早期胃印戒细胞癌临床病理特征

目的 探讨早期胃癌中印戒细胞癌的临床病理特征。方法回顾性分析了2010年4月至2012年9月间经南京军区福州总医院手术病理证实的早期胃癌中41例印戒细胞癌和104非印戒细胞癌患者的临床病理资料。结果早期胃癌中,印戒细胞癌与非印戒细胞癌在年龄、性别、肿瘤部位上存在差异（P〈0．05）,而无论发病前有无腹痛,以及在血型、癌胚抗原值、肿瘤直径、浸润深度、淋巴结转移、内镜下肉眼类型无显著差异（P〉0．05）。结论早期胃癌中的印戒细胞癌好发于年轻人、女性及胃下部（胃窦）,内镜下也缺乏特异性表现。其早期无明显症状,癌胚抗原值无特异性增高。     

原发性肺印戒细胞癌临床病理分析

正原发性肺印戒细胞癌(signet ring cell carcinoma,SRCC)发病率较低,国外报道占肺腺癌的0.14%～1.90%[1],我院2001年收治1例,结合国内外文献,作如下报告。病例报告一、患者女性,61岁,因上腹部不适伴胸闷三周于2004年5月12日入院。患者三周前无明显诱因始出现上腹部不适,时有恶心呕吐,并感颈部压迫感,轻咳,少痰,伴有不规则发热,伴明显胸闷,无胸痛咯血。查胃镜、肠镜示:粘膜慢性     

161例胃印戒细胞癌的内镜,病理及临床分析

胃印戒细胞癌（signetringcellcarcinoma）是一种由印戒细胞构成的浸润型腺癌，在原发性胃癌中占有一定比例。我们收集3家医院1993年1月1日至1996年12月31日经内镜、病理诊断的各型胃癌1058例，其中印戒细胞癌161例的内镜病理及临床资料，分析如下。材料与方法一、一般资料3家医院4年内所有经内镜检查和病理证实的胃癌共1058例，其中胃印戒细胞癌161例，占15．2％，男73例，女88例，男女之比为1：1．2，年龄为29～88岁，平均49士5．6岁。因腹胀（128／161）、消瘦及贫血（48／161）、暖气（77／161）、呕血及黑便（2V161）、腹块（13161）…     

伴印戒细胞分化的乳腺癌一例

<正>1病例介绍患者,女,65岁。以“发现右乳结节3年,增大1周”为主诉入院。查体:右乳3点位可触及3.0 cm×4.0 cm肿物,质硬,界限欠清,活动度尚可。双侧腋下未触及肿大淋巴结。2021年9月8日于外院查乳腺彩超示:右乳低回声乳腺影像报告与数据系统(Breast Imaging Reporting and Data System,BI-RADS) 5类,右侧腋下多发淋巴结肿大。2021年9月9日于延边大学附属医院查乳腺钼靶示:右乳内上象限见大小约3.6 cm×2.2 cm肿块影BI-RADS 5类,可见浅分叶及毛刺影,双乳见散在细小钙化灶。双侧腋下未见明显肿大淋巴结影。乳腺粗针穿刺活检:浸润性癌,肿瘤细胞呈印戒样,CD68 (-),CK(+),E-cad(-)。     

原发性肺印戒细胞癌1例并文献复习

病例介绍 林某,女,62岁,以“咳嗽伴气短半个月,加重1周”入院。入院前半个月,患者无诱因出现咳嗽,夜间明显,无咳痰,无咯血,无发热。伴气短,无胸痛,无声音嘶哑及饮水呛咳等。曾在大连市第三人民医院行胸部CT检查提示：左肺上叶占位肿块,大小约2．8cm×1．8cm;双肺多发结节;肺门淋巴结肿大,左侧胸腔积液,心包积液。     

胰腺囊腺癌临床病理特征分析

胰腺囊腺癌临床较为少见,约占胰腺癌总体的5％～10％[1]。研究认为,胰腺囊腺癌恶性程度相对较低,肿瘤常有纤维包膜,手术切除率较高,预后较好。近年国外报道的囊腺癌术后5年生存率已达63％[2]。本文对52例胰腺囊腺癌患者的临床资料进行分析,试图找出胰腺囊腺癌的若干特点。     

