膀胱尿路上皮癌HER2表达及临床病理分析

目的 探讨膀胱尿路上皮癌(bladder urothelial carcinoma, BUC)中HER2的表达情况,并分析其临床意义。方法 收集膀胱非浸润性低级别BUC 27例、非浸润性高级别BUC 5例、浸润性高级别BUC 60例,采用免疫组化MaxVision法法检测各组织样本中HER2蛋白的表达,并分析HER2表达与临床病理特征的关系。通过GEPIA数据库或直接在肿瘤基因组图谱(The Cancer Genome Atlas, TCGA)中分析HER2(ERBB2)表达与BUC的关系。结果 浸润性高级别BUC中HER2 2+/3+表达率(26.67%,16/60)显著高于非浸润性低级别BUC(7.41%,2/27)和非浸润性高级别BUC(0,0/5)(P<0.05)。多灶性浸润性高级别BUC中HER2 2+/3+表达率(75.00%,6/8)显著高于单灶性患者(19.23%,10/52)(P<0.05)。各组织学亚型中HER2 2+/3+表达率差异有统计学意义(P<0.05),其中普通型为30%(6/20)、腺样分化型为57.14%(4/7)、微乳头型为66.6...     

膀胱尿路上皮癌中LRG1和TGF-β1的表达及临床病理意义

目的 探讨富亮氨酸α2糖蛋白1（leucine-rich alpha-2-glycoprotein 1, LRG1）及转化生长因子beta 1（transforming growth factor-beta 1, TGF-β1）在膀胱尿路上皮癌（bladder urothelial carcinoma, BUC）组织中的表达及意义。方法 采用免疫组化SP法检测LRG1、TGF-β1及Ki-67在64例BUC组织及25例癌旁组织中的表达,分析LRG1、TGF-β1在各组间表达的差异及相关性。结果 LRG1在BUC组织中强阳性27例（42.19%）,癌旁组织中强阳性仅2例（8.00%）,两组相比差异有统计学意义（P<0.05）;TGF-β1在BUC组织中阳性49例（76.56%）,在癌旁组织中阳性10例（40.00%）,差异有统计学意义（P<0.05）;相关性分析显示,LRG1与TGF-β1表达呈正相关（r²=0.658 2,P<0.05）;LRG1、TGF-β1表达均与BUC病理学分级、浸润深度及Ki-67增殖指数相关（P<0.05）。结论 ...     

膀胱浆细胞样尿路上皮癌1例

患者男性,70岁.无明显诱因出现肉眼血尿4个月余,伴尿频、尿痛,遂于2019年4月就诊于我院.男性泌尿系超声示膀胱壁低回声伴环状钙化,增强CT示膀胱左侧后壁局部不均匀增厚隆起(图1);腹膜后大血管旁多发淋巴结肿大.膀胱镜检查见膀胱左侧壁有一宽基息肉状新生物,膀胱内广泛滤泡样及鱼鳞样改变,侵及膀胱颈口及双侧输尿管开口.     

RIN1在膀胱尿路上皮癌中的表达及临床特征

目的探讨膀胱尿路上皮癌中RINl蛋白的表达与临床病理学特征的关系。方法用sP免疫组化法检测手术切除的88例原发性膀胱尿路上皮癌标本和20例癌旁正常组织标本。所有组织用10％福尔马林固定。石蜡包埋,连续切片,厚度4μm。所有上述患者术前均未接受放疗,化疗。通过卡方检验,分析RINl表达与膀胱尿路上皮癌的临床病理学特点。结果免疫组化法发现,88例膀胱尿路上皮癌中有49例RINl表达升高,20例癌旁组织的RINl表达正常。RINl的表达与肿瘤的病理分级（P〈0．05）和临床分期（P〈0．05）呈正相关,与年龄、性别、肿瘤大小、是否多发则无相关性（P〉0．05）。结论RINI在膀胱尿路上皮癌中存在高表达,且在膀胱癌中发挥着重要作用。     

miR-1在膀胱尿路上皮癌中的表达及其功能

目的研究miR-1在膀胱尿路上皮癌中的表达和临床意义,探讨miR-1在膀胱癌发病的作用。方法应用real-time PCR方法分别检测60例配对的新鲜膀胱尿路上皮癌及癌旁正常组织中miR-1的表达,统计分析miR-1表达差异与临床病理因素间的关系,应用CCK8法检测miR-1对膀胱癌T24细胞增殖能力的影响。结果miR-1在膀胱癌组织较癌旁正常组织中表达水平显著降低,而且肌层浸润性膀胱癌(T2-T4)患者组织中的miR-1表达显著低于非肌层浸润性膀胱癌组织(Ta-T1)。miR-1异常低表达与膀胱癌复发或转移、临床分期及病理分级密切相关,miR-1能够抑制膀胱癌T24细胞的增殖能力。结论miR-1在膀胱癌的发病过程中可能发挥着重要作用,可能成为未来膀胱癌治疗的新靶点及预后预测因子。     

