The influence of pathological network management system on pathological report process / 医学研究生学报

Objective The pathological network management system provides a good working platform for pathological diagnosis, but there are few related reports. In order to give full play to the influence of pathological network management system on the whole process of pathological report, optimize the process of pathological report, and improve the efficiency of process and the quality of pathological report, we statistical analyzed the 41535 pathological reports time in our hospital.Methods The 33696 pathological reports time from the pathology department of our hospital in 2012 and 41535 in 2017 were statistical analyzed, to investigate the influence of the system on the pathological reporting process, which was included pathological specimen reception, information input, technical production, pathological report writing, capture and so on. The failure rates of pathological reports by single-site working mode in 2012 with multi-site working mode in 2017 were compared.Results Among the 33696 pathological reports in 2012, 18482 were outpatients, of which 17779(96.2%) cases were reported in ≤3 days, and 15214 were inpatients, of which 14590 (95.9%) cases were reported in ≤5 days. Among the 41535 pathological reports in 2017, 22832 were outpatients, of which 22271(97.5%) cases were reported in ≤3 days, and 187037 were inpatients, of which 18347 (98.1%) cases were reported in ≤5 days. The failure rate of pathological reports in 2012 was 5.69%, while in 2017 was 1.93%. Pathological network management system was through the whole process of pathologic examination, from the specimen reception, production, diagnosis, application and pathology report card printing.Conclusion The operation process of pathological work is standardized, the labor time of the staff is shortened, the human error is reduced, the quality of the pathological report is improved, and the Objective basis for pathological quality control is provided by using the pathological network management system.

Expression of ID3 protein in prostate cancer and its clinicopathological significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the expression of the ID3 protein in prostate cancer and its clinicopathological significance.</p><p><b>METHODS</b>We detected the expression of the ID3 protein in PC-3M cells by indirect immunofluorescence, and that in 29 prostate cancer and 15 prostate hyperplasia specimens by immunohistochemistry. Then we analyzed the correlation between the expression level of ID3 and the clinicopathological parameters.</p><p><b>RESULTS</b>The ID3 protein was expressed predominantly in the nucleus of PC-3M cells. Its expression rate was 82.7% (24/29) in the prostate cancer specimens, significantly higher than 6.6% (1/15) in prostate hyperplasia (P < 0.05), and was positively correlated with the Gleason score of prostate cancer (P < 0.05).</p><p><b>CONCLUSION</b>The ID3 protein is expressed in prostate cancer, and is elevated with the increase of Gleason score.</p>

Expression of CD20 in thymomas and its clinical implication / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the expression of CD20 in thymomas and its clinical significance.</p><p><b>METHODS</b>One hundred and seventy-nine cases of thymoma were enrolled into the study. The histologic diagnosis was reviewed by two experienced pathologists on the basis of the 2004 WHO classification. One hundred and two cases were selected for immunohistochemical study for CD20, pancytokeratin, TdT, CD3, CD43, CD99 and S-100 protein. The cases were further categorized into two groups, according to the association with clinical evidence of myasthenia gravis. The immunostaining pattern was then statistically analyzed.</p><p><b>RESULTS</b>Amongst the 102 cases studied, 7 cases belonged to type A thymoma, 32 cases type AB thymoma, 17 cases type B1 thymoma, 15 cases type B2 thymoma, 17 cases type B3 thymoma and 14 cases thymic carcinoma. The expression rates of CD20 in neoplastic epithelial cells of type A, type AB, type B1, type B2 and type B3 thymomas and thymic carcinomas were 3/7, 84.4% (27/32), 1/17, 2/15, 0/17, 0/14, respectively. The proportions of CD20-positive lymphocytes in the background were 3/7, 18.8% (6/32), 14/17, 11/15, 11/17, 6/14, respectively. The proportion of CD20-positive intra-tumoral B lymphocytes in the group of thymomas with myasthenia gravis was 67.5% (22/40), in contrast to 35.5% (22/62) in those without myasthenia gravis.</p><p><b>CONCLUSIONS</b>The neoplastic epithelial cells in cases of type A and type AB thymoma, as well as few cases of type B1 and B2 thymoma, express CD20. The immunostain highlights the presence of oval, stellate or spindly cells. Thymomas associated with myasthenia gravis contain a significant population of CD20-positive intra-tumoral B lymphocytes. Type AB thymomas may be originated from different populations of cells, rather than a simple admixture of type A and B thymoma cells.</p>

