乳腺癌肉瘤二例及文献复习

目的探讨乳腺癌肉瘤的临床病理学特征、鉴别诊断、预后。方法对我院2例乳腺癌肉瘤进行组织病理学和免疫表型观察并复习文献加以讨论。结果镜检显示病变边界清楚,一例由分化较好的浸润性导管癌成分及恶性梭形细胞组成;一例为恶性梭形细胞成分伴有骨分化和软骨分化,其边缘有分化稍差的浸润性导管癌成分。免疫表型：梭形细胞vimentin阳性,S-100蛋白阳性,CKAE与CK34均阴性;癌细胞CKAE、CK34均阳性,vimentin阴性、S-100蛋白例1癌细胞阴性,例2癌细胞散在阳性。结论原发于乳腺的癌肉瘤较罕见,诊断需与肉瘤化癌、叶状囊肉瘤、产生基质的癌相鉴别。     

VEGF和Ki-67在滑膜肉瘤中的表达及临床意义

目的:探讨VEGF和Ki-67在滑膜肉瘤中的表达及生物学意义,揭示这两种蛋白表达的相关性。方法:应用免疫组织化学S.P法检测62例滑膜肉瘤和18例腱鞘巨细胞瘤石蜡包埋组织中VEGF和Ki-67的表达,对56例病例进行整理和随访。结果:VEGF和Ki-67在滑膜肉瘤中显著表达,明显高于对照组。复发组中VEGF蛋白和Ki-67蛋白表达明显高于未复发组(P<0.05)。随临床分期的升高,VEGF和Ki-67的阳性表达上升,差异均具有显著性意义(均P<0.05)。分析在滑膜肉瘤中两种蛋白表达的关系时发现,VEGF和Ki-67之间呈明显正相关性(r=0.795,P<0.05)。结论:Ki-67可作为滑膜肉瘤恶性表型标志,且与滑膜肉瘤的血管形成有关。VEGF和Ki-67蛋白表达对判定滑膜肉瘤的预后和了解其生物学行为均有一定价值。     

乳腺实性乳头状癌临床病理分析

目的 探讨乳腺实性乳头状癌的临床病理特征,提高对乳腺实性乳头状癌认识.方法 分析10例乳腺实性乳头状癌的临床病理学资料,并行免疫组织化学染色.结果 10例患者均为女性,年龄51～75岁,主要表现为乳腺肿块和乳头溢液.镜下见肿瘤细胞排列呈实体状结构,内见纤维血管轴心,细胞形态较一致呈卵圆形或梭形,细胞核级别为低级别至中级别.免疫表型:ER、PR均强阳性且高表达,c-erbB-2无表达,肿瘤细胞CK5/6均阴性;7例瘤巢周围可见p63、Calponin或CD10阳性细胞,3例部分瘤巢周围无p63、Calponin或CD10阳性细胞;CgA阳性表达率70％,Syn阳性表达率为80％,Ki-67指数≤20％.结论 乳腺实性乳头状癌为乳腺癌较少见的类型,临床病理特点及免疫表型有特征性,预后良好,鉴别诊断很重要.     

活检小标本中肺神经内分泌癌的病理诊断

目的探讨在纤维支气管镜活检标本中肺类癌和肺小细胞癌的鉴别诊断。方法分析纤维支气管镜活检标本被误诊为小细胞癌的7例肺类癌的形态特点和免疫组织化学特征,同时以9例小细胞癌活检标本作为对照组。结果肺类癌肿瘤细胞核染色质颗粒状,免疫组织化学染色呈Syn和CgA高表达,Ki-67增殖指数低(典型者20%)。小细胞癌核染色质细致均匀分布,呈Syn和CgA低表达,Ki-67增殖指数高(典型者50%)。结论在肺小活检标本中,尤其是对于有组织挤压伤的标本,存在着类癌过诊为小细胞癌的危险性。Ki-67增殖指数的检测对诊断有重要的意义。     

