BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association betwee...BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical res...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.展开更多
The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%...The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.展开更多
BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been ...BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been reported successively. But its imageological detection needs to be further investigated. OBJECTIVE: To analyze the characteristics of clinical manifestations, skull MRI examination and pathological results in patients with WE. DESIGN: Retrospective analysis. SETTING: The General Hospital of Chinese PLA. PARTICIPANTS: Ten patients of WE admitted to the Department of Neurology, General Hospital of Chinese PLA were recruited. Among them, five patients were diagnosed pathologically after death. Their pathological changes accorded with the pathological characteristics of WE. The other 5 patients were diagnosed clinically before death. Their pathological changes accorded with clinical and imageological manifestations and had definite reaction to the treatment of thiamine. Ten patients, 7 males and 3 females, were aged (47±13) years ranging from 33 to 73 years. Their disease courses averaged 6 weeks ranging from 3 to 10 weeks. They all were non-alcoholics. Four patients developed WE after acute pancreatitis, two patients after the recurrence of gastric cancer, two patients after cholecystectomy, one patient after hepatitis medicamentosa, one patient after Alzheimer disease. Informed consents were obtained from all the patients and their relatives. METHODS: After admission, clinical manifestations of patients were observed and recorded. Five patients underwent skull MRI examination and their detected results were recorded. Five dead patients underwent autopsy and brain pathological examinations. Neuropathological examination involved cerebrum, cerebellum and brain stem. MAIN OUTCOME MEASURES: Clinical manifestations, MRI examination results, pathological analysis results and prognosis of all the patients. RESULTS: Ten patients with WE were involved in the final analysis. ①Nine patients presented various degrees of mental and conscious disturbance. Six patients initially presented vertigo, nausea, and vomiting. Five patients showed opthalmoplegia. Three patients presented hypotension (BP < 120/60 mm Hg, 1 mm Hg= 0.133 kPa). Two patients showed ataxia. One patient showed severe polyneuropathy. Both lower extremities were more severe. EMG showed axonal degeneration. ②Five patients accepted skull MRI examination. Three patients showed typical high signals in periaqueductal regions and circumference of third and fourth ventriculus in T2 -weighted and flair-weighted images, two of them showed high signals in fornixes in T2 -weighted and flair-weighted images, and one of them showed high signals in optic chiasma, both mammillary bodies, and subcortical white matter. No abnormality was found in the other two patients. Two patients who accepted the supplements of thiamine showed obviously improvements in the second MRI examination. ③Macroscopically, the border between gray and white matters was clear in the coronal section of cerebrum. Congestions, edema and multiple petechial hemorrhages were found in periaqueductal regions, circumference of third and fourth ventriculus, and both mammillary bodies. Microscopically, various degrees of necrosis of parenchymal structures, loss of nerve cells and ischemic changes were found. Myelinated fibers were more affected than neurons. There were focal capillary proliferation and multiple petechial hemorrhages. Prominent astrocytic proliferations were found in gelatinous fiber staining. And demyelinations were found in myelin staining. These pathological findings were all in accord with the diagnostic criteria of WE. ④In the diagnosis before death, 4 of 5 patients who were supplemented with thiamine had obvious improvement 2 weeks later and 1 of them abandoned therapy due to progressive aggravation of jaundice caused by recurrence of stomach cancer. The other 5 patients who were not diagnosed definitely before death and not supplemented with thiamine died. Final diagnosis was performed in autopsy examination. CONCLUSION: The clinical manifestations of this group of WE patients are atypical. MRI and pathological examination results are corresponding, and both have the characteristic manifestations of WE.展开更多
Objective To identify the expression of DLK1 protein in different types of renal cell carcinomas and its correlations with pathological characteristics and metastasis. Methods Immunohistochemistry analysis was perform...Objective To identify the expression of DLK1 protein in different types of renal cell carcinomas and its correlations with pathological characteristics and metastasis. Methods Immunohistochemistry analysis was performed to evaluate the expression of DLK1 protein in展开更多
Objective To investigate the correlation between the expression of the immunohistochemical marker cytokeratin(CK)-19 and the clinical characteristics and prognosis of dual-phenotype hepatocellular rcarcinoma(DPHCC).Me...Objective To investigate the correlation between the expression of the immunohistochemical marker cytokeratin(CK)-19 and the clinical characteristics and prognosis of dual-phenotype hepatocellular rcarcinoma(DPHCC).Methods The data of patients diagnosed with hepatocellular carcinoma(HCC)who underwent surgical resection were collected.DPHCC cases were screened by immunohistochemistry,followed up,and grouped.The correlation between the expression of the immunohistochemical marker CK-19 and the clinical pathological characteristics and prognosis of DPHCC was analyzed by statistical methods.The enumeration data were compared using the X?test or FFisher'sexact probabilitymethod between groups.Results The expression of CK199 was significantly correlated with factors such as the tumor size,histological grade,liver tissue cirrhosis surroundings,microvascular invasion(MVI),and serum carbohydrate antigen 199(CA-199)levels in DPHCC,and the differences were statistically significant(P<0.05).There was no significant correlation between the expression of CK19 and the gender,age,tumor necrosis,multiple lesions,liver capsule invasion,serum alpha-fetoprotein(AFP),and immunohistochemical CK7 and mucin 1(MUC-1)in DPHCC patients,,and the differences were not statistically significant(P>0.05).The results of univariate analysis showed that immunohistochemical CK19 