泌尿生殖系恶性淋巴瘤PCNA及肿瘤类型与预后的关系

目的探讨泌尿生殖系恶性淋巴瘤增殖细胞核抗原（ＰＣＮＡ）及肿瘤类型与预后的关系。方法应用免疫组化技术对１０例泌尿生殖系恶性淋巴瘤组织ＰＣＮＡ及免疫表型进行检测。结果发现肿瘤类型（组织学类型和免疫表型）与ＰＣＮＡ增殖指数有关,免疫表型或肿瘤生物学行为属Ｔ细胞性,淋巴瘤的ＰＣＮＡ指数高于Ｂ细胞性和非Ｔ非Ｂ细胞性淋巴瘤,前者预后亦较后者差。结论ＰＣＮＡ可作为评估淋巴瘤病人预后的重要指标之一。     

增殖细胞核抗原在肾孟输尿管癌中的表达及临床意义

为了探讨ＰＣＮＡ表达与肾盂输尿管癌病理分期、细胞分级、复发及预后的关系，作者采用免疫组化Ｓ－Ｐ法对４７例肾盂输尿管癌ＰＣＮＡ增殖指数进行研究。结果表明：肾盂输尿管癌ＰＣＮＡ增殖指数随病理分期，细胞分级升高而增高，Ｔ３加Ｔ４ＰＣＮＡ增殖指数明显高于Ｔ１加Ｔ２（Ｐ＜０．０１）．ＧＰＣＮＡ增殖指数明显高于Ｇ１加Ｇ２（Ｐ＜０．００１），ＰＣＮＡ增殖指数高者（Ⅲ加Ⅳ级）术后膀胱癌再发率为６０％（１２／２０）明显高于增殖指数低者（Ⅰ加Ⅱ级）２２．２％（６／２７）Ｐ＜０．０１。ＰＣＮＡ增殖指数Ⅲ加Ⅳ级同时伴发尿路上皮多器官癌占３５％（７／２０），Ⅰ加Ⅱ级同时伴发尿路上皮多器官癌占７．４％（２／２７）Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级术后局部复发转移率为７．４％〔２／２７），Ⅲ加Ⅳ级局部复发转移率为４０％（８／２０），Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级５年生存率为８６．７％（１３／１５），Ⅲ加Ⅳ级５年生存率为３５．７％（５／１４）Ｐ＜０．０５。提示ＰＣＮＡ增殖指数与肾盂输尿管癌的病理分期，细胞分级有关，是低分化、侵袭性以及同时或相继发生尿路上皮多器官癌的重要特征，可能是判断肾盂输尿管癌预后的重要指标。     

膀胱移行细胞癌增殖细胞核抗原表达的研究

采用免疫组化ＬＳＡＢ法对４８例膀胱移行细胞癌增殖细胞核抗原（ＰＣＮＡ）进行检测，发现ＰＣＮＡ增殖指数随肿瘤分级的升高而增高，浸润生长肿瘤ＰＣＮＡ增殖指数明显高于乳头状生长者（Ｐ＜０．００１），ＰＣＮＡ高表达组（增殖指数＞５０％）预后明显差于ＰＣＮＡ低表达组（增殖指数≤５０％）。结果表明ＰＣＮＡ可作为膀胱移行细胞癌恶性程度及预后指标之一。     

肾癌增殖细胞核抗原与病理及预后关系的研究

为探讨肾癌增殖细胞核抗原（ＰＣＮＡ）与临床病理及预后的关系，采用免疫组织化学Ｓ－Ｐ法对５３例肾癌组织中ＰＣＮＡ进行检测。其中ＰＣＮＡ阳性细胞数和分布呈异质性，ＰＣＮＡ表达与细胞类型、肿瘤分期与分级均相关，ＰＣＮＡ高表达（３￣４级）术后５年生存率明显低于低表达（１￣２级）。结果表明ＰＣＮＡ可以定量地肿瘤分化程度及恶性度，强度ＰＣＮＡ与临床分期结合能更好地判定肾癌的预后，ＰＣＮＡ高表达者易发生转移且预     

