The Characteristics of Immunophenotype in Acute Lymphoblastic Leukemia and Its Clinical Significance

Objective： To study the characteristics of immunophenotype in acute lymphoblastic leukemia （ALL） and its clinical significance. Methods： Immunophenotyping was performed on 81 ALL patients by three-color flow cytometry analysis using CD45/SSC gating, meanwhile the cytogenetic analysis was performed on 45 cases out of 81 ALL patients. Results： （1） CD19 was the most commonly expressed of all B-lineage antigens detected with the positive rate being 100%. In T-ALL, the positive expression rate of CD5 and CD7 was the highest, being 90%. Both B-ALL and T-ALL overlapped in expression of lineage antigens. There was no significant difference in the complete remission rate （CR rate） between T-ALL and B-ALL. （2） The incidence of ALL with rayeloid antigens expression （My＋ALL） was 39.5%. CD13 was most often seen among the myeloid markers. My＋ALL always involved in B-lineage antigens and the CR rate in children and adults was 72.2% and 78.6% respectively. （3） The incidence of HAL was 19.8%. Coexpression of B-lineage and myeloid-assoeiated antigens was the commonest subtype in HAL. The expression of CD34 was commonly seen in HAL patients （81.3%）. The CR rate was low in HAL, 50% for children and 40% for adults. （4） Compared to T-ALL, B-ALL, My＋ALL, and HAL had a higher positive rate of CD34 expression with the difference being significant （P〈0.025）. Conclusion： Immunophenotyping had remarkable predominance in diagnosing special category of ALL （such as HAL and My＋ALL）; CD19 and CD5 were highly sensitive in diagnosing B-ALL and T-ALL, but less special, and overlapping was found in expression. No significant association was found between the expression of CD34 or myeloid antigens and CR rate, while low CR rate was found in HAL patients, especially for those coexpressing CD34 antigen.

Effects of DDPH on HECCM-induced Proliferation and Immunophenotypes of the Pulmonary Vascular Pericytes

In order to study the effects of 1-(2,6-dimethylphenoxy)-2-(3,4-dimethoxyphenylethylamino) propane hydrochloride (DDPH) on proliferation and immunophenotypes of newborn rat pulmonary vascular pericytes induced by hypoxic endothelial cell conditioned medium (HECCM) from porcine pulmonary arteries, the cultured pericytes were divided into 4 groups according to the endothelial cell conditioned medium (ECCM) used: normoxic ECCM (NECCM) group, NECCM+DDPH group, HECCM group and HECCM+DDPH group. Cell culture, immunocytochemical staining, image analysis and flow cytometric method were used to investigate the effects of HECCM and DDPH on the expression of α-smooth muscle actin (α-SM-Actin) antigen, CD34 antigen, S-100 antigen and proliferating cell nuclear antigen (PCNA) and cell cycle in pericytes. The results showed that the α-SM-Actin antigen in the pericytes in HECCM group was stronger positively expressed than in the other three groups, but CD34 antigen and S-100 antigen were negatively expressed. The expression of α-SM-Actin antigen, CD34 antigen and S-100 antigen was positive in the groups of NECCM, NECCM+DDPH and HECCM+DDPH; The expression of α-SM-Actin and PCNA in HECCM group was 1.32 times (P<0.01) and 1.24 times (P<0.05) that in NECCM group, 1.30 times (P<0.01) and 1.21 times (P<0.05) that in HECCM+DDPH group, respectively. The percentage of the cells in the GO-G1 phase in the HECCM group was lower by 11.7 % and 9.1 %, in S phase higher by 5.6 % and 4.2 %, in G2-M phase higher by 6.1 % and 4.9 % than in the groups of NECCM,HECCM+DDPH, respectively. The inhibitory rate of DDPH on the increased α-SM-Actin and PCNA syntheses in pericytes induced by HECCM were 23.4 % and 17.1 % respectively. The inhibitory rate on the increased pericytes from GO-G1 phase to S phase was 8.3 %. These results suggest that DDPH can directly inhibit pericytes from proliferation and immunophenotypical transformation of smooth muscle-like cells induced by HECCM.