expression,MVI,number of lesions,tumor necrosis,tumor differentiation degree,serum AFP,and carbohydrate antigen 199 levels were related factors affecting the prognosis in DPHCC patients(P<0.05);while gender,age,capsule invasion,tumor size,and expression of immunohistochemical markers(vascular endothelial growth factor,CK7,MUC-1)were not significantly correlated with the prognosis in DPHCC patients(P>0.05).The results of multivariate analysis showed that tumor necrosis(P=0.042,95%CI:1.031-5.501)and serum AFP levels were independent risk factors affecting the prognosis in DPHCC patients(P<0.001,95%CI:2.581-24.075).Conclusion The expression of CK19 is closely related to the prognosis of patients with DPHCC.Patients with high CK19 expression have faster disease progression than those with low CK19 expression.Furthermore,the overall survival rate of patients with high CK19 expression is significantly lower than that of patients with low CK19 expression,which is a risk factor for poor prognosis in patients with DPHCC.展开更多
BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.Howe...BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.However,their associations with tumor characteristics and clinical outcomes require further clarification.AIM To investigate the associations of serum gastrin and H.pylori infection with path-ology and prognosis in gastric cancer.METHODS This hospital-based cohort study included 226 gastric cancer patients undergoing surgery and 100 matched controls from January 2019 to December 2023.Serum gastrin and H.pylori status were assessed and compared.Gastric cancer patients were stratified by biomarker status to analyze associations with tumor-nodes-metastasis(TNM)stage,lymph node metastasis,and tumor differentiation.Kaplan-Meier analysis was used to evaluate disease-free and overall survival(OS).Statistical significance was set at P<0.05.RESULTS Gastric cancer patients exhibited significantly higher serum gastrin levels and H.pylori infection rates than controls(P<0.05).Among gastrin-positive patients,the proportions of advanced TNM stage(III-IV),lymph node metastasis,and poorly differentiated tumors were significantly higher than in gastrin-negative patients(P<0.05).In contrast,H.pylori infection status showed no significant association with TNM stage,lymph node metastasis,or tumor differentiation(P>0.05).Kaplan-Meier analysis indicated no significant difference in disease-free survival between gastrin-positive and negative patients(hazard ratio=1.516,95%confidence interval:0.895-2.550),but gastrin-positive patients had significantly worse OS(hazard ratio=2.717,95%confidence interval:1.311-5.633).CONCLUSION Gastric cancer patients have elevated serum gastrin and higher H.pylori prevalence;elevated gastrin is associated with aggressive tumor features and poorer OS,indicating prognostic value.展开更多
Objective:To analyze the pathological characteristics of patients with transient cerebral ischemic attack(TIA)through multidimensional laboratory indicators and explore their clinical significance.Methods:Patients who...Objective:To analyze the pathological characteristics of patients with transient cerebral ischemic attack(TIA)through multidimensional laboratory indicators and explore their clinical significance.Methods:Patients who visited the outpa-tient department or were hospitalized in Rongxian Hospital of Traditional Chi-nese Medicine from January to December 2024 were selected.TIA patients were set as the experimental group(n=31),and healthy physical examination subjects were set as the control group(n=50).Multidimensional laboratory indicators such as blood routine,liver function,kidney function,blood lipids,electrolytes,hemorheology and blood glucose were detected and compared between the two groups.Results:In the experimental group,the WBC and NEUT#indexes in the blood routine were significantly different from those in the control group(P<0.05);the AST,AST/ALT,TP,GLO and A/G indexes in liver function were sig-nificantly different between the two groups(P<0.05);the K and CA indexes in electrolytes were significantly different between the two groups(P<0.05).Alt-hough there were differences in other indexes,they did not reach statistical sig-nificance.Conclusion:Multidimensional laboratory indicator detection is help-ful in revealing the pathological characteristics of TIA patients,and the abnormal changes of some indicators can provide an important reference for clinical diag-nosis,disease assessment and treatment.展开更多
BACKGROUND： As aging in elderly people, their brain tissue has degeneration and brain atrophy of different severity, and the volume of cranial cavity is relatively enlarged, it has greater compensatory ability to the...BACKGROUND： As aging in elderly people, their brain tissue has degeneration and brain atrophy of different severity, and the volume of cranial cavity is relatively enlarged, it has greater compensatory ability to the space occupying lesion, and it is difficult to detect the meningioma because it grows to expand slowly, the tumor locates in non-functional region, and there are atypical symptoms and deficiency of localization signs. OBJECTIVE： To investigate the clinicopathologic features of senile meningiomas. DESIGN： A retrospective analysis. SETTING： Affiliated Hospital of Hebei University. PARTICIPANTS： Forty-nine elderly patients with meningioma were selected from the Department of Neurosurgery, Affiliated Hospital of Hebei University from May 1999 to March 2005, including 15 males and 34 females, 60-74 years of age, and they were all diagnosed by CT and MRI. METHODS： The sites of tumors were identified by CT and MRI examinations in all the patients. The tumors were partially or totally resected according to their own conditions. The types of the resected tumor were pathologically observed. The conditions of postoperative recovery were observed after 1, 3 and 6 months, and without new neurological dysfunction or complication was considered as good outcome. MAIN OUTCOME MEASURES： ① Sites and pathological types of the tumor; ② Postoperative outcomes and complications. RESULTS： All the 49 patients were involved in the analysis of results. ① The tumors had wide distributions with a main location in brain convexity. Among the 49 cases of meningioma, there were 25 cases of fibrocystic type, 12 cases of meningothelial type, 6 cases of psammomatous type, 4 cases of angiomatous type and 2 cases of microcystic type. ② Among the 49 patients, 35 had good outcome, 8 had self-care ability, 4 required care by others, 2 （4.1%） died postoperatively. No long-term complication related to the operation was observed during the follow-up postoperatively. CONCLUSION： Meningioma has a main location in brain convexity, and its pathological type is mainly fibrocystic one, and there is good operative outcome.展开更多