胃印戒细胞癌与胃混合印戒细胞癌患者临床病理资料及预后对比分析

目的 通过对比分析胃印戒细胞癌（SRCC）与胃混合印戒细胞癌（mixed-SRCC）的临床病理资料及预后情况,为胃癌的个体化、精准化治疗提供参考。方法 接受根治性手术切除的含印戒细胞成分的胃癌患者481例,其中胃SRCC 161例、胃mixed-SRCC 320例。比较胃SRCC、胃mixed-SRCC的临床病理资料及预后。分析胃SRCC、胃mixed-SRCC的预后影响因素。结果 胃SRCC肿瘤直径>5 cm、肿瘤位于胃下1/3、淋巴结转移阴性、浸润深度T1a者比例高于mixed-SRCC(P均<0.05);早期胃SRCC远端胃切除术、肿瘤直径>5 cm、浸润深度T1a、病理分期ⅠA期者比例高于早期胃mixed-SRCC,进展期胃SRCC淋巴结转移阴性、脉管侵犯阴性者比例高于胃mixed-SRCC(P均<0.05)。胃SRCC患者总体3年生存率及进展期患者3年生存率高于胃mixed-SRCC患者（P均<0.05）。淋巴结转移（HR=0.407,95%CI 0.177～0.937,P=0.035）、浸润深度（HR=4.409,95%CI 1.269～15....     

肺转移性印戒细胞癌1例并文献复习

目的研究胃印戒细胞癌肺转移的临床特点。方法介绍1例对肺转移性印戒细胞癌的病例,并进行文献复习。结果以慢性咳嗽患者影像学上支气管周围斑片状阴影及多发纵隔淋巴结肿大并伴有外周血嗜酸粒细胞的增多,应考虑消化道肿瘤的可能。结论恶性度极高的黏液细胞型胃癌,可以跳跃转移到肺及纵膈。如果慢性咳嗽的患者,外周血嗜酸粒细胞的增多时,应尽早行肿瘤标记物及内窥镜的检查,以提高肿瘤的早期诊断率。     

胃印戒细胞癌的临床病理特征及耐药基因表达特点分析

目的 探讨胃印戒细胞癌的病理学及P-糖蛋白(P-gp)、谷胱甘肽转移酶(GST-π)、拓扑异构酶Ⅱ(TopoⅡ)的表达特点,进一步提高其诊治水平.方法 分析32例胃印戒细胞癌(胃镜活检标本21例,大部切除胃标本11例)的临床病理及GST-π、P-gp、TopoⅡ的表达特点.结果 胃镜下以经典型印戒细胞数量最多,弥漫性生长;相关基因检测结果显示,GST-π、P-gp、TopoⅡ阳性表达率与同期32例高一中分化腺癌比较,GST-π阳性率无显著差异,P-gp阳性率明显升高,TopoⅡ阳性率明显降低(P均＜0.05).结论 胃印戒细胞癌以典型印戒细胞数量最多,且呈弥漫性生长;GST-π、P-gp、TopoⅡ的表达检测有助于胃印戒细胞癌诊断.     

原发性膀胱印戒细胞癌2例报告

原发性膀胱印戒细胞癌（SRCC）临床罕见,我们曾收治2例。现报告如下。     

消化道转移癌25例临床病理性特征分析

［摘要］　目的　探讨消化道转移癌的临床病理特征,为恶性肿瘤患者消化道转移早发现和诊断提供经验。方法　回顾性收集郑州大学第一附属医院2011年1月至2021年12月病理诊断为消化道转移癌的25例患者的临床病理资料,进行归纳性描述和分析。结果　25例消化道转移癌中肺癌11例,乳腺癌8例,肾细胞癌4例,尿路上皮癌2例。男14例,女11例;年龄28～73岁,平均55.6岁,确诊消化道转移癌时平均57.9岁。原发癌与消化道转移癌确诊时间间隔平均36个月。上消化道转移癌9例,下消化道转移癌16例。当确诊消化道转移癌时,15例患者存在其他脏器的转移灶,其余10例患者均存在全身多处淋巴结转移。镜下可见黏膜表面多完整,癌组织与周围黏膜过渡陡然,易见脉管癌栓;转移性肺腺癌多呈实性片状生长,乳腺癌多表现为低分化、条索状浸润生长。转移癌能较好地特异性表达相关免疫组化标志。结论　癌发生消化道转移往往是其进展的晚期事件。当遇到形态学较为特殊的消化道恶性上皮性肿瘤时,应考虑转移癌的可能,关注患者病史,并合理选用免疫组化检测,以避免漏诊和误诊。     

