Management of retroperitoneal high-grade serous carcinoma of unknown origin:A case report

BACKGROUND Retroperitoneal high-grade serous carcinoma(HGSC)of unknown origin is a sporadic tumor that can originate from ovarian cancer.Herein,we report the case of a woman with retroperitoneal HGSC of unknown origin and describe how she was diagnosed and treated.CASE SUMMARY A 71-year-old female presented with the tumor marker CA125 elevated to 1041.9 U/mL upon a regular health examination.Computed tomography revealed retroperitoneal lymph node enlargement.Subsequently,positron emission tomography scanning revealed lesions with increased F-18 fluorodeoxyglucose uptake at the nodes.As a result,she underwent laparoscopic lymph node resection,and pathology revealed metastatic adenocarcinoma with CK7(+),PAX8(+),WT1(+),PR(-),and p53 mutational loss of expression,indicating that the origin may be from the adnexa.The patient was admitted to our ward and underwent laparoscopic staging;however,the pathological results were negative.Under the suspicion of retroperitoneal HGSC of unknown origin,chemotherapy and targeted therapy were initiated.Tumor marker levels decreased after treatment.CONCLUSION We present a case of HGSC of unknown origin managed using retroperitoneal lymphadenectomy,staging surgery,chemotherapy,and targeted therapy.

High-grade serous carcinoma of the fallopian tube in a young woman with chromosomal 4q abnormality:A case report

BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young woman.CASE SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 deletion.Upon arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting dullness.Ascites were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral adnexa.Blood tests showed elevated CA-125 levels.Paracentesis was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian cancer.The patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian tube.Subsequently,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current condition.CONCLUSION This study demonstrates a rare correlation between a chromosome 4q abnormality and HGSC.UBE2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer development.In addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.

Rescue of p53 functions by in vitro-transcribed mRNA impedes the growth of high-grade serous ovarian cancer

Background:The cellular tumor protein p53(TP53)is a tumor suppressor gene that is frequently mutated in human cancers.Among various cancer types,the very aggressive high-grade serous ovarian carcinoma(HGSOC)exhibits the high-est prevalence of TP53 mutations,present in>96%of cases.Despite intensive efforts to reactivate p53,no clinical drug has been approved to rescue p53 func-tion.In this study,our primary objective was to administer in vitro-transcribed(IVT)wild-type(WT)p53-mRNA to HGSOC cell lines,primary cells,and ortho-topic mouse models,with the aim of exploring its impact on inhibiting tumor growth and dissemination,both in vitro and in vivo.Methods:To restore the activity of p53,WT p53 was exogenously expressed in HGSOC cell lines using a mammalian vector system.Moreover,IVT WT p53 mRNA was delivered into different HGSOC model systems(primary cells and patient-derived organoids)using liposomes and studied for proliferation,cell cycle progression,apoptosis,colony formation,and chromosomal instabil-ity.Transcriptomic alterations induced by p53 mRNA were analyzed using RNA sequencing in OVCAR-8 and primary HGSOC cells,followed by ingenuity path-way analysis.In vivo effects on tumor growth and metastasis were studied using orthotopic xenografts and metastatic intraperitoneal mouse models.Results:Reactivation of the TP53 tumor suppressor gene was explored in differ-ent HGSOC model systems using newly designed IVT mRNA-based methods.The introduction of WT p53 mRNA triggered dose-dependent apoptosis,cell cycle arrest,and potent long-lasting inhibition of HGSOC cell proliferation.Transcriptome analysis of OVCAR-8 cells upon mRNA-based p53 reactivation revealed significant alterations in gene expression related to p53 signaling,such as apoptosis,cell cycle regulation,and DNA damage.Restoring p53 function concurrently reduces chromosomal instability within the HGSOC cells,under-scoring its crucial contribution in safeguarding genomic integrity by moderating the baseline occurrence of double-strand breaks arising from replication stress.Furthermore,in various mouse models,treatment with p53 mRNA reduced tumor growth and inhibited tumor cell dissemination in the peritoneal cavity in a dose-dependent manner.Conclusions:The IVT mRNA-based reactivation of p53 holds promise as a potential therapeutic strategy for HGSOC,providing valuable insights into the molecular mechanisms underlying p53 function and its relevance in ovarian cancer treatment.

