胃肠道印戒细胞癌超微结构分型

通过对３８例胃肠道印戒细胞癌进行超微细胞结构观察，发现印戒细胞癌可有三种类型，即粘液型、微囊型和糖原型。结合粘液组化染色，作者对印戒细胞癌的细胞起源以及癌细胞不同形态表现的原因和意义进行了探讨，认为印戒细胞癌起源于具有多潜能分化的干细胞，癌细胞超微结构形态特征的变化是其畸形分化或功能代谢不同的具体表现。     

胃印戒细胞癌临床病理特征研究

目的通过对比胃印戒和非印戒细胞癌患者的临床资料,分析胃印戒细胞癌的病理特征。方法对110例胃印戒细胞癌(SRC)及同期326例非印戒细胞癌（NSRC)的临床病理特点进行回顾性分析。结果印戒细胞癌组患者男女比例(1.4∶1)明显小于非印戒细胞癌组(2.5∶1)（P<0.01）;印戒细胞癌组患者发病年龄<60岁的比例（43.6%）明显高于非印戒细胞癌组（30.9%）（P<0.05）;在Ⅰ期胃癌患者,胃印戒细胞癌患者所占比为31.4%,而Ⅰ期以上印戒细胞癌患者在所有晚期胃癌患者中所占比为23.3%（P<0.05）;印戒细胞癌组中肿瘤浸润深度达T1以上者（70%）低于非印戒细胞癌组(86.9%)（P<0.001）;而两组在肿瘤发生部位、淋巴结转移率上的差异无统计学意义。结论胃印戒细胞癌好发于年轻女性,早期发生率较高且浸润到黏膜下层速度较慢。     

乳腺印戒细胞癌6例临床病理分析

[目的]探讨乳腺印戒细胞癌的临床病理特征.[方法]收集确诊的6例乳腺印戒细胞癌患者的临床、光镜、免疫组化资料.[结果]患者主要症状为局部肿块,镜下表现为与小叶癌相关和导管癌相关.印戒细胞胞质内黏液AB染色呈蓝色,黏液卡红染色呈红色.免疫组化CK7、GCDFP-15、MG、ER、PR均阳性,CK20为阴性,患者血清巾乳酸脱氢酶未见明显升高,而白细胞介素6和白细胞介素12的含量明显高于正常值.[结论]乳腺印戒细胞癌临床注意与分泌性癌、转移性印戒细胞癌和富于糖原的透明细胞癌进行鉴别.     

Lymph Node Metastasis in Early Signet Ring Cell Carcinoma:Endoscopic Mucosal Resection

Objective:To identify clinicopathological factors predictive of lymph node metastases(LNM)in early signet ring cell carcinoma(SRC),and further to expand the possibility of using endoscopic mucosal resection(EMR)for the treatment of early SRC.Methods:Data from 27 surgically treated patients with early SRC were collected,and the association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses.Results:In the ...     

MACC1和c-Met蛋白在胃印戒细胞癌中的表达及意义

摘 要：［目的］探讨结肠癌转移相关基因1（metastasis-associated in colon cancer 1,MACC1）和肝细胞生长因子受体（hepatocyte growth factor receptor,c-Met）在胃印戒细胞癌（signet ring cell carcinoma,SRCC）组织中的表达及其与临床病理特征的相关性。［方法］应用免疫组化法检测80例SRCC组织及其对应癌旁组织和25例癌前病变组织中MACC1和c-Met蛋白的表达情况,统计学分析MACC1和c-Met表达水平与临床病理特征的关系。［结果］MACC1和c-Met在SRCC组织中的阳性率均明显高于癌旁组织和癌前病变组织（P＜0.05）。MACC1和c-Met阳性率均与肿瘤浸润深度、TNM分期、淋巴结转移和腹膜转移相关（P<0.05）,而与年龄、性别、肿物部位、大小、CEA和CA199无统计学意义相关（P＞0.05）。SRCC组织中MACC1和c-Met的表达呈正相关（r=0.301,P=0.007)。［结论］MACC1和c-Met在SRCC的侵袭和转移过程中发挥重要作用,有望成为SRCC预后的标志及潜在治疗靶点。     

Thirty-Five-Year-Old Woman with Signet Ring Cell Gastric Carcinoma Secondary to the Chernobyl Nuclear Accident: A Case Report

The 1986 Chernobyl nuclear accident resulted in radiation exposures throughout much of Europe, with the highest exposures within the city of Pripyat, Ukraine, where the accident occurred. We report a woman who was exposed to the Chernobyl accident at age 13. Beginning in her early thirties, she experienced several years of upper abdominal pain that became progressively more severe. At age 35, she underwent upper endoscopy and gastric biopsy. Histological examination revealed a signet ring cell (SRC) gastric carcinoma. The tumor was discovered at an advanced stage and proved unresectable. She died 3 months following her diagnosis. The mean age for SRC gastric carcinoma diagnosis is about 62 years; the median survival following diagnosis is 13 months. The early appearance and aggressive clinical course of this malignancy in relation to the Chernobyl nuclear accident is discussed.Key words: Chernobyl, Signet ring cell gastric carcinoma, Malignancy, Fallout     

Retroperitoneal Fibrosis as a Result of Signet Ring Cell Gastric Cancer: a Case-Based Review

Background

Retroperitoneal fibrosis is a rare and obvious condition in the abdominopelvic cavity. Signet ring cell carcinoma of the stomach with gross appearance of linitis plastica is another rare association.

