AIM:To investigate differential points of solid-pseudo-papillary neoplasm (SPN) of the pancreas and pancre-atic endocrine tumor (PET).METHODS:Ten cases of SPN and fourteen cases of PET were studied in this retrospecti...AIM:To investigate differential points of solid-pseudo-papillary neoplasm (SPN) of the pancreas and pancre-atic endocrine tumor (PET).METHODS:Ten cases of SPN and fourteen cases of PET were studied in this retrospective study. Clinical and pathologic features,immunostaining reactions and β-catenin gene mutations were analyzed.RESULTS:The mean age of SPN patients was 25.6 years and these patients had no specific symptoms. The mean diameter of the tumors was 11.0 cm,9/10 cases were cystic or a mixture of solid and cystic structures,and there was hemorrhage and necrosis on the cut surface in 8/10 (80%) cases. Characteristic pseudo-papillary structure and discohesive appearance of the neoplastic cells were observed in all 10 (100%) cases. The results of immunostaining showed that nuclear expression of β-catenin and loss of E-cadherin in all the cases,was only seen in SPN. Molecular studies discov-ered that 9/10 (90%) cases harbored a point mutation of exon 3 in β-catenin gene. On the other hand,the mean age of PET patients was 43.1 years. Eight of 14 cases presented with symptoms caused by hypoglyce-mia,and the other 6 cases presented with symptoms similar to those of SPN. The mean size of the tumors was 2.9 cm,most of the tumors were solid,only 3/14 (21%) were a mixture of solid and cystic structures,and macroscopic hemorrhage and necrosis were much less common (3/14,21%). Histologically,tumor cells were arranged in trabecular,acinar or solid patterns and demonstrated no pseudopapillary structure and discohesive appearance in all 14 (100%) cases. The results of immunostaining and mutation detection were completely different with SPN that membrane and cytoplastic expression of β-catenin without loss of E-cadherin,as well as no mutation in β-catenin gene in all the cases. CONCLUSION:Both macroscopic and microscopic features of SPN are quite characteristic. It is not difficult to distinguish it from PET. If necessary,immunos-taining of β-catenin and E-cadherin is quite helpful to make the differential diagnosis.展开更多
目的明确人附睾蛋白4(human epididymis protein 4,HE4)在慢性肾脏疾病不同分期患者中的表达水平,探讨其诊断价值。方法选择2018年1月—2022年9月溧阳市人民医院收治的100例慢性肾脏疾病患者作为观察组,选择同期在本院进行体检的100名...目的明确人附睾蛋白4(human epididymis protein 4,HE4)在慢性肾脏疾病不同分期患者中的表达水平,探讨其诊断价值。方法选择2018年1月—2022年9月溧阳市人民医院收治的100例慢性肾脏疾病患者作为观察组,选择同期在本院进行体检的100名健康志愿者作为对照组。利用脲酶法、酶法、胶乳增强免疫比浊法及化学发光微粒子免疫分析法检测血清中尿素氮(BUN)、肌酐(Crea)、胱抑素C(Cys C)、β_(2)微球蛋白(β_(2)-MG)及HE4的含量。对比不同分期慢性肾脏疾病患者与健康体检者之间各项指标的表达差异,并利用受试者工作特征曲线(ROC)评估其诊断价值。结果随着分期的增加,观察组各项指标呈升高趋势,HE4在CKD1期患者血清中的表达与对照组对比,差异有统计学意义(P<0.05);3期、4期、5期的CKD患者与1期患者HE4表达水平相比,差异有统计学意义(P<0.05)。ROC曲线显示HE4对应的曲线下面积最大(AUC=0.920),诊断灵敏度和特异性分别达87.0%和90.0%。结论可通过检测血清HE4辅助慢性肾脏疾病的早期诊断,同时可一定程度反映疾病的进展。展开更多
基金Supported by Department of Pathology, Xiangya Basic Medical School, Central-south University
文摘AIM:To investigate differential points of solid-pseudo-papillary neoplasm (SPN) of the pancreas and pancre-atic endocrine tumor (PET).METHODS:Ten cases of SPN and fourteen cases of PET were studied in this retrospective study. Clinical and pathologic features,immunostaining reactions and β-catenin gene mutations were analyzed.RESULTS:The mean age of SPN patients was 25.6 years and these patients had no specific symptoms. The mean diameter of the tumors was 11.0 cm,9/10 cases were cystic or a mixture of solid and cystic structures,and there was hemorrhage and necrosis on the cut surface in 8/10 (80%) cases. Characteristic pseudo-papillary structure and discohesive appearance of the neoplastic cells were observed in all 10 (100%) cases. The results of immunostaining showed that nuclear expression of β-catenin and loss of E-cadherin in all the cases,was only seen in SPN. Molecular studies discov-ered that 9/10 (90%) cases harbored a point mutation of exon 3 in β-catenin gene. On the other hand,the mean age of PET patients was 43.1 years. Eight of 14 cases presented with symptoms caused by hypoglyce-mia,and the other 6 cases presented with symptoms similar to those of SPN. The mean size of the tumors was 2.9 cm,most of the tumors were solid,only 3/14 (21%) were a mixture of solid and cystic structures,and macroscopic hemorrhage and necrosis were much less common (3/14,21%). Histologically,tumor cells were arranged in trabecular,acinar or solid patterns and demonstrated no pseudopapillary structure and discohesive appearance in all 14 (100%) cases. The results of immunostaining and mutation detection were completely different with SPN that membrane and cytoplastic expression of β-catenin without loss of E-cadherin,as well as no mutation in β-catenin gene in all the cases. CONCLUSION:Both macroscopic and microscopic features of SPN are quite characteristic. It is not difficult to distinguish it from PET. If necessary,immunos-taining of β-catenin and E-cadherin is quite helpful to make the differential diagnosis.
文摘目的明确人附睾蛋白4(human epididymis protein 4,HE4)在慢性肾脏疾病不同分期患者中的表达水平,探讨其诊断价值。方法选择2018年1月—2022年9月溧阳市人民医院收治的100例慢性肾脏疾病患者作为观察组,选择同期在本院进行体检的100名健康志愿者作为对照组。利用脲酶法、酶法、胶乳增强免疫比浊法及化学发光微粒子免疫分析法检测血清中尿素氮(BUN)、肌酐(Crea)、胱抑素C(Cys C)、β_(2)微球蛋白(β_(2)-MG)及HE4的含量。对比不同分期慢性肾脏疾病患者与健康体检者之间各项指标的表达差异,并利用受试者工作特征曲线(ROC)评估其诊断价值。结果随着分期的增加,观察组各项指标呈升高趋势,HE4在CKD1期患者血清中的表达与对照组对比,差异有统计学意义(P<0.05);3期、4期、5期的CKD患者与1期患者HE4表达水平相比,差异有统计学意义(P<0.05)。ROC曲线显示HE4对应的曲线下面积最大(AUC=0.920),诊断灵敏度和特异性分别达87.0%和90.0%。结论可通过检测血清HE4辅助慢性肾脏疾病的早期诊断,同时可一定程度反映疾病的进展。