Clinicopathologic features of granulocytic sarcoma: a study of 38 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of granulocytic sarcoma.</p><p><b>METHODS</b>The clinical and pathologic findings of 38 cases of granulocytic sarcoma were retrospectively analyzed. Immunohistochemical study was performed and the literature was reviewed.</p><p><b>RESULTS</b>The age of patients ranged from 2 to 77 years (mean = 43.3 years). The male-to-female ratio was 1.5:1. Major clinical presentations included superficial lymph node enlargement and painful soft tissue mass. Follow-up data were available in 18 patients; and 14 of them died of tumor-related diseases. The average duration of survival of the patients was 16.9 months. Histologically, the tumor cells were relatively uniform in appearance and small to medium in size. The cytoplasm was scanty and pale in color. The nuclei were round or focally irregular, with fine chromatin and inconspicuous nucleoli. Mitosis figures were readily identified. Scattered immature eosinophilic myelocytes were seen. Immunohistochemical study showed that the tumor cells in all cases expressed MPO and CD43. Most cases were also positive for CD68, lysozyme, CD99 and TdT. The staining for CD3, CD20, CD79a, pan-cytokeratin and PLAP were negative.</p><p><b>CONCLUSIONS</b>Granulocytic sarcoma is a known histologic mimicker of non-Hodgkin lymphoma, Ewing sarcoma/PNET and embryonal rhabdomyosarcoma. Detailed morphologic examination, when coupled with immunohistochemical study, is useful in arriving at a correct diagnosis.</p>

Analysis of 12 206 cases of external pathology consultation / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the concordance rate of external pathology consultation referred by hospitals of various scales and to evaluate the value of such practice.</p><p><b>METHODS</b>A total of 12 206 external pathology consultation cases referred by outside institutions were encountered during a 5-year period. The final pathologic diagnoses in 3289 cases were compared with the original interpretations. Each case was reviewed by at least two experienced pathologists. Immunohistochemical study was carried in selected examples. The pathologic findings were categorized as follows: (1) no diagnostic discrepancy, (2) minor diagnostic discrepancy and (3) major diagnostic discrepancy.</p><p><b>RESULTS</b>Amongst the 12 206 cases studied, 7198 cases (59.0%) were sampled from the digestive tract, hematolymphoid system, soft tissue or breast. Seven thousand eight hundred and sixty-five cases (64.4%) were referred by small and medium-sized hospitals, while only 948 cases (7.8%) were referred by large hospitals (ranked IIIA). The diagnoses in 1842 cases (15.1%) were confirmed upon examination of the original paraffin sections, while the diagnoses in 2569 cases (21.1%) were made with cutting of additional sections from the paraffin blocks. On the other hand, the diagnoses in 7795 cases (63.8%) were arrived with the application of ancillary studies, including histochemistry and immunohistochemistry. Amongst the 3289 cases reviewed, diagnostic agreement was noted in 582 cases (17.7%), while major diagnostic discrepancy was observed in 113 cases (3.4%), including a change in diagnosis from "benign" to "malignant" in 31 cases (0.9%) and from "malignant" to "benign" in 38 cases (1.1%). The pathologic classification of the original diagnoses was modified in 44 cases (1.3%).</p><p><b>CONCLUSIONS</b>External pathology consultation is useful for patient management in small and medium-sized hospitals, especially in resolving difficult and controversial pathologic diagnoses. Application of ancillary techniques, including immunohistochemistry, further helps to clear up the potential diagnostic dilemma.</p>

