Disseminated tumour cells as a prognostic biomarker in colorectal cancer

Background:

The study was performed to determine detection rate and prognostic relevance of disseminated tumour cells (DTC) in patients receiving curatively intended surgery for colorectal cancer (CRC).

Methods:

The study population consisted of 235 patients with CRC prospectively recruited from five hospitals in the Oslo region. Bone marrow (BM) aspirates were collected at the time of surgery and the presence of DTC was determined by two immunological methods; immunomagnetic selection (using an anti-EpCAM antibody) and immunocytochemistry (using a pan-cytokeratin antibody). Associations between the presence of DTC and metastasis-free, disease-specific and overall survival were analysed using univariate and multivariate methods.

Results:

Disseminated tumour cells were detected in 41 (17%) and 28 (12%) of the 235 examined BM samples by immunomagnetic selection and immunocytochemistry, respectively, with only five samples being positive with both methods. The presence of DTC was associated with adverse outcome (metastasis-free, disease-specific and overall survival) in univariate and multivariate analyses.

Conclusion:

The presence of DTC was associated with adverse prognosis in this cohort of patients curatively resected for CRC, suggesting that DTC detection still holds promise as a biomarker in CRC.     

前哨淋巴结活检在胃癌外科中临床意义的研究

目的 探讨前哨淋巴结活检在胃癌外科中的临床应用及其意义.方法 术中在肿瘤四周的胃壁上注射亚甲蓝,第一个蓝染淋巴结,即前哨淋巴结(SLN),摘取所有前哨淋巴结并进行HE染色及细胞角蛋白免疫组化(IHC-CK)染色检查.结果 96例患者中92例成功检出前哨淋巴结,检出率为95.8%.在T1,T2期胃癌中,由SLN预测胃周淋巴结转移的准确率为93.8%(15/16),敏感性为87.5%(7/8),在T3期胃癌中,由SLN预测胃周淋巴结转移的准确率为67.1%(51/76),敏感性为52.8%(28/53).结论 术中使用亚甲蓝染色定位胃癌前哨淋巴结是安全可行的,前哨淋巴结的检出对胃癌淋巴结清扫范围的选择有一定意义.     

非小细胞肺癌紫杉醇化疗耐药前后血清CK18水平的变化

目的 研究血清细胞角蛋白18(CK18)水平与非小细胞肺癌患者紫杉醇化疗耐药的关系.方法 以紫杉醇联合卡铂方案化疗(2～6个周期)第1个周期结束时点RECIST疗效评价为病情稳定或以上的30例非小细胞肺癌患者作为研究对象,采集第1个治疗周期结束时点及出现病情进展(耐药)时点的外周血样本.ELISA双抗体夹心法检测耐药前后患者血清CK18水平.结果 患者耐药前后血清CK18水平分别为(0.356±0.199)ng/mL和(0.566±0.189)ng/mL,差异有统计学意义(P=0.002);其中4例患者血清CK18水平略有下降(＜20%),均为化疗第2个周期结束时点疗效评价为病情进展(即耐药)的患者;其余26例患者血清CK18水平表现为升高,且均为接受至少3个周期化疗后发生病情进展的患者;其中20例增高大于20%,最高达947.17%.结论 血清CK18水平与非小细胞肺癌患者紫杉醇化疗耐药有关.血清CK18水平检测可为晚期非小细胞肺癌患者的个性化治疗提供参考依据.     

