AMACER CK34βE12在前列腺穿刺活检组织中的表达

目的：探讨AMACER和CK3413E12在前列腺穿刺活检组织中的表达，评估其在前列腺癌诊断上的意义．方法：应用免疫组织化学法检测178例前列腺穿刺活检组织中AMACER和CK3413E12表达情况，其中前列腺腺癌（Cap）69倒、良性前列腺增生（BPH）101例、前列腺上皮内组织瘤（PIN）5例、不典型小腺体增生（ASAP）3例．结合临床资料进行分析、，结果：AMACER在微粒穿刺活检组织中CaP阳性表达率为100％，其中弥漫阳性率（≥＋＋＋）为98．6％；BPH中（-）84例（83．2％），（＋）17例（15．8％），（＋＋）1例（1．0％）；PIN和ASAP均为阴性表达。CK3413E12在全部CaP和ASAP病例中为阴性表达，在BPH和PIN病例中均为阳性表达．结论：AMACER是前列腺腺癌的特异性肿瘤标记物，将其与CK3413E12联合应用于穿刺活检所获得前列腺微粒组织的检测，可以确诊前列腺癌，提高早期癌和小体积癌（〈0．5ml）的检出率。     

免疫组化P504S、p63、34βE12在前列腺病变组织中的表达

目的探讨P504S、p63、34βE12在前列腺病变组织中的表达,以评估其在鉴别诊断中的意义。方法应用免疫组化PV9000二步法检测43例前列腺腺癌、27例前列腺重度上皮瘤变、40例前列腺结节性增生组织中P504S、p63、34βE12的表达情况。结果P504S在前列腺癌性腺体与重度上皮瘤变、前列腺结节性增生腺体组织中的阳性表达率之间均有非常显著性差异(P<0.01);但在Gleason评分分值显示,不同的前列腺腺癌组织中的表达无显著性差异(P>0.05);p63、34βE12在所有前列腺癌腺体组织中均呈阴性,在重度上皮瘤变组织中呈弱阳性、阳性或强阳性,在前列腺结节性增生组织中均呈强阳性。结论P504S是前列腺腺癌敏感而特异性的标志物,其与p63、34βE12联合标记在前列腺病变的鉴别诊断中具有重要意义,为临床早期发现、早期治疗前列腺腺癌提供了有力的理论依据。     

免疫组化鸡尾酒法检测P504S、P63和34βE12在前列腺病变诊断中的意义

背景与目的： 探讨在前列腺穿刺活检标本组织中联合检测α-甲酰基辅酶A消旋酶(P504S)、P63蛋白和高分子量角蛋白(34βE12)对前列腺良恶性病变诊断及鉴别诊断的意义。 材料与方法: 采用组合式单克隆抗体和双酶标记的免疫组化鸡尾酒法检测32例前列腺癌(PCa)、16例前列腺不典型腺瘤样增生(AAH)和44例良性前列腺增生(BPH)穿刺活检标本,在同一张组织切片上检测P504S、P63和34βE12抗原的表达情况。 结果: PCa中P504S均呈阳性表达,阳性率100％,而P63和34βE12呈阴性表达;AAH中上述3种蛋白的阳性表达率均为75％;BPH中P504S均呈阴性表达,而P63、34βE12均呈阳性表达,阳性率100％;P504S、P63和34βE12抗原在PCa、AAH、BPH 3组标本中的表达两两比较差异均有统计学意义(P<0.05)。 结论： 免疫组化鸡尾酒法可作为前列腺疾病诊断及鉴别诊断的一种有效辅助手段;P504S是PCa高度敏感和特异的标志物, P63和34βE12联合标记基底细胞的特异性高, 3者联合检测能提高前列腺穿刺活检标本诊断的准确性。     