Association of Morphology and Immunophenotype in Diffuse Large B-Cell Lymphomas with Bone Marrow Infiltration in a Sample Mexican Population

Introduction: Diffuse large B-cell lymphoma (DLBCL), not otherwise specified, is a large B-cell lymphoma with a diffuse growth pattern and aggressive clinical course. It is divided in subgroups according to its morphology, immunophenotype, and primary site. Dissemination to bone marrow occurs in 11% to 35% of cases and can be of concordant or discordant morphology. Objective: To examine the association, the type of bone marrow involvement in relation to the primary site, morphology, immunohistochemistry of DLBCLs and to determine the cases of Epstein-Barr virus positive DLBCLs. Materials and Methods: We reviewed lymph node and extranodal biopsies as well as the respective bone marrow biopsies in all cases of DLBCL diagnosed in the Hospital General de México during the period from 2002 to 2010. We used immunohystochemistry for immunophenotype identification (Hans’s algorithm) and an in-situ hybridization technique to detect presence of Epstein Barr encoded RNA (EBER). Results: We included 108 patients with a mean age of 51.9 years, 59 (55%) were men. DLBCL involved lymph nodes in 60% of cases and palatine tonsils in 13%. The centroblastic variant predominated (80%) and 58% originated from activated B-cells. Infiltration of bone marrow was present in 30% of cases and was discordant in 55% of these cases. Correlation between morphology and bone marrow infiltration was statistically significant (P = 0.0003). Presence of Epstein-Barr virus was demonstrated in 15% of patients older than 50 years. Conclusions: Dissemination to bone marrow occurred in 30% of cases and discordant involvement was most common. DLBCL originating from activated B-lymphocytes predominated and the most common extranodal sites were palatine tonsils, suggesting that our population has a clinical behavior similar to Asiatic populations.

Application of Flow Cytometry in Examination of Immunophenotypes in Human Cells

[Objectives]This study was conducted to establish a method for detecting the immunophenotypes of venous blood CIK cells in healthy donors and patients with triple-negative breast cancer or lung cancer by flow cytometry,and to further analyze and discuss the proportion of cellular immunophenotypes such as CD3^(+),CD4^(+),CD8^(+),CD3^(+)CD8^(+),CD3^(+)CD56^(+)in CIK cells.[Methods]Human venous blood was drawn,then anticoagulated with heparin and isolated with lymphocyte isolation solution,and the relevant immunophenotypes were detected by flow cytometry after 21 d of culture.[Results]The expression of CD3^(+)CD8^(+)and CD3^(+)CD56^(+)in the venous blood CIK cells was significantly higher in healthy donors than that in triple-negative breast and lung cancer patients.[Conclusions]CD3^(+)CD8^(+)and CD3^(+)CD56^(+)CIK cells have high anti-tumor activity.

Immunophenotype and differentiation capacity of bone marrow-derived mesenchymal stem cells from CBA/Ca,ICR and Balb/c mice

AIM:To assess the capacity to isolate and expand mesenchymal stem cells(MSC)from bone marrow of CBA/Ca,ICR and Balb/c mice. METHODS:Bone marrow of tibia and femur were flushed,cultured and maintained in supplemented Dulbecco’s modified Eagle’s medium.MSC immunophenotype of cultures were tracked along increasing passages for positivity to CD106,Sca-1 and CD44 and negativity to CD45,CD11b and MHC classⅡ.Differentiation capacity of MSC towards osteogenic and adipo-genic lineages were also assessed. RESULTS:MSC were successfully cultured from bone marrow of all 3 strains,albeit differences in the temporal expression of certain surface antigens.Their differentiation into osteocytes and adipocytes were also observed. MSC from all 3 mouse strains demonstrated a shift from a haematopoietic phenotype(CD106-CD45+CD11b+Sca-1low)to typical MSC phenotype(CD106+CD45-CD11b-Sca-1high)with increasing passages. CONCLUSION:Information garnered assists us in the decision of selecting a mouse strain to generate MSC from for downstream experimentation.

