BACKGROUND Gastric cancer(GC)is a highly heterogeneous disease,and the identification of molecular subtyping of gastric adenocarcinoma emerged as a promising option to define therapeutic strategies and prognostic subg...BACKGROUND Gastric cancer(GC)is a highly heterogeneous disease,and the identification of molecular subtyping of gastric adenocarcinoma emerged as a promising option to define therapeutic strategies and prognostic subgroups.However,the costs and technical complexity of molecular methodologies remains an obstacle to its adoption,and their clinical significance by other approaches needs further evidence.AIM To evaluate the clinicopathological characteristics and long-term survival of GC based on the subgroups of molecular classification by immunohistochemistry(IHC)and in situ hybridization(ISH).METHODS We retrospectively evaluated all patients who underwent D2-gastrectomy between 2009 and 2016 in a Western cohort of GC patients treated with curative intent.Microsatellite instability(MSI)status,E-cadherin,and p53 expression were analyzed by IHC,and Epstein-Barr virus(EBV)by ISH.Tissue microarrays were constructed for analysis.Clinicopathological characteristics and survival of GC were evaluated according to subtypes defined by The Cancer Genome Atlas(TCGA)Research Network Group and Asian Cancer Research Group(ACRG)classification systems.RESULTS A total of 287 GC patients were included.Based on IHC and ISH analysis,five profiles were defined as follows:E-cadherin aberrant(9.1%),MSI(20.9%),p53 aberrant(36.6%),EBV positivity(10.5%),and p53 normal(31%),which corresponded to tumors that showed no alteration in another profile.A flowchart according to the TCGA and ACRG classifications were used to define the subtypes,where clinical and pathological characteristics associated with GC subtypes were evidenced.Proximal location(P<0.001),total gastrectomy(P=0.001),and intense inflammatory infiltrate(P<0.001)were characteristics related to EBV subtype.MSI subtype was predominantly associated with advanced age(P=0.017)and the presence of comorbidities(P=0.011).While Laurén diffuse type(P<0.001)and advanced stage(P=0.029)were related to genomically stable(GS)subtype.GS tumors and microsatellite stable/epithelial to mesenchymal transition phenotype subtype had worse disease-free survival(DFS)and overall survival(OS)than other subtypes.Conversely,MSI subtype of GC had better survival in both classifications.Type of gastrectomy,pT and the TCGA subtypes were independent factors associated to DFS and OS.CONCLUSION The IHC/ISH analysis was able to distinguish immunophenotypic groups of GC with distinct characteristics and prognosis,resembling the subtypes of the molecular classifications.Accordingly,this method of classification may represent a viable option for use in a clinical setting.展开更多
