Clinicopathological correlation of various prostatic lesions with serum prostate-specific antigen level – A hospital-based cross-sectional study

Background: The prostate is a male reproductive accessory gland which gives rise to several pathological conditions. The present study aims to study the correlation of histopathology of prostatic diseases with the clinical profile of the patient coming to VSS Medical College (VSSMC), Burla for histopathological reporting of prostatic biopsies. Aim and Objectives: The objectives of this study were as follows: (1) To correlate serum prostate-specific antigen (PSA) level with various clinical and pathological lesions of the prostrate gland, in a Hospital-based sample of Western Odisha population. (2) As the male gender represents almost half of the entire population, to find out different clinicopathological lesions, percentage-wise, so as to know the frequency of occurrence of such lesions. Materials and Methods: Fifty-seven cases of prostatic diseases were recorded in the Department of Pathology, VSSMC, Burla for histopathological examination of prostatic tissue for 2 years from September 2017 to August 2019. All the samples were fixed in 5 ? sections with 10% neutral buffered formalin. Then Hematoxylin and Eosin stain (H and E stain) was used for staining. Appropriate clinical data comprising signs and symptoms, laboratory findings, and serum PSA levels were recorded. Results: The present study, in the beginning, consisted of 64 patients, out of which seven patients were excluded by exclusion criteria, and finally, 57 cases were analyzed. The most prevalent age group for all prostatic diseases was 61–70 years with a mean of 67 years. The majority of the cases (73.67%) were benign mostly benign prostatic hyperplasia (BPH). Prostatic intraepithelial neoplasia (PIN) was 12.29% and malignant cases (all adenocarcinoma) were also 12.29%. All patients showed prostatomegaly. About 50% of cases suggestive of malignancy by digital rectal examination (DRE) were confirmed to be carcinoma by histopathological study. Serum creatinine level was raised in 16.27% of benign and 21.42% of premalignant and malignant conditions. Serum PSA level below 4 ng/mL were all benign and above 10 ng/mL were majority malignant conditions. However, at level 4–10 ng/mL, BPH and PIN cases were overlapped with cases of carcinoma. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Serum PSA level <4 ng/mL is associated with benign conditions and more than 10 ng/mL is associated more with carcinomas. Although, investigations such as DRE and serum PSA estimation aid in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies.

Clinicopathological comparison of intrahepatic cholangiocarcinoma with and without viral hepatitis / 中华普通外科杂志

Objective:To analyze the different clinicopathological features of intrahepatic cholangiocarcinoma with and without viral hepatitis.Methods:The clinicopathological data of 79 intrahepatic cholangiocarcinoma cases from Mar 2012 to Sep 2018 at Henan Provincial People's Hospital were retrospectively analyzed.Results:Twenty-five of the 79 patients with intrahepatic cholangiocarcinoma were accompanied by viral hepatitis. Those with viral hepatitis had a lower mean age at onset than those without [(53±11) years vs. (60±11) years, P=0.011], higher proportion of male patients (80% vs. 52%, P=0.017), higher AFP positive rate (40% vs. 19%, P=0.041), lower CA19-9 positive rate (48% vs. 72%, P=0.036), tend to occur in the right liver lobe (76% vs. 44%, P=0.009), a lower rate of bile duct invasion (16% vs. 41%, P=0.03), and were more likely to be mass type (mass type proportion 96% vs. 72%, P=0.032). Conclusions:Viral hepatitis is common in intrahepatic cholangiocarcinoma. Intrahepatic cholangiocarcinoma with and without viral hepatitis differ in clinicopathology. Intrahepatic cholangiocarcinoma with viral hepatitis is more likely to have the characteristics of hepatocellular carcinoma, while intrahepatic cholangiocarcinoma without viral hepatitis is more likely to have the characteristics of cholangiocarcinoma.

