Presence of multiple abnormal immunologic markers is an independent prognostic factor of diffuse large B-cell lymphoma / 医学前沿

Autoimmune diseases (ADs) increase the risk of non-Hodgkin's lymphoma and contribute to poor prognosis of patients. However, the association between immunologic markers and clinical outcome has rarely been investigated. This study aims to analyze the prognostic value of pretreatment immunologic markers in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively reviewed the data on 502 patients with DLBCL treated in our institution from January 2013 to March 2018. Survival functions were estimated using Kaplan-Meier method and Cox regression model. The 3-year progression free survival (PFS) and overall survival (OS) rates were 70.2% and 80.9%, respectively, and the complete remission (CR) rate was 78.1%. Among the patients, those with multiple ( ⩾ 3) abnormal immunologic markers had significantly shorter 3-year PFS (52.7% vs. 77.3%, P 60 years for OS (P = 0.014). In conclusion, the immunologic status was closely related to lymphoma progression, and this study provides new insights into the risk stratification of patients with DLBCL.

Clinicopathologic features of gastric plexiform fibromyxoma / 中华病理学杂志

Objective@#To analyse the clinicopathologic features of gastric plexiform fibromyxoma (PF) including diagnosis, differential diagnosis, immunohistochemistry and molecular pathology.@*Methods@#Eight cases of PF were collected from June 2006 to June 2017 at the Second Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University. The clinicopathologic findings of eight cases of PF were retrospectively analyzed, and immunohistochemistry (EnVision method) and molecular detection of glioma-associated oncogene homologue 1 (GLI1) gene translocation were performed. All cases were histologically reviewed with immunohistochemical staining for smooth muscle actin (SMA), CD10, CD117, DOG1, CD34, ER, PR, ALK and S-100. Fluorescence in situ hybridization (FISH) was used to detect the GLI1 gene translocation, and mutation of CKIT exons 9, 11, 13 and 17; and PDGFRA exons 12, 14 and 18 were identified by Sanger sequencing in four cases. Relevant literature was reviewed.@*Results@#The study included four men and four women, age ranged from 26 to 72 years (mean 51 years). Histologically, the tumors were rich in small thin-walled blood vessels and myxoid matrix, and exhibited multiple nodular growth pattern in the gastric wall. The tumor cells were bland, spindled or oval. Immunohistochemically, all cases strongly expressed vimentin and SMA, and some expressed CD10 (4/8), desmin (3/8), H-caldesmon (5/8) and PR (5/8), but were negative for CD34, S-100, ER, ALK, CD117 and DOG1. The GLI1 gene translocation detection was performed in eight cases by FISH with three positive cases and five negative cases. Mutation analyses for exons 9, 11, 13, and 17 of CKIT genes and exons 12, 14, and 18 of the PDGFRA genes were performed and the tumors all of four tested cases were wild-type. Seven patients were followed up (ranged from 24 to 95 months, mean 50 months) after diagnosis and none of the patients had recurrence or metastasis.@*Conclusions@#PF is a rare novel mesenchymal tumor of the stomach. Its distinct clinicopathologic features and immunohistochemical positivity for SMA, CD10 and PR can help differentiating this entity from other gastrointestinal mesenchymal tumors. FISH detection of GLI1 gene translocation offers an additional molecular diagnostic marker for the diagnosis.

Diagnosis and clinical characteristics of adrenal schwannoma：report of 8 cases and literature review / 中国癌症杂志

Background and purpose:Adrenal schwannoma is extremely rare, mostly benign, lack of special characteristics in clinical and imaging presentation. The aim of this study was to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of adrenal schwannoma, in order to improve the accuracy of diagnosis. Methods:The CT and MRI features of 8 patients with pathology-proven adrenal schwannoma were reviewed. Among the 8 patients, 4 patients underwent CT scanning, 3 patients underwent MR scanning, 1 patient underwent both CT and MR scanning.Results:The tumors were located at the left adrenal in 5 cases and at the right in 3 cases. Tumors showed no signs of endocrine activity in all cases. All tumors were well-circumscribed, oval or lobulated masses, 2 cases with calcification, 5 cases with cystic change, 2 cases with intratumoral hemorrhage. CT or MR enhancement showed moderate, heterogeneously delayed enhancement in 7 cases with enhanced capsule. Four cases showed rabbit tail sign.Conclusion:The imaging and pathological features of adrenal schwannoma have certain characteristics. The CT and MRI features, such as intact capsule, cystic degeneration, rabbit tail sign, calcification and progressive enhancement, are helpful to improve the accuracy of diagnosis of adrenal schwannoma.

