Primary hepatic angiosarcoma: a clinicopathological analysis of nine cases / 中华病理学杂志

Objective: To investigate the clinical manifestations, histomorphology, and differential diagnosis of primary hepatic angiosarcoma. Methods: Nine cases of primary hepatic angiosarcoma diagnosed in the Department of Pathology, the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2021 were collected, including biopsy and surgical specimens. The histomorphology, clinical, and radiologic findings were analyzed. The relevant literature was also reviewed. Results: There were six males and three females, aged 30 to 73 years (mean 57 years). Grossly, the growth pattern of the tumor was classified as either mass formation or non-mass formation (sinusoidal). Microscopically, the mass-forming primary hepatic angiosarcoma were further subdivided into vasoformative or non-vasoformative growth patterns; and those non-vasoformative tumors had either epithelioid, spindled, or undifferentiated sarcomatoid features. Sinusoidal primary hepatic angiosarcoma on the other hand presented with markedly dilated and congested blood vessels of varying sizes, with mild to moderately atypical endothelial cells. Follow-up in all nine cases revealed 8 mortality ranging from 1 to 18 months (mean 5 months) from initial diagnosis. One patient was alive with disease within a period of 48 months. Conclusions: Primary hepatic angiosarcoma is a rare entity with a wide spectrum of histomorphology, and often misdiagnosed. It should be considered when there are dilated and congested sinusoids, with overt nuclear atypia. The overall biological behavior is aggressive, and the prognosis is worse.

Survey of HIV infection in men who have sex with men living for 5 years or less in Wenzhou, Zhejiang province / 中华流行病学杂志

Objective: To assess the prevalence of HIV infection and related factors in men who have sex with men (MSM) living for ≤5 years in Wenzhou of Zhejiang province. Methods: MSM who were aged ≥16 years, had lived in Wenzhou for ≥3 months and had anal sex and/or oral sex with men in the last 12 months were recruited through respondent-driven sampling (RDS) from February to October in 2015. The MSM recruited completed a questionnaire for the information collection on socio-demographic characteristics, sexual behavior, awareness of HIV and related intervention, mental health status. Blood samples were collected from them for serological detection of HIV and syphilis antibodies. Software SPSS 18.0 was used to analyze HIV infection and related factors. Results: A total of 454 MSM were investigated, 108 of them (23.7%) were HIV positive. There were 267 MSM who lived in Wenzhou for ≤5 years, and 73 of them (27.3%) were HIV positive. Most of them were workers and commercial servants aged ≥25 years with personal monthly income <4 000 yuan and educational level of junior high school or below. According to multiple logistics regression analysis, age of 25-68 years old (OR=12.19, 95%CI: 2.29-65.02), heterosexual behavior in recent 6 months (OR=0.42, 95%CI: 0.18-0.96), believing it was possible to be infected with HIV (OR=0.06, 95%CI: 0.01-0.95), believing it was impossible to be infected with HIV (OR=0.03, 95%CI: 0.01-0.35) and syphilis status (OR=3.32, 95%CI: 1.05-10.52) were the risk factors associated with HIV infection. Conclusion: Compared with MSM who lived in Wenzhou for >5 years, MSM who lived in Wenzhou for ≤5 years had higher HIV infection rate and higher prevalence of risk behavior. It is necessary to conduct targeted intervention among them.

Association between AOX1, IRF4 methylation in peripheral blood leukocyte DNA and the risks of breast cancer: a case-control study / 中华流行病学杂志

Objective: To understand the relationship between AOX1, IRF4 gene methylation status in peripheral blood leukocyte DNA, as well as its interaction with environmental factors, and the risk of breast cancer. Methods: A case-control study was conducted among 401 breast cancer patients and 555 cancer-free controls selected from 2010 to 2014. Methylation sensitive-high resolution melting curve analysis was used to detect the methylation status of AOX1 and IRF4. The multiplication interaction effect between genes' methylation and environmental factors on the risk of breast cancer was analyzed by using unconditional logistic regression, and Excel software was used to analyze the additive interaction effect. Results: Individuals without AOX1 methylation had a 1.37-fold (95%CI: 1.02-1.84) higher breast cancer risk compared to individuals with AOX1 methylation. AOX1 methylation interacted with fungi intake (OR=2.06, 95%CI: 1.12-3.79) and physical activity (OR=2.18, 95%CI: 1.16-4.09) synergistically, on the risk for breast cancer, but no additive interaction effects were observed. Non-methylation of IRF4 could increase the risk for breast cancer, with statistical significance (OR=1.71, 95%CI: 0.99-7.43). Neither multiplication nor additive interactions were observed between IRF4 methylation and environmental factors. Conclusion: Non-methylation of AOX1 and IRF4 were a risk factors for breast cancer.