BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling protein MORC family CW-type zinc finger 4(MORC4)as a biomarker in CRC patients,and to explore its relationship with pathological features and prognosis.METHODS A total of 143 CRC specimens and 57 adjacent tissue specimens,surgically removed from our hospital between January 2020 and January 2021,were collected.MORC4 protein expression was assessed using immunohistochemistry after paraffin embedding.The relationship between MORC4 protein expression and clinicopathological characteristics of patients was analyzed.Kaplan-Meier survival curves were plotted to analyze the relationship between MORC4 protein expression and prognosis in CRC patients.RESULTS Compared with adjacent tissues,the expression rate of MORC4 protein in CRC tissues was significantly higher(P<0.05).No significant difference was observed in the high expression rate of MORC4 protein in CRC tissues among patients of different gender,age,tumor location,tumor diameter,and primary tumor status(P>0.05).However,significant differences were found in the high expression rate of MORC4 protein in patients with different degrees of differentiation,lymph node metastasis,distant metastasis,tumor-lymph node-metastasis stage,and serum carcinoembryonic antigen levels(P<0.05).Compared with patients with low MORC4 expression,patients with high MORC4 expression had a worse prognosis(P<0.05).CONCLUSION The upregulation of MORC4 expression in CRC patients is closely related to disease severity and prognosis,suggesting its potential as an evaluation biomarker,which warrants further investigation.展开更多
BACKGROUND Colorectal cancer(CRC)is the third most common cancer and the second most common cause of cancer-related mortality worldwide.Mesenchymal-epithelial transition factor(MET)gene participates in multiple tumor ...BACKGROUND Colorectal cancer(CRC)is the third most common cancer and the second most common cause of cancer-related mortality worldwide.Mesenchymal-epithelial transition factor(MET)gene participates in multiple tumor biology and shows clinical potential for pharmacological manipulation in tumor treatment.MET amplification has been reported in CRC,but data are very limited.Investigating pathological values of MET in CRC may provide new therapeutic and genetic screening options in future clinical practice.AIM To determine the pathological significance of MET amplification in CRC and to propose a feasible screening strategy.METHODS A number of 205 newly diagnosed CRC patients undergoing surgical resection without any preoperative therapy at Shenzhen Cancer Hospital of Chinese Academy of Medical Sciences were recruited.All patients were without RAS/RAF mutation or microsatellite instability-high.MET amplification and c-MET protein expression were analyzed using fluorescence in situ hybridization(FISH)and immunohistochemistry(IHC),respectively.Correlations between MET aberration and pathological features were detected using the chi-squared test.Progression free survival(PFS)during the two-year follow-up was detected using the Kaplan-Meier method and log rank test.The results of MET FISH and IHC were com pared using one-way ANOVA.RESULTS Polysomy-induced MET amplification was observed in 14.4%of cases,and focal MET amplification was not detected.Polysomy-induced MET amplification was associated with a higher frequency of lymph node metastasis(LNM)(P<0.001)and higher tumor budding grade(P=0.02).In the survival analysis,significant difference was detected between patients with amplified-and non-amplified MET in a two-year follow-up after the first diagnosis(P=0.001).C-MET scores of 0,1+,2+,and 3+were observed in 1.4%,24.9%,54.7%,and 19.0%of tumors,respectively.C-MET overexpression correlated with higher frequency of LNM(P=0.002),but no significant difference of PFS was detected between patients with different protein levels.In terms of concordance between MET FISH and IHC results,MET copy number showed no difference in c-MET IHC 0/1+(3.35±0.18),2+(3.29±0.11)and 3+(3.58±0.22)cohorts,and the MET-to-CEP7 ratio showed no difference in three groups(1.09±0.02,1.10±0.01,and 1.09±0.03).CONCLUSION In CRC,focal MET amplification was a rare event.Polysomy-induced MET amplification correlated with adverse pathological characteristics and poor prognosis.IHC was a poor screening tool for MET amplification.展开更多
AIM To investigate the relationship between autophagy and perineural invasion(PNI), clinical features, and prognosis in patients with pancreatic cancer. METHODS Clinical and pathological data were retrospectively coll...AIM To investigate the relationship between autophagy and perineural invasion(PNI), clinical features, and prognosis in patients with pancreatic cancer. METHODS Clinical and pathological data were retrospectively collected from 109 patients with pancreatic ductal adenocarcinoma who underwent radical resection at the First Affiliated Hospital of Zhengzhou University from January 2011 to August 2016. Expression levels of the autophagy-related protein microtubuleassociated protein 1 A/1 B-light chain 3(LC3) and PNI marker ubiquitin carboxy-terminal hydrolase(UCH) in pancreatic cancer tissues were detected by immunohistochemistry. The correlations among LC3 expression, PNI, and clinical pathological features in pancreatic cancer were analyzed. The patients were followed for further survival analysis. RESULTS In 109 cases of pancreatic cancer, 68.8%(75/109) had evidence of PNI and 61.5%(67/109) had high LC3 expression. PNI was associated with lymph node metastasis, pancreatitis, and CA19-9 levels(P < 0.05). LC3 expression was related to lymph node metastasis(P < 0.05) and was positively correlated with neural invasion(P < 0.05, r = 0.227). Multivariate logistic regression analysis indicated that LC3 expression, lymph node metastasis, pancreatitis, and CA19-9 level were factors that influenced neural invasion, whereas only neural invasion itself was an independent factor for high LC3 expression. Univariate analysis showed that LC3 expression, neural invasion, and CA19-9 level were related to the overall survival of pancreatic cancer patients(P < 0.05). Multivariate COX regression analysis indicated that PNI and LC3 expression were independent risk factors for poor prognosis in pancreatic cancer(P < 0.05). CONCLUSION PNI in patients with pancreatic cancer is positively related to autophagy. Neural invasion and LC3 expression are independent risk factors for pancreatic cancer with a poor prognosis.展开更多
Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological e...Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.展开更多
BACKGROUND Breast cancer is the most common malignancy in women all around the world.According to the latest statistics in 2018,there were more than 2.08 million new breast cancer cases all around the world and more t...BACKGROUND Breast cancer is the most common malignancy in women all around the world.According to the latest statistics in 2018,there were more than 2.08 million new breast cancer cases all around the world and more than 620000 deaths;the proportion of breast cancer deaths in women with cancer is 15%.By studying age,clinicopathological characteristics and molecular classification,age at menarche,age at birth,number of births,number of miscarriages,lactation time,surgical history of benign breast lesions,history of gynecological diseases,and other factors,we retrospectively summarized and compared the disease history of patients with primary breast cancer and patients with benign thyroid tumors admitted to our hospital in the past 10 years to explore the clinicopathological characteristics and risk factors for primary breast cancer.AIM To investigate the clinical and pathological features and risk factors for primary breast cancer treated at our center in order to provide a reference for the prevention and treatment of breast cancer in the Zhuhai-Macao region.METHODS Through a retrospective case-control study,149 patients with primary breast cancer diagnosed and treated at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to March 2020 were included as a case group,and 165 patients with benign breast tumors diagnosed and treated from January 2019 to March 2020 were included as a control group.The data collected included age,age at menarche,age at first birth,number of births,number of miscarriages,lactation time,history of surgery for benign breast lesions,history of familial malignant tumors,history of gynecological diseases,history of thyroid diseases,and the tumor characteristics of the patients in the case group including pathological diagnosis,pathological type,tumor size,lymph node metastasis,distant metastasis,stage,and molecular classification,among others.In the case group,the chi-square test was used to analyze the clinical and pathological features of patients in three age groups(<40,40-59,and≥60 years).A multifactor logistic regression analysis was used to analyze correlations between the two groups.RESULTS Among 149 patients with primary breast cancer,the average age was 48.20±12.06 years,and the proportion of patients at 40-59 years old was the highest,accounting for 61.8%of cases.The molecular type was mainly luminal B type,accounting