人羊膜负载人羊膜间充质干细胞对SD大鼠皮肤创面愈合的影响

目的观察人羊膜(HAM)负载人羊膜间充质干细胞(hAMSCs)对SD大鼠皮肤创面愈合的影响。方法采用胰酶消化HAM的上皮细胞,将hAMSCs接种于HAM上培养,然后贴覆于大鼠创面,观察创面大体变化,采用HE染色和免疫组织化学染色法检测创面愈合情况,并与单纯羊膜组和对照组进行比较。结果 HAM负载hAMSCs组大鼠创面的平均愈合时间为(18.3±0.9)d,明显快于对照组的(26.4±0.7)d(P<0.01)和单纯羊膜组的(21.5±1.2)d(P<0.05);术后11 d和14 d,HAM负载hAMSCs组大鼠的创面愈合率分别为(81.5±7.2)%和(94.3±3.6)%,明显高于对照组的(48.5±3.2)%和(74.3±4.3)%及单纯羊膜组的(68.5±4.5)%和(86.8±4.8)%(P均<0.01)。皮肤切片HE染色结果证实,HAM负载hAMSCs组大鼠的伤口愈合质量明显优于单纯羊膜组和对照组。免疫组织化学染色结果显示,术后14 d,HAM负载hAMSCs组大鼠皮肤CK19阳性表皮干细胞数为48.2±3.2,明显高于单纯羊膜组的37.7±3.1(P<0.05)和对照组的29.6±2.4(P<0...     

Pleomorphic adenoma (formerly chondroid syringoma) of the eyelid margin with a pseudocystic appearance

Among the adenomas and adenocarcinomas spawned by the adnexal glands of the eyelids, pleomorphic adenoma (also referred to as benign mixed tumor or chondroid syringoma in dermatopathology) is among the rarest. Pleomorphic adenomas (PAs) can arise from sweat glands in the dermis of the eyelid skin and must be distinguished from those of the accessory lacrimal glands of Krause and Wolfring. We describe an eyelid margin skin PA that appeared clinically to be a cyst and was not associated with an accessory lacrimal gland. Histopathologically, the lesion was circumscribed but nonencapsulated and composed of branching ductular structures with a double layer of epithelial cells set in a myxoid and sclerotic stroma that did not contain cartilage. The outer ductular (myoepithelial) cells delaminated to populate the stroma. Histochemistry disclosed abundant extracellular mucopolysaccharides that conferred the “cystic” character clinically. The inner ductular cells were uniformly positive for cytokeratin 7 and focally for gross cystic fluid disease protein-15, an apocrine marker. The inner and outer ductular cells were negative for alpha-smooth muscle actin. These pathologic findings support an apocrine (gland of Moll) origin for this tumor, which is consistent with the fact that there are no eccrine glands at the eyelid margin.     

血清CEA、CYFRA21-1与非小细胞肺癌化疗疗效及预后的临床研究

目的研究血清癌胚抗原（CEA）及细胞角蛋白19片断（CYFRA21-1）在评价非小细胞肺癌（NSCLC）患者化疗疗效及预后中的临床意义。方法 120例NSCLC患者接受2个周期含铂类方案的联合化疗,检测血清CEA及CYFRA21-1表达水平的变化,同时行影像学检查评价客观疗效,应用ROC曲线评价血清CEA及CYFRA21-1下降率在评估化疗疗效中的作用。结果 2个周期化疗后以影像学方法评价的客观有效率为36.4%,化疗后CEA下降率预测化疗疗效的最佳截断点为19.8%,化疗后CYFRA21-1下降率预测化疗疗效的最佳截断点为35.5%,血清CEA、CYFRA21-1下降率与影像学客观疗效有明显的相关性。结论血清CEA和CYFRA21-1下降率是反映NSCLC化疗疗效的可信指标。     

Immunohistochemical Localization of Cytokeratins in the Junctional Region of Ectoderm and Endoderm

