AIM:To identify those with a micropapillary pattern,ascertain relative frequency and document clinicopathological characteristics by reviewing gastric carcinomas.METHODS:One hundred and fifty-one patients diagnosed wi...AIM:To identify those with a micropapillary pattern,ascertain relative frequency and document clinicopathological characteristics by reviewing gastric carcinomas.METHODS:One hundred and fifty-one patients diagnosed with gastric cancer who underwent gastrectomy were retrospectively studied and the presence of a regional invasive micropapillary component was evaluated by light microscopy.All available hematoxylin-eosin(HE)-stained slides were histologically reviewed and 5 tumors were selected as putative micropapillary carcinoma when cancer cell clusters without a vascular core within empty lymphatic-like space comprised at least5%of the tumor.Tumor tissues from these 5 invasive gastric carcinomas were immunostained using an antimucin 1(MUC1)antibody(clone MA695)to detect the characteristic inside-out pattern and with D2-40antibody to determine the presence of intratumoral lymph vessels.Detection of intraepithelial neutrophil apoptosis was evaluated in consecutive histological tissue sections by three independent methods,namely light microscopy with HE staining,the conventional terminal deoxynucleotidyl transferase-mediated d UTP-biotin nick end-labeling(TUNEL)method and immunohistochemistry for activated caspase-3(clone C92-605).RESULTS:Among 151 gastric cancers resected for cure,5(3.3%)were adenocarcinomas with a micropapillary component.Four of the patients died of disease from 6 to 23 mo and one patient was alive with metastases at 9 mo.All patients had advanced-stage cancer(≥p T2)and lymph node metastasis.Positive MUC1 immunostaining on the stroma-facing surface(inside-out pattern)of the carcinomatous cluster cells,together with negative immunostaining for D2-40 in the cells limiting lymphatic-like spaces,confirmed the true micropapillary pattern in these gastric neoplasms.In all five cases,several micropapillae were infiltrated by neutrophils.HE staining,TUNEL assay and immunostaining for caspase-3 demonstrated apoptoticneutrophils within cytoplasmic vacuoles of tumor cells.These data suggest phagocytosis(c展开更多
目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)EGFR、KRAS基因突变情况及其临床病理学特征。方法:根据2011年的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pat te...目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)EGFR、KRAS基因突变情况及其临床病理学特征。方法:根据2011年的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pat tern,MPP),将144例肺腺癌病例分为MPP阳性组77例和MPP阴性组77例。MPP阳性组中又按MPP所占比例分为(+、++、+++)三亚组。RT-PCR法检测两组EGFR、KRAS基因突变情况。结果:在144例肺腺癌病例中EGFR突变62例(43.1%),KRAS突变9例(6.25%),EGFR突变与性别(P=0.018)和肿瘤体积(P=0.016)有关。MPP阳性组EGFR突变率高于MPP阴性组(P<0.001);KRAS突变率低于MPP阴性组(P=0.016)。EGFR基因突变频率在MPP三亚组中无明显不同(P=0.932)。结论:伴微乳头结构的肺腺癌EGFR突变频率高于肺腺癌其它亚型,KRAS突变频率低于肺腺癌其它亚型,说明其有独特的分子生物学特点。展开更多