for 69.2%of cases,and at the time of diagnosis,the tumor stage was mainly stage I/II,accounting for 62.4%of cases.There were no statistically significant differences in the distributions of tumor location,pathological type,tumor size,lymph node metastasis,stage,or molecular classification among the three age groups(<40,40-59,and≥60 years)(P≥0.05).The differences in the distribution of distant metastasis among the three age groups(<40,40-59,and≥60 years)were statistically significant(P<0.01).The differences in lactation time,history of familial malignant tumors,history of gynecological diseases,and history of thyroid diseases between the two groups were not statistically significant(P≥0.05).The differences in age at disease diagnosis,age at menarche,and history of surgery for benign breast lesions were statistically significant(P<0.01).The difference in age at first birth was also statistically significant(P<0.05).CONCLUSION The highest incidence of breast cancer in the Zhuhai-Macao region is present among women aged 40-59 years.There is a larger proportion of stage I/II patients,and the luminal B type is the most common molecular subtype.Distant metastasis occurs mainly in the≥60-year-old group at the first diagnosis;increased age,late age at menarche,and late age at first birth may be risk factors for primary breast cancer,and a history of surgery for benign breast lesions may be a protective factor for primary breast cancer.展开更多
BACKGROUND：Devic＇s neuromyelitis optica （DNMO） and multiple sclerosis in Asian populations have been considered to be the same disease. However, there is an increasing number of studies suggesting that DNMO and mu...BACKGROUND：Devic＇s neuromyelitis optica （DNMO） and multiple sclerosis in Asian populations have been considered to be the same disease. However, there is an increasing number of studies suggesting that DNMO and multiple sclerosis are different diseases.OBJECTIVE：Little information is available regarding comparisons of DNMO patients between China and other countries, as well as clinical manifestations of Chinese patients with DNMO and multiple sclerosis. The present study performed a multi-center, pathological, retrospective analysis.DESIGN, TIME AND SETTING：A retrospective analysis of clinical data from seven patients with DNMO diagnosed between 1957 and 1998.PARTICIPANTS：Data from Chinese DNMO patients was provided by the Shanghai Second Medical University, Sun Yat-sen University of Medical Sciences and the First Affiliated Hospital of Harbin Medical University in China.METHODS：Clinical and pathological data from Chinese patients with DNMO were retrospectively analyzed. The clinical characteristics of DNMO were compared between Chinese and Caucasian patients. In addition, clinical and pathological differences between DNMO and multiple sclerosis Chinese patients were compared.MAIN OUTCOME MEASURES：Clinical and pathological features of Chinese patients with DNMO.RESULTS：All seven Chinese patients with DNMO exhibited abrupt onset of vision disturbance, with a disease course of 3 clays to 9 years. DNMO recurred in two of the patients. Demyelinating lesions were observed in all patients, with necrotic lesions and gitter cells in five patients, collagenous hyperplasia in one patient, and perivascular inflammatory cell infiltration in six patients. Comparison between Chinese and Caucasian DNMO patients revealed no significant differences in age at onset, clinical onset, duration, or interval between optic neuritis and myelitis. Compared with Chinese multiple sclerosis patients, Chinese DNMO patients presented with fewer recurrences, higher occurrence of necrosis, perivascular inflammatory cell infiltration and gitter cells, and a lower occurrence of collagenous hyperplasia.CONCLUSION：There was no difference in DNMO clinical features between Chinese and Caucasian patients. However, the clinical and pathological features of DNMO were different compared with multiple sclerosis in Chinese patients. Results suggested that the characteristics of DNMO in Chinese patients were significantly different than multiple sclerosis.展开更多
Objective： To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992-2005 and the relationship between the changes and etiology factor...Objective： To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992-2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention. Methods： A total of 1003 gastric cancer specimens resected surgically between 1992-2005 in Zhuanghe Center Hospital were studied. The specimens were fixed in formalin and diagnosed by routine pathology. Results： The incidence of patients with gastric cancer was highest at age of 60-69, the next high was at age of 50-59 and it was significantly higher in male than in female （P〈0.001）, the ratio was 3.0：1. During the past 14 years, there were 159 （15.9%） EGC, 195 （19.4%） moderate and 649 （64.7%） advanced gastric cancer detected. In macroscopical features, type Ⅲ remained dominant in EGC, the next was mixed type in EGC. In advanced gastric cancer the Borrmann＇s type Ⅲ remained the dominant, the next was type Ⅱ. For nodal metastasis, positive cases were decreasing and negative were increasing in EGC, moreover negative cases were higher than positive ones each year. There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year. In histological features, papillary, moderately and poorly differentiated tubular adenocarcinoma remained downtrend, mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year. The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion： There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years.展开更多
Objective To investigate the endoscopic and pathological features and the independent risk factors for early esophageal cancer combined with multiple primary cancer.Methods Endoscopic and pathological features of 324 ...Objective To investigate the endoscopic and pathological features and the independent risk factors for early esophageal cancer combined with multiple primary cancer.Methods Endoscopic and pathological features of 324 patients diagnosed as having early esophageal cancer from January 2013 to January 2022 in Beijing FriendshipHospital wereretrospectivelycollected.Independent risk factors for early esophageal cancer combined with multiple primary cancer were selected by multivariate logistic regression analysis.Results Among the 324 patients with early esophageal cancer,47(14.51%)patients(29 metachronous and 18 synchronous)had multiple primary cancer.Multivariate logistic regression analysis showed that alcohol drinking≥5 standard drinks/day(OR=6.23,95%CI:2.49-15.57,P<0.001),submucosal layer invasion(0R=2.80,95%Cl:1.07-7.30,P=0.036),lesion location at lower esophagus(0R=4.18,95%CI:1.98-8.97,P<0.001)and multiple lesions in esophagus(0R=3.30,95%CI:1.57-6.92,P=0.002)were independent risk factors for early esophageal cancer combined with multiple primary cancer.Conclusion Alcohol drinking≥5 standard drinks/day,submucosal layer invasion,lower lesions location,and multiple lesions in the esophagus are independent risk factors that are more likely to develop multiple primary cancer in patients with early esophageal cancer.It is recommended to prioritize monitoring patients with these factors,and enhance endoscopic follow-up and assessment.展开更多
The atherosclerotic lesions from 4 major epicardial coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) of 23 nonagenarians patients were compared with that from 23 pat...The atherosclerotic lesions from 4 major epicardial coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) of 23 nonagenarians patients were compared with that from 23 patients aged 60?9. The arteries were cut into transversely 5 mm long segments and were examined by microscope. The inside circumferences of the lumen were measured by computerized morphometric analysis. The results showed that the numbers of atherosclerotic plaques, percentages of narrowing of the coronary arterial lumen and circumferences of the arterial lumen in both groups were similar. But there were much more fibrous and resting (silent) or regressive plaques in the group aged 90-99 years as well as less lipid and active or progressive plaques than those in the group of 60-69 years. The above morphological findings may be correlated with the fact that there was a similar incidence of coronary heart disease but a less risk of acute myocardial infarction in patients aged 90?9 years than those aged 60?9 years.展开更多
Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Ca...Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Cancer Center(FUSCC).Methods:This retrospective cohort study analyzed 21,141 pathologically confirmed CRC cases diagnosed at FUSCC from 2008 to 2020.Patients were divided into five groups for different analytical purposes:(1)the before vs.since 2014 groups to analyze the influence of the changes in the classification criteria of pT3 and pT4 staging on the survival of patients;(2)the partial vs.total mesorectal excision(TME)groups to analyze whether evaluation of completeness of the mesorectum have impact on the survival of patients;(3)the tumor deposit(TD)(+)N0 vs.TD(+)N1c groups to analyze the influence of the changes in the pN staging on the survival of patients with positive TD and negative regional lymph node metastasis(LNM);(4)the before vs.since 2013 groups to analyze the influence of the changes in the testing process of deficient mismatch repair on the survival of patients;and(5)the groups with vs.without RAS/BRAF gene mutation testing to analyze the influence of these testing on the survival of patients.Patients’clinicopathological parameters,including age at diagnosis,sex,tumor size,location,differentiation,mucinous subtype,TD,lymphovascular invasion,perineural invasion,tumor depth,LNM and distant metastasis,and tumor-node-metastasis(TNM)stage,were compared between groups.Kaplan-Meier analysis with log rank method was performed for patients’overall survival(OS)and disease-free survival(DFS)analyses.Results:In pathological reports,there were three parameter changes that impacted patient outcomes.Firstly,changes in the pT staging criteria led to a shift of the ratio of patients with stage pT3 to stage pT4 from 1:110.9 to 1:0.26.In comparison to patients admitted before 2014(n=4,754),a significant difference in prognosis between pT3 and pT4 stages was observed since 2014(n=9,965).Secondly,we began to evaluate the completeness of the mesorectum since 2016.As a result,91.0%of patients with low rectal cancer underwent TME(n=4,111)surgery,and patients with TME had significantly better OS compared with partial mesorectal excision(PME,n=409).Thirdly,we began to stage TD(+)LNM(-)as N1c since 2017.The results showed that N1c(n=127)but not N0(n=39)can improve the prognosis of patients without LNM and distal metastasis.In molecular testing,there have been three and five iterations of updates regarding mismatch repair(MMR)/microsatellite instability(MSI)status and RAS/BRAF gene mutation detection,respectively.The standardization of MMR status testing has sharply decreased the proportion of deficient MMR(dMMR)patients(from 32.5%to 7.4%)since 2013.The prognosis of patients underwent MMR status testing since 2013(n=867)were significantly better than patients before 2013(n=1,313).In addition,detection of RAS/BRAF gene mutation status(n=5,041)resulted in better DFS but not OS,for patients with stage I-III disease(n=16,557).Conclusion:Over the past few decades,updates in elements in pathological reports,as well as the development of standardized tests for MMR/MSI status and RAS/BRAF gene mutations have significantly improved patient outcomes.展开更多
The low detection rate of Mycobacterium tuberculosis in clinical practice leads to a high rate of missed diagnosis for pulmonary tuberculosis(PTB).As a noninvasive,high-resolution,real-time imaging technology,polariza...The low detection rate of Mycobacterium tuberculosis in clinical practice leads to a high rate of missed diagnosis for pulmonary tuberculosis(PTB).As a noninvasive,high-resolution,real-time imaging technology,polarization-sensitive optical coherence tomography(PS-OCT)may be feasible for the rapid identification of pathological feature.This study aimed to explore the feasibility of using PS-OCT to identify pathological features of PTB.In the experiments,PTB samples containing some surrounding lung tissues were imaged using PS-OCT.It is demonstrated that PS-OCT images showed good consistency with the corresponding pathological images and were able to identify PTB-related characteristic pathological regions.We think PS-OCT can serve as an effective supplement for the diagnosis of PTB,enabling rapid and accurate diagnosis,and aiding in the understanding of the pathological characteristics and pathophysiological processes of PTB.展开更多
Liver cancer is one of the main malignant tumors in the digestive system.Early detection and treatment have positive significance in improving patient prognosis and reducing mortality.MRI is the main method for liver ...Liver cancer is one of the main malignant tumors in the digestive system.Early detection and treatment have positive significance in improving patient prognosis and reducing mortality.MRI is the main method for liver cancer examination,which mainly uses computers to compare imaging of different energy regions of tumors,observe the density and signal changes of liver cancer,and the degree of tumor enhancement.In particular,various new MRI functional imaging technologies,such as diffusion-weighted imaging,perfusion weighted imaging,delayed imaging,liver cell specific contrast agent enhanced imaging,etc.,can be used at the molecular level Multiple aspects such as cell function provide clinicians with richer diagnostic information.Therefore,further comparative analysis of MRI manifestations and pathological results of liver cancer can help to gain a deeper understanding of the biological behavior of tumors and provide a basis for treatment decision-making and prognosis evaluation.展开更多
The classification of pathological voice from healthy voice was studied based upon 27 acoustic features derived from a single sound signal of vowel /a:/. First, the feature space was transferred to reduce the data dim...The classification of pathological voice from healthy voice was studied based upon 27 acoustic features derived from a single sound signal of vowel /a:/. First, the feature space was transferred to reduce the data dimension by principle component analysis (PCA). Then the voice samples were classified according to the reduced PCA parameters by support vector machine (SVM) using radial basis function (RBF) as a kernel function. Meanwhile, by changing the ratio of opposite class samples, the accuracy under different features combinations was tested. Experimental data were provided by the voice database of Massachusetts Eye and Ear Infirmary (MEEI) in which 216 vowel /a:/ samples were collected from subjects of healthy and pathological cases, and tested with 5 fold cross-validation method. The result shows the positive rate of pathological voices was improved from 92% to 98% through the PCA method. STD, Fatr, Tasm, NHR, SEG, and PER are pathology sensitive features in illness detection. Using these sensitive features the accuracy of detection of pathological voice from healthy voice can reach 97%.展开更多
Objective:There is currently no consensus on whether extra-gastrointestinal stromal tumors(EGISTs)and gastrointestinal stromal tumors(GISTs)are the same type of tumor,and whether the diagnosis and treatment of EGISTs ...Objective:There is currently no consensus on whether extra-gastrointestinal stromal tumors(EGISTs)and gastrointestinal stromal tumors(GISTs)are the same type of tumor,and whether the diagnosis and treatment of EGISTs can directly replicate the current diagnostic and treatment standards for GISTs.This study aims to further elucidate the clinical and pathological characteristics,diagnosis,treatment,and prognosis of EGISTs by analyzing the research results of domestic scholars in the field of EGISTs in the past decade.Methods:A review was conducted on original Chinese and English research articles published from 2013 to 2022 focusing on EGISTs.A descriptive approach was used to extract key information from the literature,including patient demographics,tumor location,tumor diameter,mitotic figures,risk stratification,immunohistochemical markers,cell type,and prognostic factors.The data were subjected to statistical analysis.Results:A total of 12 articles containing 780 EGIST patients were included.The male-to female incidence of EGISTs was 0.92꞉1.The most common sites of EGISTs were mesentery(30.96%),peritoneum or retroperitoneum(28.53%),omentum(20.32%),and pelvic cavity(12.52%).52.77%of EGISTs had tumor diameters greater than 10 cm,and the proportions of EGISTs with nuclear fission patterns greater than 5/50 high power field(HPF)and greater than 10/50 HPF were 51.24%and 26.11%,respectively.The proportion of high-risk EGISTs was 79.05%.The positive rates of immune markers CD117,CD34,and DOG-1 in EGISTs were 82.3%,69.0%,and 79.5%,respectively.The proportion of Ki-67>5%was 49.2%,and the proportion of Ki-67>10%was 24.8%.The proportions of EGISTs in spindle cells,epithelial cells,and mixed cells were 74.4%,14.8%,and 13.1%,respectively.The diameter of the tumor,resection method,risk level,Ki-67 index,mitotic counts,presence of rupture/bleeding/necrosis/peripheral tissue invasion/recurrence and metastasis,as well as the use of imatinib treatment after surgery were important factors affecting the prognosis of EGISTs.Conclusion:Current medical research is relatively well cognizant of GISTs with primary sites in the gastrointestinal tract.Compared with GISTs,EGISTs have large tumor diameters,high mitotic counts,a high percentage of high-risk grades,relatively unique molecular expression,and high aggressiveness.EGISTs differ from GISTs in clinicopathological characteristics.Whether EGISTs and GISTs share a common origin remains unclear.If they are distinct tumor entities,separate diagnostic and treatment guidelines for EGISTs should be established.If EGISTs are ultimately confirmed to be a special subtype of GISTs,then directly applying existing GIST-based standards to EGISTs may be inappropriate.A more scientific approach would involve subclassifying EGISTs based on anatomical location and then tailoring treatment strategies accordingly with reference to GIST guidelines.展开更多