Immunophenotype and Ultrastructure of B-cell Lymphoproliferative Disorder with Cytoplasmic Projection

To identify the knowledge of rare lymphoproliferative disorder, the clinical and biological features of three kinds of lymphoproliferative disorders with cytoplasmic projections were compared The clinical manifestations, ultrastructure and immunophenotype were analyzed The results showed that hairy cell leukemia (HCL), splenic lymphoma with villous lymphocyte (SLVL) and hairy cell leukemia-variant (HCL-V) had some common characters including splenomegaly, peripheral blood and bone marrow infiltration by villous lymphocyte and B lymphocyte immunophenotype; but these three disorders had specific features respectively It was concluded that overall analysis of clinical and laboratory features might be contributive to the differential diagnosis of these three disorders

Effect of Chinese Medicine Treatment Based on Pattern Identification on Cellular Immunophenotype of Myelodysplastic Syndrome

Objective： To observe the influence of treatment based on Chinese medicine pattem identification on cellular immunophenotype of the myelodysplastic syndrome （MDS）. Methods： Sixty patients with MDS were randomly and equally assigned to the treatment group and the control group using a randomized digital table. Thirty patients in each group included 3 risk levels （low, moderate and high risks） with each level 10 patients according to the international prognostic scoring system. The control group was given conventional therapy which was also used in the treatment group. While the treatment group was given Zuogui Pill （左归丸） and Yougui Pill （右归丸） for low risk patients; Qingwen Baidu Decoction （清瘟败毒饮） and Bazhen Decoction （八珍汤） for moderate risk patients; Gexia Zhuyu Decoction （膈下逐瘀汤） and Qinghao Biejia Decoction （青蒿鳖甲汤） combined with Shiquan Dabu Decoction （十全大补汤 ） for high risk patients. After the treatment, the differences of overatl response rate and immunophenotype （CD13, CD14, CD15, CD33 and CD34） of each group were analyzed. Results： The overall response rate of the treatment group was significantly higher than the control group in low risk and moderate risk patients （P=0.029）, there was no statistical differences of overall response rate between the treatment group and the control group in high risk patients （P=0.089）. The expressions of CD13, CD14, CD33 and CD34 in all three risk levels of the treatment group were obviously decreased after the treatment, while CD15 in all three risk levels of the treatment group was obviously increased after the treatment （P〈0.05 or P〈0.01）. Meanwhile, the difference values of CD13 and CD33 in low risk level of the treatment group, CD33 and CD34 in moderate risk level of the treatment group as well as CD34 and CD15 in high risk level of the treatment group, were all greater than the control groups and they were statistically significant （P〈0.05 or P〈0.01）. Conclusions： It shows a better therapeutic effect if the MDS patients treated with Chinese medicine pattern identification in addition to conventional therapy. Since the treatment may inhibit the malignant clones and improve the dysmaturity of granulocyte differentiation, it is a feasible option in clinical practice.