Primary Burkitt lymphoma of the seminal vesicle: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features of primary Burkitt lymphoma of the seminal vesicle.</p><p><b>METHODS</b>We reported the clinical characteristics, histological changes and the results of immunohistochemical staining and molecular in situ hybridization of 1 case of primary Burkitt lymphoma of the seminal vesicle. We also reviewed the related literature and studied the pathomorphological characteristics and differential diagnosis of the tumor.</p><p><b>RESULTS</b>The characteristic manifestations of the patient were frequent micturition with dysuria, followed by inguinal lymphadenectasis 2 months later. Medical imaging showed a diffuse and monotonous infiltration of neoplastic cells with scanty cytoplasm and a few mitosis images. Microscopy displayed a starry sky pattern. The tumor cells were positive for CD10, CD20, CD79alpha, Bcl-6 and EBER in situ hybridization, but negative for CD3, CD6 and Cyclin D1. The Ki-67 index was > 95%.</p><p><b>CONCLUSION</b>Primary Burkitt lymphoma of the seminal vesicle is a very rare tumor with aggressive behavior. The pathological diagnosis of the tumor depends on histopathological examination and immunohistochemical techniques. However it should be differentiated from diffuse large B-cell lymphoma, lymphoblastic lymphoma and small cell carcinoma of the seminal vesicle or prostate gland.</p>

Clinicopathological characterization of prostatic small cell carcinoma: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the clinicopathological characteristics, treatment and prognostic features of prostatic small cell carcinoma (SCC).</p><p><b>METHODS</b>One case of SCC was reported, and the relevant literature was reviewed and analyzed.</p><p><b>RESULTS</b>Prostate specific antigen (PSA) was increased (39.26 ng/ml); computed tomography revealed multiple nodules in the retroperitoneum and cavita pelvis; ECT showed multiple osseous metastasis; and needle biopsy of the prostate confirmed SCC. Negative expressions of PSA, Bcl-2 and P504S were found by immunohistochemical staining. The cancer was clinically staged at T4N1M1. Because the patient was beyond surgery and refused chemotherapy, Zadaxin (thymosin alpha 1) was given to relieve the clinical symptoms. The patient died five months after the diagnosis.</p><p><b>CONCLUSION</b>SCC is a rare subset of prostate cancer, with high malignancy, rapid growth, fast metastasis and very poor prognosis. Its diagnosis relies on pathological examinations. PSA cannot be a specific tumor marker of SCC, but some immunophenotypes may help its differential diagnosis. As for its treatment, surgery should be considered in the early stage; neither hormonal therapy nor chemotherapy can afford a favorable prognosis, although the latter may effect a short-term relief of the clinical symptoms.</p>

Histologic subtyping and prognosis of thymoma: a study of 108 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the prognostic and clinical relevance of histologic subtyping of thymoma according to the World Health Organization (WHO) classification.</p><p><b>METHODS</b>The clinicopathologic features of 108 patients with thymoma removed surgically were retrospectively reviewed. The histologic diagnosis of the tumors was made on the basis of 2004 WHO classification by two experienced pathologists. The correlation between Masaoka tumor stage, WHO histologic subtype, completeness of resection, presence of myasthenia gravis, other clinical parameters (including age, gender and tumor size) and survival was studied.</p><p><b>RESULTS</b>According to WHO classification, there were 7 cases (6.5%) of type A thymoma, 19 cases (17.6%) of type AB thymoma, 23 cases (21.3%) of type B1 thymoma, 19 cases (17.6%) of type B2 thymoma, 27 cases (25.0%) of type B3 thymoma and 13 cases (12.0%) of type C thymoma. According to Masaoka tumor staging, 36 cases (33.3%) were in stage I, 34 cases (31.5%) in stage II, 27 cases (25.0%) in stage III and 11 cases (10.2%) in stage IV(a). The association between histologic subtype and Masaoka tumor stage was statistically significant (P = 0.000). The 5-year survival rates of type A, AB, B1, B2 and B3 thymoma cases were 100%, 100%, 93%, 83% and 43%, respectively; while the 10-year survival rates were 100%, 100%, 81%, 70% and 33%, respectively. The median survival time of type C thymoma was 62.5 months. Type B2 and B3 thymoma cases had an intermediate prognostic ranking in comparison with type C thymoma and other groups (P = 0.000). The 5-year survival rates of tumors in stage I, II and III were 100%, 77% and 54%, respectively; while the 10-year survival rates were 100%, 70% and 27%, respectively. The median survival time of patients in stage IV(a) was 14.0 months. Masaoka tumor stage was highly significant in predicting survival of patients (P = 0.000). On multivariate analysis, Masaoka tumor stage was an independent predictive factor for survival (P = 0.027). On the other hand, the WHO subtype (type A to B1 versus type B2 to B3 versus type C) and completeness of resection could predict the tumor-related survival.</p><p><b>CONCLUSIONS</b>The Masaoka tumor stage is the single most important prognostic factor of thymoma. The WHO histologic subtype and completeness of resection affect mainly the post-operative survival. The classification of thymoma may also reflect the clinical behavior of the tumor. Type A, AB and B1 thymomas belong to the low-risk group, while type B2 and B3 thymomas have an intermediate prognostic ranking. Type C thymoma carries the worst prognosis.</p>

