p63蛋白在食管磷状细胞癌中的表达及意义

目的检测p63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p63蛋白在53例食管磷癌及癌旁组织中的表达情况。结果p63蛋白在食管癌组织中的阳性表达率为71.7%（38/53）,而在癌旁食管组织中的阳性表达率为35.8%（19/53）,两者比较有显著性差异（P〈0.01）。p63蛋白的表达与食管磷癌分化程度密切相关（P〈0.05）,其在低分化磷癌中的阳性表达率（89.5%）显著高于在高分化磷癌中的阳性表达率（46.2%）。p63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p63蛋白在食管磷癌组织中呈高表达,表明其可能参与食管磷癌的发生发展。     

p57kip2、cyclin D1在食管癌中的表达及意义

目的研究p57kip2在食管癌中的表达及意义,探讨其与cyclin D1在食管癌中表达的相关性。方法采用免疫组织化学SP法检测50例食管癌组织及15例正常食管上皮组织中p57kip2、cyclin D1的表达情况;应用流式细胞术对这些组织的DNA含量和细胞周期分布进行分析。结果免疫组化:p57kip2蛋白在食管癌组织中阳性表达率(34.0%)低于正常组织(80%)(P<0.01),与食管癌组织分化程度、浸润深度和淋巴结转移情况有关(P<0.05);cyclin D1蛋白在食管癌组织中的阳性表达率(64.0%)高于正常组织(13.33%)(P<0.01),与浸润深度和淋巴结转移情况有关(P<0.05),与食管癌组织分化程度无关(P>0.05)。p57kip2和cyclin D1之间表达负相关(r=-0.429,P<0.01)。流式细胞术:与正常组织相比,癌组织中DNA含量增高,异倍体细胞增加;G0/G1期细胞减少,而S期和G2/M期细胞增多,增殖指数(PI)高于正常组织。结论p57kip2蛋白低表达可能与食管癌的发生发展有关;p57kip2与cyclin D1联合检测可作为评估食管癌恶性程度指标。     

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.     

非小细胞肺癌组织中TRIM59、p53表达与临床病理特征及预后的相关性分析

目的 分析非小细胞肺癌(NSCLC)组织中三重基序蛋白(TRIM)59、p53表达与患者临床病理特征及预后的关系。方法 选取我院73例NSCLC患者的癌组织及癌旁组织,免疫组织化学法检测患者NSCLC组织及癌旁组织中TRIM59及p53蛋白的表达;qRT-PCR检测TRIM59及p53 mRNA表达。Pearson检验分析NSCLC组织中TRIM59 mRNA与p53 mRNA表达的相关性;采用TCGA数据库分析TRIM59及p53蛋白与NSCLC患者预后的关系;Kaplan-Meier法分析TRIM59、p53蛋白与NSCLC患者预后的关系;COX回归分析影响NSCLC患者预后的危险因素。结果 NSCLC组织中TRIM59及p53蛋白阳性表达率显著高于癌旁组织(74.0%vs.9.6%,65.8%vs.5.5%,P<0.05),TRIM59 mRNA、p53 mRNA表达水平显著高于癌旁组织[(2.17±0.62)vs.(1.00±0.24)、(1.85±0.49)vs.(1.00±0.26),P<0.05]。NSCLC组织中TRIM59及p53蛋白阳性表达与患者TNM分...     

Nrf2在食管鳞癌组织中的表达及意义

目的:探讨Nrf2(Nuclear factor E2 p45-related factor2)在食管鳞癌组织中的表达及其与临床病理学特征的关系。方法:采用免疫组化SP法检测Nrf2在32例食管鳞癌,30例癌旁组织,21个阳性淋巴结和24个阴性淋巴结组织中的表达。结果:Nrf2阳性表达主要定位于细胞核中,在食管鳞癌中的阳性表达率为78.13%,显著高于癌旁组织(13.33%),淋巴结癌转移阳性组织中的表达率(66.67%)也显著高于淋巴结癌转移阴性组织中的表达水平(20.83%),均具有统计学意义(P<0.05)。Nrf2的阳性表达随淋巴结的转移度的增加而表达增加(P<0.05),但在不同年龄、性别、TNM分期、肿瘤分化程度及不同部位之间差异无统计学意义。结论:Nrf2在食管鳞癌中高表达,表达的高低与淋巴结转移与否及转移度有关。     