尿路上皮癌组织学变异型的病理特征及诊断

肾盏、肾盂、输尿管、膀胱及尿道均由尿路上皮衬覆，各部位发生的癌大多有相似的组织病理学特征。如膀胱恶性肿瘤90％-95％是尿路上皮癌（urothelial carcinoma，UC），而其余5％～10％是间叶性肿瘤和其他罕见型上皮性肿瘤，后者虽罕见但同样起源于尿路上皮，说明尿路上皮细胞具有多能性或异向分化能力，由此发生的肿瘤被称为UC伴异向分化（UCwith divergent differentiation）。特别是高核级或高分期的UC，最常见的是伴有灶性鳞状分化或腺上皮分化区，偶可伴骨和软骨等间叶性成分。     

膀胱微乳头状尿路上皮癌的临床病理学特征

收集2013—2019年间21例膀胱微乳头尿路上皮癌（MPUC）及同期117例膀胱非特殊型浸润性尿路上皮癌的临床病理资料,探讨MPUC临床病理学特征,并比较两组病例临床病理特征及预后的差异。MPUC患者男女比17∶4,中位年龄67岁,微乳头成分占5%~70%,12例（12/21,57.1%）有脉管侵犯。10例（47.6...     

多色荧光原位杂交检测尿沉渣诊断膀胱尿路上皮癌

目的研究应用多色荧光原位杂交检测尿沉渣诊断膀胱尿路上皮癌的可行性,并与尿脱落细胞学相比较。方法M-FISH法分析100例可疑膀胱尿路上皮癌或有相关病史患者和10例良性前列腺增生患者晨尿尿沉渣,同时行尿脱落细胞学检查,以病理为诊断标准。FISH探针是用随机引物法标记3、7、17号染色体着丝粒及9p21区带,统计染色体畸变组合诊断膀胱尿路上皮癌的阳性率。结果M-FISH低级别尿路上皮癌灵敏度75.6%,高级别尿路上皮癌为100%,总体灵敏度85.5%;尿脱落细胞学低级别尿路上皮癌灵敏度33.3%,高级别是96.0%,总体灵敏度62.9%,两者总体灵敏度之间有统计学差异(P<0.05);两者特异性分别是84.6%和87.8%,无统计学差异。结论M-FISH法检测灵敏度比尿脱落细胞学高,特异性相似,并可以诊断出所有的高级别浸润性肿瘤。     

A new system for substaging pT1 papillary bladder cancer: a prognostic evaluation

Superficially invasive (pT1) papillary urothelial cell carcinomas (UCCs) may run a variable course. Several attempts have been made for the substaging of UCC to identify the clinically aggressive tumors. We present a new substaging system, based on the extent of invasion. From a series of 53 primary pT1 UCC, 24 cases showed invasion of the subepithelial stroma by an invasive front extending more than a maximum length of 0.5 mm (pT1mic), and 29 showed extensively (>0.5 mm) infiltrating UCC (pT1ext). We tested diagnostic reproducibility between 2 pathologists and found 81% agreement. Furthermore, all cases were analyzed for mutations in the fibroblast growth factor receptor 3 (FGFR3) gene, which represents the favorable pathway of urothelial cell carcinogenesis. Mutant FGFR3 was commonly observed in pT1mic UCC (15/24, 63%), but rarely (2/29, 7%) in pT1ext UCC (chi2 test, P < .001). The presence of pT1ext at initial diagnosis proved to be the strongest predictor for progression, also when adjusted for FGFR3 mutation status in a Cox regression model. If confirmed on a larger series of pT1 UCC, this relatively simple and new substaging system for pT1 UCC may prove to be of prognostic value and supportive to clinical decision-making.     

Polyp pT1 colorectal cancer

With the introduction of NHS Bowel Cancer Screening Programme, coupled with advances made in endoscopic equipment and techniques, there is a higher detection rate for early pT1 polyp colorectal cancers (CRC). The current clinical trend is towards a conservative approach without surgical resection, if felt that there is successful endoscopic excision and without unfavourable histology parameters. Nonetheless, the further management of malignant polyps, observation or resection, remains controversial.     