Although tridermic species have two junctional regions of ectoderm and endoderm between their epidermis and digestive tract, we actually know little about these particular boundaries. Cytokeratins are the major intermediate filaments of epithelial cells and show a high degree of tissue specificity. Therefore, to characterize the epithelial cells in the junctional region of ectoderm and endoderm, we immunohistochemically examined the localization of cytokeratins 5, 7/17, 14, 18, Sox17, and alpha‐fetoprotein (AFP) in the oropharyngeal and anorectal regions during the mouse gastrulation process. At embryonic day (E) 9.5, cytokeratins 5, 7/17, 14, and 18 were detected in all epithelial cells of the oropharyngeal region. At E12.5, cytokeratin 5‐positive cells were not observed in the middle area of the oral cavity; however, the immunoreactivity was strong in the anterior and posterior areas. The immunoreaction of cytokeratins 18 was seen only in the middle and posterior areas of the oral mucosa. Cytokeratins 7/17 and 14 were localized in all areas of the oropharyngeal region. Sox17 and AFP, which are endodermal markers, were detected in the middle and posterior areas of the oral mucosa, but not in the anterior area. Moreover, this same localization pattern of cytokeratins also existed in the anorectal region of the E12.5 embryo, suggesting that the localization of cytokeratins and endodermal markers might give an implication for the boundary between ectoderm and endoderm. These results also suggest that these cytokeratins are useful molecules for monitoring the epithelial cell differentiation in the junctional region of the germ layers. Anat Rec, 2010. © 2010 Wiley‐Liss, Inc.     

Sarcomatoid carcinoma of the prostate: a case report

Sarcomatoid carcinoma of the prostate is a rare variant of prostatic cancer, with less than 100 cases reported in the literature up to date. Tumors are most commonly composed of an admixture of both malignant glandular and spindle cell elements. The sarcomatoid component can vary from 5 to 99%. We report a case of a 76-year old Caucasian man who underwent transurethral resection of the prostate for the treatment of bladder outlet obstruction. Histopathologic examination revealed a tumor with malignant epithelial and sarcomatous elements. The malignant epithelial component consisted of poorly differentiated adenocarcinoma (Gleason score 5+4=9/10) and the sarcomatous component was mainly composed of undifferentiated spindle cells. On immunohistochemistrythe latter expressed a positive staining for vimentin. Several cells were positively stained for cytockeratin AE3 and myoD1 while all were negative for actin, desmin and myogenin. The diagnosis of sarcomatoid carcinoma was finally made. Although sarcomatoid carcinoma of the prostate is a highly aggressive neoplasm and patients have a poor prognosis, our patient is still alive one year after diagnosis.     

检测骨髓细胞角蛋白对淋巴结阴性的乳腺癌患者的临床意义

目的：研究采用RT—PCR方法检测腋淋巴结阴性乳腺癌患者骨髓微小转移的意义。方法：对常规HE染色腋淋巴结阴性的80例乳腺癌患者采用RT—PCR方法检测骨髓细胞角蛋白CK19的表达情况。结果：RT—PCR方法检测到CK19阳性表达率为23．75％（19／80）。结论：常规病理检查腋淋巴结阴性的乳腺癌患者,用RT—PCR法对其骨髓血作进一步检测,可以发现微小转移的存在。     

Expression of cytokeratins in the epithelium of canine odontogenic tumours

Odontogenic tumours are considered to be relatively rare; however, several histologically distinct types have been identified in dogs. The more common canine odontogenic tumours are peripheral odontogenic fibroma and canine acanthomatous ameloblastoma. The expression of cytokeratins (CKs) has been established for the human dental germ and odontogenic tumours. The aim of the present study was to describe the immunohistochemical expression of a panel of CKs in the epithelium of the canine dental germ, normal gingiva and odontogenic tumours arising in this species. Samples from 20 odontogenic tumours, 12 tooth germs and three normal gingival tissues were obtained. Each sample was stained with haematoxylin and eosin and subjected to immunohistochemistry for CK expression. The typical expression pattern of CKs in the odontogenic epithelium and gingiva of dogs was CK14 and CK5/6. CKs 7, 8, 18 and 20 were generally absent from the canine dental germ, gingiva and odontogenic tumours. Dogs and man therefore exhibit similar CK expression in the odontogenic epithelium.