RESUMO
Objective:To explore the value of tumor stroma ratio (TSR) in non-small lung cancer (NSCLC) tissue in predicting the efficacy of tumor immunotherapy.Methods:The clinical and histopathological data of patients with stage ⅢB-Ⅳ NSCLC treated with immune checkpoint inhibitors in the Renmin Hospital of Wuhan University from January 2017 to December 2020 were collected. Taking 50% as the TSR boundary value, the patients were divided into low TSR group (≤50%) and high TSR group (>50%) . The histopathological features, 4-cycle objective response rate (ORR) and disease control rate (DCR) , 6-cycle ORR and DCR, and progression-free survival (PFS) were compared between the two groups. Univariate and multivariate Cox regression models were used to analyze the prognostic factors related to PFS.Results:A total of 50 patients were included, including 27 with low TSR and 23 with high TSR. There were no significant differences between the two groups in age ( χ2=0.59, P=0.441) , gender ( P=0.578) , smoking history ( χ2=0.12, P=0.730) , histopathological type ( χ2=2.33, P=0.313) , TNM stage ( χ2=0.22, P=0.636) , 4-cycle ORR ( χ2=0.48, P=0.487) and DCR ( P=0.593) , 6-cycle ORR ( χ2=0.05, P=0.818) and DCR ( P=0.641) . The incidence of brain metastasis was higher in the high TSR group than that in the low TSR group [34.8% (8/23) vs. 7.4% (2/27) , χ2=4.23, P=0.040]. Kaplan-Meier survival analysis showed that the PFS in the low TSR group was significantly longer than that in the high TSR group (15.6 months vs. 10.2 months, χ2=13.84, P<0.001) . Univariate analysis showed that TSR value ( HR=0.29, 95% CI: 0.14-0.58, P<0.001) and brain metastasis ( HR=2.38, 95% CI: 1.12-5.05, P=0.024) were correlated with the worse prognosis of NSCLC patients. Multivariate Cox regression analysis showed that TSR value was an independent prognostic factor for NSCLC immunotherapy ( HR=0.32, 95% CI: 0.14-0.70, P=0.004) . Conclusion:TSR is an independent predictor of immunotherapy for NSCLC, but whether it can predict the short-term efficacy of immunotherapy for advanced NSCLC still needs further research.
RESUMO
Objective To explore the clinicopathological features and diagnosis of adenoid cystic carci noma of the breast (ACCB).Methods Clinical data of 3 cases of ACCB were collected and followed up to observe the clinical pathological features.Immunohistochemistry was used to determine the immune phenotype.Results All the 3 cases were female,aging from 55 to 72 years old (61 years old as the average).The tumors were found in subareolar region well-circumscribed.ACCB was characterized by the presence of a dual cell population of luminal and basaloid cells arranged in cribriform and tubular-trabecular patterns.On immunohistochemical staining,the myoepithelial cells expressed SMA,CK5/6,P63,CD117 and the glandular epithelium cells were mostly positive for CK18,EMA,CK7,while no expression of ER,PR,HER-2,CD10 was observed.Conclusions ACCB is a rare neoplasm with a triple-negative,basal-like phenotype,but exhibits an indolent clinical behavior.The diagnosis can be worked out by evaluation of clinical characterstics,histological and immunohistochemical features.
RESUMO
Objective To observe the expression of transforming growth factor factor-β1 (TGF-β1) and vas cular endothelial growth factor (VEGF) in breast cancer to explore the correlation between each other and their relationship with invasion,metastasis and prognosis of breast cancer.Methods Immunohistochemistry was used to detect the expression of TGF-β1 and VEGF in 230 breast cancer tissues and adjacent tissues.The correlation between them and the relationship between their expression and the clinical pathological parameters of breast cancer were analyzed.Results The positive rates of TGF-β1 and VEGF in breast cancer were 72.6％ and 68.3％,respectively.But in adjacent breast tissues,the positive rate was 21.3％ and 42.2％,respectively.The expression of TGF-β1 was closely related to the histological grade,ER state and 5-year recurrence (P＜0.05),while ER status and 5-year recurrence were independent predictors of the positive expression of TGF-β1.The expression of VEGF was significantly correlated with ER status and 5-year recurrence (P＜0.05),while ER status was independent predictor of the positive expression of TGF-β1.The expression of VEGF was significantly positively correlated with the expression of TGF-β1 (γ=0.419,P＜0.01).Conclusion The expression of TGF-β1 and VEGF in breast cancer is closely related to the invasion,metastasis and prognosis of breast cancer,which has a certain clinical significance.
RESUMO
Purpose To explore the clinicopathological features,immunophenotype,differential diagnosis and prognosis of the composite pheochromocytoma (CP)-ganglioneuroma.Methods 3 cases of CP-ganglioneuroma were stained by immunohistochemical SP method,and the related literatures were reviewed.Results 3 cases of CP-ganglioneuroma were one male and 2 females,the age were 37-64.Case 3 were of primary mediastinal.Microscopically,the tumor tissues were composed of two components:one type of tumor cells were arranged in nests with a predominant Zellballen pattern,round or oval nuclei,fine granular cytoplasm and rare mitotic,another part of the neoplasm showed scattered and aggregated distributed ganglion cells in the background of neurofibromatosis which aligned bundles and interwoven,the edge of the tumor was still residual adrenal tissue.Immunohistochemically,components of pheochromocytoma were positive for CD56,CgA,Syn,vimentin and negative for SMA,Melan-A,α-inhibin NF with low Ki-67 proliferation index.S-100 was positive in supporting cells,ganglioneuroma components were positive for NF,S-100 with low Ki-67 proliferation index.CgA and Syn were weakly positive or negative in the ganglion cells.Conclusion CP is a relatively rare tumor,which can not be distinguished from pheochromocytoma in clinical and radiological diagnosis.The corresponding clinical treatment and follow-up management should be taken according to the different ingredients (benign or malignant).