Goblet Cell Carcinoid of the Vermiform Appendix with Ovarian Metastasis Mimicking Mucinous Cystadenocarcinoma

We describe a case of goblet cell carcinoid of the vermiform appendix, which metastasized to the bilateral ovaries, uterus, vagina and peritoneum three years and four months after appendectomy. The appendiceal tumor showed transmural infiltration of carcinoembryonic antigen-positive goblet cell-type tumor cells, intermingled with a small number of argyrophilic cells immunoreactive for serotonin and chromogranin A. The presence of neurosecretory-type granules was confirmed ultrastructurally in some mucin negative tumor cells. The pattern of proliferation was typical of carcinoid tumor originating from the lowermost part of the mucosa, and showed lymphatic permeation. The metastatic lesions in the pelvic organs showed either diffuse infiltration of goblet cell-type tumor cells or mucinous cystadenocarcinoma like features, the latter being evident in the right ovary. No neuroendocrine component was identified in the metastatic deposits. The kinship of appendiceal goblet cell carcinoid to adenocarcinoma is discussed. Acta Pathol Jpn 41: 455–460,1991.     

The Effects of Cyclic Stretching on the Proliferation of Lung Adenocarcinoma Cells in Vitro

Using FX-4000 strain unit, the prolieration in human lung adenocarcinoma A549 cells that underwent mechanical strain of different waveform、frequency and duration were studied. Image analysis revealed that cellular proliferation rate(PR) reduced significantly after cells were subjected to square wave with 0～20% elongation at frequency 30,40,50 and 60 cycles/min for 2h. The PR had no distinct difference at heart wave , triangle wave and sine wave group compared with control. It is concluded that square wave and higher frequency play an important role in inhibiting A549 cells proliferation.     

Pseudomesotheliomatous Adenocarcinoma of the Lung with Rhabdoid Features

Pseudomesotheliomatous adenocarcinoma of the lung is a rare entity, clinically and pathologically mimicking diffuse malignant pleural mesothelioma.

We report a case of pseudomesotheliomatous adenocarcinoma consisting of two distinct histopathologic components with marked differences in morphological appearance and immunohistochemical staining pattern: a small subpleural nodule consisting of adenocarcinoma and undifferentiated carcinoma with rhabdoid features, the latter extending to the visceral pleura in a diffuse mesothelioma-like growth pattern. The adenocarcinomatous component showed strong reactivity with various epithelial markers, but no reactivity with vimentin. The undifferentiated component showed strong reactivity for vimentin, but no reactivity for epithelial markers. Both components showed no reactivity with CEA, Ber Ep4, MOC-31, B72.3, cytokeratin 5/6, calretinin and thrombomodulin. Metastatic lesions in the duodenum and the periumbilical skin consisted entirely of undifferentiated carcinoma with rhabdoid features.

Fluorescence in situ hybridisation (FISH) was performed for chromosomes 4, 7, 20, and 22. FISH results showed polysomy 7 in both components. The diagnosis of pseudomesotheliomatous adenocarcinoma in this case was based on the finding of the subpleural nodule. We conclude that in cases of undifferentiated malignant pleural tumors with cells of rhabdoid phenotype, the possibility of peripheral pulmonary adenocarcinoma dedifferentiating into a more aggressive phenotype should be considered.     

Extremely Well Differentiated Papillary Adenocarcinoma of the Lung with Prominent Cilia Formation

We describe a 54-year-old woman with primary pulmonary adenocarcinoma showing a characteristic papillary architecture and prominent cilia formation. Immunohistochemically, the tumor cells were positive for carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and Leu Ml, and negative for lactoferrin and surfactant apoprotein. An ultrastructural study also indicated differentiation toward bronchial surface epithelial cells. To our knowledge, this type of neoplasm has not been reported as peripheral-type adenocarcinoma of the lung. Acta Pathol Jpn 42: 745–750, 1992.     