子宫癌肉瘤4例临床病理分析及文献复习

目的 探讨子宫癌肉瘤的临床病理学特点、病理诊断及鉴别诊断.方法 对4例子宫癌肉瘤的组织病理学观察及免疫组织化学检测.结果 光镜下,4例子宫癌肉瘤均可见明确的癌及肉瘤成分,癌均为子宫内膜样腺癌,1例肉瘤成分为平滑肌肉瘤,2例肉瘤成分为子宫内膜间质肉瘤,1例肉瘤成分为子宫内膜间质肉瘤和平滑肌肉瘤. 免疫组化:癌区域细胞角蛋白(CK)阳性;平滑肌肉瘤区域波形蛋白(Vim)阳性、肌动蛋白(actin)阳性、结蛋白(desmin)阳性;子宫内膜间质肉瘤区域波形蛋白阳性、CD10阳性.结论 子宫癌肉瘤是侵袭性肿瘤,易发生子宫外播散、转移.免疫组化对诊断及鉴别诊断有重要意义.     

6例卵巢恶性中胚叶混合瘤临床及病理分析

目的:探讨女性卵巢恶性中胚叶混合瘤的发生、免疫表型和鉴别诊断。方法:对6例卵巢恶性中胚叶混合瘤进行临床病理和免疫组织化学观察。结果:6例卵巢恶性中胚叶混合瘤,中胚叶组织同源性3例,异源性3例,异源性肿瘤恶性程度更高。免疫表型:6例肿瘤所有癌成分CK和所有肉瘤成分VIM呈阳性表达,1/3病例肉瘤成分呈CK和VIM双表达,肉瘤成分的肌源性成分Desmin均呈阳性表达。结论:卵巢恶性中胚叶混合瘤是来源于中胚层,少见、高恶、转移快、死亡率高的肿瘤,免疫组化对肿瘤的诊断和鉴别诊断很有帮助。     

Skp2、p27和Ki-67在乳腺癌中的表达及意义

目的检测乳腺癌中Skp2、p27和Ki-67的表达情况,探讨三者在乳腺癌中表达的意义及相互关系。方法制作80例乳腺癌肿瘤组织芯片,其中浸润性导管癌,非特殊型42例,浸润性小叶癌12例,特殊类型浸润性癌14例(黏液癌7例,小管癌4例,实性乳头状癌3例),导管原位癌8例,小叶原位癌4例。腋窝淋巴结阳性43例,阴性37例。采用组织芯片技术和免疫组织化学方法检测乳腺癌中Skp2、p27和Ki-67的表达。结果 80例乳腺癌中Skp2、p27的阳性率分别为46.3%、45.0%,Ki-67指数高表达率56.3%(45/80)。p27与Skp2同时阳性表达7例,p27阴性者中Skp2阳性30例(P0.01)。37例Skp2阳性者中Ki-67高表达29例,43例Skp2阴性者中Ki-67仅16例高表达(P0.01)。36例p27阳性者中Ki-67高表达仅7例,44例p27阴性者中Ki-67高表达38例(P0.01)。结论 Skp2高表达、p27失表达和Ki-67指数增高共同参与了乳腺癌的发生和发展过程,并与腋窝淋巴结转移密切相关。乳腺癌组织中Skp2的表达与p27呈负相关,与Ki-67的表达呈正相关,p27与Ki-67的表达呈负相关。     

VEGF与Ki-67在NSCLC中的表达及其临床意义

目的:探讨血管内皮生长因子(VEGF)与核增殖抗原(Ki-67)在非小细胞肺癌(NSCLC)中的表达及临床意义.方法:选取150例NSCLC患者为研究对象,分为死亡组(n=38)和存活组(n=112).分别取每例患者的癌组织及癌旁组织各1份,采用SP法检测VEGF及Ki-67水平.比较死亡组与存活组、癌组织与癌旁组织VEGF及Ki-67阳性表达水平;分析VEGF和Ki-67阳性表达与NSCLC临床病理特征的关系及癌组织VEGF与Ki-67阳性表达的相关性.结果:死亡组患者癌组织VEGF和Ki-67阳性表达率高于存活组(P＜0.05);癌组织VEGF和Ki-67阳性表达率高于癌旁组织(P＜0.05);相关性分析显示,VEGF阳性表达与肿瘤直径、淋巴结转移、远处转移及临床分期相关(P＜0.05),Ki-67阳性表达与淋巴结转移相关(P＜0.05);回归分析显示,癌组织VEGF与Ki-67阳性表达呈正相关(P＜0.05).结论:NSCLC患者中,癌组织中VEGF与Ki-67表达水平较高,且与患者临床病理学特征相关,可作为早期诊断及判断预后的重要依据.     

