应用原位免疫PCR技术检测乳腺癌p53抑癌基因过表达

本文应用原位免疫ＰＣＲ技术对２０例ＡＢＣ法染色ｐ５３基因蛋白弱阳性及阴性的乳腺浸润性导管癌石腊组织进行抗原－抗体反应信号放大研究，结果显示１２例ｐ５３蛋白弱阳性病例经该方法放大后呈强阳性反应，２例阴性病例呈显阳性反应、因此，应用该方法可明显提高免疫组化抗原－抗体结合的敏感性。     

Cx26和Cx43在大鼠胚胎肝发育过程中的时空表达

目的:观察Cx26和Cx43在大鼠胚胎肝发育过程中的时空表达,以了解其在肝脏发育过程中的作用。方法:用E8d～E20d及P1d的SD大鼠,石蜡切片,免疫组化染色,光镜下观察Cx26和Cx43在大鼠发育E1d～P1d过程中的表达。结果:①Cx26在E15d开始表达,此时只有少数体积大、核大的肝细胞呈Cx26阳性反应,阳性反应产物见于肝细胞浆及细胞核。②E16d开始出现少量Cx26呈弱阳性的造血细胞,E17d和E18d反应阳性强度增加,至E20d时反应消失。③E14d开始出现Cx43呈弱阳性的肝实质细胞,E15d～P1d多数肝细胞浆呈Cx43强阳性,P1d少数肝细胞核呈Cx43阳性反应。④E18d～P1d肝内可见呈Cx43阳性的造血细胞。结论:①Cx26与肝细胞的生长分化关系不大,而与肝细胞的技能分化密切相关;Cx43与肝的结构发育和成熟分化相关;Cx26和Cx43均可能与肝内造血细胞与肝实质细胞之间的信息传递有关。②胚胎肝组织中Cx26和Cx43呈不同表达状态,推测可能是由于胚胎肝细胞间、间质细胞间、肝细胞和间质细胞间以及胚胎肝细胞与造血细胞间装配的缝隙连接通讯通道结构有所不同所致。     

Cx26和Cx43在大鼠胚胎肝发育过程中的时空表达

目的：观察Cx26和Cx43在大鼠胚胎肝发育过程中的时空表达，以了解其在肝脏发育过程中的作用。方法：用E8d-E20d及P1d的SD大鼠，石蜡切片，免疫组化染色，光镜下观察Cx26和Cx43在大鼠发育E1d～P1d过程中的表达。结果：①Cx26在E15d开始表达，此时只有少数体积大、核大的肝细胞呈Cx26阳性反应，阳性反应产物见于肝细胞浆及细胞核。②E16d开始出现少量Cx26呈弱阳性的造血细胞，E17d和E18d反应阳性强度增加。至E20d时反应消失。③E14d开始出现Cx43呈弱阳性的肝实质细胞，E15d～P1d多数肝细胞浆呈Cx43强阳性，P1d少数肝细胞核呈Cx43阳性反应。④E18d～P1d肝内可见呈Cx43阳性的造血细胞。结论：①Cx26与肝细胞的生长分化关系不大。而与肝细胞的技能分化密切相关；Cx43与肝的结构发育和成熟分化相关；Cx26和Cx43均可能与肝内造血细胞与肝实质细胞之间的信息传递有关。②胚胎肝组织中Cx26和Cx43呈不同表达状态，推测可能是由于胚胎肝细胞间、间质细胞间、肝细胞和间质细胞间以及胚胎肝细胞与造血细胞间装配的缝隙连接通讯通道结构有所不同所致。     

上皮样肉瘤的病理学研究

本文报道13例上皮样肉瘤的光镜、电镜及免疫组化观察结果。光镜下瘤细胞呈结节状分布,瘤结节由不同程度异形的上皮样细胞和肥胖性梭形细胞组成,其中心有坏死。电镜观察可见部分瘤细胞胞质内有大量中间微丝、桥粒样的细胞连接或由微绒毛围绕的小的细胞间腔。免疫组化染色瘤细胞对波形蛋白和角蛋白都显阳性反应。文内还对本病的诊断、鉴别诊断和组织发生进行了讨论。     

