Myxoid liposarcoma: magnetic resonance imaging appearances with clinical and histological correlation

Myxoid liposarcoma is the most common type of liposarcoma. The magnetic resonance imaging (MRI) features of this tumor were evaluated and correlated with its clinical and histological features in seven patients to determine under what circumstances the tumor should be considered in differential diagnosis and why its signal intensity differs from those of lipoma and lipoma-like (lipoblastic) liposarcoma. In all patients the tumor presented in a lower extremity (5 thigh, 2 calf) as a painless, slowly growing mass which had been present for several months to several years. MRI examination revealed the tumors to be encapsulated, noninfiltrating, and usually septated. On T₁-weighted sequences five of seven lesions (71%) showed lacy, amorphous, or linear foci of high signal within a low signal mass. These foci are believed to represent fat within the tumor and distinguish it from several other benign and malignant masses. If an indolent mass in a lower extremity demonstrates a predomiantly low signal with a few amorphous or linear high signal foci on T₁-weighted sequences, one should consider the possibility of myxoid liposarcoma even if it appears benign by all other criteria. Histologic evaluation showed that myxoid liposarcomas contain less than 10% mature fat, which accounts for their low signal on T₁-weighted sequences in contrast to the high signal of lipomas and lipoblastic liposarcomas.     

实验性风湿性心脏炎动物模型的建立

目的　建立风湿性心脏炎动物模型 ,观察其心脏病理改变 .方法　 73只家兔随机分为 组 (n=11)和 组 (n=6 2 ) , 组应用 A组乙型溶血性链球菌静脉感染并结合感染后青霉素肌肉注射 ,根据心肌病理结果将 组存活家兔分为 A风湿性心脏炎组和 B单纯感染组 ;观察各组外周血WBC,ESR,ASO,CIC,CRP的变化 ;应用促凝血活性试验测定感染后家兔外周血淋巴细胞的促凝血活性 (PCA) ;应用HE染色和透射电境观察各组心脏病理变化 .结果　 A组家兔占 组存活家兔的 4 1.6 7% ,HE染色显示存在粘液样和纤维素样变性、风湿细胞浸润、类阿孝夫小体样肉芽肿和风湿性赘生物形成等病理改变 ,透射电境下所见与临床风湿性心脏炎心肌超微结构相似 ; A组 WBC,ESR,ASO,CIC,CRP增高较 B组明显且持续时间较长 ,其中 WBC,ESR,ASO变化呈明显的双峰改变 ,其 PCA值显著高于 组和 B组 ,(2 9.0 6± 12 .87) % vs(8.95± 3.2 2 ) %和 (12 .0 9±5 .96 ) % (P<0 .0 1) .结论　本研究建立的家兔风湿性心脏炎动物模型较为可靠 ,风湿性心脏炎的发病率较同类研究明显增高 ,心脏病理特点和实验室结果均证明家兔风湿性心脏炎的存在 ,可用于进一步的实验研究 .     

宫颈癌患者血清和癌组织中NF-κB及TNF-α蛋白的表达及其意义

目的：探讨不同宫颈病变患者血清和宫颈组织中核因子（NF-κB）及肿瘤坏死因子α（TNF-α）蛋白的表达,阐明其生物学意义和早期联合诊断的价值。方法：对100例有宫颈癌病变高危因素的患者（宫颈炎37例、宫颈内瘤变39例和宫颈癌24例）抽取静脉血同时行阴道镜检。采用ELISA方法检测血清及镜检宫颈组织中NF-κB和TNF-α蛋白的含量;采用RT-PCR法检测宫颈组织中NF-κB及TNF-α的mRNA表达水平;采用免疫组织化学方法检测宫颈组织中NF-κB及TNF-α的蛋白表达;结合临床病理特点进行分析。结果：宫颈内瘤变及宫颈癌患者血清及镜检组织中NF-κB和TNF-α含量明显高于宫颈炎患者（P<0.01）,宫颈癌患者其含量明显高于宫颈内瘤变患者（P<0.01）;宫颈内瘤变和宫颈癌患者宫颈组织中NF-κB和TNF-α mRNA及其蛋白表达水平明显高于宫颈炎患者（P<0.01）,且宫颈癌患者宫颈组织中其表达水平明显高于宫颈内瘤变患者（P<0.01）。宫颈炎、宫颈内瘤变及宫颈癌患者宫颈组织中NF-κB与TNF-α含量呈正相关关系（r=0.69,P＜0.05）。结论：NF-κB和TNF-α均可独立作为早期诊断宫颈癌前病变及宫颈癌的标记物,二者的正相关性使得联合检测可提高宫颈癌的早期诊断率。     

