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Objective@#To analyze the clinicopathological characteristics and prognosis of diffuse midline glioma (DMG) with H3K27M mutation.@*Methods@#Thirty cases of DMG were collected in Guangdong Sanjiu Brain Hospital from October 2016 to May 2018. The patients′ clinicopathological data including age, tumor site and histological grade, treatment and follow-up data were collected and analyzed.@*Results@#There were 21 males and 9 females, with a mean age of 26 years (range 5-53 years). Fourteen tumors were located in thalamus, 12 in brainstem (one involved both thalamus and brainstem), and one each in hypothalamus, fourth ventricle, and sellar region, respectively. Two cases presented as diffuse intracranial lesions. Three cases (10.0%) were of WHO grade Ⅰ, 10 cases (33.3%) were grade Ⅱ, eight cases (26.7%) were grade Ⅲ, and nine cases (30.0%) were grade Ⅳ.All patients with gradeⅠ tumors were older than 20 years. Histologically, all were pilocytic astrocytoma-like. Immunohistochemical staining demonstrated that all tumors were IDH1 negative. Twenty-eight tumors showed diffuse expression of H3K27M, and two showed focal expression. Twenty-one tumors(100.0%, 21/21) showed absent expression of H3K27me3. Sixteen tumors (57.1%, 16/28) showed strongly positive expression of p53, and ATRX was negative in eight tumors (38.1%, 8/21). The Ki-67 proliferation index ranged from 5% to 40%. Eight cases (including two cases of H3K27M expression of individual cells) showed K27M mutation in H3F3A gene. Intracranial and spinal cord dissemination occurred in six cases (20.0%, 6/30). Median progression-free survival (PFS) was 9.5 months and median overall survival (OS) was 34 months. Mean PFS was 11.2 months and mean OS was 24.3 months. Compared with adults (>20 years old), children/adolescents (no more than 20 years old) had significantly shorter median OS (8 months vs. 34 months, P=0.013). There was no significant difference in PFS and OS between DMGs located in the brain stem/thalamus and other sites within midline (P>0.05). There was no significant difference in PFS and OS between WHO grade ⅠDMGs and WHO grade Ⅱ-Ⅳ DMGs (P>0.05).@*Conclusions@#DMGs occur more commonly in children and adolescents with male predominance. DMGs present with WHO Ⅰ-Ⅳ tumors morphologically, and pilocytic astrocytoma-like lesions with WHO Ⅰ are more common in adults. Expression of H3K27M but not H3K27me3 is helpful for diagnosis of DMG. The prognosis of children/adolescents is significantly worse than that of adults, whereas histological grade and tumor location do not affect prognosis.
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Objective To investigate the neuroimaging and pathological features of epithelioid glioblastoma (EGBM) to improve the diagnosis.Methods The clinical and pathological features of 4 E-GBM cases were analyzed retrospectively.Results E-GBMs occurred predominantly in young adults.MRI examination showed irregular solidcystic lesion with heterogeneous or ring enhancement in 4 cases.Histological examination revealed uniform population of epithelioid or rhabdoid cells with prominent nucleoli and mitotic activity as well as geographic necrosis..Immunohistochemical staining showed various positive signals of Vimentin and S-100 protein in 4 cases,positive signal of BRAF (VE1) in 3 cases and focal positive signal of GFAP in 1 case.However,IDH-1 was negative and 1p/19q codeletion was lack.All patients were followed-up for 2-6 months.One patient had tumor recurrence 3 months and one patient died of disease 6 months after surgical excision.Conclusion E-GBM has a poor outcome and is closely associated with pleomorphic xanthoastrocytoma.MRI and epithelioid histological features are very important for the differential diagnosis.
