少枝胶质细胞瘤的形态观察

目的研究少枝胶质细胞瘤（ＯＤＧ）的超微结构及组织学特性。方法用光镜，部分用电镜及免疫组化观察６５例ＯＤＧ。结果根据ＷＨＯ有关ＯＤＧ病理分级，６５例中Ⅰ级１９例，Ⅱ级３２例，Ⅲ级１４例。结论ＯＤＧ中瘤细胞出现胶质微丝是异质性分化的结果。除按瘤细胞分化程度分级外，细胞密度、核分裂数亦有重要意义。     

诱发口腔鳞癌细胞凋亡嵌合基因表达载体的构建

目的：获取含凋亡基因fas表达调控元 件cdc25A片段和fas开放阅读框架的cdc25A -fas嵌合基因，构建和鉴定真核表达载体pAdTrack-CMV-cdc25A -fas和pAdTrack-cdc25A-fas，为将口腔鳞癌细胞固有的 促细胞增殖信号转变为促细胞凋亡信号的研究奠定基础。方法:根据fa s基因、cdc25A已知序列设计合成引物，采用PCR技术从pBLF58-1质 粒中扩增得到嵌合基因cdc25A-fas；然后定向克隆至真核表达载 体pAdTrack-CMV和pAdTrack，分别转化大肠杆菌E.coli DH5α感受态细胞；卡那霉素筛 选阳性克隆；进行PCR、酶切鉴定和序列分析。结果：PCR扩增得到特异 的 1 603 bp的cdc25A-fas片段；筛选并鉴定得到含pAdTrac k-CMV-cdc25A-fas和pAdTrack-cdc25A- fas的大肠杆菌E.coli DH5α阳性克隆。结论:成功构建了真核表 达载体pAdTrack-CMV-cdc25A-fas和pAdTrack-cdc25 A-fas,为下一步研究其在肿瘤基因治疗中的作用奠定基础。     

Pilot study of an HLA-A2 peptide vaccine using flt3 ligand as a systemic vaccine adjuvant

A pilot vaccine study was conducted to test the safety and immunological efficacy of four monthly immunizations of an MHC class I peptide vaccine, the E75 HLA-A2 epitope from HER-2/neu, using flt3 ligand as a systemic vaccine adjuvant. Twenty HLA-A2-expressing subjects with advanced stage prostate cancer were randomly assigned to one of four immunization or treatment schedules: (a) Flt3 ligand (20 g/kg per day) administered subcutaneously daily for 14 days on a 28-day cycle, monthly for four months; (b) flt3 ligand course as above with the E75 peptide vaccine administered on day 7 of each flt3 ligand cycle; (c) flt3 ligand course as above with the E75 peptide vaccine administered on day 14 of each flt3 ligand cycle; or (d) E75 peptide admixed with granulocyte–macrophage colony-stimulating factor and administered intradermally once every 28 days, as has previously been reported. The primary endpoints of the study were the determination of safety and immunological efficacy in generating E75-specific T cells as determined by peptide-specific interferon-gamma ELIspot. Adverse events included one grade 3 skin reaction and the development of grade 2 autoimmune hypothyroidism in two subjects with preexisting subclinical autoimmune hypothyroidism. Dendritic cells were markedly increased in the peripheral blood of subjects receiving flt3 ligand with each repetitive cycle, but augmentation of antigen-presenting cells within the dermis was not observed. Apart from a single subject, no significant peptide-specific T-cell responses were detected by ELIspot, whereas delayed-type hypersensitivity responses were detectable in control subjects and in subjects receiving peptide vaccine early in the course of flt3 ligand administration. The absence of robust peripheral immune responses in the current study may be attributable to the small numbers of subjects or differences in the subject population. In addition, the inability of flt3 ligand to augment the number of peripheral skin antigen-presenting cells may have contributed to the absence of robust peptide-specific immunity detectable in the peripheral blood of immunized subjects treated with flt3 ligand.     

