Primary gastric Burkitt's lymphoma: a clinicopathological analysis of four cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features,diagnosis,treatment and prognosis of primary gastric Burkitt's lymphoma. Methods The clinical and pathological features were retrospectively analyzed in 4 case of primary gastric Burkitt's lymphoma. The endoscopic features,immunophenotype and molecular pathology were also analyzed and discussed with review of the literatures. Results Primary gastric Burkitt' s lymphoma mainly occurred in children,with an average age of 8 years (3～15 years) . Endoscopic findings were tuberous protuberance with surface ulcers (3 cases) . The diffuse distribution of atypical lymphoid cells with"starry sky"phenomenon in gastric mucosa was observed under microscope,the cells were of medium size and single shape,the nucleus was round or oval and the shape was uniform,the chromatin was thicker,and there were several small nucleoli,the cytoplasm was rare and slightly basophilic,and the nuclear mitosis was more frequently noted. Immunophenotyping showed that both CD20 and CD79a were all strongly positive,and the Ki-67 proliferative index was higher than 95％. The positive intensity of CD10 and BCL-6 varied from one to another. MUM1 and CD3 were all negative. One case was positive for EBER (in situ hybridization) . Meanwhile, all of these cases showed MYC gene breakage,one of them was detected by IGH/BCL-2 fusion gene but no fusion was found. Conclusion Primary gastric Burkitt's lymphoma is rare. Its endoscopic features,histomorphology,immunophenotype and molecular pathology are relatively typical and it is mainly distinguished from high-grade B cell lymphoma,lymphoblastic lymphoma and myeloid sarcoma. Burkitt's lymphoma is a highly malignant tumor,but the current treatment is relatively mature. Early diagnosis and early treatment can significantly improve the prognosis of these patients.

Isolation of gastric cancer stem cells based on colony morphology and detection of their sensitivity to 5-fluorouracil / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the sensitivity of gastric cancer stem cells (GCSCs) to 5-fluorouracil (5-FU), and to explore the cytological mechanism of drug-resistance of gastric cancer.</p><p><b>METHODS</b>Immunohistochemical staining was employed to examine expression of stem cell marker CD44 and drug-resistance protein thymidylate synthase (TS) in 71 cases with gastric cancer. Based on morphology of cell colonies derived from AGS gastric cell line, colonies consisting of GCSCs were isolated, and expression of CD44 and TS, as well as self-renewal capacity of GCSCs were detected. Sensitivity of GCSCs to 5-FU was examined through CCK-8 assay.</p><p><b>RESULTS</b>The positive rates of CD44 and TS were 59.2% (42/71) and 56.3% (40/71) in gastric cancer, and expression of CD44 was associated with that of TS (χ(2)=12.76, P<0.01; Kappa=0.41). Serial sections indicated that CD44+ cancer cells simultaneously expressed TS. AGS developed morphologically diverse colonies, and the GCSCs colonies exhibited a tight and regular shape, which were called holoclone. Holoclones expressed CD44 and TS strongly, possessing capacity of robust self-renewal and forming a lot of second passage clones after incubation. Subclones expressed CD44 and TS weakly, forming less second passage clones. Paraclones almost did not express CD44 and TS, forming no second passage clone after incubation. Affected by 5-Fu, three holoclones showed less growth inhibition compared with another colony type and wild-type AGS cells. Furthermore, IC50 of 5-FU for three holoclones was (113.43±5.81), (272.68±25.75) and (118.14±17.75) μmol/L respectively, which were significantly higher than that of one subcolony type [(16.97±1.01) μmol/L] and AGS cells [(27.52±0.59) μmol/L] (all P<0.05).</p><p><b>CONCLUSIONS</b>GCSCs possess lower sensitivity to 5-FU, and may play a critical role in drug-resistance of gastric cancer.</p>

Effect of ecoimmunonutrition supports on maintenance of integrity of intestinal mucosal barrier in severe acute pancreatitis in dogs / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>One of the major causes of death in severe acute pancreatitis (SAP) is severe infection owing to bacterial translocation. Some clinical studies suggested that ecoimmunonutrition (EIN) as a new strategy had better treatment effect on SAP patients. But the experiment studies on the precise mechanism of the effect of EIN were less reported. In this study, we mainly investigated the effects of EIN on bacterial translocation in SAP model of dogs.</p><p><b>METHODS</b>SAP was induced by retrograde infusion of 5% sodium taurocholate into the pancreatic duct in healthy hybrid dogs. The SAP dogs were supported with either parenteral nutrition (PN) or elemental enteral nutrition (EEN) or EIN. The levels of serum amylase, serum aminotransferase and plasma endotoxin were detected before and after pancreatitis induction. On the 7th day after nutrition supports, peritoneal fluid, mesenteric lymph nodes (MLN), liver, and pancreas were collected for bacterial culture with standard techniques to observe the incidence of bacterial translocation. Pathology changes of pancreas were analyzed by histopathologic grading and scoring of the severity of pancreas, and the degree of intestinal mucosal damage was assessed by measuring mucosal thickness, villus height, and crypt depth of ileum.</p><p><b>RESULTS</b>Compared with PN and EEN, EIN significantly decreased the levels of serum amylase, serum aminotransferase, plasma endotoxin, and the incidence of bacterial translocation. Furthermore, compared with the others, the histology scores of inflammation in pancreas and the ileum injury (ileum mocosa thickness, villus height, and crypt depth) were significantly alleviated by EIN (P < 0.05). Moreover, concerning liver function, the serum levels of alanine aminotransferase, aspartate aminotransferase and albumin were ameliorating significantly in the EIN group.</p><p><b>CONCLUSION</b>Our results suggested that EIN could maintain the integrity of intestinal mucosal barrier and reducing the incidence of bacterial translocation in SAP dogs. Early EIN was safe and more effective treatment for SAP dogs.</p>