Pathological classification of malignant peritoneal mesothelioma and comparative analysis with peritoneal carcinomatosis / 中华劳动卫生职业病杂志

Objective: To analyze the pathological classification of malignant peritoneal mesothelioma (MPeM) and screen the immunohistochemical markers that can distinguish MPeM from peritoneal metastatic carcinoma (PC) . Methods: In June 2020, the pathological results of peritoneal biopsy of 158 MPeM and 138 PC patients from Cangzhou Central Hospital, Cangzhou People's Hospital, and Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from May 2011 to July 2019 were retrospectively analyzed, and the pathological classifications of MPeM in Cangzhou were summarized. Immunohistochemical markers of MPeM and PC patients were analyzed, and receiver operating characteristic curve (ROC curve) was drawn for differential diagnosis of MPeM and PC. Results: There were 55 male and 103 female MPeM patients in Cangzhou, with an average age of 57.1 years old. The asbestos exposure rate was 91.14% (144/158). The most common pathological classifications were cutaneous type, accounting for 90.51% (143/158). There were significant differences in the expression of calreticulum protein, CK5/6, vimentin, D2-40, carcinoembryonic antigen (CEA) and tail type homologous nuclear gene transcription factor 2 (CDX-2) between MPeM and PC (P<0.05). Among the 6 positive markers, the sensitivity of calreticulum protein was the highest (0.905) and CEA was the lowest (0.428) . Conclusion: Calreticulum protein, CK5/6, vimentin, D2-40, CEA and CDX-2 may be used as specific markers to distinguish the diagnosis of MPeM from PC.

Analysis of clinical characteristics of elderly patients with rheumatoid arthritis and lung cancer / 中华老年医学杂志

Objective:To investigate the clinical features of elderly rheumatoid arthritis(RA)patients with lung cancer, and to improve clinicians' understanding of this condition.Methods:Retrospective analysis was conducted over general information, clinical manifestations, laboratory results, pathological types, clinical stages, treatment and prognosis in elderly inpatients(≥60 years old)diagnosed with RA and lung cancer admitted to the Second Xiangya Hospital, Central South University from January 2012 to December 2019.Differences between male and female patients were compared.Results:There were 12 elderly patients with RA combined with lung cancer, including 7 males and 5 females, with an average age of(65.8±5.7)years(60-78). The median years from the diagnosis of RA to lung cancer was 11(7.5, 17.3). Eleven patients had clinical symptoms before the diagnosis of lung cancer, with cough and sputum as the most common initial manifestations(9/11). The proportion of smokers in male patients was 71.4%(5/6). Most patients(11/12)had elevated erythrocyte sedimentation rates(ESR)and C-reactive protein(CRP). Eight patients underwent rheumatoid factor(RF-IgM, IgA, IgG)and anti-cyclic citrullinated peptide(ACPA)examinations, and the positive rate was 100% for RF and 87.5% for ACPA.Among 10 patients undergone tumor marker examination, 6 had elevated CEA, 4 had elevated CYFRA21-1, 2 had SCC, 2 had NSE, and 2 had elevated CA125.Among the 12 patients, 7 had adenocarcinoma, 2 had squamous cell carcinoma, 2 had small cell lung cancer, and 1 had carcinoma in situ.Except for 1 case of carcinoma in situ, the remaining 11 patients were all at stage Ⅲ or Ⅳ at the time of diagnosis.Three patients gave up anti-cancer treatment, while the remaining 9 patients received different therapies.In the end, 10 patients died and 2 patients survived so far.The average follow-up time was 17.5(5, 25)months.Further analysis showed that there was no significant difference in clinical manifestations, laboratory test results, pathological types, treatment and prognosis between male and female patients, except that the ESR level was higher in the female group than in the male group(Z=-2.589, P=0.010). However, the average age of male patients was older than that of female patients(68±6.2, 62.6±3.1), and the age of male patients at the diagnosis of RA was also older (56.4±3.8, 52.0±9.5). The proportion of smokers in male patients was significantly higher than in female patients(71.4%, 20.0%), while women had higher proportions than men with elevated CEA(75%, 50%)and NSE(50%, 0.0%). The proportion of women with adenocarcinoma was slightly higher than that of men(80.0%, 42.9%), while the proportions of men with squamous cell carcinoma(28.6%, 0.0%)and small cell carcinoma(28.6%, 0.0%)were slightly higher than those of women.Male patients had a higher mortality rate(100.0%, 60.0%)and a shorter median follow-up time[16.0(2.0, 18.0), 26.0(11.5, 50.0)monthes]. Conclusions:Elderly RA patients with lung cancer are more common in men, and the average age is older than that of female patients.The occurrence of lung cancer is more likely in RA patients with longer disease duration.Most patients are positive with RF and ACPA.Adenocarcinoma is the most common pathological type of lung cancer, and most patients are at clinical stages Ⅲ and Ⅳ.Mortality is high and prognosis is poor.Thus, for elderly RA patients, it is necessary to receive regular monitoring in changes in pulmonary imaging for early detection of lung cancer and improved prognosis.

