摘要:目的：探讨皮肤平滑肌肉瘤的临床病理特点和诊断要点及预后。方法:对2例皮肤平滑肌肉瘤组织病理学、免疫组化观察,并复习相关文献。结果: 例1为皮下平滑肌肉瘤,具有结节型的生长形态,瘤细胞丰富,异型性较大,核分裂活跃；例2为真皮平滑肌肉瘤,具有弥漫型的生长形态,瘤细胞较少,分化好,核分裂象不明显。免疫组化2例均表达SMA、MSA、Vim,1例灶性表达Desmin。2例随访迄今均无复发及转移。结论:皮肤平滑肌肉瘤少见,可分为真皮和皮下两种类型,两者具有不同的组织起源和预后特点,我们要注意区分,诊断除核分裂象计数外,尚需进行综合评估,对某些病例建议采用恶性潜能未定的平滑肌肉瘤的诊断,治疗首选外科手术切除。Abstract: Objective: To investigate the clinic pathological features diagnosis main point and prognosis of cutaneous leiomyosarcoma（CLMS）.Methods:Histopathology,immunohistochemical stainings observation were analyzed in two cases of CLMS and the related literatures were reviewed. Results:Case 1 was subcutaneous leiomyosarcoma with tubercular growth pattern,rich tumor cell,big heterogeneous type,active mitotic；Case 2 was dermis leiomyosarcoma with diffuse growth pattern,few tumor cell,well differentiated,no more mitotic. Immunohistochemically,the two cases reacted positively with smooth muscle action、MSA and Vim,Case 1 also expressed desman partially. The two cases were revisited to date,no recurrences and metastases.Conclusion:Cutaneous leiomyosar coma is a rare tumor,subdivided into dermis and subcutaneous forms because of their different tissue origins and prognosis features. We must discriminate between them. Diagnosis need synthetic appraisal besides mitotic counts and “smooth muscle tumor of uncertain malignant potential” should be used for diagnosis of certain cases.Primary treatment for cutaneous leiomyosarcoma is surgical excision.
Objective To investigate the clinicopathological characteristics of proximal gastric cancer (PGC). MethodsThe clinical course and pathologic feature of 118 PGC patients were analyzed, and compared with those of 310 distal gastric cancer (DGC) patients. ResultsThe incidence of PGC was lower than DGC, the percentage of Ⅲ,Ⅳ stages and undifferentiated type in the PGC group were significantly higher than in DGC. For the surgical procedure, patients in the PGC had significantly higher percentages of total gastrectomy and other organ resection than in DGC. The percentage of patients with positive margin and lymph node metastasis in PGC was also significantly higher than in DGC. Esophageal invasion and lymph node metastasis were much more in PGC. The 5year survival of patients with PGC was significantly lower than that with DGC. No significant differences were found between the two groups with respect to the mortality rates and complications. Conclusion The relatively poor prognosis associated with PGC is mainly from advanced cases and esophageal invasion. Early detection and treatment is the most important strategy to improve the survival of patients with PGC.
To investigate the relationship between clinicopathological features and lymph node metastasis in the primary gastric cancer and affer the basis for deciding appropriate extent of lymph node dissection, a total of 192 patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Result: The total rate of lymph node metastasis was 60.4%, with 28.9% of the resected lymph nodes involved. The lymph node metastasis of C, M, A region and the whole stomach were 64.6%, 57.7%, 59.1% and 90.9% respectively. The rates of the lymph node metastasis increased successively in carcinoma of early, middle and late stages (Ｐ＜0.05), the rate of the infiltrative tumor (Borr Ⅲ，Ⅳ) being 76.5% which was significantly higher than that of the circumscribed tumor (Borr Ⅰ，Ⅱ) (43.2%)。 Relating with the tumor size ＜4cm in diameter showed lesser rate, while 4-8 cm and ＞8cm in diameter showed increasingly higher metastaticrate (Ｐ＜0.01). As a result, we should decide the appropriate extent of lymph node dissection during the operation on the basis of clinicopathological stages, type of Borrmann’s, site and maximum diameter of gastric cancer along with the state of lymph node metastasis in carcinoma of different region of the stomach.