卵巢肿瘤的角蛋白免疫组化研究

本文对47例卵巢肿瘤进行了角蛋白免疫组化的研究。41例上皮性肿瘤均呈阳性反应,其中浆液性肿瘤呈弱阳性,而粘液性肿瘤、宫内膜样肿瘤、恶性Brenner氏瘤及伴随于肿瘤的鳞状细胞灶多呈强阳性反应;肿瘤的角蛋白分布特点与超微结构观察到的微丝分布相一致。6例非上皮性肿瘤中,卵泡膜瘤及无性细胞瘤角蛋白定位为阴性,1例畸胎瘤的上皮性成份为阳性而间质成份为阴性。角蛋白免疫组化对判断和区分卵巢不同类型的上皮性肿瘤有重要价值。     

外阴富于细胞性血管纤维瘤临床病理观察

目的:探讨富于细胞性血管纤维瘤的临床病理特征和鉴别诊断.方法:对1例外阴富于细胞性血管纤维瘤进行临床组织病理学和免疫组织化学观察,并复习相关文献.结果:镜下见肿瘤有薄层纤维包膜,由短梭形细胞和大量小至中等大小的血管构成,梭形细胞分布疏密不均,可见多核瘤细胞,血管壁增厚伴广泛玻璃样变,部分血管扩张.免疫组化:肿瘤Vimentin弥漫阳性,CD34弱阳性,EMA局灶阳性,而desmin,actin,ER,PR,S100,CD117均阴性.结论:富于细胞性血管纤维瘤是一种罕见的良性的间叶性肿瘤,应注意与血管肌纤维母细胞瘤,侵袭性血管粘液瘤,软组织多形性玻璃样变血管扩张性肿瘤等鉴别.     

CD10、Nestin蛋白在皮肤附属器肿瘤组织中的表达及意义

目的:探讨白细胞分化抗原簇10(CD10)、巢蛋白(Nestin)在皮肤附属器肿瘤组织中的表达及意义。方法:收集2018年1-12月本院收治的40例皮肤附属器肿瘤患者的肿瘤组织标本,另选择5例乳腺癌根治手术切除标本中远离肿瘤的皮肤为正常皮肤对照。免疫组织化学标记CD10、Nestin蛋白,观察各例肿瘤CD10、Nestin蛋白的表达情况、阳性细胞的类型和分布。结果:汗腺肿瘤、毛分化肿瘤及皮脂腺肿瘤中的CD10蛋白表达情况比较,差异有统计学意义(P=0.000),但Nestin蛋白的表达情况比较差异无统计学意义(P=0.277)。CD10在正常皮肤的皮脂腺、汗腺周围的肌上皮细胞呈阳性表达,在小汗腺和大汗腺上皮呈阴性;Nestin在正常皮肤的皮脂腺外围基底样细胞、汗腺分泌部上皮细胞呈弱阳性表达,在分化的皮脂细胞呈阴性,肌上皮细胞阳性表达。多数类型汗腺肿瘤CD10阴性,部分病例显示瘤细胞胞质内CD10阳性表达。汗管瘤的Nestin为阴性;螺旋腺瘤肌上皮部分Nestin阳性。透明细胞汗腺瘤腺腔样结构腔膜缘细胞显示Nestin颗粒状阳性。乳头状汗腺腺瘤肌上皮细胞Nestin阳性。多数类型毛分化肿瘤表达CD10及Nestin:毛母细胞瘤间质细胞CD10阳性表达,Nestun弱阳性;毛母质瘤瘤细胞CD10阳性,Nestin阳性;毛囊瘤瘤细胞CD10阳性,角化细胞Nestin阳性。皮脂腺瘤和皮脂腺癌的CD10多呈阳性表达,各例皮脂腺瘤和皮脂腺癌的Nestin表达类似,多显示为阴性或呈弱阳性表达,部分病例显示个别瘤细胞胞质内颗粒状阳性表达。结论:CD10是毛分化、皮脂腺分化皮肤附属器肿瘤的特异性标记物,干细胞标记物Nestin在这些肿瘤的表达方式可以作为肿瘤成分分化特点的参考。     