目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、...目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、预后差异。结果93例TNBC中腔面雄激素受体型23例(24.7%),免疫调节型24例(25.8%),基底样免疫抑制型39例(42.0%),间充质型7例(7.5%)。TNBC亚型的临床病理特征:pT分期(P=0.030)、组织学分级(P<0.001)、肿瘤间质淋巴细胞浸润模式(P<0.001)、PD-L1(P<0.001)、HER2低表达(P=0.024)差异均有统计学意义;各亚型间的无瘤生存率差异无统计学意义(P>0.05)。单因素分层生存分析:亚型间pT1分期的无瘤生存率差异有统计学意义(P=0.011),其余临床病理特征均为非独立预后因素。结论TNBC基于组织学、免疫组化分型的临床病理特征有差异,有望替代复杂基因表达谱分型,为TNBC分型和靶向治疗提供理论依据。展开更多
目的:研究溶质载体家族6成员9(solute carrier family 6 member 9,SLC6A9)表达对结直肠癌细胞增殖、迁移和5-氟尿嘧啶(5-fluorouracil,5-FU)药物敏感性的影响。方法:TCGA数据库分析、实时荧光定量PCR和Western blot分析检测SLC6A9在结...目的:研究溶质载体家族6成员9(solute carrier family 6 member 9,SLC6A9)表达对结直肠癌细胞增殖、迁移和5-氟尿嘧啶(5-fluorouracil,5-FU)药物敏感性的影响。方法:TCGA数据库分析、实时荧光定量PCR和Western blot分析检测SLC6A9在结肠癌组织、正常结肠细胞系(NCM460)和结直肠癌细胞系(SW620、HCT116、HT29、Lovo和SW480)中的表达。将SCL6A9过表达质粒及阴性对照(SLC6A9 OE、Vector)转染HT29细胞,将SCL6A9小干扰RNA及阴性对照(SLC6A9 siRNA1#、siRNA2#和Scramble)转染SW620细胞。划痕愈合实验和Transwell实验检测各组细胞的迁移、侵袭能力。Western blot和细胞免疫荧光检测EMT相关蛋白E-cadherin、Vimentin的表达水平。利用CCK-8法和构建裸鼠移植瘤模型检测SLC6A9过表达对结直肠癌细胞5-FU药物敏感性的影响。结果:与正常结肠组织和NCM460细胞相比,SLC6A9在结肠癌组织和结直肠癌细胞系中低表达(均P<0.05)。SLC6A9过表达引起E-cadherin蛋白表达增加,Vimentin蛋白水平降低,抑制结直肠癌细胞的迁移、侵袭(P<0.05)。SLC6A9低表达引起E-cadherin蛋白表达降低,Vimentin蛋白水平增加,促进结直肠癌细胞的迁移、侵袭能力(P<0.05)。SLC6A9过表达提高了5-FU的药物敏感性,并使肿瘤生长缓慢,质量减轻(P<0.05)。而SLC6A9低表达降低了5-FU的药物敏感性(P<0.05)。结论:SLC6A9过表达能够抑制结直肠癌细胞的迁移、侵袭和EMT进程,并增强5-FU对结直肠癌细胞的药物敏感性。展开更多
AIM To investigate the chemopreventive effect of sulindac, one of the nonstroidal anti inflammatory drugs (NSAIDs), on the growth of N methyl N nitrosourea (MNU) induced mouse colonic tumors.
AIMS Using a new approach of regional adjuvant chemotherapy to prevent cancer cells hepatic metasta- sis after radical surgery of large bowel cancer. METHODS A model of liver with metastasis of hu- man colonic cancer ...AIMS Using a new approach of regional adjuvant chemotherapy to prevent cancer cells hepatic metasta- sis after radical surgery of large bowel cancer. METHODS A model of liver with metastasis of hu- man colonic cancer (HCC) cells in nude mice was used to observe the effect in prevention of metastasis of HCC cells inoculated via spleen applied with early postoper- ative intraperitoneal (IP) chemotherapy using large dose of 5-FU. RESULTS The incidence of metastasis to liver was decreased by 40%,the mean number of metastatic liv- er nodules in each animal was reduced by 50.89% and the mean survival times of each animal was prolonged by 48.21% by using 5-FU 40 mg/NS 40 ml/kg IP for two consecutive days as compared with the controls. CONCLUSIONS IP is a new and more effective re- gional adjuvant chemotheraputic approach in the pre- vention of liver metastasis HCC cells after radical surgery of large bowel cancer.展开更多
