Expression of GPNMB in renal eosinophilic tumors and its value in differential diagnosis / 中华病理学杂志

Objective: To investigate the expression of glycoprotein non metastatic melanoma protein B (GPNMB) in renal eosinophilic tumors and to compare the value of GPNMB with CK20, CK7 and CD117 in the differential diagnosis of renal eosinophilic tumors. Methods: Traditional renal tumor eosinophil subtypes, including 22 cases of renal clear cell carcinoma eosinophil subtype (e-ccRCC), 19 cases of renal papillary cell carcinoma eosinophil subtype (e-papRCC), 17 cases of renal chromophobe cell carcinoma eosinophil subtype (e-chRCC), 12 cases of renal oncocytoma (RO) and emerging renal tumor types with eosinophil characteristics [3 cases of eosinophilic solid cystic renal cell carcinoma (ESC RCC), 3 cases of renal low-grade eosinophil tumor (LOT), 4 cases of fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and 5 cases of renal epithelioid angiomyolipoma (E-AML)], were collected at the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2017 to March 2022. The expression of GPNMB, CK20, CK7 and CD117 was detected by immunohistochemistry and statistically analyzed. Results: GPNMB was expressed in all emerging renal tumor types with eosinophil characteristics (ESC RCC, LOT, FH-dRCC) and E-AML, while the expression rates in traditional renal eosinophil subtypes e-papRCC, e-chRCC, e-ccRCC and RO were very low or zero (1/19, 1/17, 0/22 and 0/12, respectively); the expression rate of CK7 in LOT (3/3), e-chRCC (15/17), e-ccRCC (4/22), e-papRCC (2/19), ESC RCC (0/3), RO (4/12), E-AML(1/5), and FH-dRCC (2/4) variedly; the expression of CK20 was different in ESC RCC (3/3), LOT(3/3), e-chRCC(1/17), RO(9/12), e-papRCC(4/19), FH-dRCC(1/4), e-ccRCC(0/22) and E-AML(0/5), and so did that of CD117 in e-ccRCC(2/22), e-papRCC(1/19), e-chRCC(16/17), RO(10/12), ESC RCC(0/3), LOT(1/3), E-AML(2/5) and FH-dRCC(1/4). GPNMB had 100% sensitivity and 97.1% specificity in distinguishing E-AML and emerging renal tumor types (such as ESC RCC, LOT, FH-dRCC) from traditional renal tumor types (such as e-ccRCC, e-papRCC, e-chRCC, RO),respectively. Compared with CK7, CK20 and CD117 antibodies, GPNMB was more effective in the differential diagnosis (P<0.05). Conclusion: As a new renal tumor marker, GPNMB can effectively distinguish E-AML and emerging renal tumor types with eosinophil characteristics such as ESC RCC, LOT, FH-dRCC from traditional renal tumor eosinophil subtypes such as e-ccRCC, e-papRCC, e-chRCC and RO, which is helpful for the differential diagnosis of renal eosinophilic tumors.

ARCH model-based empirical analysis of drug price fluctuation in our country / 中华医学图书情报杂志

Objective To study the characteristics and trends of drug price fluctuation in our country in order to provide reference for the governments in evaluating their policy for the macro-control and management of drug price. Methods The drug price fluctuation was empirically analyzed using the ARCH model according to the monthly drug price data from 2011 to 2017. Results The drug price presented a fluctuant increasing trend with an even fluctuation amplitude and frequency, especially after its reform in 2015. The fluctuation of drug price did not show any clustered feature and significant impact on information but a rather strong memory. Conclusion The fluctuation of drug price is relatively stable in our country. The drug price control policy plays a rather effectively role in stabilizing thefluctuation of drug price. It is thus suggested that the governments should bring their role into full play in controlling drug price, regulating drug marketing, and supervising drug price.