C—myc癌基因产物在食管癌中的表达及其意义

用免疫组化LSAB方法检测了50例食管鳞癌及癌旁组织中C-myc蛋白的过表达,结果38例癌组织显示强弱不一的阳性反应,阳性反应强度与癌组织分化程度间无显著性相关。癌旁组织仅见2例非典型增生上皮有少数细胞弱阳性。c-myc癌基因激活可能是食管癌变过程中的一个晚期事件。     

胃肠道间质瘤诊断及治疗进展

胃肠道间质瘤（GIST）是一组主要发生于胃肠道的含有梭形细胞、上皮样细胞,高表达CD117,可能起源于Caja1间质细胞的肿瘤。1983年,Mazur和C1ark运用电镜和免疫组织化学重新评估胃间叶源性肿瘤的组织发生,提出GIST的概念,免疫组化和超微结构的研究显示大部分肿瘤无典型平滑肌和神经细胞特征。[第一段]     

血管球瘤临床及病理分析

目的探讨血管球瘤(GT)的临床和病理学特征。方法通过组织学观察,结合免疫组织化学技术对8例GT病例的临床资料进行回顾性分析。结果全部病例均发生于四肢末端,组织学上多由形态较一致的小圆细胞组成,细胞间界限清楚,胞浆透明或嗜酸性,胞核多数较小而圆位于中央,瘤细胞团巢间可见散在分布的薄壁血管。免疫组化显示Vim、SMA阳性,Desmin、CK、S-100、CgA、LCA、Tg、Syn、FⅧa和CD34阴性。结论血管球瘤较为少见,多属于良性肿瘤。典型血管球瘤结合其特殊的好发部位、组织病理学特点和免疫组化标记一般可作出准确诊断,而伴有异型细胞核的血管球瘤和血管球肉瘤诊断较难。     

19例原发性心脏肿瘤的病理学研究

报告原发性心脏肿瘤19例,其中粘液瘤16例,临床症状及体征可随体位改变而变化。所有粘液瘤均位于左心房内,并有一短蒂与卵圆窝相连。这些特点在临床上颇具诊断价值。根据光学及电子显微镜检查,心脏粘液瘤属真性肿瘤,其组织发生可能来自心内膜下的多能性原始间叶细胞。     

Pathological study of 51 cases of cardiac tumors

51 cases of cardiac tumors were studied pathologically, including light and electron microscopic observation. Among 47 cases of benign tumors, 46 were cardiac myxomas and one was leiomyoma. Among the remaining 4 cases of malignant cardiac tumors, there were two malignant myxomas, one lymphoma and one metastatic squamous epithelial cell cancer. Cardiac tumors might be grossly divided into three types: papillary, massive and lobular types, while the papillary type was most commonly seen. In this article, diagnosis of cardiac tumors, pathologic features of cardiac myxoma and pathohistological difference between tumor and organized thrombus are discussed.     

MORPHOLOGIC STUDY OF CARDIAC MYXOMAS

The morphology of 48 cardiac myxomas obtained from 45 cases is studied by light and electron microscopy. Among them 41 are located in the left atria, 5 in the right atria and l each in the left ventricle and right ventricle. Except for l case having 3 myxomas and another with recurrent myxoma after excision of the first, patients had only l tumor. Myxomal cells are either scattered or in cord-like arrangement. Glands are seen in 3 myxomas. In 41 myxomas, many vessels are surrounded by myxomal cells. The glands and perivascular myxomal cells are directly connect- ed to or in transit to the cord-like myxomal cells. Myxoma pedicles are separated from the heart wall by a layer of ela.stic fibers. The pulmonary emboli of myxomatous tissue arising from a well differentiated myxoma show evid- ence of local implantation.     

