Analysis of the Clinical Value of Immunohistochemical Testing in the Pathological Diagnosis of Breast Cancer

Objective:To investigate the clinical value of immunohistochemistry(IHC)detection in the pathological diagnosis of breast cancer.Methods:Eighty breast cancer patients admitted to Baoding No.1 Central Hospital from June 2022 to June 2023 were selected as study subjects.The samples were divided into a positive group(40 cases)and a negative group(40 cases)according to ER and PR test results.Immunohistochemistry was performed on all patients to compare the differences between the two groups in C-erbB-2 positive expression and axillary lymph node metastasis.Results:The positive expression rate of C-erbB-2 in the positive group(35.00%)was significantly lower than that in the negative group(80.00%),with a highly significant difference(P<0.001).The axillary lymph node metastasis rate in the positive group(40.00%)was significantly lower than that in the negative group(75.00%),with a significant difference(P<0.05).Conclusion:Immunohistochemical detection in breast cancer pathology enhances diagnostic accuracy,predicts prognosis,and supports personalized treatment by identifying ER,PR,and C-erbB-2.It is worth being widely adopted in clinical practice.

Gallbladder carcinosarcoma with a poor prognosis: A case report

BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.

Application of TCT to Research on Value in Screening for Cervical Cancer in Postmenopausal Women

Objective:To study the screening for cervical cancer in postmenopausal women in liquid-based cell test(TCT)application value.Methods:From January 2023 to March 2024 hospital check-ups and outpatient reached 400 cases of postmenopausal women,and they were TCT and HPV detection,during the study period to pathological diagnosis of numerical results as the standard,analysis of TCT detection application of screening for cervical cancer in postmenopausal women and the effect.Results:After the TCT detection,the inflammation group and normal group by use of HPV testing positive rate higher than other groups(P<0.05).Hospital after pathological diagnosis and research,after the screening system found CINⅠlevel and above cases about 39 cases,the TCT and HPV detection rate of positive difference is not obvious,and there is no statistical significance(P>0.05).Joint test analysis,the sensitivity and specificity were higher than that of TCT and HPV testing positive(P<0.05).Conclusion:TCT detection screening for cervical cancer in postmenopausal women is of great importance to the application,if you can join HPV testing,help to improve the detection sensitivity,avoid missed diagnosis of problems,and then for treatment and later restore to lay a solid foundation.

The Value of p63 and CK5/6 Expression in the Differential Diagnosis of Ductal Lesions of Breast

Summary： In order to explore the value of p63, smooth muscle actin （u-SMA） and cytokeratin 5/6 （CK5/6） in the differential diagnosis of ductal lesions of breast, 88 tissue specimens of ductal lesions of breast were collected and examined histologically by HE staining. By using immunohistochemistry, the expression of p63, α-SMA and CK5/6 was detected. The results showed that in 38 cases of benign breast lesions, the proliferating cells were all positive for p63 and α-SMA. In 19 cases of ductal carcinoma in situ （DCIS） and 7 cases of intraductal papillary carcinoma, α-SMA positive cells formed a layer of continuous embroider-shaped structure and the p63 positive cells formed a layer of evenly separated embroider-shaped structure around the ducts. There was no cross-reaction between p63 and interstitial myofibroblasts and vascular smooth muscle cells. In 38 cases of benign breast lesions, the positive rate of CK5/6 expression was 100 %. In 5 cases of atypical ductal hyperplasia, there were few positive cells in the ducts. In 19 cases of CDIS, no tumor cells expressed CK5/6. In 19 cases of invasive ductal carcinoma, almost no CK5/6 was detectable. It was suggested that p63 could serve as a novel specific marker for the identification of breast myoepithelial cells. CK5/6 is of value in differentiating ductal proliferation of varying degrees, especially in the differentiation between cancerous and non-cancerous changes. Simultaneous detection of p63, CK5/6 and α-SMA can help increase the diagnostic accuracy of breast diseases.