Clinicopathological and immunohistochemical analysis of maxillofacial granular cell tumor / 华西口腔医学杂志

OBJECTIVES@#To analyze the clinicopathological features of maxillofacial granular cell tumors (GCT) with the aid of immunohistochemical staining.@*METHODS@#Seven cases of maxillofacial GCT were retrospectively collated, and the microscopic morphology of maxillofacial GCT was analyzed. The expression of S-100, neuron-specific enolase (NSE), SOX-10, CD68, actin, desmin, and Ki-67 in GCT was detected by immunohistochemical staining. The cases were observed in the follow-ups after clinical treatment.@*RESULTS@#All seven GCT tumors lacked envelopes and were poorly defined. Microscopically, the sizes of the tumor cells were large and appeared with inconspicuous cell membranes, forming a syncytium-like appearance. The cytoplasm was filled with characteristic eosinophilic granules. The immunohistochemical results showed that six cases were NSE-positive, five cases were S-100-positive, seven cases were CD68-positive, five cases were SOX-10-positive, one case was actin-positive, and seven cases were desmin-negative. The Ki-67 index did not exceed 5% in all cases. In the follow-up sessions, none of the six cases presented a recurrence.@*CONCLUSIONS@#Maxillofacial GCT has a characteristic histological structure. Immunohistochemical S-100, CD68, and other indicators can assist in diagnosis, and the prognosis is good after clinical resection.

Clinicopathological features and prognosis of clear cell papillary renal cell carcinoma / 现代泌尿外科杂志

【Objective】 To investigate the clinicopathological features and prognosis of clear cell papillary renal cell carcinoma (CCPRCC). 【Methods】 The clinicopathological and follow-up data of 40 CCPRCC patients treated during Jun. 2011 and Oct.2021 were retrospectively analyzed. The prognosis was compared with that of 40 cases of clear cell renal cell carcinoma (ccRCC) and 19 cases of papillary renal cell carcinoma (PRCC) treated in the same period. Survival analysis was performed by Log-rank test and Kaplan-Meier survival curves were plotted. 【Results】 Among the 40 patients, 28 were male and 12 were female, aged 31-84 years; 38 cases had unilateral and 2 cases had bilateral tumors; 3 cases had multifocal lesions. All patients received surgery. The maximum diameter of the masses ranged from 3.0 to 95.0 mm, with an average of (27.6±18.1) mm. Pathological grade was Fuhrman 1-2 in all cases. Immunohistochemical tests were positive for CK7 and CA-IX. During the follow-up of 5-129 (average 56) months, 1 case died after bone metastasis, 2 had ipsilateral recurrence, and 1 developed primary esophageal cancer. CCPRCC patients had a significantly better prognosis than CCRCC (P<0.001) and PRCC (P=0.005) patients, while there was no significant difference in the prognosis between CCRCC and PRCC patients (P=0.93). 【Conclusions】 CCPRCC has low malignancy. The diagnosis relies on characteristic pathological and immunohistochemical features. Surgery is an effective treatment. CCPRCC has a better overall prognosis than CCRCC and PRCC.

Colorectal cancer in younger adults (<50 years); a retrospective study on its clinicopathological characteristics

Background:Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods:A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults(<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P?0.05 was considered statistically significant.Results:CRC among younger adults comprised 40.3% of total patientsmedian age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history,lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histologycompared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients haddistant metastasis at diagnosis compared to in one fourth patients in older patients. Peritoneal metastasis was significantly higher among younger adults compared to older patients (p=0.000). Significantly greater proportion of patients among younger adults initially presented with bowel obstruction (p=0.034), for which upfront emergency surgical procedures was performed in significantly higher proportion of patients compared to the older age group (p=0.007).Conclusions:Advanced stage and aggressive disease biology of CRC in younger adult warrants inclusion of one decade younger age group into present screening recommendation.