Bilateral vocal fold immobility: Clinical findings of ten cases and suggested treatment options

ObjectiveTo present the clinical findings of 10 cases of bilateral vocal fold immobility (adducted type) and suggest potential treatment options.MethodsThis retrospective study included 10 patients who underwent tracheostomy for restricted airway due to bilateral vocal fold immobility of the adducted type during the period from 2007 to 2017. All 10 patients underwent unilateral laterofixation surgery with or without additional arytenoidectomy using a CO₂ laser. The effect of laterofixation surgery for decannulation was evaluated. Statistical analysis was performed to assess the effects of laterofixation based on the results of preoperative and intraoperative examinations including endoscopic examinations, electromyography, and the intraoperative traction-mobility test.ResultsInitial laterofixation surgery for decannulation was effective in 6 cases. In the 4 cases that exhibited laterofixation failure, additional endoscopic subtotal arytenoidectomy was performed. Statistical analysis of the effects of laterofixation revealed that, in cases with bilateral preserved muscle tone, unilateral simple laterofixation surgery was unable to achieve a significantly effective glottal airway. Additional subtotal arytenoidectomy was also ineffective in a case with bilateral ankylosis.ConclusionBased on the clinical findings in these 10 cases of bilateral vocal fold immobility of the adducted type, treatment options are suggested and a severity classification system of bilateral vocal fold immobility is proposed that focuses mainly on electromyography results for assessment of dynamic restenosis and traction-mobility test results for assessment of static restenosis. Validation of the classification system is needed in a larger cohort of cases of bilateral vocal fold immobility.     

Case report 619

A case of intraosseous lipoma of the sacrum with dystrophic calcification and cystic degeneration is presented. The differential diagnosis of fat-containing bone tumors is considered.     

免疫组化检测端粒酶活性和p53在宫颈上皮内瘤变及宫颈癌中的表达

目的:探讨免疫组化检测端粒酶活性与宫颈癌变发生的关系,以及p53在宫颈肿瘤中的表达.方法:采用免疫组化S-P法检测端粒酶活性及p53的表达,对11例慢性宫颈炎,64例各级宫颈上皮内瘤变(CIN),20例宫颈浸润性鳞癌(ISCC)进行对比研究分析.结果:端粒酶在宫颈慢性炎中无表达,在CIN Ⅰ,Ⅱ,Ⅲ级中,阳性表达逐渐增强,阳性率分别为30%(6/20),31.82%(7/22), 77.27%(17/22),在ISCC中高表达,阳性率为80%(16/20).结果表明,端粒酶活性表达在炎症组,低级别CIN,高级别CIN及癌这三者间有差异;p53的表达在各级CIN之间差异有显著性.结论:免疫组化检测端粒酶活性方法简便易行,对宫颈癌变的早期病理诊断有一定意义.     

舒林酸诱导胃癌BGC-823细胞凋亡的研究

目的 探讨舒林酸诱导人胃癌BGC-823细胞株凋亡的作用及其机制。方法将舒林酸作用于人胃癌BGC-823细胞，并设置不同的作用浓度和作用时间，应用流式细胞术、TUNEL法检测胃癌细胞的凋亡率；免疫组化（S-P）法检测凋亡基因蛋白bcl-2、Sru—vivin的表达以及环氧合酶-2（COX-2）蛋白的表达情况。结果 流式细胞仪检测出凋亡峰；其凋亡检测率及TUNEL法检测的细胞凋亡率均高于对照组（P〈0.05）；免疫组化结果显示凋亡基因蛋白bcl-2、survivin等在胃癌细胞表达下降，COX-2蛋白的表达阳性率也显著低于对照组，均呈时间和剂量依赖性（P〈O.05）。结论舒林酸可诱导胃癌BGC-823细胞凋亡，其机制与抑制凋亡抑制基因bcl-2和survivin的表达及下凋COX-2蛋白的表达有关。     