BRG1 expression in prostate carcinoma by application of tissue microarray / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expression of gene BRG1 in prostatic intraepithelial neoplasia and adenocarcinoma, and the relationship between gene BRG1 expression and the clinicopathological features of prostate carcinoma.</p><p><b>METHODS</b>Gene BRG1 expression was evaluated in 37 cases of human prostate carcinoma, 13 human prostatic intraepithelial neoplasia (PIN) and 14 human benign prostatic hyperplasia (BPH) by using immunohistochemistry (EnVision method) and tissue microarray.</p><p><b>RESULTS</b>The positive rates of BRG1 protein were 81.08% (30/37), 38.46% (5/13) and 14.28% (2/14) in prostate carcinoma, PIN and BPH, respectively, significantly higher in the first group than in the latter two (P < 0.05). There was no statistically significant difference in BRG1 gene expression either between PIN and BPH (P > 0.05) or between the groups of the moderate differentiation (the Gleason histologic grading: 5-7) and the lower one (the Gleason histologic grading: 8-10) (P > 0.05).</p><p><b>CONCLUSION</b>BRG1 may play an important role in the development of prostate carcinoma. Tissue microarray technology, with the advantages of high throughput, conciseness, rapidity, high efficiency, low cost, and nice reproducibility, has significant practical value and broad application prospects in pathology.</p>

Preventing inflammatory reaction with estrogen after cerebral ischemia/reperfusion injury / 中国组织工程研究

BACKGROUND:Leukocytic infiltration induced by release of inflammatory cytotkines and up-regulation of adhesion molecules is closely associated with the formation of cerebral infarcted focus. The related factors have been widely studied.OBJECTIVE: To explore influence of estrogen on inflammatory reaction in rats after focal ischemia/reperfusion injury.DESIGN: Randomized controlled experiment.SETTING: Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA.MATERIALS:The experiment was performed at the Department of Neurology, Department of Pathology, Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Adult male SD rats were selected to establish cerebral ischemic models, with the body mass of 280-350 g.METHODS:The rats were assigned into 3 groups: control group,ovariectomized group and estrogen treatment group (estradiol, 200 μg/kg,subcutaneous injection, once a week for 4 weeks). Four weeks later, models with right middle cerebral artery occlusion (MCAO) for 1 hour and 2 hours as well as reperfusion for 0, 1, 3, 6, 22 and 70 hours were established with thread embolism method. Mean number of infiltrative neutrophils in brain tissue was calculated under microscope with 10 high power fields in ischemic hemisphere with hematoxylin and eosin staining. Expression of nuclear factor-κB was determined with immunohistochemical method.MAIN OUTCOME MEASURES:Infiltration of neutrophils and expression of nuclear factor-κB in brain parenchyma.RESULTS: ①Expression of nuclear factor-κB: There was expression of nuclear factor-κB in the ovariectomized group at hour 1 after ischemia.Positive cells appeared at hour 2 after ischemia in the control group and estrogen treatment group. The expression was in the peak at ischemia for 2hours and reperfusion for 3 hours in the three groups, and decreased gradually. There was slight expression at reperfusion for 70 hours in the ovariectomized group, while there was no clear factor-κB positive cell at reperfusion for 22 hours in the control group and estrogen treatment group.②Infiltrative neutrophils in cerebral ischemic region in the ovariectomized group significantly increased at ischemia for 2 hours and reperfusion for 22 hours. Compared with the estrogen treatment group, there was significant difference (P=0.045). At ischemia for 2 hours and reperfusion for 70 hours,infiltrative neutrophils in the ovariectomized group were more than those in the control group and estrogen treatment group, but there were significant differences only between ovariectomized group and control group.CONCLUSION: Estrogen can inhibit inflammatory reaction after cerebral ischemia/reperfusion injury.