Background:Cervical cancer is the fourth most common cancer in women gobally.Although human paillonavinus(HPV)testing plays an increasing role in cervical cancer screening and treatment,HPV-negative cervical cancer re...Background:Cervical cancer is the fourth most common cancer in women gobally.Although human paillonavinus(HPV)testing plays an increasing role in cervical cancer screening and treatment,HPV-negative cervical cancer remains a consistenty reported entity globally.Whle numerous studies have focused on HPV-positve cervical cancers,detailed studies on HPV-negative counterparts remain limited.Results:This literature review aims to discuss several aspects of HPV-negative cervical cancers including the prevalence of HPV-negative cervical carcinomas and precancerous lesions and their relation to sample types(parffin-embedded tsse blocks or liquid samples).Addionally.we explore possible reasons for false HPV-negative cases.Furthermore,we review histomorphological,molecular and cdinical features of HPV-negative cervical cancers.Conclusions:The topic of HPV-negative cervical cancers is of importance given the drive towards HPV primary screening,itition of self-collected HPV testing and widespread use of HPV vaccination.展开更多
BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pa...BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pathological features of GSRC with those of gastric adenocarcinoma of different degrees of differentiation and the differences in survival prognosis between the different disease processes.METHODS By screening gastric cancer patients from 2010 to 2015 in the database of Surveillance,Epidemiology and End Results,and collecting the clinicopathological and prognostic data of gastric cancer patients who underwent surgery from January 2014 to December 2016 in the Second Affiliated Hospital of Nanchang University,we analyzed the general pathological characteristics of GSRC by the chi-square test.Univariate and multivariate analyses were conducted to compare the factors affecting the survival and prognosis of early and advanced gastric adenocarcinoma.The Kaplan-Meier curves were plotted to reveal the survival difference between early and advanced GSRC and different differentiated types of gastric adenocarcinoma.The prognosis model of advanced GSRC was established with R software,and the area under curve(AUC)and C-index were used to assess the accuracy of the model.RESULTS Analysis of pathological features revealed that signet ring-cell carcinoma(SRC)was more frequently seen in younger(<60 years),female,and White patients compared to non-SRC patients.SRC was less commonly associated with early gastric cancer(EGC)(23.60%vs 39.10%),lower N0(38.61%vs 61.03%),and larger tumour sizes>5 cm(31.15%vs 27.10%)compared to the differentiated type,while the opposite was true compared to the undifferentiated type.Survival prognostic analysis found no significant difference in the prognosis of SRC patients among EGC patients.In contrast,among advanced gastric cancer(AGC)patients,the prognosis of SRC patients was correlated with age,race,tumour size,AJCC stage,T-stage,and postoperative adjuvant therapy.The predictive model showed that the 3-year AUC was 0.787,5-year AUC was 0.806,and C-index was 0.766.Compared to non-SRC patients,patients with SRC had a better prognosis in EGC[hazard ratio(HR):0.626,95%confidence interval(CI):0.427-0.919,P<0.05]and a worse prognosis in AGC(HR:1.139,95%CI:1.030-1.258,P<0.05).When non-SRC was divided into differentiated and undifferentiated types for comparison,it was found that in EGC,SRC had a better prognosis than differentiated and undifferentiated types,while there was no significant difference between differentiated and undifferentiated types.In AGC,there was no significant difference in prognosis between SRC and undifferentiated types,both of which were worse than differentiated types.A prognostic analysis of postoperative adjuvant therapy for SRC in patients with AGC revealed that adjuvant postoperative radiotherapy or chemotherapy significantly improved patient survival(34.6%and 36.2%vs 18.6%,P<0.05).CONCLUSION The prognosis of SRC is better than that of undifferentiated type,especially in EGC,and its prognosis is even better than that of differentiated type.SRC patients can benefit from early detection,surgical resection,and aggressive adjuvant therapy.展开更多
BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficul...BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.展开更多
Objective:To investigate the effect of programmed death-ligand 1(PD-L1)gene polymorphism on pathological characteristics and clinical prognosis quality in patients with esophageal cancer.Methods:86 patients with esoph...Objective:To investigate the effect of programmed death-ligand 1(PD-L1)gene polymorphism on pathological characteristics and clinical prognosis quality in patients with esophageal cancer.Methods:86 patients with esophageal cancer treated in our hospital from January 2014 to January 2017 were selected as the observation group,and 100 healthy patients were selected as the control group during the same period.The single nucleotide polymorphisms of rs2890658,rs17718883,rs2297136 and rs4143185 at different sites were determined.And the impact of PD-L1 gene polymorphism on pathological features and prognosis of esophageal cancer were analyzed.Results:The observation group finally completed 84 cases,and the control group included 99 cases.There were differences between the observation group and the control group in the PD-L1 different genetic locus rs17718883,rs2890658,rs2297136(P<0.05).The PD-L1 locus rs17718883 was related to the pathological type and degree of differentiation of esophageal cancer,the difference was statistically significant(P<0.05),rs2890658 was related to the degree of differentiation of esophageal cancer,the difference was statistically significant(P<0.05).Log-rank test showed that the genotype of rs17718883 in patients with esophageal cancer was related to prognostic survival,and the difference was statistically significant(P<0.05).Cox proportional hazards model analysis showed that age,degree of differentiation,lymph node metastasis,and rs17718883 genotype were independent factors in the prognosis of patients with esophageal cancer,and the difference was statistically significant(P<0.05).Conclusion:The polymorphisms of rs17718883 and rs2890658 loci of PD-L1 gene have an impact on the clinicopathological characteristics of patients with esophageal cancer,and the polymorphisms of rs17718883 locus of PD-L1 gene have an impact on the clinical prognosis quality.展开更多
AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiv...AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.展开更多
BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).I...BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each other.AIM To study the histologic and clinical features of PSC patients with and without IBD.METHODS We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years 1999-2013.PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration.Clinical data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were noted.RESULTS PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to UC.They required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC patients.The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD.No PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of IBD.The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.展开更多
基金was approved by the Ethics Committee of Cangzhou Central Hospital,No.29795793.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling protein MORC family CW-type zinc finger 4(MORC4)as a biomarker in CRC patients,and to explore its relationship with pathological features and prognosis.METHODS A total of 143 CRC specimens and 57 adjacent tissue specimens,surgically removed from our hospital between January 2020 and January 2021,were collected.MORC4 protein expression was assessed using immunohistochemistry after paraffin embedding.The relationship between MORC4 protein expression and clinicopathological characteristics of patients was analyzed.Kaplan-Meier survival curves were plotted to analyze the relationship between MORC4 protein expression and prognosis in CRC patients.RESULTS Compared with adjacent tissues,the expression rate of MORC4 protein in CRC tissues was significantly higher(P<0.05).No significant difference was observed in the high expression rate of MORC4 protein in CRC tissues among patients of different gender,age,tumor location,tumor diameter,and primary tumor status(P>0.05).However,significant differences were found in the high expression rate of MORC4 protein in patients with different degrees of differentiation,lymph node metastasis,distant metastasis,tumor-lymph node-metastasis stage,and serum carcinoembryonic antigen levels(P<0.05).Compared with patients with low MORC4 expression,patients with high MORC4 expression had a worse prognosis(P<0.05).CONCLUSION The upregulation of MORC4 expression in CRC patients is closely related to disease severity and prognosis,suggesting its potential as an evaluation biomarker,which warrants further investigation.