增殖细胞核抗原在肝外胆管癌组织中的表达及其临床意义

为探讨增殖细胞核抗原（ＰＣＮＡ）在原位检测肝外胆管癌临床中的应用价值及与其预后的关系，采用免疫组织化学方法（ＬＳＡＢ法）研究肝外胆管癌组织中ＰＣＮＡ的表达及其临床意义。结果发现：４０例肝外胆管癌ＰＣＮＡ阳性２９例，定位于肝外胆管癌细胞核，ＰＣＮＡ标记指数（ＰＣＮＡＬＩ）范围为９．５％－８１．３％，ＰＣＮＡ表达与肝外胆管癌分化程度、浸润程度有关。ＰＣＮＡＬＩ与肝外胆管癌术后生存期呈极显著负相关（Ｐ＜０．０１），ＰＣＮＡＬＩ越高，生存期越短，预后越差。结果说明：ＰＣＮＡＬＩ是肝外胆管癌预后判断的良好指标。     

前列腺癌增殖细胞核抗原的免疫组化研究

为了探讨增殖细胞核抗原（ＰＣＮＡ）与前列腺癌分化程度的关系及其对预后的影响，采用ＰＣＮＡ单克隆抗体及免疫组织化学链菌素－生物素标记法（ＬＳＡＢ法），对３８例前列腺癌穿刺的石蜡标本中ＰＣＮＡ的表达进行了检测，以１５例前列腺良性增生及１０例正常前列腺组织作为对照，通过观察、统计组织切片中ＰＣＮＡ表达阳性细胞数目，计算出ＰＣＮＡ表达的阳性指数。结果发现，在低分化癌、中分化癌、高分化癌、前列腺良性增生及正常前列腺组织中，其ＰＣＮＡ阳性指数依次为８．０±４．０％、５．２±１．８％、２．４±１．１％、１．１±０．３％、０．８±０．６％，呈逐渐降低趋势。３８例前列腺癌患者经去势手术后随访１年以上者２５例，其中死亡６例，死亡组ＰＣＮＡ表达平均指数为９．０±３．０％，非死亡组为５．０±４．２％。两组比较Ｐ＜０．０５。结果表明：ＰＣＮＡ是判断细胞增殖程度的重要指标，对估计前列腺癌的分化程度及推测预后具有重要参考价值。     

增殖细胞核抗原和C－erbB－2基因产物P185蛋白在人类肾癌中表达的研究

应用增殖细胞核抗原（ＰＣＮＡ）和Ｐ１８５单克隆抗体，通过免疫组织化学方法检测５例正常肾组织和４５例肾癌组织中Ｃ－ｅｒｂＢ－２癌基因产物Ｐ１８５蛋白和ＰＣＮＡ的表达状况。结果：５例正常肾组织中未发现Ｐ１８５蛋白和ＰＣＮＡ阳性表达；４５例肾癌中Ｐ１８５蛋白和ＰＣＮＡ阳性表达率分别为８４．４％和４４．４％。表明阳性表达的Ｐ１８５蛋白和ＰＣＮＡ分别定位于肿瘤的细胞膜上和细胞核内；Ｐ１８５蛋白和ＰＣＮＡ阳性表达率与肾癌的病理分级、临床分期和患者术后生存期相关。提示Ｐ１８５蛋白和ＰＣＮＡ阳性表达在肾癌发生和发展中起着重要作用，可作为评价肾癌预后的新参数。     

增殖细胞核抗原和C—erbB—2基因产物P185蛋白在人类肾癌中表达 …

应用增殖细胞核抗原（ＰＣＮＡ）和Ｐ１８５单克隆抗体，通过免疫组织化学方法检测５例正常肾组织和４５例肾癌组织中Ｃ－ｅｒｂＢ－２癌基因产物Ｐ１８５蛋白和ＰＣＮＡ的表达状况，结果：５例正常肾组织中未发现Ｐ１８５蛋白和ＰＣＮＡ阳性表达，４５例肾癌中Ｐ１８５蛋白和ＰＣＮＡ阳性表达率分别为８４．４％和４４．４％，表明阳必表达的Ｐ１８５蛋白和ＰＣＮＡ分别定位于肿瘤的细胞膜上和细胞核内；Ｐ１８５蛋白和ＰＣＮＡ阳性     

