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Primary female urethral adenocarcinoma is rare. This paper reports a case of primary urethral mucinous adenocarcinoma complicated with signet ring cell carcinoma. The patient underwent urethral tumor resection in another hospital. Postoperative examination indicated that the tumor remained, and the tumor was completely removed after urethral tumor resection. After 11 months of follow-up, there was no tumor residue or recurrence.
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Objective To explore the expressions of hypoxia inducible factor ( HIF), vascular endothelial growth factor receptor 2 ( VEGFR 2), and microvessel density ( MVD) in adrenocortical adenoma ( ACA) and adrenocortical carcinoma ( ACC), in order to discuss their potential role in the development of adrenal tumours. Methods Fifty-five adrenal tumour specimens resected in the hospital with complete clinical data (including 30 ACA cases and 25 ACC cases) were examined by immunohistochemistry for the expressions of HIF-2α, HIF-1α, VEGFR 2, and MVD. Results VEGFR 2 and MVD up-regulated were found in the ACC group (P＜0.05). The expression of HIF-2α and HIF-1α correlated with VEGFR 2 (P＜0.05). The expressions of VEGFR 2 and MVD were related to some clinicopathological features ( P＜0. 05 ). Additionally, tumour size, expression of VEGFR 2 and MVD were independently associated with ACC (P＜0.05). Conclusions The high expression of HIF-2α, VEGFR 2, and MVD in adrenal tumours suggested their roles in tumour angiogenesis, which indicated that anti-angiogenesis therapies deserve intensive studies for malignant adrenocortical tumours.
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<p><b>OBJECTIVE</b>To study the clinicopathologic features of clear cell papillary renal cell carcinoma (CCPRCC).</p><p><b>METHODS</b>The clinical, morphologic and immunohistochemical characteristics of 6 cases of CCPRCC were reviewed, with analysis of follow-up data.</p><p><b>RESULTS</b>There were altogether 3 men and 3 women. The mean age of patients was 56 years. The size of tumors ranged from 1.0 to 4.5 cm in greatest dimension. They had solid or solid-cystic cut surface. Histologically, the tumors were encapsulated and showed several morphologic patterns, with tubules, papillae, acini, interconnecting ribbons and macro/microcysts lined by single layer of cells with clear or small amount of eosinophilic cytoplasm and low-grade nuclei (corresponding to Fuhrman grade 1 or 2). Mitotic figures were rarely seen. Characteristically, there was linear arrangement of the nuclei away from the basement membrane, conferring an appearance similar to that of endometrial glands in early secretory phase. Tubules and cysts contained serosanguineous fluid or colloid-like secretion were identified. No foamy histiocytes, psammomatous calcifications or hemosiderin was present in the papillary areas. Two of the tumors showed focal or extensive angioleiomyoma/leiomyoma-like components. No coagulative necrosis, sarcomatoid dedifferentiation, nor microscopic vascular invasion was observed. Immunohistochemically, all tumors showed strong co-expression of CK7 and CA9 (with characteristic "goblet" staining pattern). The staining for EMA, CK (AE1/AE3), vimentin, CK8, CK18, CK19 and PAX-8 were also positive in all cases. Ki-67 was expressed in less than or about 5% of the tumor cell nuclei. The staining for CD10, P504S, CD117, TFE3 and TFEB was negative. Follow-up data were available in all patients, with mean duration of 14 months (range = 7 to 27 months). All of the patients were disease-free after operation.</p><p><b>CONCLUSION</b>CCPRCC is a special type of low-grade renal neoplasm with characteristic histopathologic and immunohistochemical features. It needs to be distinguished from clear cell renal cell carcinoma or papillary renal cell carcinoma.</p>
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Background and purpose:Renal cell carcinoma is the most common type of adult renal cancer, and the Fuhrman grading system is the most widely accepted independent indicator for the prognosis of kidney tumors. This study aimed to explore the correlation between the conventional diffusion weighted imaging (DWI) with various b values and Fuhrman grade of clear cell renal cancer, and assess the diagnostic efifciency of ADC values at different b values in differentiating Fuhrman low- and high-grade tumor. Methods:Thirty-three patients with pathologically proved clear cell renal cell cancer (CCRCC) and qualiifed images were included for the research. The diagnostic efif-ciency of ADC values at different b values for