Clinical significance of multigene assay in papillary thyroid carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the clinical significance of multigene assay in papillary thyroid carcinoma（PTC）. Methods:Patients who underwent thyroidectomy in a tertiary hospital from August 2021 to May 2022 were enrolled. The eight-gene panel was used to detect the tumor tissue of patients, and the correlation between gene mutations and clinical features was analyzed. Results:Among 161 patients, mutation rate of BRAF V600E, RET/PTC1 and TERT promotor were 82.0%, 6.8% and 4.3%, respectively. BRAF V600E mutation was more common in male patients（P=0.023）. TERT promotor-mutated tumors had a large diameter（P=0.019）, a high proportion of multifocal lesions（P=0.050）, and a large number of lymph node metastases（P=0.031）. Among 89 patients who completed preoperative BRAF detection, there was a strong consistency between the preoperative aspiration test and postoperative panel（Cohen κ=0.694, 95%CI: 0.482-0.906, P<0.01）. In the hematoxylin-eosin sections obtained from 80 patients, BRAF V600E was still the main type of gene mutation, and the classical/follicular type was more distributed. TERT promotor and RET/PTC1 mutation were the main genetic events for tall-cell/columnar/hobnail type and diffuse sclerosing type, respectively. One-way ANOVA showed that there were differences in diagnosis age（P=0.029） and tumor size（P<0.01） among different pathological types. Conclusion:As a simple and feasible clinical detection method for PTC, the multigene assay can supplement the identification of important genetic events other than BRAF V600E, and provide more prognostic information and follow-up hints for postoperative patients.

Comparative study on pathological characteristics of four different antigen-induced rheumatoid arthritis mouse models / 药学学报

Rheumatoid arthritis (RA) is an autoimmune disease driven by antigens and mediated by T cells. Collagen II (CII) and fibrinogen (Fib) are the two main antigens in the pathogenesis of RA. The antigen produced after citrulline modification (Cit) is also one of the inducements to induce the body to produce a pathogenic anti-citrulline protein antibody (ACPA). To provide a reference for RA-related research, this study intends to establish an RA animal model by using CII, Cit-CII, Fib, and Cit-Fib antigens, emulsification with complete Freund's adjuvant and immunization with DBA/1 mice, respectively, to compare the pathological characteristics of RA models induced by different antigens from the aspects of pathology, imaging and serum biochemistry. Animal welfare and experimental process are in accordance with the regulations of the Experimental Animal Ethics Committee of the China Academy of Chinese Medical Sciences. The results showed that the CII, Cit-CII, and Cit-Fib induced mice all had symptoms such as joint redness and swelling, and toe deformation and the clinical score and incidence rate were higher than those of the normal group. The CII group had the most serious lesions, with a incidence rate of 100%, and the Cit-CII and Cit-Fib groups had mild symptoms, with a incidence rate of 25% and 37.5%, respectively; pathological and imaging examination results showed that the joints of mice in CII-induced group showed severe synovial inflammation, cartilage and bone destruction, while those in Cit-CII and Cit-Fib group showed only slight inflammatory infiltration, joint cavity stenosis and bone destruction; the results of serum antibody detection showed that CII, Cit-CII and Cit-Fib groups all produced high levels of anti-cyclic citrullinated peptide (CCP) antibodies, among which, Cit-Fib group > Cit-CII group > CII group > Fib group, and both Cit-CII and Cit-Fib groups produced high levels of citrullinated epitope-specific antibodies, while the total IgG level was the highest in CII group; serum ELISA and RT-PCR analysis of joint tissue showed that the expression of pro-inflammatory factors and bone destruction-related molecules increased most significantly in the CII-induced group, followed by Cit-Fib and Cit-CII. The above results showed that among the four different antigens, the symptoms and conditions of arthritis in RA mice induced by CII were the most serious, and IgG instead of anti-CCP antibody was its typical immunological feature, and CII could be the first choice for the model of RA mice; Cit-Fib has certain immunogenicity, can partially induce the symptoms and conditions of RA arthritis in mice, and produce high-level anti-CCP antibody and anti-Cit-Fib antibody, which is more suitable for the study of citrulline-related RA; although Cit-CII has certain immunogenicity, the incidence, and severity of RA arthritis induced by Cit-CII in mice are low.

Diagnosis, treatment and prognosis of primary mediastinal yolk sac tumor in 18 patients / 中国胸心血管外科临床杂志

@#Objective    To investigate the clinical characteristics and treatment of primary mediastinal yolk sac tumor (PMYST). Methods    We collected the clinical data of PMYST patients who were admitted to the Department of Thoracic Surgery of Peking Union Medical College Hospital from September 2000 to September 2020. The clinical and pathological characteristics, treatment and prognosis of PMYST patients were retrospectively analyzed. Results     Finally 18 patients were enrolled, including 17 males and 1 female with a median age of 22.0 (16.6, 26.2) years. Patients had increased level of alpha fetoprotein (AFP). The pathological type can be single yolk sac tumor or combined with other mediastinal germ cell tumors. Chemotherapy and radical surgery were the main treatment methods. Extensive resection was feasible for patients with tumor invasion of other organs. Seven patients developed lung or pleural metastasis after operation, and 3 of them had extrapleural metastasis. One patient recurred within 1 year after surgery. All patients were followed up by telephone or outpatient department. At the last follow-up, 5 patients survived, 9 died, and 4 were lost to follow up, with a median survival of 16.8 months. The median disease-free survival was 14.9 months. The survival rates at 1, 3 and 5 years were 73.3%, 28.6% and 11.8%, respectively. Conclusion    PMYST often occurs in young-middle aged male patients. Preoperative puncture can provide an effective diagnostic basis. R0 resection, AFP returning to normal after treatment and no metastasis may be potential indicators of good prognosis. The overall prognosis of PMYST is poor, and some patients can achieve long-term survival after treatment.

