Clinical significance of circumferential margin foresophageal squamous cell carcinoma / 中华胸心血管外科杂志

Objective:To analyze the relationship between the circumferential resection margin status and prognosis and clinicopathological features of esophageal squamous cell carcinoma.Methods:The information of esophageal squamous cell carcinoma patients who underwent radical resection at the Fourth Hospital of Hebei Medical University from October 2017 to March 2019 were collected. All patients were diagnosed with advanced squamous cell carcinoma by postoperative pathology. Demographic data including sex, age, T stage, N stage, tumor location, lesion length, gross pathological type, vascular tumor embolization, nerve invasion and circumferential resection margin were collected and analyzed. The circumferential resection margins were evaluated using the College of American Pathologists(CAP) criteria. A total of 328 cases were included in this study according to the inclusion criteria. Using SPSS 20.0 statistical software, univariate survival analysis was assessed by Kaplan- Meier survival curves, survival curves were compared using Log- rank tests, and multivariate analysis was carried out by Cox regression. The Fisher exact and Chi- square tests were used to compare counting data. Results:As of the follow-up date, the 1-year and 2-year overall survival rates of 328 patients with esophageal squamous cell carcinoma were 91.9% and 84.8%, respectively. The median overall survival was 16 months(range 2-25 months). Univariate analysis showed that T stage, vascular embolism and nerve invasion were the influencing factors of overall survival, multivariate analysis showed that nerve invasion was an independent risk factor for overall survival, stratified analysis showed that the circumferential resection margin was related to overall survival in patients less than 60 years old( P=0.006), patients with ulcerative type of gross pathology( P=0.002) and patients with tumor length ≥4 cm( P=0.046). The 1-year and 2-year disease-free survival rates of the whole group were 89.7% and 67.8%, respectively. The median disease-free survival was 16 months(range 2-25 months). Univariate analysis showed that N stage was the influencing factor of disease-free survival in patients with esophageal squamous cell carcinoma, and stratified analysis showed that the disease-free survival rate of patients with ulcerative type( P=0.002), tumor length ≥4 cm( P=0.015) and circumferential resection margin negative group were better than that of circumferential resection margin positive group. There were 66 patients with positive circumferential resection margin in the whole group, and the positive rate of circumferential resection margin was 20.1%. Univariate analysis showed that T stage, N stage, vascular embolism, nerve invasion and gross pathological type were the influencing factors of circumferential resection margin, while multivariate logistic regression analysis showed that T stage, vascular embolism and gross pathological type were the influencing factors of circumferential resection margin. Conclusion:According to CAP criteria, circumferential resection margin is not related to the prognosis of patients with esophageal squamous cell carcinoma.Positive circumferential resection margins of esophageal squamous cell carcinoma correlate with T stage, vascular embolism, and gross pathologic type, but not with other clinicopathologic features.

Application value of cell keratin 7 ,thyroid transcription factor-1,Napsin A,cell keratin5/6,p40 and p63 immunohistochemical stains in lung adenocarcinoma and squamous cell carcinoma / 中国综合临床

Objective To study the significant immunohistochemical marker to identify lung adenocarcinoma(ADC) and squamous cell carcinoma(SCC).Methods Three hundred and twenty-nine Choose 329 cases of nonsmall-cell lung cancer (NSCLC) were chosen.Analysis of the clinical and pathological features.The expression of cell keratin 7 (CK7),thyroid transcription factor-1 (TTF-1),Napsin A,CK5/6,p40 and p63 were detected by using immunohistochemistry.Results (1) Among 329 specimens,containing 129 cases of resections,195 cases of biopsies and 5 cases of pleural effusion specimens.(2)In these cases,187 cases were classified to be ADC,142 cases were classified to be SCC.(3) CK7,TTF-1,Napsin A,CK5/6,p40,p63 sensitivity were 97.9％,87.2％,81.3％,6.4％,3.7％,18.7％ in ADC groups,and 25.4％,11.3％,0,92.3％,95.1％,98.6％ in SCC groups,and the differences of two groups were significant statistically (x2 =190.665,187.432,214.542,242.003,274.407,206.818;P＜ 0.001).(4) In the 3 IHC of ADC,CK7 had the highest sensitivity,Napsin A had the highest specificity.In the 3 IHC of SCC,p63 had the highest sensitivity,p40 had the highest specificity.Conclusion CK7,TTF-1,Napsin A,CK5/6,p40 and p63 can be a markable panel of immunohistochemistry in the differential diagnosis of NSCLC.