恩度联合培美曲塞与顺铂治疗晚期肺腺癌的临床效果观察

目的 比较重组人血管内皮生成抑制素注射液（恩度）联合培美曲塞及顺铂化疗方案与单用培美曲塞联合顺铂方案治疗晚期肺腺癌的临床疗效。方法 选取81例经病理组织学或细胞学检查确诊的晚期肺腺癌初治患者,随机分为观察组（41例）和对照组（40例）。两组患者均给予培美曲塞+顺铂（PP方案）化疗,观察组在此基础上给予恩度治疗。评价两组近期临床疗效,采用生活质量卡氏（KBS）评分评价患者治疗前后生存质量及治疗期间不良反应,计算中位进展时间。结果 观察组近期有效率为46.15%,高于对照组的37.50%,差异有统计学意义（P＜0.05）;观察组中位肿瘤进展时间为8.65个月,高于对照组的5.31个月,差异有统计学意义（P＜0.05）;两组生活质量评分及不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 恩度联合培美曲塞+顺铂治疗晚期肺腺癌可提高近期临床疗效,延长肿瘤进展时间,改善生活质量,且不增加不良反应,具有较好的临床疗效及安全性。     

Screening of Methylation Gene Sites as Prognostic Signature in Lung Adenocarcinoma

PurposeMost lung adenocarcinoma (LUAD) patients are diagnosed at the advanced stage and have poor prognosis. DNA methylation plays an important role in the prognosis prediction of cancers. The objective of this study was to identify new DNA methylation sites as biomarkers for LUAD prognosis.Materials and MethodsWe downloaded DNA methylation data from The Cancer Genome Atlas data portal. Cox proportional hazard regression model and random survival forest algorithm were applied to identify the DNA-methylation sites. Methylation of sites were validated in the Gene Expression Omnibus cohorts. Function annotation were done to explore the biological function of DNA methylated sites signature.ResultsSix DNA methylation sites were identified as prognosis signature. The signature yielded acceptable discrimination between the high-risk group and low-risk group. The discrimination effect of this DNA methylation signature for the OS was obvious, with a median OS of 21.89 months vs. 17.74 months for high-risk vs. low-risk groups. This prognostic prediction model was validated by the test group and GEO dataset. The predictive survival value was higher for the prognostic prediction model than that for the tumor node metastasis stage. Adjuvant hemotherapy could not affect the prediction of the signature. Functional analysis indicated that these signature genes were involved in protein binding and cytoplasm.ConclusionWe identified the prognostic signature for LUAD by combining six DNA methylation sites. This could service as potential robust and specificity signature in the prognosis prediction of LUAD.     

肺腺癌5-羟色胺受体的免疫组织化学定位

目的 对人肺腺癌肿瘤组织的5-HTR的定位观察。方法 β型5-HT抗独特型抗体，免疫组织化学PAP。结果 人肺腺癌肿瘤细胞内有大量5-HTR免疫反应阳性物质，结论 肺腺癌细胞上有5-HTR表达，5-HT可能参与人肺腺癌的生长调控。为研究肺腺癌的发生和发展机制以及临床治疗提供有价值的参考。     

生物信息学分析筛选肺腺癌靶基因及评估预后的价值

目的 基于生物信息学分析筛选肺腺癌靶基因及评估预后价值。方法 对三个数据集（GSE118370、GSE32863、TCGA-LUAD）分别使用limma和edgeR包筛选出肺腺癌差异表达基因,对共同差异基因进行功能富集分析,通过String数据库构建蛋白质-蛋白质相互作用（PPI）网络,采用Cytoscape进行可视化分析并用其插件cytoHubba来筛选关键基因,采用Kaplan-Meier曲线进行总体生存分析。结果 共224个共同差异基因,其中上调基因34个,下调基因190个。共同差异基因在血管生成、白细胞调节、免疫反应等生物学过程富集。通过从PPI网络中筛选出8个关键基因,分别为IL6、VWF、PECAM1、SPP1、CDH5、CXCL12、TIMP1、CLDN5。生存分析显示,PECAM1与LUAD的预后有关。肿瘤组织中PECAM1表达高于正常组织,差异有统计学意义（P＜0.05）。结论 PECAM1是一种与肺腺癌预后相关的新的生物标志物,有望成为肺腺癌的一个治疗的靶点。     