Multiple cerebral aneurysms and brain metastasis from primary cardiac myxosarcoma: a case report and literature review

Primary neoplasms of the heart are rare. Malignant cardiac myxoma, or so-called myxosarcoma, accounts for about 6% of primary malignant cardiac tumors. Cerebral metastasis of malignant cardiac myxoma is extremely rare; only three cases have been reported and two of them included an autopsy study. The case described herein is the first reported brain metastasis combined with multiple cerebral aneurysms originating from primary cardiac myxosarcoma. The true incidence of cerebral myxomatous aneurysm is unknown and the pathogenesis of myxomatous aneurysm formation has not been fully defined. The current hypothesis favors that tumor materials from cardiac myxomas embolize into the vasa vasorum of the peripheral arteries and subsequently prolifere in the vessel wall. This then leads to a weakening of subintimal tissue, such as the internal elastic lamina, with subsequent aneurysm formation. The prognosis of cardiac myxosarcoma is very poor. Although malignancies most likely develop from the mesenchymal cells, they are difficult to treat with any modality (operation, chemotherapy, radiotherapy or transplantation) because these tumors have usually undergone extensive spread by the time the diagnosis is made.     

Myxoma of the gingiva: a case report and literature review

Soft tissue myxomas of the oral and para-oral tissue are extremely rare. Only two cases of myxoma of gingiva have been reported in the literature. The histogenesis of these lesions remains obscure. We report a case of gingival myxoma in a 37-year-old man. A firm ovoid soft tissue mass measuring 1.5 x 1.2 x 1 cm in size was noted at the mesio-lingual gingiva of a partially impacted right mandibular third molar. Radiographic examination revealed an impacted mandibular third molar with normal radiographic bony consistency of the mandible. Excisional biopsy was performed with no evidence of recurrence after 8 months. Histological examination showed stromal mass composed of myxoid-like fluid in fibrovascular stroma and scanty inflammatory cell infiltration, suggesting myxomas of the oral soft tissues and jaws. Immunohistochemical stains with S-100 protein, desmin and smooth muscle specific actin yielded negative results, and those with alcian blue, periodic-acid-Schiff, mucicarmine, vimentin and reticulin were positive. Tumor cells of mesenchymal origin without neurogenic or muscular derivations and myxoid matrix composed of acid mucopolysaccharides in this lesion further confirmed the diagnosis of myxoma. Periodontal ligament origin cannot be completely excluded due to tumor location and its association with an impacted molar. However, further study is necessary to clarify the origin and histogenesis of these lesions.     

Risk factors for postoperative recurrence of cardiac myxoma and the clinical managements: a report of 5 cases in one center and review of literature

Background  Recurrence or metastasis of myxomas is not rare and can lead to malignancy. We aimed to analyze the risk factors for postoperative cardiac myxoma recurrence and to summarize its clinical characteristics, treatments and classification.

Methods  The clinical data of 5 patients with recurrent cardiac myxoma were retrospectively analyzed and our clinical experience was summarized. Moreover, the relevant literatures were reviewed.

Results  All the five cases of primary myxomas were derived from atypical positions. One patient had early distant metastasis, one had family history, and two suffered malignant recurrence. The recurrence interval was (2.30±2.16) years and the recurrent tumors were all found in different chambers from those of the corresponding primary tumors. Re-operation was performed after recurrence. One patient died of heart failure after malignant recurrence, and the other 4 cases had satisfactory therapeutic outcomes after re-operations. Our experience advocated a clinical classification of “typical” and “atypical” cardiac myxoma, the typical myxomas referred to the tumors locating at the left atria, with single pedicle, rooted at or around the fossa ovalis, involving no genetic causes, and the atypical myxomas included the familial tumors, tumors stemming from multiple chambers, rooted in abnormal positions of the left atrium, with evident genetic mutation, or with malignant tendency.

Conclusions  Postoperative follow-up is of vital importance for patients with myxomas characterized by multi-chamber distribution, early distant metastasis, atypical origin, and family history. Once recurs, re-operation is necessary and should be performed immediately.