Clinical pathological characteristics and prognosis of 468 thymoma patients / 中国胸心血管外科临床杂志

@#Objective    To assess the correlation of WHO pathological classification and Masaoka stage of thymomas with its prognosis. Methods    A total of 468 patients with thymomas who received surgeries during 2009-2019 in Huashan Hospital, Fudan University, were collected. There were 234 males and 234 females with an average age of 21-83 (49.6±18.7) years. A total of 132 patients underwent video-assisted thoracic surgery (VATS) and 336 patients underwent thymectomy with median sternal incision. The follow-up time was 5.7±2.8 years. The clinical data of the patients were analyzed. Results    The amount of intraoperative bleeding was 178.3±133.5 mL in the median sternal incision group, and 164.8±184.1 mL in the VATS group (P=0.537). The operative time was 3.3±0.7 h in the median sternal incision group and 3.4±1.2 h in the VATS group (P=0.376). Postoperative active bleeding, phrenic nerve injury and chylothorax complications occurred in 8 patients, 9 patients and 1 patient in the VATS group, respectively, and 37 patients, 31 patients and 7 patients in the median sternal incision group, respectively. There was no statistical difference between the two groups (P=0.102, 0.402, 0.320). The 5-year cumulative progression free survival (PFS) rates of patients with WHO type A, AB, B1, B2, B3 and C thymomas were 100.0%, 100.0%, 95.7%, 81.4%, 67.5% and 50.0%, respectively (P<0.001). The 5-year PFS rates of patients with Masaoka stageⅠ-Ⅳ thymomas were 96.1%, 89.2%, 68.6% and 19.3%,  respectively (P<0.001). The 5-year PFS rate was 87.3% in patients with myasthenia gravis (MG) and 78.2% in patients without MG (P<0.001). The 5-year PFS rates of patients with different surgeries were 82.4% and 83.8%, respectively (P=0.904). Conclusion    WHO pathological classification and Masaoka stage have significant clinical prognosis suggestive effect. Thymoma patients combined with MG have better prognosis, which suggests early diagnosis and treatment of thymoma are important.

Clinicopathological analysis and surgical strategy of primary appendiceal neoplasms / 中华胃肠外科杂志

Objective: To investigate the clinicopathological features, surgical methods and prognosis of primary appendiceal neoplasms. Methods: A descriptive case series study was performed. Clinical data of patients diagnosed with primary appendiceal neoplasms in Peking University First Hospital from 2006 to 2017 were retrospectively analyzed. Patients who underwent surgery and were confirmed as appendiceal neoplasms by postoperative pathology were included. Cases of cecal tumor invading the appendix and other organ tumors implanting in the appendix and cases of recurrent appendix tumors were excluded Pathological classification was based on the 4th edition of the WHO classification of digestive tract tumors (2010 edition), and the efficacy of operation methods of low grade appendiceal mucinous neoplasm (LAMN) were analyzed. Results: A total of 115 patients were enrolled, including 52 males and 63 females with a median age of 59 (51, 71) years. Clinical symptoms usually manifested as dormant pain in the right lower quadrant, migrating right lower abdominal pain, fever and bloating. Twenty-four cases were accidentally discovered during surgery, and 21 cases were found by physical examination. The preoperative diagnosis rate of CT and ultrasound was 40.2% (43/107) and 25.5% (24/94) respectively. The postoperative pathological types contained 83 cases of LAMN, 12 cases of mucinous adenocarcinoma, 9 cases of appendiceal neuroendocrine neoplasms (aNEN), 2 cases of mucinous adenocarcinoma with signet ring cells, 3 cases of serrated adenoma, 2 cases of goblet cell carcinoid, 2 cases of lymphoma, 1 case of leiomyoma and 1 case of schwannomas. All the patients underwent surgical resection, including 41 cases of appendectomy, 21 cases of partial cecectomy, 48 cases of right hemicolectomy, and 5 cases of combined organ resection due to appendiceal tumor infiltration or dissemination. Eighteen cases were diagnosed with pseudomyxoma peritonei (PMP) during operation. A total of 98 patients were enrolled for follow-up. The median follow-up time was 58 (5-172) months. The 5-year disease-free survival (DFS) rate was 84.5% and 5-year overall survival (OS) was 88.2%. Multivariate analysis revealed that high-grade malignancy tumors (HR=25.881, 95% CI: 2.827-236.935, P=0.004) and PMP formation (HR=42.166, 95% CI: 3.470-512.439,P=0.003) were independent risk factors for prognosis. Patients undergoing right hemicolectomy presented longer operation time, more blood loss and higher morbidity of complication as compared to those undergoing appendectomy and partial cecectomy (all P<0.05), while no significant differences in 5-year DFS (P=0.627) and 5-year OS (P=0.718) were found. Conclusions: Primary appendiceal neoplasms usually have no typical features, accompanied with low preoperative diagnosis rate. The common pathological types are LAMN, mucinous adenocarcinoma and aNEN. Appendectomy or partial cecectomy for LAMN may achieve satisfactory prognosis. High-grade malignancy tumors and PMP formation are independent risk factors for prognosis.