多层螺旋CT用于小细胞肺癌与肺鳞癌的鉴别诊断价值分析

目的 分析多层螺旋CT用于小细胞肺癌与肺鳞癌的鉴别诊断价值。方法 选取2015年1月~2017年12月本院接收的肺癌患者106例,由病理类型分组,小细胞肺癌53例作为A组,另53例为肺鳞癌作为B组,两组患者均需进行多层螺旋CT鉴别诊断,回顾分析两组影像学特征以及A组相关危险因素。结果 A组和B组在密度、性状、强化形式、支气管形态、阻塞性改变、淋巴结融合、淋巴结肿大、大血管侵袭等影像特征对比上,差异具有统计学意义（P＜0.05）,但在远处转移、胸膜转移和心包积液等特征比较上,差异无统计学意义（P＞0.05）。经多因素分析得知,小细胞肺癌的危险因素主要为支气管狭窄通畅、肿瘤均匀强化和淋巴结融合。结论 多层螺旋CT用于小细胞肺癌与肺鳞癌具有较高的鉴别诊断价值,能清晰显示出小细胞肺癌与肺鳞癌的影像特征差异,为临床鉴别诊断提供科学的参考依据。     

Gallbladder Adenocarcinoma with Florid Neuroendocrine Cell Nests and Extensive Paneth Cell Metaplasia

We report a unique case of gallbladder adenocarcinoma associated with florid neuroendocrine cell nests and extensive Paneth cell metaplasia that has not been described previously. The patient was a 79-yr-old woman with a pedunculated, polypoid mass in the gallbladder. Microscopically, the mass was composed of tumor cells showing tubular and papillary growth patterns, consistent with well-differentiated adenocarcinoma. One-third or more of the tumor cells showed Paneth cell appearance. Goblet cell-type tumor cells were also intermingled. In addition, neuroendocrine cell nests, that were connected to the neoplastic glands, were scattered throughout the stroma. Immunohistochemically, the labeling index of MIB-1 in adenocarcinoma cells including Paneth cell-type carcinoma cells was approx 40%. Neuron-specific enolase, chromogranin A, and synaptophysin were positive in the neuroendocrine cells forming solid nests and intermingled within neoplastic glands. They were immunopositive for serotonin but negative for insulin, glucagon, somatostatin, and pancreatic polypeptide (PP). Although MIB-1-positive neuroendocrine cell nests were very few with weak staining, we think that the neuroendocrine cell nests were neoplastic in nature. The formation of the multifocal neuroendocrine nests may be a consequence of the trophic effects of unknown substance(s), which can promote serotonin-producing neuroendocrine cells to proliferate. We postulate that Paneth cell-type carcinoma cells may be intimately related to such substance(s) in our case.     

非小细胞肺癌患者血清PCNA和癌组织NapsinA表达及与病理类型的关系

目的 研究分析非小细胞肺癌(NSCLC)患者血清细胞增殖抗原(PCNA)及癌组织NapsinA表达与患者病理类型的关系.方法 选取2016年2月至2017年2月我院收治的NSCLC患者100例为观察组,另取同期健康体检者50例为对照组.采用酶联免疫吸附法分别检测两组人员的血清PCNA水平,并分析PCNA与NSCLC患者临床病理特征的关系.采用免疫组化SP方法检测观察组癌组织以及癌旁组织的NapsinA表达情况,分析与患者临床病理特征的关系.结果 观察组患者的血清PCNA水平为(444.2 ±26.7) pg/mL,显著高于正常对照组的(290.5±16.2) pg/mL.癌组织NapsinA表达阳性率为80.00％ (80/100),显著低于癌旁正常组织的100.00％ (100/100).NSCLC分化程度为低中分化、TNM分期为Ⅲ～Ⅳ期以及有淋巴结转移患者的血清血清PCNA水平分别为(469.5±27.3) pg/mL、(472.5±26.8)pg/mL、(477.1±26.2) pg/mL,均显著高于高分化、TNM分期为Ⅰ～Ⅱ期以及无淋巴结转移患者.NSCLC病理类型为腺癌、高中分化、TNM分期为Ⅰ～Ⅱ期以及无淋巴结转移患者的NapsinA表达阳性率分别为100.00％ (72/72)、100.00％ (46/46)、95.24％(40/42)、92.31％ (48/52),均显著高于鳞癌与大细胞癌、分化程度为低中分化、TNM分期为Ⅲ～Ⅳ期、有淋巴结转移患者.以上对比均P ＜0.05差异有统计学意义.结论 NSCLC患者血清PCNA水平与病理类型无相关性,而癌组织NapsinA在腺癌中的表达显著高于鳞癌以及大细胞癌,上述两指标可作为判断患者分化程度、TNM分期及淋巴结转移的参考指标.而癌旁组织NapsinA阳性率对区分患者病情程度不具备参考价值     