The clinicopathological characteristics and therapeutic analysis of renal oncocytoma / 中华泌尿外科杂志

Objective:To discuss the clinical and pathological features of the patients with renal oncocytoma.Methods:Making a retrospective analysis of the clinical data of 35 patients with renal oncocytoma who were admitted to the department of urology in the First affiliated Hospital of China Medical University from January 2013 to August 2020, discussing their clinical features, pathological characteristics, treatment and prognosis. The age range of the 35 patients was 35-79 years, with an average age of (59.0±11.3) years, there were 15 males and 20 females. The tumors of the 35 patients were unilateral, concluded 22 cases on the left side and 13 cases on the right side.Among the 35 patients, the tumors of 7 cases located in the upper pole, 14 in the middle pole, and 14 in the lower pole. At the time of admission, 5 patients complained with flank pain, 3 patients had gross hematuria, and the other patients were found during physical examination or examination due to other diseases. In the imaging examination, there were 33 cases of ultrasound data, including 18 cases of hypoechoic, 10 cases of hyperechoic, 3 cases of isoechoic and 2 cases of mixed echo. The data of CT were collected in 30 cases. The tumors showed isointense or slightly hypointense on plain scan, after enhancement, it showed low enhancement with clear boundary to the renal parenchyma and 12 patients had typical central stellate scar sign. All patients accepted surgical treatment, including 23 cases of retroperitoneal laparoscopic surgery and 12 cases of open surgery, but only 12 cases had partial nephrectomy.Results:The tumors were incised after the operation, the range of the tumors’diameter was 1.3-14.0 cm, with an average of (4.0±2.3) cm. The color of the cross-section was tawny in 14 cases, mahogany in 19 cases and 2 cases of other colors. The typical features of tumor cell under microscope were arranged in nests, alveolar or tubular shapes, the cells were round or polygonal.The cell size was uniform, the cytoplasm was rich in eosinophilic granules, the nuclei was deeply stained and the nucleoli was small. There are 9 indicators reach to 20 cases in immunohistochemical stain, and the positive rates of each indicator are respectively EMA 100.0%(23/23), E-cadherin 100.0%(20/20), CK 96.2%(25/26), CD117 95.5%(21/22), p504S(AMACR)35.0%(7/20), CD10 33.3%(9/27), CK7 31.0%(9/29), Vimentin 17.2%(5/29), Ki-67(0/28). Thirty-five patients were followed up after surgery, 4 patients were lost to follow-up, and the follow-up time of the other 31 patients ranged from 7 to 90 months, with an average of (46.9±25.0) months. All patients had a good prognosis without recurrence or metastasis. Among them, 3 patients had mild renal insufficiency in a short time after operation, and they have all recovered. Three patients with gross hematuria before the operation disappeared after the operation. In 5 patients with low back pain, only two patients felt significant improvement, and the other three still felt intermittent episodes of dull lumbar pain.Conclusions:Renal oncocytoma is a relatively rare benign tumor of the kidney. Because of the lack of effective diagnostic methods, it is difficult to differentiate from renal malignant tumors preoperatively. Pathological results are the golden standard for the diagnosis and differential diagnosis of renal oncocytoma. The main treatment of renal oncocytoma is surgery, and after surgery, the patient's prognosis is good, but renal oncocytoma has the possibility of recurrence and metastasis, regular follow-up and surveillance are still required.

Analysis of clinical pathological characteristics of high-level squamous endotausal lesions in the postmenopausal cervix / 中国综合临床

Objective:To investigate the clinical pathologic features of high-grade squamous intraepithelial lesions (HSIL) in postmenopausal women.Methods:The clinical data of hospital patients with HSIL admitted to the Department of Gynecology of The First People's Hospital of Lianyungang, Jiangsu Province from January 2019 to December 2020 were retrospectively analyzed. Patients undergoing liquid-based thin-layer cytology, high-risk human papillomavirus (HR-HPV), colposcopy, cervical biopsy and Endocervical curettage (ECC), pathological diagnosis of HSIL, followed by cold knife conization (CKC). The diagnosis and treatment process conformed to the cervical cancer diagnosis and treatment norms, and there were a total of 594 patients with no previous cervical surgery history,including 463 cases in the premenopausal group and 131 cases in the menopausal group, and the age, contact bleeding, gynecological examination, HR-HPV, liquid-based thin layer cytology, colposcopy and biopsy results, and post-cervical cone surgery pathological results were compared and analyzed, and multivariate Logistic regression analysis was carried out for statistically different factors to identify the clinical pathological characteristics of postmenopausal HSIL patients. T-test was used for the comparison between measurement data groups with normal distribution, and rank sum test was used for the comparison between measurement data groups with non normal distribution. Counting data use χ 2 test or Fisher exact probability method. Logistic regression analysis was used in multivariate analysis. Results:There was no significant difference in the positive rate of contact bleeding (12.98%(17/131)) and HR-HPV (77.86%(102/131)) between postmenopausal group and non postmenopausal group (11.45%(53/463) and 80.56% (373/463))(χ 2 values were 0.23 and 0.46; P values were 0.632 and 0.496). The proportion of cervical columnar epithelium displacement (43.51% (57/131)) and abnormal liquid-based thin-layer cytology (87.79%(115/131)) in the postmenopausal group were lower than those in the non postmenopausal group (64.36%(298/463) and 93.74%(434/463)). There was significant difference between the two groups (χ 2 values were 18.46 and 5.16; P values were < 0.001 and 0.023). The positive rate of ECC (62.60%(82/131)), cervical type Ⅲ transformation area (73.28%(96/131)), the proportion of pathological upgrading after conization (9.92%(13/131)) and the positive rate of cutting edge after conization (24.43%(32/131)) in menopausal group were higher than those in non menopausal patients (46.22%(214/463), 26.78%(124/463), 1.73%(8/463) and 5.40%(25/463)). There were significant differences between the two groups (χ 2 values were 10.95, 94.68, 20.11 and 42.62; P values were 0.001, <0.001, <0.001 and <0.001). Multivariate Logistic regression analysis showed a high proportion of cervical type Ⅲ transformational zones ( OR=6.569, 95% CI 4.130-10.446), high ECC positivity ( OR=1.978, 95% CI 1.250-3.128), the positive rate of cone incision margins was high ( OR=4.581, 95% CI 2.386-8.794), the proportion of pathological escalation after cone surgery ( OR=4.612, 95% CI 1.557-13.668) and the proportion of smooth cervical appearance were high ( OR=0.464, 95% CI 0.294-0.731), which was the clinicopathological feature of postmenopausal HSIL ( P values were <0.001, 0.004, <0.001, 0.006 and 0.001). Conclusion:There were differences in HSIL in patients before and after menopause, clinical symptoms and screening manifestations were atypical, and lesions are easy to involve the cervical canal, the positive rate of the cut margin after coneectomy was high, and the proportion of pathological escalation was high, so more aggressive intervention should be taken for women diagnosed with precancerous cervical lesions after menopause