胰岛素样生长因子Ⅱ与结肠直肠癌患者预后的关系

目的 探讨胰岛素样生长因子Ⅱ（ＩＧＦ－Ⅱ）表达水平与癌细胞的增殖,凋亡及结肠直肠癌患者预后的关系。方法 结肠直肠腺癌患者１４２例,术前纤维结肠镜直视下采集肿和正常结肠直肠粘膜的组织标本。以Ｓ－Ｐ法检测ＩＧＦ－Ⅱ,多媒体图文分析系统定量阳性染色区灰度值。Ｓ－Ｐ法检测增殖细胞核抗原（ＰＣＮＡ）,计算ＰＣＮＡ标记指数。ＴＵＮＥＬ法检测凋亡细胞,计算凋亡指数,患者均作随访,观察并记录无病生存时间和总生存时     

肾脏和睾丸原发性非霍奇金淋巴瘤(附八例报告)

目的探讨泌尿生殖系原发性恶性淋巴瘤的临床特点。方法总结１９８０～１９９７年收治肾脏和睾丸原发性恶性淋巴瘤共８例,其中肾脏２例,睾丸６例,病理类型均为非霍奇金淋巴瘤。结果全部患者均手术治疗,术后１例行化疗和放疗,２例行单纯放疗,５例单纯化疗。２例生存已超过３年和２年。结论对肾脏和睾丸原发性非霍奇金淋巴瘤应积极采取手术治疗,术后辅以化疗、放疗,以提高生存率     

Primary gastric T-cell lymphoma without human T-lymphotropic virus type 1: report of a case

Although primary gastric malignant lymphoma accounts for slightly more than 10% of all lymphomas at extranodular sites, it is relatively rare clinically, representing only 1% of all malignant diseases of the stomach. In addition, most such diseases tend to be B-cell lymphoma, while T-cell lymphoma is extremely rare. We encountered a patient with primary gastric T-cell malignant lymphoma who, although demonstrating a very rare phenomenon, was negative for antihuman T-lymphotropic virus type 1 antibody. A 73-year-old man was admitted to the hospital with the chief complaint of upper abdominal pain. The primary lesion was a type 3 tumor located at the cardia to the posterior wall of the upper body of the stomach, which had invaded the tail of the pancreas and a part of the transverse colon. A total gastrectomy, pancreatosplenectomy, and partial resection of the transverse colon were performed. The surgical section contained a giant ulcerative lesion with its bank cleaved, and a histological examination revealed a diffuse, small cell (Lymphoma Study Group classification) malignant lymphoma. An immunohistochemical analysis of the surgical specimen was positive for LCA/CD45, UCLH-1/CD45RO, and Leu-4/CD3, and negative for L-26/CD20, and it was diagnosed to be primary gastric T-cell malignant lymphoma. Received: June 28, 2001 / Accepted: November 20, 2001     

Primary B cell lymphoma of the penis: successful treatment with organ preservation

Malignant lymphoma uncommonly manifests in the genitourinary tract. Primary penile lymphoma is extremely rare. A 77-year-old male presented with primary malignant B-cell lymphoma of the penis with the chief complaint of a painless and itching nodule on the penile glans for more than 2 months. The pathologic examination with immunohistochemical stain of penile biopsy revealed malignant B cell lymphoma, mixed cellular type. The physical examination and the computed tomography scan of chest, abdomen, and pelvis showed no evidence of superficial, thoracic, abdominal, or pelvic lymphadenopathy. This case was treated with local excision and systemic chemotherapy with good cosmetic and functional results. There was absence of recurrence 16 months after therapy.     

Reliable and cost-effective paraffin section immunohistology of lymphoproliferative disorders

