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摘要： Purpose/Objective(s) Soft tissue sarcomas (STS) is a large group of rare cancers which present high intratumoral heterogeneity. Thus, the assessment of response to the neoadjuvant treatment applied for locally advanced STS remains a challenge. We hypothesized that the pathological response (PR) could be predicted using biomarkers of the tumor microenvironment, hypoxia, and DNA damage. Materials/Methods We analyzed prospectively collected core biopsy tissue samples from patients who received preoperative 5 × 5 Gy with doxorubicin-ifosfamide for marginally resectable high-grade STS in a phase II clinical trial. We have chosen tumor-infiltrating macrophages (TAMs) and intratumoral microvascular density (IMVD) as biomarkers for the tumor microenvironment. Hypoxia-inducible factor 1-alpha (HIF1A) expression was selected as a biomarker of intratumoral hypoxia. Double-strand DNA breaks were evaluated by expression of the phosphorylated form of H2A histone family member X (gH2AFX). Immunohistochemical analysis (CD163, CD68, CD105, CD34, HIF1A, gH2AFX) was evaluated by experienced sarcoma pathologists blinded to sample identification with a semi-quantitative method. We scored TAMs by counting the number of positive-staining macrophages per mm2: 0-none, 1-low, and 2-high. IMVD were counted in five randomly selected fields at 200x magnification (∼6.9 mm2), and a total number of microvessels included scoring scale: 1 (1-25), 2 (26-50), 3 (51-100), and 5 (> 500). HIF1A and gH2AFX were assessed in H-score scale, including intensity: 0-none, 1-weak, 2-moderate, 3-strong, and percentage of stained cells in each category (range: 0-300). All markers were studied preoperatively, while HIF1A was additionally assessed in postoperative tissues to define hypoxic microenvironment shift after therapy. PR to the treatment was classified using the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group recommendations; grades A, B, C indicated good PR, wh

关键词： 三疣梭子蟹(Portunus trituberculatus)   “乳化病”   病理   血卵涡鞭虫(Hematodinium sp.)  

摘要： 为从病理学角度阐明三疣梭子蟹(Portunus trituberculatus)“乳化病”的致病机理,选取中度和重度感染“乳化病”的三疣梭子蟹进行了病理研究。结果显示:河北省黄骅地区池塘养殖三疣梭子蟹“乳化病”的致病病原为血卵涡鞭虫(Hematodinium sp.);患病三疣梭子蟹的血淋巴、心脏、肝胰腺、鳃、体肌肉、螯足、第一步足和性腺等重要的组织器官均会受到不同程度的破坏。中等程度感染的病蟹多数组织器官尚存比较完整的组织结构;而重度感染的病蟹组织器官被严重破坏,其中肝胰腺和螯足肌肉已经失去原有组织结构,性腺也几乎完全消失。

关键词： 弥漫性软脑膜胶质神经元肿瘤   磁共振成像   病理学  

摘要： 1临床资料患者,男性,25岁,以“发作性动作停滞1年余”于2018年6月6日入住南京医科大学附属脑科医院。患者1年前无明显诱因下出现首次发作,表现为脑中出现熟悉的画面,动作停滞,发作持续10余秒钟,3~4个月发作1次。近3个月发作增多,3~5 d发作1次,遂来本院就诊。既往身体健康,否认脑炎、脑膜炎、脑外伤等,否认高血压、糖尿病、冠心病病史,否认肝炎、结核等传染病史;否认外伤史、输血史,否认药物食物过敏史。生于原籍,否认烟酒等不良嗜好,否认长期外地居住史,否认有毒有害物质长期接触史。

摘要： Purpose/Objective(s) In light of ALLIANCE02150, the role of preoperative stereotactic body radiotherapy (SBRT) for pancreatic cancer is controversial. We studied patients who had surgery after preoperative SBRT to assess pathologic and clinical outcomes, and evaluate if elective nodal irradiation (ENI) decreases locoregional failure (LRF). Materials/Methods Patients with pancreatic cancer who received SBRT at one center from 2007 to 2020 followed by oncologic surgery were reviewed. Local (primary tumor), regional (peripancreatic or perivascular per RTOG consensus), and distant failures were coded. Pathologic treatment response per College of American Pathologists was reviewed. Incidence of LRF with death as competing risk was assessed. Time to overall (OS) and progression-free survival (PFS) from date of pathologic diagnosis was assessed via Kaplan-Meier. Association testing via Cox analysis for OS/PFS and Gray test for LRF was performed. Results Twenty-eight patients were evaluable. Median (range) ECOG was 1 (0-2). Tumor stage was cT4 in 19 (67.9%) patients. Nodal stage was cN1 in 10 (35.7 %) patients. There were 7 and 21 patients with initially unresectable and borderline resectable disease respectively. Chemotherapy (CT) was given prior to SBRT in 27 (96.4%) patients, with FOLFIRINOX and gemcitabine-paclitaxel in 21 and 4 patients, respectively. Median (range) duration of CT was 5 (0-12) cycles. Median (range) dose, BED10, and fractionation were 40 Gy (25 - 50 Gy), 72 Gy (54.78 - 100 Gy), and 5 (1-5) respectively. The median (range) time between SBRT and surgery was 6.7 (2.6 - 21.9) weeks. Whipple, Appleby, and distal pancreatectomy was performed in 22, 4, and 2 patients respectively. The R0 rate was 23/28 (82.1%). Pathologic complete, near complete, partial, and poor/no treatment response was seen in 1 (3.6%), 10 (35.7%), 15 (53.6%), and 2 (7.1%) patients, respectively. The pN1 rate was 12/28 (42.3%). Median (range) follow up was 21.5 months (6.9 - 67.2 months).