Neuroendocrine differentiation of periodic-acid Schiff and Alcian blue-negative signet-ring cell-like cells and tubular adenocarcinoma cells within a gastric cancer

A case of a Borrmann type 2 advanced gastric cancer with endocrine differentiation is described. Histologically, the cancer was either composed of cells arranged in a tubular pattern or formed solid nests of various sizes. The tubular pattern was composed of a moderately differentiated tubular adenocarcinoma. The histology showed partial carcinoid tumor-like features. Cancer cells inside solid nests had a signet-ring cell-like appearance. Periodic-acid Schiff (PAS) staining was positive in the cytoplasm of a few of the cells found in the tubular pattern and in the mucus in some lumens and on the apical surface of cells in some lumens, but PAS did not stain cancer cells in the solid nests. Neither cancer cells nor mucus in the lumens were stained with alcian blue. All cancer cells were strongly positive for Grimelius silver stain, and most of the cancer cells stained positively for chromogranin A. Electron microscopic examination showed electron dense neuroendocrine granules in the cytoplasm of cancer cells. Cancer cells were stained positively for pancytokeratin, cytokeratin 8/18 and carcinoembryonic antigen. Muc 1 mucin glycoprotein staining was positive along the cell surfaces of cancer cells, but Muc 2, 5AC and 6 stainings were negative, although Muc 3 stained positively in the cytoplasm of a few cancer cells. The present case is a gastric tubular adenocarcinoma with Muc 1-positive, neutral- and acid mucin-negative signet-ring cell-like cells, which is associated with neuroendocrine differentiation.     

Extremely well-differentiated adenocarcinoma of the stomach： Clinicopathological and immunohistochemical features

AIM: Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma (EWDA), is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS: Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected. RESULT: Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions (mean follow-up period, 56 mo). All 9 cases of EWDA could be classified into gastric phenotype (5 lesions) and intestinal phenotype (4 lesions). The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cells and their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION: Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-expression. Because of its resemblance to normal gastric mucosa or mucosa with intestinal metaplasia, EWDA is often misdiagnosed. To prevent the misdiagnosis of such lesions, the clinical and pathologic characteristics should be taken into consideration.     

伴有薄壁空腔形成的周围型肺腺癌的CT表现

目的探讨伴有薄壁空腔形成的周围型肺腺癌的CT表现,提高对该病的诊断准确率。方法回顾性分析21例经病理证实的伴有薄壁空腔形成的周围型肺腺癌的CT影像资料,对其进行总结、分析。结果 21例中有14例位于双肺中上叶,13例实性病灶呈类椭圆形,边缘可见分叶征、毛刺征、血管集束征和胸膜增厚、牵拉的例数分别为18、15、11和3。所有空腔病灶的壁较薄,平均(2.04+1.02)mm,厚度在2mm以下者有11例;17例空腔病灶位于实性病灶的周边部,12例空腔壁厚度较均匀,9例可见壁结节形成;空腔内血管穿行征及分隔形成者分别为8例和5例。结论伴有薄壁空腔形成的周围型肺腺癌的CT表现具有一定特征,即病灶多位于中上肺、实性病灶多呈类椭圆形,边缘多见分叶征、毛刺征、血管集束征等恶性征象;而空腔病灶多位于实性病灶的周边部,空腔壁较薄且厚度较均匀,壁结节少见。     

65例间质性肺疾病临床特征分析

目的分析总结我院呼吸科间质性肺疾病（ILDs）的临床特点。方法对我院呼吸科间质性肺疾病患者的临床资料进行分析总结。结果 1年间共收治ILDs患者65例,临床表现主要为活动后气短（89.23%）,17例肺功能检查DLco均下降,胸部CT可有不同的表现,磨玻璃影（74.55%）,网格影（38.18%）,蜂窝肺（29.09%）,结节影（14.55%）,实变影（14.55%）,支气管扩张影（27.27%）,多以双下肺和胸膜下为著,血气分析以低氧血症（41.27%）为主,P（A-α）O2均有不同程度的升高,支气管肺泡灌洗液细胞计数以中性粒细胞比例增高为主,肺动脉压力亦有不同程度升高。结论间质性肺疾病的临床表现、实验室检查、影像学与肺功能特征等可做出初步诊断。     

