Desmoid-type fibromatosis of the mesentery: a clinicopatho-logical and genetic analysis of 9 cases / 浙江大学学报·医学版

Nine cases of mesenteric desmoid-type fibromatosis were diagnosed and treated in Taizhou Hospital, Wenzhou Medical University between January 2010 and May 2022, including 2 females and 7 males, aged 16 to 59 years. The lesions were in the mesentery of small intestine with 7 cases, ileocecal junction with 1 cases and transverse colon with 1 case. The tumors had an unclear boundary and no envelope, the section was solid, gray and tough. The mean maximum diameter was (10.7±8.5) cm (range 3.5-33.0 cm). Microscopically, fusiform fibroblasts and myofibroblasts were parallel, bunched or staggered, buried in a large amount of extracellular collagen. The cell morphology was relatively consistent, without obvious atypia, and mitosis was rare. Immunohistochemistry showed that the tumor cells were positive for vimentin (9/9), β-catenin (9/9), while smooth muscle actin (5/9) stains were focally positive. Ki-67 proliferation index was 1%-10%. Cytokeratin Pan, S-100, STAT6, CD117, DOG1, CD34, desmin and anaplastic lymphoma kinase stains were negative. Genetic analysis showed that there were 7 cases of c.121G>A(p.Thr41Ala) mutation of CTNNB1 gene, 1 case of c.121G>A(p.Thr41Ala) and 1 case of c.134C>T(p.Ser45Phe) double mutation, and 1 case of wild type. Tumors were surgically resected in all 9 cases. Eight cases had no recurrence or metastasis, 1 case had recurrence 6 months later, and no recurrence or metastasis after additional surgical resection.

Gastrointestinal inflammatory myofibroblastic tumor: a clinicopathologic study / 中华病理学杂志

Objective@#To study the clinicopathologic characteristics, immunophenotype and ALK gene alterations of gastrointestinal inflammatory myofibroblastic tumor.@*Methods@#Clinical data, histological features and immunohistochemical results were analyzed in 7 cases of gastrointestinal inflammatory myofibroblastic tumor at Zhejiang Province Taizhou Hospital from January 2005 to December 2016. ALK gene status was investigated by ALK fluorescence in situ hybridization.@*Results@#There were 4 female and 3 male patients. The age of patients ranged from 1 to 72 years (median age=53 years and mean age=40 years). The tumor was located in stomach (n=4), left hemicolon (n=1), right hemicolon (n=1) and rectum (n=1). Histologically, the tumors consisted of spindle fibroblast and myofibroblast cells growing in bundles with inflammatory infiltration primarily composed of plasma cells and lymphocytes. Immunohistochemical study showed spindle tumor cells were positive for vimentin (7/7), SMA (7/7), but were negative for CD34, CKpan, CD117, DOG1, S-100 and desmin. Two cases expressed ALK protein and fluorescence in-situ hybridization revealed the presence of ALK gene rearrangement in the both cases.@*Conclusions@#Gastrointestinal inflammatory myofibroblastic tumor is a rare neoplasm that is easily misdiagnosed. Its surgical removal is a reliable treatment. ALK may be a potential novel therapeutic target for inflammatory myofibroblastic tumor.

Expression of Pax2 and E-cadherin in renal cell carcinoma: correlation with clinicopathologic parameters / 中国医师杂志

Objective To investigate the expression of paired box 2 (Pax2) and E-cadherin in human renal cell carcinoma (RCC) and their correlation with clinicopathologic parameters.Methods The RCC tissue microarrays containing 85 renal cell carcinoma specimens and 35 normal kidney tissue specimens were used to detect Pax2 and E-cadherin expressions by immunohistochemistry.Results The positive expression rate of Pax2 was 77.6％ (66/85) in RCC specimens,which was significantly higher than that in 35 normal kidney tissue specimens (P ＜ 0.01).The positive expression rate of E-cadherin was 30.6％ (26/85) in RCC specimens,which was significantly lower than that in 35 normal kidney tissue specimens (P ＜ 0.01).The expression of Pax2 in RCC was significantly related to histological classification and pathological grade (P ＜ 0.05),while it was not related to the size of tumor and clinical stage (P ＞ 0.05).The expression of E-cadherin in RCC was significantly related to the size of tumor,histological classification,pathological grade and clinical stage (P ＜ 0.05).The positive expression rate of E-cadherin in survival group was significantly higher than that in death group (P ＜ 0.05).Conclusions The abnormal expressions of Pax2 and E-cadherin may play a crucial stage in development of human RCC.Detection of the expressions of Pax2 and E-cadherin can be used in the evaluation of malignant degree and prognosis of RCC.

