外周T细胞淋巴瘤-非特指型中的临床病理预后模型的探讨

目的：探讨外周T细胞淋巴瘤-非特指型（PTCL-U）的临床病理预后模型。方法：应用免疫组化的方法检测2005-05/2008-05 55例经病理确诊的PTCL-U患者的病理组织的NF-κB/p50、P-gp170、GST-π、TOPO、Ki-67的表达情况,结合国际预后指数（IPI）分析临床病理预后因子与治疗效果、预后的关系。结果：本组55例患者中NF-κB/p50、P-gp170糖蛋白、GST-π、TOPO的表达阳性率分别为21.8%（12/55）、60.0%（33/55）、50.9%（28/55）和54.5%（30/55）。Ki-67的表达阳性率在5%~90%之间,中位的百分率为65%。NF-κB/p50阳性组,耐药阳性组,Ki-67高表达（≥65%）组与对照组相比较首程治疗完全缓解率无显著差异。本文提出了将NF-κB/p50阳性、MDR阳性（本文定义）和Ki-67高表达分别赋值1分,结合IPI5分的共计8分的临床病理预后模型（CPPI）。≥4分为高危组,〈4分为低危组,根据CPPI评分的低、高危组间首程治疗完全缓解率、总的生存率间的差异显著（P=0.014 6;P=0.000 0）。多因素生存分析显示,CPPI评分（P=0.034）是PTCL-U的独立预后因素。结论：临床病理预后模型（CPPI）能够在一定程度上预测PTCL-U对化疗的反应性和预后。

Comparative analysis of CT and pathological findings of peripheral nerve sheath tumors

Objective: To improve the qualitative diagnosis of peripheral nerve sheath tumors by computed tomography (CT). Methods: CT findings of 64 cases of pathologically confirmed nerve sheath tumors were compared with the pathological findings of the tumors. Results: Low density of the tumors shown in plain CT images was related to dominating reticular structure in the tumor as found pathologically. Tumors with intact capsule found by pathological findings were shown with smooth margin in CT images. Inhomogeneous density and enhancement of the tumors in CT images was related to tumor necrosis, liquefaction and cystic degeneration, and inhomogeneous enhancement also involved the reticular structure. Conclusion: Nerve sheath tumors are characterized by distribution along the nerves, lower density than that of muscles in plain CT images, and inhomogeneous enhancement in enhanced CT, which can help differentiate nerve sheath tumors from other soft tissue tumors. When nerve sheath tumors lack distinctive CT features, the diagnoses have to depend on their pathological findings.

胸腹部巨大Askin廇并对侧胸腹交界区转移1例报告并文献复习

目的探讨青少年胸部Askin瘤的影像表现。方法对1例青少年Askin瘤的临床表现、病理学特点及影像资料进行分析,并结合文献进行复习。结果 Askin瘤好发于儿童和青少年,女性多见,瘤体一般较大,包膜不完整或无包膜,CT表现单侧胸腔内巨大肿块,可累及胸膜、膈肌等,CT能清晰显示肿瘤的内部密度、肿瘤的范围、显示肺内的转移、肿块与肺、胸膜、纵隔的关系以及肋骨破坏的情况。病理学特点瘤细胞由小圆细胞构成,有菊形团;免疫表型:CD99、NSE、VIM、S100阳性;电镜下观察到肿瘤细胞胞浆内神经内分泌颗粒。结论 Askin瘤临床与影像学表现有一定的特点,但均为非特征性表现,最后诊断须依靠病理、免疫组化及电镜检查。