食管癌中p73蛋白的表达及与临床病理特征的关系

目的:检测p73蛋白在食管癌组织中的表达情况,并探讨其与食管癌临床病理特征的关系。方法:采用免疫组化检测p73蛋白在53例食管磷癌及癌旁组织中的表达情况。结果:p73蛋白在食管癌组织中的阳性表达率为84.9%(45/53),而在癌旁食管粘膜组织中的阳性表达率为32.7%(17/53),两者比较有显著性差异(P<0.01)。p73蛋白的表达与食管磷癌分化程度密切相关(P<0.05),其在低分化癌组织中的阳性表达率(94.7%)显著高于在高分化癌组织中的阳性表达率(61.5%)。p73蛋白的表达与食管磷癌的TNM分期、淋巴结转移、浸润深度均无明显相关性(P>0.05)。结论:p73蛋白在食管磷癌组织中呈高表达,表明可能参与食管癌的发生。     

p53蛋白在宫颈鳞癌组织中的表达及意义

目的探讨p53蛋白在宫颈鳞癌组织中的表达及临床意义。方法应用免疫组化SP法分别对宫颈鳞癌切除标本和正常宫颈组织标本中的p53蛋白的表达状况进行检测。结果 p53蛋白在35例正常组织中不表达,在65例宫颈鳞癌组织中,p53蛋白阳性表达38例,阳性率为58.46%。癌组织中p53蛋白的表达率与正常组织比较差异有统计学意义（P〈0.05）。p53蛋白的阳性表达率与年龄及临床分期差异无统计学意义（P〉0.05）,即p53蛋白表达阳性与宫颈鳞癌患者年龄及临床分期无明显相关。p53蛋白的表达量与宫颈鳞癌的分化程度及局部淋巴结转移差异有统计学意义（P〈0.05）,即p53蛋白的表达量与病理分化程度及局部淋巴结转移有关。结论 p53蛋白的表达与宫颈鳞癌的发生发展有关,可作为宫颈鳞癌的早期诊断、治疗及预后评估的一项参考指标。     

PTEN和mTOR在食管鳞癌组织中的表达及意义

目的观察食管鳞癌组织中PTEN与m TOR的表达,探讨其与临床病理特征的关系。方法应用免疫组化染色检测148例食管鳞癌组织、癌旁组织及其正常食管组织中PTEN和m TOR表达,分析其与常见临床病理特征的关系。结果PTEN在癌组织中阳性表达率为43.9%,癌旁组织为67.6%,而正常组织为93.2%,食管癌组织中PTEN表达率均低于癌旁组织及正常食管黏膜组织,差异有统计学意义（P〈0.05）;m TOR在癌组织中阳性表达率为85.8%,癌旁组织为35.1%,而正常组织为3.4%,食管癌组织中m TOR表达明显高于癌旁组织及正常食管组织,差异有统计学意义（P〈0.05）。PTEN的表达与m TOR的表达强度呈负相关（P〈0.05）。m TOR表达与性别、年龄、肿瘤长度差异无统计学意义（P〉0.05）,而与肿瘤浸润深度、肿瘤分化程度以及有无淋巴结转移上差异无统计学意义（P〈0.05）。结论 m TOR信号通路的激活与PTEN的抑制,可能在食管鳞癌的发生发展中起重要的作用,PTEN低表达与m TOR高表达与肿瘤恶性程度有关,两者联合检测可能有助于预后的判断。     

p28GANK的表达与食管鳞癌转移的相关性

目的 研究p28GANK表达在食管鳞癌转移中的意义.方法 免疫组化检测p28GANK在78例食管鳞癌及对应的癌旁组织中的表达水平,实时荧光定量PCR(qRT-PCR)及Western blot法检测p28 GANK在两株食管癌高低转移细胞中的表达差异.结果 免疫组化结果提示p28GANK在食管癌组织中阳性表达率为67.95％ (53/78),显著高于对应癌旁组织阳性表达率11.42％ (8/78)(P＜0.01);统计分析提示,p28GANK在癌组织表达水平与患者分期、淋巴结转移、淋巴管浸润、远处转移有显著相关性(P＜0.01或P＜0.05);qRT-PCR及Western blot法结果提示p28GANK mRNA及蛋白在两株高转移食管癌细胞株表达水平均显著高于对应的低转移细胞系(P＜0.05).结论 p28GANK在高转移性食管癌组织及细胞系中表达显著上调.     