The relationship between homocysteine, coagulation dysfunction and breast cancer risk / 中华肿瘤杂志

Objective: To investigate the correlation of homocysteine (HCY) and coagulation function index with the risk of breast cancer and its clinicopathological characteristics. Methods: The HCY, coagulation function test index, and clinicopathological information of female breast cancer patients (333 cases) treated in Tianjin Medical University Cancer Hospital from January 2018 to December 2018 were collected, and female patients with benign breast (225 cases) were selected during the same period for the control group. The t-test was used to compare measurement data with normal distribution, D-Dimer data were distributed discreetly and described by median, non-parametric Mann-Whitney U test was used to compare the two groups. The chi-square test was used to compare enumeration data, and the Logistic regression analysis was used for the risk analysis. Results: The levels of HCY, fibrinogen (Fbg), protein C (PC), and median D-Dimer (D-D) in peripheral blood of breast cancer patients group [(13.26±5.24) μmol/L, (2.61±0.83) g/L, (117.55±19.67)%, and 269.68 ng/ml, respectively] were higher than those in the control group [(11.58±0.69) μmol/L, (2.49±0.49) g/L, (113.42±19.82)% and 246.98 ng/ml, respectively, P<0.05]. The prothrombin time (PT), PT(INR), α2-antiplasmin (α2-AP) levels [(10.19±0.63) s, 0.91±0.07 and (110.64±13.93)%, respectively] were lower than those in the control group [(10.58±0.65) s, 0.93±0.01 and (123.81±14.77) %, P<0.05]. The serum levels of PC and median D-D in premenopausal breast cancer patients [(112.57±17.86)% and 242.01 ng/ml, respectively] were higher than those in the control group [(105.31±22.31)% and 214.75 ng/ml, respectively, P<0.05]. The levels of PT(INR), α2-AP [0.91±0.07 and (111.29±12.54)%, respectively] were lower than those of the control group[0.98±0.15 and (120.17±16.35)%, respectively, P<0.05]. The levels of HCY and median D-D in postmenopausal breast cancer patients [(14.25±5.76) μmol/L and 347.53 ng/ml, respectively] were higher than those in the control group [(11.67±2.38) μmol/L and 328.28 ng/ml, P<0.05]. The levels of PT, PT(INR), antithrombin Ⅲ (AT-Ⅲ), α2-AP levels [(10.18±0.66) s, 0.87±0.09, (97.30±12.84)% and (110.13±14.96)%] were lower than those in the control group [(10.38±0.61) s, 0.90±0.08, (102.89±9.12)%, and (127.05±12.38)%, respectively, P<0.05]. The levels of α2-AP and median D-D in T2-4 stage breast cancer patients [(111.69±14.41)% and 289.25 ng/ml, respectively] were higher than those in Tis-1 stage patients [(108.05±12.37)% and 253.49 ng/ml, respectively, P<0.05]. The levels of PT, PT (INR), Fbg, AT-Ⅲ, α2-AP, median D-D [(10.62±0.63) s, 0.95±0.06, (3.04±1.52) g/L, (103.21±9.45)%, (118.72±14.77)% and 331.33 ng/ml, respectively] in breast cancer patients with lymph node metastasis were higher than those of patients without lymph node metastasis [(10.42±0.58) s, 0.93±0.06, (2.52±0.54) g/L, (95.20±13.63)%, (106.91±13.13)% and 263.38 ng/ml, respectively, P<0.05]. In non-menopausal breast cancer patients, the level of HCY [(12.63±4.41) μmol/L] in patients with T2-4 stage was higher than that of patients with Tis-1 stage [(10.70±3.49) μmol/L, P=0.010], and the level of thrombin time [(19.35±0.90) s] of patients with T2-4 stage was lower than that of patients with Tis-1 stage [(19.79±1.23) s, P=0.015]. The levels of PT(INR), Fbg, AT-Ⅲ, α2-AP [0.97±0.56, (3.37±2.34) g/L, (102.38±8.77)% and (120.95±14.06)%] in patients with lymph node metastasis were higher than those of patients without lymph node metastasis [0.94±0.05, (2.36±0.48) g/L, (94.56±14.37)% and (109.51±11.46)%, respectively, P<0.05]. Among postmenopausal breast cancer patients, the levels of AT-Ⅲ and α2-AP in T2-4 stage patients [(98.48±11.80)% and (111.84±15.35)%, respectively] were higher than those in patients with the Tis-1 stage [(94.12±14.98)% and (105.49±12.89)%, respectively, P<0.05]. The levels of AT-Ⅲ and α2-AP in N1-3 stage patients [(103.74±9.94)% and (117.29±15.23)%] were higher than those in N0 stage patients [(95.75±13.01)% and (108.39±14.42)%, P<0.05]. Conclusions: HCY and abnormal coagulation function are related to the risk of breast cancer, T stage and lymph node metastasis in breast cancer patients.