BACKGROUND The intrapapillary capillary loop(IPCL)characteristics,visualized using magnifying endoscopy,are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma...BACKGROUND The intrapapillary capillary loop(IPCL)characteristics,visualized using magnifying endoscopy,are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma(ESCC).Japan Esophageal Society(JES)classification is the most widely used classification.Microvascular structural changes are evaluated by magnifying endoscopy for the presence or absence of each morphological factor:tortuosity,dilatation,irregular caliber,and different shapes.However,the pathological characteristics of IPCLs have not been thoroughly investigated,especially the microvascular structures corresponding to the deepest parts of the lesions'infiltration.AIM To investigate differences in pathological microvascular structures of ESCC,which correspond to the deepest parts of the lesions'infiltration.METHODS Patients with ESCC and precancerous lesions diagnosed at Peking University Third Hospital were enrolled between January 2019 and April 2023.Patients first underwent magnified endoscopic examination,followed by endoscopic submucosal dissection or surgical treatment.Pathological images were scanned using a threedimensional slice scanner,and the pathological structural differences in different types,according to the JES classification,were analyzed using nonparametric tests and t-tests.RESULTS The 35 lesions were divided into four groups according to the JES classification:A,B1,B2,and B3.Statistical analyses revealed significant differences(aP<0.05)in the short and long calibers,area,location,and density between types A and B.Notably,there were no significant differences in these parameters between types B1 and B2 and between types B2 and B3(P>0.05).However,significant differences in the short calibers,long calibers,and area of IPCL were observed between types B1 and B3(aP<0.05);no significant differences were found in the density or location(P>0.05).CONCLUSION Pathological structures of IPCLs in the deepest infiltrating regions differ among various IPCL types classified by the JES classification under magnifying endoscopy,especially between the types A and B.展开更多
目的探讨去整合素金属蛋白酶10(a disintegrin and metalloprotease 10,ADAM10)和高迁移率族蛋白B1(high mobility group box-1 protein,HMGB1)与声门型喉癌患者病理特征及预后关系分析。方法回顾性收集2017年3月~2020年12月于南京医科...目的探讨去整合素金属蛋白酶10(a disintegrin and metalloprotease 10,ADAM10)和高迁移率族蛋白B1(high mobility group box-1 protein,HMGB1)与声门型喉癌患者病理特征及预后关系分析。方法回顾性收集2017年3月~2020年12月于南京医科大学附属南京医院确诊及治疗的声门型喉癌患者50例(观察组),另取相对喉癌组织切缘0.5cm以上部位标本作为对照组。观察并比较ADAM10和HMGB1在两组中的阳性表达率,分析其阳性表达与声门型喉癌患者的病理特征关系。单因素分析影响声门型喉癌预后的危险因素,Cox多因素回归分析声门型喉癌患者不良预后的独立危险因素。结果ADAM10和HMGB1在观察组的阳性表达率均高于对照组,差异均有统计学意义(P<0.05)。声门型喉癌组织中的ADAM10与淋巴结转移和T分级差异比较有统计学意义,而与年龄、性别、饮酒史、吸烟史、分化程度差异比较无统计学意义(P>0.05);HMGB1与分化程度差异比较有统计学意义(P<0.05),而与年龄、性别、饮酒史、吸烟史、淋巴结转移、T分级差异比较无统计学意义(P>0.05)。单因素分析结果表明,淋巴结转移、T分级、分化程度、ADAM10、HMGB1是患者预后的影响因素。Cox多因素回归分析结果表明,淋巴结转移、T3+T4分级、低分化程度、ADAM10阳性、HMGB1阳性为声门型喉癌患者预后不良的独立影响因素(P<0.05)。结论ADAM10和HMGB1可作为声门型喉癌不良预后的风险评估指标。展开更多
The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancr...The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis（50.70%）, 19 cases of alcoholic chronic pancreatitis（13.38%）, 14 cases of autoimmune pancreatitis（9.86%） and 37 cases of undetermined etiology（26.06%）. Pathologically, the average inflammatory mass diameter was 3.8±3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head（n=97）, neck（n=16）, body（n=12）, tail（n=15） and whole pancreas（n=2） influenced the choice of surgical procedures. Ninety-four patients（66.20%） received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer（QLQ-C30） a decrease from 76±22 to 14±18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.展开更多
Background Lipoprotein glomerulopathy (LPG), once recognized as a rare glomerular disease, has been reported around the world in recent years. In this study, we reported 8 patients of LPG and aimed to explore the cli...Background Lipoprotein glomerulopathy (LPG), once recognized as a rare glomerular disease, has been reported around the world in recent years. In this study, we reported 8 patients of LPG and aimed to explore the clinical features and pathological characteristics of LPG under light microscope, immunofluorescence staining, and electron microscope.Methods Clinical manifestations were recorded on the day of renal biopsy. Biochemical patterns of lipids and lipoproteins were detected by routine examination. Plasma concentrations of apo B and apo E were determined by radial immunodiffusion assays. Biopsy specimens were then processed for light microscopy, immunohistochemical staining for immunoglobulins and complement components, and electron microscopy. Glomerular deposition of apo A, B, and E were detected using monoclonal antibodies on cryostatic sections.Results All of the eight patients presented with edema, microscopic hematuria, severe proteinuria, anemia, and enlarged kidney size. Biochemical profiles revealed high levels of triglycerides, apo B, and apo E. We noted increments of glomerular size and lipoprotein thrombi occupying capillary lumina in the glomeruli of all patients. Immunofluorescence staining showed that the thrombi were strongly positive for apo A, B, and E. Granules and various sizes of vacuoles were observed in the thrombi under electron microscope.Conclusion Compared with previous reports on LPG in other countries, unique clinical and pathological features were found in this group of Chinese LPG patients.展开更多
Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA(SIgA)deposition in patients with IgA nephropathy(IgAN).Methods The activation of serum complement...Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA(SIgA)deposition in patients with IgA nephropathy(IgAN).Methods The activation of serum complements was detected by immunoturbidimetry and ELISA.Renal deposition of SIgA and activation of complements were detected by immunofluorescence.展开更多
