extranodal marginal zone lymphoma of MALT-type is the main histopathological type of gastric lymphoma, often accompanied by multiple mucosa involvement and also often accompanied by a history of chronic gastric disease. The lesion is usually localized for a long time, with a very good prognosis. Survival rate has a significant correlation with lymph node involvement and clinical stage. No correlations were found between the survival rates with age, gender, B symptoms, invasive depth of the wall of stomach, the size and range of the tumors or different therapeutic measures.</p>

TTF-1 expression and its diagnostic application in lung carcinomas / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the expression of thyroid transcription factor 1 (TTF-1) and study its application in the diagnosis of lung carcinomas.</p><p><b>METHODS</b>Of 134 specimens from lung lobectomy, 105 were primary lung carcinomas including 76 non-small cell carcinomas (NSCLCs), 28 small cell lung cancers (SCLCs) and 1 complex carcinoma (SCLC and SCC), and 29 were metastatic carcinomas. Expression of TTF-1 was detected by immunohistochemistry. The expression level of TTF-1 was graded as, +:6% to 25% of tumor cells positive, ++:26% to 50%, +++:51% to 75%, and ++++:> 76%.</p><p><b>RESULTS</b>The positive nuclear immunoreactivity of TTF-1 was identified in 23 of 28 SCLCs (82.1%), but none in squamous cell cancer (SCC) (P < 0.001). The positive expression rate of TTF-1 in lung adenocarcinomas (ACs) was 73.8% (31/42). There was no correlation between TTF-1 expression and ACs differentiation or ACs subtypes (P > 0.05). All but one (thyroid follicular carcinoma) metastatic ACs were TTF-1-positive. Mesenchymal component and lymphoid or inflammatory cells were consistently TTF-1-negative.</p><p><b>CONCLUSION</b>A significant difference of TTF-1 expression may assist in distinguishing SCLC from SCC, lymphoma or inflammatory lesions. Owing to its restrictive expression in lung tissue, TTF-1 might be used to differentiate primary from metastatic adenocarcinoma of the lung.</p>