Analysis of biochemical recurrence following radical prostatectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the risk factors to impact biochemical recurrence after radical prostatectomy.</p><p><b>METHODS</b>A total of 1 090 patients who received radical prostatectomy from May 2002 to December 2013 in Department of Urology of Fudan University Shanghai Cancer Center were recruited. The average age of the patients was 67.9 years (ranged from 41 to 84 years) and the average preoperative prostate specific antigen (PSA) level was 32.7 (ranged from 3.2 to 256.3) µg/L. The distribution of patients with respect to clinical stage was: 20.09% (219/1 090) had T1, 50.09% (546/1 090) had T2 and 29.82% (325/1 090) had T3. The biochemical-free-survival curve was drawn by Kaplan-Meier method and the univariate and multivariate Cox regression models were used to evaluate the clinical and pathological variables for the development of biochemical recurrence.</p><p><b>RESULTS</b>Of all the 1 090 patients, the biochemical recurrence free survival was 95.99%, 81.90% and 70.89% at 1, 3 and 5 years. PSA level at diagnosis (P=0.000), neo-adjuvant hormonal therapy (P=0.001), pre-operative Gleason score (P=0.000), clinical stage (P=0.010), surgical margin status (P=0.028), post-operative Gleason score (P=0.000), pathological stages (P=0.000) and pelvic lymph-node metastasis (P=0.000) were associated with biochemical recurrence in the univariate analysis. However, in the multivariate analysis, only PSA level at diagnosis (P=0.000), pre-operative Gleason score (P=0.020), pathological stages (P=0.014) and pelvic lymph-node metastasis (P=0.017) were independent prognostic factors.</p><p><b>CONCLUSION</b>For the patients who received radical prostatectomy, PSA level at diagnosis, pre-operative Gleason score, pathological stages and pelvic lymph-node metastasis status are independent prognostic factors for biochemical recurrence.</p>

PTEN protein loss is associated with an increased risk of recurrence in Chinese patients after prostatectomy for clinically localized prostate cancer / 中国癌症杂志

Background and purpose:Loss of the tumor suppressor phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is one of the most common somatic genetic aberrations in prostate cancer in Western countries and is frequently associated with tumor progression and poor prognosis. This study aimed to investigate the frequency of PTEN protein loss in Chinese prostate cancer patients and to determine its association with the biochemical recurrence of prostate cancer.Methods:The data from 225 diagnosed localized prostate cancer patients with radical prostatectomy from 2006 to 2011 were collected retrospectively, including patient’s age at diagnosis, prostate-speciifc antigen (PSA) level at diagnosis, Gleason score, clinical stage, surgical margin, and time to biochemical recurrence or not. This study performed PTEN protein immunohistochemistry on tissue microarrays, which were made from 225 Chinese prostate cancer patients mentioned above, treated by radical prostatectomy with one case including 2 cancer spots and 2 adjacent normal gland spots. Correlations of PTEN loss with clinicopathological features were analyzed usingχ2 test. Kaplan-Meier survival model and Cox proportional hazards regression model were used to evaluate the predictive role of PTEN protein expression and patient characteristics for biochemical recurrence. Results:PTEN protein loss was observed in 15% of the patients and was associated with increased preoperative PSA levels (P=0.03) and old age (P=0.009). In univariate Kaplan–Meier analysis, the factors associated with the biochemical recurrence of prostate cancer included PSA levels (P=0.000 4), Gleason sum (P=0.019 8), and PTEN status (P=0.013 1). In multivariable Cox regression analysis, PTEN expression (HR=0.536, P=0.044), PSA levels (HR=1.879, P=0.001), and Gleason score (HR=1.361,P=0.03) were signiifcant in predicting biochemical recurrence of prostate cancer.Conclusion:PTEN protein loss is associated with an increased risk of recurrence, independent of known clinicopathological factors.