Esophageal cancer(EC)continues to be a significant global health concern,with twomain subtypes:esophageal squamous cell carcinoma and esophageal adenocarcinoma.Prevention and changes in etiology,improvements in early ...Esophageal cancer(EC)continues to be a significant global health concern,with twomain subtypes:esophageal squamous cell carcinoma and esophageal adenocarcinoma.Prevention and changes in etiology,improvements in early detection,and refinements in the treatment have led to remarkable progress in the outcomes of EC patients in the past two decades.This seminar provides an in-depth analysis of advances in the epidemiology,disease biology,screening,diagnosis,and treatment landscape of esophageal cancer,focusing on the ongoing debate surrounding multimodality therapy.Despite significant advancements,EC remains a deadly disease,underscoring the need for continued research into early detection methods,understanding the molecular mechanisms,and developing effective treatments.展开更多
Objective To investigate the different clinical characteristics and prognosis of patients with diabetic nephropathy(DN)accompanied byIgAdeposition diagnosed by renal biopsy.Methods The study was a retrospective cohort...Objective To investigate the different clinical characteristics and prognosis of patients with diabetic nephropathy(DN)accompanied byIgAdeposition diagnosed by renal biopsy.Methods The study was a retrospective cohort study.Clinical and pathological data of patients diagnosed with DN through renal biopsy in Beijing Anzhen Hospital affiliated to Capital Medical University from January 1,2010 to March 31,2023 were retrospectively collected.The clinical and pathological characteristics and prognosis of DN patients with IgA deposition and DN control group patients without IgA deposition were compared.Immunofluorescence staining was used to detect the intensity of galactose-deficient IgAl(Gd-IgA1)staining in renal tissue of DN patients with DN IgA deposition,and grouping was performed according to whether the staining intensity was≥2+.Enzyme linked immunosorbent assay was used to detect the serum level of Gd-IgA1 in patients.A 50%decrease in estimated glomerular filtration rate(eGFR)from baseline or progression to end-stage renal disease within 5 years was defined as a renal endpoint event,and Kaplan-Meier survival analysis and Log-rank test were used to compare the difference in cumulative incidence of renal endpoint events between two groups of patients.Results A total of 101 DN patients were enrolled in this study,including 68 males(67.3%)and 33 females(32.7%),with age of(52.2±10.3)years and a median follow-up time of 13.5(4.8,26.3)months.There were 44 patients with IgA deposition(43.6%)and 57 patients without IgA deposition(56.4%).Compared with DN control group,Kaplan-Meier analysis showed that DN patients with IgA deposition had a higher cumulative incidence of renal endpoint within 5 years(X^(2)=6.473,P=0.011).The proportion of positive glomerular Gd-IgA1(KM55)staining in the DN patients with IgAdeposition was54.5%(24/44),and immunofluorescence examination1showed consistent distribution of Gd-IgA1 and IgA in the glomerular mesangial and capillary regions.The serum level of Gd-IgA1 in the glomerular Gd-IgAl positive patients was significantly higher than that in those negative patients[(6296.4±1535.4)μg/L us.(4057.4±1082.0)μg/L,t=-3.037,P=0.010].In DN patients with IgA deposition,the age of the subgroup with endpoint events was younger[(42.8±6.9)years us.(53.3±9.4)years,t=-3.440,P=0.002],the duration of proteinuria was shorter[6.0(1.0,22.0)months us.12.0(10.0,36.0)months,Z=-2.150,P=0.032],and the proportion of patients with glomerular Gd-IgA1 staining intensity≥2+was higher[Fisher'exact test,30.8%(4/13)us.0(0/20),P=0.017].Kaplan-Meier survival analysis showed that patients with glomerular Gd-IgAl1 staining intensity≥2+had a significantly higher cumulative incidence of renal endpoint events(X=4.846,P=0.028).Conclusion DN patients with glomerular IgA deposition and Gd-IgAl positivity may be associated with worse prognosis.展开更多
Objective:To clarify the clinical and pathological characteristics of atypical polypoid adenomyoma(APA)in order to improve the criteria used to diagnose and treat this disease.Study design:In 39 cases of APA,retrospec...Objective:To clarify the clinical and pathological characteristics of atypical polypoid adenomyoma(APA)in order to improve the criteria used to diagnose and treat this disease.Study design:In 39 cases of APA,retrospective analysis was performed of theclinical data,pathological characteristics,and the follow-up findings in patients admitted to the Peking University People's Hospital from 2007 to 2019.Results:The median age was 39.6 years(range 24–60 years).Thirty seven patients were premenopausal(i.e.94.9%)and eighteen patients were nullipara(i.e.46.2%).Abnormal uterine bleeding was the most common presenting symptom.Hysteroscopic transcervical resection(i.e.TCR)identified lesions in 35 cases whereas:(a)hysterectomy identified them in 3 cases;(b)dilatation and curettage(D&C)identified them in 1 case.Immunohistochemical analysis was performed on 24 samples.In the glandular component,hormone receptors were positively expressed.In all cases,Ki67 expression was detectable in approximately 50%of the cases.In those samples,its presence was definitive in eighteen of the nineteen cases(94.7%,18/19),p53 positive expression was present in most cases(68.8%,11/16),and PTEN positive expression was detected in 40%(4/10).Stroma immunophenotype expression was exhibited as follows:(a)CD10-(12/12),Desminþ(6/7);(b)Vimentinþ(4/4);(c)α-SMAþ(3/3)and;d p16 positve staining in of 80%(4/5).The concurrent amount of atypical endometrial hyperplasia with atypical polypoid adenomyoma was 23.1%(9/39),while its concurrent level of endometrial carcinoma with atypical polypoid adenomyoma was 7.7%(3/39).Fertility preserving treatments were performed in 20 patients with strong childbearing desires.Their pregnancy success was 15%(3/20)and the live birth frequency was 10%(2/10).Follow-up findings were available in 36 cases(92.3%)with a medial follow-up of 48.1 months(range 4–122 months).Its pathological recurrence and frequency of progression into endometrial carcinoma were both 5%(1/20).One case died of another type of malignancy,while the other patients were alive.Conclusions:APA occurs mostly during the years of a women's reproductive period.Its diagnosis is based on the analysis of pathological and immunohistochemical findings.Individuals diagnosed with APA are at risk to coexist with endometrial carcinoma and atypical endometrial hyperplasia.For those individuals who desire retaining fertility,the treatment strategy involves performing TCR completely remove the lesions and close follow-up for surveillance of possible progressive APA recurrence.For those individuals who have no fertility desire,hysterectomy may be a preferred option.展开更多
文摘BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.