Case presentation

We present a rare case of a 49-year-old woman presenting with persistent nausea and vomiting for 20 days. Three months ago, she was admitted with severe flank pain and was referred to the urology service. She was placed with stents for strictures in both ureters. She underwent endoscopy for heartburn, melena, dyspepsia, and weight loss (7 kg/5 month), which revealed congestion of the mucosa of the fundus and body with fine linear erosion and decreased distensibility of the stomach suggesting linitis plastica. A biopsy indicated full-thickness infiltration by signet ring cell gastric cancer. A CT scan showed evidence of retroperitoneal fibrosis with large lymph nodes around the aorta.

Conclusion

This paper shows that the gastric linitis plastica can present with many deceptive clinical presentations, raising the risk of postponed diagnosis.     

Primary Signet Ring Cell/Histiocytoid Carcinoma of the Eyelid: Somatic Mutations in CDH1 and Other Clinically Actionable Mutations Imply Early Use of Targeted Agents

Primary signet ring cell/histiocytoid carcinoma of the eyelid is a rare ocular malignancy and its diagnosis is often delayed. This neoplasm presents as an insidious, diffusely infiltrative mass in the periocular area that later infiltrates the orbit. An exenteration is usually indicated; however, nearly one-third of patients develop local recurrence or metastasis. Morphologically, it resembles signet ring cell carcinoma of the stomach and breast, raising the possibility of mutations in CDH1, the gene encoding E-cadherin. To determine whether primary signet ring cell/histiocytoid carcinoma harbors the CDH1 mutation or other actionable mutations, we analyzed the tumor tissue via next-generation sequencing. We identified only one case of primary signet ring cell carcinoma of the eyelid with adequate DNA quality for sequencing from the pathological archive during the period 2000 to 2020. A comprehensive evaluation including histopathology, immunohistochemistry, and next-generation sequencing assay was performed on tumor tissue. Immunohistochemically, the tumor exhibited E-cadherin membranous staining with the aberrant cytoplasmic staining of β-catenin. Using next-generation sequencing, we demonstrated the mutation in the CDH1 gene. In addition, other clinically actionable mutations including ERBB2 and PIK3CA were also detected. The alterations in other actionable genes indicate a need for larger studies to evaluate the pathogenesis and potential therapies for primary signet ring cell/histiocytoid carcinoma of the eyelid.     

乳腺印戒细胞癌和粘液腺癌的临床病理分析

目的 :比较研究乳腺印戒细胞癌和粘液腺癌的临床及病理学特点的差异。方法 :对 11例乳腺印戒细胞癌和 58例乳腺粘液腺癌的临床和病理特征进行对比分析。结果 :乳腺印戒细胞癌 3年生存率 63.63% ,5年生存率 9.0 9% ,粘液腺癌 3年生存率 94 .83% ,5年生存率 81.0 3%。显微镜下二者粘液分布不同 ,肉眼所见大体标本相差甚远。结论 :乳腺印戒细胞癌较粘液腺癌恶性程度高、预后差 ,在临床上有必要从粘液腺癌中独立出来。     

A Case of Signet Ring Carcinoma of the Appendix: Dilemmas in Differential Diagnosis and Management

Purpose

Signet ring carcinoma (SRC) of the appendix consists one of the most biologically virulent cancers. We present the case of a patient with primary SRC complicated by the development of acute inflammation of the appendix.

Case Report

A 78-year-old man was admitted due to a 5-day history of increasing colicky abdominal pain and vomiting. Clinical examination revealed a firm, tender mass in the right ileac fossa. Laparotomy confirmed a tumor mass which appeared to originate from the appendix. The affected part of the bowel was resected and a right hemicolectomy with an end-to-side ileotransverse anastomosis was performed. The appendix was notably thickened with an ulcerated wall containing sinus tracts, chronic inflammation, and scarring. Moreover, a focus of SRC was detected.

Conclusions

Appendiceal SRC is a rare entity, which may sometimes be confused with other pathologies providing difficulties in differential diagnosis, having an impact on therapeutic decisions and affecting prognosis.     

