肺鳞状细胞癌中人类乳头瘤病毒16/18感染和P53蛋白表达的关系

目的研究肺鳞状细胞癌中HPV16／18型感染状态和P53蛋白表达的关系。方法原位杂交检测肺鳞状细胞癌中HPV16／18DNA，免疫组化检测P53蛋白，形态学观察癌组织中的挖空细胞。结果44例肺鳞状细胞癌中，23例（52．27％）HPV16／18型呈整合状态，9例（20．45％）呈大部分游离少许整合状态，12例（27．27％）阴性。15例非肿瘤肺组织标本中未检测到HPV16／18型，差异有极显著性意义（P〈0．01）；27例肺鳞状细胞癌（61．36％）P53蛋白阳性，其表达与HPV16／18在癌细胞中的存在状态有关（P〈0．05）；19例（43．18％）可见挖空细胞。HPV的感染、挖空细胞与肿瘤的分化程度有关（均P〈0．05）。结论HPV感染可能是一部分肺鳞状细胞癌的致癌因素之一，这部分癌中P53的表达显著低于HPV阴性和存在游离状态HPV的病例。挖空细胞某种程度上预示HPV的感染，但不是确定HPV感染的良好指标。     

Histopathological features of invasion of breast invasive ductal carcinoma and safety of breast-conserving surgery

In order to investigate the relationship between the extent of tumor invasion and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading in breast invasive ductal carcinoma as well as the optimal extent of excision during the breast-serving surgery, the clinical data of 104 patients with breast invasive ductal carcinoma who had received modified radical mastectomy were analyzed. The correlation analysis on invasive extent, which was evaluated by serial sections at an interval of 0.5 cm from 4 different directions taking the focus as the centre, and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and his- tologic grading was processed. There was a significant correlation between invasive extent and tumor size （r=-0.766, P〈0.01）, and lymph nodes metastases 0=0.574, P〈0.01）, but there was no significant correlation between invasive extent and Her-2 expression （r=-0.106, P〉0.05）, and histologic grading （r=-0.228, P〉0.05）. The 100% negative rate of infiltration in patients without nipple discharge with tumor size 〈2, 2-3 and 〉3 cm was obtained at 1.5, 2.0 and 2.5 cm away from the tumor respectively. It is concluded that the performance of breast-serving surgery in patients with breast invasive ductal carcinoma should be evaluated by tumor size in combination with axillary lymph nodes involvement to decide the possibility of breast-serving and the secure excision extent.     

母细胞性浆细胞样树状突细胞肿瘤临床病理学观察

目的:研究母细胞性浆细胞样树状突细胞肿瘤(blastic plasmacytoid dendritic cell neoplasm,BPDCN)的临床病理特征和免疫表型,探讨其诊断依据及鉴别诊断要点。方法:收集本院1例皮肤BPDCN患者的临床病理学及免疫组化特征,并复习文献。结果:BPDCN好发于老年男性,常以无症状性孤立或多发肿块为首发症状,可多部位受累,偏嗜皮肤,组织学形态表现为中等大小肿瘤细胞弥漫浸润真皮及皮下组织,瘤细胞胞质少,核不规则,染色质细,核分裂多见,无坏死及嗜表皮性。免疫组化:肿瘤细胞CD123、CD56、CD43阳性,少数细胞CD4、CD7和TdT阳性,B系、T系及髓、单核系标记均阴性。结论:BPDCN是罕见的淋巴造血系统高度侵袭性肿瘤,结合瘤细胞形态、生长方式及免疫表型有助于诊断,同时应注意与其他皮肤原发或继发淋巴造血系统肿瘤相鉴别。     

滑膜肉瘤伴不典型EWSR1信号二例

本文报道2例伴不典型EWSR1信号的滑膜肉瘤。低分化滑膜肉瘤仅通过形态学及免疫组织化学常常难以确诊,须借助分子病理学手段辅助诊断。然而分子病理检测也存在陷阱,出现不典型信号时还需谨慎解读。     

HE染色质控组织的选取及优化

<正>良好的HE切片对病理诊断至关重要,高质量的HE染色红蓝对比鲜明;可见3种红色(大红、粉红和紫红),显示色彩亮丽、对比鲜明及细腻的细节;核染色质清晰^[1]。使用质控组织评估染色效果是HE染色质量控制的重要手段,以往质控组织多选用单一类型组织,存在较大的局限性,无法全面地反映不同类型标本的染色效果。本科室运用组织芯片进行HE染色质控,取得了良好的效果,同时也遇到了组织收集和芯片蜡块制备难度大、对质控人员能力要求高、质控时间偏长等问题,     

抗胰岛素样生长因子Ⅰ型受体单克隆抗体m590抑制乳腺癌细胞增生和迁移

目的 探讨抗胰岛素样生长因子Ⅰ型受体(IGF-IR)抗体,m590,抑制乳腺癌细胞增生、迁移及其机制.方法 免疫组织化学染色30例乳腺浸润性导管癌标本;免疫印迹法、免疫荧光细胞染色及其他试验检测m590 对MCF-7细胞的作用及其机制.结果 87％的乳腺浸润性导管癌高表达IGF-IR;m590抑制胰岛素样生长因子Ⅰ(IGF-I)诱导的细胞外调节蛋白激酶(ERK)和蛋白激酶B(Akt)磷酸化以及细胞骨架蛋白(F-actin)和细胞骨架黏合班蛋白(Vinculin)在细胞内的分布,使细胞增生、迁移和黏附分别降低至58％、56％和55％,并促进细胞凋亡;M590 与赫赛汀联用抑制IGF-I诱导的ERK和 Akt 磷酸化,使细胞增生降低 76％.结论 m590 是一个有效抑制乳腺癌细胞增生、迁移和黏附的抗IGF-IR抗体.     

