ABSTRACT
Purpose To investigate the clinicopathological features and prognosis of salivary gland secretory carcinoma(SC). Methods A retrospective study was performed including reviewing the clinical documents and pathological sections of 10 cases of SC. Immunohistochemical EnVision study and histochemical staining were performed in the 10 cases. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 fusion gene. Results There were 8 men and 2 women included in this study. The mean age was 45 years(ranged from 22 to 62 years).9 cases occurred in the parotid and 1 case in submandibular gland. Local painless masses were common first symptoms. Tumor size ranged from 1 cm to 3.5 cm in maximum diameter (average 1.8 cm) and the cut surface of most tumors was solid with dusty red or grayish yellow color, of which 1 case showed cystic degeneration. Histologically, the tumors usually pushed and were invasive to the adjacent tissues. Sometimes, the tumors showed expansive growth pattern. Tumor cells demonstrated microcystic, cystic papillary and alveolar patterns. Eosinophilic secretions could be observed in both microcysts and lumen of alveolus. Immunohistochemically, 10 cases revealed diffuse positivity of cytokeratin, and 9 cases were diffusely and strongly positive for S-100, Mammaglobin, vimentin and CK7, whereas all cases were negative for CD117, Dog-1, p53, p63, SMA, and GATA3. The tumor cells were positive for PAS staining and negative for mucicarmine staining. The detection ETV6-NTRK3 fusion gene was carried out in 4 cases by FISH analysis, among which 3 cases were positive. Follow-up data were available in the 10 patients (ranged from 2 months to35 years), among which 9 patients were alive, except for 1 patient died of tumor recurrence and metastasis 16 years after surgery. Conclusion SC is a newly recognized rare malignant tumor of salivary gland with a lowgrade malignancy, slow growth pattern and favorable prognosis. The histological structures of microcysts and eosinophilic secretions are (he crucial histological characteristics of SC. Diffusely strong positive expression of S-100 and mammaglobin is helpful for the diagnosis and differential diagnosis of the tumor. The diagnosis of SC could be confirmed when ETV6-NTRK3 fusion gene could be identified.
ABSTRACT
Purpose To investigate the value of Cyclin D1 and claudin 7 expression in the differential diagnosis of renal epithelial tumors.Methods The expression of Cyclin D1 and claudin7 was detected by immunohistochemical staining with tissue microarray.Totally 309 cases of renal epithelial tumors and 20 cases of normal renal tissues were collected for immunohistochemical staining.Comparative analysis for the values of Cyclin D1 and claudin 7 was performed on the diagnosis and differential diagnosis of renal tumors.Results The positive rates of Cyclin D1 in renal oncocytoma (RO),chromophobe renal cell carcinoma (ChRCC),clear cell renal cell carcinoma (CCRCC),papillary renal cell carcinoma (PRCC),Xp11.2 translocation/TFE3 gene fusion associated renal cell carcinoma (Xp11.2/TFE3) and clear cell tubulopapillary renal cell carcinoma (CCTPRCC) were 86.2％ (50/58),8.2％ (4/49),70.0％ (98/140),8.8％ (3/34),42.9％ (6/14),and 71.4％ (10/14),respectively.The positive rates of RO were significantly different from those of ChRCC and PRCC (x2 =64.72,52.56,P ＜0.000 1).Significant differences in positive rates of CCRCC and ChRCC (x2 =55.87,P ＜ 0.000 1),PRCC and Xp11.2/TFE3 (X2 =4.28,P=0.039),CCTPRCC and ChRCC (x2 =21.69,P ＜0.000 1)were also observed.The positive rates of claudin 7 in RO,ChRCC,CCRCC,PRCC,Xp11.2/TFE3 and CCTPRCC were 20.7％ (12/58),87.8％ (43/49),8.6％ (12/140),50％(17/34),14.3％ (2/14),and 57.1％ (8/14),respectively.There were significant differences in positive ratios of RO and ChRCC (x2 =47.82,P ＜ 0.000 1),CCRCC and CCTPRCC(x2 =26.57,P ＜0.000 1),PRCC and Xp11.2/TFE3 (x2 =5.29,P ＜ 0.05).The sensitivity and specificity of Cyclin D1 +/claudin 7-immunophenotype for RO were 69％ and 95.9％ respectively.The diagnostic sensitivity and specificity of Cyclin D1-/claudin 7 + for ChRCC were 83.7％ and 96.6％.In the identification of CCRCC and CCTPRCC,the sensitivity and specificity of Cyclin D1 +/claudin 7-for CCRCC were 65.7％ and 71.4％,and the diagnostic sensitivity and specificity of Cyelin D1 +/claudin7 + for CCTPRCC were 42.9％ and 95％.Conclusion The differential expression of Cyclin D1 and claudin7 in RO and ChRCC,CCRCC and ChRCC,PRCC and Xp11.2/TFE3 suggests that combined detection of two proteins provides an important assistance for the identification of these renal epithelial tumors.
ABSTRACT
Objective To investigate the curative effect of brucellar spondylitis,so as to provide scientific proof for improving the curative level of the disease.Methods Epidemiological information was collected from 113 patients diagnosed as brucellar spondylitis,who were divided into 5 groups according to different drugs and drug combinations of doxycycline,gentamicin,sulfamethoxazole and rifampicin.Then the curative effect was investigated.Twenty-one patients who had greater paoas muscle abscess or Para vertebral abscess,intraspinal abscess of spinal canal,necrotic intervertebral disk and major osteolasia received the minimal invasive surgery and the focus removal surgery.Results The occurrence of the disease in female was much higher than that in male.Grazing and breeding beasts was the principal route of infection.Lumbars was mostly involved.they usually was infected in the adjacent 2 piece.L4 was the most common and seriuous one.The curative effect of doxycycline group was better than that without doxycycline(72.60% vs 35.00%,X2=15.14,P＜0.05).Doxycyeline+gentamicin+sulfamethoxazole was reeommended as the first choice.However,the curative effect did not increase despi~course of the treatment prolonged.The heMing rate and effective rate after 1 course was 52.21%(59/113)and 92.04%(104/113).that after 2 courses 58.41%(66/113)and 95.58%(108/113),that after 3 courses 59.29%(67/113)and 95.58%(108/113).The healing rate in different course did not present differences(P＞0.05).21 patients undergoing surgery were followed-up,12 patients were after 2 years and 9 patients were between 1-2 years.The healing rate was 95.24%(20/21),1 case was healed basically,the effective rate was 100%.None reoccurred.Conclusions There are characterized features in clinical epidemiology of the brucell spondylitis.Long term,adequate in dosage,combination and multi-approach use of antibiotics is the most reliable way to treat and prevent it from recurring.But fof the patients soitable for surgery.the minimal invasive surgery or the focus removal could shorten the course of therapy,decrease the complications and increase the cure rate.