阴茎癌肉瘤一例报告并文献复习

目的：探讨阴茎癌肉瘤的组织学特点、临床表现、鉴别诊断、治疗及预后。方法：回顾性分析1例阴茎癌肉瘤患者的临床、病理和随访资料,并复习癌肉瘤及肉瘤样癌相关文献,对二者一并进行讨论。结果：术后病理检查见上皮源性及间叶源性两种恶性成分,癌组织CK5/6（＋）,P63（＋）,CK（＋）,CK8/18（＋）,但Vimentin（-）,肉瘤组织Vimentin（＋）,Ki-67约40%,诊断为阴茎癌肉瘤,术后未行进一步治疗。结论：阴茎癌肉瘤是具有高度侵袭性、高度致死性恶性肿瘤,往往首诊时已表现为高级别与高分期的特征,预后不良。确诊依赖病理学及免疫组化检查,手术为首选治疗方法。     

乳腺癌和非癌组织中Syk、Survivin和Ki-67的表达及其相关性

目的:探讨乳腺癌和非癌组织中Syk、Survivin和Ki-67的表达及其相互关系。方法:应用免疫组化SP法检测52例乳腺浸润性导管癌和39例非癌组织(包括癌旁乳腺组织17例和乳腺纤维腺瘤组织22例)中Syk、Survivin和Ki-67的表达。结果:39例非癌组织中Syk均呈阳性表达,而Survivin及Ki-67均呈阴性表达。52例乳腺癌组织中,Syk阳性22例(42.3%),Survivin阳性36例(69.2%),Ki-67阳性32例(61.5%)。乳腺癌中Syk阳性表达率低于非癌组织(χ2=31.01,P<0.01);乳腺癌中Survivin(χ2=41.82,P<0.01)和Ki-67(χ2=34.37,P<0.01)阳性表达率均高于非癌组织。相关分析显示,Syk与Survivin的表达呈负相关(r=-0.53,P<0.01);Syk与Ki-67的表达相关系数呈负值(r=-0.22,P=0.12);Survivin与Ki-67的表达呈正相关(r=0.33,P<0.05)。结论:Syk可能有抑制乳腺癌细胞增殖和促进其凋亡的功能,提示Syk可能是一种抑癌基因,可作为乳腺癌新的分子标记物。联合检测Syk、Survivin和Ki-67在乳腺癌中的表达,有望成为估价乳腺癌生物学行为的参考指标。     

Over expression of vascular endothelial growth factor in correlation to Ki-67, grade, and stage of breast cancer

OBJECTIVE: To assess the significance of vascular endothelial growth factor (VEGF) protein over expression in human breast cancer, and its possible correlation with cell proliferation marker (Ki-67), grade and stage of breast cancer. METHODS: We carried out this study at the Department of Pathology, Kufa University, between November 2006 and September 2007. A retrospective study was employed on paraffin-embedded blocks from 52 female patients with breast cancer. A group of 21 patients with benign breast lesions was included for comparison and 14 cases of normal breast tissue as a control group. This investigation designed to employ immunohistochemistry using Avidin-Biotin Complex (ABC) method for detection of both VEGF and Ki-67. RESULTS: A total of 87 samples was included. Vascular endothelial growth factor immunoexpression was considered as positive in 61.5% of malignant and in 19% of benign breast lesions. No over expression sign has been noticed in normal breast tissue (p<0.005). No significant difference in VEGF over expression among different histological types of breast cancer (p>0.05). Vascular endothelial growth factor immunostaining was positively correlated with Ki-67, grade, stage, lymph node metastasis, and recurrence of breast cancer (p<0.05). No such correlation has been seen when the age of the patients has been considered. CONCLUSION: Vascular endothelial growth factor Vascular endothelial growth factor plays an important role in pathogenesis of breast cancer evolution, and supports the evidence of its role in angiogenesis and cell survival. This study recommended that the blocking of VEGF may be a target for blocking angiogenesis and hence improving the efficacy of anti-cancer therapy.     