文摘The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.
文摘BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been reported successively. But its imageological detection needs to be further investigated. OBJECTIVE: To analyze the characteristics of clinical manifestations, skull MRI examination and pathological results in patients with WE. DESIGN: Retrospective analysis. SETTING: The General Hospital of Chinese PLA. PARTICIPANTS: Ten patients of WE admitted to the Department of Neurology, General Hospital of Chinese PLA were recruited. Among them, five patients were diagnosed pathologically after death. Their pathological changes accorded with the pathological characteristics of WE. The other 5 patients were diagnosed clinically before death. Their pathological changes accorded with clinical and imageological manifestations and had definite reaction to the treatment of thiamine. Ten patients, 7 males and 3 females, were aged (47±13) years ranging from 33 to 73 years. Their disease courses averaged 6 weeks ranging from 3 to 10 weeks. They all were non-alcoholics. Four patients developed WE after acute pancreatitis, two patients after the recurrence of gastric cancer, two patients after cholecystectomy, one patient after hepatitis medicamentosa, one patient after Alzheimer disease. Informed consents were obtained from all the patients and their relatives. METHODS: After admission, clinical manifestations of patients were observed and recorded. Five patients underwent skull MRI examination and their detected results were recorded. Five dead patients underwent autopsy and brain pathological examinations. Neuropathological examination involved cerebrum, cerebellum and brain stem. MAIN OUTCOME MEASURES: Clinical manifestations, MRI examination results, pathological analysis results and prognosis of all the patients. RESULTS: Ten patients with WE were involved in the final analysis. ①Nine patients presented various degrees of mental and conscious disturbance. Six patients initially presented vertigo, nausea, and vomiting. Five patients showed opthalmoplegia. Three patients presented hypotension (BP < 120/60 mm Hg, 1 mm Hg= 0.133 kPa). Two patients showed ataxia. One patient showed severe polyneuropathy. Both lower extremities were more severe. EMG showed axonal degeneration. ②Five patients accepted skull MRI examination. Three patients showed typical high signals in periaqueductal regions and circumference of third and fourth ventriculus in T2 -weighted and flair-weighted images, two of them showed high signals in fornixes in T2 -weighted and flair-weighted images, and one of them showed high signals in optic chiasma, both mammillary bodies, and subcortical white matter. No abnormality was found in the other two patients. Two patients who accepted the supplements of thiamine showed obviously improvements in the second MRI examination. ③Macroscopically, the border between gray and white matters was clear in the coronal section of cerebrum. Congestions, edema and multiple petechial hemorrhages were found in periaqueductal regions, circumference of third and fourth ventriculus, and both mammillary bodies. Microscopically, various degrees of necrosis of parenchymal structures, loss of nerve cells and ischemic changes were found. Myelinated fibers were more affected than neurons. There were focal capillary proliferation and multiple petechial hemorrhages. Prominent astrocytic proliferations were found in gelatinous fiber staining. And demyelinations were found in myelin staining. These pathological findings were all in accord with the diagnostic criteria of WE. ④In the diagnosis before death, 4 of 5 patients who were supplemented with thiamine had obvious improvement 2 weeks later and 1 of them abandoned therapy due to progressive aggravation of jaundice caused by recurrence of stomach cancer. The other 5 patients who were not diagnosed definitely before death and not supplemented with thiamine died. Final diagnosis was performed in autopsy examination. CONCLUSION: The clinical manifestations of this group of WE patients are atypical. MRI and pathological examination results are corresponding, and both have the characteristic manifestations of WE.
文摘Objective To identify the expression of DLK1 protein in different types of renal cell carcinomas and its correlations with pathological characteristics and metastasis. Methods Immunohistochemistry analysis was performed to evaluate the expression of DLK1 protein in
文摘Objective To investigate the correlation between the expression of the immunohistochemical marker cytokeratin(CK)-19 and the clinical characteristics and prognosis of dual-phenotype hepatocellular rcarcinoma(DPHCC).Methods The data of patients diagnosed with hepatocellular carcinoma(HCC)who underwent surgical resection were collected.DPHCC cases were screened by immunohistochemistry,followed up,and grouped.The correlation between the expression of the immunohistochemical marker CK-19 and the clinical pathological characteristics and prognosis of DPHCC was analyzed by statistical methods.The enumeration data were compared using the X?test or FFisher'sexact probabilitymethod between groups.Results The expression of CK199 was significantly correlated with factors such as the tumor size,histological grade,liver tissue cirrhosis surroundings,microvascular invasion(MVI),and serum carbohydrate antigen 199(CA-199)levels in DPHCC,and the differences were statistically significant(P<0.05).There was no significant correlation between the expression of CK19 and the gender,age,tumor necrosis,multiple lesions,liver capsule invasion,serum alpha-fetoprotein(AFP),and immunohistochemical CK7 and mucin 1(MUC-1)in DPHCC patients,,and the differences were not statistically significant(P>0.05).The results of univariate analysis showed that immunohistochemical CK19 expression,MVI,number of lesions,tumor necrosis,tumor differentiation degree,serum AFP,and carbohydrate antigen 199 levels were related factors affecting the prognosis in DPHCC patients(P<0.05);while gender,age,capsule invasion,tumor size,and expression of immunohistochemical markers(vascular endothelial growth factor,CK7,MUC-1)were not significantly correlated with the prognosis in DPHCC patients(P>0.05).The results of multivariate analysis showed that tumor necrosis(P=0.042,95%CI:1.031-5.501)and serum AFP levels were independent risk factors affecting the prognosis in DPHCC patients(P<0.001,95%CI:2.581-24.075).Conclusion The expression of CK19 is closely related to the prognosis of patients with DPHCC.Patients with high CK19 expression have faster disease progression than those with low CK19 expression.Furthermore,the overall survival rate of patients with high CK19 expression is significantly lower than that of patients with low CK19 expression,which is a risk factor for poor prognosis in patients with DPHCC.