Juxtaglomerular cell tumor:a clinicopathological study of 5 cases / 临床与实验病理学杂志

Purpose To study the clinicopathologic features of juxtaglomerular cell tumor ( JGCT) . Methods The microscopic and immunohistochemical features were examined in 5 cases of JGCT, with review of related literatures. Results Four patients were fe-males and 1 was male, average aged 39 years ( range, 26-60 years) . Four patients had hypertension at diagnosis. Postoperative serum renin and aldosterone levels decreased obviously than before the operation in one patient. In one patient tumor had metastasized to liver and bone and died 14 months after operation. Microscopically, the tumors were well circumscribed and at least partially invested by a thick fibrous capsule. Entrapped tubules were identified. Numerous hemangiopericytoma-like vessels were focally present. The tumor tissue was made up of sheets of ovoid to polygonal cells with regular nuclei, distinct cell borders, moderately abundant eosinophilic cy-toplasm. Mast cells and lymphocyte were common. Thick-walled hyalinized blood vessels were obvious. Necrosis and high mitotic ac-tivity were identified in one case. Immunohistochemically, tumor cells were positive for renin, CD34, vimentin, and SMA (focally). Conclusions JGCT is a rare renal neoplasm. Its diagnosis and differential diagnosis must be established on the clinicopathologic fea-tures, immunohistochemical findings and ultrastructural features. Malignant JGCT is very rare. Its criteria are unknown, but malignant JGCT include histological vascular invasion, a large tumor size, relatively advanced patient age or child, necrosis and/or high mitotic activity.

Clear cell papillary renal cell carcinoma: a distinct low-grade renal tumour / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of clear cell papillary renal cell carcinoma (CCPRCC).</p><p><b>METHODS</b>The clinical, morphologic and immunohistochemical characteristics of 6 cases of CCPRCC were reviewed, with analysis of follow-up data.</p><p><b>RESULTS</b>There were altogether 3 men and 3 women. The mean age of patients was 56 years. The size of tumors ranged from 1.0 to 4.5 cm in greatest dimension. They had solid or solid-cystic cut surface. Histologically, the tumors were encapsulated and showed several morphologic patterns, with tubules, papillae, acini, interconnecting ribbons and macro/microcysts lined by single layer of cells with clear or small amount of eosinophilic cytoplasm and low-grade nuclei (corresponding to Fuhrman grade 1 or 2). Mitotic figures were rarely seen. Characteristically, there was linear arrangement of the nuclei away from the basement membrane, conferring an appearance similar to that of endometrial glands in early secretory phase. Tubules and cysts contained serosanguineous fluid or colloid-like secretion were identified. No foamy histiocytes, psammomatous calcifications or hemosiderin was present in the papillary areas. Two of the tumors showed focal or extensive angioleiomyoma/leiomyoma-like components. No coagulative necrosis, sarcomatoid dedifferentiation, nor microscopic vascular invasion was observed. Immunohistochemically, all tumors showed strong co-expression of CK7 and CA9 (with characteristic "goblet" staining pattern). The staining for EMA, CK (AE1/AE3), vimentin, CK8, CK18, CK19 and PAX-8 were also positive in all cases. Ki-67 was expressed in less than or about 5% of the tumor cell nuclei. The staining for CD10, P504S, CD117, TFE3 and TFEB was negative. Follow-up data were available in all patients, with mean duration of 14 months (range = 7 to 27 months). All of the patients were disease-free after operation.</p><p><b>CONCLUSION</b>CCPRCC is a special type of low-grade renal neoplasm with characteristic histopathologic and immunohistochemical features. It needs to be distinguished from clear cell renal cell carcinoma or papillary renal cell carcinoma.</p>