基金the National Natural Science Foundation of China,No.82002829.
文摘BACKGROUND Colorectal cancer(CRC)is the third most common cancer and the second most common cause of cancer-related mortality worldwide.Mesenchymal-epithelial transition factor(MET)gene participates in multiple tumor biology and shows clinical potential for pharmacological manipulation in tumor treatment.MET amplification has been reported in CRC,but data are very limited.Investigating pathological values of MET in CRC may provide new therapeutic and genetic screening options in future clinical practice.AIM To determine the pathological significance of MET amplification in CRC and to propose a feasible screening strategy.METHODS A number of 205 newly diagnosed CRC patients undergoing surgical resection without any preoperative therapy at Shenzhen Cancer Hospital of Chinese Academy of Medical Sciences were recruited.All patients were without RAS/RAF mutation or microsatellite instability-high.MET amplification and c-MET protein expression were analyzed using fluorescence in situ hybridization(FISH)and immunohistochemistry(IHC),respectively.Correlations between MET aberration and pathological features were detected using the chi-squared test.Progression free survival(PFS)during the two-year follow-up was detected using the Kaplan-Meier method and log rank test.The results of MET FISH and IHC were com pared using one-way ANOVA.RESULTS Polysomy-induced MET amplification was observed in 14.4%of cases,and focal MET amplification was not detected.Polysomy-induced MET amplification was associated with a higher frequency of lymph node metastasis(LNM)(P<0.001)and higher tumor budding grade(P=0.02).In the survival analysis,significant difference was detected between patients with amplified-and non-amplified MET in a two-year follow-up after the first diagnosis(P=0.001).C-MET scores of 0,1+,2+,and 3+were observed in 1.4%,24.9%,54.7%,and 19.0%of tumors,respectively.C-MET overexpression correlated with higher frequency of LNM(P=0.002),but no significant difference of PFS was detected between patients with different protein levels.In terms of concordance between MET FISH and IHC results,MET copy number showed no difference in c-MET IHC 0/1+(3.35±0.18),2+(3.29±0.11)and 3+(3.58±0.22)cohorts,and the MET-to-CEP7 ratio showed no difference in three groups(1.09±0.02,1.10±0.01,and 1.09±0.03).CONCLUSION In CRC,focal MET amplification was a rare event.Polysomy-induced MET amplification correlated with adverse pathological characteristics and poor prognosis.IHC was a poor screening tool for MET amplification.
基金Supported by the National Natural Science Foundation of China,No.U1504815
文摘AIM To investigate the relationship between autophagy and perineural invasion(PNI), clinical features, and prognosis in patients with pancreatic cancer. METHODS Clinical and pathological data were retrospectively collected from 109 patients with pancreatic ductal adenocarcinoma who underwent radical resection at the First Affiliated Hospital of Zhengzhou University from January 2011 to August 2016. Expression levels of the autophagy-related protein microtubuleassociated protein 1 A/1 B-light chain 3(LC3) and PNI marker ubiquitin carboxy-terminal hydrolase(UCH) in pancreatic cancer tissues were detected by immunohistochemistry. The correlations among LC3 expression, PNI, and clinical pathological features in pancreatic cancer were analyzed. The patients were followed for further survival analysis. RESULTS In 109 cases of pancreatic cancer, 68.8%(75/109) had evidence of PNI and 61.5%(67/109) had high LC3 expression. PNI was associated with lymph node metastasis, pancreatitis, and CA19-9 levels(P < 0.05). LC3 expression was related to lymph node metastasis(P < 0.05) and was positively correlated with neural invasion(P < 0.05, r = 0.227). Multivariate logistic regression analysis indicated that LC3 expression, lymph node metastasis, pancreatitis, and CA19-9 level were factors that influenced neural invasion, whereas only neural invasion itself was an independent factor for high LC3 expression. Univariate analysis showed that LC3 expression, neural invasion, and CA19-9 level were related to the overall survival of pancreatic cancer patients(P < 0.05). Multivariate COX regression analysis indicated that PNI and LC3 expression were independent risk factors for poor prognosis in pancreatic cancer(P < 0.05). CONCLUSION PNI in patients with pancreatic cancer is positively related to autophagy. Neural invasion and LC3 expression are independent risk factors for pancreatic cancer with a poor prognosis.
文摘Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.
文摘BACKGROUND Breast cancer is the most common malignancy in women all around the world.According to the latest statistics in 2018,there were more than 2.08 million new breast cancer cases all around the world and more than 620000 deaths;the proportion of breast cancer deaths in women with cancer is 15%.By studying age,clinicopathological characteristics and molecular classification,age at menarche,age at birth,number of births,number of miscarriages,lactation time,surgical history of benign breast lesions,history of gynecological diseases,and other factors,we retrospectively summarized and compared the disease history of patients with primary breast cancer and patients with benign thyroid tumors admitted to our hospital in the past 10 years to explore the clinicopathological characteristics and risk factors for primary breast cancer.AIM To investigate the clinical and pathological features and risk factors for primary breast cancer treated at our center in order to provide a reference for the prevention and treatment of breast cancer in the Zhuhai-Macao region.METHODS Through a retrospective case-control study,149 patients with primary breast cancer diagnosed and treated at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to March 2020 were included as a case group,and 165 patients with benign breast tumors diagnosed and treated from January 2019 to March 2020 were included as a control group.The data collected included age,age at menarche,age at first birth,number of births,number of miscarriages,lactation time,history of surgery for benign breast lesions,history of familial malignant tumors,history of gynecological diseases,history of thyroid diseases,and the tumor characteristics of the patients in the case group including pathological diagnosis,pathological type,tumor size,lymph node metastasis,distant metastasis,stage,and molecular classification,among others.In the case group,the chi-square test was used to analyze the clinical and pathological features of patients in three age groups(<40,40-59,and≥60 years).A multifactor logistic regression analysis was used to analyze correlations between the two groups.RESULTS Among 149 patients with primary breast cancer,the average age was 48.20±12.06 years,and the proportion of patients at 40-59 years old was the highest,accounting for 61.8%of cases.The molecular type was mainly luminal B type,accounting for 69.2%of cases,and at the time of diagnosis,the tumor stage was mainly stage I/II,accounting for 62.4%of cases.There were no statistically significant differences in the distributions of tumor location,pathological type,tumor size,lymph node metastasis,stage,or molecular classification among the three age groups(<40,40-59,and≥60 years)(P≥0.05).The differences in the distribution of distant metastasis among the three age groups(<40,40-59,and≥60 years)were statistically significant(P<0.01).The differences in lactation time,history of familial malignant tumors,history of gynecological diseases,and history of thyroid diseases between the two groups were not statistically significant(P≥0.05).The differences in age at disease diagnosis,age at menarche,and history of surgery for benign breast lesions were statistically significant(P<0.01).The difference in age at first birth was also statistically significant(P<0.05).CONCLUSION The highest incidence of breast cancer in the Zhuhai-Macao region is present among women aged 40-59 years.There is a larger proportion of stage I/II patients,and the luminal B type is the most common molecular subtype.Distant metastasis occurs mainly in the≥60-year-old group at the first diagnosis;increased age,late age at menarche,and late age at first birth may be risk factors for primary breast cancer,and a history of surgery for benign breast lesions may be a protective factor for primary breast cancer.