文摘BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.However,their associations with tumor characteristics and clinical outcomes require further clarification.AIM To investigate the associations of serum gastrin and H.pylori infection with path-ology and prognosis in gastric cancer.METHODS This hospital-based cohort study included 226 gastric cancer patients undergoing surgery and 100 matched controls from January 2019 to December 2023.Serum gastrin and H.pylori status were assessed and compared.Gastric cancer patients were stratified by biomarker status to analyze associations with tumor-nodes-metastasis(TNM)stage,lymph node metastasis,and tumor differentiation.Kaplan-Meier analysis was used to evaluate disease-free and overall survival(OS).Statistical significance was set at P<0.05.RESULTS Gastric cancer patients exhibited significantly higher serum gastrin levels and H.pylori infection rates than controls(P<0.05).Among gastrin-positive patients,the proportions of advanced TNM stage(III-IV),lymph node metastasis,and poorly differentiated tumors were significantly higher than in gastrin-negative patients(P<0.05).In contrast,H.pylori infection status showed no significant association with TNM stage,lymph node metastasis,or tumor differentiation(P>0.05).Kaplan-Meier analysis indicated no significant difference in disease-free survival between gastrin-positive and negative patients(hazard ratio=1.516,95%confidence interval:0.895-2.550),but gastrin-positive patients had significantly worse OS(hazard ratio=2.717,95%confidence interval:1.311-5.633).CONCLUSION Gastric cancer patients have elevated serum gastrin and higher H.pylori prevalence;elevated gastrin is associated with aggressive tumor features and poorer OS,indicating prognostic value.
文摘Objective:To analyze the pathological characteristics of patients with transient cerebral ischemic attack(TIA)through multidimensional laboratory indicators and explore their clinical significance.Methods:Patients who visited the outpa-tient department or were hospitalized in Rongxian Hospital of Traditional Chi-nese Medicine from January to December 2024 were selected.TIA patients were set as the experimental group(n=31),and healthy physical examination subjects were set as the control group(n=50).Multidimensional laboratory indicators such as blood routine,liver function,kidney function,blood lipids,electrolytes,hemorheology and blood glucose were detected and compared between the two groups.Results:In the experimental group,the WBC and NEUT#indexes in the blood routine were significantly different from those in the control group(P<0.05);the AST,AST/ALT,TP,GLO and A/G indexes in liver function were sig-nificantly different between the two groups(P<0.05);the K and CA indexes in electrolytes were significantly different between the two groups(P<0.05).Alt-hough there were differences in other indexes,they did not reach statistical sig-nificance.Conclusion:Multidimensional laboratory indicator detection is help-ful in revealing the pathological characteristics of TIA patients,and the abnormal changes of some indicators can provide an important reference for clinical diag-nosis,disease assessment and treatment.
文摘BACKGROUND： As aging in elderly people, their brain tissue has degeneration and brain atrophy of different severity, and the volume of cranial cavity is relatively enlarged, it has greater compensatory ability to the space occupying lesion, and it is difficult to detect the meningioma because it grows to expand slowly, the tumor locates in non-functional region, and there are atypical symptoms and deficiency of localization signs. OBJECTIVE： To investigate the clinicopathologic features of senile meningiomas. DESIGN： A retrospective analysis. SETTING： Affiliated Hospital of Hebei University. PARTICIPANTS： Forty-nine elderly patients with meningioma were selected from the Department of Neurosurgery, Affiliated Hospital of Hebei University from May 1999 to March 2005, including 15 males and 34 females, 60-74 years of age, and they were all diagnosed by CT and MRI. METHODS： The sites of tumors were identified by CT and MRI examinations in all the patients. The tumors were partially or totally resected according to their own conditions. The types of the resected tumor were pathologically observed. The conditions of postoperative recovery were observed after 1, 3 and 6 months, and without new neurological dysfunction or complication was considered as good outcome. MAIN OUTCOME MEASURES： ① Sites and pathological types of the tumor; ② Postoperative outcomes and complications. RESULTS： All the 49 patients were involved in the analysis of results. ① The tumors had wide distributions with a main location in brain convexity. Among the 49 cases of meningioma, there were 25 cases of fibrocystic type, 12 cases of meningothelial type, 6 cases of psammomatous type, 4 cases of angiomatous type and 2 cases of microcystic type. ② Among the 49 patients, 35 had good outcome, 8 had self-care ability, 4 required care by others, 2 （4.1%） died postoperatively. No long-term complication related to the operation was observed during the follow-up postoperatively. CONCLUSION： Meningioma has a main location in brain convexity, and its pathological type is mainly fibrocystic one, and there is good operative outcome.
基金Supported by Beijing Science and Technology Development Program(Medical and Pharmaceutical Science Project),No.7232200.