Clinicopathological characteristics of idiopathic membranous nephropathy in elderly patients / 中华老年医学杂志

Objective:To compare the clinicopathological differences between elderly and non-elderly patients with idiopathic membranous nephropathy(IMN).Methods:Patients diagnosed with IMN via renal biopsy at Beijing Huairou Hospital, Beijing Changping Hospital of Traditional Chinese Medicine, and Beijing Hospital of Traditional Chinese Medicine from January 2017 to August 2021 were retrospectively enrolled.They were classified into the elderly group(≥65 years)and the non-elderly group(<65 years), and the clinicopathological differences between the two groups were compared.Results:A total of 207 IMN patients were included in the study, with a male to female ratio of 1.7∶1.0.There were 56 patients in the elderly group, aged(68.2±3.1)years, and 151 patients in the non-elderly group, aged(48.2±6.2)years.Compared with the non-elderly group, the elderly group had a longer time from onset to renal biopsy and a higher proportion of patients with renal insufficiency and hypertension( P<0.05). The elderly group had a lower eGFR, lower serum albumin, higher serum cholesterol, and higher low-density lipoprotein than the non-elderly group( P<0.05). The proportions of patients with glomerulosclerosis, renal tubular atrophy, and interstitial fibrosis in the elderly group were higher than in the non-elderly group( P<0.05). The positive rates of glomerular PLA2R antigen staining in the two groups were 90.6%(29/32)and 91.0%(111/122), respectively, and there was no statistically significant difference between the two groups.IgG4 deposition represented the most common IgG subtype, with 93.8%(30/32)in the elderly group and 94.3%(115/122)in the non-elderly group.There was no statistical significance between the two groups( P>0.05). Conclusions:Compared with non-elderly IMN patients, a higher proportion of elderly IMN patients has renal insufficiency, hypertension and chronic renal pathology.The glomerular deposition of pathogenic antigens in elderly IMN patients was similar to that in non-elderly IMN patients, suggesting no difference in pathogenesis between the two groups.The clinicopathological differences between the two groups may be related to age and complications.

Maxillofacial connective tissue hyperplastic trichoepithelioma: report of two cases and a literature review / 口腔疾病防治

Objective@# To investigate the diagnosis and clinical treatment of maxillofacial connective tissue hyperplastic trichoepithelioma. @*Methods@# The clinical data of two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were summarized and analyzed along with the literature@*Results @# Two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were male, aged 21 and 30 years. The clinical manifestations were painless pale brown and pale white plaques in the maxillofacial region. The lesion was tough and clear, with no ulcers in the middle depression. The course was 10-16 months, with 1-3 months before medical treatment, and the tumor had a significant history of enlargement. After surgery, the skin was cut 3 mm along the outer circumference of the tumor, and local tissue defects were repaired by the adjacent flap. The pathological report showed that the tumor cells were located in the dermis, and were striped, trabecular or nested. The tiny sac contained fibrous connective tissue proliferation. The tumor cells were amorphous without obvious nuclear division. Immunohistochemical analysis reported bcl-2(-), CK7(-), CK19(-), CD34(+), P63(+), CK56(+), and Ki67(±). The pathological diagnosis was connective tissue proliferative hair epithelial tumor. The patient was followed up for 24 months. There was no recurrence of the tumor, no obvious scarring, and no deformity or dysfunction of the maxillofacial region.@*Conclusion@#Pathological and immunohistochemical examination is the basis for the differential diagnosis of maxillofacial connective tissue hyperplastic trichoepithelioma, and surgical removal of tumors is an effective treatment.

Clinicopathological Analysis of Brain Metastatic Carcinoma in Tibet / 中国医学科学院学报

Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.