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Objective To investigate the neuroimaging and pathological features of epithelioid glioblastoma (EGBM) to improve the diagnosis.Methods The clinical and pathological features of 4 E-GBM cases were analyzed retrospectively.Results E-GBMs occurred predominantly in young adults.MRI examination showed irregular solidcystic lesion with heterogeneous or ring enhancement in 4 cases.Histological examination revealed uniform population of epithelioid or rhabdoid cells with prominent nucleoli and mitotic activity as well as geographic necrosis..Immunohistochemical staining showed various positive signals of Vimentin and S-100 protein in 4 cases,positive signal of BRAF (VE1) in 3 cases and focal positive signal of GFAP in 1 case.However,IDH-1 was negative and 1p/19q codeletion was lack.All patients were followed-up for 2-6 months.One patient had tumor recurrence 3 months and one patient died of disease 6 months after surgical excision.Conclusion E-GBM has a poor outcome and is closely associated with pleomorphic xanthoastrocytoma.MRI and epithelioid histological features are very important for the differential diagnosis.
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Objective To evaluate MR relaxometry techniques and dual-energy X-ray absorptiometry (DXA) for the diagnosis of osteoporotic diseases in rats. Methods Thirty 3-month-old female rats were randomly divided (using completely randomized grouping method) into two groups (each contained 15 rats). Animals in group A without osteoporotic castration were included as normal controls, whereas osteoporotic castration was created in each animal in group B. Three parameters (BMC, BMD, Hbmdl)was measured for both groups by DXA at two time points, one immediately before the castration and another at the 12 th week after the castration. Then animals from the control group and the osteoporotic group went through the following three diagnostic procedures using a 1.5 T MR system: (1) A fast multi echo gradient echo (MEGRE) pulse train sequence with different inter-echo intervals (1000, 500, 400, 300, 200, 100) to obtain the T_2~* value. (2) A multi-echo fast spin echo sequence to obtain the T_2map. (3) A conventional spin-echo (CSE) sequence to obtain the T_1map. The statistical difference between group A and group B was tested by t-test to analyze parameters. And, the most significant parameter for diagnosis ofosteoporotic diseases was picked out from all parameters by Fisher Sequential diseriminant analysis. At the end of experiments, animals were killed and histopathological examination was performed on the femurs of animals from both control and osteoporotic groups. Results (1) Histopathological examination confirmed the presence of osteoperosis in all animals in group B. (2) BMD was picked out from 3 DXA parameters (BMC,BMD,Hbmdl) by fisher stepwise discriminant analysis, and its discriminant rates was 87.6%. (3) All 2-sample t-test results(t=6.20, 4.79, 5.18, 5.22, 5.59, 4.37, 6.14, 5.12, 5.09, 4.99, 5.57, 4.84, 4.07, 2.98, 6.75 individually) for MR relaxometry parameters(T_2~* 1000,R_2~* 1000,T_2~* 500,R-2~* 500,T_2~* 400,R_2~* 400,T_2~* 300,R_2~* 300,T_2~* 200, R_2~* 200, T_2~* 100, R_2~* 100, T_2map, R_2map, T_1map) showed statistically significant differences between groups A and B (P=0.01 for T_2~* map, P=0.00 for all other parameters) except the R_2map(P=0.07). (4) Using fisher stepwise discriminafion method in the analysis of 14 parameters of MR relaxometry techniques and 3 parameters of dual X-ray absorptiometry(T_2~* 1000,T_2~* 500,T_2~* 400,T_2~* 300,T_2~* 200,T_2~* 100,T_2map, R_2~* 1000, R_2~* 500, R_2~* 400, R_2~* 300, R_2~* 2OO, R_2~* 100,T_1map,BMC,BMD,Hbmdl), we found that the most significant difference was from the T_2map and T_1map. Conclusions The MR relaxometry parameter-T_2map in the present study is shown to be appropriate parameter for the diagnosis of osteoperotie diseases, and stability of magnetic field plays an important role in this process. It would be the optimal method to make a diagnosis of osteoporotic diseases with both MR relaxometry and DXA technological means.
