综合治疗色素沉着性绒毛结节性滑膜炎20例临床观察

目的探讨关节色素绒毛结节性滑膜炎(pigm entedvillonodular synovitis,PVS)的方法和转归。方法2000年9月—2010年10月,对20例PVS行手术治疗。其中13例弥漫型和4例弥漫结节型术后行外放疗,3例局限型未行放疗。结果术后即行外放疗的例平均随访45个月(12~108个月)未见复发;I例弥漫型术后未完成外放疗,3个月后原位复发,再行切除手术,术后加做放疗后随访36个月未见复发;局限型3例未做外放疗,随访30、69、72个月,未见复发。无感染和关节功能受限等并发症。结论病变滑膜切除术是治疗膝关节色素绒毛结节性滑膜炎的理想选择,对弥漫型和弥漫结节型PVS术后辅以适量外放疗对防止复发有益处。     

数字化X线钼靶检查结合三算子乳腺血氧检查对乳腺导管内癌的诊断价值

目的探究数字化X线钼靶与三算子乳腺血氧检查对乳腺导管内癌的诊断价值。方法对经手术病理证实的78例乳腺导管内癌患者的数字化X线钼靶征象与三算子乳腺血氧检测进行回顾性分析并与病理进行对照研究。结果 78例乳腺导管内癌的主要X线征象:肿块32例(42.1%),钙化21例(27.6%),肿块伴钙化17例(22.4%),结构扭曲及非对称致密6例(7.9%),因X线钼靶表现为阴性者而漏诊2例;三算子乳腺血氧征象:病变血氧分析表现为高血高氧15例(19.7%),高血低氧58例(76.3%),平血低氧3例(3.9%);三算子均表现为等灰度线局灶性异常,其中边缘欠光整41例(53.9%),边缘毛刺35例(46.1%),其中可见异常血管61例(78.2%),未见异常血管17例(21.8%)。结论对于典型的乳腺导管内癌无论是X线钼靶检查或是三算子乳腺血氧功能成像检查的诊断符合率都很高,对于不典型的乳腺导管内癌应用数字化X线钼靶检查结合三算子乳腺血氧检查可进一步提高诊断符合率。     

胆囊癌相关免疫组化表达与临床关系的探讨

胆囊癌好发于高龄妇女.因早期无特定的临床症状和体征,诊断非常困难,手术多为晚期.本研究通过免疫组化与形态学观察探讨生存素、癌胚抗原(CEA)和p53蛋白表达情况,并探讨与胆囊癌组织类型、病理分级和转移状况的关系.     

The correlation between chemotherapeutic efficacy and breast cancer susceptibility gene 1 and class Ⅲ β-tubulin protein expression in non-small cell lung cancer patients

Objective To investigate the predictive value of breast cancer susceptibility gene 1 (BRCA1) and class Ⅲβ-tubulin protein expression in tumor tissue for the efficacy of taxol and cisplatin combined chemotherapy (TP) in stage Ⅲβ/Ⅳ non-small cell lung cancer(NSCLC) patients. Methods A total of 92 stage Ⅲβ/Ⅳ NSCLC patients were recruited with 87 patients evaluated. Bronchoscopy or lung puncture tumor biopsy samples were obtained with BRCA1 and class Ⅲβ-tubulin protein expression examined immunohistochemically before chemotherapy. The patients were randomly assigned to be received 4 to 6 cycles of TP chemotherapy regiments and followed up until death or lost. Response rate (RR) , overall survival (OS) and time to tumor progression (TTP) were assessed. Results Among the 87 evaluated patients, the positive expression rates of BRCA1 and class Ⅲβ-tubulin were 57. 5% (50/87) and 48. 3%(42/87) respectively. There was no significant difference in clinical characteristics among patients with different positive expression rate. According to different expression of BRCA1 and class Ⅲβ-tubulin, the patients were divided into four groups: group A (low expression of both BRCA1 and class 1 p-tubulin) ,group B (high expression of both BRCA1 and class Ⅲβ-tubulin) , group C (high expression of only BRCA1) and group D (high expression of only class Ⅲβ-tubulin). The RR was higher in group A than other three groups (60. 7% , 34. 8% , 9/19 and 6/17 respectively). The OS and TTP were longer in group A than other three groups [OS: (539. 4 ± 17. 6) days, (267. 2 ± 20. 5) days, (325. 6 ± 24. 1) days and (283.7±26.2) days respectively ; TTP: (256. 9 ± 28. 4) days, (143.8±17.6) days, (179. 3 ± 19. 8)days and (152. 6 ±23. 5) days respectively]. There were no significant differences among the other three groups. Conclusions The expression level of BRCA1 and class Ⅲβ-tubulin in tumor tissue is probably a predictor for the efficacy of TP chemotherapy in NSCLC patients. TP chemotherapy is more suitable for the NSCLC patients with lower expression of both BRCA1 and class Ⅲβ-tubulin. Our study may provide a new sight for tailored chemotherapy in NSCLC patients.     