宫颈微偏腺癌2例并文献复习

目的探讨子宫颈微偏腺癌的临床特征、病理组织学形态、诊断及鉴别诊断。方法复习2例微偏腺癌的相关临床资料，并对其进行组织学观察，结合文献进行探讨。结果微偏腺癌患者白带增多呈水样。子宫颈肥大呈桶状，切面见子宫颈纤维肌层增厚，质地硬，有多个不规则微小囊腔形成。大部分肿瘤细胞异型性小，接近正常宫颈黏液性腺上皮，但腺体大多呈不规则的囊状扩张、扭曲，有鸡爪样触角形成，腺体呈浸润性生长，并有纤维间质反应，肿瘤组织易侵犯脉管和神经组织。结论微偏腺癌是1种较罕见的、细胞学异型性极轻微、宫颈刮片及活检不易明确诊断的、易被诊断为良性而生物学行为为恶性的宫颈腺瘤。     

胆囊原发性腺鳞癌一例临床病理分析并文献复习

目的：分析胆囊原发性腺鳞癌的临床病理特点、鉴别诊断及治疗预后.方法：对1例胆囊腺鳞癌的临床资料进行分析,并复习相关文献.结果：本病早期无特异临床表现,主要表现为右上腹疼痛合并胆囊内结石.组织学特点：肿瘤由鳞癌及腺癌两种成分构成.以鳞癌成分为主呈巢状结构,鳞癌细胞大小不等,异型性明显,胞浆丰富,边界清楚,核仁较明显,核分裂像可见,可见角化珠、单个细胞内角化及细胞间桥.腺癌成分较少,肿瘤细胞排列成不规则的腺体,异型性较明显.间质中淋巴细胞较丰富,部分腺癌与鳞癌间质有移行.免疫组化染色显示：部分癌细胞34βE12（＋＋）,部分癌细胞CK7（＋＋）、CEA（＋）、CA19-9（＋＋）、ki-67（＋）、p53（＋）、CK20（-）.结论：胆囊腺鳞癌是一种少见的胆囊肿瘤,其诊断主要依靠组织病理学和免疫组化标记.     

P504S、p63、34βE12在前列腺不同病变诊断中的意义

目的 探讨P504S、p63、34βE12在良性前列腺增生、不典型腺瘤样增生、前列腺上皮内瘤变和前列腺腺癌诊断中的意义.方法 收集102例前列腺不同病变的常规石蜡标本,光镜下按WHO标准分类,应用免疫组织化学二步法,观察PS04s、p63、34βE12的表达.结果 良性前列腺增生、不典型腺瘤样增生的腺泡和导管周围34βE12和p63均为(+),而P504S均(-).低级别PIN及高级别PIN的腺泡和导管周围34βE12和p63均为(+),而增生的腺上皮P504S分别为7.7%(2/26)、33.3%(1/3)呈局灶性阳性.前列腺腺癌18例中,34βE12和p63均为(-),P504S有2例呈局灶性阳性(11.1%),15例P504S呈阳性(83.3%).结论 P504S是前列腺腺癌敏感而特异性的标记物,联合检测PS04S、p63、34βE12可提高前列腺腺癌的诊断准确率,对前列腺穿刺标本进行不同病变的鉴别诊断更有帮助.     

皮下脂膜炎样T细胞淋巴瘤临床病理分析

[目的]探讨皮下脂膜炎样T细胞淋巴瘤的临床病理特征.[方法]对我院收治的2例皮下脂膜炎样T细胞淋巴瘤作临床病理形态观察和免疫组织化学分析(SP法).『结果]2例肿瘤患者均为青壮年,临床上首发症状均表现为皮下结节,单发或多发,继而向上累及皮肤,向下累及筋膜.镜下见2例肿瘤均呈脂膜炎样生长,肿瘤细胞围绕单个脂肪细胞呈花环状排列,可见核碎裂,局灶性脂肪坏死及泡沫状组织细胞.肿瘤表达T细胞免疫表型.[结论]皮下脂膜炎样T细胞淋巴瘤是累及皮下脂肪组织具有独特临床病理特征的特殊类型皮肤淋巴瘤,应与良性脂膜炎及其它皮肤坏死疾病相鉴别.     