Expression of VEGF in prostate cancer and its correlation with ET-1 / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expressions of VEGF in prostate cancer (PCa) and benign prostatic hyperplasia (BPH), their clinical significance and their relationship with that of ET-1.</p><p><b>METHODS</b>A total of 44 specimens of PCa and 36 of BPH tissues were examined by the immunohistochemical Elivision plus method for the expressions of VEGF and ET-1. The intensity of staining for VEGF and ET-1 was assessed by light microscopy on a scale from "-" to "+ + +".</p><p><b>RESULTS</b>The rates of positive expression of VEGF were 69.4% in BPH and 80.9% in PCa, positive staining mostly in the cytoplasm of glandular epithelia and cancer cells, and strongly positive in all the stroma vascular endothelial cells. The staining intensity of VEGF was significantly higher in the PCa than in the BPH group (P < 0.05) , in the bone metastasis (BM) than in the non-BM group (P < 0.01), and in the lowly than in the highly and moderately differentiated PCa tissues (P < 0.01). The expression of VEGF was positively correlated with that of ET-1 ( r(s) = 0.780, P < 0.01).</p><p><b>CONCLUSION</b>VEGF is involved in the development, progression and metastasis of PCa. VEGF and ET-1 may play a joint role in its development and progression.</p>

Primary peripheral T-cell lymphoma of the penis: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To report a case of primary peripheral T-cell lymphoma of the penis.</p><p><b>METHODS</b>We analyzed the clinicopathological characteristics of the case of primary peripheral T-cell lymphoma using histological, cytochemical and immunohistochemical methods and by review of the literature.</p><p><b>RESULTS</b>The patient was a 65 years old man and presented with a diffuse enlargement of the penis as the initial sign, followed by erosive ulcer in the caput penis and inguinal lymphadenectasis. The tumor was pathohistologically manifested as an epidermal ulcer, with tumorous necrosis around the capillary, infiltrative growth and atypical changes of the neoplastic cells and proliferation of capillaries. Immunohistochemically, the tumor cells were positive for CD43 and CD3, but negative for CD20, CD79a, CD34, CD30, CD56 and CD34. Clinically it responded to the chemotherapy designed for peripheral T-cell lymphoma.</p><p><b>CONCLUSION</b>Primary peripheral T-cell lymphoma of the penis is an extremely rare malignant tumor, the diagnosis of which relies on histopathological examination, immunohistochemical staining and differentiation between squamous cell carcinoma and other types of lymphoma.</p>

Grape seed extract induces morphological changes of prostate cancer PC-3 cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the morphological changes of prostate cancer PC-3 cells induced by grape seed extract (GSE).</p><p><b>METHODS</b>PC-3 cells were incubated with different concentrations of GSE (100, 200 and 300 microg/ml) for 24, 48 and 72 hours, and then observed for morphological changes by invert microscopy, HE staining and transmission electron microscopy.</p><p><b>RESULTS</b>The incubated PC-3 cells appeared round, small, wrinkled and broken under the invert microscope and exhibited the classical morphological characteristics of cell death under the electron microscope, including cell atrophy, increased vacuoles, crumpled nuclear membrane, and chromosome aggregation.</p><p><b>CONCLUSION</b>GSE can cause morphological changes and induce necrosis and apoptosis of PC-3 cells.</p>