Characterization of candidate factors associated with the metastasis and progression of high-grade serous ovarian cancer

Background:High-grade serous ovarian cancer(HGSOC)is the biggest cause of gynecological cancer-related mortality because of its extremely metastatic nature.This study aimed to explore and evaluate the characteristics of candidate factors associated with the metastasis and progression of HGSOC.Methods:Transcriptomic data of HGSOC patients’samples collected from primary tumors and matched omental metastatic tumors were obtained from three independent studies in the National Center for Biotechnology Information(NCBI)Gene Expression Omnibus(GEO)database.Differentially expressed genes(DEGs)were selected to evaluate the effects on the prognosis and progression of ovarian cancer using data from The Cancer Genome Atlas(TCGA)database.Hub genes’immune landscapes were estimated by the Tumor Immune Estimation Resource(TIMER)database.Finally,using 25 HGSOC patients'cancer tissues and 10 normal fallopian tube tissues,immunohistochemistry(IHC)was performed to quantify the expression levels of hub genes associated with International Federation of Gynecology and Obstetrics(FIGO)stages.Results:Fourteen DEGs,ADIPOQ,ALPK2,BARX1,CD37,CNR2,COL5A3,FABP4,FAP,GPR68,ITGBL1,MOXD1,PODNL1,SFRP2,and TRAF3IP3,were upregulated in metastatic tumors in every database while CADPS,GATA4,STAR,and TSPAN8 were downregulated.ALPK2,FAP,SFRP2,GATA4,STAR,and TSPAN8 were selected as hub genes significantly associated with survival and recurrence.All hub genes were correlated with tumor microenvironment infiltration,especially cancer-associated fibroblasts and natural killer(NK)cells.Furthermore,the expression of FAP and SFRP2 was positively correlated with the International Federation of Gynecology and Obstetrics(FIGO)stage,and their increased protein expression levels in metastatic samples compared with primary tumor samples and normal tissues were confirmed by IHC(P=0.0002 and P=0.0001,respectively).Conclusions:This study describes screening for DEGs in HGSOC primary tumors and matched metastasis tumors using integrated bioinformatics analyses.We identified six hub genes that were correlated with the progression of HGSOC,particularly FAP and SFRP2,which might provide effective targets to predict prognosis and provide novel insights into individual therapeutic strategies for HGSOC.

Early detection of pancreatic cancer

The diagnosis of pancreatic cancer associates an appalling significance.Detection of preinvasive stage of pancreatic cancer will ameliorate the survival of this deadly disease.Premalignant lesions such as Intraductal Papillary Mucinous Neoplasms or Mucinous Cystic Neoplasms of the pancreas are detectable on imaging exams and this permits their management prior their invasive development.Pancreatic intraepithelial neoplasms(PanIN)are the most frequent precursors of pancreatic adenocarcinoma(PDAC),and its particular type PanIN high-grade represents the malignant non-invasive form of PDAC.Unfortunately,PanINs are not detectable on radiologic exams.Nevertheless,they can associate indirect imaging signs which would rise the diagnostic suspicion.When this suspicion is established,the patient will be enrolled in a follow-up strategy that includes performing of blood test and serial imaging test such as computed tomography or magnetic resonance imaging,which will cost in the best-case scenario a burden of healthcare systems,and potential mortality in the worst-case scenario when the patient underwent resection surgery,worthless when there is no moderate or high grade dysplasia in the final histopathology.This issue will be avoid having at its disposal a diagnostic technique capable of detecting high-grade PanIN lesions,such is the cytology of pancreatic juice obtained by nasopancreatic intubation.Herein,we review the possibility of detection of early malignant lesions before they become invasive PADC.