EZH2蛋白在食管癌组织中的表达

目的观察EZH2蛋白在食管鳞癌和腺癌组织中的表达,探讨EZH2蛋白与侵袭、转移程度不同的食管鳞癌及不同病理分级、组织类型食管癌之间的关系。方法采用免疫组织化学染色法、免疫印迹法,分析检测食管癌标本中EZH2蛋白的表达。结果食管癌组织标本均高表达EZH2蛋白,阳性染色定位于细胞核;部分正常组织、癌旁组织也有弱阳性着色。免疫印迹分析表明,食管鳞癌组织EZH2蛋白的表达明显高于癌旁及正常黏膜组织（P〈0．01）。癌旁组织高于正常黏膜组织（P〈0．05）。浸润、转移性食管鳞癌EZH2蛋白表达明显上调,与未发生浸润、转移的相比,差异有显著性（P〈0．05）。高分化鳞癌EZH2蛋白表达低于中、低分化者;但食管腺癌则相反,高分化腺癌的表达高于中、低分化者。结论EZH2蛋白在食管癌高表达,并与其组织类型、侵袭和转移特性密切相关。     

p38γMAPK蛋白在结肠癌组织中的表达及临床意义

目的探讨人结肠癌中p38γMAPK蛋白的表达及其临床意义。方法应用免疫组织化学法检测54例结肠癌组织、近癌旁组织、癌周正常组织和15例腺瘤息肉组织中p38γ蛋白的表达情况。结果p38γ蛋白的表达主要定位于胞质中,仅少量在胞核中表达。p38γ蛋白在结肠癌组织、癌旁组织、癌周正常组织中的高表达率分别为75.93%、51.85%、37.04%,在结肠腺瘤息肉组织中高表达率为33.33%。p38γ蛋白在结肠癌中的表达明显高于癌旁组织、癌周正常组织和腺瘤息肉组织,有统计学意义（P〈0.01）。p38γ的表达与Duke分期,组织分化程度及有无淋巴结转移有显著差异（P〈0.01）,p38γ的表达与年龄、性别、肿瘤大小、肿瘤位置无明显相关（P〉0.05）。结论结肠癌组织中p38γ蛋白处于过度表达状态,与结肠癌的发生、发展和转移密切相关。     

食管癌及癌前病变中NF-κB p65/p50蛋白的表达

目的探讨核转录因子NF—κB p65／p50蛋白在食管癌与癌前病变组织的变化特征及其生物学意义。方法采用免疫组化ABC法检测食管癌手术标本的NF—κB p65／p50蛋白表达状况并分析其特征。结果NF—κB p65／p50在正常食管鳞状上皮组织无表达,而在基底细胞增生（38％／32％）、间变（54％／46％）、原位癌（53％／47％）和鳞状细胞癌（69％／62％）均出现不同程度的阳性表达,并随病变进展,阳性表达率明显升高。而基底细胞增生与鳞癌之间表达率差异有显著性（P〈0．05）。NF-κB p65／p50在食管鳞癌中表达有异质性。结论NF—κB p65／p50蛋白表达变化是食管癌和癌前病变组织常见的分子事件,可能在食管鳞癌癌变过程中起一定作用。     