生存素与Ki-67在乳腺癌的表达及临床病理意义

目的检测乳腺癌组织中生存素、Ki-67核抗原的表达，探讨两者相关性及临床病理学意义。方法采用免疫组织化学SP法及图像分析技术检测和分析80例乳腺癌、10例乳腺纤维腺瘤和10例正常乳腺组织中生存素、Ki-67的表达。结果（1）80例乳腺癌中生存素、Ki-67表达明显高于乳腺纤维腺瘤和正常乳腺组织（P〈0．01）。（2）乳腺癌中生存素表达与临床分期有关（P〈0.05），与患者年龄、肿瘤大小、组织学类型、病理分级及腋淋巴结转移均无关。（3）Ki-67表达与乳腺癌病理分级、临床分期及腋淋巴结转移有关（P〈0．01），与患者年龄、肿瘤大小、组织学类型无关。（4）乳腺癌中生存素与Ki-67的表达呈显著正相关（P〈0．05）。结论生存素在乳腺癌组织中表达上调，通过促进细胞增殖对乳腺癌发生和发展起重要作用。     

Prognostic value of clinical and pathological factors for surgically treated localized clear cell renal cell carcinoma

Background Surgical resection is the most effective treatment for renal cell carcinoma （RCC）.Currently several prognostic factors and models are used for outcome prediction.However,whether intratumoral changes are independent prognostic factors for RCC or not remains unclear.The aim of the study was to investigate the prognostic roles of intratumoral changes in surgical treated localized clear cell renal cell carcinoma （ccRCC）.Methods Patients who received partial or radical nephrectomy between 2004 and 2009 in our center were retrospectively reviewed.Univariate and multivariate analyses were used to assess gender,age,body mass index （BMI）,intratumoral hemorrhage,tumor necrosis,cystic degeneration,sarcomatoid change,Ki-67 expression,Fuhrman grade,and T stage on recurrence-free survival （RFS） and cancer-specific survival （CSS）.Results A total of 378 patients were included in our study.In univariate analysis,age,BMI,intratumoral hemorrhage,tumor necrosis,sarcomatoid change,Ki-67 expression level,Fuhrman grade,and T stage were prognostic factors for RFS.Age,BMI,tumor necrosis,sarcomatoid change,Ki-67 expression level,Fuhrman grade,and T stage were prognostic factors effecting CSS.In multivariate analysis,age,BMI,tumor necrosis,sarcomatoid change,Ki-67,Fuhrman grade,and T stage were independent prognostic factors for both RFS and CSS.Conclusion Intratumoral changes such as tumor necrosis and sarcomatoid change are independent prognostic factors for ccRCC.     

各种病理类型乳腺癌组织中细胞增殖抗原标记物、血管内皮生长因子的表达及意义

目的 探讨细胞增殖抗原标记物（Ki67）及血管内皮生长因子（VEGF）在乳腺癌组织中的表达，及其与ER、PR、C—erbB2、P53、淋巴结转移及病理类型之间的相关性。方法 用免疫组化SP法检测118例乳腺癌组织中Ki67、VEGF及ER、PR、C-erbB2、P53的基因蛋白表达情况，并与淋巴结转移情况及病理类型一起进行等级相关分析。结果 Ki67在乳腺癌组织中均有不同程度的表达，增殖率最高可达91％，最低在3％左右。其在浸润性导管癌中的平均增殖率最高，在导管内癌及预后好的乳腺癌中平均增殖率较低，与浸润性导管癌比较差异有显著性。VEGF在各种类型乳腺癌组织中表达差异无显著性。VEGF在各种类型乳腺癌组织中表达差异无显著性。等级相关分析，Kit67与雌孕激素受体的表达呈负相关，与P53及淋巴结转移呈正相关。VEGF的表达与Kit67及淋巴结转移呈正相关，与ER、PR、C—erbB2、P53的表达均无相关性。结论 Ki67表达与乳腺癌的病理分型及预后相关，联合检测ER、PR、C—erbB2、P53、Ki67及VEGF有利于乳腺癌的分型及预后判断。     