Relationship between EGFR and multidrug resistance protein in non-small cell lung cancer / 中国生化药物杂志

Objective To investigate the expression of epidermal growth factor receptor (EGFR) and multidrug resistance protein, and it's relationship with efficacy of chemotherapy in NSCLC.MethodsThe immunohistochemical (EnVision method) was used to detect the expression of EGFR and LRP, P-gp, MRP, GST-π in 95 cases of NSCLC tissues and 15 cases of normal lung samples.ResultsEGFR in NSCLC tissues was significantly correlated with the history of smoking, pathological types of cancer(squamous cell carcinoma vs adenocarcinoma), presence of lymph node metastasis, and TNM stages (P< 0.05).The positive expression rate of LRP and MRP in adenocarcinoma were higher than squamous cell Carcinoma (P< 0.05), and MRP in high differentiate cancer was higher than low differentiate cancer (P< 0.05).The expression of MRP and LRP, PGP and GST-π in NSCLC were positive correlation(r=0.341, P=0.001;r=0.213, P=0.038), there is no correlation between EGFR with LRP, P-gp, MRP, GST-π.EGFR-negative chemotherapy efficiency (62.5%) was significantly higher than EGFR-positive(37.5%, P< 0.05).ConclusionEGFR and multi drug resistance proteins are overexressed in NSCLC tissues.multi drug resistance proteins have a synergistic to drug resistance.EGFR could be used to objectively predict chemotherapy effect and prognosis of NSCLC.

Gastric glomus tumors expressing synaptophysin: clinicopathologic and immunohistochemical analyses / 中华病理学杂志

Objective@#To investigate the clincopathologic and immunohistochemical features of gastric glomus tumors and their differences from gastric neuroendocrine neoplasms.@*Methods@#Six cases of gastric glomus tumors, 8 cases of glomus tumors in other sites and 7 cases of gastric neuroendocrine neoplasms were collected from the Department of Pathology, Taizhou Hospital. The clinicopathological and immunohistochemical characteristics of these tumors were analyzed retrospectively.@*Results@#The gastric glomus tumors were located in the muscularis propria of the antrum and most cases strongly expressed synaptophysin (5/6). However, no synaptophysin expression was seen in glomus tumors of other organs.Most gastric neuroendocrine neoplasms were located in the mucosa or submucosa of the fundus and corpus. In addition to the strong expression of synaptophysin (7/7), CgA (6/7) and CD56(5/7) were strongly positive, although SMA was negative.@*Conclusions@#Gastric glomus tumors and neuroendocrine neoplasms have similar morphological characteristics and both show strongly expression of synaptophysin. However, the location and immunohistochemical characteristics of gastric glomus tumors differ from those of the neuroendocrine neoplasms.