P53和Id2蛋白在食管鳞状细胞癌的表达及其意义

目的研究P53、Id2蛋白在食管鳞状细胞癌组织的表达及其意义。方法采用免疫组织化学SP法和图像分析技术检测122例食管鳞状细胞癌及90例癌旁正常组织中P53、Id2的表达情况。结果 122例食管鳞状细胞癌中P53、Id2表达水平均高于癌旁正常组织(p0.01)。P53表达强度与患者的性别、年龄及肿瘤的分化程度未见明显相关性(p0.05),但与肿瘤的浸润深度及淋巴结转移情况相关(p0.05);Id2的表达与患者的性别、年龄及淋巴结转移情况未见明显相关性(p0.05),但与肿瘤的分化程度成负相关(p0.05),且与肿瘤浸润深度正相关(p0.05)。结论 P53、Id2在食管鳞状细胞癌的高表达可能作为判断食管鳞状细胞癌生物学行为的潜在指标。     

P53和1d2蛋白在食管鳞状细胞癌的表达及其意义

目的研究P53、Id2蛋白在食管鳞状细胞癌组织的表达及其意义。方法采用免疫组织化学SP法和图像分析技术检测122例食管鳞状细胞癌及90例癌旁正常组织中P53、Id2的表达情况。结果122例食管鳞状细胞癌中P53、Id2表达水平均高于癌旁正常组织（P〈0．01）。P53表达强度与患者的性别、年龄及肿瘤的分化程度未见明显相关性（P〉0．05）,但与肿瘤的浸润深度及淋巴结转移情况相关（P〈0．05）;Id2的表达与患者的性别、年龄及淋巴结转移情况未见明显相关性（P〉0．05）,但与肿瘤的分化程度成负相关（P〈0．05）,且与肿瘤浸润深度正相关（P〈0．05）。结论P53、Id2在食管鳞状细胞癌的高表达可能作为判断食管鳞状细胞癌生物学行为的潜在指标。     

早期食管癌中ATM和p16蛋白的表达及临床意义

目的探讨共济失调性毛细血管扩张症突变蛋白ATM和p16在早期食管癌组织及癌旁正常鳞状上皮组织中的表达,探讨两者在早期食管癌发生中的作用及相关性。方法采用免疫组化SP法检测ATM和p16蛋白在早期食管癌组织及癌旁正常鳞状上皮组织中的表达及两者表达的相关性。结果 69例早期食管癌组织中,ATM蛋白阳性率为60.9%,p16蛋白阳性率为68.1%,且两者表达与患者年龄、性别、肿块位置无关(P0.05),与癌组织分化程度、浸润深度有关(P0.05)。随着癌组织分化程度的降低、浸润深度的加深,ATM蛋白和p16蛋白表达均下降,且两者表达有一定的相关性(r=0.598)。结论 ATM和p16蛋白在早期食管癌组织中的表达随着分化程度的降低、浸润深度的加深,两者表达均下降,且两者表达有一定的相关性,提示两者在早期食管癌的发生中有一定的作用。     

Squamous cell carcinoma variants of the head and neck

Variants of squamous cell carcinoma (SCC) frequently arise within the mucosa of the upper aerodigestive tract, accounting for up to 15% of SCCs in these areas. The most common variants include verrucous, exophytic or papillary, spindle-cell (sarcomatoid), basaloid and adenosquamous carcinoma. Each of these variants has a unique histomorphologic appearance, which raises a number of different differential diagnostic considerations, with the attendant clinically relevant management decision.Verrucous squamous cell carcinoma has a broad border of pushing infiltration of a non-dysplastic squamous epithelium, essentially devoid of mitotic figures, displaying hyperkeratosis on elongated rete pegs. Papillary and exophytic SCC have a papillary or exophytic architecture, but have malignant cytologic features within the epithelium. Spindle-cell (sarcomatoid) carcinoma is an SCC blended with a spindle-cell morphology, frequently mimicking other mesenchymal tumours. Epithelial markers are often negative. Basaloid SCC is a high-grade SCC variant with small cells arranged in a palisaded architecture, with hyperchromatic nuclei and only focal areas of squamous differentiation. Adenosquamous carcinoma is a rare variant, which is a composite of adenocarcinoma and squamous cell carcinoma, often with areas of transition. The cytomorphologic features are described in detail in an attempt to allow the general surgical pathologist to separate these variants of SCC in order to achieve appropriate clinical management.     