differentiating Fuhrman low-(1 and 2) and high-grade (3 and 4) tumor were also assessed and compared by receiver operator characteristic curve (ROC), and the optimum sensitivity, speciifc-ity and accuracy were selected using Youden index. Results:The 33 patients consist one tumor of Fuhrman grade 1, 14 of grade 2, 16 of grade 3 and 2 of grade 4. A negative correlation was found between the ADC0-800, ADC0-400-800, ADC0-600-1 200, ADC0-400-800-1 200 and ADCtotal with Fuhrman grade (r:-0.553,-0.511,-0.603,-0.645,-0.610, respectively), among these the ADC0-400-800-1200 showed the strongest correlation. The AUCs [area under the (receiver operator characteristic curve) ROC curve] of those parameters for differentiating the low-and high-grade tumor were 0.789, 0.757, 0.813, 0.844 and 0.835, among which the ADC0-400-800-1 200 reveal the best result, but the difference was not statistically signif-icant (P>0.05). The sensitivity of the ADC values were 86.7%, 73.3%, 60.0%, 86.7%and 86.7%;The speciifcity were 66.7%, 77.8, 72.2%, 77.8%and 72.2%. Conclusion:ADC0-800, ADC0-400-800, ADC0-600-1 200, ADC0-400-800-1 200 and ADCtotal re-vealed signiifcant correlation with the Fuhrman grade of clear cell renal cancer, and providing high diagnostic efifciency in differentiating Fuhrman low-and high-grade tumor.
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Objective To investigate the influence of breast pure mucinous carcinoma size on sonographic characteristics and diagnostic accuracy.Methods Sonographic characteristics of 101 breast pure mucinous carcinoma in 1 00 patients were analyzed retrospectively.All lesions were divided into three groups according to maximum diameter at ultrasound.These were group Ⅰ with lesions less than 20 mm,group Ⅱwith lesions greater than or equal 20 mm,less than 40 mm,and group Ⅲ with lesions greater than or equal 40 mm.The relationship between lesions size and ultrasound parameters were analyzed.Results There were 38 lesions in group Ⅰ,52 lesions in group Ⅱ and 1 1 lesions in group Ⅲ.The patients age in group Ⅲwere older than that in group Ⅰ(F=3.442,P =0.036).Among these sonographic appearances,only shape (χ2=9.813,P =0.005)and blood flow (χ2=27.952,P =0.000)indicated significant differences.The accuracy of ultrasound diagnosis of breast cancer was 85.1%,the smaller the lesions were,the higher misdiagnosis rate the lesions were.Conclusions With lesions size increased,the lobular and internal blood flow of pure mucinous carcinoma increased.More smaller the lesions were,more higher misdiagnosis rate of lesions were.
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Background and purpose:Loss of the tumor suppressor phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is one of the most common somatic genetic aberrations in prostate cancer in Western countries and is frequently associated with tumor progression and poor prognosis. This study aimed to investigate the frequency of PTEN protein loss in Chinese prostate cancer patients and to determine its association with the biochemical recurrence of prostate cancer.Methods:The data from 225 diagnosed localized prostate cancer patients with radical prostatectomy from 2006 to 2011 were collected retrospectively, including patient’s age at diagnosis, prostate-speciifc antigen (PSA) level at diagnosis, Gleason score, clinical stage, surgical margin, and time to biochemical recurrence or not. This study performed PTEN protein immunohistochemistry on tissue microarrays, which were made from 225 Chinese prostate cancer patients mentioned above, treated by radical prostatectomy with one case including 2 cancer spots and 2 adjacent normal gland spots. Correlations of PTEN loss with clinicopathological features were analyzed usingχ2 test. Kaplan-Meier survival model and Cox proportional hazards regression model were used to evaluate the predictive role of PTEN protein expression and patient characteristics for biochemical recurrence. Results:PTEN protein loss was observed in 15% of the patients and was associated with increased preoperative PSA levels (P=0.03) and old age (P=0.009). In univariate Kaplan–Meier analysis, the factors associated with the biochemical recurrence of prostate cancer included PSA levels (P=0.000 4), Gleason sum (P=0.019 8), and PTEN status (P=0.013 1). In multivariable Cox regression analysis, PTEN expression (HR=0.536, P=0.044), PSA levels (HR=1.879, P=0.001), and Gleason score (HR=1.361,P=0.03) were signiifcant in predicting biochemical recurrence of prostate cancer.Conclusion:PTEN protein loss is associated with an increased risk of recurrence, independent of known clinicopathological factors.