Analysis of breast ultrasound imaging and pathological characteristics in patients with hereditary breast cancer-ovarian cancer syndrome / 肿瘤研究与临床

Objective:To investigate breast ultrasound imaging and pathological characteristics of patients with hereditary breast cancer-ovarian cancer syndrome (HBOC).Methods:A total of 12 patients with HBOC admitted to Shanxi Province Cancer Hospital from January 2012 to 2021 April were retrospectively analyzed. All patients were pathologically diagnosed as invasive breast cancer based on the preoperative puncture or surgical specimens, including 3 patients with double primary cancers of breast and ovary. The clinical, breast ultrasound imaging and pathological data of patients were analyzed.Results:The ultrasound imaging of HBOC usually showed regular morphology in 8 cases, clear border in 9 cases, no burr sign in 10 cases, no calcification in 10 cases, rear echo in 10 cases; the maximum blood flow velocity was (0.21±0.09) m/s, the vascular resistance index was 0.72±0.17, and aspect ratio ≤ 1 in 8 cases. Among 12 cases of HBOS, 9 cases were invasive ductal carcinoma, 3 cases were breast cancer with medullary features; histological grade: 7 cases of grade Ⅱ, 5 cases of grade Ⅲ; molecular classification: Luminal B type in 2 cases, human epithelial receptor 2 (HER2) type in 4 cases, and triple-negative type in 6 cases. The histological types of 3 patients with double primary cancers of breast and ovary were all high-grade serous carcinoma.Conclusions:HBOC is a type of neoplastic disease with a special genetic background. Ultrasound and pathological manifestations have certain characteristics. Sonographers should improve the understanding of the disease and pay attention to the medical history and family history in order to reduce the rate of misdiagnosis and increase the rate of diagnosis.

Analysis of clinical and pathological characteristics of 266 cases of colorectal laterally spreading tumor / 中华消化杂志

Objective:To analyze the clinical and pathological characteristics of colorectal laterally spreading tumor (CLST) and provide reference for clinical diagnosis and treatment of CLST.Methods:From January 1, 2016 to June 30, 2021, the clinical data of patients with CLST who underwent endoscopic resection at the Second Affiliated Hospital of Dalian Medical University were retrospectively collected. The clinical and pathological characteristics of CLST were analyzed in terms of lesion location (right colon, left colon, rectum) and morphological type (granular-homogeneous type, granular-mixed type, flat-elevated type, and pseudo-depressed type). One-way analysis of variance, Pearson′s chi-square test and Fisher′s exact test were used for statistical analysis.Results:A total of 266 patients with CLST and 296 CLST lesions were included. The most common maximum diameters of the lesions were 10 to 29 mm, accounting for 85.1% (252/296). The main morphological type was granular type, accounting for 81.4% (241/296), and the main pathological type was adenoma, accounting for 79.7% (236/296), and the most common histological type was low-grade intraepithelial neoplasia (LGIN), accounting for 81.1% (240/296). The maximum diameter of CLST lesion of rectum was larger than that of the right colon and the left colon ((24.20±16.97), (18.38±8.24) and (18.59±7.95) mm, respectively), and the difference was statistically significant ( F=6.62, P<0.001). The detection rate of granular-homogeneous type CLST in rectum was lower than that in the right colon and the left colon (22.0%, 11/50, 53.5%, 69/129 and 58.9%, 69/117, respectively), while the detection rate of granular-mixed type CLST in rectum was higher than that in the right colon and the left colon (50.0%, 25/50; 29.4%, 38/129 and 24.8%, 29/117, respectively), and the differences were statistically significant ( χ2=20.06 and 10.67, both P<0.01). The incidence of adenoma in CLST in the right colon was lower than that in the left colon and rectum (68.2%, 88/129; 87.2%, 102/117 and 92.0%, 46/50, respectively), while the incidence of serrated adenoma in CLST in the right colon was higher than that in the left colon and rectum (30.2%, 39/129; 12.8%, 15/117 and 4.0%, 2/50, respectively), and the differences were statistically significant ( χ2=19.25 and 20.85, both P<0.001). The CLST in left colon was mostly treated by endoscopic submucosa dissection (94.9%, 111/117), while the CLST in rectum was mostly treated by endoscopic mucosal resection (20.0%, 10/50), and the difference was statistically significant ( χ2=8.77, P=0.012). The maximum diameter of the pseudo-depressed type CLST was larger than that of the granular-homogeneous type, granular-mixed type and flat-elevated type ((24.18±14.07), (15.96±5.70), (23.49±13.80) and (21.21±8.02) mm), and the difference was statistically significant ( F=13.40, P<0.001). The incidence of adenoma in flat-elevated type CLST was higher than that of the granular-homogeneous type, granular-mixed type and pseudo-depressed type (92.1%, 35/38; 71.1%, 106/149; 86.9%, 80/92 and 15/17, respectively), and the difference was statistically significant ( χ2=14.13, P=0.003). The incidence of serrated adenoma in the granular-homogeneous type CLST was higher than that of the granular-mixed type, flat-elevated type and pseudo-depressed type (28.9%, 43/149; 10.9%, 10/92; 5.3%, 2/38 and 1/17, respectively), and the difference was statistically significant ( χ2=19.98, P<0.001). The incidence of adenocarcinoma in the pseudo-depressed type CLST was higher than that of the granular-homogeneous type, granular-mixed type and flat-elevated type (1/17; 0, 0/149; 2.2%, 2/92 and 2.6%, 1/38, respectively), and the difference was statistically significant (Fisher′s exact test, P=0.049). The incidence of LGIN in the granular-homogeneous type CLST was higher than that of the granular-mixed type, flat-elevated type and pseudo-depressed type (90.6%, 135/149; 76.1%, 70/92; 65.8%, 25/38 and 10/17, respectively), while the incidences of high-grade intraepithelial neoplasia and carcinoma in the pseudo-depressed type CLST were higher than those of the granular-homogeneous type, granular-mixed type and flat-elevated type (6/17; 9.4%, 14/149; 21.7%, 20/92; 31.6%, 12/38 and 1/17; 0, 0/149; 2.2%, 2/92 and 2.6%, 1/38), and the differences were statistically significant( χ2=21.58 and 16.81 and Fisher′s exact test, all P<0.05). Conclusions:The clinicopathological characteristics of CLST have certain specificity. The maximum diameter and malignant potential of the rectal CLST are both larger and higher than those of the colonic CLST. Although the granular-mixed type CLST is the granular type, it shows a larger maximum diameter and a higher degree of malignancy.

