重症肌无力伴微小胸腺瘤临床病理分析

目的探讨微小胸腺瘤伴重症肌无力(MG)患者胸腺病理特征及与临床关系。方法回顾分析2007年4月至2017年3月重症肌无力患者445例胸腺切除病理特征,对其中256例伴微小胸腺瘤胸腺病理特点进行分类并结合临床分型、年龄、术后危象发生与否进行分析。结果微小胸腺瘤伴胸腺增生86例,50岁以下者多于50岁以上者,且女性多于男性;伴胸腺萎缩124例,50岁以下者多于50岁以上者,无性别差异;伴萎缩及滤泡增生30例,无性别及年龄差异;伴非萎缩非增生胸腺16例,均为女性,无年龄差异。256例患者,年龄16~64岁,其中6例发生重症肌无力危象。结论微小胸腺瘤与MG发生相关,重视MG患者手术根治性切除胸腺并全方位病理取材,提高微小胸腺瘤检出率,为临床诊断、治疗及预后评估提供依据。

乳腺外湿疹样癌66例临床病理特点分析

湿疹样癌又称Paget病,是一种少见的上皮内肿瘤,分为乳腺Paget病和乳腺外Paget病,乳腺外Paget病好发于老年人.以胞质丰富的大细胞为乳腺外Paget病的典型特征,这类细胞又称为Paget细胞.该病早期临床表现为湿疹样皮损,容易被误诊,切除不完全后易复发.本文对乳腺外Paget病患者66例的病理标本进行临床病理特征分析,以使本病得到及时诊治.

补充说明

本刊第29卷第11期第1066-1068页《眼附属器原发性MALT淋巴瘤5例临床病理特征分析》一文,因第一作者杨家佳疏忽遗漏通讯作者“丁志燕。E-mail:dingzy39@163.com”,特此补充说明。

Clinical and Pathological Features of Riedel's Thyroiditis

Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.

Fine needle aspiration analysis of misdiagnosis of 2 cases with skin singular leiomyoma

This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.

Breast secretory carcinoma: a clinicopathologic study of four cases

Objective: To explore the clinicopathologic features of secretory carcinoma of breast (SCB). Methods: Four cases of SCB were analyzed by light microscopy, histochemistry, immunohistochemistry and electron microscopy. The clinical data were also analyzed. Special staining of periodic acid-Schiff reaction with diastase pretreatment, immunohistochemical staining of ER, PR, HER-2, p53, MIB-1, S-100, p63, CK8/18 and EMA by En Vision method were performed. Results: Solid, cribriform, tubular, or papillary architecture may be seen. Tumor forms cystic spaces filled with abundant pale pink secretory material, positive with diastase resistant periodic acid-Schiff (PAS-DR) stains. Tumor cells were small with bland nuclei and abundant pale, eosinophilic cytoplasm, rare mitotic activity and necrosis. Immunohistochemically, tumor cells were positive for CK8/18, EMA, negative for S-100, p63 and variable partially positive for p53, ER, PR, HER-2 and MIB-1. Under electron microscopy, the tumor cells possessed numerous membrane-bound secretory vacuoles in cytoplasm lined by microvilli. Conclusion: SCB is a rare, low-malignant neoplasm. SCB have pathology, clinical picture, treatment, follow-up, immunohistochemical and genetic features that distinguish them from invasive ductal carcinomas of the usual type.

Prognostic factors of gastric cancer tumours of less than 2 cm in diameter

Objective:The aim of our study was to identify clinicopathological characteristics as predictive factors for gastric cancer tumours of less than 2 cm in diameter.Methods:The clinicopathological features of 129 patients with gastric cancer tumour of less than 2 cm in diameter were reviewed retrospectively from hospital records between 1980 and 2000.The results of retrospective analysis of clinicopathological data of 58 patients with advanced cancer were compared with those of 71 patients with early cancer.Univariate and multivariate analyses of patients with gastric cancer tumours were performed to evaluate the prognostic significance of clinicopathological features.Results:Lymph-node metastasis was found more frequently in the advanced cancer group than in the early cancer group.In univariate analysis,unfavorable prognostic factors included deep cancer invasion.Using Cox's proportional hazard regression model,only depth of invasion emerged as an independent statistically significant prognostic parameter associated with long-term survival.Conclusion:Depth of invasion is an independent prognostic factor for gastric cancer tumours of less than 2 cm in diameter.Laparoscopic surgery should not be performed on tumours that are diagnosis in advanced stage and lymph-node involvement.We recommend laparoscopic surgery involving local resection of the stomach without lymphadenectomy for small,early gastric cancer tumours.However,the validity of this recommendation should be tested by a prospective randomized control trial in the future.

Transcriptomic analysis reveals key lnc RNAs associated with ribosomal biogenesis and epidermis differentiation in head and neck squamous cell carcinoma

Objective： In this study, we aimed to expand current knowledge of head and neck squamous cell carcinoma （HNSCC）-associated long noncoding RNAs （IncRNAs）, and to discover potential IncRNA prognostic biomarkers for HNSCC based on next-generation RNA-seq. Methods： RNA-seq data of 546 samples from patients with HNSCC were downloaded from The Cancer Genome Atlas （TCGA）, including 43 paired samples of tumor tissue and adjacent normal tissue. An integrated analysis incorporating differential expression, weighted gene co-expression networks, functional enrichment, clinical parameters, and survival analysis was conducted to discover HNSCC-associated IncRNAs. The function of CYTOR was verified by cell-based experiments. To further identify IncRNAs with prognostic significance, a multivariate Cox proportional hazard regression analysis was performed. The identified IncRNAs were validated with an independent cohort using clinical feature relevance analysis and multivariate Cox regression analysis. Results： We identified nine HNSCC-relevant IncRNAs likely to play pivotal roles in HNSCC onset and development. By functional enrichment analysis, we revealed that CYTOR might participate in the multistep pathological processes of cancer, such as ribosome biogenesis and maintenance of genomic stability. CY-I-OR was identified to be positively correlated with lymph node metastasis, and significantly negatively correlated with overall survival （OS） and disease free survival （DFS） of HNSCC patients. Moreover, CYTOR inhibited cell apoptosis following treatment with the chemotherapeutic drug diamminedichloroplatinum （DDP）. HCG22, the most dramatically down-regulated IncRNA in tumor tissue, may function in epidermis differentiation. It was also significantly associated with several clinical features of patients with HNSCC, and positively correlated with patient survival. CYTOR and HCG22 maintained their prognostic values in- dependent of several clinical features in multivariate Cox hazards analysis. Notably, validation either based on an independent HNSCC cohort or by laboratory experiments confirmed these findings. Conclusions： Our transcriptomic analysis suggested that dysregulation of these HNSCC-associated IncRNAs might be involved in HNSCC oncogenesis and progression. Moreover, CYTOR and HCG22 were confirmed as two independent prognostic factors for HNSCC patient survival, providing new insights into the roles of these IncRNAs in HNSCC as well as clinical applications.