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Objective:To study the anti-tumor efficacy of endostar microbubble combined with focused ultrasound radiation in colon cancer liver metastases.Method:29 mice with colon cancer liver metastasis were randomly divided into four groups. Group 1(8 mice), as the control group. Group 2(7 mice) were treated only with ultrasonic radiation. Group 3 (7 mice) treated with the ultrasonic radiation combined with SonoVue microbubbles without carrying any medicine. Group 4(7 mice), treated with the ultrasonic radiation combined with microbubbles carrying endostar. The mice were sacrificed and the tumor specimens were weighted on the 12 days after ultrasound radiation. Immunohistochemistry was used to assess CD34 expression within the metastatic tumor.Results:The tumor weight in group 4 (0.79±0.49)g was significantly lower than that in group 1 (2.67±0.61)g, group 2 (2.60±0.60)g and group 3 (1.74±0.33)g ( F=20.629, P<0.01). The liver metastatic tumor weight in group 4(0.55±0.16) g was much lower than that in group 1 (1.47±0.22)g, group 2(1.42±0.28) g and group 3 (0.95±0.27)g ( F=23.758, P<0.01). There was no obvious difference among the four groups in the number of nodules of metastatic tumor in liver ( F=0.167, P=0.918). The level of CD34 in group 4 were (8 037±1 708) , significantly lower than that in any other group, ( F=15.779, P<0.01). Conclusion:Endostar microbubble combined with focused ultrasound radiation decreases tumor angiogenesis in liver metastasis, and inhibits the growth of both primary and metastatic tumor.
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Objective:To investigate the effects of total minimally invasive surgery (TMA) and mixed minimally invasive/open surgery (HMOA) on perioperative conditions and long-term efficacy of patients with rectal cancer.Methods:The clinical data of 240 patients with rectal cancer treated with minimally invasive surgery from January 2014 to August 2018 in Hangzhou Third People′s Hospital were retrospectively analyzed. Among them, 110 patients were treated with TMA (TMA group) and 130 patients were treated with HMOA (HMOA group). The relevant indexes of patients before and after surgery were collected and analyzed.Results:The operation time in TMA group was significantly longer than that in HMOA group: (312.5 ± 20.3) min vs. (210.8 ± 15.2) min, the length of hospital stay was significantly shorter than that in HMOA group: (4.0 ± 0.5) d vs. (6.8 ± 1.0) d, and there were statistical differences ( P<0.01); there were no statistical differences in low anterior resection and surgical procedures, ileostomy, open surgery, postoperative complications, reoperation, morphine dosage at 3 d after surgery and readmission between 2 groups ( P>0.05). Multivariate Cox analysis result showed that BMI ≥ 30 kg/m 2 ( OR=4.11, 95% CI 1.68 to 9.72, P<0.01), TMA ( OR=0.13, 95% CI 0.06 to 0.42, P<0.01), delayed bowel obstruction ( OR=13.6, 95% CI 1.59 to 110.56, P<0.05) and reoperation ( OR=15.32, 95% CI 5.52 to 42.56, P<0.01) were independent risk factors of prolonged hospital stay in patients with rectal cancer. The patients were followed up for 15 to 42 (29.5 ± 0.2) months, and there were no statistical differences in 3-year overall survival (OS) rate and 3-year disease-free survival (DFS) rate between HMOA group and TMA group (92.5% vs. 92.8% and 79.6% vs. 85.5%, HR=1.20 and 0.75, 95% CI 0.35 to 3.14 and 0.28 to 1.34, P=0.98 and 0.25). Conclusions:Patients with rectal cancer treated with TMA have the advantages of shorter hospital stay and shorter short-term effects compared with those treated with HMOA. However, the long-term effects of the two minimally invasive procedures are similar.
