P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值

目的： 探讨P16/Ki-67双染联合DNA倍体分析在宫颈意义不明的不典型鳞状细胞（ASCUS）分流诊断中的应用价值。方法： 选取2016年12月-2018年8月上海市长宁区妇幼保健院收治的经液基细胞学（LCT）诊断为ASCUS的患者115例，同时行P16/Ki-67双染检测，DNA倍体分析，且以阴道镜病理活检结果为金标准。结果： 115例患者阴道镜病理活检结果提示，宫颈上皮瘤变2级及以上（CIN2+）45例，其中CIN2级20例，CIN3级23例，鳞癌2例；P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为77.8%、77.1%、77.4%；DNA倍体分析检测CIN2+的灵敏性、特异性、诊断符合率分别为71.1%、34.3%、48.7%，且DNA倍体阴性的细胞标本中P16/Ki-67双染检测结果均为阴性；DNA倍体分析联合P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为92.9%、71.4%、86.3%，其中诊断符合率明显高于单纯采用DNA倍体分析（P < 0.05）。结论： P16/Ki-67双染相较于DNA倍体分析检测CIN2+具有更高灵敏度和特异度，两者联合检测能有效提高准确率，可辅助用于ASCUS的分流诊断。     

Better visualization of a lung tumour with 99mTc-DPD than with 99mTc-glucoheptonate or 67Ga-citrate

A case of a squamous cell lung carcinoma detected with ^99mTc-DPD, ⁶⁷Ga-citrate and ^99mTc-glucoheptonate (GH) is reported. The highest uptake was seen with DPD and the lowest with ⁶⁷Ga. Emission-computed tomography was very useful in DPD imaging but gave less new information in GH and ⁶⁷Ga studies in comparison to traditional planar imaging. The patient had been given both irradiation and chemotherapy, which might be the cause of good accumulation of DPD and rather poor accumulation of GH and ⁶⁷Ga.     

Lymphomatoid Papulosis Followed by Ki-1 Positive Anaplastic Large Cell Lymphoma: Proliferation of a Common T-Cell Clone

We report a case of lymphomatoid papulosis (LyP) followed by Ki-1 positive anaplastic large cell lymphoma (LCL). A 33-year-old man developed subcutaneous nodules in the left inguinal region and the left thigh after a seven-year-history of self-healing papulonecrotic lesions of LyP. Histological and immunohistochemical examination of the subcutaneous nodules revealed LCL. DNA was isolated from a nodule of the initial stage of LyP in 1988, a subcutaneous nodule of LCL in 1993, and a papule of LyP in 1993 which appeared after chemotherapy for LCL. T cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in all the three specimens, indicating that a common T cell clone proliferated throughout the course in both the LyP and LCL lesions.     

诱导化疗对舌鳞癌肿瘤细胞增殖的影响

目的探讨诱导化疗对舌鳞癌患者原发灶肿瘤细胞增殖的影响。方法用免疫组化方法检测了DDP+5-Fu方案诱导化疗后舌鳞癌组织PCNA和Ki67的表达状况。结果舌鳞癌诱导化疗后PCNA和Ki67抗原表达分别是76.8%和58.5%;在Ki67,诱导化疗前组和诱导化疗2周内手术组间存在统计学差异(P<0.05),诱导化疗前组和诱导化疗2周后手术组间无统计学意义(P>0.05),2周内手术组和2周后手术组间存在统计学意义(P<0.05);三组间PCNA均无统计学差异。结论舌鳞癌诱导化疗后Ki67较PCNA更能较准确的反映肿瘤细胞的增殖状态;诱导化疗后舌鳞癌原发灶手术切除应于2周内完成。     

肾细胞癌bcl-2及ki-67的免疫组化研究

目的：探讨bcl-2和ki-67基因产物与肾癌生产学行为及预后的关系。方法：采用免疫组化LSAB法对60例肾细胞癌和5例正常肾组织bcl-2及ki-67表达产物进行检测。结果：66.7%肾癌bcl-2显示阳性，正常肾组织均为阴性。bcl-2表达与肾癌的分期、分级有关，且承着肾癌分期、分级的上升而降低（P＜0.01）；bcl-2表达与肾癌组织学类型无关；bcl-2阳性表达者预后较好。Ki-67在正常肾组织中低表达。在全部肾癌中ki-67均表达，程度不同，与分期、分级密切相关（P＜0.005），与组织学类型无关；ki-67高表达者预后差。结论：bcl-2及ki-67均可作为肾癌恶笥程度及预后的估价性指标，但两者表达无相关性。     

肾细胞癌中p27表达与肿瘤细胞增殖的关系研究

目的探讨肾细胞癌(RCC)中P27的表达与肾癌细胞增殖的关系.方法采用鼠抗人P27单克.隆抗体及Ki-67抗原单克隆抗体对86例肾细胞癌和86例癌旁组织进行免疫组化染色.结果RCC中p27表达明显减少,Ki-67指数(Ki-67LI)明显增高;且p27表达与Ki-67指数(Ki-67LI)在肿瘤病理分级、临床分期和淋巴结转移方面呈负相关.结论P27和Ki-67U从细胞生长抑制和增殖活性两个不同的侧面反映了肿瘤细胞的侵润能力,联合检测p27和Ki-67LI对预测肾癌的的生物学行为及预后具有重要的意义.     