A Case of Typical Ciliated Muconodular Papillary Tumor of the Lung: A Clinicopathological Analysis / 中国肺癌杂志

BACKGROUND@#The pathogenesis of a ciliated muconodular papillary tumor (CMPT) of the lung is extremely rare which is difficult to distinguish from other lung lesions and it is easy to cause misdiagnosis and missed diagnosis. By collecting CMPT data, its clinical and pathological features can provide medical treatment ideas for the majority of medical workers and reduce medical errors.@*METHODS@#The clinical data, pathological features, immunophenotype of a typical CMPT patient and related literature were analyzed.@*RESULTS@#The chest computed tomography (CT) showed there was a mixed density nodule in the right lower lung near the pleura with a diameter of about 9 mm. We performed a wedge resection on the patient. The pathological results showed that the nodule was composed of proliferated ciliated cells, mucous cells, and basal-like cells. The ciliated cells were lined on the surface of papillary structures. The basal-like cells were located in the outer layer, while the mucous cells were located between the two. The cell atypia was not obvious. Immunohistochemistry: epithelial cells CEA (+), CK7 (+), CA125 (+), weakly positive for TTF-1, CK20 (-), Ki67 (1%+), CK5/6 (+), and basal cells P63 (+).@*CONCLUSIONS@#CMPT is a rare pulmonary neoplasm. There is no definite conclusion about its biologic nature, but most experts prefer a benign to a malignant tumor. CMPT can show many malignant tumor signs on imaging and is often mistaken for lung adenocarcinoma. According to its typical histopathological characteristics and immunohistochemical phenotype, it can be differentiated from other pulmonary diseases. Whether gene mutation is the driving factor is still unknown. Surgical resection for the tumor reveals a good prognosis.

Clinicopathological analysis of ovarian pseudomyxoma peritonei / 中国肿瘤临床

Objective: To analyze the clinicopathological characteristics of ovarian pseudomyxoma peritonei (PMP). Methods: Clinical and pathological data from a total of 272 PMP patients diagnosed at Beijing Shijitan Hospital from January 2010 to January 2019 were collected from a database and retrospectively analyzed to study the origin of PMP tumors. Pathological slides marked with antigens were further studied using immunohistochemical staining, including CK7, CK20, CEA, Villin, CDX2, SATB2, CA125, ER, PR, MUC1, and MUC2. Results: Among the 272 PMP patients studied, the tumors of 245 (90.1%) originated from the appendix, while the remaining 27 (9.9%) originated from non-appendix tissues, including 5 (1.8%) from the ovaries. Ovarian cases included two ovarian teratomas, two ovarian mucinous cystadenomas, and one borderline ovarian mucinous cystadenoma. Histopathological analysis of peritoneal me-tastases further revealed two acellular mucins, two low-grade mucinous carcinoma peritonei, and one high-grade mucinous carcinoma peritonei, while immunohistochemistry revealed positive staining for CK20, CEA, Villin, and CDX2; SATB2 was also found to be partially positive in teratomas with mucinous tumors: negative in two cases and partially positive in one case. Conclusions: The occurrence of ovarian PMP is rare. Its precise diagnosis demands for a serial section of the whole appendix or suspected tissue to exclude any appen-diceal mucinous neoplasms, as well as the combination of a comprehensive analysis of its clinical signs and symptoms, imaging find-ings, surgical findings, histopathological characteristics, and immunohistochemistry.

Clinical and pathologic analysis of intermediate fibroblastic/myofibroblastic tumors in infants and young children / 中华实用儿科临床杂志