肺癌患者血管内皮生长因子和T细胞亚群表达的变化

测定和比较83例肺癌患者与60名正常人血清血管内皮生长因子(VEGF)和T细胞亚群(CD3 、CD4 、CD8 、CD8 CD28 )和NK细胞的表达水平,探讨其临床意义,VEGF采用ELISA法,T细胞亚群的表达采用流式细胞仪法。结果表明:肺癌患者VEGF水平明显高于对照组(P<0.01)。CD4 细胞、CD8 CD28 细胞和NK细胞明显低于对照组(P<0.01)。CD8 细胞则明显高于对照组(P<0.01)。提示肺癌患者血清VEGF增高和细胞免疫功能紊乱,有一定的临床意义。     

2014~2016年广西肿瘤医院肺癌患者流行病学及病理分布特征分析

目的 描述2014~2016年广西肿瘤医院收治肺癌患者的临床流行病学特征及病理类型特征,为广西肺癌的预防和控制提供参考依据。方法 对筛选出肺癌患者数据资料进行统计分析,描述肺癌患者的临床流行病学特征及病理类型特征。结果 共收集肺癌病例3510例,男性患者多于女性,男女性别比为1.99。肺癌患者主要集中在老年组（≥60岁）中,占肺癌患者总人数的50.11%,农村居民构成比超过50%。肺癌的主要病理类型为腺癌,鳞状细胞癌次之。腺癌的构成比呈上升趋势（P＜0.05）,男性、女性、中年组、老年组、城市居民以及农村居民的腺癌构成比上升（P＜0.05）。结论 60岁以上老年人,农村居民以及男性是肺癌防治的重点对象,尤其是符合多项条件的人群。     

A Case of Adenocarcinoma of the Lung with a Spindle Cell Component

We report a 60-year old man, who was admitted to the hospital with complaints of cough and sputum. His chest x-ray showed an abnormal mass in the right upper lobe. After admission he noticed the painful gingival tumor. Right upper lobectomy and resection of the gingival tumor were performed. Their histological features showed that the tumor consisted of a papillary and tubular adenocarcinoma mixed with a component of spindle cells. Immuno-histochemical study demonstrated a positive reaction in the epithelial component for keratin and epithelial membrane antigen, and not only these epithelial markers but also vimentin were expressed in some spindle tumor cells. Electron microscopic study confirmed the biphasic pattern, showing gland formation and undifferentiated cells. We diagnose this case as adenocarcinoma of the lung with a spindle cell component and the gingival tumor was meta-static. Autopsy showed that metastatic lesions were found in the left adrenal gland and in the left kidney. The tumor cells in the left adrenal gland were composed of spindle cells and the tumor in the left kidney showed gland formation. lmmunohistochemical and electron microscopic findings of surgical and autopsy specimen suggest that this tumor is of epithelial origin, and the spindle cells are derived from immature mesenchymal cell transformation of epithelial cells. Acta Pathol Jpn 42: 841–846, 1992.     

An Immunohistochemical Study of Feline Endometrial Adenocarcinoma

Feline endometrial adenocarcinomas are uncommon malignant neoplasms that have to date been poorly characterized. The present immunohistochemical study describes the expression of the pancytokeratins AE1 and AE3, cytokeratin-14, vimentin, α-actin, cyclo-oxygenase-2, E-cadherin, β-catenin, the progesterone receptor, the oestrogen receptor and caveolin-1 within normal feline uterine tissue and tissue from six cats with endometrial adenocarcinoma. Synthesis of cyclo-oxygenase-2 and reduced expression of progesterone receptors may be involved in the neoplastic transformation of feline endometrium. The loss of cellular adhesion that occurs within these tumours does not require down-regulation of E-cadherin expression and nuclear translocation of β-catenin is not a feature of these neoplasms.     