Progress in clinical diagnosis and treatment for gastric polyps / 中南大学学报(医学版)

Gastric polyps are common precancerous diseases. With the intensive study on the characteristics of different types of gastric polyps in recent years, only 1.7% of the gastric polyps were found to have dysplasia and cancer, and most of the dysplasia and cancer were found in polyps larger than 1 cm. Traditional idea suggests that polyps should be removed immediately, but routine removal of all polyps results in an increased financial burden on patients. At present, there are controversies about whether endoscopic treatment is necessary for different pathological types and small gastric polyps.

Comparison of gemstone spectral curve and CT value of gastric cancer with different pathological types and differentiation degrees / 中华肿瘤杂志

Objective@#To investigate the differences of gemstone spectral curve and CT value of gastric cancer with different pathological types and differentiation degrees.@*Methods@#91 cases of preoperative gemstone CT images with gastric cancer were collected, including 24 cases of mucinous carcinoma, 67 cases of non-mucinous carcinoma, 16 cases of signet ring cell carcinoma, 8 cases of mucinous adenocarcinoma, 32 cases of moderately differentiated adenocarcinoma and 35 cases of poorly differentiated adenocarcinoma. Gemstone CT spectral imaging was performed preoperatively, and the spectral curve of the lesion in venous phase was obtained by using GSI Viewer software, the slope of the curve was calculated, and 11 monoenergetic CT values of 40~140 keV (10 keV interval) were measured. The gemstone spectral curves and CT values of gastric cancer with different pathological types and differentiation degrees are compared.@*Results@#The curve slopes of non-mucinous carcinoma, signet ring cell carcinoma and poorly differentiated adenocarcinoma were -1.92±0.53, -1.73±0.37 and -2.14±0.54, respectively. The absolute values were higher than those of mucinous carcinoma (-1.45±0.54), mucinous adenocarcinoma (-0.90±0.34) and moderately differentiated adenocarcinoma (-1.67±0.41), and the differences were all statistically significant (P<0.05). There were significant differences in monoenergetic CT values between mucinous and non-mucinous carcinomas at 40-140 keV (all P<0.05). The former was lower than the latter in different degrees, and the lower the energy, the greater the difference was. There were significant differences in monoenergetic CT values between signet ring cell carcinoma and mucinous adenocarcinoma at 40-100 keV (all P<0.05); monoenergetic CT values between poorly differentiated adenocarcinoma and moderately differentiated adenocarcinoma at 40-90 keV showed statistically significant differences (P<0.05).@*Conclusions@#Gastric cancer with different pathological types and differentiation degrees have their characteristic spectral curves in venous phase, and the monoenergetic CT values are significantly different at low energy. The spectral curve of gemstone CT may be helpful to evaluate the pathological type and differentiation degree of gastric cancer before operation.