Objective@#To study the incidence and clinicopathological features of intermediate fibroblastic/myofibroblastic tumors(IF/MFT) in infants and the young children.@*Methods@#All available cases with soft tissue tumors in infants and children were retrieved from the files of Women and Children′s Hospital Affiliated to Qingdao University, from January 2012 to December 2017.The incidence rate of IF/MFT was observed.Cases of IF/MFT were identified and investigated by light microscopy and immunohistochemistry by reviewing the related literature.@*Results@#Among 290 soft tissue tumors, 15 cases(5.2%) were IF/MFT, accounted for 88.2%(15/17 cases) of borderline soft tissue tumors.Twelve cases were male, 3 cases were female, the median age was 8 months, and 4 cases were congenital.Clinically, 11 cases were presented with slow-growing painless masses located in the trunk or extremities.According to histopathology, 9 cases(60.0%) were categorized as infantile fibromatosis(IFM), including 5 cases(33.3%) desmoid-type and 4 cases(26.7%) diffuse-type; 3 cases(20.0%) as lipofibromatosis(LFM); 2 cases(13.3%) as infantile fibrosarcoma(IFS) and 1 case(6.7%) as giant cell fibroblastoma(GCF). All 15 tumors were characterized by the presence of spindle fibroblasts and myofibroblasts with infiltration of the surrounding structures.Immunohistochemically, all the 15 cases were diffusely positive for Vimentin(Vim), but negative for Myogenin, MyoD1, Desmin and S-100.Smooth muscle actin(SMA), β-catenin and Bcl-2 were positive in some cases to a certain degree.The Ki-67 proliferation index was higher in diffuse-type IFM and IFS, the former was 5.0%-20.0%, and the latter was about 20.0%, however, the other cases showed Ki-67 <5.0%.The main clinical treatment was complete or extensive excision.@*Conclusions@#IF/MFT accounts for a high proportion of intermediate soft tissue tumors in infants and young children, mostly seen in male children, and IFM and LFM are the main types.The clinical signs and symptoms associated with these tumors are often nonspecific, and their histopathologic manifestations may overlap.The final diagnosis of IF/MFT must depend on the characteristics of age, location, histopathologic changes and immunohistoche-mical findings.

Expression of FATS in non-small cell lung cancer and its relationship with prognosis / 中华肿瘤杂志

Objective@#To investigate the expression of fragile-site associated tumor suppressor (FATS) in non-small cell lung cancer and its relationship with clinicopathological features and prognosis.@*Methods@#A total of 140 non-small cell lung cancer (NSCLC) cases and 30 adjacent normal tissues were used to detect the expression level of FATS protein, and to analyze the relationship of FATS protein expression and clinicopathological features and prognosis of NSCLC.@*Results@#Western blot showed that the expression of FATS in adjacent normal tissues was significantly higher than that in non-small cell lung cancer tissues. The results of immunohistochemistry showed that the high expression rate of FATS in 140 cases of NSCLC was 40.0%, and the high expression rate of FATS in 30 cases of adjacent tissues was 73.3%. The difference was statistically significant (P=0.01). Further analysis showed that the TNM stage (P=0.044) and lymph node metastasis (P=0.022) were significant difference between FATS high expression group and low expression group. The 6-year overall survival (OS) rates of NSCLC patients with FATS high-expression and low-expression were 57.1% and 23.8%, respectively, and the 6-year disease-free survival (DFS) rates were 53.6% and 21.4%, respectively, with statistically significant differences (P=0.001). In Cox multivariate analysis, we found gender (HR=1.658, P=0.028; HR=1.684, P=0.023), TNM staging (HR=2.327, P=0.019; HR=2.332, P=0.013) and FATS expression (HR=0.532, P=0.010; HR=0.538, P=0.009) were independent prognostic factors for both OS and DFS of NSCLC patients.@*Conclusions@#The expression of FATS protein is associated with the development and is an independent prognostic factor of NSCLC patients. The detection of FATS protein is expected to be a new biomarker for evaluating the prognosis of NSCLC patients.

Effect of obesity and VEGF on clinical pathology and prognosis of breast cancer / 中华内分泌外科杂志