Strategy and effect of schistosomiasis emergency control after earthquake in Lushan County / 中国血吸虫病防治杂志

Objective To evaluate the effects of measures on the schistosomiasis control after the earth quake in Lushan County so as to provide the experiences for post-disaster schistosomiasis control. Methods The measures taken in schistosomi-asis control after the earth quake were reviewed in Lushan County in 2013 and the epidemic situation of schistosomiasis was in-vestigated and the results were analyzed. Results The schistosomiasis control in floating population and the control of Oncome-lania hupensis snails were enhanced and no schistosome infections were found in both human and livestock. No infected snails and infested water were found. Conclusion The measures of schistosomiasis control after the disaster are effective in Lushan County and the goal to prevent major plague after the earth quake is achieved.

Clinicopathologic features and prognostic factors of papillary renal cell carcinoma / 中国癌症杂志

Background and purpose:Papillary renal cell carcinomas (PRCC) is relatively infrequent, and there are few related researches in China. This study aimed to summarize the clinical and pathological features of PRCC, and evaluate prognostic factors for patients treated with surgery.Methods:A total of 64 patients who under-went surgery for PRCC were retrospectively assessed. PRCC tissue slides from each patient were reviewed for type (ⅠorⅡ), grade, TNM stage, coagulative tumor necrosis and microvascular invasion. We estimated overall survival using the Kaplan-Meier method. Multivariate analysis was done according to the Cox proportional hazards model of factors statistically signiifcant on univariate analysis. Results:The incidence rate of ENE was 6.04%in RCC, the median age was 55 (range 22 to 78) years. The comparison of the 22 (534.4%) typeⅠPRCCs and 42 (65.6%) typeⅡPRCCs revealed that typeⅡtumors were associated with a greater stage and grade more often. The median follow-up was 46 months (range 19 to 133). Of the 64 patients, 14 died, (4.5%) with typeⅠand 13 (31.0%) with typeⅡtumors (P=0.018). The overall survival rate was 85.7%in typeⅠtumors and 55.8%in typeⅡtumors, respectively. Univariate analysis identiifed symptoms at presentation, tumor type, TNM stage and grade as prognostic factors. On multivariate analysis only metastatic RCC remained associated with decreased overall survival (HR:14.78, P=0.004). Conclusion:The per-centage of PRCC is lower and typeⅡPRCC is relatively common compared with foreign data. Metastasis at diagnosis is an independent predictive parameter of overall survival in Chinese patients with PRCC.

Clinicopathological features of multilocular cystic renal cell carcinoma:a series of 32 cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

Comparative analysis of whole mount processing and conventional sampling of radical prostatectomy specimens / 中国癌症杂志

Background and purpose:To perform whole mount technique in the diagnosis of the prostate cancer could provide orientation to the specimen. Whole mount technique has great value in pathologic diagnosis and morphological research. However, limited by the specimen-making technique, shortage of equipment and heavy workload, this technique has not been generally accepted in China. The aim of this study was to evaluate the signiifcance of whole mount technique in the diagnosis of the prostate cancer by comparing the clinical and pathological variables between whole mount patients and conventional ones after radical prostatectomy (RP).Methods:A total number of 229 patients’ whole mount RP specimens were recruited in the study from Dec. 2012 to Feb. 2014. The control group included 393 patients’ specimens which underwent conventional sampling from Jan. 2010 to Jun. 2012. We compared the clinical and pathological variables between the groups, including age, preoperative PSA level, methods of diagnosis, preliminary diagnostic Gleason score, clinical T stage, postoperative Gleason score, pathological T stage, positive surgical margin, extraprostatic extension, seminal vesicle invasion and pelvic lymph node metastasis.Results:Two groups shared similar preoperative parameters. Also there was no signiifcant difference between the whole mount and the conventional sampling groups in postoperative Gleason score, pathological T stage, extraprostatic extension and pelvic lymph node metastasis. However, positive surgical margin and seminal vesicle invasion rates were much higher in the whole mount group than the control one and both of the differences reached statistical signiifcance (26.2%vs 17.6%, 23.1%vs 17.0%;P=0.010, 0.025)Conclusion:After compared the clinical and pathological variables, we could conclude that whole mount technique has prevalence in the diagnosis of the positive surgical margin and seminal vesicle invasion compared with the conventional sampling technique. Thus, whole mount technique should be strongly recommended in the diagnosis of prostate cancer.

