Objective To provide a better pathological method for clinical diagnosis of endometrial lesions. Design Comparing the accuracy of hematoxylin-eosin (H-E) with Papanicolaou stain for endometrial cytology. Setting The First Affiliated Hospital of Xi’an Jiaotong University. Population or Sample 180 patients. Methods Endometrial slides were stained by H-E and Papanicolaou methods, respectively. The cytology between them were compared, with histology as standard control, as well as the cost performance. Main Outcome Measures The dyeing degree of satisfaction, sensitivity, specificity, Cohen’s kappa coefficient, false positive rate, false negative rate, positive likelihood ratio, negative likelihood ratio, Youden index, positive predictive values, and negative predictive values. The price and service time of dye, dyeing efficiency, and dyeing time. Results The sensitivity of H-E stain was higher than that of Papanicolaou stain. The specificity of H-E stain was same to that of Papanicolaou stain. Cohen’s kappa coefficient indicatied a high consistency between them. The morphological characterization of Papanicolaou stain were superior to those of H-E stain. The cost performance of H-E stain was lower. Conclusions In terms of overall evaluations and economic benefits, H-E stain is better than Papanicolaou stain. If a small sample volume of endometrial cells, Papanicolaou stain is recommended. Funding The Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China, the Major Basic Research Project of Natural Science of Shaanxi Provincial Science and Technology Department, the Key Research and Development Project of Shaanxi Provincial Science and Technology Department. Keywords: H-E stain, Papanicolaou stain, Endometrium, Cytology

Background Acetyl-CoA acetyltransferase 2 (ACAT2) is a lipid metabolism enzyme and rarely was researched in epithelial ovarian cancer (EOC). Methods ACAT2 expressions were confirmed in two pairs of cell lines (A2780 and A2780/DDP, OVCAR8 and OVCAR8/DDP) from Gene Expression Omnibus database by bioinformatics analysis, and in A2780 and A2780/DDP cell lines by quantitative real-time polymerase chain reaction and western blotting. Tissue samples were stained by immunohistochemistry and scored for ACAT2 expression. The relationships between ACAT2 expression and clinicopathological characteristics were analyzed by χ 2 test. The prognosis of ACAT2 was analyzed by the log-rank tests and Cox regression models. Results ACAT2 was remarkably upregulated in the above drug-resistant cell lines by mRNA (all P < 0.05) and protein expression ( P = 0.026) than those in sensitive ones. Patients were classified as ACAT2-high (n = 51) and ACAT2-low (n = 26) according to immunohistochemical score. ACAT2 expression had a significantly inverse correlation with FIGO stage ( P = 0.030) and chemo-response ( P = 0.041). A marginal statistical significance existed in ACAT2 expression and ascites volume ( P = 0.092). Univariate analysis suggested that high-expressed ACAT2 was associated with decreased platinum-free interval (PFI) (8.57 vs. 14.13 months, P = 0.044), progression-free survival (PFS) (14.12 vs. 19.79 months, P = 0.039) and overall survival (OS) (36.89 vs. 52.40 months, P = 0.044). Multivariate analysis demonstrated that ACAT2 expression (hazard ratio = 2.18, 95% confidence interval: 1.15–4.11, P = 0.017) affected OS independently, rather than PFI and PFS. Conclusion The expression of ACAT2 in A2780/DDP and OVCAR8/DDP was higher than the corresponding A2780 and OVCAR8. High-expressed ACAT2 was associated with advanced FIGO stage, chemo-resistance, and decreased PFI, PFS and OS. It was an independent prognostic factor of OS in EOC.

Primary liver cancer (PLC) that originates in the liver is a malignant tumor with the worst prognosis. Hepatocellular carcinoma (HCC) is the most common type of PLC. Most PLC cases are diagnosed at advanced stages mainly due to their insidious onset and rapid progression. Patients with PLC undergo surgical intervention or localized treatment, but their survival is often affected by its high relapse rate. Medical treatment is the primary option for patients with liver cancer, especially with advanced extrahepatic metastases. Molecular targeted therapy exerts an anti-tumor effect by acting on various signaling pathways involved in molecular pathogenesis; however, high drug resistance and low therapeutic responsiveness of PLC to molecular targets challenge the treatment option. In recent years, after surgical intervention, radiotherapy, chemotherapy, and/or molecular targeted therapy, autologous cell immunotherapy has been adopted for PLC. As a typical autologous cell immunotherapy, CAR T-cell therapy uses genetically modified T cells to express tumor-specific chimeric antigen receptors (CARs). Its targeting ability, persistent nature, and tumor-killing function result in a significant impact on the treatment of hematological tumors. However, no breakthrough has happened in the research specific to the curation of lung cancer, liver cancer, breast cancer, and other common solid tumors. In this context, a combination of molecular targeted therapy and CAR T-cell therapy was used to treat a patient with advanced HCC to achieve a partial remission(PR) and facilitate further liver transplantation.