第19天微小残留病与急性B淋巴细胞白血病患儿预后的关系分析

目的探究第19天(D19)微小残留病(MRD)与急性B淋巴细胞白血病(B-ALL)患儿预后的关系及与相关生物学改变的联系。方法统计2016年4月至2020年4月于该院初诊且符合入组条件的88例B-ALL患儿诱导治疗D19 MRD、总生存(OS)率、无事件生存(EFS)率、染色体核型、融合基因和突变基因,以MRD≥0.01%为阳性,将入选儿童分为MRD阳性组和MRD阴性组,比较两组3年OS率、EFS率、免疫表型和分子生物学/细胞遗传学特点。结果88例患儿3年OS率和EFS率分别为92.0%和86.4%,MRD阳性组OS率及EFS率均低于阴性组,差异有统计学意义(P<0.05)。MRD阳性组CD10检出率低于MRD阴性组,差异有统计学意义(P<0.05)。32例(36.4%)患儿检出8种35个融合基因。MRD阳性组中BCR-ABL1、E2A-PBX1检出率均高于MRD阴性组,差异有统计学意义(P<0.05);48例(54.5%)患儿检出41种91个突变基因,余突变基因均<5例;18例(20.5%)患儿检出异常染色体核型,17例无核分裂相,正常和异常核型MRD无区别。二分类Logistic回归分析显示,BCR-ABL1、E2A-PBX1均是B-ALL患儿预后的影响因素(P<0.05)。结论D19 MRD阳性是B-ALL患儿OS和EFS不良的影响因素,E2A-PBX1、BCR-ABL1均对B-ALL患儿预后有不良影响。

Immunophenotype of myeloid cells in myelodysplastic syndromes and its clinical implications

OBJECTIVE: To explore the immunophenotype of myeloid cells in myelodysplastic syndyomes (MDS) and its clinical implications. METHODS: A panel of monoclonal antibody was used to detect CD13+, CD33+, CD15+ and CD14+ antigens on the membrane surfaces of myeloid cells in the bone marrow from 51 MDS, 21 aplastic anemia (AA), 21 paroxysmal nocturnal hemoglobinuria (PNH) patients. 10 acute myeloblastic leukemia (AML) patients and 15 normal subjects by immunoenzymatic assay. The morphology and chromosome karyotype of bone marrow cells of MDS patients were also examined. RESULTS: CD14+, CD13+ and CD33+ cells in the bone marrow were more in MDS patients than in normal controls, AA patients and PNH patients. CD15+ cells in the bone marrow were less in MDS patients than in normal controls. CONCLUSIONS: The percentages of CD14+, CD13+ and CD33+ positive cells in the bone marrow of MDS patients were related to the percentage of myeloblasts, the chromosomal aberrations and the response to treatment. It indicated that there is immunophenotypic misexpression of myeloid cells in MDS patients. Immunophenotype analysis of myeloid cells might be useful for the diagnosis and treatment of MDS patients.

Immune cell signatures and causal association with irritable bowel syndrome:A mendelian randomization study

BACKGROUND The mucosal barrier's immune-brain interactions,pivotal for neural development and function,are increasingly recognized for their potential causal and therapeutic relevance to irritable bowel syndrome(IBS).Prior studies linking immune inflammation with IBS have been inconsistent.To further elucidate this relationship,we conducted a Mendelian randomization(MR)analysis of 731 immune cell markers to dissect the influence of various immune phenotypes on IBS.Our goal was to deepen our understanding of the disrupted brain-gut axis in IBS and to identify novel therapeutic targets.AIM To leverage publicly available data to perform MR analysis on 731 immune cell markers and explore their impact on IBS.We aimed to uncover immunophenotypic associations with IBS that could inform future drug development and therapeutic strategies.METHODS We performed a comprehensive two-sample MR analysis to evaluate the causal relationship between immune cell markers and IBS.By utilizing genetic data from public databases,we examined the causal associations between 731 immune cell markers,encompassing median fluorescence intensity,relative cell abundance,absolute cell count,and morphological parameters,with IBS susceptibility.Sensitivity analyses were conducted to validate our findings and address potential heterogeneity and pleiotropy.RESULTS Bidirectional false discovery rate correction indicated no significant influence of IBS on immunophenotypes.However,our analysis revealed a causal impact of IBS on 30 out of 731 immune phenotypes(P<0.05).Nine immune phenotypes demonstrated a protective effect against IBS[inverse variance weighting(IVW)<0.05,odd ratio(OR)<1],while 21 others were associated with an increased risk of IBS onset(IVW≥0.05,OR≥1).CONCLUSION Our findings underscore a substantial genetic correlation between immune cell phenotypes and IBS,providing valuable insights into the pathophysiology of the condition.These results pave the way for the development of more precise biomarkers and targeted therapies for IBS.Furthermore,this research enriches our comprehension of immune cell roles in IBS pathogenesis,offering a foundation for more effective,personalized treatment approaches.These advancements hold promise for improving IBS patient quality of life and reducing the disease burden on individuals and their families.

