侵袭性指部腺癌一例报告

患者 ,男 ,6 2岁 ,近一年发现在 2 0年前手外伤处无痛性肿块。核磁共振检查 :发现中指软组织肿块 ,并与肌腱相连。病理检查 :黄褐红色组织 3cm× 2 .8cm× 1.8cm ,表皮溃疡。肿块切面呈斑斓状棕褐色。镜下改变 :多结节、囊性。有乳头向囊腔内突入 ,并可见呈现背靠背排列的腺管状结构。细胞柱状 ,中度异型性 ,核分裂相多见。免疫组化S10 0 ( )、CEA( )、细胞角质索 ( )。病理诊断 :侵袭性指部乳头状腺癌。未发现远外转移。讨　　论本例属十分罕见的小汗腺癌Ⅱ型。平均发生年龄 5 2岁 ,以男性多见 ,病因不明。临床表现为痛性或无痛性肿块 ,…     

Ki-67和cyclin D1蛋白表达的检测对胃肠道间质瘤良恶性判断的意义

目的　探讨Ki -67和cyclinD 1蛋白表达的检测对胃肠道间质瘤(GISTs)良恶性判断的意义。方法　应用免疫组织化学EnVision二步法检测41例GISTs组织中Ki -67和cyclinD1蛋白表达情况。结果　41例GISTs分为良性组(6例)、交界组(13例)和恶性组(2 2例) ,良性组、交界组与恶性组GISTs的Ki- 67标记指数分别为(8.5±3 .9) %、(16.8±8.6) %和(2 1.8%±8.3 ) % ,3组Ki 67标记指数比较有非常显著性差异(P <0 .0 1) ;Ki- 67标记指数与核分裂像数目、肿瘤直径及肿瘤坏死有关。良性组、交界组与恶性组GISTs的cyclinD1阳性表达率分别为16.7% (1/6)、5 3 .8% (7/13 )和68.2 % (15 /2 2 ) ,3个组cyclinD 1阳性表达率比较有显著性差异(P <0 .0 5 ) ,且良性组与交界组以及良性组与恶性组间cyclinD1阳性表达率有显著性差异(P <0 .0 5 ) ,但交界组和恶性组cyclinD1阳性表达率比较无显著性差异(P >0 .0 5 ) ;cyclinD 1阳性表达率与核分裂象数目有关,而与肿瘤直径及肿瘤坏死无关。结论　Ki- 67和cyclinD1蛋白是胃肠道间质瘤良恶性判断的有价值参考指标,结合胃肠道间质瘤形态学综合分析,更能准确客观地判断胃肠道间质瘤的良恶性。     

How to use progestin in hormone replacement therapy： an animal experiment

Objective To determine whether continuous or cyclic hormone replacement therapy (estrogen and progestogen) is better.Methods One hundred and forty Sprague-Dawley rats were randomly divided into seven grou ps. The 1st and 2nd groups were normal estrous and ovariectomy (OVX) controls . Treatment of the other groups imitated the clinical regimen (continuous and c yclic) with estradiol valerate (E(2)V) and medroxy progesterone (MPA) in differ ent ratios of combination. The rats were sacrificed and sections of uterus were stained with HE and histochemical metheds to detect mitosis and proliferating c ell nuclear antigen (PCNA), respectively. The mitotic index (MI) and PCNA index were calculated. Results The MI and PCNA index were similar in luminal and glandular cells. Both markers were low in the two control groups. When E(2)V was given for 1 to 6 days, both the MI and PCNA index increased with duration of treatment. When MPA was added, both markers were reduced to a very low level. In the continuous regimen, both markers decreased as the MPA dosage increased. The ratio of E(2)V∶MPA=1∶0. 5 was enough to suppress markers to a low level similar to that of normal estrous rats. A further increase in the ratio to 1∶1.0 showed no further decrease in PCNA ind ex. In the cyclic regimen, MPA was added for the last 5 days. The mitotic inde x reached a significantly low level near 0 in all ratios, but the PCNA index in each subgroup was still as high as the positive control, even though the dosage of MPA was increased several times to 1∶8.0. When MPA was added for the las t 10 days, the PCNA index at a ratio of 1∶4.0 could be reduced to a low level .Conclusion The results of this study suggest that the continuous regimen was better than th e cyclic regimen in postmenopausal hormone replacement therapy (HRT). Progesti n should be given for at least 10 days in the cyclic regimen.     