Application of SOAT1 combined with multiple markers in the auxiliary diagnosis of hepatocellular carcinoma

Objective:To explore the expression of sterol oxygen-acyltransferase 1(SOAT1)in hepatocellular carcinoma tissues and to evaluate the application value of its combination with various markers(HSP70,GS,CD10,CD34)in the diagnosis of hepatocellular carcinoma.Methods:Totally 58 cases of liver cancer tissue and its corresponding adjacent tissue,and 12 cases of benign liver lesions tissue were collected,and tissue chips were made to detect the expressions of SOAT1,HSP70,GS,CD10 and CD34(immunohistochemical staining method)which were analyzed by scientific method.Results:The expression of SOAT1 was up-regulated in hepatocellular carcinoma tissues,and the difference was statistically significant(P<0.01),and the expression level was closely related to the differentiation degree of hepatocellular carcinoma patients(P<0.05).SOAT1 was correlated with the expression of HSP70,GS,and CD34,with statistical significance(P<0.01).Positive percent agreement for the hepatocellular carcinoma was 100.00% for CD34,89.66% for GS,82.75% for HSP70,63.79% for CD10,and 63.79% for SOAT1;negative percent agreement(paracancerous tissues)was 100% for SOAT1,98.27 %for CD10,96.55% for HSP70,34.48% for CD34,and 5.17% for GS;Negative percent agreement(benign tissues)was 100%for SOAT1,83.34% for CD10,100.00% for HSP70,8.33% for CD34,and 0% for GS,respectively.Taking the positive expression of any three markers as the diagnostic criteria,39 of the 58 cases of hepatocellular carcinoma could be diagnosed,and the diagnostic rate was 67.24%(SOAT1 was not included in the list of markers).If SOAT1 is included,48 of the 58 hepatocellular carcinoma cases could be diagnosed,and the diagnosis rate could be increased to 82.76%.Conclusions:The expression level of SOAT1 was significantly up-regulated in hepatocellular carcinoma,and the expression level was higher in poorly differentiated HCC,suggesting that SOAT1 can be used as one of the indicators for the diagnosis and prognosis of hepatocellular carcinoma.Among the five markers above,CD34 and GS were more sensitive,while the specificity is better for SOAT1,CD10 and HSP70.The combined application of SOAT1 with HSP70,GS,CD10 and CD34 has certain application value in the diagnosis of hepatocellular carcinoma.

Progress in the Pathologic Diagnosis of Borderline Follicular Thyroid Tumor

With the progress of science and technology as well as the development of ultrasound technology,more and more thyroid tumors have been found.Follicular tumor is one of the most common thyroid tumors,but borderline follicular tumors are relatively rare.At present,the diagnosis of borderline follicular thyroid tumor is unclear prior to surgery,and it is difficult to identify in frozen section or even conventional section.In order to effectively improve the diagnostic sensitivity and specificity of borderline follicular thyroid tumor,this paper summarizes the new WHO(World Health Organization)classification of borderline follicular thyroid tumor along with diagnostic methods,including clinical fine needle aspiration cytology,histopathology,and molecular biology,and reviews the research progress.

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single tumor.The fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for cHCC-CCA.However,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement pattern.Histopathological examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate diagnosis.Currently,there is no standard treatment for cHCC-CCA,and surgery is the mainstay.Anatomic hepatectomy with lymphadenectomy is among the recommended surgical procedures.The role of liver transplantation in the management of cHCC-CCA is still uncertain.Transarterial chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular tumors.However,the available evidence does not support systemic therapy for advanced cHCC-CCA.The prognosis of cHCC-CCA is generally poor,and there is no established staging system.Further research is needed to better understand the histogenesis and clinical management of cHCC-CCA.This review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

Examining the Pathological Diagnostic Impact of Frozen Sections in Breast Cancer

Objective:To analyze the diagnostic value of frozen section pathology in the diagnosis of breast cancer.Methods:A total of 50 patients with breast tumors treated between July 2021 and February 2023 were randomly selected as samples.Both paraffin section and frozen section diagnoses were conducted.The paraffin section results served as the gold standard for evaluating the value of frozen section examination.Results:Among the frozen section diagnoses,48 cases(96.00%)were confirmed,1 case was misdiagnosed(2.00%),and 1 case was delayed(2.00%).Among the confirmed patients,45 cases(90.00%)were entirely consistent,and 3 cases(6.00%)were basically consistent.The diagnostic rate of the frozen section was 96.00%,compared with 100.00%for the paraffin section(P>0.05).The diagnostic time of the frozen section(35.25±2.11 min)was significantly shorter than that for the paraffin section(6911.36±58.36 min;P<0.05).Conclusion:Frozen section diagnosis is rapid and demonstrates relatively high diagnostic accuracy.It can guide doctors in determining whether to pursue breast-conserving treatment and aid in selecting appropriate surgical methods.This is beneficial for preventing unnecessary medical interventions and reducing the need for secondary surgeries in breast cancer patients.