We studied 110 neoplastic and reactive lymphoid proliferations with three monoclonal antibodies--CD20 (L26), CD43 (Leu22), and CD45RO (UCHL1)--on B5-fixed, paraffin-embedded tissue to evaluate the utility of this panel as an immunotypic screen of such lesions. All cases were initially immunotyped by conventional methods. Genotyping by Southern blot hybridization was also done in 54 cases. Seventy-four of 79 malignant lymphomas and both of two hairy cell leukemias were of B-cell origin; and five lymphomas were defined as T-cell lineage. Lineage assignment was identical for paraffin section immunohistology and conventional immunotyping in 73 of 76 B cell and all of five T-cell tumors. CD20 was reactive with 73 of 76 B-cell tumors. CD43 was reactive with 12 of 74 B-cell lymphomas, and CD20/CD43 coexpression was seen in 11 of these cases. CD43 and CD45RO marked all of five and three of five T-cell lymphomas, respectively. Lineage assignment was identical for paraffin immunohistology and genotyping in 48 of 50 cases with identifiable gene rearrangements. Twenty-four nonneoplastic and five Hodgkin's disease cases that were studied also showed similar immunoreactivity patterns by both paraffin and conventional immunotypic methods. This panel of three monoclonal antibodies is an efficient, cost-effective approach for immunotyping most lymphoid proliferations in paraffin sections. Nevertheless, the pathologist should always try to obtain fresh or frozen tissue to aid in resolving occasional discrepant cases, to establish clonality in morphologically ambiguous ones, and to profile prognostically important phenotypic deletions.     

结直肠非霍奇金淋巴瘤32例诊治分析

目的 总结结直肠非霍奇金淋巴瘤(NHL)的临床特点及诊治经验.方法 通过对1988年1月至2006年12月我院收治的32例患者的临床资料进行回顾性分析,探讨结直肠NHL的临床特点及诊治经验.结果 本研究包括B细胞NHL患者22例,T细胞NHL患者10例.B细胞型男性14例,女性8例,中位年龄60.5岁.T细胞型男性5例,女性5例,中位年龄31.0岁.回盲部为最常见的发病部位,分别占B及T细胞型的77.3%及60.0%,常见的临床表现为腹痛、消瘦及腹部包块.有明确亚分型的14例B细胞NHL患者中,弥漫大B细胞淋巴瘤(DLBCL)占64.3%.B细胞型中病变局限(Ⅰ～Ⅱ1期)者占40.9%.10例T细胞NHL为Ⅳ期,3例伴消化道大出血,4例伴穿孔.B细胞型患者均接受了手术及以CHOP为主的化疗.中位随访时间55个月,无病生存率88.2%.10例T细胞型患者中,8例接受了手术,有条件者均接受了化疗.5例患者于术后2个月内死亡,已知3例患者存活23个月以上.结论 结直肠NHL好发于回盲部,B细胞型更为常见,且绝大多数为DLBCL.手术加化疗为目前主要的治疗手段.B细胞型患者治疗后预后良好;T细胞型预后差,诊治应更为积极.结直肠NHL保留器官治疗的前景仍有待于进一步的研究来明确.

Abstract：

Objective To summarize the clinical features, diagnostic and therapeutic experiences of colorectal Non-Hodgkin's lymphoma (NHL). Methods Clinical data of 32 patients with colorectal NHL admitted to our hospital from January 1988 to December 2006 was retrospectively analyzed. Results This study included 22 B-cell NHL and 10 T-cell NHL cases. In the B-cell NHL group, the male: female ratio was 14:8 and the median age was 60. 5 years. In the T-cell NHL group, the male: female ratio was 5:5 and the median age was 31.0 years. The ileocecal region was most frequently involved in both groups, which accounted for 77. 3% and 60. 0% of the B and T group respectively. The common clinical manifestations included abdominal pain, weight loss, and abdominal mass. Of the 14 cases of B-cell NHL with definite subtype classifications, 64. 3% were of the Diffuse Large B-cell Lymphoma (DLBCL) type. Among the 22 B-cell NHL, 40. 9% were with localized diseases (stage Ⅰ - Ⅱ 1), while all 10 patients in T-cell NHL group were in stage Ⅳ with 3 patients complicated with massive GI bleeding and 4 with perforation. All patients of B-cell type received chemotherapy utilizing mainly CHOP after surgical resection. After a median follow-up of 55 months, the disease-free survival was rate 88. 2%. Among the T-cell NHL group, 8 out of 10 patients underwent surgery and chemotherapy was given to all those who could tolerate it. Five patients died within 2 months after surgery. It's known that 3 patients were still alive after 23 months. Conclusions The ileocecal region is the most frequently involved site of the colorectal NHL. The histology is usually B-cell type with a majority being DLBCL. Currently R-CHOP chemotherapy after the surgical resection is the principal treatment modality. Patients of B-cell type have a better prognosis while the prognosis of T-cell NHL is poor. Therefore more aggressive diagnostic and therapeutic approaches are recommended for T-cell NHL patients. The prospective of organ preservation treatment for colorectal NHL is still in need of further investigations.     