胆囊癌组织CD15抗原表达意义

目的 探讨CD15抗原的表达及含量与胆囊癌的临床病理意义。 方法 应用微波-LSAB免疫组织化学法和图象分析技术,检测45例胆囊癌,17例胆囊腺瘤和10例慢性胆囊炎组织中CD15抗原表达及含量。 结果 CD15抗原表达阳性率及阳性细胞积分A值,在胆囊癌中(71％,4.0±3.2)显著高于胆囊腺瘤(35％,0.9±0.3)和慢性胆囊炎(20％,0.4±0.1)(P<0.05,P<0.01);胆囊癌Ⅱ,Ⅲ级(90％,5.4±1.7)显著高于Ⅰ级(58％,2.2±3.1)(P<0.05,P<0.01);有转移的肿瘤(88％,6.5±3.5)(P<0.05,P<0.01);显著高于无转移的肿瘤(52％,3.3±2.1)(P<0.01)。 结论 CD15抗原表达与胆囊癌的发生、细胞增殖、分化和转移相关,对判断胆囊癌的恶性程度、预测生物学行为和预后具有一定临床意义。     

Sema4C在喉鳞状细胞癌组织中的表达及意义

目的:探讨脑信号蛋白4C(Sema4C)在喉鳞状细胞癌组织中的表达及意义。方法:采用免疫组化EnVision 二步法检测82例喉鳞状细胞癌及癌旁正常喉黏膜组织中Sema4C和微小染色体维持蛋白2(MCM2)蛋白的表达水平,用D2-40标记淋巴管,计数微淋巴管密度(LMVD),分析三者的表达水平变化与临床病理指标的关系。结果:Sema4C、MCM2蛋白在喉鳞状细胞癌组织中的阳性率分别为60%(49/82)及98%(80/82),均显著高于癌旁正常喉黏膜组织(P<0.01),LMVD在癌及癌旁喉黏膜中的差别无统计学意义(P=0.077); Sema4C、MCM2的表达水平与颈部淋巴结转移有关,与年龄及肿瘤T分级无显著相关。Sema4C、MCM2 蛋白表达水平和LMVD,两两间均呈正相关关系(P<均0.05)。结论:Sema4C的异常高表达与喉鳞状细胞癌的发生发展、转移及预后有关,提示Sema4C有可能成为判断喉鳞状细胞癌生物学行为及预后指标。     

Immunocytochemical results for HER2 and Ki67 in breast cancer touch-smear cell specimens are reliable

Background

Re-evaluation of the subtype of recurrent breast cancer is necessary for deciding the treatment approach, but it is often not performed due to the difficulty of obtaining tissue specimens from a recurrent lesion, etc. However, when a recurrent lesion is close to the body surface, fine-needle aspiration cells (FNA cells) can be easily obtained, and immunocytochemical (ICC) analysis of hormone receptors expression in FNA cells is said to be highly reliable. However, there is no consensus regarding ICC analysis of human epidermal growth factor receptor type 2 (HER2) expression and the Ki67 index using FNA cells.

Methods

Touch-smear cells (TSC) were prepared from resected specimens from 36 patients with primary invasive ductal carcinoma of the breast. The TSC were fixed in 95 % ethanol and subjected to ICC analysis for HER2 using HercepTest? (Dako) and Ki67 using MIB-1? (Dako). HER2 expression and the Ki67 index for the TSC were compared with the results of immunohistochemical analysis of histological section (HS). Statistical analyses used the kappa test and Pearson’s correlation coefficients.

Results

HER2 and Ki67 were analyzed in TSC from 36 and 28 patients, respectively. The HER2 expression scores in the TSC and HS groups showed good agreement (kappa value =0.640) and significant correlation (correlation coefficient =0.860, p < 0.001). The Ki67 indexes in the TSC and HS groups also showed significant correlation (correlation coefficient =0.861, p < 0.001).

Conclusions

The reliability of ICC analysis of HER2 expression and the Ki67 index using TSC were recognized.