Characteristics and influencing factors of occupational pneumoconiosis in Guizhou / 公共卫生与预防医学

Objective To analyze the characteristics, trend and influencing factors of occupational pneumoconiosis in Guizhou, and to provide reference for the prevention and treatment of occupational pneumoconiosis. Methods A total of 1 974 mining patients in Guizhou province were selected from 2019-2020 by stratified sampling survey method. According to whether they were accompanied by occupational pneumoconiosis, they were divided into control group (n=1218) and experimental group (n=756) to analyze the morbidity characteristics, changing trend and influencing factors of occupational pneumoconiosis. Results From 2019 to 2020, 756 (38.30%) of the 1974 mining people in Guizhou suffered from occupational pneumoconiosis, including 602 (79.63%) in stage I, 86 (11.38%) in Stage II, and 68 (8.99%) in stage III. The average age was (57.36±6.89) years, and the average length of service was (15.56±4.47) years. The onset age was mainly from 50 to 69 years, and the difference was statistically significant (χ2=8.214，P2=25.429，P2=8.797，P2=27.212，P<0.05). There were significant differences in age, sex, smoking ratio, length of exposure to dust and complications between the two groups (P<0.05). Logistic regression analysis showed that age, length of dust exposure and complications were independent risk factors for occupational pneumoconiosis (P<0.05). Conclusion The occupational pneumoconiosis in Guizhou area is mainly male, the high incidence age is 50-69 years old, the development is stable, while the incidence of silicosis is increasing in recent years, among which the dust exposure age, age and complications are the high risk factors of occupational pneumoconiosis.

Analysis of epidemiology and clinical pathological characteristics of 9662 cases of thyroid cancer / 中华内分泌外科杂志

Objective:To investigate the epidemiological and clinicopathological characteristics of thyroid cancer.Methods:Data of 13 673 thyroid cancer patients admitted to the First Medical Center of PLA General Hospital from Jan. 2014 to Dec. 2019 were retrospectively analyzed. According to the admission criteria, 9 662 patients were screened out, including 2 768 males and 6 894 females, with an average age of 43.98±11.28 years. According to the year of diagnosis and treatment, the incidence of thyroid cancer, the changing trend of age of new cases, the average length of hospitalization, the pathological classification of the tumor, the size of the primary tumor, multifocal tumor, and the rate of lymph node metastasis were statistically analyzed. The surgical methods were summarized and discussed.Results:① Characteristics of population economics: the ratio of males to females were 1.00:2.49, the number of cases increased year by year, and the rate of increase of female was higher than that of male. The average age of onset of the patients was (43.98±11.28) years old, and the incidence rate of the young population increased by 6.0%, showing a younger trend. The mean length of hospital stay was (7.21±2.85) d, and the length of hospital stay decreased. ② Clinicopathological features: There were 9 513 cases of papillary thyroid carcinoma (PTC) (98.46%) , 45 cases of follicular thyroid carcinoma (FTC) (0.47%) , 58 cases of medullary carcinoma (MTC) (0.60%) and 18 cases of poorly differentiated thyroid carcinoma (PDTC) (0.19%) . There were 2 cases (0.02%) of undifferentiated thyroid carcinoma (ATC) and 26 cases (0.26%) of a particular type. The tumor size was (1.10±0.85) cm, among which the microcarcinoma (D ≤1 cm) accounted for 64.5% and showed an increasing trend year by year, with the fastest growth rate. There were 3 809 cases of multifocal carcinoma (39.4%) , and the proportion of multifocal carcinoma increased year by year in recent 3 years. The central region and lateral region lymph node metastasis rates were 33.0% and 13.0%, respectively. Correlation analysis showed that the differences were statistically significant except for pathological types ( P<0.05) . ③ Surgical methods: in the first 3 years, 2 224 patients (84.2%) underwent normative primary resection, which increased to 94.9% in the last 3 years. In the first 3 years, 2 033 patients (77.0%) underwent central lymph node dissection, which increased to 91.8% in the last 3 years. In the first 3 years, 188 cases (50.5%) underwent normative lateral cervical dissection, which increased to 71.6% in the last 3 years. Conclusions:The incidence of thyroid cancer is increasing year by year, showing a younger trend; Papillary carcinoma accounts for 98.5% of thyroid cancer. The proportion of microcarcinoma and multifocal carcinoma is increasing. The rate of lymph node metastasis in the central region and lateral region is increasing; surgery is gradually standardized, and it is necessary to standardize the diagnosis and treatment of thyroid cancer and postoperative follow-up.