Clinical significance of thallium-201 and gallium-67 scintigraphy in pulmonary tuberculosis

One hundred and thirty-nine patients with pulmonary tuberculosis were evaluated by means of gallium-67 and thallium-201 scintigraphy. The disease was clinically active in 83 and inactive in 56. The uptake ratio between the lesion and the contralateral normal lung field was calculated. The ratio determined by⁶⁷Ga scintigraphy was expressed as GR, and that determined by²⁰¹Tl scintigraphy (early or delayed) as ER or DR. The²⁰¹Tl retention index (RI) was calculated using the following equation: RI=DR—ER/ER×100. The sensitivity, specificity and accuracy of²⁰¹Tl scintigraphy with respect to the activity of pulmonary tuberculosis were better than those of⁶⁷Ga scintigraphy (the figures for²⁰¹Tl scintigraphy were 88.0%, 82.1% and 85.6%, respectively, and those for⁶⁷Ga scintigraphy, 83.1%, 60.7% and 74.1%).We found a significant correlation between GR and ER, but there was no significant correlation between RI and ER. When the relationships between ER, C-reactive protein and 1-h erythrocyte sedimentation rate were examined among patients with abnormal uptake, no significant relationships were noted. In the 27 patients who could be followed up, GR and ER decreased with duration of the therapy, indicating a decrease in disease activity which was consistent with clinical findings. The RI was significantly higher in the early stages of therapy than in the later stages (P<0.01), suggesting a temporary delay in²⁰¹Tl washout in the early stages. The washout seemed to be promoted by the effects of the therapy. Overall, it is concluded that²⁰¹Tl scintigraphy is more useful and more suitable than⁶⁷Ga scintigraphy for the evaluation of disease activity and therapeutic effects in patients with pulmonary tuberculosis.     

Scintiscanning demonstration of thymoma: Comparative study on scintiscans using201Tl,67Ga and75Se

Thymus scintigraphy was performed using²⁰¹Tl-chloride,⁶⁷-Ga-citrate and⁷⁵Se-selenomethionine on 30 thymoma patients with or without myasthenia gravis. Mass negativity was observed in 6 out of 17 (35.3 per cent) and 3 out of 13 cases (23.1 per cent), respectively. A rate of 70 per cent (21 cases out of 30) of mass positivity was observed by thymus scan using²⁰¹Tl. With regard to the relation between thymus scan and cell type,²⁰¹Tl-scan exhibited a high rate of mass positivity, regardless of the cell type while the⁷⁵Sescan showed a trend toward mass positivity in epithelial cell predominant cases. With²⁰¹Tl, mass positivity was observed when the CPM/g ratio for tumors and blood exceeded 3.0. This trend can serve as an index for the suitability of supplementary chemo- and radiotherapies, as well as for prognosis in cases of relapse, and in those for whom excision was not complete.     

Recurrent Cervical Lymphadenopathy Due to Ki-1 Lymphoma in an Elderly Female

A 70-year-old female presented with recurring cervical lymphadenopathy over a 5-year period. Intermittently, symptoms of respiratory and Gl tract disease occurred, raising the possibility of malignancy. Investigation of these systems and of the breasts were negative. A lymph node biopsy was eventually done and showed intrasinusoidal proliferations of CD30-posi-tive malignant cells which were also characterized ultrastructurally. Therapy with CHOP has produced a good initial response. The value of electron microscopy in diagnostic pathology is illustrated.     

不同部位胆脂瘤侵袭性的免疫组化比较

目的用免疫组化的方法探讨不同原发部位胆脂瘤侵袭性的差异。方法根据胆脂瘤的原发部位对标本进行分组，其中上鼓室胆脂瘤7份，鼓室窦胆脂瘤8份，外耳道胆脂瘤4份。对中耳胆脂瘤根据上皮下基质炎症情况分别进行观察，其中炎症组7份，非炎症组8份。用免疫组化SP法观察增殖细胞核抗原Ki-67和Ⅳ型胶原在不同原发部位，基质不同炎症反应程度的胆脂瘤标本中的表达，并对染色结果进行量化处理，采用非参数秩和检验并进行统计学对比分析。结果Ki-67在胆脂瘤中具有明显的表达，计算表达阳性率，比较上鼓室胆脂瘤和鼓室窦胆脂瘤的阳性率，差异没有统计学意义（Z=0．189，差异参数为0．850）。中耳胆脂瘤和外耳道胆脂瘤标本之间，差异也没有统计学意义（Z=1．306，差异参数为0．192）。对同一标本的不同部位按炎症反应程度进行量化分类比较，2组之间进行非参数的秩和检验，差异具有统计学意义（Z=2．939，差异参数为0．003）。Ⅳ型胶原在胆脂瘤上皮中仅有间断表达，尤其在胆脂瘤乳头状突出的部位表达断裂明显。结论原发部位的不同不是造成胆脂瘤侵袭性差异的主要因素，而炎症的严重程度能影响胆脂瘤的侵袭性。Ⅳ型胶原在各组胆脂瘤的表达中的断裂说明胆脂瘤侵袭骨质的行为是胆脂瘤局部的至少是从局部开始并逐渐扩散的行为，局部病情的严重程度与局部的炎症反应程度密切相关。