Ki-67 and p53 expression in minimal deviation melanomas as compared with other nevomelanocytic lesions.

Minimal deviation melanoma is a controversial entity encompassing a heterogeneous group of lesions cytologically in the spectrum between recognized subtypes of nevi and conventional "primary configuration" melanomas and reported to have a better prognosis than the latter. To evaluate the distinctiveness of minimal deviation melanoma, Ki-67 proliferation rates and p53 expression in minimal deviation melanomas were compared with those in compound nevi, Spitz nevi, and vertical growth phase superficial spreading malignant melanoma. Twelve examples of each lesion were immunostained with antibodies to the Ki-67 and p53 proteins and evaluated by a pathologist who was blind to the diagnoses. The mean Ki-67 (MIB-1) proliferation rates for the compound nevi, Spitz nevi, minimal deviation melanomas, and superficial spreading malignant melanomas were 0, 3%, 13%, and 25%, respectively. The mean Ki-67 proliferation rate was statistically greater in the minimal deviation melanomas than in the compound nevi or the Spitz nevi (P <.05), but the proliferation rates in the two melanoma subtypes were not statistically significant (P =.08). The mean p53 values for these lesions were 0, 9%, 9%, and 26%, respectively; the latter two were statistically different (P <.01). Based on these Ki-67 and p53 immunophenotypes, minimal deviation melanoma may represent a distinct entity.     

Melanoma precursor lesions and borderline melanomas

The histopathological interpretation of melanoma precursor and borderline lesions remains difficult. The natural history of naevi is reviewed and, in the light of this, current views on the histological sub-types of melanoma, precursor lesions and benign lesions which may mimic melanoma are presented. As the criteria for these lesions are now becoming defined they should be applicable by most histopathologists, even those who may see only occasional cases. Childhood and minimal deviation variants, however, are likely to remain problems even for the expert. Fortunately such lesions are uncommon.     

Diagnostic specificity of synovial lesions

Sections of synovium from 393 operations on diseased joints were re-examined without knowledge of the clinical findings. Specimens were scored for each of 37 histopathologic features. Independently, patients were assigned to one of 10 diagnostic groups after review of all available clinical data. Computer analysis revealed statistically significant differences in the incidence of one or more histologic parameters between the members of all except three of the possible disease pairs. The possibility of exploiting these differences to increase diagnostic precision was examined.     

Gastrointestinal stromal tumors and other mesenchymal lesions of the gut.

In the past 5 years, there has been a paradigm shift in our understanding of gastrointestinal stromal tumors (GISTs). Once thought to be smooth muscle tumors, these uncommon neoplasms are now thought to differentiate along the lines of interstitial cells of Cajal, the pacemaker cells of the gut. Along with this understanding comes an exciting new drug therapy (Gleevec) that for the first time offers real hope to patients with malignant stromal tumors. Overall, approximately 60-70% of stromal tumors are from the stomach, 20-30% are from the small intestine, and <10% come from the esophagus, colon, rectum, omentum, and mesentery. Between 10 and 30% of GISTs are malignant. Stromal tumors should be studied in a site-specific fashion, as tumors from a given location in the gut have unique growth patterns and corresponding behaviors. Although the most important tool needed to diagnose a GIST is still a hematoxylin and eosin-stained section, a confirmatory CD117 stain is recommended (and may be required for drug therapy). True smooth muscle tumors, inflammatory fibroid polyps, fibromatoses, schwannomas, inflammatory myofibroblastic tumors, and solitary fibrous tumors all enter into the differential diagnosis of GISTs. This article reviews the histologic features of these tumors in the context of recent molecular genetic and immunohistochemical advances.     

Pancreatic lesions in shock and their significance

The pancreas was examined histologically in 146 cases of patients dying of shock. The finding of morphological evidence of disseminated intravascular coagulation (DIC) in the pancreas supports the opinion that the pancreas is highly sensitive to disturbances of blood perfusion. The presence of DIC combined with a variety of pathological lesions in the exocrine and endocrine pancreas was sufficiently characteristic to justify use of the term “shock pancreatitis”. The relative scarcity of data hitherto available on pathological changes in the pancreas caused by shock can be ascribed to changes in the management of shock. It is concluded that the pancreatic lesions described in this study could influence the outcome in shock treated by modern methods of resuscitation.     