Objective To investigate the relationship of obesity and vascular endothelial growth factor (VEGF)and the clinicopathological characteristics and prognosis of breast cancer.Methods From Jan.2013 to Dec.2015,147 breast cancer patients were treated at the Department of Breast Surgery in Jiangsu University Affiliated People's Hospital.The clinical factors such as BMI,clinicopathological data and survival prognosis were collected.The chi-square test was used to analyze the association between factors and obesity.Log-rank test and COX regression analysis were performed to make univariate and multivariate analysis.The Oncomine and Kaplan Meier plotter were employed to assess the expression of VEGF in breast cancer and its association with survival prognosis of breast cancer patients.Results The median follow-up time was 40 (ranging from 12 to 58) months.Obesity was associated with tumor size(x2=11.009,P=0.001),and there was no significant correlation between axillary lymph node status,hormone receptor and Her-2 expression.The results of single factor analysis suggested that obesity and axillary lymph node status significantly affected the breast cancer patients OS (P=0.035,P=0.038)and RFS (P=0.035,P=0.036)).Cox multivariate regression analysis results suggested that obesity could be considered as an independent prognostic factor of breast cancer:P=0.051,HR=3.849 (95％ CI:0.995-14.895);Oncomine database analysis found that VEGF was relatively high in breast cancer tissue compared to that in adjacent tissues.Kaplan Meier plotter analysis results showed better overall survival (OS)and recurrence free survival (RFS)in patients with low expression of VEGF in breast cancer tissues.Conclusions Obesity is an adverse prognostic factor in breast cancer patients,and may be associated with elevated VEGF.Weight control may improve the prognosis of breast cancer patients.

Primary breast diffuse large B-cell lymphoma: a clinicopathological analysis of four cases / 中华内分泌外科杂志

Objective To discuss the clinical pathological features,diagnosis and differential diagnosis,therapy and prognosis of primary breast diffuse large B-cell lymphoma(PB-DLBCL).Methods The clinical manifestations,pathological features,immunophenotypic characteristics of 4 cases of PB-DLBCL were retrospectively reviewed,and related literatures were reviewed.Results All of the 4 patients were women,aged 45 to 69 years,with the median 58.5 years.There were 3 cases of lesions involving the left breast and 1 case of the right breast.Microscopic observation showed that the normal structure of the mammary gland was destroyed,and no capsule was seen.There was a large number of large-to medium-sized heterotypic lymphoid cells which characterized as diffuse infiltration between the remaining ducts or lobules of mammary gland.Tumor cells infiltrated adipose tissue,mainly as central blast-like cells (3 cases) and immunoblast-like cells (1 case).No lymphatic epithelial lesions were observed.The immunophenotype showed 4 cases were non-GCB type.Immunostaining showed that the neoplastic cells were LCA,CD20,CD79a and MUM-1 positive.Ki67 index were from 50％ to 80％.The follow-up time of these cases was until Dec.2017.There was one recurrence during the follow-up period.The patient died 13 months later.One patient was alive and had survived for 66 months.Two patients were lost to follow-up.Conclusions PB-DLBCL is extremely rare,mainly found in women.Most of the cell origin types are non-GCB type,which is often misdiagnosed as breast cancer.The diagnosis of PB-DLBCL is confirmed by pathological biopsy and immunohistochemical markers.The treatment is not clear,and a comprehensive treatment plan such as R-CHOP/ CHOP chemotherapy combined with radiotherapy is recommended.

Analysis of clinicopathology and risk of lymph nodes metastasis in 315 patients with early gastric cancer according to World Health Organization criteria / 中华消化杂志

Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0％ (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7％ (37/315),which was lower than 24.8％(2 752/11 104) in Japan and 19.9％(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P＜0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 ％,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 ％) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P＜0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P＜0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.

