在黑色素瘤组织中免疫细胞的形态学观察

目的　探讨肿瘤浸润树突状细胞 (tumorinfiltratingdendriticcell,TIDC)和肿瘤浸润淋巴细胞(tumorinfiltratinglymphocyte ,TIL)的形态学特征。 方法　采用光镜、透射电镜和免疫组织化学方法观察 9例人皮肤黑色素瘤中TIDC和TIL的分布及形态。结果　TIDC主要分布在乳头层和癌周区及癌巢内 ,病变早期TIDC浸润比晚期明显 (P <0 0 1)。电镜下 ,TIDC体积大 ,形态不规则 ,表面有许多树枝状突起 ,核不规则 ,有切迹。胞浆内有丰富的线粒体、核糖体、内质网。TIDC具有两种形态 ,一种表现为突起多 ,细胞器丰富 ,另一种表现为突起较少 ,细胞器也较少。TIDC与肿瘤细胞、TIDC与TIL、TIL与肿瘤细胞之间存在多种接触形式。同时可见TIL与TIL ,TIDC与TIDC之间也有密切接触。还可见树突状细胞 淋巴细胞环 ,淋巴细胞环绕癌细胞。结论　TIDC和TIL存在于黑色素瘤组织 ,TIDC有两种类型。     

Reproducibility and prognostic significance of area of residual tumor (ART) in post-neoadjuvant resections of pancreatic ductal adenocarcinoma

BackgroundThe pathologic assessments of tumor response after neoadjuvant chemoradiotherapy (NACRT) are critical to improving the prognostic stratification for patients with pancreatic ductal adenocarcinoma (PDAC). Here we clarified the utility of our new grading system based on the area of residual tumor (ART) as compared to existing systems, such as the College of American Pathologists (CAP) and MD Anderson (MDA) score. Methods: Eight reviewers individually evaluated the tumor regression grade of 30 patients with PDAC based on three types of grading systems. The interobserver concordance and clinicopathological characteristics were compared between the three systems. Results: The interobserver concordance (kappa value) of the ART, CAP, and MDA score were 0.61, 0.48, and 0.53, respectively. Discrepant cases, which were 27% of the cases, exhibited smaller tumor and tumor bed sizes than concordant cases. The reduction in tumor size evaluated by microscopy showed a correlation with the rate of change in carcinoembryonic antigen (CEA) level, CA19-9 level, and tumor size on computed tomography (CT). The ART score was correlated with the tumor size on CT before and after NACRT and disease-free survival. The CAP and MDA scores were not associated with prognosis. Conclusion: The ART grading system may be the most practical system to assess the tumor response in post-NACRT resections of PDAC.     

血管内皮生长因子-C反义多肽对人骨肉瘤细胞生物学行为影响的研究

目的检测血管内皮生长因子-C（VEGF—C）反义多肽对人骨肉瘤细胞的生物学活性的影响,探讨VEGF—C反义多肽用于骨肉瘤基因治疗的可行性。方法制备靶向VEGF—C的反义多肽,通过与骨肉瘤细胞株共培养,噻唑蓝（MTT）法检测细胞增殖抑制率,人工基底膜侵袭实验检测细胞侵袭能力;构建骨肉瘤细胞裸鼠皮下移植瘤模型,瘤体内注射VEGF—C反义多肽,观察其对骨肉瘤细胞的抑制作用;Western Blot检测VEGF—C在瘤组织的表达情况;免疫组织化学分析肿瘤组织VEGFR-3阳性脉管密度。结果VEGF—C反义多肽具有较强的生物学活性,对骨肉瘤细胞具有明显的增殖抑制作用,其抑增殖效应呈时间和浓度依赖性;瘤组织内给予VEGF—C反义多肽后,Western blot分析VEGF—C在瘤组织中的表达降低,肿瘤生长受制,抑瘤率为52％（P〈0．05）;免疫组化分析VEGF—C反义多肽可抑制肿瘤组织VEGFR-3阳性脉管形成。结论VEGF—C具有良好的生物学活性,可通过抑制骨肉瘤细胞的增殖、侵袭转移能力及肿瘤组织VEGFR-3阳性脉管形成而发挥抗骨肉瘤作用。     

哨兵淋巴结活检预测结肠癌淋巴结转移的价值

目的探讨哨兵淋巴结活检(SLNB)预测结肠癌患者淋巴结转移状态的重要性和可行性。方法使用亚甲蓝对42例结肠癌患者进行SLNB,随后行标准的结肠癌根治术。哨兵淋巴结阴性患者进行连续切片病理检测。结果SL-NB成功率为80.95%,敏感度为97.06%,特异度为100%,预测淋巴结转移状态率为95.45%,假阴性率为4.55%。结论利用亚甲蓝淋巴定位方法进行的SLNB可以准确预测淋巴结转移状态,SLN连续切片、HE染色检测有助于提高SLNB的敏感性。     

颅内肿瘤术后主要安全隐患及护理对策

分析颅内肿瘤术后安全隐患及其发生原因,探讨安全防护措施,旨在为相关护理过程中实行护理安全管理,杜绝医患纠纷的发生,确保患者生命安全提供参考。     

一项简单易行的预测Dukes C期大肠癌切除术后肝转移的生物学指标

目的:本研究旨在探讨瘤芽在不同大肠癌病例的分布特征以及骨桥蛋白(OPN)等在原发癌灶和瘤芽的表达,以评价其可否作为简单易行的预测大肠癌术后肝转移的生物学指标。方法:将Dukes C期以上病例分成3组:A组为同时性肝转移组,B组为异时性肝转移组,C组为无肝转移组。HE染色后,重点观察位于大肠癌侵袭前沿的瘤芽的分布特征,并准确计数。应用免疫组化法分别检测OPN、NF-κB在原发癌灶和瘤芽的表达。结果:瘤芽位于肿瘤侵袭前沿,是失去极性的去分化癌细胞,呈孤立或不规则小梁状分布。瘤芽程度和OPN在大肠癌原发癌灶的强阳性表达在A与C组间的差异具有显著性(P<0.01)。OPN在瘤芽的阳性表达在A和C组以及B和C组的差异均具有显著性(P<0.01)。各组间NF-κB在原发癌灶、瘤芽的表达无显著差别。结论:瘤芽BD(+)、OPN在原发癌灶的强阳性表达均提示大肠癌发生肝转移的可能性较大。如将瘤芽分布特征结合OPN在瘤芽的表达,则可提高预测的准确性,可以考虑作为预测大肠癌术后肝转移的生物学指标。