u-PAR反义核酸载体的构建与高侵袭人前列腺癌细胞PC-3M亚系的转染

目的:为了特异封闭PC-3M高侵袭亚系尿激酶型纤溶酶原激活物受体(u-PAR)的表达,观察其对侵袭能力的抑制效应。方法: 应用RT-PCR获得u-PAR的cDNA片段,反向插入pcDNA3质粒载体中,构建u-PAR反义核酸载体并导入高侵袭亚系中;借助RT-PCR和免疫组化检测转染细胞u-PAR的表达。 结果:u-PAR反义核酸载体转染株的u-PAR mRNA和蛋白质水平明显低于对照组,抑制率分别为53%和73%,同时其体外侵袭能力亦明显降低,抑制率为79%。 结论: u-PAR反义核酸在PC-3M高侵袭亚系中发挥了特异封闭作用,为进一步观察u-PAR反义核酸抑制高侵袭前列腺癌细胞亚系的侵袭效应提供了细胞模型。     

Anaplastic large cell Ki-1 lymphoma with bone involvement: Report of two cases

Two cases of anaplastic large cell Ki-1 lymphoma involving bone as the most prominent and initial manifestation are reported. The first patient was a 20-year-old male who had back pain and incomplete paraparesis due to vertebral involvement. The second was a 14-year-old girl, whose first clinical signs were fever of unknown origin and sternal bone pain. Radiologically, skeletal lesions were lytic and destructive. Histopathologically, the tumour cells had pleomorphic bizarre nuclei and abundant basophilic cytoplasm. Immunohistochemically, Ki-1 (CD30) reactivity was strongly positive in both cases. Tumour cells were also CD3, CD4, epithelial membrane antigen and interleukin-2 receptor positive in the first case, and CD10, HLA-DR positive in the second case. The former tumour was considered to be of T-cell lineage and the latter of lymphoid progenitor cell origin. Radiation and chemotherapy were temporarily effective. However, both patients died 14 and 7 months after diagnosis, respectively, due to systemic lymph node involvement. These observations suggest that the prognosis for Ki-1 lymphoma involving bone is poorer than indicated in previous reports.     

特殊类型周围神经肿瘤

目的：介绍特殊类型周围神经肿瘤的病理诊断。方法：收集外检和会诊中遇到的各种类型周围神经肿瘤进行回顾性分析，并作必要的免疫组化标记和鉴别诊断，报道９例罕见的特殊类型周围神经肿瘤。结果：９例中：上皮样恶性周围神经鞘膜瘤，恶性嵘螈瘤，黑色素性神经鞘瘤，婴儿黑色素性神经外胚叶瘤腺性神经纤维瘤，神经鞘粘液瘤，节细胞性神经母细胞瘤，恶性颗粒细胞瘤和透明细胞肉瘤各１例，结论：特殊类型周围神经肿瘤的形成与原始神经     

前列腺特异性抗原、前列腺体积与睾酮水平的随龄变化及相关分析

目的:探讨50岁以上男性随增龄血清前列腺特异性抗原(PSA)、前列腺体积与激素变化的规律及相关性。方法:以524名50岁以上男性为研究对象,超声检测仪测前列腺体积,ELISA技术检测血清PSA含量,放射免疫分析法检测血清睾酮、促黄体生成激素(LH)含量。结果:(1)血清PSA含量随增龄增高和前列腺体积随增龄而增大;(2)血清睾酮(T)含量随增龄下降,血清LH含量则随增龄而增高;(3)血清PSA和LH含量与前列腺体积呈显著的正相关;(4)血清睾酮含量与前列腺体积呈负相关(r=-0.45,P＜0.01)。结论:血清PSA含量随增龄增高与前列腺的组织学变化有关,而睾酮水平的下降是前列腺异常增生的重要原因之一。     