TCT联合细胞DNA定量分析在桂西壮族妇女宫颈病变诊断中的应用

目的探讨宫颈液基薄层细胞学检查(TCT)联合DNA定量分析在桂西壮族妇女宫颈病变筛查中的价值。方法选取同时行TCT、细胞DNA定量分析和活组织病理学检查的430例资料进行分析。宫颈脱落细胞液基薄层制片,1张巴氏染色做TCT诊断,1张Feulgen染色,应用全自动细胞图像分析系统扫描诊断。结果以活检结果作为诊断的金标准,TCT、DNA定量分析和联合检测的检出率分别为64.2%、90.6%和96.2%。联合检测与单独DNA定量分析检出率比较,差异不显著(P>0.05),联合检测与单独TCT的检出率比较,TCT与DNA定量分析的检出率比较,差异均显著(P<0.01)。结论 DNA定量分析检出率高于TCT,二者联合应用并不能有效地提高宫颈病变的检出率。     

Diagnostic and prognostic significance of serum cholinesterase and lactate dehydrogenase in breast cancer.

Serum cholinesterase (ChE) and Lactate dehydrogenase (LDH) activities were estimated in 40 cases of carcinoma breast, 25 cases of benign tumours and compared with healthy controls (30 cases). Significant difference in enzyme activities were obtained between benign and malignant neoplasms of the breast when compared with each other as well as when compared with healthy controls. Also, there were significant enzyme changes between non-metastatic cases and those with metastasis and when Stage I and Stage II cancers were compared with those in Stage III and Stage IV. No difference in enzyme levels were recorded between pre and post-operative cases and in different types of breast cancers. While ChE was depressed in 80 per cent cases of malignancy breast, serum LDH was raised in 73.3 per cent cases.     

Diagnostic histochemistry of soft tissue lesions

Histochemical methods (HM) were, at one time, extensively used in all facets of anatomic pathology, including analysis of soft tissue lesions. That situation has changed with the advent of other adjunctive procedures, but HM still do contribute meaningfully to the evaluation of several tumefactive conditions in the soft tissue. This brief review considers selected neoplastic, quasineoplastic, and pseudoneoplastic lesions in that category, with emphasis on their histochemical properties.     

Diagnostic immunohistochemistry of breast epithelial lesions

Routine H&E sections are sufficient for diagnosis of the vast majority of breast lesions. Development of mammography mass screening and widespread use of preoperative needle biopsy diagnosis have led to diagnostic difficulties for pathologists. The samples are smaller and more and more preinvasive lesions are seen. It is mainly in those situations that immunohistochemistry (IHC) can efficiently back up histopathology. This review details the main applications of diagnostic IHC in breast pathology. The advantages of IHC in various clinical situations are discussed diagnosis of benign breast lesions mimicking malignancy, distinction between simple type ductal hyperplasia and atypical hyperplasia or ductal in situ carcinoma, confirmation of malignancy, distinction between lobular and ductal carcinoma, identification of specific histological subtypes, and, diagnosis of intra and extra mammary metastases.     

24h动态脑电图对癫痫的诊断意义

目的：了解动态脑电图对癫痫诊断的应用价值。方法：对１１２名诊断癫痫，可疑癫痫及发作性晕厥病人行２４ｈ动态脑电图检查，并在一周内做脑电图或脑电地形图检查作为自身对照。结果：发现全部病人组ＡＥＥＧ痫样放电检出率明显高于ＥＥＧ／ＢＥＡＭ组；在癫痫发作类型中，以复杂部分性发作ＡＥＥＧ痫样放电阳性率明显高于ＥＥＧ／ＢＥＡＭ组；睡眠期痫样放电检出占有痫样放电患者５６／６７（８４％），主要出现在ＮＲＥＭⅠ－Ⅱ期（７５％）。结论：动态脑电图对癫痫的诊断有重要的意义