Accurate assessment of HER2 gene status for invasive component of breast cancer by combination of immunohistochemistry and chromogenic In Situ hybridization

The specimens of ductal carcinoma in situ (DCIS) with early invasion, and specimens collected by core needle biopsy (CNB) tend to contain limited amount of invasive component, so it is imperative to explore a new technique which can assess HER2 gene status accurately for the limited invasive cancer component in these specimens. Dual staining technique of combining immunohistochemistry (IHC) for myoepithelial cells and single or dual probe chromogenic in situ hybridization (CISH) for HER2 gene was performed on routinely processed paraffin sections from 20 cases diagnosed as having DCIS with invasive cancer. Among them, 10 had fluorescence in situ hybridization (FISH)-confirmed amplification of HER2 and 10 had FISH-confirmed non-amplification of HER2. We successfully detected HER2 genetic signals and myoepithelial IHC markers (SMM-HC or CK5/6) simultaneously on a single section in all 20 specimens. Myoepithelial markers and HER2 signals detected by dual staining assay were consistent with those by individual technique performed alone. HER2 gene amplification results determined by dual staining assay were 100% consistent with those of FISH. Dual staining technique which allows simultaneous detection of myoepithelial marker protein and cancerous HER2 gene is feasible, and it has potential to be used in clinical practice for effective determination of HER2 amplification in limited invasive component.     

HPV感染与p53蛋白及P-糖蛋白表达在非小细胞肺癌中的关系及其临床意义

目的:探讨人乳头瘤病毒(humanpapillomavirus,HPV)感染在非小细胞肺癌(nonsmallcelllungcancer,NSCLC)发生中的病因学意义及其与p53蛋白和P糖蛋白(Pgp)表达之间的相关性。方法:应用PCR、免疫组化方法分别检测76例NSCLC组织中HPVDNA及其E6、E7原癌蛋白、p53蛋白和Pgp的表达情况。结果:NSCLC中HPVDNA及其E6、E7原癌蛋白的检出率分别为40.8%(31/76)、43.4%(33/76),2种检测方法的符合率为78.9%(60/76);p53蛋白和Pgp的阳性率分别为63.2%(48/76)、59.2%(45/76),且HPV感染阳性组中p53蛋白的表达率为80.6%(25/31),显著高于阴性组51.1%(23/45)(P<0.05);p53蛋白表达阳性组中Pgp的表达率为68.8%(33/48),显著高于阴性组42.9%(12/28)(P<0.05);而HPV感染阳性组与阴性组间Pgp的表达无显著性差异(P>0.05)。HPV感染与高、中分化程度的NSCLC及吸烟有关。结论:HPV感染可能是NSCLC发生的另一重要病因学因素,且HPV感染可能导致p53基因突变,后者可能促进肺癌耐药性的增加。     

腹壁切口感染对腹腔粘连形成的影响

目的　探讨腹壁切口感染对腹腔粘连形成的影响。方法　将 12 0只Wistar大鼠分为低、中、高浓度组和对照组 ,每组各 3 0只 ,前 3组动物分别按 1× 10 2 cfu/ml、1× 10 5 cfu/ml、1× 10 8cfu/ml的浓度将大肠埃希氏菌、金黄色葡萄球菌和铜绿假单胞菌的定量混合液 0 .2ml分别注入切口皮下 ,对照组注入等量生理盐水 ,建立腹部切口感染的动物模型。术后第 8天处死动物 ,观察和比较 4组动物的切口粘连情况。结果　低、中、高浓度组和对照组的切口感染率分别为 81.48%、86.67%、90 .0 0 %和 50 .0 0 % ;粘连率分别为 53 .3 3 %、60 .0 0 %、70 .0 0 %和 2 6.67% ,经 χ2 检验 ,低浓度组与对照组腹腔粘连发生率的差异有显著性意义 (P<0 .0 5) ,中、高浓度组和对照组比较差异有高度显著性意义 (P均 <0 .0 1) ;而低、中、高浓度组之间的腹腔粘连率比较差异则无显著性意义 (P>0 .0 5)。结论　腹壁切口感染可使腹膜粘连的发生率增高 ,而与细菌的数量没有明显的关系。提示腹部手术切口感染也是形成腹腔粘连的一个原因     

高频电刀对腹部切口感染影响的实验研究

目的探讨高频电刀对腹部手术切口感染的影响.方法将240只大白鼠分成100、102、105和108组,分别用电刀和普通手术刀(冷刀)制造腹部手术切口的动物模型,用生理盐水,以及102、105和108浓度的大肠埃希氏杆菌、金黄色葡萄球菌和铜绿假单胞菌的定量混合液0.2ml分别注入皮下,以观察电刀和冷刀在不同浓度细菌的条件下对切口感染的影响.结果除100组外,其他各组使用电刀的切口感染率明显高于对照组.经统计学处理,102组、105组和108组的差异均有显著性意义(P＜0.05),100组的差异无显著性意义(P＞0.05).结论电刀可降低切口对细菌感染的闺值,而增加手术感染率.