     

心内占位病变患者的诊断和外科治疗（附47例分析）

目的：总结心内占位病变诊断和外科治疗经验。方法：1995年6月至2011年4月我院收治的47例心内占位病变患者的临床资料,其中良性肿瘤43例（91．4％）,均为粘液瘤,分布于左房41例,右房1例,右室1例;恶性肿瘤2例,分别为右室横纹肌肉瘤和左房肺动脉内膜肉瘤;左室附壁血栓1例;左心耳内翻1例。所有患者均在中度低温体外循环下手术,同期行二尖瓣成形术2例,三尖瓣成形术1例。结果：1例粘液瘤术后2年复发,分布于左房及右房,再次手术切除。2例恶性肿瘤均于术后6个月内死亡。其余心内占位病变恢复良好。结论：典型粘液瘤经超声心动图即可确诊,非典型粘液瘤及其它非典型部位的心内占位病变需借助CT、MRI及PET进一步明确诊断。心脏占位病变一经诊断应尽快手术,即使发生脑梗塞也非手术禁忌,良性肿瘤预后较好．恶性肿瘤预后较差。     

超声心动图对原发性心脏肿瘤的诊断价值

目的:探讨原发性心脏肿瘤的超声心动图特征。方法:对33例经手术病理证实的原发性心脏肿瘤患者的超声心动图结果进行回顾性分析。结果:超声心动图对30例心腔内黏液瘤全部做出正确诊断,1例横纹肌瘤和2例恶性肿瘤提出相应部位的占位病变诊断。原发性心脏良性肿瘤以黏液瘤多见,恶性肿瘤以肉瘤多见,易侵及邻近组织及心包。结论:超声心动图对原发性心脏肿瘤的诊断具有重要意义,可初步区分良恶性肿瘤     

胃血管球瘤3例临床病理观察

目的:探讨胃血管球瘤的临床病理学特征、诊断、鉴别诊断和生物学行为。方法:观察3例胃血管球瘤的临床资料,进行组织形态和免疫组织化学法观察,并结合文献进行讨论。结果:3 例患者术前均被诊断为胃肠间质瘤,术后病理诊断为胃血管球瘤。肿瘤组织呈结节分叶状,被平滑肌细胞分隔包绕。肿瘤细胞大小一致,圆形或卵圆形,围绕血管排列。细胞核圆形,可见核仁,核异型性不明显,核分裂象罕见。免疫组织化学法:Vimentin、SMA、Calponin均为阳性,CgA、NSE、AE1/AE3、CD117、CD34、LCA、Desmin、CD99、S-100均为阴性。随访时间2~4年,患者术后均未见复发。结论:胃血管球瘤非常少见,具有特定的形态学特征和免疫表型,易误诊,需要和其他肿瘤鉴别。     

Operative management of intracardiac myxomas: A single center experience

Background

Cardiac myxomas are the most common benign intracardiac tumors. We studied the clinical presentation of cardiac myxomas, their morbidity, mortality and recurrence rate following surgery at our institution over a period of four years.

Methods

During August 2008 to November 2012, a total of 12023 cardiac surgeries were performed. Amongst these, 50 patients (12 males, 38 females) underwent complete removal of primary or recurrent intracardiac myxomas. Complete tumor excision with a cuff of interatrial septum followed copious saline irrigation of the cardiac chambers was performed in each case.

Results

Forty six patients survived the surgery of which 43 are being followed up at regular intervals for development of recurrence. Myxomas constituted 0.41% of the total cardiac surgeries at our institute. Most of them were noted in the fourth decade. The commonest location was left atrium (74%) followed by right atrium (22%). Only one patient had a myxoma in the right ventricle. Forty six patients (92%) survived the surgery.

Conclusion

Cardiac myxoma excision account for a very small percentage of cardiac procedures. Immediate surgical treatment is indicated in all patients. Cardiac myxomas can be excised with a low rate of mortality and morbidity.