血清淀粉酶、CA19-9、CA12-5及HE4联合检测在卵巢浆液性腺癌中的价值评价

目的探讨血清淀粉酶、CA19-9、人附睾蛋白(HE)4、CA12-5联合检测在卵巢浆液性腺癌中的价值。方法选取2020年11月—2021年10月本院收治的49例卵巢浆液性腺癌患者为病例组,52例卵巢良性疾病患者为良性病变组,63例同期接受健康体检的女性为健康组,均接受血清淀粉酶、CA19-9、CA12-5及HE4检查。分析上述肿瘤标志物单独或联合检测对卵巢浆液性腺癌的诊断价值。结果病例组CA12-5、HE4、血清淀粉酶、CA19-9水平高于良性病变组和健康组,组间对比差异有统计学意义(P<0.05);病例组CA12-5、HE4、CA19-9、血清淀粉酶阳性率高于良性病变组和健康组,组间对比差异有统计学意义(P<0.05);HE4、CA12-5、血清淀粉酶、CA19-9联合检测诊断符合率、敏感度、特异度均高于单独检测,组间对比差异有统计学意义(P<0.05)。结论血清淀粉酶、CA19-9、CA12-5及HE4均在卵巢浆液性腺癌中表达,且联合检测诊断价值较单独检测更高。

免疫细胞化学在浆膜腔积液病理检测中的应用价值探析

目的 探讨免疫细胞化学(immunocytochemistry,ICC)应用在浆膜腔积液病理检测中的临床价值,为判断浆膜腔积液性质及临床诊断与治疗提供参考依据。方法 收集139例浆膜腔积液标本,分别予以常规细胞涂片检测与免疫细胞化学检测CEA、E-Cad、Villin、Pax-8、TTF-1、CDX2、D2-40,详细记录两种方法的检验结果,对比两种方法浆膜腔积液恶性细胞的检出情况。结果 免疫细胞化学恶性细胞检出率明显高于常规细胞涂片检测,差异有统计学意义(P<0.05);免疫细胞化学CEA、E-Cad恶性细胞高表达,Villin、Pax-8、TTF-1、CDX2提示恶性细胞消化道、卵巢、肺等来源,D2-40间皮细胞高表达,且各项肿瘤标志物联合检测的价值较单独检测价值高(P<0.05)。结论 在浆膜腔积液病理检测过程中,积极实施免疫细胞化学检测具有非常显著的价值,相较常规细胞涂片检测,免疫细胞化学检测恶性细胞检出率更高,且能够确定恶性细胞类型,提示恶性细胞来源。帮助判断疾病预后,免疫细胞化学提升了细胞学标本的价值,更解决了浆膜腔积液病理诊断的疑难,值得临床推广与应用。

影像学上为实性肿块的附件高级别浆液性腺癌1例

患者,女性,43岁,因“无明显诱因出现阴道流液2月,下腹阵发性胀痛7天”就诊。患者既往体健。专科检查:左、右侧附件区分别触及一类圆形肿块,直径分别约7cm、10cm,边缘尚清,质硬,触之不活动。实验室检查:肿瘤标记物CA125:326.40kU/L(正常值:0 kU/L-35 kU/L),CA153:259.8kU/L(正常值:≤25kU/L),CA724:40.96kU/L(正常值:0 kU/L-6.9kU/L),HE4:282.5kU/L(正常值:0 kU/L-105.1kU/L),PRE-ROMA:85.75%(正常值:≤11.65%)。

Junctional adhesion molecule-A(JAM-A)in gynecological cancers:Current state of knowledge

Junctional adhesion molecule-A(JAM-A),also known as the F11 receptor(F11R),is one of the tight junction components.JAM-A is a transmembrane glycoprotein that regulates many cellular processes,i.e.,angiogenesis,leukocyte transendothelial migration,intercellular permeability,epithelial-to-mesenchymal transition,and platelet activation.Of note,it is involved in the pathogenesis of various cancer types,including gynecological cancers.Only a few studies are available about this cancer type.Observed aberrant JAM-A expression in gynecological cancers correlates with poor patient prognosis.To the best of our knowledge,conflicting JAM-A roles in various cancer types suggest that its involvement is complex and tumor-type specific.The underlying molecular mechanisms and pathways responsible for JAM-A functions were not fully elucidated and need to be identified.Finding appropriate novel molecular cancer biomarkers may reduce observed very high mortality rates and could contribute to personalized treatment development.The main aim of the present viewpoint article is to report the current knowledge about JAM-A participation in gynecological malignancies.