回顾性分析东阳市人民医院5例乳腺具有微乳头状结构的单纯型黏液癌(micropapillary pattern of pure mucinous carcinoma of the breast,MPPPMC)的临床病理特征。本组5例具有MPPPMC均为绝经前女性,年龄范围为37~48岁,5例患者中3例伴有...回顾性分析东阳市人民医院5例乳腺具有微乳头状结构的单纯型黏液癌(micropapillary pattern of pure mucinous carcinoma of the breast,MPPPMC)的临床病理特征。本组5例具有MPPPMC均为绝经前女性,年龄范围为37~48岁,5例患者中3例伴有腋窝淋巴结转移,3例患者行乳房改良根治术、1例保乳+前哨淋巴结活检、1例保乳+腋窝淋巴结清扫,术后1例口服内分泌药物+放疗、4例口服内分泌药物+化疗+放疗、2例靶向药物赫赛汀治疗。具有MPPPMC是一种界于单纯型黏液癌(pure mucinous carcinoma,PMC)与浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)之间的特殊类型,该类型发病年龄较黏液癌年轻,预后较黏液癌差,是否是乳腺IMPC或PMC的一种独立亚型目前仍未达成共识。展开更多
目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)上皮间质转化和增殖调亡特征,为临床评价其恶性潜能提供理论依据。方法:根据2011年发表的肺腺癌新分类诊断标准,以是否伴有微小乳头状结...目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)上皮间质转化和增殖调亡特征,为临床评价其恶性潜能提供理论依据。方法:根据2011年发表的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pattern,MPP)将120例肺腺癌病例分为64例MPP阳性组,56例MPP阴性组。免疫组织化学法检测Vimentin、E-cadherin、Capase-3、pEGFR的表达。结果:120例肺腺癌病例中pECFR在女性(P=0.035)、非吸烟(P=0.017)患者中高表达。Vimentin在MPP阳性组的表达(28.1%)高于MPP阴性组(16.1%)并且其多表达于微乳头结构腔内散落的细胞;Caspase-3在MPP阳性组高表达(P=0.001)。结论:微乳头结构的腔内散落细胞表现间质表型有利于癌细胞浸润转移,伴乳头结构的肺腺癌有其独特的分子生物学特征。展开更多
背景与目的:乳腺黏液癌是一种好发于老年女性且预后较好的乳腺癌,形态学上表现为细胞外间质内有大量黏液,其中漂浮着癌细胞。在伴有黏液分泌的乳腺浸润癌中可见黏液湖中漂浮的肿瘤细胞呈微乳头状,将之命名为具有微乳头状结构的乳腺黏液...背景与目的:乳腺黏液癌是一种好发于老年女性且预后较好的乳腺癌,形态学上表现为细胞外间质内有大量黏液,其中漂浮着癌细胞。在伴有黏液分泌的乳腺浸润癌中可见黏液湖中漂浮的肿瘤细胞呈微乳头状,将之命名为具有微乳头状结构的乳腺黏液癌(pure mucinous breast carcinoma with micropapillary pattern,MUMPC)。探讨MUMPC的临床病理学特征,并分析患者的预后影响因素。方法:回顾性分析2010年1月—2018年12月南京医科大学附属常州市第二人民医院收治的40例MUMPC患者的临床病理学资料。计数资料两组间比较采用χ2检验或精确概率检验,应用Kaplan-Meier法计算生存率,log-rank检验和COX回归模型进行单因素和多因素预后影响分析。结果:40例患者均为女性,年龄30~80岁,中位年龄56岁,40例患者均获得术后随访,随访时间为8.0~89.0个月,中位随访时间为60.0个月,1、3和5年无病生存(diseasefree survival,DFS)率为100%、87%和62%,1、3和5年总生存(overall survival,OS)率为100%、95%和85%。单因素分析结果显示,肿瘤临床TNM分期、肿瘤最大径、淋巴结转移、脉管侵犯、肿瘤细胞核级别、神经内分泌标志、分子分型、Ki-67增殖指数是影响MUMPC患者预后的相关因素(P<0.05)。多因素分析结果显示,肿瘤临床TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素(P<0.05)。结论:MUMPC发病率较低,5年OS率较高。TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素。展开更多
子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌...子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。展开更多
目的:通过研究EZH2在伴微乳头结构肺腺癌(pulmonary adenocarcinoma with micropapillary pattern,MPPAC)肿瘤组织中的表达,分析其与MPPAC临床病理特征的相关性,探讨EZH2在MPPAC发生发展及预后评估中的可能作用。方法:采用组织芯片技术...目的:通过研究EZH2在伴微乳头结构肺腺癌(pulmonary adenocarcinoma with micropapillary pattern,MPPAC)肿瘤组织中的表达,分析其与MPPAC临床病理特征的相关性,探讨EZH2在MPPAC发生发展及预后评估中的可能作用。方法:采用组织芯片技术和免疫组织化学检测84例MPPAC患者中EZH2蛋白的表达,分析其表达与各临床病理特征的相关性,并应用K aplan-Meier法及log-rank检验分析EZH2表达与MPPAC患者生存率的关系。结果:免疫组织化学的结果显示54.8%的MPPAC患者呈现EZH2阳性表达,统计学结果表明EZH2的表达与MPPAC患者的性别、年龄、肿瘤直径、淋巴结转移、TNM分期均无明显相关性,而与吸烟密切相关,且差异有统计学意义(P<0.05)。MPPAC中EZH2阳性和阴性组的累计生存率差异不显著(P>0.05),阳性组患者的术后无瘤生存时间明显低于阴性组,Cox回归分析显示随时间的延长,患者生存率逐渐下降,死亡风险不断增大。结论:EZH2的表达上调可能与MPPAC的发生和预后相关,为进一步探讨EZH2在MPPAC中的作用提供了理论基础。展开更多