BACKGROUND Myopericytoma is a benign tumor that typically occurs within subcutaneous tissue and most often involves the distal extremities,followed by the proximal extremities,neck,thoracic vertebrae and oral cavity.C...BACKGROUND Myopericytoma is a benign tumor that typically occurs within subcutaneous tissue and most often involves the distal extremities,followed by the proximal extremities,neck,thoracic vertebrae and oral cavity.Complete resection is often curative.Malignant myopericytoma is extremely rare and has a poor prognosis.Here,we report for the first time a case of malignant myopericytoma originating from the colon.CASE SUMMARY A 69-year-old male was admitted to our hospital with right upper quadrant pain for five days.Imaging suggested a liver mass with hemorrhage.A malignant hepatic tumor was the initial diagnosis.Surgical resection was performed after a complete preoperative work up.Initial postoperative pathology suggested that the mass was a malignant myoblastoma unrelated to the liver.Four months after the first surgery,an enhanced computed tomography(CT)scan revealed a recurrence of the tumor.The diagnosis of malignant myopericytoma derived from the colon was confirmed on histopathological examination of the specimen from the second surgery.The patient did not return to the hospital regularly for surveillance.The first postoperative abdominal CT examination six months after the second surgery demonstrated multiple liver metastases.Survival time between the diagnosis of the tumor to death was approximately one year.CONCLUSION Malignant myopericytoma is a rare cancer.Preoperative diagnosis may be difficult.Due to a lack of treatment options,prognosis is poor.展开更多
目的探讨热休克蛋白90α(heat shock protein 90α,Hsp90α)在结肠癌中的表达及潜在的临床价值。方法采用生物信息学和免疫组化法分析结肠癌中Hsp90α的表达水平,及其与临床病理学特征、预后和免疫细胞浸润水平的关系;采用CCK-8细胞增...目的探讨热休克蛋白90α(heat shock protein 90α,Hsp90α)在结肠癌中的表达及潜在的临床价值。方法采用生物信息学和免疫组化法分析结肠癌中Hsp90α的表达水平,及其与临床病理学特征、预后和免疫细胞浸润水平的关系;采用CCK-8细胞增殖实验和平板克隆实验检测敲除Hsp90AA1前后结肠癌细胞的增殖能力。结果生物信息学分析结果显示,Hsp90AA1在结肠癌组织中异常高表达,其表达水平越高,患者预后越差;Hsp90AA1表达与CD4^(+)T细胞(Th2)、CD8^(+)T细胞、髓样抑制细胞、Tregs细胞、中性粒细胞、巨噬细胞、M1巨噬细胞、M2巨噬细胞的浸润水平呈正相关;免疫组化结果显示结肠癌组织中Hsp90α表达明显高于癌旁正常组织,Hsp90α表达与患者性别、肿瘤大小、位置、分化程度、TNM分期、淋巴结转移、脉管癌栓、神经侵犯、远处转移等无关(P>0.05),与结肠癌患者年龄具有相关性(P<0.05)。Hsp90α高表达是影响结肠癌患者预后的独立危险因素。细胞实验结果显示,敲除Hsp90AA1可抑制结肠癌细胞的生长及增殖能力。结论Hsp90α在结肠癌中高表达,可能是结肠癌预后不良的潜在分子学标志物。展开更多
目的 探讨乳腺韧带样纤维瘤病(desmoid fibromatosis of the breast, DFB)的临床病理学特征、诊断、鉴别诊断和分子遗传学特征。方法 收集26例DFB患者的临床病理资料及预后信息,分析其临床特点、组织学、免疫表型和分子学特征。结果 26...目的 探讨乳腺韧带样纤维瘤病(desmoid fibromatosis of the breast, DFB)的临床病理学特征、诊断、鉴别诊断和分子遗传学特征。方法 收集26例DFB患者的临床病理资料及预后信息,分析其临床特点、组织学、免疫表型和分子学特征。结果 26例患者均为女性,年龄范围13~69岁,平均36.8岁,中位年龄34.5岁。发生于左侧乳腺10例,右侧乳腺14例,双侧乳腺2例,临床均以发现乳腺孤立无痛性肿块就诊,3例伴有乳头凹陷。大体见肿物界限不清,质韧-硬,镜下见肿物由增生的梭形细胞和多少不等的胶原纤维组成,与周围乳腺组织界限不清,呈指突样浸润乳腺导管和小叶。肿瘤细胞呈梭形或卵圆形,排列呈束状、编织状,形态温和,无明显多形性、不典型性,细胞核染色质稀疏或呈空泡状,可见小核仁,核分裂象罕见。免疫表型:肿瘤细胞β-catenin核阳性(20/26),SMA不同程度阳性(20/26),desmin局灶阳性(6/26),CKpan、CK5/6、p63、CD34、CD10、S-100均阴性,Ki67增殖指数5%~10%。Sanger测序检测到CTNNB1基因第3外显子突变(18/26),其中15例为T41A位点突变(83.3%),2例为S45P位点突变(11.1%),1例S45F位点突变(5.6%)。其中2例患者同时患有家族性腺瘤性息肉病。23例行局部肿块切除,2例行乳腺单纯切除,1例粗针穿刺诊断后未治疗。20例患者获得随访,随访时间为1~108个月,均未复发。结论 DFB罕见,易误诊为恶性,应与多种发生于乳腺的梭形细胞增生性病变鉴别,需结合组织学、免疫表型及基因检测等明确诊断。展开更多