文摘BACKGROUND：Devic＇s neuromyelitis optica （DNMO） and multiple sclerosis in Asian populations have been considered to be the same disease. However, there is an increasing number of studies suggesting that DNMO and multiple sclerosis are different diseases.OBJECTIVE：Little information is available regarding comparisons of DNMO patients between China and other countries, as well as clinical manifestations of Chinese patients with DNMO and multiple sclerosis. The present study performed a multi-center, pathological, retrospective analysis.DESIGN, TIME AND SETTING：A retrospective analysis of clinical data from seven patients with DNMO diagnosed between 1957 and 1998.PARTICIPANTS：Data from Chinese DNMO patients was provided by the Shanghai Second Medical University, Sun Yat-sen University of Medical Sciences and the First Affiliated Hospital of Harbin Medical University in China.METHODS：Clinical and pathological data from Chinese patients with DNMO were retrospectively analyzed. The clinical characteristics of DNMO were compared between Chinese and Caucasian patients. In addition, clinical and pathological differences between DNMO and multiple sclerosis Chinese patients were compared.MAIN OUTCOME MEASURES：Clinical and pathological features of Chinese patients with DNMO.RESULTS：All seven Chinese patients with DNMO exhibited abrupt onset of vision disturbance, with a disease course of 3 clays to 9 years. DNMO recurred in two of the patients. Demyelinating lesions were observed in all patients, with necrotic lesions and gitter cells in five patients, collagenous hyperplasia in one patient, and perivascular inflammatory cell infiltration in six patients. Comparison between Chinese and Caucasian DNMO patients revealed no significant differences in age at onset, clinical onset, duration, or interval between optic neuritis and myelitis. Compared with Chinese multiple sclerosis patients, Chinese DNMO patients presented with fewer recurrences, higher occurrence of necrosis, perivascular inflammatory cell infiltration and gitter cells, and a lower occurrence of collagenous hyperplasia.CONCLUSION：There was no difference in DNMO clinical features between Chinese and Caucasian patients. However, the clinical and pathological features of DNMO were different compared with multiple sclerosis in Chinese patients. Results suggested that the characteristics of DNMO in Chinese patients were significantly different than multiple sclerosis.
基金supported by the National"Tenth-Five"Key Technologies R&D Program of China(2004BA703B04-02)
文摘Objective： To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992-2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention. Methods： A total of 1003 gastric cancer specimens resected surgically between 1992-2005 in Zhuanghe Center Hospital were studied. The specimens were fixed in formalin and diagnosed by routine pathology. Results： The incidence of patients with gastric cancer was highest at age of 60-69, the next high was at age of 50-59 and it was significantly higher in male than in female （P〈0.001）, the ratio was 3.0：1. During the past 14 years, there were 159 （15.9%） EGC, 195 （19.4%） moderate and 649 （64.7%） advanced gastric cancer detected. In macroscopical features, type Ⅲ remained dominant in EGC, the next was mixed type in EGC. In advanced gastric cancer the Borrmann＇s type Ⅲ remained the dominant, the next was type Ⅱ. For nodal metastasis, positive cases were decreasing and negative were increasing in EGC, moreover negative cases were higher than positive ones each year. There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year. In histological features, papillary, moderately and poorly differentiated tubular adenocarcinoma remained downtrend, mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year. The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion： There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years.
文摘Objective To investigate the endoscopic and pathological features and the independent risk factors for early esophageal cancer combined with multiple primary cancer.Methods Endoscopic and pathological features of 324 patients diagnosed as having early esophageal cancer from January 2013 to January 2022 in Beijing FriendshipHospital wereretrospectivelycollected.Independent risk factors for early esophageal cancer combined with multiple primary cancer were selected by multivariate logistic regression analysis.Results Among the 324 patients with early esophageal cancer,47(14.51%)patients(29 metachronous and 18 synchronous)had multiple primary cancer.Multivariate logistic regression analysis showed that alcohol drinking≥5 standard drinks/day(OR=6.23,95%CI:2.49-15.57,P<0.001),submucosal layer invasion(0R=2.80,95%Cl:1.07-7.30,P=0.036),lesion location at lower esophagus(0R=4.18,95%CI:1.98-8.97,P<0.001)and multiple lesions in esophagus(0R=3.30,95%CI:1.57-6.92,P=0.002)were independent risk factors for early esophageal cancer combined with multiple primary cancer.Conclusion Alcohol drinking≥5 standard drinks/day,submucosal layer invasion,lower lesions location,and multiple lesions in the esophagus are independent risk factors that are more likely to develop multiple primary cancer in patients with early esophageal cancer.It is recommended to prioritize monitoring patients with these factors,and enhance endoscopic follow-up and assessment.
文摘The atherosclerotic lesions from 4 major epicardial coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) of 23 nonagenarians patients were compared with that from 23 patients aged 60?9. The arteries were cut into transversely 5 mm long segments and were examined by microscope. The inside circumferences of the lumen were measured by computerized morphometric analysis. The results showed that the numbers of atherosclerotic plaques, percentages of narrowing of the coronary arterial lumen and circumferences of the arterial lumen in both groups were similar. But there were much more fibrous and resting (silent) or regressive plaques in the group aged 90-99 years as well as less lipid and active or progressive plaques than those in the group of 60-69 years. The above morphological findings may be correlated with the fact that there was a similar incidence of coronary heart disease but a less risk of acute myocardial infarction in patients aged 90?9 years than those aged 60?9 years.
基金supported by National Natural Science Foundation of China(grant numbers:82273370,82202899,82172702,81972249,81902430,82002543,82002946,U1932145)Shanghai Clinical Science and Technology Innovation Project of Municipal Hospital(grant number:SHDC12020102)+5 种基金Natural Science Foundation of Shanghai(grant numbers:22ZR1413000,21ZR1414900)Artificial Intelligence Medical Hospital Cooperation Project of Xuhui District(grant number:2021-017)Shanghai Science and Technology Development Fund(grant number:19MC1911000)Shanghai Municipal Key Clinical Specialty(grant number:shslczdzk01301)Science and Technology Commission of Shanghai Municipality(grant number:18401933402)“Chenguang Program”supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission(grant number:20CG08).