IgA肾病临床与病理分析

目的:对近10年我院原发性IgA肾病50例进行随访及分析,方法:对其病理特点及临床进行相关性分析。结果:少儿组复发性肉眼血尿发生率最高。青壮年组恶性高血压发病率高,在老年组肾病综合症和急性肾衰发生率高。结论:对临床反复血尿患者应该进行肾穿刺活检。一旦确诊为IgA肾病,就必须随访,尤其是对少儿患者。     

贲门腺癌雌孕激素受体及PCNA表达相关性初探

目的：比较贲门腺癌增殖细胞核抗原(proliferating cell nuclear antigern,PCNA)及雌激素受体(ER)、孕激素受体(PR)检测结果，探讨PCNA及ER、PR与贲门癌发生发展和预后的关系。方法：应用免疫组化法对66例贲门癌进行PCNA和ER、PR检测。结果：高分化腺癌PCNA阳性率高，ER、PR低；低分化腺癌PCNA阳性率低，ER、PR高。说明PCNA、ER、PR表达与肿瘤分化程度有相关性(P＜0．05)。结论：ER、PR、PCNA与贲门癌发生、发展有关，可能是反映贲门癌生物学行为和预测预后的重要指标。其检测具有实际临床意义，对临床治疗有参考价值。     

嗜酸细胞性食管炎9例临床病理分析

目的探讨嗜酸细胞性食管炎的临床病理学特点。方法采用免疫组化SP法染色结合甲苯胺蓝染色及硫染色显示肥大细胞内颗粒,观察9例嗜酸细胞性食管炎中肥大细胞及嗜酸性粒细胞的分布。结果在黏膜各层及肉芽组织中,均见到未释放型和释放型2种肥大细胞。肥大细胞聚集区也是嗜酸性粒细胞相对集中区。结论嗜酸细胞性食管炎的发生与变态反应有关,可能是肥大细胞释放的各种介质造成黏膜损伤、肉芽组织及溃疡形成,手术切除是较好的治疗方法。     

肺原发性恶性黑色素瘤5例临床病理分析

目的分析肺原发性恶性黑色素瘤（PMML）的病理组织学形态及临床表现。方法采用免疫组化方法对5例PMML的肿瘤标本（2例为穿刺活检标本,3例为手术切除标本）进行检测,并分析患者的临床资料。结果PMML老年人居多,病变由多种类型细胞组成,免疫组化S-100、HMB-45、Vimentin和Pan—melanin呈阳性表达。结论由于临床上PMML罕见,易造成-些非典型病例的误诊、漏诊,有条件者可以对病例行有关免疫组化检测进行确诊。     

恶性心包积液细胞蜡块联合基因检测在明确肿瘤来源及肺腺癌个体化治疗中的应用

目的 探讨恶性心包积液细胞蜡块联合基因检测在明确肿瘤来源及肺腺癌患者个体化治疗中的应用价值.方法 选择50例恶性心包积液标本作为研究对象,制备细胞蜡块,进行苏木素-伊红(HE)染色,同时选择钙网膜蛋白(CR)、间皮细胞(MC)、肾母细胞瘤基因1(WT1)、癌胚抗原M2A单克隆抗体(D2-40)、尾型同源盒转录因子2(C...