子宫颈微偏腺癌1例报道及文献回顾

目的:报道1例子宫颈微偏腺癌病例,探讨其临床病理学特征。方法:对1例子宫颈微偏腺癌进行临床病理学及免疫组化观察。结果:显微镜下,腺体由分泌黏液的柱状上皮构成,腺体扭曲,外形不规则,大多数腺体与正常腺体无法区别,少部分腺体的细胞核有中度不典型增生,核分裂象可见。结论:子宫颈微偏腺癌是一种少见的高分化黏液腺癌,临床诊断应排除良性腺体增生及内膜异位。因大多数病例子宫颈活检不能诊断,所以在日常临床工作中如遇到考虑恶性肿瘤,而镜检为良性时,应考虑子宫颈微偏腺癌,腺体浸润深度是诊断的关键。     

骨桥蛋白在子宫内膜样腺癌组织中的表达及其临床意义

目的:探讨骨桥蛋白(osteopontin,OPN)在子宫内膜样腺癌组织中的表达及与子宫内膜样腺癌临床病理特征的关系,探讨OPN对判断子宫内膜样腺癌患者预后的意义.方法:采用免疫组化方法(Envision法)测定OPN在46例子宫内膜样腺癌组织、16例正常子宫内膜组织中的表达.结果:OPN在子宫内膜样腺癌及正常子宫内膜组织中都有表达,在子宫内膜样腺癌组织中表达阳性率为86.96%,显著高于正常增殖期及分泌期子宫内膜组织,差异显著(P<0.05).在子宫内膜样腺癌中的表达同其细胞分化有关,低分化者高于中分化,高分化和中分化无明显差异,OPN阳性表达与患者年龄及临床病理分期无关.OPN表达阳性患者比阴性患者生存期缩短.结论:OPN对子宫内膜样腺癌的发生、发展起重要作用,OPN阳性表达是子宫内膜样腺癌患者负性预后因子.     

细胞块制片免疫组化对胸腹腔积液转移性腺癌的诊断价值

目的 探讨细胞块制片免疫组化对胸腹腔积液转移性腺癌的诊断价值.方法 收集胸腹腔积液患者100例,经过穿刺法获取胸腹腔积液标本100 ml,病理检查,给予常规涂片和细胞块制片,均联合免疫组化法,比较两种检测方法相关蛋白阳性、阴性以及不确定性,计算细胞阳性率.结果 细胞块检测阳性率为48.0%,高于常规检测的34.0%,不确定性比例为0,低于常规的22.0%(P<0.05);两种方法对良性组织检测结果显示:CK7、MOC-31、CD51、TTF-1、CEA、CA125、Ber EP4、NapsinA、E-cad均呈低表达,WT-1、Calretinin、CK5/6均呈高表达,恶性组织检测显示CK7、MOC-31、CD51、TTF-1、CEA、CA125、Ber EP4、NapsinA、E-cad均呈高表达,并且细胞块法阳性率均高于常规涂片法(P<0.05),WT-1、Calretinin、CK5/6均呈低表达;常规涂片对不确定组织检测结果:WT-1、Calretinin、CK5/6阳性率均较高,其他均为低阳性率,CK7、MOC-31、CD51、TTF-1、CEA、CA125、Ber EP4在转移性恶性肿瘤中阳性率均较高,并且细胞块阳性率均高于相应的常规涂片法(P<0.05).结论 细胞块制片免疫组化对胸腹腔积液转移性腺癌的诊断具有重要意义,各指标间联合可以判断肿瘤类型.     

