双侧乳腺导管内实体性乳头状癌及乳腺黏液癌1例病理学观察

乳腺导管内实体性乳头状癌（双分泌型）,较少见,而双侧乳腺先后患乳腺导管内实体性乳头状癌（双分泌型）和黏液癌（纯型）,国内尚未见报道。我院收治1例双乳腺先后患2种少见乳腺癌的患者,现结合文献复习对乳腺导管内癌的分型、诊断、鉴别诊断、治疗报道如下。     

10例胃溃疡癌的病理

胃溃疡癌是指良性溃疡边缘的粘膜上皮或腺体发生癌变,仍保留大部良性溃疡的特点。慢性胃溃疡能否癌变,癌变率及其组织学特征如何,至今仍有很多争论。本文报告10例回顾性分析资料,并就其病理组织学特征及组织发生等加以讨论。材料和方法根据我国胃癌协作组规定的胃溃疡癌的组织学诊断标准,将我室1978～1982五年间诊断为慢性胃溃疡癌变(溃疡癌)及癌溃疡化病例的手术后组织标本,筛选出10例溃疡癌。每例1～3张切片,常规石蜡包埋,HE染色,光镜观察。7例作AB/     

乳腺腺样囊性癌与浸润性筛状癌的形态及免疫组化比较

目的探讨具有筛状结构的乳腺腺样囊性癌与浸润性筛状癌的形态和免疫组化特点及诊断、鉴别诊断要点。方法对具有筛状结构的乳腺腺样囊性癌及浸润性筛状癌各3例进行形态和免疫组化比较观察。结果在常规HE染色下,乳腺腺样囊性癌的筛状结构与浸润性筛状癌十分相似,但它们的免疫标记谱不同。乳腺腺样囊性癌的导管上皮细胞表达c-kit;肌上皮细胞表达p63、SMA;不表达ER、PR。浸润性筛状癌不表达c-kit,p63及SMA;总是表达ER、PR。结论乳腺腺样囊性癌是罕见的肿瘤,它的筛状结构与浸润性筛状癌非常相似。免疫组化标记c-kit;p63、SMA及ER、PR有助于它们的鉴别。     

食管复合癌:鳞形细胞癌伴神经内分泌癌1例

患者男性，５６岁。进食梗咽感４月余。钡餐及胃镜检查示食管中段癌，遂行手术治疗。病理检查　食管一段，长１２ｃｍ，剖面见一纵行溃疡型肿块，约５５ｃｍ×３ｃｍ×１５ｃｍ，灰白质脆，浸润管壁全层。镜检：肿瘤由两种界限清楚的癌组织组成。一种为明确的早期浸润高分化鳞癌，被覆在肿块的表面；另一种由小圆细胞组成，排列成小梁或假腺样，呈巢状结构，中央多见坏死，似粉刺癌图像。细胞核大、居中，圆和类圆形，染色质粗网状，少数呈泡状，浆粉染，略呈颗粒状，部分区域呈透明细胞样。癌巢间质显著粘液变性（图１，２）。后者为肿…     

乳腺浸润性导管癌与小叶癌的超声诊断分析

目的探讨乳腺浸润性导管癌和浸润性小叶癌的超声声像图特征。方法对2006年1月至2008年6月经手术、病理证实为乳腺浸润性导管癌（IDC）136例和浸润性小叶癌61例的超声声像图、彩色多普勒表现进行对比分析。结果两种病理类型的肿瘤的超声声像图在肿块形状、内部与后方回声以及血流图上差异有统计学意义（P〈0．05）。在侧方回声与内部钙化情况上差异无统计学意义（P〉0．05）。结论乳腺浸润性导管癌和浸润性小叶癌可以根据各自超声声像的特点进行诊断，组织学的不同影响乳腺癌的超声影像表现。     

原发性十二指肠癌 46 例内镜诊断及病理组织分析简

目的提高原发性十二指肠癌的诊断水平。方法选择46例原发性十二指肠癌患者,其中男性26例．女性20例：年龄31-71岁,平均年龄62_3岁。行内镜诊断和病理活组织检查或术后病理组织检查。回顾性分析其临床、内镜及病理学关系。结果46例十二指肠癌发生于十二指肠球部9例,水平部5例．乳头部30例．乳头下段2例。病理活组织检查或术后病理学诊断示中分化腺癌8例,低分化腺癌26例．印戒细胞癌10例．未分型2例。结论临床应提高对原发性十二指肠癌的警惕性;原发性十二指肠癌以十二指肠乳头部好发,病理分型以腺癌为主,诊断首选上消化道内镜及活组织检查,内镜操作时应尽可能观察到十二指肠降部以下,特别应注意观察乳头部。对十二指肠球部溃疡反复治疗效果不佳者,应提高警惕,及时进行活组织检查。手术切除尤其是胰十二指肠切除术是最常用、最可靠的治疗方法。     