Expressions of survivin and caspase-3 in human non-small cell lung cancer and their relationship with cell apoptosis / 中国肺癌杂志

<p><b>BACKGROUND</b>Survivin, a member of inhibitor of apoptosis protein (IAP) family, can directly inhibit caspase-3 and caspase-7 activity and plays an important role in oncogenesis. The aim of this study is to investigate the expressions of survivin and caspase-3 in human non-small cell lung cancer (NSCLC), and to evaluate their relationship with cell apoptosis.</p><p><b>METHODS</b>The expressions of survivin and caspase-3 in 88 patients with NSCLC were examined by using immunohistochemical SP methods, and TNUEL method was used to detect the cell apoptosis simultaneously.</p><p><b>RESULTS</b>The positive expression rates of survivin in NSCLC tissues and normal lung tissues were 61.4% (54/88) and 13.8% (4/29) respectively, there was a significant difference between them (P < 0.01). Survivin expression in NSCLC was not related to the histologic type, pathological grade and lymph node metastasis (P > 0.05), but correlated with TNM stage (P < 0.05). The positive expression rate of caspase-3 was 89.7% (26/29) in normal lung tissues, which was higher than that in NSCLC tissues (73.9%, 65/88), but there was no significant difference (P > 0.05). Caspase-3 expression in NSCLC was associated with pathological grade (P < 0.05). The average apoptosis index (AI) of survivin-positive cases was significantly higher than that of surviving-negative ones (1.63±0.58 vs 3.29±0.76)(P < 0.05). The average AI of the caspase-3 positive cases was significantly higher than that of the caspase23 negative cases (2.42±0.59vs1.28±0.65)(P < 0.05). Expression of survivin was negatively correlated with caspase-3 (P < 0.05).</p><p><b>CONCLUSIONS</b>Survivin may play an important role in the process of carcinogenesis of NSCLC by inhibiting cell apoptosis. Moreover, survivin may prevent cell apoptosis by inhibiting caspase-3 activation.</p>

A clinicopathologic study of dysembryoplstic neuroepithelial tumor / 中华病理学杂志

<p><b>UNLABELLED</b>OBJECTIVE To study the clinicopathologic features, radiologic findings, treatment modalities and prognosis of dysembryoplastic neuroepithelial tumor (DNT).</p><p><b>METHODS</b>The clinical features, histopathologic findings, immunohistochemistry and electron microscopy of 18 cases of DNT were analyzed. Results Among the 18 cases studied, 14 were males and 4 females. The age of these patients ranged from 3 to 46 (mean age = 22. 8 years). Partial seizure was the main presenting symptom in all patients. The history of epilepsy could be as long as 17 years. On magnetic resonance imaging (MRI) study, the tumor was hypodense on T1 and hyperdense on T2. There was neither edema nor mass effect. All but 2 cases were supratentorial and intracortical in location. Ten cases were treated by complete surgical excision and the remaining 8 tumors were partially excised. In the 14 patients with follow-up data available, 13 survived for 1.4 to 11 years after the operation (with more than 10 years survival observed in 2 patients). The average survival period was 5.5 years. None of the cases showed tumor recurrence after operation. Histologically, all tumors demonstrated a multinodular architecture and were intracortical in location, sometimes with extension into the white matter. The characteristic "glioneuronal constituent" was an essential feature for making the diagnosis of DNT. The tumor was formed by an admixture of oligodendrocyte-like cells, mature neurons and astrocytes, with obvious microcystic changes. These neurons were often dispersed singly in the mucoid matrix. In most cases, the foci of cortical dysplasia were found in adjacent areas. Immunohistochemical study demonstrated positivity for synaptophysin, neurofilament and S-100 protein in the neurons and some oligodendrocyte-like cells. The staining of glial fibrillary acidic protein in the oligodendrocyte-like cells was negative. Electron microscopy showed early neuronal, astrocytic and oligodendroglial differentiation of the oligodendrocyte-like cells.</p><p><b>CONCLUSIONS</b>DNT is a benign tumor (corresponding to WHO grade I) that can be cured by surgical excision, despite sometimes incomplete tumor removal. A correct diagnosis of this entity requires thorough understanding of the clinical, radiologic, histologic and immunohistochemical features.</p>

Detection of activated cytotoxic cells in lymphoma by tissue microarray / 解放军医学杂志

