[Breast cancer subtypes based on ER/PR and Her2 expression: comparison of MR imaging features].

OBJECTIVE: To evaluate the magnetic resonance (MR) imaging findings of breast cancer subtypes based on the profiles of ER/PR and Her2. METHODS: A retrospective study was conducted for 267 breast cancer subjects between February 2007 and January 2011. Clinicopathologic features and MR imaging findings of four subtypes were compared. The Chi-square (χ(2)) test, Fisher's exact test and χ(2) section method were employed for categorical variables. RESULTS: MR imaging findings:Patients with segment or linear enhancement type accounted for 25.6% in ER/PR(+), Her2(+) subtype group and 36.1% in ER/PR(-), Her2(+) subtype, no significant difference existed between them (χ(2) = 1.112, P = 0.641). But they were significantly higher than ER/PR(+), Her2(-) subtype group and ER/PR(-), Her2(-) subtype group (χ(2) = 32.793, P < 0.001; χ(2) = 14.565, P < 0.001). ER/PR(-), Her2(-) subtype patients accounted for 14.6% of the total breast cancer patients (39/267). Subjects with ER/PR(-), Her2(-) subtype were more likely to present unifocal (91.7%, 33/36) and mass type lesion (92.3%, 36/39). The mass type lesions in ER/PR(-), Her2(-) subtype group were more likely to showed smooth margin [58.3% (21/36), P < 0.001], very high intratumoral signal and peripheral hyperintense pattern on fat suppression T2-weighted imaging (P < 0.001) and early rim enhancement [81.5% (29/36), P < 0.001]. No significantly difference of four subtypes were found on number of mass, mass shape and pattern at dynamic enhancement imaging (χ(2) = 1.413, P = 0.713; χ(2) = 8.423, P = 0.204; χ(2) = 4.657, P = 0.540). CONCLUSION: Segment or linear enhancement type is characterized by MR imaging. Early rim enhanced mass is ER/PR(-), Her2(-) breast cancer. The most important characteristics of MR imaging include a smooth edge of breast mass, very high intratumoral signal on fat suppression T2-weighted imaging and peripheral hyperintense pattern.

[Clinicopathologic study on 61 cases of uterine papillary serous carcinoma with or without adjuvant therapy].

OBJECTIVE: To study the clinicopathologic features of uterine papillary serous carcinoma (UPSC) and the roles of adjuvant therapy. METHODS: Sixty-one cases of UPSC with operation done and followed up for a period of 4 to 9 years were enrolled into the study. The histology of slides specimens were reviewed and immunohistochemical study was performed. The follow-up and survival data were analyzed. RESULTS: All of the 61 patients were post-menopausal, with a median age of 68 years. The clinical presentations included abnormal vaginal bleeding, abdominal symptoms and abnormal Pap smears. The median size of the tumors was 7.5 cm (range=1.2 to 14.8 cm). There were 27.9% cases in FIGO stage I (8.2% in stage IA, 14.8% in stage IB and 4.9% in stage IC), 9.8% in stage II, 32.8% in stage III and 29.5% in FIGO stage IV. The histologic features were similar to those of the ovarian counterpart, with tumor cells containing the high-grade nuclei and arranged in complex papillae. Psammoma bodies were identified in 24.6% of the cases. Immunohistochemical study showed that the tumor cells demonstrated diffuse and strong nuclear staining for p53 and Ki-67. They were negative for estrogen receptor and progesterone receptor. Fifteen of the 61 cases (24.6%) showed no evidence of myometrial invasion. However, ten of the 15 cases had extrauterine disease, with peritoneal (6/15) and nodal (9/15) involvement. Tumors with deep myometrial invasion, lymphovascular permeation and nodal metastasis were associated with worse prognosis by univariate analysis. Fifty-six patients received adjuvant therapy. The number of patients receiving adjuvant chemotherapy alone, adjuvant radiotherapy alone and combined adjuvant chemotherapy/radiotherapy were 42, 24 and 10, respectively. The median survivals of the chemotherapy group and non-chemotherapy group (with or without radiotherapy) were 66.4 months and 32.8 months, respectively. CONCLUSIONS: UPSC has distinctive clinical and pathologic features. The tumor stage, lymph node status, lymphovascular permeation and depth of myometrial invasion were important prognostic factors. Adjuvant chemotherapy for stage III/IV tumors or recurrent UPSC may have survival benefit.