Expression of PH Domain Leucine-rich Repeat Protein Phosphatase, Forkhead Homeobox Type 0 3a and RAD51, and their Relationships with Clinicopathologic Features and Prognosis in Ovarian Serous Adenocarcinoma

Background： Ovarian serous adenocarcinoma can be divided into low- and high-grade tumors, which exhibit substantial differences in pathogenesis, clinicopathology, and prognosis. This study aimed to investigate the difl＇erences in the PH domain leucine-rich repeat protein phosphatase （PHLPP）, tbrkhead llomeobox type O3a （FoxO3a）, and RAD51 protein expressions, and their associations with prognosis in patients with low- and high-grade ovarian serous adenocarcinomas. Methods： The PH LPP, FoxO3a, and RA D51 protein expressions were examined in 94 high- and 26 low-grade ovarian serous adenocarcinomas by immunohistochemistry. The differences in expression and their relationships with pathological features and prognosis were analyzed. Results： In high-grade serous adenocarcinomas, the positive rates of PHLPP and goxO3a were 24.5% and 26.6%, while in low-grade tumors, they were 23.1% and 26.9%, respectively （P 〈 0.05 vs. the control specimens; low- vs. high-grade： P 〉 0.（15）. The positive rates of RAD51 were 70.2% and 65.4% in high- and low-grade serous adenocarcinomas, respectively （P 〈 0.（15 vs. the control specimens; low- vs. high-grade： P 〉 0.05）. Meanwhile, in high-grade tumors, Stage Ⅲ/Ⅳ tumors and lymph node and omental metastases were significantly associated with lower PHLPP and FoxO3a and higher RAD51 expression. The 5-year survival rates of patients with PHLPP- and FoxO3a-positive high-grade tumors （43.5% and 36.0%） were significantly higher than in patients with PHLPP-negative tumors （5.6% and 7.2%, respectively; P 〈 0.05）. Similarly, the 5-year survival rate of RAD5 l-positive patients （3.0%） was significantly lower than in negative patients （42.9%： P〈 0.05）. In low-grade tumors, the PHLPP, FoxO3a, and RAD51 expressions were not significantly correlated with lymph node metastasis, omental metastasis, Federation of Gynecology and Obstetrics stage, or prognosis. Conclusions： Abnormal PHLPP, FoxO3a, and RAD51 protein expressions may be involved in the development of high- and low-grade ovarian serous adenocarcinomas, suggesting conlmon molecular pathways. Decreased PH LPP and FoxO3a and increased RAD51 protein expression may be important molecular markers for poor prognosis, and RAD51 may be an independent prognosis factor, of high-grade, but not low-grade, ovarian serous adenocarcinomas.

联合检测E-cadherin、CEA及Calretinin在浆膜腔积液细胞学鉴别诊断中的意义

背景与目的:浆膜腔积液中转移性腺癌细胞、恶性上皮型间皮瘤细胞和反应性间皮细胞的形态有不少相似之处,有时仅凭形态学特征不能做出准确诊断。近年来免疫细胞化学在这方面得到较多应用,但国内报道仅局限于用CK、EMA、CEA、Vim和HBME-1几种抗体,而且不能较好地进行细胞学的鉴别诊断。本研究旨在探讨联合检测E-cadherin、CEA及calretinin在浆膜腔积液鉴别诊断中的应用价值。方法:选用浆膜腔积液标本共93例,其中胸水66例、腹水24例、心包积液3例。经组织学检查或结合临床资料证实的转移性腺癌55例、恶性上皮型间皮瘤6例、间皮细胞反应性增生32例。每例均制备HE染色的涂片和细胞块,并用细胞块切片作免疫细胞化学染色。结果:E-cadherin、CEA对诊断转移性腺癌的敏感性分别为85.5%(47/55)、78.2%(43/55),特异性分别为100%(38/38)、97.4%(37/38)。E-cadherin和CEA联合应用诊断浆膜腔积液转移性腺癌的阳性率为96.4%(53/55)。Calretinin对诊断间皮瘤和间皮细胞增生的敏感性和特异性分别为81.6%(31/38)和87.2%(48/55)。结论:E-cadherin、CEA和calretinin是鉴别浆膜腔积液转移性腺癌细胞和间皮源性细胞有价值的一组抗体。