AIM:To compare the accuracy of hydrocolonic sonography (HUS) in determining the depth of invasion (T stage) in colon and rectal cancer. METHODS:A total of 1000-2000 mL of saline was instilled per rectum using a system...AIM:To compare the accuracy of hydrocolonic sonography (HUS) in determining the depth of invasion (T stage) in colon and rectal cancer. METHODS:A total of 1000-2000 mL of saline was instilled per rectum using a system for barium enemas,and then ultrasonography was conducted by a SSA-270A (Toshiba Co,Japan) sonolayer unit with a 3.75 MHz for 17 patients with colon cancer and 13 patients with rectal cancer before operation.After operation,T stage in HUS was compared with postoperative histological findings. RESULTS:Overall,the accuracy of T stage was 70%.It was 88% in colon cancer and 46% in rectal cancer.In evaluating nodal state,the accuracy of HUS was low in both colon (71%) and rectal cancers (46%) compared with conventional CT or MRI.The overall accuracy of N staging was 60%. CONCLUSION:HUS is valuable to evaluate the depth of invasion in colon cancer,but is less valuable in rectal cancer.Because HUS is low-cost,noninvasive,and readily available at any place,this technique seems to be useful to determine the preoperative staging in colon cancer,but not in rectal cancer.展开更多
Ischemic colitis can mimic a carcinoma on computed tomographic (CT) imaging or endoscopic examination. A coexisting colonic carcinoma or another potentially obstructing lesion has also been described in 20% of the cas...Ischemic colitis can mimic a carcinoma on computed tomographic (CT) imaging or endoscopic examination. A coexisting colonic carcinoma or another potentially obstructing lesion has also been described in 20% of the cases of ischemic colitis. CT scan can differentiate it from colon cancer in 75% of cases. However, colonoscopy is the preferred method for diagnosing ischemic colitis as it allows for direct visualization with tissue sampling. Varied presentations of ischemic colitis have been described as an ulcerated or submucosal mass or as a narrowed segment of colon with ulcerated mucosa on colonoscopy. Awareness and early recognition of such varied presentations of a common condition is necessary to differentiate from a colonic carcinoma, and to avoid unnecessary surgery and related complications.展开更多
基金Supported by Fundação de Amparo à Pesquisa do Estado de São Paulo(FAPESP agency),No.2016/25524-0.