Expression pattern of Mycobacterium tuberculosis Ag85B and its value in pathological diagnosis / 中华病理学杂志

<p><b>OBJECTIVE</b>To detect the expression of Mycobacterium tuberculosis secreted protein Ag85B in paraffin-embedded tissues by immunohistochemistry (IHC), and to evaluate its application in the pathological diagnosis of tuberculosis.</p><p><b>METHODS</b>One hundred and five tuberculosis specimens (54 pulmonary tuberculosis, 51 lymph nodal tuberculosis) and 51 specimens of other diseases (8 lung cancer, 10 pulmonary abscess, 10 bronchiectasis, 7 lymphoma, 5 necrotizing lymphadenitis, 4 reactive hyperplasia lymphoid, and 7 sarcoidosis) were collected from January 2012 to July 2013 from Beijing Chest Hospital, Capital Medical University. One-step IHC was performed on paraffin-embedded tissues using antibody directed against Ag85B.</p><p><b>RESULTS</b>IHC and Ziehl-Neelsen (ZN) acid-fast staining showed that distribution and intensity of Ag85B expression were concordant with the distribution and number of acid-fast bacilli. IHC showed significantly higher sensitivity than ZN staining (50.5%, 53/105 vs. 31.4%, 33/105; χ² = 7.877, P = 0.005). The combined sensitivity of IHC and ZN staining was 59.0%. Moreover, oil immersion was not necessary for IHC, allowing more rapid diagnosis.</p><p><b>CONCLUSION</b>IHC detection of Ag85B is a simple method with higher sensitivity than ZN staining, and demonstrated good value in the pathological diagnosis of tuberculosis.</p>

Expression of E-cadherin and β-catenin and their significance in non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Because invasion and metastasis of cancer threaten seriously human's life, it is of more important clinical significance to understand and evaluate the biologic behavior of can-(cer) correctly. Abnormal expression of E-cadherin and β-catenin plays important roles in invasion and metastasis of cancer. The objective of this study is to investigate their expression in non-small cell lung cancer (NSCLC) and to find out their correlation with histological type, cell differentiation, metastasis and prognosis of NSCLC.</p><p><b>METHODS</b>The expression of E-cadherin and β-catenin was detected in 129 NSCLC tissues by high sensitive S-P immunohistochemical method.</p><p><b>RESULTS</b>The abnormal expression rate of E-cadherin and β-catenin was 62.0% and 65.1% respectively. The abnormal expression rate of E-cadherin in squamous cell carcinoma was much higher than that in adenocarcinoma (P < 0.05). The abnormal expression rate of E-cadherin and β-catenin in poorly differentiated cells was significantly higher than that in well and moderately differentiated cells (P < 0.05, P < 0.05). Stage III/IV NSCLC showed markedly higher abnormal expression rate of E-cadherin and β-catenin than stage I/II NSCLC did (P < 0.01, P < 0.01). The abnormal expression rate of E-cadherin and β-catenin in patients with lymphatic metastasis was significantly higher than that in those without lymphatic metastasis (P < 0.05, P < 0.01). The mean survival duration and 5-year survival rate in patients with normal E-cadherin and β-catenin expression were remarkably higher than those in patients with abnormal expression (P < 0.05, P < 0.01).</p><p><b>CONCLUSIONS</b>The abnormal expression of E-cadherin and β-catenin is closely related to histological type, differentiation and metastasis in NSCLC. Detection of their expression might be helpful to predict prognosis of NSCLC.</p>