卵巢浆液性腺癌组织中TK1和Ki-67表达的意义

目的探讨细胞质胸苷激酶1(cytoplasmic thymidinekinas-1,TK1)、Ki-67在卵巢浆液性腺癌中表达的意义。方法回顾性研究55例经手术治疗的卵巢浆液性腺癌患者的临床病理资料,并运用免疫组化技术观察TK1、Ki-67在卵巢浆液性腺癌中的表达情况及与临床病理参数之间的意义。结果 TK1阳性表达定位于细胞质,阳性率为72.7%。TK1的表达与肿瘤的最大径、复发、pTNM分期、病理分级密切相关(P<0.05)。Ki-67阳性表达定位于细胞核,阳性率为80.0%,Ki-67的表达与肿瘤的复发、pTNM分期、病理分级有关(P<0.05)。Kappa检验显示TK1的表达与卵巢浆液性腺癌复发较一致(k=0.559,P=0.000),且判断复发比Ki-67更为优越。Kaplan-Meier检验显示pTNM分期、肿瘤复发、MDACC分级、Ki-67、TK1表达分别与预后有关(P<0.05)。COX回归多因素分析显示:肿瘤复发是影响卵巢浆液性腺癌患者的独立性预后因素。结论卵巢浆液性腺癌的复发影响患者的预后,TK1对判断卵巢浆液性腺癌是否有复发倾向具有参考价值,且优于Ki-67,初次手术后肿瘤组织免疫组化TK1高表达预示患者存在高复发的风险,提示临床要加强术后的治疗方案,并提高随访频数。

宫腔镜检查对Ⅱ型子宫内膜癌患者腹腔细胞学结果及预后的影响

目的：研究宫腔镜检查对Ⅱ型子宫内膜癌患者腹腔细胞学结果及预后的影响,探讨其用于Ⅱ型子宫内膜癌术前诊断的安全性。方法：回顾分析2001年6月至2010年6月在我院接受手术治疗且术后确诊为Ⅱ型子宫内膜癌的84例患者的临床病理资料。根据其术前诊断方式,分为宫腔镜检查组（32例）和传统诊刮组（52例）。比较两组患者的临床病理特点和腹腔细胞学检查阳性率,评价宫腔镜检查对Ⅱ型子宫内膜癌癌细胞腹腔播散的影响;分析术前不同诊断方式对Ⅱ型子宫内膜癌患者预后的影响。结果：两组患者的年龄、病理类型、临床分期、肌层浸润、累及附件及淋巴转移及治疗方式等比较,差异均无统计学意义（P〉0.05）。宫腔镜诊刮组与传统诊刮组的腹水细胞学检查阳性率分别为37.5%（12/32）和17.3%（9/52）,差异有统计学意义（χ^2=4.308,P=0.036）。宫腔镜检查组与传统诊刮组患者的5年总生存率（OS）分别为56.8%和69.2%,5年无进展生存率（PFS）分别为50.7%和67.9%;两组患者的总生存率曲线和无进展生存曲线分别比较,差异均无统计学意义（P=0.329;P=0.424）。结论：宫腔镜检查用于Ⅱ型子宫内膜癌的诊断,可增加癌细胞腹腔播散的风险,但对其长期生存可能无影响。

卵巢浆液性腺癌BRMS1、RIZ1和SATB1蛋白表达及其与预后的关系

目的探讨卵巢低、高级别浆液性腺癌中BRMS1、RIZ1和SATB1蛋白表达及其临床病理意义。方法应用免疫组化Eli Vision法检测卵巢低、高级别浆液性腺癌组织中BRMS1、RIZ1和SATB1蛋白的表达,对比分析三者在不同级别浆液性腺癌中的表达规律,并应用Kaplan-Meier单因素统计法分析三者与不同级别浆液性腺癌患者预后的关系。结果 BRMS1、RIZ1和SATB1蛋白在高级别组中的阳性率分别为43.9%、46.3%和51.2%;与对照组相比,BRMS1、RIZ1的表达明显降低,而SATB1明显升高(P<0.05)。低级别组中三者的阳性率分别为30.0%、35.0%和75.0%;交界性囊腺瘤中分别为55.6%、50.0%和55.6%;与对照组和囊腺瘤组比较,BRMS1、RIZ1的表达明显降低,而SATB1明显升高(P<0.05)。BRMS1、RIZ1和SATB1在低、高级别浆液性腺癌中的表达差异无显著性(P>0.05)。Kaplan-Meier单因素统计分析结果显示,高级别组BRMS1和RIZ1阳性患者3、5年生存率明显高于阴性患者,而SATB1阳性患者生存率明显低于阴性患者(P<0.05)。低级别组中二者未见明显差异(P>0.05)。结论 BRMS1和RIZ1表达降低,SATB1表达升高,它们既参与了高级别浆液性腺癌,也参与了低级别浆液性腺癌的发生,提示不同级别浆液性腺癌的发生仍然存在一些相同的分子改变。三者表达与高级别浆液性腺癌的预后有关,而与低级别浆液性腺癌无关。