Low-grade endometrioid carcinoma of the ovary associated with undifferentiated carcinoma: case report and review of the literature

The association of low-grade endometrioid carcinoma with undifferentiated carcinoma (UC) was first reported in endometrium carcinoma, termed with dedifferentiated carcinoma (DC). However, the coexistence of low-grade endometrioid carcinoma (LGEC) or serous carcinoma (LGSC) with UC has received minimal attention in ovary, and the behavior of this kind of neoplasm remains at further discussion. In this study, we reported a case of low-grade ovarian endometrioid carcinoma associated with UC and reviewed another four cases previously reported. We found a histological continuity between the LGEC and UC components in H&E section, which suggested a dedifferentiation from LGEC to UC components. In summary, this kind of pathological type has aggressive behavior and these patients have very poor prognosis regardless of the amount of undifferentiated carcinoma.     

Pleomorphic ductal carcinoma of the breast with predominant micropapillary features

An 83-year-old woman with long-standing chronic ischemic cardiac and obstructive pulmonary disease, presented with a painless tumor in her right breast. Microscopically the tumor consisted of micropapillary formations and loosely cohesive nests and strands of large, highly pleomorphic cells. Micropapillary formations were surrounded by peritumoral retraction clefting, and the papillae lacked a true fibrovascular core. Multinucleated giant and bizarre tumor cells were also present and numerous. Within the tumor a high-grade intraductal component with the same cell morphology and necrosis and mucin production was found. Micropapillary pattern occupied approximately 60% of the tumor mass, loosely cohesive nests and strands approximately 20% and an intraductal component was noted in approximately 20% of the tumor mass. On immunohistochemistry the tumor cells were positive for pan-cytokeratin, epithelial membrane antigen (EMA), S100 protein and E-cadherin while estrogen and progesterone receptors, HER2-neu and Bcl2 were negative. EMA staining was diffuse and observed in the outer and inner margins of neoplastic nests. The diagnosis of pleomorphic breast carcinoma with predominant micropapillary features was established. In summary, micropapillary carcinoma can be distinguished from other types of breast carcinoma with micropapillary growth pattern on the basis of reverse cell polarity, which is easily confirmed on immunohistochemistry.     

Endometrial carcinomas with ambiguous features

Endometrial carcinomas are a heterogenous group of tumors that show variable histologies, molecular abnormalities and clinical outcomes. The idea of rigid distinctions between tumor types is appealing to pathologists, gynecologists, researchers and patients, but in a recent study where high grade endometrial carcinomas were reviewed by three experienced gynecologic pathologists, diagnostic agreement about tumor type was reached in only approximately one half of cases. In general, biologically and clinically validated diagnostic criteria are lacking for high grade endometrial carcinomas and for those that appear mixed epithelial. Until such criteria are developed, it remains important to define which morphologic patterns convey accurate clinical and biological information and which do not or might not. "Endometrial carcinomas with ambiguous features," the focus of this review, are tumors with comparatively uninformative morphologic features. Some publications indicate that gland forming and papillary endometrial carcinomas that appear morphologically low grade or ambiguous are really high grade. There are also indications that high grade endometrial carcinomas are biologically heterogeneous and that the morphologic clues we currently use to distinguish one subtype from another fail to correlate with biological data. Many tumors that appear morphologically mixed are, in fact, not biologically or clinically confused: most represent biologically "pure" tumors with variant morphology. Interesting associations between the presence of Lynch Syndrome (hereditary nonpolyposis colorectal carcinoma syndrome) and ambiguous morphology have been discussed in the literature. An apparent relationship between morphologic ambiguity and malignant mixed Müllerian tumor (MMMT) also exists. The identity of some morphologically ambiguous endometrial carcinoma can be elucidated with immunohistochemistry or other ancillary techniques at present, but the nature of many still remains undefined. This review presents the concept of morphologically ambiguous endometrial carcinomas, proposes morphological gold standard diagnostic criteria for tumors that are not ambiguous (an effort that helps define tumors that are ambiguous), provides a relevant literature review and offers practical guidance for sorting through diagnostically challenging cases.     