Clinical study of brush liquid-based cytology combined with automatic immunohistochemistry in the classification and diagnosis of lung cancer / 中华肿瘤杂志

Objective@#To explore the feasibility of bronchoscopic brushing liquid-based slide cytology combined with automatic immunocytochemistry (ICC) for pathological typing of lung cancer.@*Methods@#A liquid-based thin-prep was prepared from 171 bronchoscopic brushing specimens of patients with pulmonary lesions. ICC was detected by automatic immunohistochemistry instrument while cytomorphological diagnosis was made. The results were compared with those of histopathological diagnosis.@*Results@#Among 171 patients, 130 (76.0%) could be classified by cell morphology alone, including 31 squamous cell carcinomas, 44 adenocarcinomas and 55 small cell carcinomas; 162 (94.7%) could be classified by cell morphology combined with ICC, including 38 squamous cell carcinomas, 61 adenocarcinomas and 63 small cell carcinomas (P<0.001). According to the gold standard of histopathological diagnosis, the coincidence rate of cytomorphology combined with ICC was higher than that of cell morphology alone. The coincidence rate of squamous cell carcinoma was increased from 85.2% to 97.1% (P=0.093), adenocarcinoma from 92.5% to 98.0% (P<0.001), and small cell carcinoma from 96.1% to 98.3% (P=0.465).@*Conclusion@#The combination of liquid-based thin-prep cytology and automatic immunohistochemistry can effectively improve the accuracy of pathological typing of brushing specimens under fiberoptic bronchoscopy, and provide more objective diagnostic results for clinical treatment.

Clinical Evaluation of A New Pathological Classification for Non-small Cell Lung Cancer Based on Histogenesis of Bronchial Tree / 中国肺癌杂志

BACKGROUND@#Due in part to remarkable advances over the past decade in our understanding of lung cancer, there is a pressing need for a revised classification. The aim of this study was to explore and verify the clinical significance of a new molecular classification of non-small cell lung cancer (NSCLC) on the basis of anatomic site of bronchial tree.@*METHODS@#Double-immunohistochemistry were performed in 105 tumor samples paring with normal lung tissue from non-small cell lung cancer patients by using monoclonal antibody of P63/NapsinA and TTF-1/CK7. By comprehensively analyzing the express profiles of tumors and normal lung tissues, histological characteristics we proposed a brand new pathological classification based on histogenesis for NSCLC and divided them as: bronchiole epithelial cell carcinoma, bronchiole-alveolar cell carcinoma, alveolar cell carcinoma and secretory adenocarcinoma. And to analyze the relationship between this classification and epidermal growth factor receptor (EGFR) mutation and ognosis.@*RESULTS@#Further investigation revealed that our new classification showed strong relevancy with EGFR mutations and effective indicators for prognosis.@*CONCLUSIONS@#The classification system for NSCLC proposed by our research group is convenient for pathological diagnosis and valuable in clinical application.

Current diagnosis and treatment progress of small pancreatic neuroendocrine neoplasm / 中华外科杂志

Small(≤2 cm)pancreatic neuroendocrine neoplasm(pNEN) is a very special subgroup of pNEN featuring a small size, concealed pathogenesis, indolent course and remarkable heterogeneity.Differences in its diagnosis and interventional criteria have evolved from routine pNEN.During recent years, the incidence of small pNEN has increased sharply, while optimal management strategy of this subgroup still remains controversial.In this paper, the biological characteristics, pathological classification, diagnosis, intervention indication and therapeutic principles of small pNEN are reviewed based on recent researches, and current situations of diagnosis and treatment of small pNEN are summarized.

Overview and clinical application in the 2017 World Health Organization classification of pituitary tumors / 中华内分泌代谢杂志

The fourth edition of the World Health Organization classification of tumors of the pituitary gland was promulgated in 2017. The revised classification emphasized the classification of pituitary tumors based on the origin of cell differentiation. The term of atypical pituitary adenoma was no longer recommended, and morphological parameters should be considered as an important prognostic feature in aggressive adenomas. Genetic profile and susceptibility of pituitary tumors were updated. And an additional novel aspect was the definition of some of the nonneuroendocrine tumors. The revised classification will help the pathologists to make better diagnosis, and contribute to improve our understanding of clinical outcomes for those patients. (Chin J Endocrinol Metab, 2018, 34: 623-626)

CT-guided percutaneous transthoracic needle biopsy for the diagnosis of non-small cell lung cancer: a retrospective analysis of its diagnostic accuracy / 介入放射学杂志