文摘BACKGROUND The intrapapillary capillary loop(IPCL)characteristics,visualized using magnifying endoscopy,are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma(ESCC).Japan Esophageal Society(JES)classification is the most widely used classification.Microvascular structural changes are evaluated by magnifying endoscopy for the presence or absence of each morphological factor:tortuosity,dilatation,irregular caliber,and different shapes.However,the pathological characteristics of IPCLs have not been thoroughly investigated,especially the microvascular structures corresponding to the deepest parts of the lesions'infiltration.AIM To investigate differences in pathological microvascular structures of ESCC,which correspond to the deepest parts of the lesions'infiltration.METHODS Patients with ESCC and precancerous lesions diagnosed at Peking University Third Hospital were enrolled between January 2019 and April 2023.Patients first underwent magnified endoscopic examination,followed by endoscopic submucosal dissection or surgical treatment.Pathological images were scanned using a threedimensional slice scanner,and the pathological structural differences in different types,according to the JES classification,were analyzed using nonparametric tests and t-tests.RESULTS The 35 lesions were divided into four groups according to the JES classification:A,B1,B2,and B3.Statistical analyses revealed significant differences(aP<0.05)in the short and long calibers,area,location,and density between types A and B.Notably,there were no significant differences in these parameters between types B1 and B2 and between types B2 and B3(P>0.05).However,significant differences in the short calibers,long calibers,and area of IPCL were observed between types B1 and B3(aP<0.05);no significant differences were found in the density or location(P>0.05).CONCLUSION Pathological structures of IPCLs in the deepest infiltrating regions differ among various IPCL types classified by the JES classification under magnifying endoscopy,especially between the types A and B.
文摘目的探讨去整合素金属蛋白酶10(a disintegrin and metalloprotease 10,ADAM10)和高迁移率族蛋白B1(high mobility group box-1 protein,HMGB1)与声门型喉癌患者病理特征及预后关系分析。方法回顾性收集2017年3月~2020年12月于南京医科大学附属南京医院确诊及治疗的声门型喉癌患者50例(观察组),另取相对喉癌组织切缘0.5cm以上部位标本作为对照组。观察并比较ADAM10和HMGB1在两组中的阳性表达率,分析其阳性表达与声门型喉癌患者的病理特征关系。单因素分析影响声门型喉癌预后的危险因素,Cox多因素回归分析声门型喉癌患者不良预后的独立危险因素。结果ADAM10和HMGB1在观察组的阳性表达率均高于对照组,差异均有统计学意义(P<0.05)。声门型喉癌组织中的ADAM10与淋巴结转移和T分级差异比较有统计学意义,而与年龄、性别、饮酒史、吸烟史、分化程度差异比较无统计学意义(P>0.05);HMGB1与分化程度差异比较有统计学意义(P<0.05),而与年龄、性别、饮酒史、吸烟史、淋巴结转移、T分级差异比较无统计学意义(P>0.05)。单因素分析结果表明,淋巴结转移、T分级、分化程度、ADAM10、HMGB1是患者预后的影响因素。Cox多因素回归分析结果表明,淋巴结转移、T3+T4分级、低分化程度、ADAM10阳性、HMGB1阳性为声门型喉癌患者预后不良的独立影响因素(P<0.05)。结论ADAM10和HMGB1可作为声门型喉癌不良预后的风险评估指标。
文摘The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis（50.70%）, 19 cases of alcoholic chronic pancreatitis（13.38%）, 14 cases of autoimmune pancreatitis（9.86%） and 37 cases of undetermined etiology（26.06%）. Pathologically, the average inflammatory mass diameter was 3.8±3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head（n=97）, neck（n=16）, body（n=12）, tail（n=15） and whole pancreas（n=2） influenced the choice of surgical procedures. Ninety-four patients（66.20%） received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer（QLQ-C30） a decrease from 76±22 to 14±18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.
文摘Background Lipoprotein glomerulopathy (LPG), once recognized as a rare glomerular disease, has been reported around the world in recent years. In this study, we reported 8 patients of LPG and aimed to explore the clinical features and pathological characteristics of LPG under light microscope, immunofluorescence staining, and electron microscope.Methods Clinical manifestations were recorded on the day of renal biopsy. Biochemical patterns of lipids and lipoproteins were detected by routine examination. Plasma concentrations of apo B and apo E were determined by radial immunodiffusion assays. Biopsy specimens were then processed for light microscopy, immunohistochemical staining for immunoglobulins and complement components, and electron microscopy. Glomerular deposition of apo A, B, and E were detected using monoclonal antibodies on cryostatic sections.Results All of the eight patients presented with edema, microscopic hematuria, severe proteinuria, anemia, and enlarged kidney size. Biochemical profiles revealed high levels of triglycerides, apo B, and apo E. We noted increments of glomerular size and lipoprotein thrombi occupying capillary lumina in the glomeruli of all patients. Immunofluorescence staining showed that the thrombi were strongly positive for apo A, B, and E. Granules and various sizes of vacuoles were observed in the thrombi under electron microscope.Conclusion Compared with previous reports on LPG in other countries, unique clinical and pathological features were found in this group of Chinese LPG patients.
文摘Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA(SIgA)deposition in patients with IgA nephropathy(IgAN).Methods The activation of serum complements was detected by immunoturbidimetry and ELISA.Renal deposition of SIgA and activation of complements were detected by immunofluorescence.
基金Key Project of In-hospital Research SubjectChinese Academy of Medical Sciences,Grant/Award Number:SZ2020ZD002Young Scientists Fund of the National Natural Science Foundation of China,Grant/Award Number:82202938。
文摘Esophageal cancer(EC)continues to be a significant global health concern,with twomain subtypes:esophageal squamous cell carcinoma and esophageal adenocarcinoma.Prevention and changes in etiology,improvements in early detection,and refinements in the treatment have led to remarkable progress in the outcomes of EC patients in the past two decades.This seminar provides an in-depth analysis of advances in the epidemiology,disease biology,screening,diagnosis,and treatment landscape of esophageal cancer,focusing on the ongoing debate surrounding multimodality therapy.Despite significant advancements,EC remains a deadly disease,underscoring the need for continued research into early detection methods,understanding the molecular mechanisms,and developing effective treatments.