Neuroendocrine differentiation and Wilms' tumor protein-1 expression in breast mucinous carcinoma and their significance / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate neuroendocrine differentiation and Wilms' tumor protein-1 (WT-1) expression in breast mucinous carcinoma and their clinicopathological significance.</p><p><b>METHODS</b>The clinicopathological data of 65 patients with breast mucinous carcinoma, including 31 cases of mixed mucinous carcinoma, 23 cases of hypocellular pure mucinous carcinoma and 11 cases of hypercellular pure mucinous carcinoma, admitted in Taizhou Hospital from January 2010 to June 2015 were retrospectively reviewed. The expression of neuroendocrine markers and WT-1 was detected by immunohistochemistry staining in all cases.</p><p><b>RESULTS</b>The mixed mucinous carcinomas and hypercelluar pure mucinous carcinomas had higher incidence of axillary lymph node metastasis and human epidermal recepter 2 (HER-2) positive than hypocellular pure mucinous carcinoma (all (P<0.01). However, the difference was not significant between mixed mucinous carcinomas and hypercellular pure mucinous carcinomas (all P>0.05). The expression of neuroendocrine marker was stronger in hypercellular mucinous carcinoma than that in mixed mucinous carcinoma and hypocellular mucinous carcinoma (all (P<0.05), but the difference was not statistically significant between mixed mucinous carcinoma and hypocellular pure mucinous carcinoma (P>0.05). The expression of WT-1 was weaker in mixed mucinous carcinoma than that in hypercellular and hypocellular pure mucinous carcinoma(all (P<0.05), but the difference was not statistically significant between hypercellular and hypocellular pure mucinous carcinoma (P>0.05). The mucinous carcinomas with lymph node metastasis had lower expression of neuroendocrine markers than those without lymph node metastasis ((P<0.01). The expression of WT-1 in breast mucinous carcinoma with lymph node metastasis trended lower than that in those without lymph node metastasis, but the difference was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>Hypercellular pure mucinous breast carcinoma has higher rates of lymph node metastasis and HER-2 amplification than hypocellular pure mucinous carcinoma, the sub-classification of breast pure mucinous carcinoma should be considered. Neuroendocrine differentiation and WT-1 expression may be helpful in distinguishing the subtypes of breast mucinous carcinoma. Breast mucinous carcinoma with neuroendocrine differentiation trends to have less lymph node metastasis.</p>

Expression of IgG4 in Rosai-Dorfman disease and its significance / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the prevalence of IgG4-positive plasma cells in Rosai-Dorfman disease and to assess the association between Rosai-Dorfman disease and IgG4-related sclerosing disease (IgG4-SD).</p><p><b>METHODS</b>The clinicopathologic features of 12 tissue samples of Rosai-Dorfman disease (11 extranodal and one nodal) from nine patients were reviewed. The degree of fibrosis and occlusive phlebitis was studied by HE staining. The expression of IgG4 and IgG in plasma cells were studied by immunohistochemistry (EnVision) and quantitatively analyzed by medical image analysis system.</p><p><b>RESULTS</b>Nine tissue samples showed different degree of fibrosis (four tissue samples were mild, one tissue sample was moderate and four tissue samples were severe) and two tissue samples showed occlusive phlebitis in the lesional tissue. Immunohistochemical study showed marked infiltration by IgG4-positive plasma cells (> 50 per high-power field) in four tissue samples, moderate infiltration (30 to 50 per high-power field) in two tissue samples, mild (10 to 29 per high-power field) in three cases and negative infiltration (< 10 per high-power field) in three tissue samples (P < 0.01). Three tissue samples fulfilled the diagnostic criteria of IgG4-SD (> 50 IgG4-positive plasma cells per high-power field and IgG4-to-IgG ratio > 40%), including one tissue sample each of Rosai-Dorfman disease in the left facial skin, above the left eye socket, and in the right parotid.</p><p><b>CONCLUSIONS</b>Some cases of Rosai-Dorfman disease fulfill the diagnostic criteria and show the histologic features of IgG4-SD. They may represent members of the IgG4-SD spectrum. The detection of IgG4-positive plasma cells in the lesional tissues of Rosai-Dorfman disease may have clinical pathological significance.</p>

Clinicopathological analysis of langerhans cell histiocytosis / 中华全科医师杂志

The clinicopathological data of 13 patients with Langerhans cell histiocytosis (LCH) from January 2004 to January 2014 were retrospectively analyzed.There were 8 males and 5 females with a mean age of 35 (6-63)years.For all 13 cases,there were 15 lesions.Histologically,there was a diffuse distribution of Langerhans cells accompanied by a variable number of eosinophils and some other inflammatory cells.Immunohistochemical study showed tumor cells were positive for S-100 protein,CD1a and Langerin.During a follow-up period of 6-101 months,all survived.The diagnosis of LCH was assisted by immunophenotypic analyses for S-100,CD1a and Langerin.Combination therapy was effective.Most patients had an excellent prognosis.