关键词： 肺肿瘤   腺癌   电子计算机断层扫描   表皮生长因子受体  

摘要： 目的探讨肺腺癌患者组织病理学及电子计算机断层扫描(CT)特征与表皮生长因子受体(EGFR)基因突变的关系。方法选取肺腺癌患者97例,术前均行64排螺旋CT检查,记录病灶在横轴位上的最大直径,肿瘤内是否有磨玻璃密度影,是否有囊腔样改变及毛刺征、分叶征、血管集束征、胸膜凹陷征、空气支气管征、空泡征。采用PCR结合扩增阻滞突变系统(ARMS)技术检测手术切除的肿瘤标本EGFR基因突变情况。结果97例肺腺癌患者中61例(62.89%)发生EGFR基因突变,突变位点主要分布于21外显子33例(34.02%)和19外显子21例(21.65%)。在不同组织病理学特征的肺腺癌患者中,EGFR基因突变主要分布于腺泡为主30例(30.93%)、贴壁为主16例(16.49%)、乳头为主10例(10.31%)。EGFR基因突变率在不同性别、吸烟史、淋巴结转移情况的肺腺癌患者之间差异有统计学意义(P<0.01)。EGFR基因突变率在组织病理学特征是否为贴壁为主、腺泡为主、微乳头为主、实体为主的肺腺癌患者之间差异有统计学意义(P<0.05)。EGFR基因突变率在是否存在磨玻璃密度影、毛刺征、血管集束征、胸膜凹陷征、空气支气管征、囊腔样改变的肺腺癌患者之间差异有统计学意义(P<0.05)。结论肺腺癌患者组织病理学分类以贴壁为主、腺泡为主的EGFR基因突变率较高,以微乳头为主、实体为主的EGFR基因突变率较低;部分CT征象用于辅助预测EGFR基因突变状态具有一定价值。

关键词： RS   超声检查   病理学  

摘要： 目的:总结乳腺放射状瘢痕(RS)超声表现及病理特征,提高对本病的认识,提高超声对乳腺放射状瘢痕的正确诊断。方法:对2015年1月至2019年12月经福建医科大学附属南平第一医院收治的术前经超声检查的乳腺手术病例经病理证实的73例乳腺放射状瘢痕的超声表现与病理特征进行分析。结果:患者均为女性,年龄22-55岁,平均45.6岁,中位年龄45岁。69例乳腺放射状瘢痕患者共73个病灶,其中单发65例,多发4例,病灶大小(2.8mm-38.3mm)×(2.2mm-10.2mm),平均9.7mm×5.7mm;73病灶中6.8%(5/73)为单纯RS,87.6%(64/73)伴有乳腺良性病变,5.6%(4/73)伴有乳腺恶性肿瘤。冰冻病理诊断符合率为73/73。4例RS伴乳腺癌患者的超声检查均诊断为乳腺癌,73例RS患者均接受手术治疗。结论:RS多伴其他乳腺病变,以伴随良性病变居多,与乳腺癌的关系尚不明确,RS声像图与乳腺癌声像图相似,易被误诊为乳腺恶性病变,若能结合病理结果可以提高病变的检出率。