2011年,国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)、美国胸科学会(American thoracic society,ATS)和欧洲呼吸学会(European Respiratory Society,ERS)同时将微乳头结构(micropapillary pattern...2011年,国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)、美国胸科学会(American thoracic society,ATS)和欧洲呼吸学会(European Respiratory Society,ERS)同时将微乳头结构(micropapillary pattern,MPP)为主型肺腺癌划分为一种独立的病理类型,并将其定义为微乳头型肺腺癌(micropapillary-predominant adenocarcinoma,MPA),其组织学特异性和临床特殊性受到了学者的广泛关注。伴微乳头结构肺腺癌(lung adenocarcinoma with a micropapillary pattern,MPPAC)常具有侵袭性强、转移率高、术后易复发等预后不良的生物学行为。目前,MPPAC的临床诊断有赖于术后病理组织学检查,但针对其病理学异质性、分子生物学特点、临床特征和预后等方面的系统性研究较少。本文对MPPAC的病理和临床特征相关研究进展作一综述。展开更多
文摘AIM:To identify those with a micropapillary pattern,ascertain relative frequency and document clinicopathological characteristics by reviewing gastric carcinomas.METHODS:One hundred and fifty-one patients diagnosed with gastric cancer who underwent gastrectomy were retrospectively studied and the presence of a regional invasive micropapillary component was evaluated by light microscopy.All available hematoxylin-eosin(HE)-stained slides were histologically reviewed and 5 tumors were selected as putative micropapillary carcinoma when cancer cell clusters without a vascular core within empty lymphatic-like space comprised at least5%of the tumor.Tumor tissues from these 5 invasive gastric carcinomas were immunostained using an antimucin 1(MUC1)antibody(clone MA695)to detect the characteristic inside-out pattern and with D2-40antibody to determine the presence of intratumoral lymph vessels.Detection of intraepithelial neutrophil apoptosis was evaluated in consecutive histological tissue sections by three independent methods,namely light microscopy with HE staining,the conventional terminal deoxynucleotidyl transferase-mediated d UTP-biotin nick end-labeling(TUNEL)method and immunohistochemistry for activated caspase-3(clone C92-605).RESULTS:Among 151 gastric cancers resected for cure,5(3.3%)were adenocarcinomas with a micropapillary component.Four of the patients died of disease from 6 to 23 mo and one patient was alive with metastases at 9 mo.All patients had advanced-stage cancer(≥p T2)and lymph node metastasis.Positive MUC1 immunostaining on the stroma-facing surface(inside-out pattern)of the carcinomatous cluster cells,together with negative immunostaining for D2-40 in the cells limiting lymphatic-like spaces,confirmed the true micropapillary pattern in these gastric neoplasms.In all five cases,several micropapillae were infiltrated by neutrophils.HE staining,TUNEL assay and immunostaining for caspase-3 demonstrated apoptoticneutrophils within cytoplasmic vacuoles of tumor cells.These data suggest phagocytosis(c