CK34βE12、p63和P504S联合检测在前列腺癌诊断中的应用

 目的 探讨CK34βE12、p63和P504S联合免疫组化标记在前列腺良、恶性病变鉴别诊断中的应用价值。方法 应用免疫组织化学方法，观察74例前列腺病变标本[包括前列腺癌（PC）27例、高级别前列腺上皮内瘤（HGPIN）6例、低级别前列腺上皮内瘤（LGPIN）10例、前列腺非典型腺瘤性增生（AAH）3例、良性前列腺增生（BPH）28例]中CK34βE12、p63和P504S的表达情况。结果 p63和CK34βE12在AAH、LGPIN和BPH中均为阳性染色，而在PC中均为阴性，在6例HGPIN中5例为阳性，PC组表达率明显低于其他病变组差异有统计学意义（P＜0.01）；P504S 在PC、AAH、HGPIN、LGPIN和BPH中阳性率分别为92.6 %（25／27）、0、66.7 %、10 %和0，PC组明显高于AAH、LGPIN和BPH组（P＜0.01），与HGPIN组之间差异无统计学意义（P = 0.132）；P504S阳性协同p63或CK34βE12阴性两种标记在PC、AAH、HGPIN、LGPIN和BPH中表达率分别为92.6 %、0、16.7 %、0和0，两种标记表达在前列腺癌与其他病变之间差异有统计学意义（P＜0.01）。结论 利用P504S与p63或CK34βE12联合检测有助于提高前列腺癌诊断的准确率。     

涎腺淋巴上皮癌5例临床病理分析

目的:探讨涎腺淋巴上皮癌的临床病理学特征.方法:对5例涎腺淋巴上皮癌的临床特征、组织学形态和免疫组织化学表型进行观察,并对相关文献进行复习.结果:4例肿瘤发生在腮腺,1例发生于左颌下腺.其中1例继发于良性淋巴上皮病变.临床主要表现为局部包块,活动度差,伴有疼痛.组织学特点:涎腺组织中淋巴组织及纤维组织增生,淋巴样间质中见上皮样肿瘤细胞团呈片状、岛状、条索状和巢状浸润,淋巴细胞呈多少不一浸润肿瘤组织,肿瘤细胞核呈泡状,可见淋巴滤泡形成.免疫组化检测,瘤细胞AE1/AE3(+),EMA(+),p63(+),CK5/6(+),S-100(-),SMA(-),Vimentin(-),LCA(-),肿瘤间质淋巴细胞表达CD3(+)或CD20(+);原位杂交检测,瘤细胞EBER(+).结论:涎腺的淋巴上皮癌作为独立的肿瘤实体,有其特征,免疫表型呈AE1/AE3(+),EMA(+),p63(+),CK5/6(+),需与良性淋巴上皮病变等鉴别.     

Anal gland carcinoma

BACKGROUND: Anal gland carcinoma is a rare entity. The authors conducted a joint study of cases coded as definite or possible anal gland carcinoma from the archives of the Armed Forces Institute of Pathology and the Canadian Reference Center for Cancer Pathology. METHODS: Seven cases of potential anal gland carcinoma were identified from the Canadian files and 12 from the Armed Forces Institute of Pathology archives. Of these 19 cases, 14 had adequate material to allow clinical, histologic, and immunohistochemical analysis. RESULTS: Seven of these 14 cases met a modified World Health Organization (WHO) definition of anal gland carcinoma. The mean age of these patients was 66 years (range, 60-72 years), with a male-to-female ratio of 6:1. The tumors were composed of haphazardly dispersed, small glands with scant mucin production that invaded the wall of the anorectal area with no obvious intraluminal component observed clinically or microscopically. Immunohistochemical studies were performed on all seven of these cases, revealing cytokeratin (CK) 7+/CK 20- expression in six cases, and CK 7+/CK 20+ expression in one case. The remaining seven cases showed no intraluminal component but did not meet a modified WHO definition of anal gland carcinoma. This group included three mucinous adenocarcinomas (two clinically arising in anal fistulas), all of which were CK 7+/CK 20+, and a rectal-type adenocarcinoma that was CK 7-/CK 20+. There was also a tumor interpreted as probable rectal-type adenocarcinoma that was CK 7+/CK 20+, and a tumor interpreted as probable squamous cell carcinoma that was CK 7-/CK 20-. The seventh tumor in this group, which could not be classified, was CK 7+/CK 20-. CONCLUSIONS: A useful and discriminating definition of anal gland carcinoma is an anal canal tumor composed of haphazardly dispersed, small glands with scant mucin production invading the wall of the anorectal area without an intraluminal component. The glands are positive for CK 7.     