151例下咽鳞癌的治疗方式与预后

目的：探讨下咽鳞癌的临床治疗疗效及影响预后的因素。方法：回顾性收集本院151例下咽鳞癌临床资料病理类型中高分化鳞癌63例，中分化鳞癌50例，低分化鳞癌38例；原发部位梨状窝122例，咽后壁16例，环后区13例：TNM分期Ⅰ期2例．Ⅱ期17例，Ⅲ期28例，Ⅳ期104例；治疗方法中放射治疗组70例，手术；台疗组24例，单纯化疗组19例，放疗＋手术综合治疗38例累积生存率计算采用Kaplan-Meier法，生存率差异比较采用Log-rank检验，多因素分析采用Cox逐步回归3模型结果：全组3年及5年总生存率分别为40.81％和24.38％，Ⅰ～Ⅳ期5年累积生存率分别为100．00％，56．47％，27．68％及16．78％。T分期、淋巴结转移情况、临床分期、治疗方式及初治是否完全缓解与预后有关，病理分级、原发灶部位与预后无关多因素分析显示，临床分期和初治疗效是影响预后的独立因素结论：下咽鳞癌初诊多为晚期，预后较差，病理分级与预后关系不大。治疗采用手术＋放疗为主的治疗方式能明显提高生存率，手术和放疗搭配时机还值得进一步探讨颈部淋巴结转移率较高，有无颈淋巴结转移直接影响预后，初诊时对其进行准确评估可能有助于改善预后。     

原发性输卵管癌40例临床分析

目的:探讨原发性输卵管癌临床特点及影响预后的相关因素。方法:回顾性分析40例原发性输卵管癌患者的临床资料,采用Kaplan-Meier 生存曲线、Cox 单因素和多因素分析方法,对原发性输卵管癌预后因素进行分析。结果:患者中位年龄51岁,均接受手术治疗;29例（72.5%）诊断为Ⅰ期或Ⅱ期,11例为Ⅲ期或Ⅳ期;32例（80.0%）病理分级为低分化,22例（55.0%）为浆液性腺癌。37例患者术后分别接受了PAC/PC或TC方案化疗。6 例患者在术后23~56个月复发。Ⅰ~ Ⅱ期与Ⅲ~ Ⅳ期中位生存时间分别为79个月和35个月,5 年生存率分别为58.0%和0（P=0.005）。 经单因素和多因素分析发现FIGO分期（Ⅰ~ Ⅱ期与Ⅲ~ Ⅳ期）、病理分级（Gl +G2 级与G3 级）、术后残留灶（无肉眼残留灶、残留灶<1cm与>1cm）均是影响该病预后的独立因素。依据公式计算CA125 半衰期,比较术后3 周时血CA125 较术前下降情况（T1/2>3 周组、T1/2<3 周组）,5 年生存率分别为78.0% 和50.0%（P=0.036）。 结论:临床工作中须重视原发性输卵管癌术前各项辅助检查的联合筛查作用,进行全面的鉴别诊断避免误诊,连续动态监测血清CA125 水平对评估预后有重要作用。      

Clinical Analysis of Primary Colorectal Signet-Ring Cell Carcinoma

The objective of the study was to investigate the clinicopathological features of primary colorectal signet-ring cell carcinoma. We retrospectively analyzed the clinical and survival data of 37 patients with primary colorectal signet-ring cell carcinoma. The mean survival time of patients in stage II, III, and IV were estimated using Student t test and the cumulative survival rates were estimated according to the method of Kaplan–Meier. The significance of the differences in survival rates were calculated using the log rank test. The incidence of primary colorectal signet-ring cell carcinoma was 1.40%, the median age of 37 patients was 50 years, the male to female ratio was 1.47:1, and 21 patients (56.8%) received a radical resection. Most patients 33 (89.2%) had an advanced tumor stage at the time of diagnosis (17 patients 45.9% stage III and 16 patients 43.2% stage IV), 34 (94.5%) patients showed a tumor depth of >T3, lymph node involvement occurred in 26 patients (70.3%), patients had a high incidence of peritoneal metastasis (16 patients 43.2% at presentation, 30 patients 81.1% at presentation and recurrence) and a low incidence of liver metastases (1 patients 2.7% at presentation, 5 patients 13.5% at presentation and recurrence). The 5-year survival rate after the initial surgery was 10.8%, the mean survival time of 37 patients was 27.1 ± 3.3 months, the mean survival time of patients in stage II, III, and IV were 47.0 ± 12.8 months, 37.1 ± 3.9 months, and 10.5 ± 1.4 months, respectively (P < .000). Colorectal signet-ring cell carcinoma is a rare neoplasm with a predominance in men. Its characteristic features were the advanced stage at the time of diagnosis, a high incidence of peritoneal metastases, a low incidence of liver metastasis, and a poor prognosis.