ALK阳性组织细胞增生症5例临床病理特征研究

［摘要］　目的　探究ALK阳性组织细胞增生症患者的临床病理特征。方法　收集5例ALK阳性组织细胞增生症患者的临床病历资料和病理组织。所有组织均经常规苏木精-伊红染色观察组织病理学特征;采用EnVision免疫组化法检测ALK蛋白表达水平;采用荧光原位杂交（FISH）法及二代测序（NGS）法检测ALK基因突变情况。结果　5例中,成人3例,儿童2例;女性4例,男性1例。1例肿瘤细胞呈梭形细胞样,1例呈泡沫样组织细胞样,另外3例呈上皮样、组织细胞样。所有病例均强表达组织细胞标志CD163、CD68及ALK蛋白。5例均有ALK基因易位,均为KIF5B-ALK融合基因。结论　5例ALK阳性组织细胞增生症的组织学形态谱系涵盖上皮样、泡沫样组织细胞及梭形细胞形态,均强表达组织细胞学标志CD163、CD68及ALK蛋白,均检测到ALK基因断裂,且均为KIF5B-ALK融合基因。     

肺腺癌胸腔积液沉渣间变性淋巴瘤激酶融合基因蛋白表达与临床病理特征的关系及克唑替尼疗效观察

目的 探讨原发性肺腺癌胸腔积液沉渣间变性淋巴瘤激酶(ALK)蛋白表达与临床病理特征的关系及克唑替尼的治疗效果.方法 回顾性分析2013年9月至2014年1 1月首都医科大学附属北京胸科医院以胸腔积液沉渣包埋标本进行ALK基因重排检测的原发性肺腺癌病例85例,男42例,女43例,年龄30～87岁,平均58岁.采用Ventana全自动免疫组织化学染色和D5F3抗体试剂盒检测ALK蛋白表达,分析表达阳性患者的临床病理特征及克唑替尼的疗效.结果 85例标本中ALK蛋白表达阳性13例(15.3％);＜60岁患者ALK蛋白阳性12例,≥60岁1例(26.1％,2.6％,x2 =9.015,P=0.002);男性8例ALK蛋白表达阳性,女性5例(19.1％,11.6％,x2=0.903,P =0.259);不吸烟组ALK阳性8例,吸烟组5例(17.0％,13.5％,x2=0.379,P=0.827).13例ALK阳性患者中6例接受表皮生长因子受体(EGFR)基因突变检测,其中5例EGFR为野生型,1例不同肺叶病灶中检测出19外显子突变.13例ALK阳性患者中接受克唑替尼治疗4例,疗效评价均为部分缓解.结论 ALK蛋白阳性多见于晚期肺腺癌中较年轻的患者,ALK阳性患者罕见EGFR基因突变;对原发性肺腺癌合并胸膜转移出现恶性胸腔积液的患者,可根据胸腔积液沉渣包埋标本检测ALK蛋白表达,指导临床靶向治疗.     

Coexistence of multifocal gastric adenocarcinoma with signet-ring cell morphology and a gastrointestinal stromal tumour in a stomach with hp-associated gastritis

A 79-year-old man was admitted because of anemia during marcumar therapy with suspected bleeding in the gastrointestinal tract. Endoscopy revealed a large mutifocal poorly differentiated gastric signet ring cell adenocarcinoma. After staging by the usual oesophagogastroduodenoscopic method, a total D 2 gastrectomy was performed. In the pathological resection specimen of the stomach, a multifocal poorly differentiated signet ring cell adenocarcinoma, infiltrating the submucosa (so called early cancer of sm-type) and an incidental gastroinstinal stromal tumour, 0.8 cm in diameter, was diagnosed. This is the first case report of the synchronous occurrence of a multifocal poorly differentiated gastric adenocarcinoma with signet-ring cell morphology (diffuse type according to the Lauren classification) and a GIST incidentally within a stomach with Hp-associated gastritis.     

Relationship between clinicopathological features and mucin phenotypes of advanced gastric adenocarcinoma

AIM: To investigate a relationship between the clinicopathological features and mucin phenotypes in advanced gastric adenocarcinoma (AGA). METHODS: Immunohistochemical staining was performed to determine the mucin phenotypes in 38 patients with differentiated adenocarcinomas (DACs), 9 with signet-ring cell carcinomas (SIGs), and 48 with other diffuse-type adenocarcinomas (non-SIGs) of AGA. The mucin phenotypes were classified into 4 types: gastric (G), gastrointestinal (GI), intestinal, and unclassified. RE...