文摘目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)EGFR、KRAS基因突变情况及其临床病理学特征。方法:根据2011年的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pat tern,MPP),将144例肺腺癌病例分为MPP阳性组77例和MPP阴性组77例。MPP阳性组中又按MPP所占比例分为(+、++、+++)三亚组。RT-PCR法检测两组EGFR、KRAS基因突变情况。结果:在144例肺腺癌病例中EGFR突变62例(43.1%),KRAS突变9例(6.25%),EGFR突变与性别(P=0.018)和肿瘤体积(P=0.016)有关。MPP阳性组EGFR突变率高于MPP阴性组(P<0.001);KRAS突变率低于MPP阴性组(P=0.016)。EGFR基因突变频率在MPP三亚组中无明显不同(P=0.932)。结论:伴微乳头结构的肺腺癌EGFR突变频率高于肺腺癌其它亚型,KRAS突变频率低于肺腺癌其它亚型,说明其有独特的分子生物学特点。
文摘回顾性分析东阳市人民医院5例乳腺具有微乳头状结构的单纯型黏液癌(micropapillary pattern of pure mucinous carcinoma of the breast,MPPPMC)的临床病理特征。本组5例具有MPPPMC均为绝经前女性,年龄范围为37~48岁,5例患者中3例伴有腋窝淋巴结转移,3例患者行乳房改良根治术、1例保乳+前哨淋巴结活检、1例保乳+腋窝淋巴结清扫,术后1例口服内分泌药物+放疗、4例口服内分泌药物+化疗+放疗、2例靶向药物赫赛汀治疗。具有MPPPMC是一种界于单纯型黏液癌(pure mucinous carcinoma,PMC)与浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)之间的特殊类型,该类型发病年龄较黏液癌年轻,预后较黏液癌差,是否是乳腺IMPC或PMC的一种独立亚型目前仍未达成共识。
文摘目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)上皮间质转化和增殖调亡特征,为临床评价其恶性潜能提供理论依据。方法:根据2011年发表的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pattern,MPP)将120例肺腺癌病例分为64例MPP阳性组,56例MPP阴性组。免疫组织化学法检测Vimentin、E-cadherin、Capase-3、pEGFR的表达。结果:120例肺腺癌病例中pECFR在女性(P=0.035)、非吸烟(P=0.017)患者中高表达。Vimentin在MPP阳性组的表达(28.1%)高于MPP阴性组(16.1%)并且其多表达于微乳头结构腔内散落的细胞;Caspase-3在MPP阳性组高表达(P=0.001)。结论:微乳头结构的腔内散落细胞表现间质表型有利于癌细胞浸润转移,伴乳头结构的肺腺癌有其独特的分子生物学特征。
文摘背景与目的:乳腺黏液癌是一种好发于老年女性且预后较好的乳腺癌,形态学上表现为细胞外间质内有大量黏液,其中漂浮着癌细胞。在伴有黏液分泌的乳腺浸润癌中可见黏液湖中漂浮的肿瘤细胞呈微乳头状,将之命名为具有微乳头状结构的乳腺黏液癌(pure mucinous breast carcinoma with micropapillary pattern,MUMPC)。探讨MUMPC的临床病理学特征,并分析患者的预后影响因素。方法:回顾性分析2010年1月—2018年12月南京医科大学附属常州市第二人民医院收治的40例MUMPC患者的临床病理学资料。计数资料两组间比较采用χ2检验或精确概率检验,应用Kaplan-Meier法计算生存率,log-rank检验和COX回归模型进行单因素和多因素预后影响分析。结果:40例患者均为女性,年龄30~80岁,中位年龄56岁,40例患者均获得术后随访,随访时间为8.0~89.0个月,中位随访时间为60.0个月,1、3和5年无病生存(diseasefree survival,DFS)率为100%、87%和62%,1、3和5年总生存(overall survival,OS)率为100%、95%和85%。单因素分析结果显示,肿瘤临床TNM分期、肿瘤最大径、淋巴结转移、脉管侵犯、肿瘤细胞核级别、神经内分泌标志、分子分型、Ki-67增殖指数是影响MUMPC患者预后的相关因素(P<0.05)。多因素分析结果显示,肿瘤临床TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素(P<0.05)。结论:MUMPC发病率较低,5年OS率较高。TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素。
文摘子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。
文摘2011年,国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)、美国胸科学会(American thoracic society,ATS)和欧洲呼吸学会(European Respiratory Society,ERS)同时将微乳头结构(micropapillary pattern,MPP)为主型肺腺癌划分为一种独立的病理类型,并将其定义为微乳头型肺腺癌(micropapillary-predominant adenocarcinoma,MPA),其组织学特异性和临床特殊性受到了学者的广泛关注。伴微乳头结构肺腺癌(lung adenocarcinoma with a micropapillary pattern,MPPAC)常具有侵袭性强、转移率高、术后易复发等预后不良的生物学行为。目前,MPPAC的临床诊断有赖于术后病理组织学检查,但针对其病理学异质性、分子生物学特点、临床特征和预后等方面的系统性研究较少。本文对MPPAC的病理和临床特征相关研究进展作一综述。