关键词： 骨肿瘤   横纹肌肉瘤   病理特征  

摘要： 本文旨在回顾性探究骨髓转移性横纹肌肉瘤在临床上的病理学特征,以提高该病在临床中的认知和诊断水平。方法:抽取来我院进行骨髓转移性横纹肌肉瘤治疗的4例患者作为本文研究的对象,所有患者均在2020年2月-2021年2月间在我院进行了骨髓转移性横纹肌肉瘤的诊断和治疗。本文就4例骨髓转移性横纹肌肉瘤患者的一般临床资料、病例学检测结果、免疫学检测结果进行回顾性的分析,最后就4例骨髓转移性横纹肌肉瘤患者的临床特征、病理学特征、免疫学特征进行总结分析。结果:结果显示所有患者在初诊的时候就出现骨髓转移。其中2例女性患者出现了严重的贫血,多处淋巴结出现肿大;一例男性患者出现大腿和腰背部的疼痛,睾丸出现巨大肿物,对其进行CT检测时发现患者全身多处骨质发生损坏;一例男性患儿在入院时出现弥漫性血管内凝血,各器官和淋巴结出现异常;对患者的骨髓活检可见切片中出现多处形状不规则细胞,细胞核深染,核仁轮廓不清,且见横纹肌母细胞;患者均高表达了desmin、MyoD1、Myogenin等与横纹肌分化相关的抗原。结论:对4例患有骨髓转移性横纹肌肉瘤患者的一般资料、病理资料、免疫学检测结果进行回顾性整理,发现该病的病例检测结果、以及免疫学检测结果对疾病的诊断有重要的辅助意义,其中骨髓转移性横纹肌肉瘤的临床表现与血液体统疾病容易混淆,常在临床中增加诊断困难,出现误诊。

关键词： 膀胱肿瘤   膀胱影像报告和数据系统   磁共振成像   诊断,鉴别   病理学,外科  

摘要： 目的评价膀胱影像报告和数据系统(VI-RADS)术前评估膀胱癌不同组织病理学特征的应用价值。资料与方法收集术前行多参数磁共振成像(mp-MRI)扫描并经病理证实为膀胱癌的89例患者,根据组织病理学结果分为肌层浸润性膀胱癌(MIBC)或非肌层浸润性膀胱癌(NMIBC)组、低级别(LG)或高级别(HG)组以及淋巴血管侵犯(LVI)阳性或阴性组,评估VI-RADS评分与MIBC、肿瘤分级及LVI状态的相关性。应用受试者工作特征(ROC)曲线分析VI-RADS评分对3种膀胱癌组织病理学特征的诊断效能。结果VI-RADS评分在MIBC与NMIBC、LG与HG、LVI阳性与LVI阴性组间差异均有统计学意义(Z=-7.033、-2.632、-4.059,P均<0.05)。ROC曲线分析显示:VI-RADS诊断MIBC以及肿瘤级别的阈值均为≥3分,曲线下面积分别为0.936(95%CI 0.86~0.98)、0.660(95%CI 0.55~0.76)(P均<0.05),敏感度和特异度分别为93.33%和84.75%、51.79%和75.76%;诊断膀胱癌LVI的阈值为≥4分,曲线下面积为0.774(95%CI 0.67~0.86,P<0.001),敏感度和特异度分别为60.87%、93.94%。VI-RADS评分对MIBC的诊断效能高于肿瘤分级及LVI,差异有统计学意义(Z=4.35、2.34,P均<0.05)。结论VI-RADS对于术前评估膀胱癌组织病理学特征具有重要价值,对于MIBC的诊断价值高,肿瘤分级及LVI次之。

关键词： 以问题为基础的学习   法医病理学   课程设计   教案  

摘要： 死亡原因分析是法医学实践中最常面对也是最基础的工作内容。在以问题为基础的学习(problem-based learning,PBL)教学目标问题设计时,应以死亡原因分析为主线,兼顾其他相关问题。PBL课程案例选择要以目标问题为中心;同时考虑解决这些问题所用的法医病理专业理论知识点,使学生通过解决案例的问题切实学到专业理论知识;此外,还应考虑案例难易度、资料的趣味性、结论的明确性等。法医病理学PBL课程的环节包括通过案例提出目标问题,学生自主学习和探索解决问题,共同讨论获得目标问题答案。可根据每环节中的问题或知识点分成几幕,每幕以一个小问题引出一个或几个知识点,充分引导学生在解决问题中学习知识。教师的工作重点是把控学生工作方向,掌握学生能力状态,平衡学生机会等,以推动课程顺利实施并达到教学目的。

关键词： 人畜共患病   细菌性疾病   组织病理学   蜂窝织炎   心内膜炎   化脓性脑膜炎   海豚链球菌   鲟鱼  

摘要： 鲟鱼是一种经济价值很高的大型冷水经济鱼类。近年来,鲟鱼养殖业发展迅速,各种病害尤其是细菌性疾病日益严重,制约了鲟鱼养殖业的健康发展。链球菌是一种条件性人畜共患病病原菌,可引起局部组织蜂窝织炎、心内膜炎及化脓性脑膜炎等。其中,海豚链球菌可感染多种海淡水鱼类。