Objective To detect the expression and distribution of activated cytotoxic cells in types of lymphoma with tissue microarray, and provide evidences for clinical treatment and prognosis. Methods Immunohistochemical staining by S-P technique was used to detect the expression and distribution of perforin and granzyme B in the lymphoma tissue microarray, composed of 60 cases of lymphoma tissue. Ten cases of NK/T-cell lymphoma routine sections were used for relative research, and ten cases of reactive hyperplasia were used for comparison. Results In the tissue microarray, originated from intranode and extranode were 48 cases and 12 cases, respectively; consisting of 42 cases of B-cell lymphoma, 16 cases of T-cell lymphoma, two cases of Hodgkin's disease. 42 cases of B-cell lymphoma cells were negative in perforin and granzyme B. In Ten cases of peripheral T-cell lymphoma, perforin and granzyme B positive were eight cases and nine cases, respectively, but the positive cells were no tumor cells. In 12 cases of NK/T-cell lymphoma (two in the tissue microarray, ten routine sections), both perforin and granzyme B were strongly positive. B-cell lymphoma, T-cell lymphoma and NK/T-cell lymphoma differed significantly (P<0.01). Conclusion Perforin and granzyme B were immunity markers for the identification of activated cytotoxic cells, which also could be used as diagnostic markers of NK/T-cell lymphoma. Their expression in B-cell lymphoma reflected the anti-tumor immunologic reaction of host. Tissue microarray technology has the behavior of high-throughput, convenient, effective, small experiment error, good replication and so on, and can be used as a useful tool for research of lymphoma.

Clinicopathological and immunohistochemical characteristics of renal epithelioid angiomyolipoma:case report / 医学研究生学报

Objective:To investigate the clinicopathological features and differential diagnosis of 2 patients with renal epithelioid angiomyolipoma (AML), representing 5.4 % of a series of 37 patients undergoing biopsy for renal tumors. Methods:The histopathological, immunohistochemical and clinical characteristics of renal epithelioid angiomyolipoma were studied by immunohistochemical stain for melanoma marker (HMB45), (Pan)melanoma marker Ab-1,cytokeratin (CK), smooth muscle actin (SMA), epithelial membrane antigen (EMA),vimentin (Vim), p53, proliferating cell nuclear antigen(PCNA), Ki67 antigen. Results:Two patients,aged 31 and 39,were alive for 8 and 10 months,respectively.Microscopically, both tumors were mainly made up of diffuse sheets of epithelioid cells and scattered thick-walled blood vessels, necrosis was account for up to 30% of the mass. The epithelioid cells had huge, extremely pleomorphic nuclei with abundant eosinophilic cytoplasm. Scattered tumor giant cells with prominent nuclei were also seen. The epithelioid AML regions of these tumors were immunoreactive for HMB45, (Pan)melanoma marker Ab-1, SMA, Vim and PCNA. Neither atypical epithelioid cells nor typical AML cells were immunoreactive for cytokeratin (CK) and epithelial membrane antigen (EMA).Conclusion: The results of this study suggested that the renal epithelioid AML was a mild malignant tumor before distant metastases. The differential diagnosis between renal malignant AML and sarcomatoid renal cell carcinoma was established by immunohistochemical findings.

Gleason histologic grading of prostate carcinoma in relation to serum PSA, PSA in situ and immunohistochemical expression of 34 beta E12 and P504S / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the Gleason histologic grading of prostate carcinoma in relation to the serum prostate-specific antigen (PSA) level and the PSA in situ of the tumor, and the immunohistochemical staining of basal cell-specific cytokertain(34 beta E12) and alpha-Methylacyl-CoA racemase(P504S) of the tumor.</p><p><b>METHODS</b>The serum PSA levels were measured in 40 cases of prostate carcinoma. The Gleason histologic grading was based on histopathologic examination of the tumors, and the immunohistochemical staining including PSA in situ (35 cases), 34 beta E12(12 cases) and P504S(10 cases) was examined.</p><p><b>RESULTS</b>The higher the Gleason histologic grading of prostate carcinoma, the higher the serum PSA level(P < 0.01), and the weaker the positive reaction of the immunohistochemical staining of PSA of the tumor(P < 0.05). And the tumor cells displayed positive reaction for P504S and negative for 34 beta E12.</p><p><b>CONCLUSION</b>The Gleason histologic grading of prostate carcinoma is positively related to the serum PSA level and negatively to PSA in situ of the tumor immunohistochemically. It is important to use immunohistochemical staining for 34 beta E12 and P504S in the pathologic diagnosis of prostate carcinoma.</p>