Features of intestinal T-cell lymphomas in Chinese population without evidence of celiac disease and their close association with Epstein-Barr virus infection.

BACKGROUND: Intestinal T-cell lymphoma (ITCL) is a heterogeneous lymphoid neoplastic group with variable clinical and pathological features. ITCL in oriental countries is different from enteropathy-type intestinal T-cell lymphoma (ETCL) in relation to celiac disease and Epstein-Barr virus (EBV). The objective of this study was to investigate the clinicopathological features, immunophenotype, expression of cytotoxic molecule (TIA-1), T-cell receptor (TCR)-gamma gene rearrangement, and Epstein-Barr virus (EBV) latent infection in primary ITCL without celiac disease in Chinese. METHODS: The clinical data of 42 patients were analyzed, and the patients were followed up. Compared with human reactive lymphoid tissues, in situ hybridization for EBER1/2, polymerase chain reaction for TCR-gamma gene rearrangement, and immunohistochemical staining for immunophenotypes, TIA-1 and EBV latent membrane proteins (LMP-1) were investigated. Survival curves of different clinicopathological features, immuno-phenotypes, expression of LMP1, TCR-gamma gene rearrangement and therapy were analyzed. RESULTS: Three fourths of the patients suffered from ITCL in China were men with a peak age incidence in the 4th decade. Common presenting features included fever and hemotochezia. The prognosis was poor with a median survival of 3.0 months. The lesions were mostly localized in the ileocecum and colon. About 38/42 (90.5%) patients demonstrated pleomorphic medium-sized on large cells. Histological features of celiac disease were rarely seen. All 42 patients with ITCL revealed CD45RO positive. Neoplastic cells partially expressed T-cell differentiated antigens (CD3epsilon, CD4, CD8) and NK cell associated antigen (CD56). The positive frequency of CD3epsilon, CD4, CD8 and CD56 was 28/42 (66.7%), 7/42 (16.7%), 10/42 (23.8%) and 12/42 (28.6%) respectively. Thirty-nine cells (92.9%) expressed TIA-1, but none expressed CD20 and CD68. More than half of the patients (64.3%, 64.3% and 59.5%) revealed TCR-gamma gene rearrangement by three different TCR-gamma primers respectively. EBER1/2 was detected in 41 (97.6%) of the 42 patients. The expression frequency of LMP-1 was 38.1% (16/42). CONCLUSIONS: Primary ITCL without celiac disease in Chinese is a special highly EBV-associated clinicopathological entity. There are few similarities in patients with celiac disease in western countries. A small proportion of primary ITCLs in Chinese and extranodal NK/T-cell lymphoma of nasal type belong to the same spectrum.

Influence of N,N'-diacetyl-L-cystine on D-galactosamine/lipopolysaccharide induced immunological liver failure in mice.

AIM: To study the therapeutic effects of N,N'-diacetyl-L-cystine (DiNAC) on immunological liver failure. METHODS: Serum ALT, AST and T cell subsets in peripheral blood of the experimental animals during the trial period were analyzed by an automatic serum analyzer and a flow cytometer, respectively. The sectioned liver specimens were examined under a light microscope. And 24 h after the injection of Gal/LPS, the survival rate of rats was calculated. RESULTS: DiNAC (50, 200, 800 mg x kg(-1), i.p.) suppressed the elevation of serum levels of ALT and AST, markedly enhanced proliferation and differentiation of T cell subsets (CD4+, CD8+ and Th1, Th2), and improved all the histopathological features. In mice of fulminant hepatic failure (FHF), the survival time significantly prolonged and the survival rate increased 24 h after i.p. DiNAC. These effects were obviously dose-dependent. CONCLUSION: DiNAC on mice with FHF has an inhibitory action which is related to immune mechanism.