Artificial intelligence technique in detection of early esophageal cancer

Due to the rapid progression and poor prognosis of esophageal cancer(EC),the early detection and diagnosis of early EC are of great value for the prognosis improvement of patients.However,the endoscopic detection of early EC,especially Barrett's dysplasia or squamous epithelial dysplasia,is difficult.Therefore,the requirement for more efficient methods of detection and characterization of early EC has led to intensive research in the field of artificial intelligence(AI).Deep learning(DL)has brought about breakthroughs in processing images,videos,and other aspects,whereas convolutional neural networks(CNNs)have shone lights on detection of endoscopic images and videos.Many studies on CNNs in endoscopic analysis of early EC demonstrate excellent performance including sensitivity and specificity and progress gradually from in vitro image analysis for classification to real-time detection of early esophageal neoplasia.When AI technique comes to the pathological diagnosis,borderline lesions that are difficult to determine may become easier than before.In gene diagnosis,due to the lack of tissue specificity of gene diagnostic markers,they can only be used as supplementary measures at present.In predicting the risk of cancer,there is still a lack of prospective clinical research to confirm the accuracy of the risk stratification model.

Focal nodular hyperplasia of the liver: pathological analysis of 11 cases

BACKGROUND: Focal nodular hyperplasia (FNH) is a benign tumor-like lesion of the liver, predominantly affect- ing women. Its etiology is obscure and its pathogenesis is poorly understood. FNH should be differentiated from oth- er benign and malignant hepatic lesions. The aim of this study was to explore the pathological characteristics of FNH of the liver. METHODS: Eleven patients with FNH were studied retro- spectively by using hematoxylin and eosin, immunohisto- chemical and histochemical staining. RESULTS: In 8 female and 3 male FNH patients aged 19 to 54 years (mean 32), most of lesions showed central scars macroscopically. Microscopically 8 patients were found of classical type, 2 were of telangiectic type, and 1 was of mixed type. CONCLUSION: FNH is an uncommon benign hyperplastic lesion of the liver. It should be differentiated from hepato- cellular adenoma, alpha-fetoprotein negative hepatocellular carcinoma, and fibrolamellar carcinoma.

Clinicopathologic Observation of 6 Cases with Neuroendocrine Carcinoma of the Urinary Bladder

OBJECTIVE To discuss the pathologic characteristics and theprognosis of neuroendocrine carcinoma of the bladder(NECB)in order to assist in making a precise diagnosis and to effectivelytreat the disease.METHODS Clinicopathologic features of the 6 cases with NECBwere analyzed retrospectively.The personal data of the patientsand the pathologic and immunohistochemical characteristics ofthe tumor were investigated.The follow-up of these patients wasconducted over a time period ranging from 3 months to 9 years.RESULTS Transurethral resection of the bladder tumorwas performed in all 6 patients.Based on the results of thepathologic examination,4 of the cases were diagnosed as smallcell neuroendocrine carcinoma and the other 2 were diagnosedas atypical carcinoid tumor.On immunohistochemical stainingall tumors expressed neuroendocrine markers includingneuronspecific enolase(CD56),synaptophysin(Syn)andchromogranin(CgA).In patients receiving partial cystectomyfollowed by postoperative chemotherapy,relapse was found in 4of the 6 cases on follow up.CONCLUSION NECB is a rare entity and a tumor with highmalignant potential and characteristic pathologic features.Hematuria is the cardinal symptom of NECB.Metastasis mayoccur at an early stage and the prognosis of the disease is poor.Final diagnosis of NECB depends on histopathologic examinationand immunohistochemical assays.Surgical excision combinedwith radiotherapy and chemotherapy is considered an effectivetreatment.

Solitary splenic tuberculosis:A case report

BACKGROUND Solitary splenic tuberculosis(TB) is unusual and rarely reported.Whether splenic TB is best treated surgically is still controversial.We describe a 73-year-old man with solitary splenic TB and no extrapulmonary TB.CASE SUMMARY We report the case of a 73-year-old man with solitary splenic TB who complained of emaciation and fatigue.Abdominal computed tomography(CT) images suggested a splenic space-occupying lesion.We then performed a CT-guided splenic biopsy.The postoperative pathological examination revealed splenic TB.The patient took quadruple anti-TB medication.After 1 year,the patient recovered his normal weight and had no feeling of fatigue,and the splenic lesion had shrunk significantly.CONCLUSION If patients receive combined,appropriate,regular,full-time anti-TB treatment,solitary splenic TB may be cured.