Malignant lymphoma complicating ulcerative colitis

Carcinoma of the colon as a complication of chronic ulcerative colitis is relatively common, whereas malignant lymphoma is apparently rare. We report two cases of patients with malignant lymphoma complicating ulcerative colitis, a CD 30 + T-cell lymphoma of the intestine and a low grade B-cell non-Hodgkin's lymphoma of MALT type. It is important to be aware of the possibility of malignant lymphoma in ulcerative colitis in order to evaluate correctly any lymphoid infiltrate seen in a biopsy, especially when anti-inflammatory treatment seems to be ineffective or when symptoms change.     

原发性肾脏淋巴瘤2例报道并文献复习

目的探讨原发性肾脏淋巴瘤的临床特点。方法总结2例原发性肾脏淋巴瘤患者的临床资料,结合文献讨论其发病特点、影像学特征、治疗及预后。结果 2例患者均实施手术加化疗,病理诊断均为非何杰金淋巴瘤,1例死于术后2月,另1例已存活1年,仍在随访中。结论原发性肾脏淋巴瘤是一种罕见的恶性淋巴瘤,影像学征象与肾细胞癌相似,以成人发病为主,易误诊为肾癌,病理类型多为B细胞来源的非何杰金淋巴瘤,综合治疗是延长生存的较好方式。     

Epstein-Barr virus negative clonal plasma cell proliferations and lymphomas in peripheral T-cell lymphomas: a phenomenon with distinctive clinicopathologic features

Clonal B-cell populations have been described in peripheral T-cell lymphomas (PTCL) as secondary Epstein-Barr virus (EBV) driven B-cell expansions that may evolve to an overt B-cell lymphoma. EBV-negative B-cell proliferations associated with T-cell lymphomas are uncommon and not well characterized. We studied 15 patients who developed an EBV-negative B-cell proliferation or malignant lymphoma associated with PTCL. The T-cell tumors were 8 PTCL, not otherwise specified, 4 angioimmunoblastic T-cell lymphomas, and 3 cutaneous PTCL. The B-cell component was intermingled with the PTCL in all patients and it was classified as clonal/monotypic plasma cell proliferation in 8 lesions, clonal/monotypic large B-cell proliferation in 4 patients, and B-cell lymphoma with plasmacytic/plasmablastic differentiation in 3 patients. Two patients had 2 clonally unrelated plasma cell proliferations associated with the same PTCL. All cases showed cytoplasmic Ig light chain restriction. Clonal IgH and T-cell receptor rearrangements were detected in 11/12 and 11/13 cases examined, respectively. EBV, cytomegalovirus, and HHV-8 were not observed in any of the examined cases. Sequential samples in 7 patients showed persistence of the PTCL and the B-cell component in 4, the PTCL without the B-cell lymphoma in 2, and progression of the B-cell neoplasm in 1. Patients followed an aggressive clinical course similar to conventional PTCL. In conclusion, EBV-negative clonal or mononotypic B-cell proliferations in patients with PTCL present with a spectrum of lesions ranging from plasma cell proliferations to overt lymphomas with plasmacytic/plasmablastic features. The distinctive features of these patients suggest that these lesions represent a specific phenomenon in PTCL.     

肠道NK／T细胞淋巴瘤4例诊治分析

目的：探讨肠道NK／T细胞淋巴瘤的临床特点、诊断及治疗。方法：回顾性分析4例肠道NK／T细胞淋巴瘤的临床资料,对其发病特点、临床表现、实验室检查、诊断和治疗方法进行总结分析。结果：3例为小肠NK／T细胞淋巴瘤,CD45RO（＋）,cD3（＋）,CD56（＋）,CD20（-）,TIA（-）。1例为结肠NI/T细胞淋巴瘤,CD45RO（＋）,CD3（＋）,CD56（＋）,CD20（-）,TIA（＋）。4例患者术后分别存活61、58、14、7d。结论：肠道NK／T细胞淋巴瘤确诊需依赖术后病理组织学及免疫组织化学检查,早期诊断、尽早实施合理的治疗是降低死亡率的关键。