文摘BACKGROUND Gastric cancer(GC)is a highly heterogeneous disease,and the identification of molecular subtyping of gastric adenocarcinoma emerged as a promising option to define therapeutic strategies and prognostic subgroups.However,the costs and technical complexity of molecular methodologies remains an obstacle to its adoption,and their clinical significance by other approaches needs further evidence.AIM To evaluate the clinicopathological characteristics and long-term survival of GC based on the subgroups of molecular classification by immunohistochemistry(IHC)and in situ hybridization(ISH).METHODS We retrospectively evaluated all patients who underwent D2-gastrectomy between 2009 and 2016 in a Western cohort of GC patients treated with curative intent.Microsatellite instability(MSI)status,E-cadherin,and p53 expression were analyzed by IHC,and Epstein-Barr virus(EBV)by ISH.Tissue microarrays were constructed for analysis.Clinicopathological characteristics and survival of GC were evaluated according to subtypes defined by The Cancer Genome Atlas(TCGA)Research Network Group and Asian Cancer Research Group(ACRG)classification systems.RESULTS A total of 287 GC patients were included.Based on IHC and ISH analysis,five profiles were defined as follows:E-cadherin aberrant(9.1%),MSI(20.9%),p53 aberrant(36.6%),EBV positivity(10.5%),and p53 normal(31%),which corresponded to tumors that showed no alteration in another profile.A flowchart according to the TCGA and ACRG classifications were used to define the subtypes,where clinical and pathological characteristics associated with GC subtypes were evidenced.Proximal location(P<0.001),total gastrectomy(P=0.001),and intense inflammatory infiltrate(P<0.001)were characteristics related to EBV subtype.MSI subtype was predominantly associated with advanced age(P=0.017)and the presence of comorbidities(P=0.011).While Laurén diffuse type(P<0.001)and advanced stage(P=0.029)were related to genomically stable(GS)subtype.GS tumors and microsatellite stable/epithelial to mesenchymal transition phenotype subtype had worse disease-free survival(DFS)and overall survival(OS)than other subtypes.Conversely,MSI subtype of GC had better survival in both classifications.Type of gastrectomy,pT and the TCGA subtypes were independent factors associated to DFS and OS.CONCLUSION The IHC/ISH analysis was able to distinguish immunophenotypic groups of GC with distinct characteristics and prognosis,resembling the subtypes of the molecular classifications.Accordingly,this method of classification may represent a viable option for use in a clinical setting.
文摘目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、预后差异。结果93例TNBC中腔面雄激素受体型23例(24.7%),免疫调节型24例(25.8%),基底样免疫抑制型39例(42.0%),间充质型7例(7.5%)。TNBC亚型的临床病理特征:pT分期(P=0.030)、组织学分级(P<0.001)、肿瘤间质淋巴细胞浸润模式(P<0.001)、PD-L1(P<0.001)、HER2低表达(P=0.024)差异均有统计学意义;各亚型间的无瘤生存率差异无统计学意义(P>0.05)。单因素分层生存分析:亚型间pT1分期的无瘤生存率差异有统计学意义(P=0.011),其余临床病理特征均为非独立预后因素。结论TNBC基于组织学、免疫组化分型的临床病理特征有差异,有望替代复杂基因表达谱分型,为TNBC分型和靶向治疗提供理论依据。
文摘目的:研究溶质载体家族6成员9(solute carrier family 6 member 9,SLC6A9)表达对结直肠癌细胞增殖、迁移和5-氟尿嘧啶(5-fluorouracil,5-FU)药物敏感性的影响。方法:TCGA数据库分析、实时荧光定量PCR和Western blot分析检测SLC6A9在结肠癌组织、正常结肠细胞系(NCM460)和结直肠癌细胞系(SW620、HCT116、HT29、Lovo和SW480)中的表达。将SCL6A9过表达质粒及阴性对照(SLC6A9 OE、Vector)转染HT29细胞,将SCL6A9小干扰RNA及阴性对照(SLC6A9 siRNA1#、siRNA2#和Scramble)转染SW620细胞。划痕愈合实验和Transwell实验检测各组细胞的迁移、侵袭能力。Western blot和细胞免疫荧光检测EMT相关蛋白E-cadherin、Vimentin的表达水平。利用CCK-8法和构建裸鼠移植瘤模型检测SLC6A9过表达对结直肠癌细胞5-FU药物敏感性的影响。结果:与正常结肠组织和NCM460细胞相比,SLC6A9在结肠癌组织和结直肠癌细胞系中低表达(均P<0.05)。SLC6A9过表达引起E-cadherin蛋白表达增加,Vimentin蛋白水平降低,抑制结直肠癌细胞的迁移、侵袭(P<0.05)。SLC6A9低表达引起E-cadherin蛋白表达降低,Vimentin蛋白水平增加,促进结直肠癌细胞的迁移、侵袭能力(P<0.05)。SLC6A9过表达提高了5-FU的药物敏感性,并使肿瘤生长缓慢,质量减轻(P<0.05)。而SLC6A9低表达降低了5-FU的药物敏感性(P<0.05)。结论:SLC6A9过表达能够抑制结直肠癌细胞的迁移、侵袭和EMT进程,并增强5-FU对结直肠癌细胞的药物敏感性。
文摘AIM To investigate the chemopreventive effect of sulindac, one of the nonstroidal anti inflammatory drugs (NSAIDs), on the growth of N methyl N nitrosourea (MNU) induced mouse colonic tumors.
