气管上段腺样囊性癌的临床病理

目的　探讨气管上段腺样囊性癌的临床病理特征及诊断和鉴别诊断要点。方法　收集2000年1月至2014年2月在北京协和医院确诊的4例气管上段腺样囊性癌病例，通过光镜、免疫组织化学及组织化学染色分析其临床病理特征、免疫组织化学特点、诊断及鉴别诊断要点。结果　4例气管上段腺样囊性癌患者中，男1例，女3例，平均年龄47岁(38~57岁）；既往均无腺样囊性癌病史，1例患者既往有结节性甲状腺肿手术史。镜下检查4例均为筛状/管状型腺样囊性癌，3例累及甲状腺组织，3例累及神经组织，未见淋巴结受累。免疫组织化学染色示4例P16、CD117、BCL2、P63、SMA均阳性，Ki67指数平均8%，TTF1和P53均阴性；4例中基底膜样物胶原Ⅳ阳性；组织化学染色示AB/PAS阳性。术后均接受总剂量为48~56 Gy的放疗，随访6~120个月，平均72.5个月，1例术后96个月复发，3例随访期间无复发及转移。结论　气管上段腺样囊性癌是罕见的原发于气管的低度恶性肿瘤，肿瘤生长缓慢，就诊时多数已侵及甲状腺组织，需要与原发于甲状腺的恶性肿瘤相鉴别，特别是在甲状腺穿刺及术中冰冻检查时。结合电子喉气管镜下表现、典型的形态学及免疫组织化学和组织化学染色有助于准确诊断。手术难以切除干净，术后放疗对延缓疾病复发有一定帮助。     

Transporters in the neurohypophysial neuroendocrine system, with special reference to vesicular glutamate transporters (BNPI and DNPI): a review.

Recent advances in gene technology have helped to identify novel proteins and allowed study of their distribution and functions in the mammalian brain. One class of these proteins is that of transporters, which exist in plasma and organellar membranes of neurons and other cells to move substances selectively across membranes. These transporters can be categorized further into subclasses by their structural property, substrate selectivity, and site of action. Some of them have been identified in the hypothalamus, which is the only brain site where a neural signal is converted to a humoral one, namely, a hormone for a target organ. This unique neural mechanism has long attracted attention as the neuroendocrine system, part of which has been extensively studied as the hypothalamic-neurohypophysial system involved in secretion of vasopressin and oxytocin. However, transporters in this system have been less well studied. A morphological examination of novel transporters would give us cues to a better understanding of the neuronal organization and function of the system. In this review, we first summarize recent findings on expression of transporter gene and immunoreactivity in the hypothalamus. In the second part, we explain our observations on two vesicular glutamate (inorganic phosphate) transporters (BNPI and DNPI) in the supraoptic and paraventricular nuclei and neurohypophysis. Further study of these and other transporters will provide a basis on which to reevaluate the organization and function of the hypothalamic-neurohypophysial system.     

Patterns of Fos-like immunoreactivity in the brains of parent ring doves (Streptopelia risoria) given tactile and nontactile exposure to their young.

Neuronal activation was examined by fos immunohistochemistry in ring doves (Streptopelia risoria) reunited with their young after overnight separation. In an initial study, squab-exposed parents showed more fos immunoreactivity (ir) in the preoptic area (POA) and lateral hypothalamus (LH) than squab-deprived parents. In a 2nd study, parents allowed free access to young and those separated from young by a wire mesh partition showed more fos-ir in the POA, LH, and lateral septum than box-exposed controls. Contact with young also increased fos-ir in the medial preoptic nucleus and bed nucleus of the stria terminalis, but noncontact exposure did not. Conversely, nontactile squab exposure stimulated more fos-ir in the POA than did free access to young, which suggests POA involvement in appetitive aspects of parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stromal CCL5 Promotes Breast Cancer Progression by Interacting with CCR3 in Tumor Cells

Chemokines secreted from stromal cells have important roles for interactions with carcinoma cells and regulating tumor progression. C-C motif chemokine ligand (CCL) 5 is expressed in various types of stromal cells and associated with tumor progression, interacting with C-C chemokine receptor (CCR) 1, 3 and 5 expressed in tumor cells. However, the expression on CCL5 and its receptors have so far not been well-examined in human breast carcinoma tissues. We therefore immunolocalized CCL5, as well as CCR1, 3 and 5, in 111 human breast carcinoma tissues and correlated them with clinicopathological characteristics. Stromal CCL5 immunoreactivity was significantly correlated with the aggressive phenotype of breast carcinomas. Importantly, this tendency was observed especially in the CCR3-positive group. Furthermore, the risk of recurrence was significantly higher in the patients with breast carcinomas positive for CCL5 and CCR3 but negative for CCR1 and CCR5, as compared with other patients. In summary, the CCL5-CCR3 axis might contribute to a worse prognosis in breast cancer patients, and these findings will contribute to a better understanding of the significance of the CCL5/CCRs axis in breast carcinoma microenvironment.     