A Clinicopathological study of subdural membranes

Background: One of the most common neurosurgical entities is chronic subdural hematoma and its characteristic presence of enveloping subdural membranes. The membrane study acts as a rough guide to estimate the time since injury, the nature of the entity and the associated clinical condition. Aim and objectives: To study the demographics, incidence, symptomatology, neurological status, histopathology, risk factors, diagnosis, treatment and outcome of the patients presenting with subdural membranes. Materials and methods: The study was conducted in the Department of Neurosurgery, Government General Hospital (GGH), Kakinada (referral teaching hospital of Rangaraya Medical College). The study population comprised of all patients from both sexes who were diagnosed to have subdural collections with membranes that presented in GGH during the study period. Patients who met inclusion criteria had their independent variables ascertained were included in the study. The study was designed as prospective study. Neurological status, symptomatology, histopathology and Postoperative outcome were assessed immediately after surgery in the ward, and then two weeks and one month afterwards in the OPD. Relevant investigations were done as patient‘s condition dictated. Results: A total of 19 patients were included in the study for the final analysis. All the patients presenting with the diagnosis of Chronic Subdural Hematoma, or diagnosed after screening for symptoms suggestive of subdural collections were included in the study. CT/ MRI scan was used for diagnosis and preoperative evaluation of the patients. After procedure the specimen was sent for pathological evaluation. All the patients were thoroughly examined clinically and findings noted. The Pathological reports according to Nagahori, et al was followed and was noted. Surgical management was offered for all the patients. All the patients were evaluated preoperatively for any co-morbidity Premjit Ray M, Kodandagirirao D, Vijayasekhar Manda, Mahipal Rathod. A Clinicopathological study of subdural membranes. IAIM, 2018; 5(1): 70-76. Page 71 and managed accordingly, to be fit for surgical procedure. Adequate blood was reserved. Patient and attendants were explained in detail about the nature history of the disease, the prognosis and the need for surgery with its associated complications. Informed consent was obtained for surgery. Post operatively, antibiotics were given and patients observed for any CSF leaks, wound infection or meningitis. Patients were discharged after 7-9 days post-operatively. Neurological status was assessed at discharge and follow up. It was noted that most common age group affected was between 61-70 years, males were more commonly affected than females. Most common risk factors were hypertension 47.38% followed by diabetes 21.05%. Most commonly associated risk factor noted in the present study was both alcoholism with smoking. Most common presenting symptom was hemiparesis 52.6% followed by headache 29.41%. Most common type of membrane in our study was Type III 68.38% followed by Type II 15.58%. Most common type of membrane in our study was Type III 68.38% followed by Type II 15.58%. Most common type of lesion encountered in our study was chronic followed by acute on chronic. Most lesions were observed on the right side. Most common site of lesion was fronto-parietal followed by fronto-temporoparietal in location. Associated lesions were seen in 57.86% of cases. Generally outcome based on (GCS) preoperative and postoperative scores were good in about 78.90%. Generally outcome based on (GCS) preoperative and postoperative scores were good in about 78.90%. Conclusion: This study underlines that craniotomy and subtotal membranectomy is still an acceptable, safe, efficient and even a better procedure for patients presenting with subdural membranes.

Expression and clinical significance of mismatch repair gene in colorectal cancer / 中国肿瘤临床

Objective: To investigate the expression and clinical significance of mismatch repair genes (MMR) MLH1, MSH2, MSH6, and PMS2 in colorectal carcinoma. Methods: Colorectal cancer tissues, collected from 607 patients enrolled in Sichuan Provincial People's Hospital from January 2015 to September 2016, were assigned into two groups based on whether the samples were positive or nega-tive for MMR expression to determine the relationship between MMR expression and clinicopathology. We then evaluated the diag-nostic value of MMR expression in the screening of Lynch syndrome and sporadic colorectal cancer. Results: The deletion rate of MMR protein was 35.58%. No statistically significant difference in age, sex, tumor size, P53, CD34, and D2-40 expression was detected be-tween the negative group with MMR protein deficiency and the positive group with normal expression (P>0.05). Differences in tumor location, differentiation, TNM stage, lymph node metastasis, and VEGF and Ki-67 expression between the two groups were statistically significant (P<0.05). The combined detection of MLH1, MSH2, PSM2, and MSH6 proteins may serve as a simple and economical meth-od for screening patients with Lynch syndrome. Conclusions: The risk of colorectal cancer can be reduced by MMR detection of surgi-cal specimens from colorectal cancer patients, screening of patients with Lynch syndrome and their family members, and assisting with proper management and intervention.