Diagnosis and treatment of hepatic veno-occlusive disease induced by sedum aizoon in HBsAg positive patients / 中华临床感染病杂志

Objective To review the diagnosis and treatment of hepatic veno-occlusive disease(HVOD)induced by sedum aizoon in HBsAg positive patients. Methods Clinical data of 35 HBsAg positive cases who took sedum aizoon decoction and developed HVOD were collected, the clinical manifestation, imaging examination, histological examination of liver puncture biopsy, and the outcomes of patients were reviewed. Results Hepatomegaly, liver dysfunction, abdominal effusion and map-like density changes in liver CT scan were observed in 35 patients. Liver biopsy wag performed in 17 patients. In histopathological examination, the swelling and point-like necrosis of liver cells, expansion and congestion of sinus, endothelial swelling, wall thickening, incomplete lumen occlusion of small liver vascular were observed. Map-like density changes in liver CT scan were found in all 17 patients who were diagnosed by histological examination. Fifteen patients presented small amount of ascites within 4 weeks of onset, 13 of whom recovered or improved after treated with low-molecular weight heparin and albumin; while among the remaining 20 patients. only half of them were benefited from the same treatments. Conclusion HVOD can be diagnosed by liver CT scan instead of histological examination; treatment of patients in early stage may improve the outcome.

Comprehensive analysis of factors that involve in survival and prognosis in patients with gastrointestinal stromal tumors / 中华消化杂志

Objective To investigate the survival and prognostic factors in patients with gastrointestinal stromal tumors(GIST).Methods The histopathological slides from 153 patients with GIST were reviewed. The expression of CDllT,CD34,platelet-derived growth factor receptor alpha (PDGFR-a) and Ki-67 proteins were measured by immunohistochemical staining. The factors thatinvolved in the survival and prognosis were analyzed based on the clinical features and GIST biological behavior ranking.The Kaplan-Meier and Cox model were used to evaluate the effect of variant factors on survival and prognosis.Results The survival rate of 135 patients was 94.1% 76.3% and 65.9% at 1,3 and 5 years,respectively.On univariate analysis survival was predicted by tumor size (χ2= 40.565,P＜0.01),primary tumor location (χ2=13.245,P＜0.01),mitotic count (χ2= 22.626,P＜0.01),risk ranking (χ2=19.186,P＜0.01),necrosis (χ2==28.665,P＜0.01),incomplete resection χ2=2 =29.110,P＜0.01) and Ki-67 index (χ2=15.953,P＜0.01).Multivariate analysis demonstrated that thetumor size ＞ 10 cm,primary tumor location,mitotic count＞ 10/50 HPF,high risk subgroup,tumor necrosis and Ki 67 index ＞ 5 % were poor predictors of survival.Ki-67,tumor size and mitotic count were strong poor predictors of survival.Conclusions Fletcher's biological behavior ranking is a good approach to predict prognosis of GIST patients and has significant clinical value.It's better to combine itwith other factors such as Ki-67 index and primary tumor location in order to provide evidence for therapy.

The relation among nm23-H_1 gene expression,DNA contents and lymph node metastases of head and neck squamous cell carcinoma / 实用口腔医学杂志

Objective:To study the relation among nm23-H 1 expression,DNA contents and lymph node metastases of head and neck squamous cell carcinoma(HNSCC).Methods:Fresh specimens from 30 previously untreated patients with HNSCC were examined for the determination of nm23-H 1 expression with immunohistochemistry, Aneuploid and S-phase fraction(SPF) with flow cytometry(FCM).The association among these parameters with lymph node metastases was studied.Results: nm23-H 1 expression was found in 18 cases (60%).and aneuploid in 20 (66.7%).Correlation was found between lymph node metastasis and nm23-H 1 protein expression (P