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Objective@#To study the clinicopathological features, immunohistochemical phenotype, molecular changes, differential diagnosis and prognosis of eosinophilic solid and cystic renal cell carcinoma (ESC RCC).@*Methods@#A total of 15 cases were selected from 2005 to 2019 at Nanjing Jinling Hospital,Nanjing University School of Medicine for clinicopathological and immunohistochemical analysis, 10 of which were subject to cancer-associated mutation analysis using targeted next-generation sequencing (NGS) panel. A literature review was also performed.@*Results@#The patients′ ages ranged from 15 to 68 years (mean, 33 years). The male-to-female ratio was 1.1∶1.0. During a mean follow-up of 22 months, none of the patients developed tumor recurrence, progression or metastasis. Histologically, the tumors typically demonstrated solid and cystic architectures and the neoplastic cells contained voluminous eosinophilic cytoplasm with prominent granular cytoplasmic stippling. Immunohistochemically, tumor cells in all cases were immunoreactive for CK20. Signal pathway related protein mTOR and S6 were positive in 14/15 and 6/15 cases, respectively. Cathepsin K, Melan A and HMB45 were at least focally positive in 12/15, 6/15 and 2/15 cases, respectively. CK7 and CD10 showed focal immunostain positivity in some cases, while TFE3, TFEB, CA9 and CD117 were negative in all cases. NGS demonstrated TSC1/TSC2 mutations in all tested cases (10/10).@*Conclusions@#ESC RCC is a rare tumor that tends to occur in young patients with an indolent behavior. Diagnosis can be established by its distinct clinical and histopathologic findings, immunohistochemical phenotype and molecular genetics. The tumor may be considered as a new subtype of RCC.
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Objective@#To investigate the clinical manifestations, imaging features, clinicopathologic features, and differential diagnosis of solitary fibrous tumors/anginoblastomas (SFT/HPCs) originating in the central nervous system.@*Methods@#Sixty cases of SFT/HPCs originating in the central nervous system were collected at Nanjing Jinling Hospital, from January 1, 2008 to December 31, 2016. The clinical data, imaging data, histomorphologic changes and immunohistochemical finding were analyzed in the sixty cases.@*Results@#The 60 cases included 26 males and 34 females, aged 14 to 85 (median 49) years. The main clinical manifestations were headache, dizziness with nausea and vomiting. Radiologically, the tumors were large, enhancing, solid and cystic masses attached to the dura. Histopathologically, the neoplasms were composed of spindle cells with oval nuclei, inconspicuous nucleoli and moderate amount of eosinophilic cytoplasm arranged in fascicles with areas of hyalinized stroma, myxoid changes and a staghorn vascular pattern. Immunohistochemically, tumor cells of all cases were positive for vimentin (100.0%, 60/60), STAT6 (98.3%, 59/60), CD34 (61.7%, 37/60), and the tumor cells were typically positive for CD99, bcl-2, EMA and SSTR2 as well.Negative for S-100 protein, SOX10, E-cadherin, GFAP. Ki-67 index ranged from 1% to 50%. Forty cases were followed up for 6 to 82 months with average of 40 months, 30 patients were alive and 10 patients died.@*Conclusions@#Central nervous system SFT/HPCs can be aggressive and relapses may occur several years after diagnosis. STAT6 is highly sensitive and specific for the diagnosis. Complete tumor resection is optional treatment followed by radiotherapy and chemotherapy. There is a correlation between the prognosis and the location of the disease, the histological grade, Ki-67 index, and fusion gene variants.