Ki-67、p53及uPA在乳腺浸润性导管癌组织中的表达及临床意义

目的:研究Ki-67蛋白、p53蛋白及尿激酶型纤溶酶原激活剂(urokinase-type plasminogen activator,uPA)在乳腺浸润性导管癌组织中的表达情况、相互关系以及临床意义。方法:运用免疫组织化学SP法,对110例乳腺浸润性导管癌组织及30例癌旁正常乳腺组织标本中Ki-67、p53及uPA表达情况进行检测。结果:Ki-67在乳腺浸润性导管癌和正常乳腺组织中的阳性表达率分别为77.7%(85/110)和13.3%(4/30),p53的阳性率为51.5%(57/110)和20.0%(6/30),uPA的阳性率为64.6%(71/110)和10.0%(3/30),差异均有统计学意义(P<0.05)。相关性分析结果显示Ki-67与uPA和p53的表达均相关(r=0.282,P<0.05;r=0.387,P<0.01)。结论:在乳腺浸润性导管癌中,Ki-67、p53及uPA阳性表达明显高于正常乳腺组织,为乳腺癌预后和靶向治疗提供了理论依据。     

P53、Ki-67、C-erbB-2在乳腺癌组织中的表达及临床意义

目的探讨P53、Ki-67、C—erbB-2在乳腺癌组织中的表达及其相关性。方法采用免疫组化法检测54例乳腺癌组织中P53、Ki-67、C—erbB-2的表达,并应用统计学方法对P53、Ki-67、C—erbB-2三者间的相关性进行分析。结果P53、Ki-67、C—erbB-2在乳腺癌组织中的阳性表达率分别为48．1％、66．7％、70．4％。P53、Ki-67、C—erbB-2在乳腺癌组织中的阳性表达均与淋巴结转移、TNM分期有关,而与乳腺癌患者的年龄、肿块大小、组织学分级无关。经Pearson相关分析,C—erbB-2与P53、Ki-67在乳腺癌组织中表达呈正相关（r=0．63、0．71,P〈0．05）;P53与Ki-67在乳腺癌组织中表达呈正相关（r=0．67,P〈0．05）。结论Ki-67、C—erbB-2和P53的阳性表达可以作为乳腺癌发生、发展的评价指标,三者联合检测更加有助于乳腺癌患者的临床治疗和预后判断。     

The predictive value of p53, Ki-67 and angiogenetic factors in primary hypopharyngeal carcinoma

To evaluate the predictive role of the oncogene p53, the proliferating marker Ki-67, angiogenic factors platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/dThdPase) and vascular endothelial growth factor (VEGF) in primary hypopharyngeal carcinoma, we immunohistochemically studied a series of 84 primary hypopharyngeal carcinoma patients who were treated at the Department of Otolaryngology of Kurume University Hospital between 1990 and 1997. The correlation of each score according to the intensity and percentage of the labeled cells with the TNM stage, histological grade, metastasis and survival status was analyzed. The positive rate of p53 was 52.4%. The percentages of Ki-67 labeled cells in patients with or without metastasis showed a significant difference (p = 0.011). VEGF also showed a significant difference between the live and death groups (p < 0.05) and also among the differentiation group (p < 0.05). A statistically significant correlation was also seen between the score of Ki-67 and VEGF (r = 0.438, p < 0.001) or the score of Ki-67 and PD-ECGF (r = 0.259, p < 0.001), respectively. In conclusion, the present study suggests that a correlation exists between proliferating and angiogenesis, and VEGF and Ki-67 are thus considered to be possible prognostic discriminators in hypopharyngeal carcinoma.