The effects of preoperative selective arterial perfusion chemotherapy (PSAPC) in the treatment of 20 cases of histologically confirmed gastric cancers is reported in which 12 patients were operated on, and a comparison with that of general chemotherapy in 10 cases of gastric cancers (as controls) was made. In the PSAPC group, besides the improvement of clinical symptoms and singns, the cancer cells of lesions in situ and metastatic lymph nodes have different degrees of degeneration and necrosis. This result show significant differences in two group comparison (Plt;O.01). We conclude that the PSAPC has good short-term effect and little side-effect. It can improve the resection rate and radical resection rate, and prevent the iatrogenic metastasis and implantation during operation, and decrease the postoperative recurrence of the patients with gastric cancer.
Four hundred and eighty two paients suffering from intrahepatic bile duct stone undergoing lobectomy and segmental resection (from 1975 to 1994,9) has reported. 63% of the patient in this group underwent 1-5 operations, including different types of biliary-intestinal anastomosis (21.6%). 482 cases underwent different types of hepatectomy, including left lateral-lobetomy 321 cases (66.6%),left hemihepatectomy 80 cases(16.6%), right hemihepatectomy 19 cases (3.9%), and multiple segmental resections 39 cases (8.1%, including Ⅴ+Ⅷ 11 cases, Ⅵ+Ⅶ 28 cases). Other type hepatectomy combined with guadrate lobectomy 20 cases (4.1%). Postoperative complication rate was 10.2%, including diliary fistula. hemobilia and subdiaphragmatic and resectional surface infectioin, 85% of the patients were followed up with an excellent result of 88%. The authors emphsize that hepatic lobectomy nad segmental resection is the core of treatment and selection of operative methods depends on clinical-patholigic types of the disease.
Abstract:Objective To investigate the clinicopathological features and prognostic aspect of basaloid squamous carcinoma （BSC）. Methods From July 2000 to May 2003, the clinical data of 1 257 documented cases that underwent potentially curative resection on esophageal carcinoma in our department were retrospectively analysed, and 18 cases of BSC （BSC group） were detected. And 54 cases of typical squamous carcinoma of esophagus（ESC） were randomly selected as control （ESC group）, to analyse the clinicopathological and prognostic parameters of BSC patients. Results The age of BSC group patients was higher than that of ESC group （61. 56 ± 7. 62 years vs. 56.11± 10. 58 years; t=-2. 012,P=0. 048）, and the ratio of T4 stage was much higher than that in ESC group （27.8% vs. 5.6%;x2= 6. 750, P= 0. 020）. The follow-up showed that, comparing with ESC group, the ratio of metastasis was higher（62.5% vs. 25.0%, P=0. 047）, and mean survival time（P〈0.05） was significantly shorter in patients of BSC group after curative resection. There were no statisticaly differences in patient gender （P = 0. 494）, or ratio of recurrence （P=0. 887） between two groups. Conclusion The BSC is a rare carcinoma involving esophagus, which occurs in elder patients. Both invasiveness and metastasis of BSC are more usual than those of typical ESC.
【摘要】 目的 探讨卵巢两性母细胞瘤的临床及病理组织学特征。 方法 观察总结2004年3月-2008年3月6例卵巢两性母细胞瘤的临床及病理学特征，以及免疫组化染色结果。 结果 患者以月经紊乱、闭经、绝经后阴道出血为主要临床表现。肿瘤含两种成分，即颗粒细胞和Sertoli-Leydig细胞，两者均呈成熟性的组织学形态，1例伴有异源性分化成分。6例肿瘤呈α-inhibin和vimentin强阳性，3例呈CD99阳性，5例呈calretinin阳性，2例的Sertoli细胞呈CK阳性。4例患者有随访资料，随访期14～60个月，均无瘤存活。 结论 两性母细胞瘤以内分泌异常相关症状为主要临床表现，大部分患者诊断时处于临床1期，预后较好。对诊断为两性母细胞瘤的患者应进行长期的临床随访。【Abstract】 Objective To observe the clinical pathologic and immunophenotypic features of gynandroblastoma. Methods The pathologic samples of six patients with gynandroblastoma from March 2004 to March 2008 were observed and analyzed. Immuohistochemistry staining was performed by SP method using antibodies of α-inhibin,CD99,Vimentin,Calretinin,CK,EMA. Results The main clinical features included menstrual disorders, amenorrhea, and postmenopausal bleeding. The tumor was composed of ranulose cells and Sertoli cells, both of which were well differentiated. Strongly positive expression of α-inhibin and vimentin was found in all the patients, while CD99 (+) was in three, calretinin (+) was in five, and CK (+) of Sertoli cells was in two. Four patients were followed up for 14-60 months and all were tumor free. Conclusion The main clinical features of gynandroblastoma are estrogenic or androgenic manifestations. Nearly all the patients are diagnosed in stage 1 and have a good prognosis. Patients with gynandroblastoma should be followed up for a long period.