Objective To investigate the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy (PTNB) for non - small cell lung cancer (NSCLC), and to discuss the factors affecting the diagnostic accuracy of puncture biopsy. Methods The clinical data of a total of 203 patients with pathologically-proved NSCLC, who received CT-guided PTNB during the period from January 1, 2010 to November 1, 2016, were retrospectively analyzed. CT - guided PTNB was performed in all patients before surgery, and tissue specimens were collected for pathological study. The diagnostic accuracy of needle biopsy was calculated, and the factors that might affect the diagnostic accuracy of needle biopsy were analyzed. Results (l)The coincidence rate of pathological results of CT-guided PTNB (small specimens) with surgical specimens (large specimens) was 92. 6％ (188/203). The squamous cell carcinoma and adenocarcinoma had the highest coincidence rates, which were 100％ and 97. 5％ respectively. The coincidence rate of large cell carcinoma type was 20％. No statistically significant differences in the coincidence rate of adenocarcinoma and squamous cell carcinoma existed between small specimens and large specimens (κ=0. 872, P=0. 250). (2)Chi square test showed that only the lesion size was an important factor that affected the diagnostic accuracy of needle biopsy (P=0. 008). Conclusion In diagnosing commonly seen NSCLC, CT - guided PTNB has high coincidence rate with surgical specimens, therefore, CT-guided PTNB is worth popularizing widely in clinical practice. The lesion size is an important factor that affected the diagnostic accuracy of needle biopsy. (J Intervent Radiol, 2018, 27:274-277)

Relationship between different types of Helicobacter pylori infection and progress of atrophic gastritis / 中华消化杂志

Objective To observe the distribution of different types of Helicobacter pylori (H.pylori)infection in non-atrophic gastritis,atrophic gastritis and intestinal metaplasia.Methods From January 2015 to January 2017,457 hospitalized patients with gastritis were collected.All the inpatients received 14C-urea breath test(14C-UBT), H.pylori antibody typing detection, anesthesia gastroendoscopy and pathological analysis of biopsies.According to the results of H.pylori antibody typing,all patients were divided into typeⅠ H.pylori infection group,typeⅡ H.pylori infection group and H.pylori negative group.The relation among different types of H.pylori infection,age and pathological type were analyzed.Analysis of variance and chi-square test were performed for statistical analysis.Results The mean age of patients in typeⅠH.pylori infection group(n=135),typeⅡ H.pylori infection group(n=98)and H.pylori negative group(n=224)in patients with non-atrophic gastritis was(47.5 ± 9.0),(49.0 ± 9.0)and(52.0 ± 11.0)years,respectively, which were lower than those of patients with atrophy gastritis((56.8 ± 10.3),(57.5 ± 12.4)and(62.6 ± 10.4) years,respectively)and patients with intestinal metaplasia((59.2 ± 11.1),(57.5 ± 12.6)and(57.8 ± 10.0)years,respectively),and the differences were statistically significant(F=17.90,6.82 and 18.30,all P<0.01).The proportion of patients with non-atrophic gastritis in H.pylori negative group,typeⅡ H.pylori infection group and typeⅠ H.pylori infection group decreased in turn(56.3%,126/224;40.8%,40/98 and 34.8%,47/135, respectively),and the differences were statistically significant(χ2 =18.44,P<0.01).The proportion of patients with intestinal metaplasia in H.pylori negative group,type Ⅱ H.pylori infection group and type Ⅰ H.pylori infection group increased in turn(23.2%,52/224;26.5%,26/98 and 42.2%,57/135),and the difference was statistically significant(χ2 =11.44,P=0.003).There was no significant difference in the proportion of patients with atrophic gastritis among H.pylori negative group,type Ⅱ H.pylori infection group and type Ⅰ H.pylori infection group(20.5%,46/224;32.7%,32/98 and 23.0%,31/135;χ2 = 5.60,P=0.061).Conclusions Gastric atrophy is easily induced in patients with H.pylori infection.In patients without symptoms,H.pylori should be eradicated before gastric atrophy,which can provide the greatest benefit to the patients.Different types of H.pylori infection have different role in the progress of atrophic gastritis.TypeⅠ H.pylori infection accelerate the progress of atrophic gastritis,especially from atrophic gastritis to intestinal metaplasia,which should be actively eradicated.