11例孤立性纤维性肿瘤的临床病理分析

目的 探讨孤立性纤维性肿瘤(SFT)的临床病理、免疫表型和预后。方法 收集11例SFT患者的临床及病理资料,行HE染色及免疫组化检测,总结其临床及影像学表现、组织学形态、免疫表型特征及预后,并结合相关文献进行复习。结果 11例患者中,男性9例,女性2例,年龄25~85岁。影像学均表现为结节状软组织肿块。肿瘤最大径3.5~30 cm,切面实性,部分有完整包膜。肿瘤细胞呈卵圆形或梭形、短梭形,疏密不均,可见薄壁鹿角形血管。部分病例细胞轻-中度异型,偶见奇异形核。免疫组化结果显示,所有肿瘤均表达CD34,8例STAT6核阳性。目前手术完整切除仍是SFT的首选治疗方法。本组10例患者获得随访,其中8例无病生存,1例死亡患者原因不详,1例术后复发仍带瘤生存。结论 SFT具有相对独特的病理组织学和分子遗传学改变,发生于胸膜外者生物学行为更具侵袭性。具有恶性组织学特征者具有较高的局部复发和转移率,因此正确的诊断对于治疗和患者管理具有重要意义。

母细胞性浆细胞样树突状细胞肿瘤临床和病理特征分析

目的:归纳并分析母细胞性浆细胞样树突状细胞肿瘤(BPDCN)的临床资料,为进一步认识该类疾病提供依据。方法:回顾性分析11例BPDCN患者的临床表现、免疫表型及病理特点、治疗与预后。结果:11例明确诊断BPDCN的患者中,男性8例、女性3例,中位年龄44(6-81)岁。临床主要以皮疹、包块等为首发症状,并伴有淋巴结、骨髓受累。肿瘤性母细胞性浆细胞样树突状细胞(pDC)表达HLA-DR、CD4、CD56、CD123,不表达cCD3、cMPO、cCD79a,部分病例可表达CD38、CD99、CD36。临床上手术切除、多次化疗失败的患者复发快,患者生存期短。首次化疗达到完全缓解的患者pDC细胞不表达CD56,且经骨髓移植后具有较长的生存期。结论:BPDCN免疫表型具有异质性,CD56是区分肿瘤性和正常pDC细胞的良好标志物;化疗缓解后进行造血干细胞移植的BPDCN患者预后较好。

Blastic plasmacytoid dendritic cell neoplasm in Jinhua,China:Two case reports

BACKGROUND Blastic plasmacytoid dendritic cell neoplasm(BPDCN)is a rare and clinically aggressive hematologic malignancy originating from the precursors of plasmacytoid dendritic cells.BPDCN often involves the skin,lymph nodes,and bone marrow,with rapid clinical progression and a poor prognosis.The BPDCN diagnosis is mainly based on the immunophenotype.CASE SUMMARY In this paper,we retrospectively analyzed 2 cases of BPDCN.Both patients were elderly males.The lesions manifested as skin masses.Morphological manifestations included diffuse and dense tumor cell infiltration of the dermis and subcutaneous tissues.Immunohistochemistry staining showed that cluster of differentiation CD4,CD56,CD43,and CD123 were positive.CONCLUSION In this paper,we retrospectively analyzed 2 cases of BPDCN.Both patients were elderly males.The lesions manifested as skin masses.Morphological manifestations included diffuse and dense tumor cell infiltration of the dermis and subcutaneous tissues.Immunohistochemistry staining showed that cluster of differentiation CD4,CD56,CD43,and CD123 were positive.