S100A6 (Calcyclin) is a prostate basal cell marker absent in prostate cancer and its precursors

S100A6 (Calcyclin) is a calcium-binding protein that has been implicated in a variety of biological functions as well as tumorigenesis. The aim of our study was to investigate the involvement of S100A6 during prostate cancer development and progression. Using immunohistochemistry, the expression of S100A6 was examined in benign (n=66), premalignant (n=10), malignant (n=66) and metastatic prostate (n=5) tissues arranged in a tissue-microarray or whole sections as well as in prostate cancer cell lines. The S100A6 immunostaining pattern in tissues was compared with that of cytokeratin 5 (a basal cell marker) and 18 (a benign luminal cell marker). In all cases of benign epithelium, intense S100A6 expression was seen in the basal cell layer with absent staining in luminal cells. In all cases of prostatic adenocarcinoma (matched), metastatic lesions and 3/10 high-grade prostatic intraepithelial neoplasia lesions, an absence of S100A6 was seen. Western blotting and RT-PCR analysis of cell lines showed S100A6 expression to be absent in LNCaP, LNCaP-LN3 and LNCaP-Pro5 but present in Du145, PC3, PC-3M and PC-3M-LN4. LNCaP cells treated with 5-Azacytidine, caused re-expression of S100A6 mRNA. Sequencing of bisulphite modified DNA showed CpG methylation within the S100A6 promoter region and exon 1 of LNCaP, LNCaP-LN3 and LNCaP-Pro5 cell lines but not in Du145 cells. Our data suggest that loss of S100A6 protein expression is common in prostate cancer development and may occur at an early stage. The mechanism of loss of expression may involve hypermethylation of CpG sites. The finding of intense S100A6 expression in the basal cells of benign glands but loss of expression in cancer could be useful as a novel diagnostic marker for prostate cancer.     

前列腺干细胞抗原在前列腺组织的表达及意义

目的演探讨前列腺干细胞抗原(prostatestemcellantigen,PSCA)在前列腺组织中的表达及其意义。眼方法演应用核酸分子原位杂交穴ISH雪技术,对PSCAmRNA在26例前列腺癌、20例良性前列腺增生(BPH)和9例正常前列腺(NP)标本中的表达水平进行检测及定位。眼结果演PSCAmRNA在NP、BPH及前列腺癌组织表达阳性率分别为66.7%、70.0%及84.6%,强阳性率分别为0、10.0%及57.7%。NP与BPH组织表达水平无显著差异(P>0.05),其表达定位于前列腺上皮的基底细胞层;PSCAmRNA在前列腺癌组织主要表达于癌细胞,细胞间质和肌肉组织均无表达。前列腺癌与NP、BPH组织表达水平均有显著差异(P<0.01)。PSCAmRNA表达水平与前列腺癌临床分期、病理分级均无相关性(P>0.05)。眼结论演PSCA高表达是前列腺癌的共同特征;PSCA在前列腺癌早期诊断与免疫靶向治疗方面有良好的开发应用前景。     

GOLPH2 protein expression as a novel tissue biomarker for prostate cancer: implications for tissue-based diagnostics