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Objectives To investigate the expression of matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor (TIMP-1) in cutaneous squamous cell carcinomas (SCC) and the relationship between the expression and invasive growth and metastasis of SCC. Methods Immunohistochemical method of streptavidin-peroxidase (SP) was used to detect the expression of MMP-9 and TIMP-1 proteins on the paraffin embedded sections of 65 patients with cutaneous SCC and 5 cases of normal epidermis. The immunohistochemical results were analyzed quantitatively using an image analysis system. Results MMP-9 and TIMP-1 proteins were diffusely expressed on the tumor nests and the mesenchymal cells around the nests, while in normal epidermis MMP-9 and TIMP-1 were weakly positive. The expression level of MMP-9 protein and the ratio of MMP-9/TIMP-1 were higher in aggressive SCC group than those SCC in situ group (t = 2.33 and 2.36, respectively, P
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<p><b>OBJECTIVE</b>To study the diagnosis and the differential diagnosis of nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL).</p><p><b>METHODS</b>245 cases of Hodgkin's lymphoma (HL) diagnosed between 1980 and 2000 from 3 hospitals in Guangzhou were reviewed. Four cases of NLPHL were confirmed according to the WHO classification of lymphoid neoplasms. Among the other 3 cases of NLPHL, 2 collected from other clinical centers and 1 from Fudan University Cancer Hospital. Immunohistochemistry (IHC) were performed on paraffin sections through SP technique using a panel of markers to define the large neoplastic cells (CD45, CD20, CD15, CD30 and vimentin) as well as the non-neoplastic background cells (CD3, CD20, CD45RO, CD57, CD68 and TIA-1).</p><p><b>RESULTS</b>Seven patients with NLPHL were 4 males and 3 females, age 29 to 70 years, average 43.8 years. All patients had lymphadenopathy. Histologically, in NLPHL, instead of the structure of normal lymph nodes, the tumor tissue became nodular in architecture. Characteristic lymphocytic and histiocytic (L&H) cells with scant cytoplasm and large multilobulated nuclei distributed among a predominant population of small lymphoid cells. The large cells exhibited a CD45+, CD20+, but CD15-, CD30- and vimentin-phenotype. The background cellularity was relatively rich in B cells and the majority of T-cells infiltrated were CD57(+) cells. TIA-1+ cells were few.</p><p><b>CONCLUSIONS</b>NLPHL can be diagnosed according to the morphologic and immunophenotypic features rather than by morphology alone. It is important to distinguish this tumor from its morphologic mimics, such as lymphocyte-rich classical Hodgkin's lymphoma (LRCHL) and T-cell rich B-cell lymphoma (TCRBCL). The immunophenotype of neoplastic cells and background cells are the helpful criteria for the differential diagnosis.</p>
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Humans , B-Lymphocytes , Diagnosis, Differential , Hodgkin Disease , Immunophenotyping , Lymphoma, B-CellABSTRACT
Objective To explore the feasibility and value of MRI examination in colorectal carcinoma. Methods Thirty-eight patients with clinically suspected colorectal carcinoma were included in this study and all of them underwent MRI examination. About 300- 1 000 ml water was administered transrectally before scanning. Axial plain scan, three-planar enhanced scan and hydrography were performed, respectively. Results In 38 patients, 31 cases were pathologically proved as colorectal carcinoma. The main MRI findings were: intraluminal soft tissue mass (n=5), irregular thickening of colorectal wall and partial or circumferential stenosis of colorectal lumen (n=26). The tumors were all demonstrated as medium signal intensity on T 1-weighted images. Thirty of 31 cases showed slightly hyperintensity and one was conspicuous high signal intensity on T 2-weighted images. Marked enhancement was demonstrated in all foci. Focal low signal structures were presented in the pericolorectal fat on precontrast T 1-weighted SE sequence in 5 cases. Smooth margins were revealed in 12 cases and irregular and/or nodular margins of peripheral wall in 19 cases. Colorectal hydrography showed that there were intraluminal irregular filling defects (n=14), and that "cuff sign" or "sawn-off sign" was demonstrated in the distal end of tumor and its proximal part couldn't be seen (n=10). Thirty of 31 patients with pathologically proved colorectal carcinoma and 4 of 7 patients with non-colorectal carcinoma were correctly identified by MRI. The sensitivity, specificity, and accuracy were 96.8%, 57.1%, and 89.5%, respectively. The accuracy of MRI in T staging was 83.9% (26/31). The accuracy in T1-2, T3, and T4 staging was 75.0% (9/12), 88.2% (15/17), and 100% (2/2), respectively. Conclusion MRI could clearly show the longitudinal and horizontal invasion of colorectal carcinoma as a whole. It could accurately determine the invasive depth of local lesions. Barium enema examination may be partially replaced by colorectal hydrography with MIP reconstruction. It is of directorial value in clinical treatment.