Characteristics of clinicopathology and immunohistochemical molecular markers of 92 cases of heterotopic pancreas in upper gastrointestinal tract / 中华消化杂志

Objective To investigate the clinicopathological characteristics and the expression of related molecular markers of heterotopic pancreas for better understanding and avoiding overtreatment of this disease.Methods From 24th March 2009 to 10th November 2016,92 patients with heterotopic pancreas in upper digestive tract diagnosed after endoscopic submucosal dissection(ESD),were collected. Tissues were sectioned and pathologically classified by Heinrich classification.The expressions of seven different molecular markers including cytokeratin(CK)19,insulin,trypsin,Ki-67,p53,CD133 and CD56 were detected by immunohistochemistry staining. Clinical features, pathological features and immunohistochemical results were retrospectively analyzed.Analysis of variance and Kruskal-Wallis test were used.Results According to Heinrich classification,the percentages of type Ⅰ,Ⅱ,and Ⅲ of heterotopic pancreas were 27.2%(25/92),63.0%(58/92)and 9.8%(9/92),respectively.There was no type Ⅳ patients.The heterotopic pancreas mainly located in stomach with proportion being about 91.3%(84/92)of the total heterotopic pancreas.CK19(the marker of pancreas ducts),insulin(as marker of endocrine function)and trypsin(as the marker of exocrine function)were all expressed in heterotopic pancreas.The positive rate of CD56,a pancreatic neuroendocrine marker,was 66.3%(61/92).The umbilicus like depression was the typical endoscopic appearance of heterotopic pancreas,which only found in 29 patients(31.5%).The average rate of Ki-67,cell proliferation index,was(2.08 ± 1.41)%.The expression of mutant p53 was negative in all 92 cases of heterotopic pancreas.The average staining area of CD133,a marker of pancreatic cancer stem cell,was(2.53 ± 2.43)%.The average follow-up period of 92 patients was(43.6 ± 27.5)months.No relapse and malignant change were found and all patients survived after ESD.Conclusions Heterotopic pancreas has normal pancreatic construction and function.The cell proliferation index is low in heterotopic pancreas and no mutant p53 expression is found.The expression of CD133 is also low.Heterotopic pancreas is a congenital benign disease which requires a long-term follow-up rather than overtreatment.

Correlation analysis between T lymphocyte subsets, neutrophilto lymphocyte ratio and lung cancer pathological classificationand clinical stage of non-small cell lung cancer / 安徽医科大学学报

Objective To analyze the relationship between T lymphocyte subsets,neutrophil to lymphocyte ratio(NLR) and lung cancer pathological classification,clinical stage of non-small cell lung cancer.Methods The proportion of T lymphocyte subsets in 60 patients with lung cancer were detected by flow cytometry,the NLR were measured by blood sampling.Results The proportion of CD4+T lymphocytes,the proportion of CD8+T lymphocytes,CD4+/CD8+ and NLR in patients with lung adenocarcinoma,lung squamous cell carcinoma,small cell lung cancer patients were not statistically significant.The proportion of CD4+T lymphocytes and CD4+/CD8+ in patients with advanced non-small cell lung cancer(stage Ⅲ~Ⅳ) were lower(P<0.05) than in the early group(stage Ⅰ~Ⅱ).The proportion of CD8+T lymphocytes and NLR in patients with advanced non-small cell lung cancer(stage Ⅲ~Ⅳ) were higher(P<0.05) than that of early stage group(stage Ⅰ~Ⅱ).Conclusion The T lymphocyte subsets and NLR in the peripheral blood of non-small cell lung cancer patients have a certain correlation with the clinical stage of non-small cell lung cancer,which can be used as a reference index for clinical staging.

Correlation between dynamic contrast-enhanced magnetic resonance imaging features and the prognosis and pathological classification of breast cancer / 新乡医学院学报

Objective To investigate the correlation between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) features and the prognosis and pathological classification of breast cancer.Methods Forty patients with breast cancer were proved by DCE-MRI and pathological examination in the Third Affiliated Hospital of Xinxiang Medical University from January to December 2016.The DCE-MRI features,estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (Her-2) and the pathological classification of breast cancer were collected.The correlation between DCE-MRI features and molecular biology indexes in breast cancer was analyzed by Spearman rank correlation analysis.Results There was no significant correlation between the lesion size and the positive expression rate of ER,PR and Her-2 (r =-0.119,0.063,0.237;P ＞ 0.05).The lesion morphology was positively correlated with the positive expression rate of Her-2(r =0.296,P ＜ 0.05) but there was no significant correlation between the lesion morphology and the expression of ER and PR (r =0.219,0.211;P ＞ 0.05).The lesion enhancement form was negatively correlated with PR positive expression (r =-0.304,P ＜ 0.05),and it was not correlated with the expression of ER and Her-2 (r =0.396,-0.393;P ＞ 0.05).There was no significant correlation between the TIC type of the lesion and the expression of ER,PR and Her-2 (r =0.254,0.315,0.396;P ＞0.05).The early enhancement rate was positively correlated with Her-2 positive expression (r =0.498,P ＜ 0.05),but there was no correlation between early enhancement rate and the expression of ER and PR(r =0.125,0.241;P ＞ 0.05).The lesion morphology,enhancement and early enhancement rate of the lesion were significantly correlated with the pathological type of breast cancer (r =0.399,0.323,0.513;P ＜ 0.05).The lesion size and the TIC type were not significantly correlated with the pathological type of breast cancer (r =0.313,0.308;P ＞ 0.05).Conclusion The shape,edge and enhancement form of lesion in DCE-MRI are correlated with the prognosis and pathological types of breast cancer;which provides a theoretical basis for the evaluation of biological behavior,prognosis and severity of breast cancer through the imageology.