肺多形性癌的病理学观察

目的 对１０例肺多形性癌回顾性临床病理研究,探讨肺多形性癌的临床病理特点。方法 采用组织病理学、免疫组织化学ＳＰ法标记（角蛋白、波形蛋白 Ｍａｃ３８７、结蛋白、肌动蛋白、Ｓ－１００蛋白）对１０例肺多形性癌进行研究。结果 肺多形性癌多见于５０岁以上的男性,临床首发症状咳嗽咳痰、咯血或患侧胸痛,镜下以鳞癌、腺癌等成分为主,伴有多少不等的梭形细胞或（和）巨细胞成分。肿瘤的上皮成分表达角蛋白,梭形细胞表达波形蛋白,３例上皮及梭形细胞成分同时表达角蛋白及波形蛋白。结论 肺多形性癌具有多种病理组织形态特征,病理诊断上易与癌肉瘤混淆。明确该肿瘤的组织发生,对于诊断及鉴别诊断有重要意义。     

甲状腺乳头状癌和滤泡癌病理诊断中的一些问题

绝大多数甲状腺肿瘤是由滤泡细胞组成的原发性上皮肿瘤,这些肿瘤种类相对较少,其中以滤泡性腺瘤、乳头状癌和滤泡癌最为常见,其诊断特征也比较单一而又明确,这就给初学者造成一种假象,会认为甲状腺肿瘤的诊断是一个易于掌握的领域。事实上,看似简单的甲状腺肿瘤的诊断却有许多值得推敲的细节和诊断陷阱,特别是乳头状癌和具有滤泡生长方式的肿瘤,已经受到了人们的关注”…。在日常工作中如何识别这些诊断陷阱是正确诊断甲状腺肿瘤的关键。下面提出避免诊断陷阱的要点,以期达到尽量减少和避免误诊的目的。     

超声鉴别诊断乳腺典型髓样癌与不典型髓样癌的价值分析

目的分析病理证实的乳腺髓样癌及不典型髓样癌的超声及病理资料,证明超声诊断乳腺髓样癌价值。方法回顾性分析114例乳腺髓样癌病灶病理资料,将其分为髓样癌组及不典型髓样癌组,分析其超声声像图中病灶的形态、大小、边缘、边界、内部回声、血流情况等,探讨两组超声声像图的差异。结果乳腺典型髓样癌病灶93例,不典型髓样癌病灶21例,两组的超声声像图上各特征均无明显统计学差异。超声诊断典型髓样癌和不典型髓样癌良恶性的准确性分别为83.87%、85.71%。结论超声对鉴别乳腺髓样癌良恶性方面具有诊断价值,但在鉴别髓样癌与不典型髓样癌方面价值有限。     

肺原发性大细胞癌及肉瘤样癌的病理特征和鉴别诊断

2004年出版的WHO肺肿瘤组织学分类（第4版）将肺癌分为鳞状细胞癌，小细胞癌、腺癌、大细胞癌、腺鳞癌、肉瘤样癌，类癌和唾液腺型肿瘤8个主要类型，其中肺大细胞癌及肉瘤样癌同属于发生于肺的低分化或未分化癌，有多种形态学表现，根据病理形态学特征，肺大细胞癌及肉瘤样癌又分为数个亚型，可能造成诊断上的混淆。     

The effect of visual deprivation on gastrointestinal ulceration

Visual deprivation reduced the incidence of perforated ulcers and increased the survival time of dogs subjected to the Exalto-Mann-Williamson ulcer and reduced both the time of onset and the degree of ulceration in rats subjected either to the Shay ulcer or to the restraint-cold ulcer procedure.     

Microscopic examination of the activity-stress ulcer in the rat

Gastric lesions were produced in albino rats by allowing continuous access to a running wheel, but only one hour's access to food each day. A reliable pattern of changes in activity, food intake, and body weight, culminating in severe debilitation, resulted. Animals were sacrificed when food intake fell below 2 g. The glandular stomachs of these rats showed extensive pathology, ranging from mucosal hemorrhage, with or without focal necrosis, through acute ulcers characterized by discontinuity of the muscularis mucosa. With one exception, all experimental rats showed this entire range of pathology, and in addition, 33% had at least one lesion showing signs of regeneration. Focal erosions predominated, but all experimental rats had at least one ulcer penetrating the muscularis mucosa. No control rat had a lesion of any sort.     