Effect of Smad7 antisense oligodeoxynucleotide on the expression of MMP-2, TIMP-2 and proliferation in human pancreatic cancer cells SW1990 / 中华胰腺病杂志

ObjectiveTo investigate the effect of Smad7 antisense oligodeoxynucleotide (ASODN) on proliferation in human pancreatic cancer cell line SW1990,with a focus on the expression of matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2).To explore the underlying mechanism of the role of Smad7 in the pathogenesis and development of pancreatic cancer.MethodsSmad7 ASODN was transfected into SW1990 cells through lipofectamine.Nosense oligodeoxynucleotide (NSODN),ASODN and lipofectamine was used as control. The transfection efficiency was assessed by fluorescence microscopy and flow cytometry.The expressions of Smad7,MMP-2 and TIMP-2 in transfected cells were detectedby RT-PCR and Western blot.Cell viability was assessed by dimethyl thiazoldiphenyltetrazoliumbromide (MTT) method. Results Smad7 was expressed in SW1990 cells.The transfection efficiency of SW1990 was 81.2％.The expressions of Smad7 mRNA were 0.34 ± 0.06,0.95 ±0.07,1.03 ± 0.11 in transfected group,ASODN and lipofectamine group; and the expressions of MMP-2 mRNAwere 0.54 ± 0.08,1.15 ± 0.13,1.27 ± 0.16 ; and the expressions of TIMP - 2 mRNA were 0.26 ±0.07,0.72 ± 0.13,0.78 ± 0.17,the mRNA expressions were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).The expressions of Smad7 protein were 0.14 ± 0.03,0.29 ± 0.05,0.28 ± 0.07 in transfected group,ASODN and lipofectamine group; the expressions of MMP-2 protein were 0.17 ±0.02,0.29 ±0.05,0.31 ±0.04,and the expressions of TIMP-2 protein were 0.20 ± 0.03,0.41 ± 0.11,0.43 ± 0.09,the protein expressions were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).The A490 values of proliferation were 0.83 ± 0.03,1.02 ±0.02,0.99 ±0.02 in transfected group,ASODN and lipofectamine group,the proliferation were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).ConclusionsSmad7 ASODN could effectively inhibit the expressions of Smad7,therefore decrease the expressions of MMP-2,TIMP-2 and reduce the proliferation.

CT and MRI features of primary adrenal lymphoma / 中华放射学杂志

dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.

Expression of caspase-3 during hepatocyte apoptosis in the mice with TNF-? induced fulminant hepatic failure / 中华传染病杂志

Objective To study the expression of protein and mRNA of caspase-3 during hepatocyte apoptosis in the mice with fulminant hepatic failure (FHF). Methods Liver damage was induced by tumor necrosis factor-? (TNF-?) in D-galactosamine (GalN) sensitized BALB/c mice. Hepatocyte apoptosis was examined by electric microscopy, in site end labeling (ISEL) and DNA electrophoresis on 1.5% agarose gel. The expression of protein and mRNA of caspase-3 was detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). Results After 1.5 h, 3.5 h, 6 h, and 9 h of administration of GalN and TNF-?, rates of hepatocyte apoptosis were found to be 0.0%, 0.3%, 3.15% and 3.19% respectively. The rates of caspase-3 positive hepatocytes were 0.7%, 4.6% , 17.8% and 24.2% respectively. The relative expressive density of caspase-3 mRNA were 0.26%, 0.29%, 0.41% and 0.38% respectively. Conclusions The expression of caspase-3 is up regulated in the TNF-? induced FHF model and may trigger hepatocyte apoptosis and finally lead to FHF.