人参皂苷Rg3联合顺铂对高转移人卵巢癌细胞系H0-8910PM增殖的抑制作用

背景与目的:人参皂苷(Rg3)有抑制肿瘤细胞生长的作用,顺铂为诱导肿瘤凋亡的化疗药物,中西医结合治疗肿瘤日益受到重视.本研究探讨Rg3联合顺铂对高转移人卵巢癌细胞系H0-8910PM增殖的抑制作用.方法:采用我院自建的高转移人卵巢癌细胞系H0-8910PM进行实验研究.实验分成6组:①空白对照组:只加新鲜的全培养液;②Rg3低浓度组:10、μg/ml Rg3培养液;③Rg3中浓度组:20μg/ml Rg3培养液;④Rg3高浓度组:40μg/ml Rg3培养液;⑤顺铂单药对照组:含10μg/ml顺铂的培养液;⑥顺铂 Rg3(中浓度)联合用药组:含10μg/ml顺铂 20μg/ml Rg3培养液.分别观察各组对细胞核分裂指数、细胞集落形成率的影响.结果:随着Rg3浓度增高及Rg3和DDP的联合应用细胞核分裂指数下降,以联合用药组下降最明显(F=5.498,P=0.011).空白对照组和Rg3高浓度组,顺铂单药组及顺铂 Rg3(中浓度)联合用药组相比,差异有非常显著性(P=0.011,0.007和0.001);Rg3低、中浓度组分别与顺铂 Rg3(中浓度)联合用药组相比,差异有显著性(P=0.010和0.015).细胞集落形成率随着Rg3浓度增高而下降(F=100.69,P=0.000),高浓度的Rg3、DDP和联合用药组三者结果相近(P=0.887).Rg3高浓度组、顺铂单药组合顺铂 Rg3(中浓度)组与空白对照组、Rg3低浓度组和Rg3中浓度组相比,及Rg3高浓度组与其他各组相比,差异均有显著性(P<0.05).结论:Rg3对高转移人卵巢癌细胞有一定的杀伤作用,能有效抑制细胞核分裂、细胞集落形成,但未发现Rg3和顺铂联合用药会相加或协同作用.     

孕激素对子宫平滑肌瘤生长的影响

探讨孕激素对子宫平滑肌瘤生长的影响。方法对１３２例子宫平滑肌瘤标本的组织切片进行分析,观察每１００个高倍视野中核分裂数目与增生期和分泌期以及与患者年龄的关系。结果发现孕激素水平最高时的分泌晚期核发裂数明显高于增生期,分泌期核分裂数青年组明显高于老年组。结论表明孕激素是子宫平滑肌瘤的促生长因素之一。     

激素替代疗法中孕激素加用方式的研究

本实验为探讨激素替代治疗中孕激素的加用方式,以去势后ＳＤ雌性大鼠作为动物模型,以核分裂率与增殖细胞核抗原指数作为指标,模拟临床激素替代疗法中两种孕激素的加用方式——连续与周期。观察大鼠子宫内膜的增殖与抑制情况。结果显示,周期加用孕激素５天,雌孕激素比例为１∶８时不能抑制内膜增殖;加用１０天,比例为１∶４时能抑制内膜增殖。连续用药比例仅为１∶０．５即能抑制内膜增殖。结论：（１）激素替代疗法中孕激素加用方式,连续优于周期。（２）周期加用孕激素需至少１０天     

如何计算显微镜下视野面积

在显微镜下进行病理读片,是病理医师工作中的重要内容之一.显微镜观察和记录的结果是临床诊断的科学依据.正确标准的使用显微镜,观察和记录读片结果才具有科学性.众所周知,显微镜的成像首先是由物镜对标本放大成像,然后由目镜一次放大被人们肉眼观察到.     

宫颈鳞状上皮癌化疗前后SCC、Ki-67和核分裂数的变化

目的：探讨宫颈鳞状上皮癌化疗效果与组织标本中的核分裂数、Ki-67及血清SCC值的关系。方法：以肿瘤直径大于4 cm的宫颈鳞状上皮癌患者12例（Ⅰb期：3例,Ⅱ期：9例）为对象,采用奈得铂、异环磷酰胺、硫酸培洛霉素 (SIP疗法)治疗1~2个疗程,MRI判断疗效;采用HE染色法、免疫组化法（LSAB法）及放射免疫法测量组织标本中的核分裂数、Ki-67及血清SCC值。结果：12例患者治疗1个疗程(6例)或2个疗程(6例)后,有效7例,无效5例,有效率58.8%,有效病例1疗程结束时肿瘤体积较治疗前明显缩小,血清SCC值明显降低,组织核分裂数1疗程后减少,Ki-67无明显变化;无效病例组织核分裂数1疗程后无明显变化,Ki-67及血清SCC有增加倾向。结论： 1疗程结束后MRI、血清SCC值、组织标本中的核分裂数、Ki-67阳性细胞数的变化可以预测宫颈鳞状上皮癌术前化疗效果。     

原发性脾血管内皮肉瘤1例

患者女,73岁.发现左上腹包块3 d.查体:左上腹肋缘下可触及一大小约8cm×10 cm包块,质硬,无压痛.伴贫血及血小板减少.CT检查:平扫示脾脏体积明显增大,达7个肋单元,其内密度不均,见不规则大片状低密度灶,CT值为30～65Hu;增强示脾脏巨大占位性病变,考虑脾血管瘤.全麻下行睥切除术后送病检.     

区别“象”与“像”

在医学书刊中,"象"与"像"的应用常有混淆。区别如下:象:指形状、样子,如形象、景象、印象等;有关的医学名词有象限(如乳房的某个象限)、象征等。核分裂表明核在细胞周期中所呈现的一种形状,应称核分裂象,(见《医学