MDM2和P53蛋白表达与原发性肝细胞肝癌发生的关系

目的:研究MDM2和突变型P53蛋白表达与原发性肝细胞肝癌(HCC)发生的关系。方法: 用免疫组织化学SP法,检测55例HCC癌组织、23例癌旁组织、10例正常肝组织MDM2和突变型P53蛋白表达情况。结果: 55例HCC中MDM2蛋白阳性表达17例(30.9%),突变型P53蛋白阳性表达23例(41.8%),二者均阳性表达11例(20%),MDM2和突变型P53蛋白表达有相关性(r=0.310, P＜0.05)。23例癌旁组织MDM2蛋白阳性1例,突变型P53蛋白阳性表达2例,肝癌组织和癌旁组织MDM2和突变型P53蛋白表达有差异(P＜0.05)。10例正常肝组织无MDM2和突变型P53蛋白表达。结论: 肝细胞癌组织有MDM2和突变型P53过量表达,MDM2蛋白和/或 p53 基因突变使 p53 基因功能失活在HCC发生中可能有重要作用。     

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。     

胰腺癌p53上下游基因mdm2、p21WAF/CIP1以及P14ARF蛋白的表达及相互关系

目的 探讨p14ARF、p53、mdm2及p21WAF/CIP1蛋白在胰腺癌组织中的表达、相互关系及意义。方法 选取167例胰腺癌、101例癌旁与13例良性病变组织构建组织芯片(又称组织微阵列),应用免疫组织化学EnVision二步法检测这4种蛋白在胰腺良恶性病变中的表达。结果 p14ARF、p53、mdm12及p21WAF/CIP1在胰腺癌中表达的阳性率分别为35.3％(59/167)、57.5％(96/167)、64.1％(107/167)和39.5％(66/167)。同癌旁组织相比,p53和mdm2表达明显升高(P<0.01),而p14ARF和p21WAF/CIP1的表达明显降低(P<0.05)。p21WAF/CIP1的阳性表达与年龄、神经受累显著相关(P<0.05);p53的阳性表达与肿瘤的分化、淋巴结转移和神经受累均显著相关(P<0.05);mdm2的阳性表达与肿瘤的分化显著相关(P<0.05);p14ARF与年龄和浸润转移显著相关(P<0.05)。四者阳性表达两两之间统计学上具有关联性(P<0.05)。结论 p53和mdm2的过表达以及p14ARF和p21WAF/CIP1的缺失表达可能会导致胰腺癌的形成和进展;4种蛋白主要以p14ARF-p53-mdm2-p21WAF/CIP1通路的方式作用于细胞的转化和肿瘤的形成;联合检测p53和mdm2的表达可用于评定胰腺癌的恶性程度。     

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。     

胃腺癌中EZH2、Akt蛋白的表达及意义

研究果蝇zeste基因增强子同源物2(enhancer of zeste homolog 2,EZH2)及Akt蛋白在胃腺癌中的表达及与其临床意义。方法应用S-P免疫组化技术检测73例胃腺癌及其相应的癌旁正常组织中EZH2和Akt蛋白的表达。73例胃腺癌组织中EZH2、Akt蛋白的阳性表达率67.1%(49/73)、61.6%(45/73)均高于癌旁正常组织5.5%(4/73)、10.4%(7/73),差异具统计学意义(P<0.05);EZH2的表达与肿瘤分化程度、浸润深度、淋巴结转移及临床分期相关,有统计学意义(P<0.05);Akt蛋白的表达与淋巴结转移相关有统计学意义(P<0.05)。EZH2与Akt蛋白在胃腺癌组织中的表达呈负相关关系(rs=-0.252,P<0.05)。EZH2与Akt在胃腺癌的发生发展中发挥重要作用,且EZH2的调控可能与Akt的活化有关。     

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.