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AIM: This study is based on the result of the study in HL and ALCL employing gene chip technique, in which writer found that there was distinctly different expression of caspase-4 between HL and ALCL cell lines at the level of mRNA. From the point of view, we try to identify at the level of protein whether there is different expression of this gene in HL and ALCL tissues as well. METHODS: HE staining, the monoclonal antibodies CD30 (BerH2), CD15 (C3D-1), CD20 (L26) and CD45RO (UCHL1) were used for selecting the cases of HL and ALCL. Specific high affinitive anti-caspase-4 polyclonal antibody was used by immunohistochemical staining to analyze the expression of caspase-4 in 18 cases of HL and 15 cases of ALCL. RESULTS: The expression of caspase-4 demonstrated a strong positive staining in all ALCL cases (15/15,100%), whereas negative in 16 HL cases (88 8%), while other two cases were weakly stained (11 2%), showing a distinct difference (P
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AIM: To observe the effect of partial liquid ventilation with perfluorocarbon on gas exchange, hemodynamics and lung histological change in the piglets with surfactant depletion-induced acute lung injury. METHODS: 12 piglets were treated by lung lavage to a partial pressure of oxygen in arterial blood (PaO 2) below 100 mmHg for one hour and randomly divided into gas ventilation group (control group) and partial liquid ventilation (PLV) group, in PLV group, piglets received PFC (FC3280) intratracheally at doses of 15 mL/kg. The parameters of gas exchange and hemodynamics were measured before lung lavage, after lung lavage when the acute lung injury (ALI) was established, and 1 hour, 2 hours after ALI. Animals underwent euthanasia at the end of the study, lung histologic analysis followed. RESULTS: Surfactant depletion by lung lavage induced a stable acute lung injury.Gas exchange increased markedly in the animals that underwent PLV, less hemodynamic damage was observed in PLV group compared with the animals in GV group. Lung histologic analysis demonstrated a less lung damage, including atelectasis, neutrophil excudation, intra-alveolar hemorrhage and interstitial edema in PLV group compared with control group. CONCLUSION: In piglets with surfactant depletion-induced acute lung injury, partial liquid ventilation with perfluorocarbon can improve the gas exchange with less adverse hemodynamic effect and less lung injury compared with conventional gas ventilation.
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AIM: To detect the expression of cytoplasmic inhibitor of apoptosis protein 2 (c-IAP2) and growth arrest-specific gene 1 (GAS1) in Hodgkin's lymphoma (HL) and anaplastic large cell lymphoma (ALCL) and to investigate the role of two genes in the pathogenesis of HL and ALCL.METHODS: HE staining,the antibodies CD30,CD15,CD45RO and CD20 were used to screen the cases of HL and ALCL from 288 cases of lymphoma. The clarified HL and ALCL were subjected for immunohistochemical staining by SP and ABC methods to analyze the expression of c-IAP2 and GAS1. RESULTS: ①The positive rate of c-IAP2 in HL was 25/26(96.1%) while that in ALCL was 6/19(31.6%),there presented statistic significance between HL and ALCL groups( P
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AIM: To study the expression of MDM2 and muta nt-type P53 proteins in primary hepatocellular carcinoma(HCC). METHODS: Using immunohistochemical staining method(SP),the expression of mutant-t ype P53 and MDM2 proteins was examined in 55 cases of HCC,23 cases of correspond ing paracancerous tissues and 10 cases of normal hepatic tissues. RESULT S: The frequencies of MDM2 and P53 positive expression in HCC were 17/55 (30 9%) and 23/55 (41 8%), respectively. There was both positive expression of MDM2 and mutant-type P53 in 11 cases (20%) with HCC. Expression of MDM2 showed a significantly positive correlation with expression of mutant-type P53 (r=0 310,P