文摘Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Cancer Center(FUSCC).Methods:This retrospective cohort study analyzed 21,141 pathologically confirmed CRC cases diagnosed at FUSCC from 2008 to 2020.Patients were divided into five groups for different analytical purposes:(1)the before vs.since 2014 groups to analyze the influence of the changes in the classification criteria of pT3 and pT4 staging on the survival of patients;(2)the partial vs.total mesorectal excision(TME)groups to analyze whether evaluation of completeness of the mesorectum have impact on the survival of patients;(3)the tumor deposit(TD)(+)N0 vs.TD(+)N1c groups to analyze the influence of the changes in the pN staging on the survival of patients with positive TD and negative regional lymph node metastasis(LNM);(4)the before vs.since 2013 groups to analyze the influence of the changes in the testing process of deficient mismatch repair on the survival of patients;and(5)the groups with vs.without RAS/BRAF gene mutation testing to analyze the influence of these testing on the survival of patients.Patients’clinicopathological parameters,including age at diagnosis,sex,tumor size,location,differentiation,mucinous subtype,TD,lymphovascular invasion,perineural invasion,tumor depth,LNM and distant metastasis,and tumor-node-metastasis(TNM)stage,were compared between groups.Kaplan-Meier analysis with log rank method was performed for patients’overall survival(OS)and disease-free survival(DFS)analyses.Results:In pathological reports,there were three parameter changes that impacted patient outcomes.Firstly,changes in the pT staging criteria led to a shift of the ratio of patients with stage pT3 to stage pT4 from 1:110.9 to 1:0.26.In comparison to patients admitted before 2014(n=4,754),a significant difference in prognosis between pT3 and pT4 stages was observed since 2014(n=9,965).Secondly,we began to evaluate the completeness of the mesorectum since 2016.As a result,91.0%of patients with low rectal cancer underwent TME(n=4,111)surgery,and patients with TME had significantly better OS compared with partial mesorectal excision(PME,n=409).Thirdly,we began to stage TD(+)LNM(-)as N1c since 2017.The results showed that N1c(n=127)but not N0(n=39)can improve the prognosis of patients without LNM and distal metastasis.In molecular testing,there have been three and five iterations of updates regarding mismatch repair(MMR)/microsatellite instability(MSI)status and RAS/BRAF gene mutation detection,respectively.The standardization of MMR status testing has sharply decreased the proportion of deficient MMR(dMMR)patients(from 32.5%to 7.4%)since 2013.The prognosis of patients underwent MMR status testing since 2013(n=867)were significantly better than patients before 2013(n=1,313).In addition,detection of RAS/BRAF gene mutation status(n=5,041)resulted in better DFS but not OS,for patients with stage I-III disease(n=16,557).Conclusion:Over the past few decades,updates in elements in pathological reports,as well as the development of standardized tests for MMR/MSI status and RAS/BRAF gene mutations have significantly improved patient outcomes.
基金funded by the Tianjin Foundation of Natural Science(No.21JCYBJC00260)Tianjin Key Medical Discipline(Thoracic Surgery)Construction Project No.TJYXZDXK-018A and the National Natural Science Foundation of China(62375144 and 61875092).
文摘The low detection rate of Mycobacterium tuberculosis in clinical practice leads to a high rate of missed diagnosis for pulmonary tuberculosis(PTB).As a noninvasive,high-resolution,real-time imaging technology,polarization-sensitive optical coherence tomography(PS-OCT)may be feasible for the rapid identification of pathological feature.This study aimed to explore the feasibility of using PS-OCT to identify pathological features of PTB.In the experiments,PTB samples containing some surrounding lung tissues were imaged using PS-OCT.It is demonstrated that PS-OCT images showed good consistency with the corresponding pathological images and were able to identify PTB-related characteristic pathological regions.We think PS-OCT can serve as an effective supplement for the diagnosis of PTB,enabling rapid and accurate diagnosis,and aiding in the understanding of the pathological characteristics and pathophysiological processes of PTB.
文摘Liver cancer is one of the main malignant tumors in the digestive system.Early detection and treatment have positive significance in improving patient prognosis and reducing mortality.MRI is the main method for liver cancer examination,which mainly uses computers to compare imaging of different energy regions of tumors,observe the density and signal changes of liver cancer,and the degree of tumor enhancement.In particular,various new MRI functional imaging technologies,such as diffusion-weighted imaging,perfusion weighted imaging,delayed imaging,liver cell specific contrast agent enhanced imaging,etc.,can be used at the molecular level Multiple aspects such as cell function provide clinicians with richer diagnostic information.Therefore,further comparative analysis of MRI manifestations and pathological results of liver cancer can help to gain a deeper understanding of the biological behavior of tumors and provide a basis for treatment decision-making and prognosis evaluation.
文摘The classification of pathological voice from healthy voice was studied based upon 27 acoustic features derived from a single sound signal of vowel /a:/. First, the feature space was transferred to reduce the data dimension by principle component analysis (PCA). Then the voice samples were classified according to the reduced PCA parameters by support vector machine (SVM) using radial basis function (RBF) as a kernel function. Meanwhile, by changing the ratio of opposite class samples, the accuracy under different features combinations was tested. Experimental data were provided by the voice database of Massachusetts Eye and Ear Infirmary (MEEI) in which 216 vowel /a:/ samples were collected from subjects of healthy and pathological cases, and tested with 5 fold cross-validation method. The result shows the positive rate of pathological voices was improved from 92% to 98% through the PCA method. STD, Fatr, Tasm, NHR, SEG, and PER are pathology sensitive features in illness detection. Using these sensitive features the accuracy of detection of pathological voice from healthy voice can reach 97%.
基金supported by the National Natural Science Foundation(81960508)。
文摘Objective:There is currently no consensus on whether extra-gastrointestinal stromal tumors(EGISTs)and gastrointestinal stromal tumors(GISTs)are the same type of tumor,and whether the diagnosis and treatment of EGISTs can directly replicate the current diagnostic and treatment standards for GISTs.This study aims to further elucidate the clinical and pathological characteristics,diagnosis,treatment,and prognosis of EGISTs by analyzing the research results of domestic scholars in the field of EGISTs in the past decade.Methods:A review was conducted on original Chinese and English research articles published from 2013 to 2022 focusing on EGISTs.A descriptive approach was used to extract key information from the literature,including patient demographics,tumor location,tumor diameter,mitotic figures,risk stratification,immunohistochemical markers,cell type,and prognostic factors.The data were subjected to statistical analysis.Results:A total of 12 articles containing 780 EGIST patients were included.The male-to female incidence of EGISTs was 0.92꞉1.The most common sites of EGISTs were mesentery(30.96%),peritoneum or retroperitoneum(28.53%),omentum(20.32%),and pelvic cavity(12.52%).52.77%of EGISTs had tumor diameters greater than 10 cm,and the proportions of EGISTs with nuclear fission patterns greater than 5/50 high power field(HPF)and greater than 10/50 HPF were 51.24%and 26.11%,respectively.The proportion of high-risk EGISTs was 79.05%.The positive rates of immune markers CD117,CD34,and DOG-1 in EGISTs were 82.3%,69.0%,and 79.5%,respectively.The proportion of Ki-67>5%was 49.2%,and the proportion of Ki-67>10%was 24.8%.The proportions of EGISTs in spindle cells,epithelial cells,and mixed cells were 74.4%,14.8%,and 13.1%,respectively.The diameter of the tumor,resection method,risk level,Ki-67 index,mitotic counts,presence of rupture/bleeding/necrosis/peripheral tissue invasion/recurrence and metastasis,as well as the use of imatinib treatment after surgery were important factors affecting the prognosis of EGISTs.Conclusion:Current medical research is relatively well cognizant of GISTs with primary sites in the gastrointestinal tract.Compared with GISTs,EGISTs have large tumor diameters,high mitotic counts,a high percentage of high-risk grades,relatively unique molecular expression,and high aggressiveness.EGISTs differ from GISTs in clinicopathological characteristics.Whether EGISTs and GISTs share a common origin remains unclear.If they are distinct tumor entities,separate diagnostic and treatment guidelines for EGISTs should be established.If EGISTs are ultimately confirmed to be a special subtype of GISTs,then directly applying existing GIST-based standards to EGISTs may be inappropriate.A more scientific approach would involve subclassifying EGISTs based on anatomical location and then tailoring treatment strategies accordingly with reference to GIST guidelines.