Small cell (oat cell) carcinoma of the breast

A case of small cell (oat cell) carcinoma, which represents both the most dlstlnctlve and the least common type of mast carcinoma wtth neuroendocrine dlfterentiation and usually shows the most aggressive behavior, is described. Radlcal mastectomy was performed on a Wyearold female for a 10 cm tumor located in the outer part of the right breast with cutaneous ulceration Microscoplcally, the tumor predominantly consisted of a diffuse proliteration of small, round to ovoid cells with hyperchromatlc nuclei and ill-defined, scant cytoplasm that was reminiscent of oat cell carclnoma of the lung. There were foci of invasive ductal carcinoma and ductal carcinoma in situ . Small cell carcinoma areas constituted approximately 90% of the neoplasm. The patlent had axlllary lymph node metastasis. The small tumor cells were argyrophlllc and positive for CAM5.2, carclnoembryonic antigen, neuron-specific enolase, Leu-7, chromogranln A and synaptophysin. Flow cytometric analysis showed an aneuplold DNA content. The patient was alive and well without disease 4 years after surgery. Small cell carcinomas of the breast may exhibkt a spectrum of malignancy that is comparable to similar tumors at better known primary sites.     

Molecular abnormalities in ovarian carcinoma: clinical,morphological and therapeutic correlates

The histopathological classification of ovarian surface epithelial carcinomas (referred to hereafter as ‘ovarian carcinoma’) has shifted over the past 10 years to reflect more clearly our understanding of molecular events during carcinogenesis. Ovarian carcinoma is no longer viewed as a single entity but as multiple disease processes, with each having different molecular pathways altered during oncogenesis, resulting in differences in clinical and pathological features, such as biomarker expression, pattern of spread and response to chemotherapy. There are five subtypes of ovarian carcinoma that are sufficiently distinct and well‐characterized that they should be considered to be different diseases, i.e. high‐grade serous, clear cell, endometrioid, mucinous and low‐grade serous, from most to least common, respectively. This review summarizes the molecular abnormalities of these five ovarian carcinoma subtypes, relating them to clinical and pathological features.     

The encapsulated follicular carcinoma of the thyroid

Summary In a retrospective study of 86 follicular carcinomas of the thyroid gland, 35 lesions were classified as encapsulated carcinomas (40.7%). In two of these, lymph node metastases were detected initially. Another patient presented with distant metastases. The biological behaviour of these 35 tumours was studied over a long-term follow-up period (0.4–19.1 years, mean 10.3 years) which featured three cases of death from thyroid carcinoma 0.4–5.0 years after thyroidectomy. Another patient suffered from local recurrence of a follicular carcinoma 13.9 years later. The morphological and clinical findings of those five patients who initially presented with metastases and/or whose follow-up registered the local recurrence of thyroid cancer or death as a result of it, were compared with the remaining 30 cases which were of a benign clinical course. Statistical analysis showed that the prognosis of encapsulated follicular carcinoma is more serious when tumours occur in patients older than 65 years of age and when the tumour diameter is 5.0 cm or more. There was a tendency towards poorer prognosis in those tumours exclusively composed of oxyphilic epithelium.Sponsored by: Hamburger Stiftung zur Förderung der Krebsbekämpfung     

Columnar cell variant of papillary thyroid carcinoma: A diagnostic dilemma in fine‐needle aspiration cytology

Columnar cell variant of papillary thyroid carcinoma (PTC) is an uncommon variant with an aggressive course as compared to classic papillary carcinoma. Cytologic diagnosis of these tumors is difficult due to absence of characteristic nuclear features of classic pattern of papillary carcinoma. We present a case of columnar cell variant in a young female misdiagnosed on aspiration cytology. A 21‐year‐old female presented with solitary nodule in the left aspect of thyroid. A diagnosis of medullary thyroid carcinoma was rendered. The resected thyoroidectomy specimen revealed a columnar cell variant of PTC which was further supported by immunohistochemical staining. Diagn. Cytopathol. 2016;44:816–819. © 2016 Wiley Periodicals, Inc.