Objective. To investigate the magnetic resonance (MR) features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings.Methods. Eleven cases with...Objective. To investigate the magnetic resonance (MR) features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings.Methods. Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd - DTPA enhanced MR imaging. The enhancement patterns and features, as well as the types of meningeal involvement, were retrospectively analyzed.Results. Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd - DTPA, abnormal pia mater enhancement was detected in 9 cases, demonstrating as the continuous, thin, and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum, brainstem, and cerebrum. No abnormal enhancement in the subarach-noid space was found. Abnormal dura - arachnoid enhancement was seen in 3 cases, showing as the continuous, thick, and curvilineal high signal intensity over the convexities or in the tentorium without extension into the cortical sulci. Cerebral dura - arachnoid involvement was found in all 3 cases and one of them also showed abnormal enhancement in cerebellar dura - arachnoid and tentorium. Of the 11 cases, 9 with pial involvement had abnormal cerebrospinal fluid (CSF) results, 2 involving only the dura - arachnoid had normal CSF results.Conclusion. Meningeal carcinomatosis could be well demonstrated by Gd - DTPA enhanced MR imaging, and its type could be differentiated by the enhancement features. Combined with the clinical information, Gd - enhanced MR imaging may lead to the diagnosis and guide the therapy of meningeal carcinomatosis.展开更多
Leptomeningeal involvement is usually reported as a secondary event in advanced gastric carcinoma. Leptomeningeal carcinomatosis (LMC), as the initial manifestation of asymptomatic gastric cancer, is exceedingly rare ...Leptomeningeal involvement is usually reported as a secondary event in advanced gastric carcinoma. Leptomeningeal carcinomatosis (LMC), as the initial manifestation of asymptomatic gastric cancer, is exceedingly rare with only a few cases reported in recent years. The presenting neurologic symptoms include headache, vomiting and seizures and are usually clinically atypical. The diagnosis of LMC is made via identification of malignant cells that originate from epithelial cells in the cerebrospinal fluid by cytological examination and provides cues to track the primary tumor. Endoscopic examinations are crucial to confirm the presence of gastric cancer, and imaging studies, especially gadolinium-enhanced magnetic resonance imaging of the brain, are sometimes helpful in diagnosis. Thus far, there is no standard therapy for LMC, and despite all measures, the prognosis of the condition is extremely poor. Here, we report on the clinical features and diagnostic procedures for a patient with occult gastric cancer with Bormann type I macroscopic appearance and poor differentiation in pathology, who presented with LMC-induced neurological symptoms as the initial clinical manifestation. Additionally, we review the similar cases reported over the past years, making comparison among cases in order to provide more information for the future diagnosis.展开更多
【目的】通过免疫组化法实验观察PARP‐1和 HMGA2在乳腺癌不同分子分型中的表达，探讨其在乳腺癌中表达的意义及其与临床特点的相关性。【方法】采用免疫组化法检测240例乳腺癌术后肿瘤标本和60例乳腺良性肿瘤组织中PARP‐1与 HMGA2蛋...【目的】通过免疫组化法实验观察PARP‐1和 HMGA2在乳腺癌不同分子分型中的表达，探讨其在乳腺癌中表达的意义及其与临床特点的相关性。【方法】采用免疫组化法检测240例乳腺癌术后肿瘤标本和60例乳腺良性肿瘤组织中PARP‐1与 HMGA2蛋白的表达情况。分析 PARP‐1和 HMGA2在不同分子类型乳腺癌组织中的表达差异；分析两者在不同分子类型表达的相关性及其与原发肿瘤直径、腋窝淋巴结转移等病理特征相关性。【结果】在乳腺癌中 PARP‐1阳性表达率为65．4％显著高于癌旁组织中的22．4％；HMGA2阳性表达率为58．8％高于癌旁组织中的36．4％，PARP‐1及 HMGA2在乳腺癌各分子分型中的阳性表达与腋窝淋巴结转移情况具有相关性（ P ＜0．05），HMGA2的阳性表达在luminal A型及luminal B型中与原发肿瘤大小存在相关性（ P ＜0．05），而在 H ER‐2过表达型及三阴性乳腺癌中不存在相关性（ P ＞0．05）。【结论】PARP‐1与HMGA2在乳腺癌的浸润、转移过程中相互作用，是反映乳腺癌进展的生物学指标。PARP‐1与HMGA2高表达的患者易发生淋巴结转移，预后不良。展开更多
【目的】探讨乳腺癌易感基因PALB2启动子甲基化与乳腺癌临床病理特征、预后的关系。【方法】采用MSP法检测128例乳腺癌石蜡组织中PALB2启动子甲基化情况，分析其与乳腺癌临床病理特征及临床预后的相关性。【结果】128例乳腺癌中有淋巴...【目的】探讨乳腺癌易感基因PALB2启动子甲基化与乳腺癌临床病理特征、预后的关系。【方法】采用MSP法检测128例乳腺癌石蜡组织中PALB2启动子甲基化情况，分析其与乳腺癌临床病理特征及临床预后的相关性。【结果】128例乳腺癌中有淋巴结转移的患者中14．04％（8／57）检测出PALB2启动子甲基化，高于无淋巴结转移患者的2．82％（2／71），且差异具有显著性（ P ＜0．05）。PALB2启动子甲基化组的中位无瘤生存时间与中位总生存时间分别为50个月和51．5个月，无甲基化组的中位无瘤生存时间与总生存时间分别为54个月和88个月，两者相比较差异均具有显著性（ P ＜0．01）。乳腺癌患者预后相关因素分析提示N分期及PALB2启动子甲基化情况均是影响乳腺癌患者预后的独立危险因素。【结论】乳腺癌组织PALB2基因启动子甲基化情况与是否有淋巴结转移相关。与PALB2启动子无甲基化组比较，有甲基化组乳腺癌患者的预后更差。PALB2启动子甲基化作为影响乳腺癌患者预后的独立危险因素，对于评估患者临床预后有着重要意义。展开更多