多形性横纹肌肉瘤临床病理特征分析

目的 探讨多形性横纹肌肉瘤(pleomorphic rhabdomyosarcoma, PRMS)的临床病理学特征及鉴别诊断要点。方法 回顾性收集2008年6月至2023年3月苏州大学附属第一医院收治的PRMS患者的临床表现、病理学特征、免疫表型、治疗经过,通过电话随访获取患者生存状态及有无复发和转移。结果 共纳入6例PRMS患者,其中男性5例,女性1例;年龄29~77岁,平均年龄54.17岁;发病部位分别为右上臂、右肾盂、左鼻窦/颈部/下颌、右肩背、右臀大肌和鼻咽部。4例临床资料完整的患者中,1例表现为涕中带血,喉部异物感;3例表现为肿块进行性增大,其中2例伴压痛,影像学均提示占位性病变。组织学上,3例(50%)有凝固性坏死,4例(66.7%)呈典型的多形性肉瘤形态,2例(33.3%)以异型的梭形细胞为主。免疫组化染色显示:6例(100%)弥漫表达desmin,5例(83.3%)灶性表达myogenin,4例(66.7%)灶性表达MyoD1,1例(16.7%)灶性表达SMA;Ki-67增殖指数30%~70%。6例患者均接受手术治疗;4例患者获得完整随访资料,均于术后进行放疗和(或)化疗,出现不同程度的复发或转移后死亡。结论 PRMS作为一种罕见的横纹肌肉瘤,恶性程度高,预后差,鉴别诊断尤为重要,目前仍无有效治疗方法。

非M3型急性髓系白血病患者骨髓原始细胞酪氨酸蛋白激酶CD117的表达及意义

目的探讨酪氨酸蛋白激酶CD117在非M3型急性髓系白血病(AML)患者的表达及其与AML患者疗效和预后的关系。方法选择2013年1月至2018年6月淮安市第一人民医院收治的83例初诊为非M3型AML患者为研究对象,根据骨髓原始细胞免疫表型流式细胞术检测结果将患者分为CD117抗原阴性组(CD117-组,n=40)和CD117抗原阳性组(CD117+组,n=43),采用R显带技术分析AML患者的染色体核型,多重反转录聚合酶链式反应法检测AML患者的基因突变情况,结合患者染色体及基因突变结果,将所有患者预后分层为预后良好、预后中等、预后不良。所有患者根据病情选择以下诱导方案中的1种进行化学治疗:(1)IA方案[去甲氧柔红霉素10~12 mg·m^(-2)(第1~3天)+阿糖胞苷100 mg·m^(-2)(第1~7天)];(2)DA方案[柔红霉素60~90 mg·m^(-2)(第1~3天)+阿糖胞苷100 mg·m^(-2)(第1~7天)];(3)HA方案[高三尖杉酯碱2.5 mg·m^(-2)(第1~7天)+阿糖胞苷100 mg·m^(-2)(第1~7天)]。1个疗程后未达完全缓解(CR)的患者可选择原方案或更改诱导方案;达CR的患者选择中大剂量阿糖胞苷(1~2 g·m^(-2),12 h 1次,第1~4天)方案进行巩固化学治疗。患者均完成1个疗程及以上标准诱导化学治疗方案。观察所有患者的CR率、微小残留病(MRD)阴性率及总生存期(OS)。结果2组患者的染色体核型及FLT3、CEBPA、NPM1、C-kit等基因突变状态、预后分层比较差异无统计学意义(P>0.05)。CD117-组1个疗程后CR率为77.50%(31/40),CD117+组1个疗程后CR率为76.74%(33/43);2组患者1个疗程后CR率比较差异无统计学意义(χ^(2)=0.007,P>0.05)。CD117-组达CR患者的MRD阴性率为90.30%(28/31),CD117+组达CR患者的MRD阴性率为57.60%(19/33);CD117-组达CR患者的MRD阴性率显著高于CD117+组(χ^(2)=8.797,P<0.01)。CD117-组患者的中位OS为33.09[95%置信区间(CI):28.22~37.97]个月,CD117+组患者的中位OS为20.61(95%CI:17.89~23.33)个月;CD117-组患者的中位OS显著长于CD117+组(P<0.01)。结论CD117与非M3型AML患者的MRD相关,是影响AML患者预后的因素,对指导AML患者的临床治疗具有重要意义。