文摘Background:Cervical cancer is the fourth most common cancer in women gobally.Although human paillonavinus(HPV)testing plays an increasing role in cervical cancer screening and treatment,HPV-negative cervical cancer remains a consistenty reported entity globally.Whle numerous studies have focused on HPV-positve cervical cancers,detailed studies on HPV-negative counterparts remain limited.Results:This literature review aims to discuss several aspects of HPV-negative cervical cancers including the prevalence of HPV-negative cervical carcinomas and precancerous lesions and their relation to sample types(parffin-embedded tsse blocks or liquid samples).Addionally.we explore possible reasons for false HPV-negative cases.Furthermore,we review histomorphological,molecular and cdinical features of HPV-negative cervical cancers.Conclusions:The topic of HPV-negative cervical cancers is of importance given the drive towards HPV primary screening,itition of self-collected HPV testing and widespread use of HPV vaccination.
基金Supported by National Natural Science Foundation of China,No.81860433Natural Science Youth Foundation of Jiangxi Province,No.20192BAB215036+2 种基金Jiangxi Province Natural Science Key R&D Project-General Project,No.20202BBG73024Training Plan for Academic and Technical Young Leaders of Major Disciplines in Jiangxi Province,No.20204BCJ23021Jiangxi Provincial Education Department,Science and Technology Research Project-Youth Project,No.GJJ210252。
文摘BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pathological features of GSRC with those of gastric adenocarcinoma of different degrees of differentiation and the differences in survival prognosis between the different disease processes.METHODS By screening gastric cancer patients from 2010 to 2015 in the database of Surveillance,Epidemiology and End Results,and collecting the clinicopathological and prognostic data of gastric cancer patients who underwent surgery from January 2014 to December 2016 in the Second Affiliated Hospital of Nanchang University,we analyzed the general pathological characteristics of GSRC by the chi-square test.Univariate and multivariate analyses were conducted to compare the factors affecting the survival and prognosis of early and advanced gastric adenocarcinoma.The Kaplan-Meier curves were plotted to reveal the survival difference between early and advanced GSRC and different differentiated types of gastric adenocarcinoma.The prognosis model of advanced GSRC was established with R software,and the area under curve(AUC)and C-index were used to assess the accuracy of the model.RESULTS Analysis of pathological features revealed that signet ring-cell carcinoma(SRC)was more frequently seen in younger(<60 years),female,and White patients compared to non-SRC patients.SRC was less commonly associated with early gastric cancer(EGC)(23.60%vs 39.10%),lower N0(38.61%vs 61.03%),and larger tumour sizes>5 cm(31.15%vs 27.10%)compared to the differentiated type,while the opposite was true compared to the undifferentiated type.Survival prognostic analysis found no significant difference in the prognosis of SRC patients among EGC patients.In contrast,among advanced gastric cancer(AGC)patients,the prognosis of SRC patients was correlated with age,race,tumour size,AJCC stage,T-stage,and postoperative adjuvant therapy.The predictive model showed that the 3-year AUC was 0.787,5-year AUC was 0.806,and C-index was 0.766.Compared to non-SRC patients,patients with SRC had a better prognosis in EGC[hazard ratio(HR):0.626,95%confidence interval(CI):0.427-0.919,P<0.05]and a worse prognosis in AGC(HR:1.139,95%CI:1.030-1.258,P<0.05).When non-SRC was divided into differentiated and undifferentiated types for comparison,it was found that in EGC,SRC had a better prognosis than differentiated and undifferentiated types,while there was no significant difference between differentiated and undifferentiated types.In AGC,there was no significant difference in prognosis between SRC and undifferentiated types,both of which were worse than differentiated types.A prognostic analysis of postoperative adjuvant therapy for SRC in patients with AGC revealed that adjuvant postoperative radiotherapy or chemotherapy significantly improved patient survival(34.6%and 36.2%vs 18.6%,P<0.05).CONCLUSION The prognosis of SRC is better than that of undifferentiated type,especially in EGC,and its prognosis is even better than that of differentiated type.SRC patients can benefit from early detection,surgical resection,and aggressive adjuvant therapy.
基金Natural Science Foundation of Liaoning Province,China,No.2022-YGJC-71
文摘BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.
基金Scientific research project of Jiangsu Health and Family Planning Commission(No.H2017082)。
文摘Objective:To investigate the effect of programmed death-ligand 1(PD-L1)gene polymorphism on pathological characteristics and clinical prognosis quality in patients with esophageal cancer.Methods:86 patients with esophageal cancer treated in our hospital from January 2014 to January 2017 were selected as the observation group,and 100 healthy patients were selected as the control group during the same period.The single nucleotide polymorphisms of rs2890658,rs17718883,rs2297136 and rs4143185 at different sites were determined.And the impact of PD-L1 gene polymorphism on pathological features and prognosis of esophageal cancer were analyzed.Results:The observation group finally completed 84 cases,and the control group included 99 cases.There were differences between the observation group and the control group in the PD-L1 different genetic locus rs17718883,rs2890658,rs2297136(P<0.05).The PD-L1 locus rs17718883 was related to the pathological type and degree of differentiation of esophageal cancer,the difference was statistically significant(P<0.05),rs2890658 was related to the degree of differentiation of esophageal cancer,the difference was statistically significant(P<0.05).Log-rank test showed that the genotype of rs17718883 in patients with esophageal cancer was related to prognostic survival,and the difference was statistically significant(P<0.05).Cox proportional hazards model analysis showed that age,degree of differentiation,lymph node metastasis,and rs17718883 genotype were independent factors in the prognosis of patients with esophageal cancer,and the difference was statistically significant(P<0.05).Conclusion:The polymorphisms of rs17718883 and rs2890658 loci of PD-L1 gene have an impact on the clinicopathological characteristics of patients with esophageal cancer,and the polymorphisms of rs17718883 locus of PD-L1 gene have an impact on the clinical prognosis quality.
文摘AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.
文摘BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each other.AIM To study the histologic and clinical features of PSC patients with and without IBD.METHODS We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years 1999-2013.PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration.Clinical data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were noted.RESULTS PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to UC.They required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC patients.The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD.No PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of IBD.The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.