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Objective At present, there are few studies about myelolipoma within adrenal cortical adenoma.Our aim was to provide more basis for correct diagnosis and treatment by investigation into its clinical and pathological features.Methods The clinical and pathological data were retrospectively reviewed in 11 patients of myelolipoma within adrenal cortical adenoma, along with relative literature reviews.Results The median age of 11 patients (7 females, 4 males) was 49±9.5 years, among whom 3 patients presented Cushing's syndrome, 1 patient with more than 10 years' recurrent dizzy with hypertension, other 7 patients were found coincidently by routine examination.Adrenal mass were found by imaging examination.Pathologically, myelolipomas were in solitary nodule distribution and/or admixed with adrenal cortical adenomas.Myelolipomas were composed of variable admixture of mature adipose tissue and hematopoietic elements.Surgical treatment was performed for all 11 patients, and no relapse was found in 2 months' to 11 years' follow-up.Conclusion Myelolipoma within adrenal cortical adenoma is extremely rare, which is common in females.The patients may present with Cushing's syndrome, hypertension or without obvious clinical syndrome.All the patients are in favorable prognosis after surgical resection.
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Objective In order to play the role of pathological network management system better in pathological examination, this study explore the present status of new pathology network management system, give an objective evaluation for the operation condition, reveal the effectiveness and the existing problems of this system, and provide reference for its development and improvement.Methods The software of pathological network management system was applied to the pathological specimen reception, patient information and examination status query, pathological diagnosis and technology process, as well as the paraffin block archive, statistical analysis, data recording, and so on.At last, we recorded all the information and made a classification and arrangement.Results Pathological network management system was running normally through the whole process of pathologic examination, including specimen receiving, all examinations, print of pathological applications and spontaneous print of pathological reports in ward, which really achieve one-stop services.But the system has unstable phenomenon occasionally.Conclusion Pathological network management system links each examination process closely, which can improve the work efficiency, and provide scientific basis for pathology quality control.
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Objective@#To study the clinicopathologic characteristics and diagnostic criteria of primary mediastinal B-cell lymphoma (PMBL), and to distinguish PMBL from classic Hodgkin lymphoma(CHL) and systemic diffuse large B-cell lymphoma(DLBCL).@*Methods@#The clinical features, histologic findings, results of immunohistochemical study and prgnosis in 27 PMBL cases were analyzed, with review of literature.@*Results@#The age of patients ranged from 19 to 82 years (median age 34 years). All cases were located in the mediastinum and frequently accompanied by superior vein cava syndrome. Histologically, the tumor cells were pleomorphic and diffusely distributed. Clear cytoplasm and spindle tumor cells were seen in some cases. Varying amount of sclerosing stroma with collagen deposition was seen.Immunohistochemical study showed that the tumor cells were positive for CD20(100%, 27/27), CD30 (64.0%, 16/25), CD23 (77.3%, 17/22) and p63 (16/19). Clonal B cell gene rearrangement was seen.@*Conclusions@#PMBL is a subtype of diffuse large B-cell lymphoma with various histomorphology. Immunohistochemistry can help to confirm the diagnosis, and the prognosis is better than diffuse large B cell lymphoma, not otherwise specified.