Mucinous Colorectal Adenocarcinoma with Signet-Ring Cells: Immunohistochemical and Ultrastructural Study

A primary mucinous colorectal adenocarcinoma tissue with signet-ring cells, as revealed after histological evaluation, was examined ultrastructurally. The authors also analyzed the immunohistochemical data of the tissue for serotonin, vasoactive intestinal polypeptide (VIP), bombesin, somatostatin, and glucagon, using the peroxidase anti-peroxidase (PAP) method and the immunogold labeling method for light and electron microscope, respectively. Electron microscopically mucinous adenocarcinoma was characterized by the formation of small lumen. Adenocarcinoma cells were full of mucous granules of varying electron density, providing a good environment for the tumor cells to grow. They also exhibited a significant loss of microvilli and intracytoplasmic junctions, which could allow the cells to disseminate. Signet-ring cells were located in the basal site of the ducts or in the lamina propria and appeared neoplastic, with mucin accumulation intracellularly and an eccentric crescent-shaped nucleus. The cytoplasmic organelles were decreased and at the periphery of the cell. The PAP method demonstrated that these cells were strongly positive for bombesin and also positive for vasointestinal polypeptide (VIP). The immunogold method detected bombesin immunoreactivity in the vacuoles as well as in other cytoplasmic membranes, whereas VIP was localized mainly in the plasma membrane. The location of signet-ring cells combined with the immunoreactivity for bombesin and VIP indicated that signet-ring cells were of neuroendocrine origin and probably dedifferentiated enterochromaffin-like endocrine cells. These findings have implications for understanding the biological behavior of these composite malignant tumors and could help in the knowledge of the origin of signet-ring cells.     

Goblet cell adenocarcinoma: concepts and updates

Appendiceal goblet cell adenocarcinoma, previously called goblet cell carcinoid and adenocarcinoma ex goblet cell carcinoid, is a rare neoplasm that occurs almost exclusively in the appendix. Several classification and grading systems have been proposed that can separate patients into prognostic groups. This review will provide an update on various classification systems with emphasis on the newly published 2019 World Health Organization Classification of Tumors, which proposed a 3-tiered grading system for appendiceal goblet cell adenocarcinoma based on the extent of low and high-grade patterns.     

Combined Choriocarcinoma and Adenocarcinoma of the Lung

Combined choriocarcinoma and adenocarcinoma in the lung of a 71-year-old Japanese male is reported. In the upper lobe of the right lung (S1+ 2), a choriocarcinoma coexisted with an adenocarcinoma, but distinct metastatic lesions were noticed separately in the lungs, kidney, bone marrow and lymph nodes. Although immunohistochemical examination revealed intensely positive reactivity with anti-human chorionic gonadotropin (HCG) in trophoblastic cells, weak immunoreactivities were also observed in a few cells with anti-human placental lactogen (HPL), anti-pregnancy specific β glycoprotein (SPI), anti-epithelial membrane antigen (EMA), anti-carcinoembryonic antigen (CEA), anti cytokeratin (keratin) and KM-93 (lung adenocarcinoma-associated antibody). In the adenocarcinoma, the tumor cells were positively stained for CEA, EMA, keratin and KM-93, but there were no positive reactivities for HCG, HPL and SPI. These findings suggest that primary choriocarcinoma of the lung may arise through dedifferentiation of adenocarcinoma.     

一株人胰腺癌细胞系的建立及其特性

人胰腺癌是很难建系的癌细胞之一,特别是从原发瘤建立的细胞系。我们成功地从一个胰腺癌组织建立了一株人胰腺癌细胞系,命名为PC-3。PC-3细胞呈上皮样,贴壁生长,经过四年连续培养,细胞系稳定。通过免疫组化、电镜观察、染色体及DNA含量分析,细胞集落形成及裸鼠移植,生长因子对瘤细胞生长的影响和癌基因的表达证实PC-3细胞系为人胰腺癌细胞系。PC-3细胞系的建立进一步丰富了人胰腺癌细胞库,对深入了解人胰腺癌细胞生物学及分子生物学特性提供了有力的物质基础。