11例SMARCA4(BRG1)缺失性癌的临床病理分析

目的探讨SMARCA4(BRG1)缺失性癌患者的临床病理特征、免疫表型及诊治要点。方法回顾性分析11例SMARCA4(BRG1)缺失性癌患者的临床资料,总结其HE染色后的形态及免疫组织化学特征,并结合文献进行分析。结果11例患者中男性8例,女性3例;中位年龄60岁。8例行根治性手术切除,3例行传统化疗联合靶向及免疫治疗。镜下肿瘤细胞胞质丰富、红染,呈上皮样、横纹肌样或梭形,具明显的嗜酸性核仁,核分裂象易见(>5/10 HPF),肿瘤组织内见多灶状坏死,脉管内见大量癌栓,可伴间质黏液样变性。11例肿瘤细胞SMARCA4(BRG1)表达缺失,同时表达上皮源性CK和间叶源性Vim标记,SMARCB1(INI1)表达保留,p53突变型,肿瘤细胞呈高增殖活性(Ki-67>60%),突触素Syn呈中等强度阳性。3例为错配修复蛋白缺陷,分别表现为MLH1/PMS2、PMS2、MSH6表达缺失,其中1例经Sanger测序法检测证实为高度微卫星不稳定型。结论SMARCA4(BRG1)缺失性癌发病率低,易与其他肿瘤混淆,术前诊断困难,需依靠免疫组织化学明确诊断。

骨髓多形性套细胞淋巴瘤的临床病理分析

目的 探讨骨髓多形性套细胞淋巴瘤的临床病理特征、免疫表型、诊断及鉴别诊断。方法 对9例多形性套细胞淋巴瘤进行骨髓活检、免疫组化染色、流式免疫表型、骨髓染色体核型分析并与13例经典型套细胞淋巴瘤、26例弥漫大B细胞淋巴瘤进行对比分析并复习相关文献。结果 骨髓多形性套细胞淋巴瘤中有核细胞均过度增生,肿瘤性淋巴细胞累及骨髓的比例均值为80%(70%~90%),呈“弥漫型”浸润模式,肿瘤细胞胞体大、核染色质细致,部分可见核仁,核分裂象小于1个/HPF。免疫表型为:CD20、CD5、CD38、FMC7、CD79b、P53、CyclinD1、SOX11阳性,部分CD71、IgM阳性,Ki-67增殖指数高,CD10、CD23、CD200、LEF1、c-myc、Bcl-6绝大部分阴性。少部分多形性套细胞淋巴瘤可出现复杂核型,而弥漫大B细胞淋巴瘤复杂核型比例高,经典型套细胞淋巴瘤极少出现复杂核型。结论 多形性套细胞淋巴瘤少见,诊断需结合形态、免疫表型及FISH-CCND1综合分析。

以胸腺囊肿为首发症状的胸腺肠型腺癌1例并文献复习

目的探讨胸腺肠型腺癌(TEAC)的临床病理学特征、免疫表型特征、诊断及鉴别诊断。方法回顾性分析2023年4月20日安庆市立医院收治的1例TEAC的临床病理学特征,行免疫组化EnVision两步法进行检测,并复习相关文献。结果病人女性,47岁,因咳嗽10 d,体检发现纵膈占位1 d入院行肿瘤切除术,镜下病变呈多房囊性病变,肿瘤呈多灶性,散在分布囊壁的纤维及脂肪内,组织学表现为管状腺癌及黏液腺癌,主要由柱状上皮、胞质含黏液上皮细胞及潘氏样细胞组成。部分区域可见肿瘤细胞与温和的梭形胸腺上皮过渡移行。免疫表型:肿瘤细胞CDX2、CK7、MUC-2、CD117、SATB2、CEA、CK20均阳性,P53错义突变,CD20、P63阴性,Ki67增殖指数约20%。Masaoka-Koga分期:Ⅰ期;TNM分期:Ⅰ期。结论胸腺肠型腺癌是一种罕见胸腺的原发腺癌,临床症状无特异性,常与胸腺囊肿伴随,具有与结直肠腺癌相同的组织学和免疫组化特征,无特异性分子诊断指标。诊断及鉴别诊断重点是排除转移性恶性肿瘤。病人术后无进展,治疗建议参考其他常见胸腺癌。