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Objective@#To study the molecular features of metanephric adenoma (MA) and discuss their values in differential diagnosis.@*Methods@#BRAF V600E immunohistochemistry (IHC) using the mutation-specific VE1 monoclonal antibody and Sanger sequencing of BRAF mutations were performed on 21 MAs, 16 epithelial-predominant Wilms tumors (e-WT) and 20 the solid variant of papillary renal cell carcinomas (s-PRCC) respectively. p16 protein was detected by IHC also. Fluorescence in situ hybridization (FISH) analyses using centromeric probes for chromosome 7 and 17 were performed on the three renal tumors in parallel.@*Results@#Fourteen (14/21, 66.7%) of 21 MA cases demonstrated diffuse, moderate to strong cytoplasmic BRAF V600E IHC staining and the BRAF V600E protein expression was detected in 2 (2/16) of 16 e-WT cases for the first time, whereas all s-PRCCs were negative (P<0.05). All cases (including 14 MAs and 2 e-WTs) with diffuse, moderate to strong cytoplasmic BRAF V600E IHC staining were confirmed to harbor BRAF V600E missense mutations using Sanger sequencing, and no BRAF mutations were detected in cases with negative BRAF V600E protein expression. One case (1/21, 4.8%) showed trisomy of chromosome 7 alone, and another one (1/21, 4.8%) showed trisomy of chromosome 17 alone in 21 MAs. Two cases (2/16) of 16 e-WTs showed trisomy of chromosome 17 alone. In 20 s-PRCCs, trisomy of chromosomes 7 alone was reported in 2 cases (2/20), trisomy of chromosome 17 alone in 3 cases (3/20) and trisomy of chromosome 7 and 17 in 14 cases (14/20). The total positive rates of trisomy of chromosome 7 and/or 17 in MAs, e-WTs and s-PRCCs were 9.6% (2/21), 2/16 and 95.0% (19/20). p16 protein was positive in 81.0% (17/21) MAs, whereas the positive rates in e-WTs and s-PRCCs were 2/16 and 5.0% (1/20).@*Conclusions@#Most MAs harbor BRAF V600E mutations, and MAs lack the gains of chromosome 7 and 17 that are characteristic of papillary renal cell carcinoma. These molecular features can be used to distinguish MA from its mimics. BRAF V600E IHC using the mutation-specific VE1 monoclonal antibody provides an effective method in BRAF V600E mutations detection of renal tumors. p16 is overexpressed in MA, and the finding suggests that the low proliferative rate of the tumor might be attributed to BRAF V600E-induced senescence mediated by p16.
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Objective When pathologists from hospitals at various levels encounters pathological sections diffcult to make clear diagosis, it is necessary to invite pathologists from higher hosiptals or special hospitals for pathologic consultation.In the study, we compared the pathological diagnosis of cases sent to other hospitals for pathological consultation with the original diagnostic result to analyze the differences by the evaluation on the impact of these differences on the treatment and prognosis of these patients, which would provide an effective evidence for the quality control of pathological diagnosis. Methods Cases initially diagnosed at the de-partment of Nanjing General Hospital and later sent to other hospitals for pathological consultation from 2010 to 2014 were collected. All the diagnostic results were examined by at least 3 senior pathologists to find exact diffrences between consultation results and origi-nal diagnostic results. Results Among 2055 cases, it was found that there were 1813 cases (88.2%) without diagnostic discrepan-cy, while 218 cases (10.6%) with minor diagnostic discrepancy and 24 cases (1.2%) with completely distinct diagnostic results. Conclusion The diagnostic results of the vast majority of consultation cases are in accordance with the original results, despite of di-agnostic discrepancies in some cases due to the complexity of disease. Expert consultation has reference for the pathological diagnosis of complicated cases, which also plays a potent supervisory role on the quality control of original pathologic results.
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<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics of primary renal hemangioblastoma.</p><p><b>METHODS</b>The morphologic features, immunophenotype and molecular findings of 3 cases of primary renal hemangioblastoma were studied, with review of literature.</p><p><b>RESULTS</b>The age of patients ranged from 43 to 57 years. There were 2 women and a man. The patients often presented with renal mass. Histologically, the tumors were surrounded by thick fibrous capsule and composed of epithelioid or spindle cells. Two cases had a prominent stromal component and the other one was rich in capillary network. Lipid vacuoles were observed in all cases. Features of hemorrhage were demonstrated in 2 cases. Capsular invasion and necrosis were seen in 1 case. Immunohistochemical study showed that the stromal cells were positive for alpha-inhibin (3/3), S-100 protein (3/3), EGFR (2/2), PAX-2 (2/2), PAX-8 (2/2) and CA9 (2/2) but negative for CKpan (2/2) and HMB45 (2/2). Focal membranous staining for CD10 (3/3) was noted. No VHL gene mutations or chromosome 3p deletion were detected in the 2 cases studied.</p><p><b>CONCLUSIONS</b>Renal hemangioblastoma shows distinctive morphologic appearance with a wide range of variation. The unexpected positive staining for PAX-2, PAX-8 and CD10 in renal hemangioblastoma needs to be aware. Immunohistochemical study may be helpful in differential diagnosis of these renal tumors.</p>