文摘Objective. To investigate the magnetic resonance (MR) features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings.Methods. Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd - DTPA enhanced MR imaging. The enhancement patterns and features, as well as the types of meningeal involvement, were retrospectively analyzed.Results. Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd - DTPA, abnormal pia mater enhancement was detected in 9 cases, demonstrating as the continuous, thin, and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum, brainstem, and cerebrum. No abnormal enhancement in the subarach-noid space was found. Abnormal dura - arachnoid enhancement was seen in 3 cases, showing as the continuous, thick, and curvilineal high signal intensity over the convexities or in the tentorium without extension into the cortical sulci. Cerebral dura - arachnoid involvement was found in all 3 cases and one of them also showed abnormal enhancement in cerebellar dura - arachnoid and tentorium. Of the 11 cases, 9 with pial involvement had abnormal cerebrospinal fluid (CSF) results, 2 involving only the dura - arachnoid had normal CSF results.Conclusion. Meningeal carcinomatosis could be well demonstrated by Gd - DTPA enhanced MR imaging, and its type could be differentiated by the enhancement features. Combined with the clinical information, Gd - enhanced MR imaging may lead to the diagnosis and guide the therapy of meningeal carcinomatosis.
基金Supported by Research Fund for the Doctoral Program of Higher Education of China,No.20104425120009
文摘Leptomeningeal involvement is usually reported as a secondary event in advanced gastric carcinoma. Leptomeningeal carcinomatosis (LMC), as the initial manifestation of asymptomatic gastric cancer, is exceedingly rare with only a few cases reported in recent years. The presenting neurologic symptoms include headache, vomiting and seizures and are usually clinically atypical. The diagnosis of LMC is made via identification of malignant cells that originate from epithelial cells in the cerebrospinal fluid by cytological examination and provides cues to track the primary tumor. Endoscopic examinations are crucial to confirm the presence of gastric cancer, and imaging studies, especially gadolinium-enhanced magnetic resonance imaging of the brain, are sometimes helpful in diagnosis. Thus far, there is no standard therapy for LMC, and despite all measures, the prognosis of the condition is extremely poor. Here, we report on the clinical features and diagnostic procedures for a patient with occult gastric cancer with Bormann type I macroscopic appearance and poor differentiation in pathology, who presented with LMC-induced neurological symptoms as the initial clinical manifestation. Additionally, we review the similar cases reported over the past years, making comparison among cases in order to provide more information for the future diagnosis.
文摘【目的】通过免疫组化法实验观察PARP‐1和 HMGA2在乳腺癌不同分子分型中的表达，探讨其在乳腺癌中表达的意义及其与临床特点的相关性。【方法】采用免疫组化法检测240例乳腺癌术后肿瘤标本和60例乳腺良性肿瘤组织中PARP‐1与 HMGA2蛋白的表达情况。分析 PARP‐1和 HMGA2在不同分子类型乳腺癌组织中的表达差异；分析两者在不同分子类型表达的相关性及其与原发肿瘤直径、腋窝淋巴结转移等病理特征相关性。【结果】在乳腺癌中 PARP‐1阳性表达率为65．4％显著高于癌旁组织中的22．4％；HMGA2阳性表达率为58．8％高于癌旁组织中的36．4％，PARP‐1及 HMGA2在乳腺癌各分子分型中的阳性表达与腋窝淋巴结转移情况具有相关性（ P ＜0．05），HMGA2的阳性表达在luminal A型及luminal B型中与原发肿瘤大小存在相关性（ P ＜0．05），而在 H ER‐2过表达型及三阴性乳腺癌中不存在相关性（ P ＞0．05）。【结论】PARP‐1与HMGA2在乳腺癌的浸润、转移过程中相互作用，是反映乳腺癌进展的生物学指标。PARP‐1与HMGA2高表达的患者易发生淋巴结转移，预后不良。
文摘【目的】探讨乳腺癌易感基因PALB2启动子甲基化与乳腺癌临床病理特征、预后的关系。【方法】采用MSP法检测128例乳腺癌石蜡组织中PALB2启动子甲基化情况，分析其与乳腺癌临床病理特征及临床预后的相关性。【结果】128例乳腺癌中有淋巴结转移的患者中14．04％（8／57）检测出PALB2启动子甲基化，高于无淋巴结转移患者的2．82％（2／71），且差异具有显著性（ P ＜0．05）。PALB2启动子甲基化组的中位无瘤生存时间与中位总生存时间分别为50个月和51．5个月，无甲基化组的中位无瘤生存时间与总生存时间分别为54个月和88个月，两者相比较差异均具有显著性（ P ＜0．01）。乳腺癌患者预后相关因素分析提示N分期及PALB2启动子甲基化情况均是影响乳腺癌患者预后的独立危险因素。【结论】乳腺癌组织PALB2基因启动子甲基化情况与是否有淋巴结转移相关。与PALB2启动子无甲基化组比较，有甲基化组乳腺癌患者的预后更差。PALB2启动子甲基化作为影响乳腺癌患者预后的独立危险因素，对于评估患者临床预后有着重要意义。