CT features in predicting the pathological classification and prognosis in gastroenteric neuroendocrine neoplasm / 实用放射学杂志

Objective To analyze the correlations between the CT features and pathological classifications of gastroentric neuroendocrineneoplasm(GE-NEN) and to evaluate the association between prognostic value and CT features.Methods 45 cases pathologically and immunohistochemically proved GE-NEN were studied retrospectively.The correlation between the CT features (tumor's volume,shape,enhancement patterns and TNM stage) and pathological classifications was analyzed.Meanwhile,the association between the CT features and patients' overall survival was evaluated by Kaplan Meier method using Log-rank test and multivariate analysis in Cox proportional hazard model.Results The CT features were proved to be associated statistically with pathological classifications including the tumor's volume,shape,with or without areas of cystic change,necrosis or ulceration,T stage and lymphadenopathy (P ＜ 0.05).On the other side,the patients' overall survivals were associated with age,pathological classifications,volume of tumors,with or without areas of cystic change,necrosis or ulceration and TNM stage.Age,areas of cystic change,necrosis or ulceration and metastases were the independent prognostic factors.Conclusion Contrast-enhanced CT can be useful in the classification of GE-NEN and predicting the patient's survival.

Cystosarcoma phyllodes: Pathological enigma: A retrospective review of 162 cases.

PURPOSE: Phyllodes tumor (PT) is a rare fibroepithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B), borderline (BL), and locally recurrent to malignant (M) and metastatic type. The aim of our study was to analyze the clinicopathological factors, compare treatment options, and evaluate outcome in patients with PT. METHODS: We retrospectively reviewed 162 women with PT. The surgical intervention varied from simple excision (lumpectomy)/wide local excision (WLE) in benign cases to simple/modified radical or radical mastectomy (SM/MRM/ RM) in malignant and recurrent tumors. RESULTS: Out of 162 patients, B, BL, and M were 95 (58.64%), 29 (18%), and 38 (23.45%), respectively. Mean age, duration of lump, and size were 38 ± 8 years, 28 ± 10 months, and 12 ± 5 cm, respectively. Recurrence rate with B, BL, and M was 15.78%, 41.37%, and 55.26%, respectively (P = 0.00001). As compared to WLE (22%), SM (23.8%), and MRM/RM (14.2%), recurrence was higher with lumpectomy (48.9%) (P = 0.004). Positive correlation was found between recurrence rate with the size of tumor (P = 0.008) and also number of recurrence with holoprosencephaly (P = 0.047). There was no association between the number of recurrences and size of tumor (P = 0.63). Malignant PT was seen in 38 (24%) and distant metastasis was seen in 7 (18%). Mean duration of follow‑up was 42 months. CONCLUSION: WLE with negative margins should be the initial surgery for PT. The role of adjuvant radiotherapy and chemotherapy is uncertain. PT is pathological enigma. Till date, no factors can accurately predict the recurrence and outcome. PT is known for unpredictable behavior and high recurrence rates, hence long‑term follow‑up is advised.