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Purpose To investigate the expression of EphA1 in renal cell carcinomas ( RCC) and to analyze its correlation with clini-copathological parameters in order to explore the clinical significance of EphA1 protein in renal cell carcinomas ( RCC) . Methods The immunocytochemical method was employed to measure the expression of EphA1 in 144 clear cell RCC ( ccRCC) tissues, 18 chro-mophobe RCC tissues and 6 papillary RCC tissues. Correlation between EphA1 protein expression and clinical parameters was evaluated by statistics. Results High level of the expression of EphA1 was observed in all normal renal tubes. The EphA1 protein was negative-ly or weakly expressed in 93 out of 144 ccRCC (64. 6%) and positively expressed in 51 out of 144 ccRCC (35. 4%). Positive expres-sion of EphA1 was observed in all samples of chromophobe RCC and papillary RCC. The high level expression of the EphA1 protein was significantly associated with younger patients (P<0. 001), sex (P=0. 016) and lower nuclear grade (P<0. 001). No significant relation between the expression of EphA1 and tumor diameter was found ( P=0. 316 ) . Conclusion EphA1 protein may be a new marker for the prognosis of ccRCC.
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<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype, differential diagnosis and prognosis of renal cell carcinoma (RCC) associated with t(6;11)(p21.2;q13)/MALAT1-TFEB gene fusion.</p><p><b>METHODS</b>A total of 9 cases of such rare tumor were selected for clinicopathologic, immunohistochemical and molecular analysis, with review of literature.</p><p><b>RESULTS</b>The age of the patients ranged from 21 to 42 years (mean=31.3 years). The patients included four men and five women. Histologically, 4 of the 9 cases studied showed classic morphologic features of TFEB RCC, with hyaline material, pigments and psammoma bodies frequently identified. The remaining 5 cases demonstrated uncommon morphology, mimicking perivascular epithelioid cell neoplasm, clear cell RCC, chromophobe RCC or papillary RCC. Immunohistochemical study showed that TFEB and vimentin were positive in all cases. Most of the tumors studied also expressed Ksp-cadherin, E-cadherin, CD117, HMB45, Melan A and Cathepsin K. CKpan showed immunostaining in only 1 case. The staining for TFE3, CD10 and CK7 were all negative. TFEB gene rearrangement was detected in all the 9 cases studied using fluorescence in-situ hybridization. MALAT1-TFEB fusion gene was identified in 2 cases by polymerase chain reaction and direct sequencing. TFEB RCC seemed to be an indolent tumor. During a mean follow-up of 31 months, none developed tumor recurrence, progression, or metastasis.</p><p><b>CONCLUSIONS</b>TFEB fusion-associated RCC is a rare neoplasm, tends to occur in young age group and carries an indolent behavior. Diagnosis relies on clinicopathologic findings and immunohistochemical analysis. TFEB break-apart FISH assay is a reliable tool in confirming the diagnosis.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Basic Helix-Loop-Helix Leucine Zipper Transcription Factors , Genetics , Carcinoma, Renal Cell , Genetics , Pathology , Chromosomes, Human, Pair 11 , Chromosomes, Human, Pair 6 , Diagnosis, Differential , Gene Fusion , Gene Rearrangement , Genes, Neoplasm , Immunohistochemistry , In Situ Hybridization, Fluorescence , Kidney Neoplasms , Genetics , Pathology , Prognosis , RNA, Long Noncoding , Genetics , Translocation, GeneticABSTRACT
Purpose To explore the clinicopathological characteristics of primary non-Hodgkin lymphoma ( PNHL) of lung. Methods The clinical features, morphology and immunohistopathological phenotypes were retrospectively studied in 28 cases of PNHL and re-viewed of the literature. Results The composition of this group of cases is 18 cases of male, 10 cases female. The a median age of pa-tients was 57 years old. According to the WHO classification, all of the 28 cases of in our PNHL series were diagnosed as non-Hodgkin lymphoma ( NHL) , including 17 mucosa-associated lymphoid tissue extranodal marginal zone lymphomas ( MALT) , 5 diffuse large B cell lymphomas ( DLBLC) , 2 NK/T cell lymphomas and 2 anaplastic large cell lymphomas, 1 mantle cell lymphoma ( MCL) and 1 pe-ripheral T cell lymphomas, unspecified, respectively. One-third PNHL patients presented with specific clinical symptoms such as cough, chest pain, dyspnea, and fatigue, Imaging examination showed unilateral or bilateral pulmonary infiltrate, single lesions or multiple nodules, and the lesions always involved with the trachea, bronchus and lung. Follow-up was completed in 16 patients ( range, 3 to 38 months) . 