肾细胞癌转移潜能的分子学研究进展

在肾细胞癌中发现癌转移标志物,对确定癌转移危险性及选择新靶标治疗至关重要。现经PIQOR“微阵列研究证实,在透明细胞肾细胞癌（ccRCC）的非转移、早发转移和迟发转移癌间存在着明显的基因表达差异。应用这种差异,可知其转移可能性及早发或迟发转移,并制定出适合个性化的特殊治疗计划,使疗效更显著。     

湖北省潜江市人、牛同步化疗控制血吸虫病16年纵向观察

目的评价湖沼渠网型重疫区采取人、牛同步化疗措施的效果.方法收集1992-2008年湖北省潜汀市人、牛同步化疗的年报资料,根据当地1989年的居民感染率将流行村划分为3级,并依据1992--2003年和2004--2008年两种化疗方案的实施,来对当地的血吸虫感染情况进行比较分析.结果通过16年纵向观察,人群感染率下降了72.37%(X2:9.85,P<0.01),牛感染率下降65.18%(X2=5.63,P<0.01),钉螺感染率及感染螺密度分别下降了63.64%及69.44%.结论实施人、牛同步化疗16年后,血吸虫病得到有效控制.     

Are synchronous and metachronous bilateral breast cancers different? An immunohistochemical analysis aimed at intrinsic tumor phenotype

The biology and pathomechanism of bilateral breast cancers is not fully understood. We compared the morphological and immunohistochemical characteristics of primary tumors in patients with synchronous bilateral breast cancers and metachronous bilateral breast cancers, with special focus on intrinsic tumor phenotype. Methods: Tumor morphology and expression of 8 immunohistochemical markers were assessed in tissue microarrays containing primary breast tumor cores from 113 metachronous bilateral breast cancers and 61 synchronous bilateral breast cancers. Analyzed markers included hormone receptors (estrogen receptor, progesterone receptor), HER2, Ki67, cytokeratin 5/6, E-cadherin, vimentin and epidermal growth factor receptor. Cutoff levels are provided in the table. Results: Metachronous bilateral breast cancers tumors had lower estrogen receptor expression (p=0.047) and higher expression of cytokeratin 5/6 (p=0.017) and of vimentin (p=0.008); in multivariate analysis only vimentin retained the significance (p=0.01). Ten (13%) and 11 (26%) of metachronous bilateral breast cancers and synchronous bilateral breast cancers had luminal A phenotype, 39 (50%) and 15 (36%) were luminal B HER2-negative, 13 (17%) and 12 (28%) - luminal B HER2-positive, 3 (4%) and 2 (5%) - HER2-positive (not luminal), and 12 (16%) and 2 (5%) had triple negative phenotype (p=0.07). Conclusion: Metachronous bilateral breast cancers, compared to synchronous bilateral breast cancers, are characterized by more aggressive phenotype, expressed by lower expression of estrogen receptor and stronger expression of cytokeratin 5/6 and vimentin; this does not, however, translate into differences in the distribution of intrinsic tumor phenotypes.     

Laparoscopic resections of colorectal cancer and synchronous liver metastases: a case controlled study

Purpose: To investigate the efficacy and safety of laparoscopic simultaneous resections of colorectal cancer and synchronous colorectal liver metastases (SCRLM), relative to open surgery.

Methods: Between 1 January 2009 and 20 April 2014, 20 of 25 patients who underwent laparoscopic simultaneous colorectal cancer and SCRLM resections were matched with 20 of 29 patients who underwent an open approach, based on prognostic propensity scores. Perioperative results and survival outcomes were compared.

Results: The laparoscopic and open groups were comparable in demographics, cancer characteristics, surgery characteristics, and chemotherapy treatment. No postoperative mortality occurred in either group. The estimated blood loss and postoperative stay were significantly greater in the open group than in the laparoscopic group (all, p?Conclusions: The postoperative complications and survival rates of patients given laparoscopic simultaneous colorectal cancer and SCRLM resections were similar to those treated with an open approach, but with greater short-term benefits. Laparoscopy in this setting by an experienced surgical team appears safe and effective, and is a feasible alternative to an open approach for selected patients.     

Synchronous primary mediastinal seminoma in a patient with colorectal adenocarcinoma

Primary mediastinal germ cell tumours are a rare primary tumour of the mediastinum. They share the same immunomorphological features to their gonadal counterparts but carry a worse prognosis. Primary mediastinal seminomas are exclusively found in male patients. Their diagnosis requires exclusion of primary gonadal germ cell tumours.     

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Synchronous malignancies in a pleural effusion are rare. A case of concurrent pleural infiltration by adenocarcinoma of unknown primary site and chronic lymphocytic leukemia (CLL) is presented in this case study, which was diagnosed by effusion cytology. Pleural effusion is not an uncommon complication in patients with B‐CLL. Even in a pleural effusion rich in monoclonal lymphocytes, the presence of a second cancer must be excluded because this can be the main cause of mortality. The role of cytology in such cases is of paramount importance. Diagn. Cytopathol. 2014;42:151–155. © 2012 Wiley Periodicals, Inc.     

Synchronous Bilateral Breast Carcinoma in a Patient with Cowden Syndrome: A Case Report with Morphologic,Immunohistochemical and Genetic Analysis

Abstract: Synchronous bilateral breast carcinoma (SBBC) and early onset are important characteristics of hereditary cases. The lifetime risk for breast carcinoma in Cowden syndrome (CS) is estimated to be 25–50%. We reported a 44‐year‐old woman presenting SBBC and characteristic mucocutaneous lesions of CS, confirmed by PTEN gene mutation analysis. Bilateral modified mastectomy and axillary dissection were performed. Histopathologic examination revealed a moderate‐differentiated invasive ductal carcinoma with mixed features of luminal A immunophenotype (Estrogen and/or Progesterone Receptors >50% and/or Ki67 < 30% of positive cells). The skin lesions showed the characteristic findings of tricholemmoma. Lack of PTEN expression was observed in all specimens. Sequencing analysis confirmed the presence of PTEN splice‐acceptor site mutation in intron 8 (c.1027‐2A>G), a germline mutation which had not been previously reported in CS. The patient received adjuvant chemotherapy and tamoxifen for 5 years. After 5 years of follow‐up, she persists recurrence‐free. SBBC with early onset suggests a hereditary predisposition. Thus, analysis of PTEN expression abnormality, easily assessed by immunohistochemistry, may be of clinical value to screen those patients with CS.     

头皮脑电图继发双侧同步(癎)样放电的特点及其临床意义

目的:探讨局灶性癫(癎)患者头皮脑电图(EEG)上继发双侧同步(癎)样放电(SBSD)的表现特点及临床意义.方法:回顾性地分析自2002年3月至2006年3月,于我研究所接受治疗的所有局灶性癫(癎)患者的EEG资料,排除所有颞叶癫(癎),共32例患者的术前EEG上均存在SBSD表现.对这些患者的发作间期与发作期EEG结果进行分析研究.结果:32例患者中,SBSD起源于额区者20例,枕区者10例,顶区者2例.SBSD可表现为棘或尖波、棘慢复合波与快节律三种类型,以棘慢复合波最为常见,占63%.SBSD发作间期较为常见的特点是双侧存在时间差,SBSD始于EEG局灶性异常改变以及局限性慢波一侧;53%的病人发作期EEG表现为局灶性起源.结论:SBSD在局灶性癫(癎)患者中并不少见,而且以额叶最为常见.通过分析SBSD波形的各个特点,有助于判断SBSD原发灶侧别,并与全面性癫(癎)相鉴别,对癫(癎)外科的术前评估具有非常重要的临床意义.