Pathological typing and clinical features of primary iris stromal cysts / 中华实验眼科杂志

Background Primary iris stromal cysts is a rare clinical disease.In recent years,the pathological findings of primary iris stromal cysts are different from previous literature reports.It is very important to understand the pathological characteristics of primary iris stromal cysts for illuminating its pathogenesis and accurate treatment.Objective This study was to analyze the pathological types and clinical manifestations of primary iris stromal cysts.Methods Histopathological sections of 14 patients with primary iris stromal cysts from January 1979 to December 2012 in Tianjin Eye Hospital were retrospectively analyzed.The primary iris stromal cysts were typed based on the hematoxylin-eosin staining,periodic acid-Schiff (PAS) staining and immunochemistry, and the clinical chacteristics upon different types were evaluated.Results In 14 specimens of primary iris stromal cysts,squamous epithelial type was found in 9 specimens,lens epithelial type in 3 specimens and ciliary body epithelial type in 2 specimens.The primary iris stromal cysts of squamous epithelial type were constituted of non-cuticular stratified squamous epithelium cells,and sporadic goblet cells were found in some specimens.The primary iris stromal cysts of lens epithelial type were consisted of lens epithelium cells and lens capsular analogic tissue and the cysts were tightly adherent to the lens.Crystalline lens dysplasia were seen in 2 specimens.The primary iris stromal cysts of ciliary body epithelial type showed single or stratified ciliary body like epithelium cells.Iris-ciliary dysplasia or anterior chamber angle abnormality was displayed in 1 specimen in this type of cysts.Under the slit lamp microscope,superior-temporal clear cysts were often seen in the primary iris stromal cysts of squamous epithelial type, and translucent cysts or diffuse swelling cysts were exhibited in the lens epithelial type and might be accompanied with lens dysplasia and cataract.Diffuse swelling was found in the cysts of ciliary body epithelial type which were often associated with chamber dysplasia and infantile glaucoma.Conclusions Primary iris stromal cysts are pathologically classified into squamous epithelial type, lens epithelial type and ciliary body epithelial type and present with different clinical appearances.

Distribution and significance of B-cell infiltrates in lupus nephritis / 中华风湿病学杂志

Objective To investigate B-cell distribution in lupus nephritis and evaluate its significance in pathological classification.Methods Kidney biopsy specimens were obtained consecutively from 119 patients with LN, B lymphocytes distribution were detected using immunohistochemical staining with specific antibodies and were classified into 5 groups.Chi-square test and t test were used for statistical analysis.Results ①B lymphocytes infiltration occurred in 52.1% of the LN patients (62/119), B lymphocytes were mainly distributed in the renal interstitial tissue, which occurred most frequently in class Ⅳ LN but rare in class Ⅴ LN. ②B-cell infiltrating group was associated with active disease presentations and chronic indices P＜0.01). Blood urea nitrogen(BUN)[(12±9) vs (6±3) mmol/L] and serum creatinine(Cr)[(105±84) vs(61±21) μmol/L] were higher in B-cell infiltrates group than non-B-cell infiltration group (all P＜0.01). ③Kidney biopsy specimens showed predominantly IgG deposit in immune-fluorescency intensity examination.The Ig subtype which deposited in B-cell infiltrating group was not statistically different from those deposited in non-B cell infiltrating group (P＞0.05). Conclusion This study has shown that renal B cell infiltration occurs in 52.1% of the LN patients.Patients with renal B cell infiltration have more severe kidney tissue injury and poorer renal outcomes than patients without B cell infiltration. Renal B lymphocytes infiltration may contribute to the pathogenesis of LN in a non-antibody-secreting way.

The analysis of clinic and pathology in children with primary nephrotic syndrome / 中国医师杂志

Objective To investigate the relationship of clinic and pathology in children with pri-mary nephrotic syndrome to predict the pathological classification .Methods Retrospective analysis of the relationship of clinical manifestations and therapy in 46 hospitalized children with primary nephrotic syn-drome.Results The main clinical manifestations in 46 patients were proteinuria, hematuria, hyperten-sion, renal insufficiency, the renal pathological type were 18 (39.1%) mesangial proliferative glomerulone-phritis, 14 (30.4 %) minimal change nephropathy , 11 (23.9%) focal segmental glomerulosclerosis , 2 (4.3%) membrane proliferative glomerulonephritis , and 1 (2.3%) membranous nephropathy , respective-ly.Mesangial proliferative glomerulonephritis and minimal change nephropathy patients responded well to treatment, but focal segmental glomerulosclerosis , membranoproliferative glomerulonephritis and membra-nous nephropathy responded poorly to treatment .Conclusion Children with primary nephrotic syndrome mainly showing mesangial proliferative glomerulonephritis and minimal change nephropathy have good re -sponse to treatment.However, primary nephrotic syndrome children with clinical manifestations of hematuri-a, hypertension, renal insufficiency or poor response to treatment should perform renal biopsy .