多参数MRI纹理分析预测直肠癌患者放射治疗后早期股骨头坏死

目的 探讨多参数MRI(mpMRI)纹理分析预测直肠癌患者放射治疗(放疗)后早期股骨头坏死(FHN)的价值。方法 回顾性分析52例接受盆腔放疗直肠癌患者放疗前2周及放疗后3个月内的盆腔MRI,其中31例未见FHN,21例出现早期FHN(Ⅰ期16例,Ⅱ期5例)。采用3D-slicer软件基于T1WI、T2WI和弥散加权成像(DWI)分割右侧股骨头,并提取其纹理参数;对比放疗前后纹理参数,将差异有统计学意义的放疗前参数纳入多因素logistic回归分析,建立模型_T1WI、模型_T2WI、模型_DWI及模型_{T1WI+T2WI+DWI}。根据放疗后影像学所见行股骨头坏死骨循环研究协会(ARCO)分期,以受试者工作特征(ROC)曲线分析单一纹理参数及联合模型预测直肠癌患者放疗后早期FHN的效能。结果 T1WI及T2WI纹理参数中,放疗前股骨头能量及均匀性高于放疗后;DWI纹理参数中,放疗前股骨头能量高于、而长行程高灰度强调及短行程高灰度强调低于放疗后。上述放疗前纹理参数单一预测直肠癌患者放疗后早期FHN的曲线下面积(AUC)为0.581~0.712,模型_T1WI、模型_T2WI、模型_DWI和模型_{T1WI+T2WI+DWI}的AUC分别为0.660、0.713、0.770和0.853。结论 mpMRI纹理分析可有效预测直肠癌患者放疗后早期FHN。     

18F-FDG PET/CT代谢参数预测胸腺上皮肿瘤恶性程度

目的 观察¹⁸F-FDG PET/CT代谢参数对预测胸腺上皮肿瘤(TET)恶性程度的价值。方法 回顾性分析95例经病理诊断的TET患者,根据病理结果进行组织学分型(低危型胸腺瘤、高危型胸腺瘤、胸腺癌)及临床分期(Ⅰ~Ⅳ期)。基于¹⁸F-FDG PET/CT获取原发灶最大标准摄取值(SUV_max)、峰值标准摄取值(SUV_peak)、原发灶SUV_max与纵隔血池平均标准摄取值的比值,即靶区本底比值(TBR),分别以SUV=2.5及40%SUV_max为阈值,获得病灶糖酵解总量(TLG_2.5、TLG_40%)及肿瘤代谢体积(MTV_2.5、MTV_40%)。比较不同类型及临床分期TET各代谢参数的差异。针对两两比较差异均有统计学意义的代谢参数绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估其预测不同组织学分型TET的效能。结果 95例中,27例低危型胸腺瘤、15例高危型胸腺瘤、53例胸腺癌;临床分期Ⅰ期28例、Ⅱ期8例、Ⅲ期12例、Ⅳ期47例。不同类型TET间SUV_max、SUV_peak及TBR差异均有统计学意义(P均<0.05),高危型胸腺瘤及胸腺癌TLG_2.5和MTV_2.5均高于低危型胸腺瘤(P均＜0.05),胸腺癌TLG_40%高于低危型胸腺瘤(P＜0.05);其他代谢参数差异均无统计学意义(P均＞0.05)。临床Ⅳ期TET的SUV_max、SUV_peak、TBR、TLG_2.5、TLG_40%、MTV_2.5均高于Ⅰ期(P均＜0.05),Ⅲ期TET的TLG_2.5高于Ⅰ期(P＜0.05),不同临床分期TET其余代谢参数差异均无统计学意义(P均＞0.05)。以SUV_max、SUV_peak及TBR预测低危型与高危型胸腺瘤的AUC分别为0.857、0.840及0.857,预测高危型胸腺瘤与胸腺癌的AUC分别为0.769、0.758及0.755。结论 ¹⁸F-FDG PET/CT代谢参数可有效预测TET恶性程度。     

Diagnosis of metastatic lesions to the stomach by salvage cytology

Summary Secondary neoplasms of the stomach are rare and are often clinical and diagnostic problems. Three patients with bleeding volcano-like ulcers were diagnosed by combined endoscopic salvage cytology and surgical biopsy as having metastatic submucosal lesions from hematologic spread. The combination of endoscopic appearance, clinical findings, and tissue and cytologic examination can lead to the correct diagnosis. The results from these cases support the utility of this cytologic technique in combination with biopsy in this clinical setting.