胰腺癌免疫基因组学分型、特征及其临床意义研究

目的 通过基因组学建立胰腺癌免疫分型,并进一步探讨其免疫特征和临床意义。方法 癌症基因组图谱数据库下载178例胰腺癌患者的基因表达谱及临床特征数据,通过单样本基因集富集分析(ssGSEA)评分对患者进行分组;采用ESTIMATE及CIBERSORT分别评估各胰腺癌免疫分型样本中免疫微环境及免疫细胞的组成;采用Kaplan-Meier绘制生存曲线并对组间差异进行log-rank检验;GSEA鉴定不同免疫分型GO富集通路。结果 根据基质评分、免疫评分和肿瘤纯度将患者分为高、中、低免疫组,三组间预后具有统计学差异。高免疫组所包含的免疫细胞和基质细胞数量最多,肿瘤纯度最低;HLA、PD-L1(CD274)和CTLA4表达明显增高;浆细胞、活化的CD4^(+)记忆性T细胞、CD8^(+)T细胞以及γδT细胞含量最高,而M0巨噬细胞和M2巨噬细胞最少;总生存率明显低于低免疫组患者;抗免疫活性明显升高。结论 胰腺癌免疫分型有助于判断患者的预后,高免疫组患者具有较高的抗免疫活性和较低的生存率。

ASXL1、TET2阳性急性髓系白血病免疫表型及预后研究

目的探讨ASXL1、TET2阳性急性髓系白血病(AML)患者的免疫表型及临床预后。方法纳入2019年1月1日-2022年5月31日期间于蚌埠医学院第一附属医院就诊的162例初诊AML(M3型除外)患者的临床资料,其中ASXL1和TET2双突变组(ASXL1^(+)TET2^(+)组)患者10例,ASXL1突变组(ASXL1^(+)组,包括双突变组)患者26例,TET2突变组(TET2^(+)组,包括双突变组)患者25例,无ASXL1或TET2突变组(双阴性组)患者121例。通过对4组患者免疫表型及预后进行回顾性分析,比较4组患者的完全缓解(CR)率、中位无进展生存时间(PFS)和中位总生存时间(OS)。结果4组患者在年龄、性别、WBC、RBC、Hb、PLT计数和FAB分型上差异无统计学意义(P>0.05);与双阴性组相比,ASXL1^(+)TET2^(+)组、ASXL1^(+)组和TET2^(+)组异常染色体核型的发生频率更高(P=0.046),且初诊时骨髓原始细胞数低(P=0.037)。ASXL1^(+)组患者CD7、CD33和CD38、CD34抗原表达率低于双阴性组(均P<0.05)。CASXL1^(+)TET2^(+)组、ASXL1^(+)组和TET2^(+)组首次CR率均低于双阴性组,且ASXL1^(+)TET2+组总CR率低于双阴性组(均P<0.05)。双阴性组中位PFS和OS均较ASXL1^(+)TET2^(+)组、ASXL1^(+)组和TET2^(+)组显著延长(均P<0.05),其中ASXL1^(+)TET2^(+)组中位OS较TET2^(+)组明显缩短(P=0.019),较ASXL1^(+)组存在缩短的趋势(P=0.055)。结论ASXL1是一个不良预后的指标,合并TET2突变可能缩短了AML患者的生存时间。