GOLPH2 is coding the 73-kDa type II Golgi membrane antigen GOLPH2/GP73. Upregulation of GOLPH2 mRNA has been recently reported in expression array analyses of prostate cancer. As GOLPH2 protein expression in prostate tissues is currently unknown, this study aimed at a comprehensive analysis of GOLPH2 protein in benign and malignant prostate lesions. Immunohistochemically detected GOLPH2 protein expression was compared with the basal cell marker p63 and the prostate cancer marker alpha-methylacyl-CoA racemase (AMACR) in 614 radical prostatectomy specimens. GOLPH2 exhibited a perinuclear Golgi-type staining pattern and was preferentially seen in prostatic gland epithelia. Using a semiquantitative staining intensity score, GOLPH2 expression was significantly higher in prostate cancer glands compared with normal glands (P<0.001). GOLPH2 protein was upregulated in 567 of 614 tumours (92.3%) and AMACR in 583 of 614 tumours (95%) (correlation coefficient 0.113, P = 0.005). Importantly, GOLPH2 immunohistochemistry exhibited a lower level of intratumoral heterogeneity (25 vs 45%). Further, GOLPH2 upregulation was detected in 26 of 31 (84%) AMACR-negative prostate cancer cases. These data clearly suggest GOLPH2 as an additional ancillary positive marker for tissue-based diagnosis of prostate cancer.     

伴有明显间质纤维化的胆囊腺癌19例临床病理分析

背景与目的:胆囊癌的肉眼类型多是息肉型、隆起型或菜花状肿块,组织学类型有高、低分化腺癌,粘液腺癌和未分化癌。而伴有明显间质纤维化的胆囊腺癌较少见,本研究旨在探讨其临床病理特征。方法:应用光镜和免疫组化SP法,对19例伴有明显间质纤维化的胆囊腺癌手术标本切片进行病理学观察,并结合临床资料进行分析。结果:伴有明显间质纤维化的胆囊腺癌临床表现多有长期的胆囊炎、胆囊结石病史,B超检查提示胆囊壁呈不规则增厚或结节状改变。其大体形态不形成癌结节突入胆囊腔,胆囊壁呈局限性增厚,少数病例胆囊壁呈弥漫性不规则增厚。病理组织学特点:腺癌细胞多呈单层排列,较少复层排列,形成大小不等、形态不一、排列不规则的腺样结构;核显示异型性,核分裂像可见,但较少;增生的大量纤维性结缔组织间可伴有以淋巴细胞、浆细胞为主的炎性细胞浸润。免疫表型:强阳性表达CK(AE1/AE3)、CK(AE1)、CK7(OV-TL12/30)、CK8(C51)、CK18(Dc-10)、CK19(RCK108)、EMA(Mc-5);中等阳性表达CEA(COL-1)、CK20(Ks20.4)、MUC-5AC(CLH2);弱阳性表达MUC-2(B306.1);灶性表达CK17(E3)。结论:伴有明显间质纤维化的胆囊腺癌的临床表现、肉眼类型、组织学特点等不同于其它腺癌;其发生可能与慢性胆囊炎有关。     

Detection of C-KIT (CD117) molecule in benign and malignant salivary gland tumours

C-KIT (CD117), a tyrosine kinase receptor, is involved in the growth and development of normal tissues and some types of neoplasms. In the present study we analysed the expression of this molecule in salivary gland tumours. Archival formalin-fixed, paraffin-embedded sections of 40 benign and 57 malignant salivary gland tumours were retrieved and retrospectively studied immunohistochemically using a polyclonal C-KIT antibody in an Envision/HRP technique. In addition five samples of chronic submandibular sialadenitis, five normal minor salivary glands and parotid or submandibular gland tissue adjacent to benign tumour were also studied. C-KIT expression was observed in cases of adenoid cystic, acinic cell polymorphous low grade, epithelial-myoepithelial, carcinosarcoma and basal cell adenocarcinomas, as in luminal cells of pleomorphic adenomas, in serous acinar and only in intercalated and a small number of striated ductal cells of inflammatory salivary gland tissue, whereas normal salivary lobules were generally negative except a weak positivity of intercalated cells. Contrary to other reports, this study suggests that, C-KIT protein does not appear to be an exclusively specific marker for benign or malignant salivary gland neoplasms, but may be useful in differential diagnosis of adenoid cystic carcinoma from polymorphous low grade adenocarcinoma. Furthermore its expression in serous acinar cells in sialadenitis and intercalated ductal cells in normal and inflammatory lesions may indicate a possible participation in pathogenesis of both neoplastic and non-neoplastic salivary gland diseases.