基金Supported by the National Science Foundation of China,No.39270650
文摘AIMS Using a new approach of regional adjuvant chemotherapy to prevent cancer cells hepatic metasta- sis after radical surgery of large bowel cancer. METHODS A model of liver with metastasis of hu- man colonic cancer (HCC) cells in nude mice was used to observe the effect in prevention of metastasis of HCC cells inoculated via spleen applied with early postoper- ative intraperitoneal (IP) chemotherapy using large dose of 5-FU. RESULTS The incidence of metastasis to liver was decreased by 40%,the mean number of metastatic liv- er nodules in each animal was reduced by 50.89% and the mean survival times of each animal was prolonged by 48.21% by using 5-FU 40 mg/NS 40 ml/kg IP for two consecutive days as compared with the controls. CONCLUSIONS IP is a new and more effective re- gional adjuvant chemotheraputic approach in the pre- vention of liver metastasis HCC cells after radical surgery of large bowel cancer.
文摘BACKGROUND Myopericytoma is a benign tumor that typically occurs within subcutaneous tissue and most often involves the distal extremities,followed by the proximal extremities,neck,thoracic vertebrae and oral cavity.Complete resection is often curative.Malignant myopericytoma is extremely rare and has a poor prognosis.Here,we report for the first time a case of malignant myopericytoma originating from the colon.CASE SUMMARY A 69-year-old male was admitted to our hospital with right upper quadrant pain for five days.Imaging suggested a liver mass with hemorrhage.A malignant hepatic tumor was the initial diagnosis.Surgical resection was performed after a complete preoperative work up.Initial postoperative pathology suggested that the mass was a malignant myoblastoma unrelated to the liver.Four months after the first surgery,an enhanced computed tomography(CT)scan revealed a recurrence of the tumor.The diagnosis of malignant myopericytoma derived from the colon was confirmed on histopathological examination of the specimen from the second surgery.The patient did not return to the hospital regularly for surveillance.The first postoperative abdominal CT examination six months after the second surgery demonstrated multiple liver metastases.Survival time between the diagnosis of the tumor to death was approximately one year.CONCLUSION Malignant myopericytoma is a rare cancer.Preoperative diagnosis may be difficult.Due to a lack of treatment options,prognosis is poor.