3 cases were conducted with pneumonectomy, among which 2 cases were given postoperative adjuvant chem-otherapy. Seven patients were given chemotherapy alone, and 5 patients did not give any treatment following initial diagnosis. At the time of last follow-up, 13 patients were alive with disease, 2 patients were died. The tumor metastasis in the left inguinal lymph node was found in one patient after 2 years by surgery. Conclusions It was shown that there was no specific clinical manifestations and fea-tures of pulmonary PNHL. Among of them, the MALT is the most common diseases, and the highly aggressive lymphomas many be oc-cur, such as the DLBLC, NK/T cell lymphoma. The diagnosis of PNHL depends on pathological examination. The immunohistochemi-cal staining and molecular pathological technology may helpful for the diagnosis and differential diagnosis of the tumors.
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Purpose To study the clinicopathologic features retrospectively and to explore the prognosis of 15 cases of young pulmonary primary salivary gland tumor. Methods The 15 cases of young pulmonary primary salivary carcinoma were analyzed respectively. Re-sults The 15 cases showed 7 cases with adenoid cystic carcinoma and 8 cases with mucoepidermoid carcinoma. Cough and bloody sputum were main symptoms, while chest pain, chest distress and fever were less seen. There were 10 cases performed with partial pul-monary lobectomy, 3 cases performed with unilateral total lobectomy, 1 case performed with artery perfusion treatment and bronchial ar-tery embolization and 1 case performed with conservative treatment for pancreatic metastasis after diagnosis. The mean follow-up time was 28 months ( from 4 to 96 months) . Conclusion The primary salivary gland-type lung tumor belonged to benign or low-grade ma-lignant tumor, mainly accompanied with hacking cough and bloody sputum, which was commonly found in trachea and bronchus. Final diagnosis could be made through bronchoscopy and biopsy. Complete surgical excision is the primary method and the prognosis is usual-ly good, especially in the young.
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Purpose To investigate the clinicopathological changes of the diffuse-type giant cell tumor of the bone and joint. Methods 42 cases of the diffuse-type giant cell tumor of the bone and joint were studied and the follow-up data were reviewed. Results The male patients were 19 and the female were 23, with the male to female ratio of 1 ∶ 1. 2. The age of the patients was 8~69 years (the average age was 37. 6). It was displayed that the patients presented local pain and swelling (34 cases), including dysfunction (18 ca-ses) of the bone and joint. Clinically, the lesions located on the knee joint ( 71. 4%) in 30 cases, the hip and ankle in 9 cases (21. 4%), and the wrist elbow in 3 cases (7. 1%). 27 cases were examined by MRI. Among them, the diffuse-type giant cell tumor was diagnosed in 9 cases (33. 3%). The effusive lesions of the joint presented in 5 cases, the non-specific synovial lesions and others in 3 cases. The obviously diffuse hyperplasia of synovial cells with nodular growth pattern was found. However, a high proliferative in-dex of the tumor cells and the rich-cell tumor were found. But there was no tumor necrosis. Histopathologically, the tumor cells of dif-fuse-type giant cell tumor contained marked brown pigments, multinucleated giant cells formation and a lot of lymphocytes proliferation or follicular reaction in 17 cases (40. 5%) with invasive growth and involvement of the joint and surrounding tissue. 6 cases recurred (20%) , including 2 cases with 2 times. Conclusions The diffuse type-giant cell tumors most commonly involve the knee, followed by the hip and ankle. Preoperative examination of MRI can be help for the diagnosis of the tumor. Histopathologically, diffuse-type gi-ant cell tumor with synovial cells rich-hyperplasia and the villous structures formation more likely recur. The main biological character-istics of diffuse-type giant cell tumor are invasive growth pattern, usually into the soft tissue around the joints.