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Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.
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Background and purpose:To perform whole mount technique in the diagnosis of the prostate cancer could provide orientation to the specimen. Whole mount technique has great value in pathologic diagnosis and morphological research. However, limited by the specimen-making technique, shortage of equipment and heavy workload, this technique has not been generally accepted in China. The aim of this study was to evaluate the signiifcance of whole mount technique in the diagnosis of the prostate cancer by comparing the clinical and pathological variables between whole mount patients and conventional ones after radical prostatectomy (RP).Methods:A total number of 229 patients’ whole mount RP specimens were recruited in the study from Dec. 2012 to Feb. 2014. The control group included 393 patients’ specimens which underwent conventional sampling from Jan. 2010 to Jun. 2012. We compared the clinical and pathological variables between the groups, including age, preoperative PSA level, methods of diagnosis, preliminary diagnostic Gleason score, clinical T stage, postoperative Gleason score, pathological T stage, positive surgical margin, extraprostatic extension, seminal vesicle invasion and pelvic lymph node metastasis.Results:Two groups shared similar preoperative parameters. Also there was no signiifcant difference between the whole mount and the conventional sampling groups in postoperative Gleason score, pathological T stage, extraprostatic extension and pelvic lymph node metastasis. However, positive surgical margin and seminal vesicle invasion rates were much higher in the whole mount group than the control one and both of the differences reached statistical signiifcance (26.2%vs 17.6%, 23.1%vs 17.0%;P=0.010, 0.025)Conclusion:After compared the clinical and pathological variables, we could conclude that whole mount technique has prevalence in the diagnosis of the positive surgical margin and seminal vesicle invasion compared with the conventional sampling technique. Thus, whole mount technique should be strongly recommended in the diagnosis of prostate cancer.
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Objective To probe into the perioperative nursing method during osterior fusion and fmation for idiopathic scoliosis. Methods The study involved 31 patients with idiopathic scoliosis treated with posterior correction nails and selective spinal fusion with hook-rod system fixation.The severe patients were treated with extensive posterior release or anterior correction and fusion posterior to release.Before the operation,the patients were administrated with mental nursing,lung function exercise,self-elongation exercise,wake-up pilot training,self-image appraisement and bed and life skills exercise.After the operation,an observation was done on the change of nervous system,propor turning the body over best clinostatism,drainage tube care,respiratory passage care,functional exercise instruction and discharge instruction. Results The operation was accomplished successfully in all the patients,which showed that the body height was increased 2-15 cm.There found no complications including loosening or breakage of the nails or sticks,nervous system injury,incisional wound infection or press~e sore. Conclusion Preoperative sufficient preparation and fine postoperative nursing are important guarantee to successful operation and fast rehabilitation.
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OBJECTIVE:To probe into effect of aerosol inhalation of ambroxol hydrochloride on phlegm-removing and airway obstruction in patients undergoing anterior cervical spine surgery. METHODS:62 patients undergoing anterior cervical spine surgery were treated with primary treatment. Treatment group were additionally given 30 mg ambroxol hydrochloride added into aerosol inhalation and control group were treated with 4 000 IU ?-chymotrypsin added into aerosol inhalation. Both groups were treated wreistpho innshea lraattieo nw oefr e6 ～978% L ?fomr intr-e1a tomxyengte ng-roduripv eann dae 7ro1s%ol s ftowr icceo nat rdoal yg reoaucph (timP
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Cancer stem cells(CSCs) are a small proportion of tumor cells with the property of stem cells in the tumor tissue;they are capable of self-renewal,multi-lineage differentiation and serve as the source of tumor cells and tumor tissues.The discovery of multiple myeloma CSCs and the study on its relationship with side population cells and niche provide a new interpretation on the pathogenesis of multiple myeloma.
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Side population (SP) cells are highly enriched for stem cell activity and characterized by their ability to efflux the vital dye Hoechst 33342,because they express the ATP binding cassette (ABC)-dependent transporter ABCG2.SP cells can be selected from main population using flow cytometric analysis.Currently SP cells have been isolated from many tissues and organs.SP cells of different origins have some common characteristics.This article introduces the classifications,surface marker,and characteristics of SP cells.