Expression of P2X7 receptor in pancreatic carcinoma and the mechanisms in cell migration and invasion / 中国现代普通外科进展

Objective:The aim of this study was to detect the P2X7 receptor (P2X7R) protein expression in pancreatic carcinoma and to analyze its association with clinicopathology features of pancreatic carcinoma.And furtherly to explore the effects and underlying mechanisms of P2X7R on invasion and migration of PANC-1 cell line.Methods:P2X7R expression was determined by immunohistochemistry in specimens of primary cancer and adjacent noncancerous tissues respectively,and analyzed the relationship between P2X7R expression and clinicopathology features of pancreatic carcinoma.The transwell assay and wound healing assay were used for investigating cell invasion and migration ability of PANC-1,and western blotting was performed to measure the expresions of MMP2 and MMP9.Results:P2X7R protein was highly expressed in both PANC-1 cell line and tumor tissue,and associated positively with the histological differentiation and lymph node staging.The active P2X7R could increase the cell migration and invasion ability of PANC-1 cell line through up-regulated MMP2 and MMP9.Conclusions:The overexpression of P2X7R plays crucial roles in the migration and invasion of pancreatic carcinoma,and may represent a novel molecular target in pancreatic carcinoma therapy.

Clinicopathologic features of 9 cases of adult rhabdomyosarcoma / 上海交通大学学报（医学版）

Objective·To investigate the clinicopathologic characteristics and prognosis of adult rhabdomyosarcoma (RMS).Methods·The clinical and pathological data,immunohistochemical test results of 9 RMS were analyzed retrospectively.Results·The information of 6 males and 3 females were collected in this research,whose average age was (46.89+20.09) years old.The tumors had a wide range distribution.The subtypes of histology included 6 cases of embryonal RMS,1 case of alveolar RMS,1 case of spindle cell RMS and 1 case of pleomorphic RMS.Immunohistochemically study showed that 6 cases were myogenin positive,4 cases were MyoDl positive and 8 cases were desmin positive.During the follow-up period of the 7 cases,only 2 patients survived free of tumors,2 patients presented with tumor recurrence and metastasis after the operations,and 3 patients died of tumor.Conclusion·In this study,embryonaI RMS is the most common type,and immunohistochemistry test is helpful to diagnosis of RMS.

Expression of CD44, TRIM24, TAGLN-2, ER and PR in breast invasive ductal carcinoma and their clinicopathologic significance / 临床与实验病理学杂志

Purpose To study the expression of biomolecules of PI3K-AKT signaling pathway including CD44,TRIM24,TAGLN-2,ER and PR in breast invasive ductal carcinoma,and to explore their clinicopathologic significance.Methods The expression of CD44,TRIM24,TAGLN-2,ER and PR in 73 cases of breast invasive ductal carcinoma were detected by immunohistochemist~ (IHC) technology.And the relationship between the expression of these biomarkers and the age of patients,tumor size,histological grade,lymph node metastasis was analyzed.Besides,the influence of these biomarkers on prognosis and the relationship between the expression of these biomarkers were also analyzed.Results There was no significant relationship between the expression of these biomarkers and the age of patients,tumor size,histological grade,lymph node metastasis.CD44 expression was positively conelated with TAGLN-2 expression (r =0.311,P =0.007),TRIM24 expression was positively correlated with TAGLN-2 expression (r =0.421,P =0.000).CD44 expression was negatively correlated with ER expression (r =-0.285,P =0.015).ER expression was positively correlated with PR expression (r =0.598,P =0.000).The postoperative 5-year cumulative survival-rate of CD44 positive group was lower than those of CD44 negative group (P =0.002),in contrast,the postoperative 5-year survival rate of ER positive group was higher than those of ER negative group (P =0.026).Conclusion Through PI3K-AKT signaling pathway,CD44 and TRIM24 may up-regulate TAGLN-2 expression,however,CD44 may down-regulate ER and PR expression.CD44 and ER may act an useful predictor for the prognosis of breast invasive ductal carcinoma.Combined detection of CD44,ER and PR may provide additional therapeutic information which may be useful in breast cancer treatment.