根治性前列腺癌病理分期及pT2病理亚分期的意义

目的探讨根治性前列腺癌病理分期及p T2病理亚分期的意义。方法回顾性分析根治性前列腺癌30例,观察肿瘤累及范围、前列腺外及精囊腺侵犯情况,依据2002/2010年TNM分期系统对其行病理分期。结果 30例术前临床评估为局限性前列腺癌,前列腺癌根治术后病理分期:p T2期15例,p T3a期10例,p T3b期5例。p T2期肿瘤中2例为p T2a,13例为p T2c,占p T2期肿瘤的86.7%,无p T2b期肿瘤。结论根治性前列腺癌术后病理分期更加直观和准确,更能够反映肿瘤真实的状态,对预后的评估更有价值,而2002/2010年TNM分期系统对于p T2期肿瘤的亚分期,仅依据肿瘤累及腺叶的范围划分并不完善,需进一步加以改善。     

Stage pT1 bladder carcinoma: diagnostic criteria, pitfalls and prognostic significance

Recognition of early invasion (stage pT1) in urothelial neoplasia is one of the most challenging areas in bladder pathology, and reproducibility between pathologists is a major issue. This fact, together with the proposal by some urologists to treat early invasive tumours more aggressively, makes the accurate detection of pT1 lesions even more relevant in clinical practice. In recent years, the morphologic features and patterns of invasion of tumour into the lamina propria have been more accurately characterised and standardised, and although some of the features are subtle, they can be of great utility in the accurate assessment of pT1 staging. Histologic grade, changes at the stroma-epithelial interface, the characteristics of the invading epithelium, and the stroma-associated response are among the most important clues for appropriate pT1 staging and these are discussed in this review. Common problems in stage pT1 disease evaluation include, tangential sectioning--due to an inability to orient transurethral resection specimens--crush and cautery artefacts, and a streaking inflammatory infiltrate. With few exceptions, the criteria discussed in this review allow pathologists to separate superficial bladder tumours consistently and reproducibly into non-invasive (pTa) tumours and tumours that have invaded the lamina propria (pT1), the latter having a significantly poorer prognosis. This review is intended to assist the surgical pathologist by presenting appropriate diagnostic criteria, by describing common pitfalls and by outlining the different histologic patterns of invasion of urothelial carcinoma into the lamina propria. The value of pT1 tumour substaging, as a predictor of bladder cancer progression is also discussed.     

pT1 urothelial carcinoma of the bladder: criteria for diagnosis, pitfalls, and clinical implications

One of the challenging areas in genitourinary pathology is the recognition of early invasion in urothelial neoplasia. Not uncommon, the patterns of invasion into lamina propria are subtle because a desmoplastic response is absent. Tangential sectioning due to inability to orient transurethral resection of bladder tumor specimens, crush and cautery artifacts further compound this problem. This review is presented to familiarize surgical pathologists with the criteria and different patterns of lamina propria invasion by urothelial carcinoma. Problems and pitfalls associated with the recognition of invasion and the clinicopathologic significance of lamina propria invasive urothelial cancer are also discussed.     

Prognostic value of combined p53 and survivin in pT1G3 urothelial carcinoma of the bladder

pT1G3 bladder tumors have a high tendency to recur and progress. We evaluated the prognostic values of the depth of submucosal invasion and immunostaining with survivin and p53 in 30 pT1G3 urothelial carcinomas at the first endoscopic resection. The depth of invasion was evaluated toward the muscularis mucosa and measured using a micrometer. Survivin and p53 immunostaining were performed using an automated immunostainer. Of the patients, 19 (63%) had tumor recurrence, 11 (37%) had tumor progression, 10 (33%) had metastatic spread, and 10 (33%) died of the disease. Infiltration of deep lamina propria (pT1b) and a micrometric measure of 1.5 mm or more were associated with an increased risk of tumor local and/or metastatic progression (P = .03 and P = .02, respectively). A combined high expression of survivin (相似文献   

Evaluation of endothelial markers in detecting blood and lymphatic channel invasion in pT1 transitional carcinoma of bladder

In a study of 40 patients with high-grade (G2 and G3) transitional cell carcinoma of bladder invading the lamina propria--stage pT1, retraction artifact was often misdiagnosed as vascular/lymphatic tumour invasion. Vascular/lymphatic infiltration was diagnosed in five cases based on haematoxylin and eosin stained sections, but confirmed in only two of these using immunohistochemical techniques to demonstrate endothelial markers. Of the latter, these preparations demonstrating von-Willebrand factor and binding the monoclonal antibody QBEND/10 were technically superior to those in which Ulex europaeus agglutinin 1 was used. It is unlikely that the demonstration of vascular/lymphatic infiltration, a rare feature, will prove of value in defining prognostic groups for treatment.