Cell viability between anterior and posterior spinal growth plate in adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the cell viability of chondrocytes between the anterior and the posterior spinal growth plates in adolescent idiopathic scoliosis (AIS) by proliferation and apoptosis labelling.</p><p><b>METHODS</b>Seventeen AIS patients (4 male and 13 female, mean age 13.6 years old, ranged from 10 to 17 years old) were recruited in this study. Growth plates were harvested during anterior and posterior surgery. PCNA (proliferating cell nuclear antigen) and TUNEL (terminal deoxynucleotide transferase-mediated nick end labeling) were used for proliferation and apoptosis labeling on chondrocytes respectively.</p><p><b>RESULTS</b>In AIS, the distribution of the proliferating nests were denser and more parallel in anterior column than those in posterior under microscope observation. In the proliferative and hypertrophic zone the PCNA index and PCNA/TUNEL ratio were higher in the anterior column than those in the posterior column (P < 0.05 and P < 0.01 respectively). While in resting zone the differences were not so significant.</p><p><b>CONCLUSION</b>In adolescent idiopathic scoliosis the growth viability of chondrocytes is more vigorous in anterior spinal column than in the posterior column.</p>

Choroid plexus tumors of the cerebellopontine angle / 医学研究生学报

Objective:To investigate the clinicopathological and immunohistochemical features, histogenesis and biologic behaviors of choroids plexus tumors of the cerebellopontine(CP) angle. Methods:Four cases of choroids plexus tumors of the CP angle were studied by histopathological analysis, immunohistochemical staining and electron microscopic examination. The literatures were review emphasising the diagnostic criteria, differential diagnosis and histogenesis. Results:The histopathologic features of choroid plexus tumors of the CP angle were identical to that in the ventricular system. Immunohistochemical analysis showed that S-100, vimentin and CK of the tumor cells express positive. Choroid plexus papilloma expressed GFAP. The carcinoma of choroid plexus expressed CEA as well. Conclusion:Choroid plexus tumors arising in and occupying the CP angle are rare. The final diagnosis can be made by pathologic examination. The histogenesis may be the small choroid tuft protruding from the foramen of Luschka into the CP angle.

Immunohistochemical staining of lung tissue in mice with Chlamydia pneumoniae / 医学研究生学报

Objectives:To investigate the pathogenesis of Chlamydia pneumoniae (C.pneumoniae) pneumoniae with immunohistochemical staining of tissue biopsies. Methods:The Icr mice were inoculated with C.pneumoniae, strain CWL 029, by the intranasal or intravenous routes. After a single inoculation, mice were killed on the 1st, 3rd, 7th, 14th, 21st, 28th and 60th day separately. Lung specimens were obtained from the acute stage of C.pneumoniae pneumonitis and stained using a C.pneumoniae specific monoclonal antibody. Results:In the intranasal inoculation of mice, the immunoperoxidase staining of C.pneumoniae in lung tissue was positive on day 3,7,14. The positive staining of inflammatory lung tissue was not even but local. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages, the interstitial cells and the lymphoid tissues surrounding the bronchi. After iv inoculation, a similarly changes were found but the degree was lighter than that of intranasal inoculation group. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages and the interstitial cells. Conclusions:Immunohistochemistry is beneficial to the diagnosis of the acute stage of C.pneumoniae pneumonitis in the mice, and the pathogenesis of infection in intranasal inoculation group was more serious than that of iv inoculation group.