卵巢浆液性腺癌中SP1、KLF4和p21表达及其预后意义

目的探讨不同级别卵巢浆液性腺癌中SP1、KLF4和p21蛋白表达的差异和预后意义。方法应用免疫组化EliVision法检测卵巢低级别和高级别浆液性腺癌中SP1、KLF4和p21蛋白的表达,Kaplan-Meier单因素和Cox多因素生存分析其与患者预后的关系。结果 SP1、KLF4和p21蛋白在高级别浆液性腺癌中的阳性率分别为74.5%、17.0%和11.7%,低级别浆液性腺癌中的阳性率分别为65.2%、34.8%和26.1%,与对照组相比,SP1表达均明显升高(P<0.05),而KLF4和p21表达均明显降低(P<0.05)。三者在高、低级别液性腺癌中的表达差异无显著性(P>0.05)。SP1、KLF4和p21蛋白表达与高级别液性腺癌FIGO分期密切相关,且SP1还与术后有无残留灶密切相关(P<0.05)。卵巢高级别液性腺癌中SP1表达与KLF4、p21的表达均呈显著负相关(P<0.05)。高级别液性腺癌中SP1蛋白阳性者的5年生存率明显低于阴性者,而KLF4和p21蛋白阳性者的5年生存率明显高于阴性者(P<0.05)。Cox多因素分析显示,FIGO分期和SP1高表达是影响高级别浆液性腺癌预后的独立因素。结论 SP1蛋白过表达以及KLF4和p21蛋白低表达,参与了高、低级别浆液性腺癌的发生,三者表达与高级别浆液性腺癌的预后有关,且SP1是独立预后因素。

浆膜腔积液中转移性腺癌与间皮细胞的病理学研究

目的探讨浆膜腔积液中转移性腺癌与反应性间皮细胞增生的鉴别。方法选取胸、腹水转移癌48例及反应性间皮细胞增生30例,采用常规涂片HE染色观察两者形态学特点,并应用免疫细胞化学SP法检测HBME-1c、alretinin、E-cadherin、MOC-31和BerEP4的表达。结果腺癌和间皮细胞两者形态各有特点,但是分化好的腺癌和明显增生的间皮细胞仅从常规涂片难以鉴别;免疫细胞化学显示反应性间皮细胞HBME-1和calretinin阳性率为86.7%和76.7%;而腺癌细胞只有少量表达,特异性高达95.8%和100%。MOC-31、E-cadherin和BerEP4对转移性腺癌细胞阳性率为70.8%、77.1%和88.4%,间皮细胞表达很少,特异性分别为90%、93.3%、93%。两者对5种抗体的表现差异显著。结论应用常规涂片和免疫细胞化学相结合的方法对鉴别转移性腺癌和间皮细胞增生有很大的帮助,最好应用一组抗体综合分析判断,HBME-1、Calretinin、E-cadherin、MOC-31及BerEP4是目前非常有效的组合。