Multimodal therapy in the management of primary orbital mesenchymal chondrosarcoma

AIM:To evaluate the ophthalmic manifestations,radiographic features,and prognosis of Chinese patients with primary orbital mesenchymal chondrosarcoma(MCS).METHODS:The study included 6 cases with primary orbital MCS treated at Tianjin Eye Hospital from January 2009 to December 2019.Patitent ophthalmic manifestations,radiographic features,diagnosis,pathology,therapeutic regimens,and prognosis were retrospectively reviewed.RESULTS:Six patitents with primary orbital MCS were identified.The mean age at the first visit was 33y(range,25-42y).All six patients displayed manifestations of exophthalmos,diplopia,limitation of eye displacement,upper eyelid oedema,decreased visual acuity and ptosis.The mean disease history and range were 5 and 2-8mo,respectively.The tumors were located in the superonasal extraconal compartment(2/6,33.3%),intraconal compartment(2/6,33.3%),and bitemporal extraconal compartment(2/6,33.3%),respectively.Radiographic features were a well-defined,orbital mass with calcification and ossification on computed tomography(CT),and marked heterogenous enhancement on dynamic magnetic resonance imaging(MRI).Five patients were treated with tumor resection and one patient received orbital exenteration.Five patients in the cohort received postoperative radiation therapy,two patients received chemotherapy,and one patient did not receive postoperative adjuvant therapy because he refused.The histopathologic classification revealed a tumour composed of a mixture of mature chondroid tissue surrounded by small,round,and undifferentiated mesenchymal cells.Immunohistochemistry revealed Bcl-2,vimetin,CD99,and S-100 were expressed were expressed.After surgeries,two patients have developed a local recurrence.The median recurrence time of 58 mo(52-64 mo).One patient had distant recurrence included the lungs occurred 52mo after the initial surgery.CONCLUSION:The possibilty of orbital MCS need to be considered when a painless,slowly growing orbital mass with calcification and ossification.From our experience,trimodality treatment of radiation therapy,chemotherapy and surgery maybe the best option.Orbital MCS has a high tendency for late recurrence,regular long-term follow-up after complete excision is mandatory.

Subcutaneous angiolipoma in the scrotum: A case report

BACKGROUND Angiolipoma has been reported in many cases,and it often occurs in the skin of the trunk and limbs.However,angiolipoma in the scrotum is a rare disease with unknown etiology.This condition is difficult to diagnosis with other lumps in the scrotum.CASE SUMMARY A 32-year-old man presented to the urinary department with a history of an enlarged left scrotum with increasing discomfort for about 5 years.Physical examination revealed that there were a palpable mass measuring about 7.0 cm×6.5 cm in the left scrotum,with smooth surfaces but without tenderness or adhesion to the skin.Ultrasound showed that there was a hyperechoic mass under the skin of the top scrotum,about 72 mm×64 mm×21 mm in size,with clear borders,uneven internal echo,and abundant blood flow signals.Serum human chorionic gonadotropin and alpha-fetoprotein were in normal level.Subcutaneous mass resection at the bottom of the left scrotum was performed under local anesthesia with 1%lidocaine.Postoperative pathological examination resulted in a diagnosis of subcutaneous angiolipoma of the scrotum.No evidence of recurrence was found at 6 mo after surgery and there were no complaints of discomfort.CONCLUSION Angiolipoma is an extremely rare type of benign tumor extremely rarely found in the scrotum,but needs to be considered when evaluating scrotal masses especially when the mass is solid.According to the characteristics of angiolipoma,surgical resection is the best treatment strategy and it is not prone to recurrence after resection.

Rectal tubular adenoma with submucosal pseudoinvasion misdiagnosed as adenocarcinoma:A case report

BACKGROUND Differential diagnosis of colorectal intramucosal tumors from invasive adenocarcinoma is important in clinical practice due to the different risks of lymph node metastasis and different treatment options.The phenomenon of a colorectal adenoma with part of the gland entering the submucosa is known as pseudoinvasion of the adenoma,which is a major challenge for pathological diagnosis.It is essential to raise awareness of colorectal adenoma with submucosal pseudoinvasion clinically to avoid overtreatment.CASE SUMMARY We describe a case of rectal adenoma with submucosal pseudoinvasion in a 48-year-old man.The patient was admitted to Jinhua People's Hospital due to a change in stool habit for 5 d.We performed colonoscopy,and the results suggested a submucosal bulge approximately 1.0 cm×1.0 cm in size in the rectum 8 cm from the anal verge,with red surface erosion.Ultrasound colonoscopy was also performed and a homogeneous hypoechoic mass about 0.52 cm×0.72 cm in size was seen at the lesion,protruding into the lumen with clear borders and invading the submucosa.Endoscopic surgery was then performed and the pathological specimen showed a tubular adenoma with high-grade intraepithelial neoplasia(intramucosal carcinoma)involving the adenolymphatic complex.In addition,we performed a literature review of rectal tubular adenoma with submucosal pseudoinvasion to obtain a deeper understanding of this disease.CONCLUSION The aim of this study was to improve awareness of this lesion for clinicians and pathologists to reduce misdiagnosis.