Importancia de las características socio-demográficas y epidemiológicas en el manejo de los tumores de ovario / Importance of the socio-demographic and epidemiological characteristics, in the management of ovary tumors

Objetivo: Describir las principales características socio-demográficas y epidemiológicas, de las pacientes con tumores de ovarios. Métodos: Estudio descriptivo, transversal, con una población de 133 pacientes que acudieron a la consulta de Ginecología Oncológica, del Servicio Oncológico Hospitalario del IVSS, entre julio de 2016 y julio de 2017,con diagnóstico de tumores de ovarios, donde solo 24cumplieron con los criterios de inclusión. Resultados: Mayor procedencia Estado Miranda con 42%. La raza mestiza 46%.El promedio de edad 48,33 años. Menarquia promedio 12,29años. Sexarquia promedio de 19,14 años. Parejas sexuales entre 1-2, 46%. Antecedentes obstétricos: 2,5 gestaciones. Anticonceptivos orales 21%. Dispositivos intrauterinos en 21%.Hábito tabáquico 29%. Síntomas en el 83% (58% aumento de volumen abdominal) con evolución de 4,05 meses. 63%tumores benignos (cistoadenoma mucinoso con 46%), 33%tumores malignos (adenocarcinoma endometroide con 37%)y 4% tumor borderline (atípicamente proliferativo), el tipo(mucinoso). Según la clasificación FIGO estadio 1C y 3C con38% respectivamente. La lateralidad predominante lado derecho(54%). El promedio del tamaño fue de 17,60 cm. Conclusión: Las características socio-demográficas, epidemiológicas y clínico-patológicas, determinan el manejo adecuado de los tumoresde ovarios, por lo que deben ser investigadas a fondo, y deesta manera, ofrecer el mejor tratamiento individualizado a laspacientes(AU)

Objective: To describe the main socio-demographic and epidemiological characteristics of patients with ovarian tumors. Methods: Descriptive, cross-sectional study, with a population of 133 patients who attended the Oncology Gynecology clinic of the Hospital Oncology Service of the IVSS, between July 2016 and July 2017, with diagnosis of ovarian tumors, where only 24 complied with the inclusion criteria. Results: Of the 133 patients who attended the Oncology Gynecology clinic with a diagnosis of ovarian tumors, only 24 patients met the inclusion criteria. Highest origin Miranda State with 42%. The 46% mixed race. The average age 48.33 years. Average menarche 12.29 years. Average sexarchy of 19.14 years. Sexual couples between 1-2, 46%. Obstetric history: 2.5 pregnancies. Oral contraceptives 21%. Intrauterine devices in 21%. Smoking habit 29%. Symptoms in 83% (58% increase in abdominal volume) with evolution of 4.05 months. 63% benign tumors (mucinous cystadenoma with 46%), 33% malignant tumors (endometroid adenocarcinoma with 37%) and 4% borderline (atypically proliferative), the type (mucinous). According to the FIGO stage 1C and 3C classification with 38% respectively. The predominant laterality on the right side (54%). The average size was 17.60 cm. Conclusion: The socio-demographic, epidemiological and clinical-pathological characteristics determine the proper management of ovarian tumors, so they must be thoroughly investigated, and thus offer the best individualized treatment to patients(AU)

Characteristics of benign and malignant lesions of ampullary polyps and the accuracy of forceps biopsy / 北京大学学报(医学版)

OBJECTIVE@#To distinguish the endoscopic and clinical features of ampullary polyps, to investigate the endoscopic cancer risk factors of ampullary polyps based on the compared differences of benign lesions and adenocarcinoma, and to assess the accuracy of forceps biopsy.@*METHODS@#Authors retrospectively analyzed the data extracted from patients treated with endoscopic papillectomy (EP) from January 2009 to May 2019 in the Department of Gastroenterology, Peking University Third Hospital. Endoscopic pictures and pathology reports were reevaluated and analyzed. Differences between benign and cancer groups were conducted.@*RESULTS@#In the study, 42 cases were involved, 35 to 83 years old, containing 83.3% older than 50 years old patients. The histological types were as follows, 2 for inflammatory polyps (4.8%), 1 for neuroendocrine tumor (2.4%), 1 for hyperplastic polyp (2.4%), 5 for grade Ⅰ adenoma (11.9%), 10 for grade Ⅱ adenoma (23.8%), 4 for grade Ⅲ adenoma (9.5%) and 19 for adenocarcinoma (45.2%), and 90.5% were adenoma or adenocarcinoma. The average age of benign group (inflammatory polyps and adenomas) was (56.7±9.2), which was significantly younger than that of adenocarcinoma group [(66.0±9.8), P=0.004]. Tumor diameter in adenocarcinoma group[(2.3±0.8) cm] was significantly larger than that in benign group[(1.6±0.6) cm, P=0.002]. Benign lesions only showed Yamada type Ⅰ(57.1%)and type Ⅱ(42.9%). The percentage of Yamada type Ⅰ (36.8%)and type Ⅱ(31.6%) in adenocarcinoma group was lower than that in benign group. Moreover, Yamada type Ⅲ (31.5%) was only found in the adenocarcinoma group. Significant differences were observed between the two groups in Yamada types (P=0.046). Most of the benign lesions had clear boundary(18/21, 85.7%). The percentage of clear boundary in adenocarcinoma group (2/19, 10.5%) was significantly lower than that in the benign group (P < 0.001). No significant differences were investigated in color (P=0.353) and surface (P=0.324) between benign and adenocarcinoma lesions. Pooling age, lesion diameter, Yamada type and clear boundary into Logistic regression analysis, only age (OR=1.186, 95%CI 1.025-1.373, P=0.022) and clear boundary (OR=66.218, 95%CI 3.421-1 281.840, P=0.006) were the independent cancer risk factors. Only 2 (10.5%) in the 19 cancer patients had positive biopsy results before EP. As compared with post-EP, 55.3% (21/38) biopsies were under-estimated, including 17 (17/19, 89.5%) adenocarcinomas and 4 (4/10, 40%) grade Ⅱ adenomas.@*CONCLUSION@#adenoma and adenocarcinoma were the major histological type of ampullary po-lyps. Age and unclear boundary were the independent risk factors of ampullary adenocarcinoma. Forceps biopsy was not enough for ampullary polyp differentiation.