Gap Junctional Communication via Connexin43 between Purkinje Fibers and Working Myocytes Explains the Epicardial Activation Pattern in the Postnatal Mouse Left Ventricle

The mammalian ventricular myocardium forms a functional syncytium due to flow of electrical current mediated in part by gap junctions localized within intercalated disks. The connexin (Cx) subunit of gap junctions have direct and indirect roles in conduction of electrical impulse from the cardiac pacemaker via the cardiac conduction system (CCS) to working myocytes. Cx43 is the dominant isoform in these channels. We have studied the distribution of Cx43 junctions between the CCS and working myocytes in a transgenic mouse model, which had the His-Purkinje portion of the CCS labeled with green fluorescence protein. The highest number of such connections was found in a region about one-third of ventricular length above the apex, and it correlated with the peak proportion of Purkinje fibers (PFs) to the ventricular myocardium. At this location, on the septal surface of the left ventricle, the insulated left bundle branch split into the uninsulated network of PFs that continued to the free wall anteriorly and posteriorly. The second peak of PF abundance was present in the ventricular apex. Epicardial activation maps correspondingly placed the site of the first activation in the apical region, while some hearts presented more highly located breakthrough sites. Taken together, these results increase our understanding of the physiological pattern of ventricular activation and its morphological underpinning through detailed CCS anatomy and distribution of its gap junctional coupling to the working myocardium.     

超声引导下肝细胞癌穿刺组织中Ezrin表达的临床意义

探讨Ezrin表达及超声引导下穿刺活检对肝细胞癌（HCC）的应用价值,实验方法如下：36例经超声引导下穿刺所得的HCC组织作肝穿癌组;45例手术切除的HCC组织作手术癌组,同时取12个癌旁肝组织作癌旁组;用免疫组化方法检测两组标本的Ezrin蛋白表达,并与临床病理学参数做统计学分析。得出结果：肝穿癌组Ezrin阳性表达...     

PEA-15 磷酸化状态与卵巢上皮性癌预后的相关分析

目的:检测卵巢上皮性癌组织中pPEA-15-Ser104表达水平,探讨其临床意义及与卵巢上皮性癌预后的相关性。方法:选取2009年1月至2013年6月收住皖南医学院第一附属医院弋矶山医院妇产科手术治疗并经病理证实的95例原发卵巢上皮性癌,所有患者术前均未行化疗。免疫组化方法检测95例原发卵巢上皮性癌pPEA-15-Ser104的表达水平,卡方检验分析pPEA-15-Ser104表达水平在不同临床特征卵巢癌患者中差异并随访患者生存情况,采用Kaplan-Meier（K-M）方法分析不同临床特征卵巢上皮癌患者生存率差异,应用多因素Cox比例风险回归模型分析卵巢上皮性癌患者预后影响因素。结果:pPEA-15-Ser104的表达在不同组织学分级、手术病理分期、分型以及有无远处转移的卵巢上皮性癌组织中的表达比较差异均具有统计学意义（P<0.05）;而在年龄、肿瘤位置、肿瘤最大径、有无淋巴结转移比较中差异无统计学意义。K-M生存分析和Cox回归分析显示,pPEA-15-Ser104高表达的卵巢癌患者预后不良,生存时间短,pPEA-15-Ser104可作为卵巢癌不良预后的独立危险因素。结论:磷酸化状态的PEA-15在卵巢上皮性癌的发展过程中发挥重要作用,高表达者预后不良,可能成为预测卵巢癌患者预后的新靶标,有望为卵巢癌患者的治疗提供重要靶点。     

The Complete Loss of p53 Expression Uniquely Predicts Worse Prognosis in Colorectal Cancer

p53 immunohistochemistry is considered an accurate surrogate marker reflecting the underlying TP53 mutation status and has utility in tumor diagnostics. In the present study, 269 primary CRCs were immunohistochemically evaluated for p53 expression to assess its utility in diagnostic pathology and prognostication. p53 expression was wild-type in 59 cases (23%), overexpressed in 143 cases (55%), completely lost in 50 cases (19%), and cytoplasmic in 10 cases (4%). p53 immunoreactivity was associated with tumor size (p = 0.0056), mucus production (p = 0.0015), and mismatch repair (MMR) system status (p < 0.0001). Furthermore, among CRCs with wild-type p53 expression, a significantly higher number of cases had decreased CDX2 than those with p53 overexpression (p = 0.012) or complete p53 loss (p = 0.043). In contrast, among CRCs with p53 overexpression, there were significantly fewer ALCAM-positive cases than p53 wild-type cases (p = 0.0045). However, no significant association was detected between p53 immunoreactivity and the “stem-like” immunophenotype defined by CDX2 downregulation and ALCAM-positivity. Multivariate Cox hazards regression analysis identified tubular-forming histology (hazard ratio [HR] = 0.17, p < 0.0001), younger age (HR = 0.52, p = 0.021), and female sex (HR = 0.55, p = 0.046) as potential favorable factors. The analysis also revealed complete p53 loss (HR = 2.16, p = 0.0087), incomplete resection (HR = 2.65, p = 0.0068), and peritoneal metastasis (HR = 5.32, p < 0.0001) as potential independent risk factors for patients with CRC. The sub-cohort survival analyses classified according to chemotherapy after surgery revealed that CRC patients with wild-type p53 expression tended to have better survival than those with overexpression or complete loss after chemotherapy. Thus, immunohistochemistry for p53 could be used for the prognostication and chemotherapy target selection of patients with CRC.