A rare case of giant panda cancer:Pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant cancer of the digestive system common among humans.However,it is rarely reported in wild animals.In 2018,a giant panda died in the Beijing Zoo.During subsequent histological observation of the pancreas,it was discovered that the glandular epithelial cells had lost the pancreatic acinar structure,tubular areas with obvious structure in the pancreas,and the ductal epithelium was substituted by high columnar mucus cells.Masson staining showed that there were several fibrous tissue proliferative reactions around the ductal adenocarcinoma and immunohistochemical staining revealed that CK7 and CK19 were positively expressed in the pancreatic tissue.Therefore,the pathological diagnosis indicated that the panda had PDAC.In this paper,the panda’s living conditions and pathological diagnosis results are examined,with the aim of providing a reference point for the future diagnosis of wild animal tumors.

A Case of Ewing’s Sarcoma Arising in the Cervical Spine with an Elevation of Serum ProGRP

We experienced a case of small, round-cell malignant neoplasm diagnosed by touch smear cytology and histopathology when an open biopsy was performed in a 50-year-old Japanese woman. She was suspected of having a cervical spine tumor after surgery for cervical spine foraminal stenosis. After consent, the cervical spine tumor histologically diagnosed by an open biopsy was confirmed to be Ewing sarcoma (EWS) by genetic testing. EWS belongs to a group of small, round-cell tumors that are morphologically similar and often difficult to differentiate. After the open biopsy, the present patient received radiotherapy, and her plasma level of Pro-Gastrin-Releasing-Peptide was decreased (217.2 pg/ml before surgery to 30.3 pg/ml;reference value: 0 - 80 pg/ml). We herein report the process for making the final diagnosis by focusing on the intraoperative cytology, histopathology, and immunohistochemical findings. Our diagnosis was validated by karyotyping and a fluorescence in-situ hybridization analysis.

Smartphone-based rapid and visual pathological diagnosis of glioma using perovskite probes

Histopathology plays a great role in diagnosing various diseases,which is considered as a golden standard for tumor identification.The tissue constituents must be stained by visible labels for microscopic analysis by medical experts.However,this process is time-consuming,labor-intensive,and expensive,which requires rapid pathological approaches for diagnosis in the operating room.Here,we present an easy-to-process and high-performance perovskite biological probes for rapid and visual pathological diagnosis of glioma.Perovskite quantum dots can be encapsulated by the copolymer into nanocrystals(PNCs)with a diameter of 100 nm,which is modified with chlorotoxin to achieve the specific recognition of glioma.Benefiting from the super photoluminescence quantum yield(above 93%)of EVA@PNCs aqueous solution,the glioma can be clearly imaged and captured via a smartphone under the excitation of a handheld UV lamp.To demonstrate the visualization and efficiency of PNC probes,different malignant grades of brain tumor sections can be distinguished in no more than 5 min.This strategy provides a general auxiliary diagnosis platform for achieving the histopathology analysis near the operating bed,which is currently not feasible with standard histochemical staining methods.

Visual recognition of cardiac pathology based on 3D parametric model reconstruction

Visual recognition of cardiac images is important for cardiac pathology diagnosis and treatment.Due to the limited availability of annotated datasets,traditional methods usually extract features directly from twodimensional slices of three-dimensional(3D)heart images,followed by pathological classification.This process may not ensure the overall anatomical consistency in 3D heart.A new method for classification of cardiac pathology is therefore proposed based on 3D parametric model reconstruction.First,3D heart models are reconstructed based on multiple 3D volumes of cardiac imaging data at the end-systole(ES)and end-diastole(ED)phases.Next,based on these reconstructed 3D hearts,3D parametric models are constructed through the statistical shape model(SSM),and then the heart data are augmented via the variation in shape parameters of one 3D parametric model with visual knowledge constraints.Finally,shape and motion features of 3D heart models across two phases are extracted to classify cardiac pathology.Comprehensive experiments on the automated cardiac diagnosis challenge(ACDC)dataset of the Statistical Atlases and Computational Modelling of the Heart(STACOM)workshop confirm the superior performance and efficiency of this proposed approach.