Research progress of non-alcoholic fatty liver disease in nonobese adults / 解放军医学杂志

Nonobese non-alcoholic fatty liver disease (NAFLD) is a special clinical phenotype of NAFLD. The patients do not have the characteristics of obesity, so they are often overlooked by people. The reports of these patients in domestic and foreign literature are not completely consistent. This paper mainly discusses its etiology, risk factors, pathological characteristics, diagnosis and lifestyle intervention, so as to provide some help for the clinical diagnosis and treatment of adult patients with nonobese NAFLD.

Idiopathic gingival fibromatosis: a case report and literature review / 口腔疾病防治

Objective @#To explore the etiology, clinical manifestations, diagnosis, differential diagnosis and treatment of idiopathic gingival fibromatosis, and to provide references for clinical diagnosis and treatment.@*Methods @#The clinical data and related literatures of a case of idiopathicgingival fibroma that occurred in the oral cavity were retrospectively analyzed. @*Results @#Total periodontal treatment was performed for the patient, and the gingival morphology was improved after periodontal surgery in the anterior region. Idiopathic gingival fibromatosis is a rare disease characterized by gingival tissue hyperplasia. The etiology and pathogenesis are unknown. The disease can occur in young children. Generally, it occurs after the permanent teeth erupt, and it manifests as extensive gingival hyperplasia, which can affect the entire gingival margin, gingival papilla and attached gingival, and can even reach the membrane-gingival junction. The pathological changes include thickening of the spinous layer of the gingival epithelium, significant increases in the epithelial styloid process, increases in the connective tissue volume, and filling with large collagen fiber bundles and a large number of fibroblasts. The blood vessels are relatively small, and inflammation is not obvious. Clinically, this disease needs to be distinguished from drug-induced gingival hyperplasia and chronic gingivitis with hyperplasia as the main manifestation. At present, the treatment of idiopathic gingival fibromatosis is mainly gingival angioplasty. The disease easily relapses after surgery. The recurrence rate is related to the quality of oral hygiene. After recurrence, it can be treated again.@*Conclusion@# Idiopathic gingival fibromatosis is relatively rare, and the diagnosis mainly depends on the history of inquiry, clinical manifestations and pathological examination. The treatment is mainly surgical resection, and future research should focus on finding a more effective treatment.

Clinicopathology observation of primary pulmonary sarcomatold carcinoma: 15 cases / 中华胸心血管外科杂志

Objective@#To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease.@*Methods@#Data including clinical manifesation, pathological findings, molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed.@*Results@#15 patients with PPSC were identified(13 men and 2 women, age ranged 56-76 years, median age 66 years). The tumor were located in the left lobus superior(8 cases), lobus inferior(6 cases), and the right lobus medius(1 case). The main clinical symptoms was cough, sputum, bloody sputum, chest pain. Among the 13 males, 10 had smoking history of more than 30 years, and 2 females had no smoking history. All cases presented with a spheroid solid lung mass. All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement, and inhomogeneous central low-attenuation areas were seen in 15 patients. Pathological pattern: 6 cases spindle cell carcinoma, 4 cases pleomorphic carcinoma, 2 cases giant cells carcinoma, 2 cases carcinosarcoma, 1 case pulmonary blastoma. The tumors were composed of both carcinomatous and sarcomatous elements. Immunohistochemistry showed that CK was all positive, EMA was positive in 7, VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer, 4 patients had MET14 jump mutation, EGFR L858R gene mutation occurred in 3 cases, KARS G13D gene mutation in 2 cases, and BRAF V600E mutation in 1 case. All 15 patients underwent lobectomy, 13 underwent adjuvant chemotherapy, and 6 underwent local radiotherapy. Postoperative follow-up was 8 to 50 months, 3 cases were lost, and 4 cases were survival 3 years after the surgery.@*Conclusion@#Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer. Compared with other NSCLC, there is no special clinical and imageing characteristics. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining, and PSC needs to be diatinguished from a variely of disease. PPSC is more aggressive and poor prognosis.

Expression and clinical significance of plasma methylated Septin9 gene in patients with gastric cancer / 中华消化杂志

Objective@#To explore the expression and clinical significance of plasma methylated Septin9 gene (mSEPT9) in patients with gastric cancer.@*Methods@#From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected. The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group. The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis.@*Results@#The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group. The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/147 vs. 4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant (χ2=43.438 and 63.912, both P<0.016). The sensitivity and specificity of plasma mSEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively. The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion, middle-late stage (stage Ⅲ and Ⅳ) in clinical classification, which were 57.6% (38/66) vs. 35.6% (26/73), 52.6%(51/97) vs. 31.0% (13/42), 53.0% (61/115) vs. 25.0% (8/32), 55.6% (65/117) vs. 13.3% (4/30), 50.8% (65/128) vs. 4/19 and 53.5% (61/114) vs. 24.2% (8/33), respectively; and the differences were statistically significant (χ2=6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P<0.05). The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA19-9 (46.9%, 69/147 vs. 32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2=6.892 and 17.437, both P<0.016).@*Conclusions@#The positive expression of plasma mSEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well, and it is also related to the clinical stage. The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer.

