Expressions of Osteopontin (OPN),αVβ3 and Pim-1 Associated with Poor Prognosis in Non-small Cell Lung Cancer (NSCLC)

Objective： To examine the expressions ot osteopontin （OPN）, αvP3 and Pim-1 in non-small cell lung cancer （NSCLC）, and investigate their potential pathogenic roles in the development of NSCLC. Methods： Immunohistochemistry was used to examine the expressions of OPN, αve3 and Pim-1 in cohort （136 cases） of NSCLC samples and their adjacent normal lung tissue specimens. Statistical analysis was performed to evaluate the relationships among expressions of OPN, αve3 and Pim-1 and their associations with patients clinico- pathological parameters. Results： The expressions of OPN and Pim-1 were predominantly observed in cytoplasm. The expression of αve3 was mostly detected in cytoplasm and/or membrane. In NSCLC samples, the positive rates of OPN, αve3 and Pim-1 expressions were 68.4% （93/136）, 77.2% （105/136） and 57.4% （78/136）, respectively. In normal lung tissues, in contrast, the positive rates of OPN, αve3 and Pim-1 were 24.0% （12/50）, 26.0% （13/50） and 16.0% （8/50）, respectively. There were significant differences of the positive expression rates of OPN, αve3 and Pim-1 between NSCLCs samples and normal lung tissues （P〈O.01）. In addition, the positive expression of OPN, αve3 and Pim-1 in NSCLCs samples was significantly associated with increased pathological grade, lymph node metastasis and advanced clinical stage （P〈O.01）, and they were independent of other clinicopathological parameters （P〉0.05）. Furthermore, a significantly positive correlation between the expression of OPN and αve3 （r=0.38, P〈O.O1）, OPN and Pim-1 （r=0.37, P〈O.01）, or av133 and Pim-1 （r=0.20, P〈0.05） was evaluated in our NSCLC cohort. Conclusion： OPN, αve3 and Pim-1 proteins are frequently overexpressed in NSCLC, and they may play important roles in the development and/or progression of NSCLC.

Gastric myeloid sarcoma without acute myeloblastic leukemia

Myeloid sarcomas(MS)involve extramedullary blast proliferation from one or more myeloid lineages thatreplace the original tissue architecture,and these neoplasias are called granulocytic sarcomas,chloromas or extramedullary myeloid tumors.Such tumors develop in lymphoid organs,bones(e.g.,skulls and orbits),skin,soft tissue,various mucosae,organs,and the central nervous system.Gastrointestinal(GI)involvement is rare,while the occurrence of myeloid sarcomas in patients without leukemia is even rare.Here,we report a case of a 38-year-old man who presented with epigastric pain and progressive jaundice.An upper GI endoscopy had shown extensive multifocal hyperemic fold thickening and the spread of nodular lesions in the body of the stomach.Biopsies from the gastric lesions indicated myeloid sarcoma of the stomach.However,concurrent peripheral blood and bone marrow examinations showed no evidence of acute myeloid leukemia.For diagnosis,the immunohistochemical markers must be checked when evaluating a suspected myeloid sarcoma case.Accurate MS diagnosis determines the appropriate therapy and prognosis.

Lowering the threshold of alanine aminotransferase for enhanced identification of significant hepatic injury in chronic hepatitis B patients

BACKGROUND The clinical and histological features of chronic hepatitis B(CHB)patients who fall into the"grey zone(GZ)"and do not fit into conventional natural phases are unclear.AIM To explore the impact of varying the threshold of alanine aminotransferase(ALT)levels in identifying significant liver injury among GZ patients.METHODS This retrospective analysis involved a cohort of 1617 adult patients diagnosed with CHB who underwent liver biopsy.The clinical phases of CHB patients were determined based on the European Association for the Study of the Liver 2017 Clinical Practice Guidelines.GZ CHB patients were classified into four groups:GZ-A(HBeAg positive,normal ALT levels,and HBV DNA≤10^(7) IU/mL),GZ-B(HBeAg positive,elevated ALT levels,and HBV DNA<10^(4) or>10^(7) IU/mL),GZC(HBeAg negative,normal ALT levels,and HBV DNA≥2000 IU/mL),and GZ-D(HBeAg negative,elevated ALT levels,and HBV DNA≤2000 IU/mL).Significant hepatic injury(SHI)was defined as the presence of notable liver inflammation(≥G2)and/or significant fibrosis(≥S2).RESULTS The results showed that 50.22%of patients were classified as GZ,and 63.7%of GZ patients developed SHI.The study also found that lowering the ALT treatment thresholds to the American Association for the Study of Liver Diseases 2018 treatment criteria(35 U/L for men and 25 U/L for women)can more accurately identify patients with significant liver damage in the GZ phases.In total,the proportion of patients with ALT≤40 U/L who required antiviral therapy was 64.86%[(221+294)/794].When we lowered the ALT treatment threshold to the new criteria(30 U/L for men and 19 U/L for women),the same outcome was revealed,and the proportion of patients with ALT≤40 U/L who required antiviral therapy was 75.44%[(401+198)/794].Additionally,the proportion of SHI was 49.1%in patients under 30 years old and increased to 55.3%in patients over 30 years old(P=0.136).CONCLUSION These findings suggest the importance of redefining the natural phases of CHB and using new ALT treatment thresholds for better diagnosis and management of CHB patients in the GZ phases.

Angioimmunoblastic T-cell lymphoma-associated pure red cell aplasia with abdominal pain

Angioimmunoblastic T-cell lymphoma(AITL)is a unique type of peripheral T-cell lymphoma with a constellation of clinical symptoms and signs,including weight loss,fever,chills,anemia,skin rash,hepatosplenomegaly,lymphadenopathy,thrombocytopenia and polyclonal hypergammaglobulinemia.The histological features of AITL are also distinctive.Pure red cell aplasia is a bone marrow failure characterized by progressive normocytic anemia and reticulocytopenia without leucopenia or thrombocytopenia.However,AITL with abdominal pain and pure red cell aplasia has rarely been reported.Here,we report a rare case of AITL-associated pure red cell aplasia with abdominal pain.The diagnosis was verified by a biopsy of the enlarged abdominal lymph nodes with immunohistochemical staining.