文摘Objective To investigate the different clinical characteristics and prognosis of patients with diabetic nephropathy(DN)accompanied byIgAdeposition diagnosed by renal biopsy.Methods The study was a retrospective cohort study.Clinical and pathological data of patients diagnosed with DN through renal biopsy in Beijing Anzhen Hospital affiliated to Capital Medical University from January 1,2010 to March 31,2023 were retrospectively collected.The clinical and pathological characteristics and prognosis of DN patients with IgA deposition and DN control group patients without IgA deposition were compared.Immunofluorescence staining was used to detect the intensity of galactose-deficient IgAl(Gd-IgA1)staining in renal tissue of DN patients with DN IgA deposition,and grouping was performed according to whether the staining intensity was≥2+.Enzyme linked immunosorbent assay was used to detect the serum level of Gd-IgA1 in patients.A 50%decrease in estimated glomerular filtration rate(eGFR)from baseline or progression to end-stage renal disease within 5 years was defined as a renal endpoint event,and Kaplan-Meier survival analysis and Log-rank test were used to compare the difference in cumulative incidence of renal endpoint events between two groups of patients.Results A total of 101 DN patients were enrolled in this study,including 68 males(67.3%)and 33 females(32.7%),with age of(52.2±10.3)years and a median follow-up time of 13.5(4.8,26.3)months.There were 44 patients with IgA deposition(43.6%)and 57 patients without IgA deposition(56.4%).Compared with DN control group,Kaplan-Meier analysis showed that DN patients with IgA deposition had a higher cumulative incidence of renal endpoint within 5 years(X^(2)=6.473,P=0.011).The proportion of positive glomerular Gd-IgA1(KM55)staining in the DN patients with IgAdeposition was54.5%(24/44),and immunofluorescence examination1showed consistent distribution of Gd-IgA1 and IgA in the glomerular mesangial and capillary regions.The serum level of Gd-IgA1 in the glomerular Gd-IgAl positive patients was significantly higher than that in those negative patients[(6296.4±1535.4)μg/L us.(4057.4±1082.0)μg/L,t=-3.037,P=0.010].In DN patients with IgA deposition,the age of the subgroup with endpoint events was younger[(42.8±6.9)years us.(53.3±9.4)years,t=-3.440,P=0.002],the duration of proteinuria was shorter[6.0(1.0,22.0)months us.12.0(10.0,36.0)months,Z=-2.150,P=0.032],and the proportion of patients with glomerular Gd-IgA1 staining intensity≥2+was higher[Fisher'exact test,30.8%(4/13)us.0(0/20),P=0.017].Kaplan-Meier survival analysis showed that patients with glomerular Gd-IgAl1 staining intensity≥2+had a significantly higher cumulative incidence of renal endpoint events(X=4.846,P=0.028).Conclusion DN patients with glomerular IgA deposition and Gd-IgAl positivity may be associated with worse prognosis.
基金funded by Peking University Medicine Seed Fund for Interdisciplinary Research and the Fundamental Research Funds for the Central Universities.(BMU2020MX003).
文摘Objective:To clarify the clinical and pathological characteristics of atypical polypoid adenomyoma(APA)in order to improve the criteria used to diagnose and treat this disease.Study design:In 39 cases of APA,retrospective analysis was performed of theclinical data,pathological characteristics,and the follow-up findings in patients admitted to the Peking University People's Hospital from 2007 to 2019.Results:The median age was 39.6 years(range 24–60 years).Thirty seven patients were premenopausal(i.e.94.9%)and eighteen patients were nullipara(i.e.46.2%).Abnormal uterine bleeding was the most common presenting symptom.Hysteroscopic transcervical resection(i.e.TCR)identified lesions in 35 cases whereas:(a)hysterectomy identified them in 3 cases;(b)dilatation and curettage(D&C)identified them in 1 case.Immunohistochemical analysis was performed on 24 samples.In the glandular component,hormone receptors were positively expressed.In all cases,Ki67 expression was detectable in approximately 50%of the cases.In those samples,its presence was definitive in eighteen of the nineteen cases(94.7%,18/19),p53 positive expression was present in most cases(68.8%,11/16),and PTEN positive expression was detected in 40%(4/10).Stroma immunophenotype expression was exhibited as follows:(a)CD10-(12/12),Desminþ(6/7);(b)Vimentinþ(4/4);(c)α-SMAþ(3/3)and;d p16 positve staining in of 80%(4/5).The concurrent amount of atypical endometrial hyperplasia with atypical polypoid adenomyoma was 23.1%(9/39),while its concurrent level of endometrial carcinoma with atypical polypoid adenomyoma was 7.7%(3/39).Fertility preserving treatments were performed in 20 patients with strong childbearing desires.Their pregnancy success was 15%(3/20)and the live birth frequency was 10%(2/10).Follow-up findings were available in 36 cases(92.3%)with a medial follow-up of 48.1 months(range 4–122 months).Its pathological recurrence and frequency of progression into endometrial carcinoma were both 5%(1/20).One case died of another type of malignancy,while the other patients were alive.Conclusions:APA occurs mostly during the years of a women's reproductive period.Its diagnosis is based on the analysis of pathological and immunohistochemical findings.Individuals diagnosed with APA are at risk to coexist with endometrial carcinoma and atypical endometrial hyperplasia.For those individuals who desire retaining fertility,the treatment strategy involves performing TCR completely remove the lesions and close follow-up for surveillance of possible progressive APA recurrence.For those individuals who have no fertility desire,hysterectomy may be a preferred option.