文摘目的探讨热休克蛋白90α(heat shock protein 90α,Hsp90α)在结肠癌中的表达及潜在的临床价值。方法采用生物信息学和免疫组化法分析结肠癌中Hsp90α的表达水平,及其与临床病理学特征、预后和免疫细胞浸润水平的关系;采用CCK-8细胞增殖实验和平板克隆实验检测敲除Hsp90AA1前后结肠癌细胞的增殖能力。结果生物信息学分析结果显示,Hsp90AA1在结肠癌组织中异常高表达,其表达水平越高,患者预后越差;Hsp90AA1表达与CD4^(+)T细胞(Th2)、CD8^(+)T细胞、髓样抑制细胞、Tregs细胞、中性粒细胞、巨噬细胞、M1巨噬细胞、M2巨噬细胞的浸润水平呈正相关;免疫组化结果显示结肠癌组织中Hsp90α表达明显高于癌旁正常组织,Hsp90α表达与患者性别、肿瘤大小、位置、分化程度、TNM分期、淋巴结转移、脉管癌栓、神经侵犯、远处转移等无关(P>0.05),与结肠癌患者年龄具有相关性(P<0.05)。Hsp90α高表达是影响结肠癌患者预后的独立危险因素。细胞实验结果显示,敲除Hsp90AA1可抑制结肠癌细胞的生长及增殖能力。结论Hsp90α在结肠癌中高表达,可能是结肠癌预后不良的潜在分子学标志物。
文摘目的 探讨乳腺韧带样纤维瘤病(desmoid fibromatosis of the breast, DFB)的临床病理学特征、诊断、鉴别诊断和分子遗传学特征。方法 收集26例DFB患者的临床病理资料及预后信息,分析其临床特点、组织学、免疫表型和分子学特征。结果 26例患者均为女性,年龄范围13~69岁,平均36.8岁,中位年龄34.5岁。发生于左侧乳腺10例,右侧乳腺14例,双侧乳腺2例,临床均以发现乳腺孤立无痛性肿块就诊,3例伴有乳头凹陷。大体见肿物界限不清,质韧-硬,镜下见肿物由增生的梭形细胞和多少不等的胶原纤维组成,与周围乳腺组织界限不清,呈指突样浸润乳腺导管和小叶。肿瘤细胞呈梭形或卵圆形,排列呈束状、编织状,形态温和,无明显多形性、不典型性,细胞核染色质稀疏或呈空泡状,可见小核仁,核分裂象罕见。免疫表型:肿瘤细胞β-catenin核阳性(20/26),SMA不同程度阳性(20/26),desmin局灶阳性(6/26),CKpan、CK5/6、p63、CD34、CD10、S-100均阴性,Ki67增殖指数5%~10%。Sanger测序检测到CTNNB1基因第3外显子突变(18/26),其中15例为T41A位点突变(83.3%),2例为S45P位点突变(11.1%),1例S45F位点突变(5.6%)。其中2例患者同时患有家族性腺瘤性息肉病。23例行局部肿块切除,2例行乳腺单纯切除,1例粗针穿刺诊断后未治疗。20例患者获得随访,随访时间为1~108个月,均未复发。结论 DFB罕见,易误诊为恶性,应与多种发生于乳腺的梭形细胞增生性病变鉴别,需结合组织学、免疫表型及基因检测等明确诊断。
文摘AIM:To compare the accuracy of hydrocolonic sonography (HUS) in determining the depth of invasion (T stage) in colon and rectal cancer. METHODS:A total of 1000-2000 mL of saline was instilled per rectum using a system for barium enemas,and then ultrasonography was conducted by a SSA-270A (Toshiba Co,Japan) sonolayer unit with a 3.75 MHz for 17 patients with colon cancer and 13 patients with rectal cancer before operation.After operation,T stage in HUS was compared with postoperative histological findings. RESULTS:Overall,the accuracy of T stage was 70%.It was 88% in colon cancer and 46% in rectal cancer.In evaluating nodal state,the accuracy of HUS was low in both colon (71%) and rectal cancers (46%) compared with conventional CT or MRI.The overall accuracy of N staging was 60%. CONCLUSION:HUS is valuable to evaluate the depth of invasion in colon cancer,but is less valuable in rectal cancer.Because HUS is low-cost,noninvasive,and readily available at any place,this technique seems to be useful to determine the preoperative staging in colon cancer,but not in rectal cancer.
文摘Ischemic colitis can mimic a carcinoma on computed tomographic (CT) imaging or endoscopic examination. A coexisting colonic carcinoma or another potentially obstructing lesion has also been described in 20% of the cases of ischemic colitis. CT scan can differentiate it from colon cancer in 75% of cases. However, colonoscopy is the preferred method for diagnosing ischemic colitis as it allows for direct visualization with tissue sampling. Varied presentations of ischemic colitis have been described as an ulcerated or submucosal mass or as a narrowed segment of colon with ulcerated mucosa on colonoscopy. Awareness and early recognition of such varied presentations of a common condition is necessary to differentiate from a colonic carcinoma, and to avoid unnecessary surgery and related complications.