Expression of transcription factor grainyhead-like-2 in breast cancer tissues and its relationship with clinicopathological features and prognosis of patients / 中国肿瘤生物治疗杂志

@#Objective: To detect the expression of GRHL2 (grainyhead-like-2) in breast cancer tissues and to explore its correlation with clinicopathological characteristics and prognosis of breast cancer (BC) patients，aiming to find new therapeutic target for breast cancer. Method: A total of 88 pairs of BC tissues and corresponding para-cancerous tissues from patients with primary BC that treated and pathologically confirmed at the Second Department of General Surgery, Xinxiang Central Hospital from January 2010 to January 2017 were collected for this study. The expression of GRHL2 in BC tissues and para-cancerous tissues was examined with IHC, and the association between GRHL2 and clinicopathological characteristics of BC patients was analyzed. Moreover, the correlation between GRHL2 and prognosis of BC patients was investigated by analyzing TCGA clinic data for BC. Result: The expression of GRHL2 was significantly higher in BC tissues (75.00%) compared with para-cancerous tissues (36.36%) (P<0.01); Based on the results of GRHL2 expression in 114 cases of normal breast tissues and 1 097 cases of primary breast cancer tissues in TCGA database, the expression of GRHL2 in primary BC tissues was significantly higher than that in normal breast tissues (P<0.01). GRHL2 expression was associated with BC TNM stage,histological grade, HER2 status and lymphnode metastasis status (all P<0.05); TCGA database showed that the RFS of 1 979 BC patients with high GRHL2 expression was significantly shorter than that of the 1 972 cases of BC patients with low GRHL2 expression (HR=1.24, 95%CI:1.11-1.38, P<0.01); GRHL2 expression exerted no significant effect on RFS of TNBC patients or ER+ BC patients (TNBC: HR=1.30，95%CI: 0.89-1.88，P=0.170; ER+: HR=1.17, 95%CI:0.76-1.78， P=0.470); however, the RFS of HER2+ BC patients with high GRHL2 expression was significantly shorter than that of HER2+ BC patients with low GRHL2 expression (HR=1.72, 95%CI:1.11-2.68, P=0.015） . Conclusion：Expression level of GRHL2 was up-regulated in BC tissues, and was associated with BC TNM stage, histological grade, HER2 status and the lymphnode metastasis status. GRHL2 plays an important role in the generation and development of BC, indicating poor prognosis.

Clinicopathology observation of primary pulmonary sarcomatold carcinoma: 15 cases / 中华胸心血管外科杂志

Objective To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease.Methods Data including clinical manifesation,pathological findings,molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed.Results 15 patients with PPSC were identified (13 men and 2 women,age ranged 56-76 years,median age 66 years).The tumor were located in the left lobus superior(8 cases),lobus inferior (6 cases),and the right lobus medius (1 case).The main clinical symptoms was cough,sputum,bloody sputum,chest pain.Among the 13 males,10 had smoking history of more than 30 years,and 2 females had no smoking history.All cases presented with a spheroid solid lung mass.All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement,and inhomogeneous central low-attenuation areas were seen in 15 patients.Pathological pattern:6 cases spindle cell carcinoma,4 cases pleomorphic carcinoma,2 cases giant cells carcinoma,2 cases carcinosarcoma,1 case pulmonary blastoma.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was all positive,EMA was positive in 7,VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer,4 patients had MET14 jump mutation,EGFR L858R gene mutation occurred in 3 cases,KARS G13D gene mutation in 2 cases,and BRAF V600E mutation in 1 case.All 15 patients underwent lobectomy,13 underwent adjuvant chemotherapy,and 6 underwent local radiotherapy.Postoperative follow-up was 8 to 50 months,3 cases were lost,and 4 cases were survival 3 years after the surgery.Conclusion Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer.Compared with other NSCLC,there is no special clinical and imageing characteristics.Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining,and PSC needs to be diatinguished from a variely of disease.PPSC is more aggressive and poor prognosis.

Expression and clinical significance of plasma methylated Septin9 gene in patients with gastric cancer / 中华消化杂志

Objective To explore the expression and clinical significance of plasma methylated Septin 9 gene ( mSEPT9) in patients with gastric cancer .Methods From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected .The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group.The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen ( CEA), carbohydrate antigen 19-9 ( CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis .Results The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group.The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/ 147 vs.4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant ( χ2 ＝43.438 and 63.912, both P?0.016).The sensitivity and specificity of plasma m SEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively.The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion , middle-late stage (stageⅢandⅣ) in clinical classification, which were 57.6%(38/66) vs.35.6%(26/73), 52.6%(51/97) vs.31.0%(13/42), 53.0%(61/115) vs.25.0%(8/32), 55.6%(65/117) vs.13.3%(4/30), 50.8%(65/128) vs. 4/19 and 53.5%(61/114) vs.24.2%(8/33), respectively; and the differences were statistically significant (χ2 ＝6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P?0.05).The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA 19-9 (46.9%, 69/147 vs.32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2 ＝6.892 and 17.437, both P?0.016).Conclusions The positive expression of plasma m SEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well , and it is also related to the clinical stage .The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer .

Advances on researches of clinical pathology and pathogenesis in patients with acute alcoholic hepatitis / 中国中西医结合急救杂志

Alcoholic hepatitis (AH) is an acute severe decompensated alcoholic liver disease (ALD), commonly occurring in heavy drinkers. The pathogenesis of AH is still not fully understood, which may be related to the interactions of multiple complex factors such as alcohol metabolism, inflammation and heredity, etc. Under the background of continuous alcoholic exposure, the pathological changes include hepatocyte steatosis, liver inflammation and fibrosis occurring in the body. This paper summarizes the recent research literatures related to the clinicopathological features, pathogenesis and prognosis evaluation of ALD to comprehensively understand the pathogenesis and pathophysiological characteristics of AH in order to provide theoretical basis for clinical diagnosis and treatment of this disease.