EphB1在卵巢浆液性腺癌中的表达及临床意义

目的探讨受体酪氨酸激酶EphB1在卵巢浆液性腺癌中的表达水平及其与临床病理特征和预后的关系。方法采用免疫组化染色法检测EphB1在74例卵巢浆液性腺癌组织中的表达情况,将免疫组化检测结果分为低表达(<6分)和高表达(≥6分);分析其表达与临床病理特征和预后的关系。结果 74例卵巢浆液性腺癌组织中EphB1阳性表达67例(90.5%),阴性表达7例(9.5%);高表达42例(56.8%),低表达32例(43.2%)。EphB1表达在不同WHO分级、肿瘤直径、MDACC分级、转移情况及Ki-67指数间的差异有统计学意义(P<0.05);在不同年龄、发生部位、临床分期和复发情况间的差异无统计学意义(P>0.05)。EphB1高表达患者的3、5年生存率分别为71.2%和65.5%,低表达者均为68.3%,差异均无统计学意义(P<0.05);当随访时间>6年,EphB1低表达者的生存率较高表达者有下降趋势。结论 EphB1在卵巢浆液性腺癌组织中阳性表达,且以高表达为主,与卵巢癌的发展及分化程度有关,有可能成为卵巢浆液性腺癌预后的新标志物。

PAX2在卵巢浆液性腺癌中的表达及在MDACC分级系统中的应用价值

目的探讨PAX2在卵巢浆液性腺癌中表达的意义,及其在二级组织学(MDACC)分级系统中的应用价值。方法回顾性研究55例经手术治疗的卵巢浆液性腺癌患者的临床病理资料,并结合临床病理参数进行统计学分析。运用免疫组化技术观察PAX2在卵巢浆液性腺癌中的表达水平,分析表达结果与组织学分级和临床病理参数之间的关系。结果 PAX2阳性表达定位于细胞核,阳性率为40%。PAX2的表达水平在肿瘤的复发、pTNM分期间有显著差异(P<0.05),Kaplan-Meier检验显示pTNM分期、肿瘤复发、MDACC分级、PAX2表达分别与预后有关(P<0.05)。Kappa检验显示PAX2表达水平与MDACC分级水平一致性较好(κ=0.773,P<0.01)。结论PAX2可以作为判断MDACC分级的辅助手段,其低表达或不表达对诊断MDACC高级别可信度较高。

卵巢浆液性腺癌中Wnt信号通路成分β-catenin、c-myc的表达及意义

目的检测Wnt信号通路成分β-catenin、c-myc在卵巢浆液性腺癌(ovarian serous adenocarcinoma,OSA)中的表达,探讨其与肿瘤FIGO分期、病理分级、复发的关系。方法应用免疫组化EnVision两步法检测60例OSA中β-catenin、c-myc的表达,并进行预后分析。结果 (1)FIGO分期:β-catenin在Ⅲ+Ⅳ组中的表达高于Ⅰ+Ⅱ组(P=0.003);c-myc表达与FIGO分期无关(P=0.069)。(2)病理分级:β-catenin的表达与病理分级无关(P=0.817);c-myc在高级别组中的表达高于低级别组(P=0.016)。(3)复发:β-catenin、c-myc表达与患者复发均无关(P=0.349,P=0.171)。(4)预后分析:β-catenin、c-myc阳性组患者的生存率均低于阴性组(P=0.032,P=0.035)。结论 Wnt信号通路成分β-catenin、c-myc可能在OSA的发生、发展及患者的不良预后中发挥作用,检测其表达可能具有一定的临床意义。

浆膜腔积液转移性肺腺癌细胞中TTF-1的表达

目的 探讨甲状腺转录因子 1(TTF 1)在浆膜腔积液肺腺癌细胞中的表达 ,为肺腺癌的诊断和鉴别诊断提供新的依据。方法 选用浆膜腔积液转移性腺癌共 6 0例 (胸水 4 0例 ,腹水 17例 ,心包积液 3例 )。经组织学或结合临床资料证实的肺腺癌 36例 ,泌尿生殖道腺癌 14例 ,胃肠道腺癌 8例 ,乳腺癌 2例。每例均制备HE染色的涂片和离心沉渣经琼脂和石蜡包埋而成的细胞块 ,并用细胞块切片作TTF 1免疫细胞化学染色。结果 36例肺腺癌中有 2 6例表达TTF 1,2 4例肺外腺癌中只有 2例表达TTF 1,其敏感性为 72 2 % ,特异性为 91 7%。结论 TTF 1在浆膜腔积液肺腺癌具有较高的敏感性和特异性 ,在排除甲状腺癌的可能性后 ,TTF