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Purpose To investigate the expression and significance of HLA-G in ovarian serous carcinoma ( OSC) . Methods HLA-G antigen was immunohistochemically labeled on paraffin-embedded sections of 108 OSCs. The relationship between HLA-G expression and the clinicopathologic parameters was studied. Results The positive expression of HLA-G was observed in 58. 33% (63/108) of OSC tissues. Positive expression of HLA-G was significantly related with lymph node metastasis, recurrence, occurrence site, FIGO stage and MDACC grading system (P<0. 05). In survival analysis, the expression of HLA-G was significantly relevant to prognosis (P=0. 015). Multivariate Cox analysis showed the expression of HLA-G was an important prognosis factor of OSC (P=0. 01). Con-clusion The positive expression of HLA-G could predict high grade and advanced stage of OSC as well as poor prognosis. Also it could distinguish high-grade OSC from low-grade OSC.
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To explore the automated immunostainer screening anaplastic lymphoma kinase (ALK) gene fusion non-small cell lung cancer (NSCLC) and clinicopathological characteristics of the molecular subtype lung cancers. Methods Five hundred and sixty-six cases of NSCLC were collected over a 16 month period. The test for ALK was performed by Ventana automated immunostainer with anti-ALK D5F3. The histological features, treatment and outcome of patients were assessed. Results Thirty-eight cases (6.7%, 38/566) of NSCLC showed ALK gene fusion. The frequency of ALK gene fusion was higher in male (7.1%, 25/350) than that in female (6.0%, 13/216) patients, but not achieving statistical significance (chi2 = 0.270, P = 0.604). ALK + NSCLC was more significantly more frequent in patients < or = 60 years (9.9%, 28/282) than >60 years (3.5% , 10/284) of age. Histologically, the ALK + NSCLCs were mostly adenocarcinoma (81.6%, 31/38) , among which eighteen cases were solid predominant subtype with mucin production; nine cases were acinar predominant subtype; one case was papillary predominant subtype and three cases were invasive mucinous adenocarcinoma. The ALK + non-adenocarcinoma included three cases of squamous cell carcinoma, three cases of adenosquamous carcinoma and one case of pleomorphic carcinoma. Among the ALK + NSCLC patients, the number of non/light cigarette smokers (86. 8% , 33/38) was more than that of heavy smokers. Twenty-nine cases were stages III and IV; twenty-nine cases showed lymph node metastasis; twenty cases showed metastases mostly to brain and bone; and one case showed EGFR gene mutation coexisting with ALK gene fusion. Twelve of fifteen patients received crizotinib therapy and remained stable. Conclusions NSCLC with ALK gene rearrangement shows distinctive clinical and histological features. Ventana-IHC may he a feasible and valid technique for detection of ALK rearrangement in NSCLC.