A clinicopathological and prognostic study of 22 cases central neurocytoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features and prognosis of 22 cases of central neurocytoma (CNC), representing 0.48% of a series of 4 528 patients undergoing biopsy for central nervous system tumors.</p><p><b>METHODS</b>The histopathological, ultrastructral, immunohistochemical and clinical features of CNC were studied by electron microscopic examination and immunohistochemical stain for Synaptophysin (Syn), neuron special enolase (NSE), Leu-7, glial fibrillary acid protein (GFAP), MBP and proliferating cell nuclear antigen (PCNA).</p><p><b>RESULTS</b>The age of the cases ranged from 4 to 44 (average 27.9 years) with all tumors localized in the ventricles. In the 18 patients followed up, 14 were alive for 8 months to 14 years and 11 months after the operation, and 4 died. The average survival period was 70.7 months. Histologically, the tumor in all 22 cases had the oligodendroglioma-like pattern with honeycomb appearance and cell-free islands of eosinophilic matrix. Cellular anaplasia, mitosis and necrotic areas were rarely seen in the tumors. Immunohistochemical study demonstrated strong positivity for Syn, NSE and Leu-7, and negative for GFAP and MBP. Ultrastructural features showed presence of round tumor cells with abundant cell processes containing microtubules, neurosecretory granules, clear vesicles and lysosome-like structures.</p><p><b>CONCLUSIONS</b>The differential diagnosis between CNC and oligodendroglioma could not be established by routine light microscopy. The importance of immunohistochemical and electron microscopic studies for making a correct diagnosis is emphasized. The prognosis of patients is usually favorable, even if the tumor was resected subtotally. The relationship between the presence of anaplastic histological features in CNC and patient outcome remains unclear.</p>

The expression of thyroid transcription factor-1 in pulmonary sclerosing hemangioma and a further investigation on histogenesis of the tumor / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the histogenesis and pathologic features of pulmonary sclerosing hemangioma (SH) and its expression of thyroid transcription factor-1 (TTF-1).</p><p><b>METHODS</b>Seventeen cases of pulmonary sclerosing hemangioma were reevaluated and 12 cases were immunostained with a panel of antibodies including TTF-1, EMA, cytokeratin, etc. Six cases were studied by electron microscopy.</p><p><b>RESULTS</b>All cases exhibited the classic histologic features with variable proportions of solid, papillary, hemorrhagic or hemangiomatic, and sclerotic pattern. The tumours consisted of solid sheets or aggregates of pale polygonal cells and papillae and clefts lined by cuboidal or columnar cells. Both TTF-1 and EMA expressions were observed in the surface lining cuboidal cells and the pale polygonal cells. In only one case both chromogranin and synaptophysin showed weakly positive in few polygonal cells and a small number of granules with high electron density was found in the polygonal cells by electronic microscopy.</p><p><b>CONCLUSIONS</b>It is suggested that pulmonary sclerosing hemangioma is an epithelial neoplasm derived from primitive respiratory epithelium capable of differentiating toward pneumocytes or Clara cells. The immunohistochemical markers such as TTF-1, EMA and CK play an important part in diagnosis of SH.</p>

A clinico-pathological study of primary adrenal lymphoma(report of 2 cases) / 中华泌尿外科杂志

Objective　To study the clinico-pathological features of primary adrenal lymphoma (PAL).　Methods　2 cases of PAL were reviewed and studied.　Results　The age of the 2 patients was 45 and 57.The presenting symptoms were nonspecific.Histologically,the neoplasm was composed of numerous medium-sized cells with round nucleus,usually 1-2 in number and with relatively abundant basophilic cytoplasm.The neoplastic cells showed frequent mitosis.Immunohistochemically,the tumor cells were strongly positive for LCA,L26 and CD74 while negative for UCHL-1,S-100 protein and CK. One case was discharged 3 months after operation because of dyscrasia and the other was lost on follow up.Prognosis of PAL was poor.　Conclusions　PAL is extremely rare with a high grade of malignancy.The diagnosis could be made on histopathological studies and immunohistochemical studies.