Current status of peptic ulcer disease in Port Harcourt metropolis,Nigeria

BackgroundEpidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries.ObjectiveThis paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis.MethodsA cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20.ResultsA total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding.ConclusionThere is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology.     

Helicobacter pylori dupA gene is not associated with clinical outcomes in the Japanese population

The dupA gene of Helicobacter pylori was suggested to be a risk factor for duodenal ulcer but protective against gastric cancer. The present study aimed to re-examine the role of dupA in H. pylori-infected Japanese patients. We found that dupA status was not associated with any gastroduodenal disease, histological score of chronic gastritis or with the extent of interleukin-8 production from gastric cell lines. These results indicate that dupA is unlikely to be a virulence factor of H. pylori in the Japanese population.     

消化系统部分疾病血浆神经降压素水平变化的初步观察

本文用放射免疫分析测定７８例肝硬化、胃溃疡、十二指肠溃疡患者的血浆神经降压素（ｎｅｕｒｏｔｅｎｓｉｎ，ＮＴ），其均值均显著高于正常对照组（Ｐ〈０．０１）。６例十二指肠球部溃疡患者血浆ＮＴ值治疗前后对比无显著变化。     

血清胃蛋白酶原与胃泌素检测对消化性溃疡病的诊断价值

目的:探讨胃、十二指肠溃疡患者血清胃蛋白酶原(PG)、胃泌素(GS)水平变化规律及临床意义。 方法:采用免疫放射分析测定了100例正常人,61例十二指肠球部溃疡,46例胃溃疡患者,66例胃癌和101例 慢性胃炎患者血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、GS含量及PGⅠ/PGⅡ比值变化。结果:十二 指肠溃疡组和胃溃疡组PGⅠ、PGⅡ、PGⅠ/PGⅡ较对照组显著增高(P<0.001),GS水平较对照组、慢性胃炎 组明显增高(P<0.001),但明显低于胃癌组(P<0.001),十二指肠球部溃疡组PGⅠ、PGⅠ/PGⅡ水平较胃溃 疡组明显增高(P<0.001)。结论:过高的PGⅠ、PGⅡ、PGⅠ/PGⅡ、GS水平增高是溃疡病的高危因素之一,作 为一项血清学指标,对溃疡病的诊断及疗效观察有重要的临床意义。     

Production of gastric ulcers in the unrestrained rat

A simple and effective procedure for inducing gastric lesions in the unrestrained rat is described. A significant feature of the present technique is that gastrointestinal lesions are observed following a relatively brief (6 hr) exposure to the shock-stress condition. Lesions are found to occur in the glandular portion of the stomach, and initial evidence implicates conflict as the ulcerogenic agent.     

Effects of Autologous Bone Marrow Cells on Apoptosis and Regeneration of Non-Healing Autoimmune Gastric Ulcers

The effects of cultured autologous bone marrow multipotent mesenchymal stromal cells on apoptosis and healing processes were studied on the model of non-healing gastric ulcers in rats. Bone marrow multipotent mesenchymal stromal cells inhibited apoptosis in epitheliocytes of the gastric mucosa and stimulated ulcer healing. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 146, No. 11, pp. 585-590, November, 2008     

Psychophysiological and cognitive characteristics of ulcer and rheumatoid arthritis patients

This study examined differences in the physiological and cognitive response patterns among peptic ulcer, rheumatoid arthritis, and healthy group subjects to two types of stressors-slides of autopsies and imagined scenes involving conflicts and attitudes proposed to be associated with the two psychosomatic disorders. Ten subjects were assessed in each group. Results indicated that the ulcer patients demonstrated a heart rate accelerative trend, while arthritic and normal subjects showed significant deceleration, in response to the aversive slides of autopsies. Ulcer patients also reported paying less attention to the slides, and experiencing more anxiety when viewing them, relative to the other subjects. In response to the imagined scenes, the arthritic patients responded with more heart rate acceleration, apparently because of the greater emotional imagery produced by the scenes in these subjects. Finally, self-report and interview data did not lend support to a derivative of the specificity-of-attitude model of psychosomatic disorders.This article is based on a dissertation submitted by the first author to the Division of Psychology, University of Texas Health Science Center at Dallas, in partial fulfillment of the requirements for the Ph.D. degree.     

肝硬化及消化性溃疡患者血浆中NPY水平变化的初步观察

应用放免法测定了28例胃溃疡,31例十二指肠溃疡以及30例肝硬化患者血浆中NPY的含量分别为:46.52±6.12ng/L、45.42±6.27ng/L、45.82±6.92ng/L均明显低于正常对照组(71.88±8.67ng/L)。结果提示:血浆中NFY的改变与上述疾病的发生、发展可能有着密切的关系。