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Female , Humans , Male , Middle Aged , Adenocarcinoma , Genetics , Pathology , Carcinoma, Adenosquamous , Genetics , Pathology , Carcinoma, Non-Small-Cell Lung , Genetics , Pathology , Carcinoma, Squamous Cell , Genetics , Pathology , Gene Fusion , Gene Rearrangement , Lung Neoplasms , Genetics , Pathology , Protein Kinase Inhibitors , Therapeutic Uses , Pyrazoles , Therapeutic Uses , Pyridines , Therapeutic Uses , Receptor Protein-Tyrosine Kinases , Genetics , Sex FactorsABSTRACT
Purpose To investigate the clinicopathological and immunohistochemical features of primary renal lymphomas ( PRL) , and to discuss the diagnosis, differential diagnosis, treatment and prognosis of the tumors. Methods Clinical data of 19 patients with PRL from January 2005 to October 2014 were retrospectively analyzed. Result The 19 patients in this study, there were 11 males and 8 females and the age ranged from 37 to 85 years old (averaged 55). Patients were mainly presented with unilateral renal masses, with lumbodynia as the main symptom. 13 patients underwent nephrectomy, 6 patients underwent renal biopsy and 17 patients received CHOP or R-CHOP chemotherapy. All of them were diagnosed as non-Hodgkin’ s lymphoma, with 14 cases of diffuse large B cell lym-phoma (DLBCL) (73. 684%, 14/19), 4 cases of B cell small cell lymphoma (21. 053%, 4/19), and 1 cases of T cell lymphoma (5. 263%, 1/19). Follow-up information was available in 15 patients. 12 were still alive and survived for 1~78 months, while the other 3 were dead with 1 case who died of cerebral infarction, and survived for 3~38 months ( averaged 23 months) . Conclusion PRL is an extranodal lymphoma which is rare in kidney and is often misdiagnosed as renal carcinomas due to its nonspecific clinical manifestations. The diagnosis of PRL can be confirmed by histopathological examination, immunohistochemistry and molecular analy-sis. The majority of the lymphomas are B cell lymphomas and most of them are DLBCL. The recommended treatment is surgery com-bined with chemotherapy and the prognosis is associated with the age, clinicopathological characteristics, tumor types and treatment.
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<p><b>OBJECTIVE</b>To study the expression, clinicopathologic correlation and prognostic significance of caveolin-1 in lung adenocarcinomas(LAC).</p><p><b>METHODS</b>Immunohistochemical study (EnVision method) for caveolin-1 and TTF-1 was carried out in 185 cases of LAC encountered during the period from 2005 to 2010. The correlation between caveolin-1 expression and various clinicopathologic parameters was analyzed statistically.</p><p><b>RESULTS</b>The rate of caveolin-1 expression in the 185 cases of LAC was 26.5% (49/185) and significantly lower than that in normal lung tissue (P<0.01). There was also higher rate of caveolin-1 expression in male patients (P=0.004), smokers (P=0.006), tumors larger than 3.5 cm (P=0.048), predominantly solid tumor subtype (P=0.025), high tumor grade (P=0.044), tumors with vascular invasion (P=0.019), lymph node metastasis (P=0.030), recurrence (P=0.021) and high clinical stage (P=0.027). The expression level of caveolin-1 in TTF1-negative cases was significantly higher than that in TTF1-positive cases and caveolin-1 expression also negatively correlated with TTF-1 expression in LAC (r=-0.154, P=0.037). The five-year overall survival rate of patients with caveolin-1 positive tumors was lower than that in caveolin-1 negative group (P<0.01).Univariate analysis indicated the expression level of caveolin-1 and TTF-1 (P<0.01), histologic subtype (P=0.002), tumor grade (P=0.002), tumor size (P=0.009), vascular invasion (P=0.019), lymph node metastasis (P=0.018), recurrence (P=0.032) and clinical stage (P=0.024) correlated with the survival of patients with LAC. COX multivariate analysis revealed that LAC with caveolin-1 positive expression, TTF-1 negative expression and high tumor grade carried a significantly unfavorable prognosis.</p><p><b>CONCLUSION</b>Caveolin-1 expression correlates with histologic subtype, tumor grade, invasiveness and metastatic potential of LAC. The detection of caveolin-1 in LAC is helpful in predicting prognosis.LAC with caveolin-1 expression carries a poor prognosis.</p>