目的：探讨宫颈微小偏离性腺癌的诊断与治疗。方法：按照WHO(2003)宫颈腺癌分类标准，回顾性分析我院收治的8例宫颈微小偏离性腺癌的临床病理资料。结果：宫颈微小偏离性腺癌占同期收治宫颈浸润腺癌的4.73％，临床表现为水样白带和/或生殖道出血、宫颈肥大变硬和赘生物，阴道B超检查示宫腔积液，宫颈细胞学诊断较困难，常需深部活检组织诊断。结论：诊断应结合临床表现，影像学检查，宫颈细胞学。当高度怀疑时应取深部组织或宫颈锥切组织诊断，早期诊治预后较好。
Objective To analyze the clinical pathological features of patients with hereditary nonpolyposis colorectal cancer （HNPCC） in northeast Chinese. Methods The clinical data of 101 probands （HNPCC group） from 1982 to 2011 in the Fourth Affiliated Hospital of China Medical University and Tumor hospital of Liaoning Province and 272 patients with sporadic colorectal cancer （sporadic CRC group） in the same period were collected. The clinicopathologic features were compared in two groups. Results In the HNPCC group， the age of onset was younger than 45 years old in 24 patients （23.8%）， proximal colon in 31 （30.7%）， multiple primary carcinomas in 26 （25.7%）， extracolonic carcinoma in 13 （12.9%）， mucinous adenocarcinoma in 32 （31.7%）， phaseⅠandⅡin 68 （67.3%）， high-middle differentiation in 70 （69.3%）， and lymph node metastasis in 33 （32.7%）， while in the sporadic CRC group were 12 （4.4%）， 54 （19.9%）， 15 （5.5%）， 11 （4.0%）， 30 （11.0%）， 127 （46.7%）， 152 （55.9%）， and 140 （51.5%）， respectively. There were significant differences between the HNPCC group and the sporadic CRC group （P＜0.05）. Meanwhile， extracolonic carcinomas in the HNPCC group were endometrial cancer in 3， bladder cancer in 3， breast cancer in 2， brain tumor in 2， ovarian cancer in 1， gastric cancer in 1， and lung cancer in 1. Conclusions Northeast China HNPCC patients with several particular clinicopathologic features such as early onset， frequent localization in proximal colon， proclivity of synchronous and metachronous tumors， excessive mucinous adenocarcinoma， less poorly differentiated tumors， lymph node metastasis， early stage of tumor， and so on. Therefore， clinicopathologic feature is still a preferred method of diagnosis of HNPCC patients or suspected HNPCC patients.
Objective To explore the expressions of androgen （AR） and Stathmin in triple negative breast cancer （TNBC） and analyze the correlation between these expressions and clinicopathologic features. Methods Eighty-three patients who were diagnosed as TNBC and met the inclusion criteria from 2005 to 2009 in the Sichuan Provincial People’s Hospital were collected retrospectively. The expressions of AR and Stathmin in the TNBC tissues by using the method of EnVision immunohistochemistry. The correlation between AR or Stathmin expression and age， tumor size， lymph node status， or histological grade was analyzed by Spearman test. Results The AR and Stathmin positive expression rates in the patients with TNBC were 37.3% （31/83） and 98.8% （82/83）， respectively. The AR expression was positively correlated with age（rs=0.302， P=0.006）and pathological grade （rs=0.225， P=0.041）， but was not correlated with tumor size or lymph node status. The Stathmin expression was not correlated with age， tumor size， lymph node status， or pathological grade （P＞0.05） . Conclusions The AR expression is correlated with the age or pathological grade but Stathmin expression was all not correlated with the clinicopathologic features. AR or Stathmin as a prognosis indicator in patients with TNBC are needed to more research.