Expressions of endothelin-1 in benign prostatic hyperplasia and prostate cancer and their significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the different expressions of endothelin-1 ET-1) in prostate cancer (PCa) and benign prostatic hyperplasia (BPH) tissues and their clinical significance.</p><p><b>METHODS</b>A total of 36 BPH and 44 PCa specimens were examined for the expression of ET-1 by immunohistochemical technique (Elivision plus method). The staining intensity for ET-1 was assessed by light microscopy on a scale from "-" to "+ + +".</p><p><b>RESULTS</b>Positive immunoreactivity was found in BPH and PCa, with a positive rate of 100%. Positive staining was located mostly in the cytoplasm of glandular epithelia and smooth muscle cells of both BPH and PCa and was noted in all stroma vascular endothelial cells. These were no significant differences in the intensity of positive staining for ET-1 between the groups of BPH and PCa (P > 0.05), bone metastasis (BM) and non-BM (P > 0.05), and highly and moderately differentiated PCa (P > 0.05), but the staining intensity for ET-1 was significantly higher in the poorly than in the highly and moderately differentiated PCa (P < 0.01).</p><p><b>CONCLUSION</b>ET-1 has a high expression and the localization is the same in both BPH and PCa. It is involved in the development and progression of BPH and PCa.</p>

Expression of Ksp-cadherin in renal epithelial neoplasm and its clinicopathologic significance / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the expression of a novel marker, kidney-specific-protein (Ksp)-cadherin, in renal epithelial neoplasms and its clinicopathologic significance.</p><p><b>METHODS</b>Immunohistochemical study (using EnVision method) for Ksp-cadherin, CD10, vimentin, epithelial membrane antigen and CK7 was carried out in normal human kidney samples, as well as in 166 cases of primary renal neoplasms (including 120 cases of clear cell renal cell carcinoma (RCC), 20 cases of papillary RCC (type I papillary RCC 15 cases and type II papillary RCC 5 cases), 18 cases of chromophobe RCC and 8 cases of oncocytoma).</p><p><b>RESULTS</b>Ksp-cadherin was expressed in distal convoluted tubules of normal kidney in a membranous pattern. It was also detected in 23% (27/120) of clear cell RCC, 20% (4/20) of papillary RCC, 100% (18/18) of chromophobe RCC and 75% (6/8) of oncocytoma. High expression of CD10 and vimentin was noted in clear cell RCC and papillary RCC. CD10 was also expressed in chromophobe RCC in cytoplasmic pattern, compared with membranous staining in the other tumors. CK7 expression was mainly seen in chromophobe RCC and papillary RCC, while epithelial membrane antigen was expressed in all variants of RCC. On the other hand, the expression of Ksp-cadherin in clear cell RCC correlated with tumor stage and grade.</p><p><b>CONCLUSIONS</b>Ksp-cadherin is expressed in normal distal convoluted tubules and the related neoplasms. It carries relatively high specificity and sensitivity in diagnosis of chromophobe RCC and oncocytoma. The expression of Ksp-cadherin also correlates with biologic behavior of clear cell RCC.</p>

Expression of survivin in human gastric adenocarcinomas: correlation with proliferation and apoptosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of survivin, ki-67 and apoptosis index in patients with advanced gastric adenocarcinoma.</p><p><b>METHODS</b>Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki-67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas.</p><p><b>RESULTS</b>The survivin was detected in the cytoplasm of carcinoma cells in 59 (49.17%) of the 120 gastric adenocarcinomas, in 32 (64.00%) of the lymph node metastasis, and in 21 (17.50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki-67) in primary tumors was 7.55%, which was significantly lower than the mean proliferative index of 8.34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1.16%, which was significantly higher than the mean apoptosis index of 0.89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis (P < 0.05). There was negative correlation between weighted survivin score and apoptosis index (P < 0.05), but no correlation with proliferative index.</p><p><b>CONCLUSION</b>The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.</p>

Ultrastructural observation of normal spermatozoa incubated with ROS in vitro / 中华男科学杂志

<p><b>OBJECTIVES</b>To observe ultrastructural changes of spermatozoa after incubate with reactive oxygen species (ROS).</p><p><b>METHODS</b>Spermatozoa of normal physiological functions selected from semen samples by Percoll gradient centrifugation technique were regarded as normal sperm models in present study. Ultrastructural changes of spermatozoa observed by transmission electron microscope after model spermatozoa were incubated with ROS generated by hypoxanthine and xanthine oxidase under aerobic environment.</p><p><b>RESULTS</b>After model spermatozoa were incubated with ROS, impairment of various extent in membrane and acrosome of spermatozoa and abnormality in mitochondria of spermatozoa were found.</p><p><b>CONCLUSIONS</b>Excessive ROS may cause ultrastructural change in membrane, acrosome and mitochondria of spermatozoa and impair function of spermatozoa.</p>