BackgroundIn the study, we aimed to evaluate the ability of micro-histology combined with cytology to improve the quality of slides and diagnose endometrial lesions.MethodsEndometrial specimens were collected from Li Brushes. Every specimen was prepared for micro-histological and cytological slides, using cell block (CB) and liquid-based cytology (LBC) technologies. Semi-quantitative scoring system was used to evaluate the qualities of slides. CB slides were assessed by 5-category scoring system. Diagnostic accuracy was calculated in LBC, CB, and LBC + CB groups based on the histological gold standard. Endometrial atypical hyperplasia, and endometrial cancer were considered positive, whereas others were considered negative.ResultsA total of 167 patients were enrolled. CB slides were inferior to LBC slides only in cellularity (p < 0.001), but superior in the other six parameters (all p < 0.001). The satisfaction rate of micro-histology accounted for 92.3%. The accuracy index in the CB group was higher than in the LBC group in terms of sensitivity (85.5% vs. 82.7%) and specificity (98.9% vs. 95.7%). The sensitivity and specificity in the LBC + CB group were increased to 94.2% and 99.0%, respectively.ConclusionsThe quality of micro-histological slides was higher than that of cytological slides. By combining micro-histology with cytology, higher accuracy was achieved for endometrial lesions diagnosis.

BackgroundExtragonadal yolk sac tumor (YST) of peritoneum is a rare malignancy.Case DescriptionA 37-year-old Chinese woman was admitted to hospital with a 3-month abdominal pain 4 years ago. Alpha-fetoprotein was 228,499.0 ng/mL. Computed tomography scan revealed a massive mass in the left lower abdomen. Exploratory laparotomy exposed a huge mesenteric mass. Then, mesenteric tumor resection, partial sigmoidectomy, and single-lumen fistula of sigmoid colon were performed. Postoperative pathologic diagnosis reported a stage IV mesenteric YST. After surgery, the patient received 6 courses of BEP (bleomycin, etoposide, and cisplatin) chemotherapy. Seven months later, the patient underwent stoma reversion of sigmoid colon and received another 2 courses of BEP chemotherapy. Three months after the last chemotherapy, liver metastases were diagnosed. She subsequently underwent 3 surgeries, radiotherapy for liver metastases, and multiple tiers of palliative chemotherapies, including TP (docetaxel and carboplatin), VIP (ifosfamide, cisplatin, and etoposide), TIP (paclitaxel, ifosfamide, and cisplatin), and so on. After the third surgery (left hepatic lesion resection and right iliac lymph node resection), she received 4 cyclic chemotherapies of BEP´ (boanmycin, etoposide, and cisplatin) without pulmonary toxic side effects.ConclusionPostoperative histopathology and immunohistochemistry are gold standards for the diagnosis of peritoneal YST. The standard first-line treatment is surgery plus BEP chemotherapy. Second-line therapy regimens and above, including VIP and TIP, improve the prognosis of recurrent germ cell tumors. This relapsed and refractory patient with peritoneal YST benefits from the secondary BEP´ chemotherapy.

OBJECTIVE:Identifying a new target of miR-532-3p and studying its functional mechanism to explore the detailed anti-tumor mechanism of miR-532-3p in ovarian cancer. METHODS:Biological and molecular methods including real-time quantitative PCR (RT-qPCR), Western blotting, colony formation, in vitro migration and invasion assays, glucose consumption and lactate production assays, RNA interference and tumor xenograft mouse models were used to study the role of miR-532-3p and its target in ovarian cancer. mRNA sequencing, dual-luciferase reporter assay and immunohistochemistry (IHC) were used to identify miR-532-3p target. STRING dataset analysis, qPCR and Western blotting were used to investigate the downstream pathway of the target of miR-532-3p. RESULTS:Forced expression of miR-532-3p inhibited the proliferation, migration and invasion of ovarian cancer cells in vitro and the tumor growth in nude mice. RNA sequencing found 299 mRNAs were downregulated in miR-532-3p-overexpressed ovarian cancer cells, and bioinformatic analysis indicated Glycoprotein Nonmetastatic Melanoma Protein B (GPNMB), a type I membrane glycoprotein, was the potential target of miR-532-3p. GPNMB was reduced at both RNA and protein levels in miR-532-3p-overexpressed ovarian cancer cells. Dual-luciferase reporter assay determined GPNMB as the target of miR-532-3p. Interference of GPNMB inhibited the proliferation, migration, invasion, glucose consumption and lactate production of ovarian cancer cells. Knocking down of GPNMB reduced the protein level of HIF-1α without affecting HIF-1α mRNA level. Overexpression of GPNMB reversed the antitumor effect of miR-532-3p. CONCLUSION:miR-532-3p exerted the anti-cancer effect by targeting GPNMB/ HIF-1α/ HK2 pathway to inhibit aerobic glycolysis in ovarian cancer.

Objective:To investigate the clinicopathological features and surgical efficacy of primary hepatic angiosarcoma (PHA).Methods:Clinical data of 4 patients who were pathologically diagnosed with PHA and underwent surgical resection in the First Affiliated Hospital of Xi'an Jiaotong University from January 2000 to December 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Literature was retrieved in CNKI, Wanfang Data and PubMed using the keywords of "primary hepatic angiosarcoma" in both Chinese and English. 49 patients who were pathologically diagnosed with PHA and underwent surgical resection were included. The expression levels of CD31, CD34, Vimentin, coagulation factor Ⅷ (FⅧ) and Ki-67 in the tumor were quantitatively detected. Clinicopathological features and clinical prognosis of PHA were summarized and analyzed.Results:A total of 53 patients with PHA were included in the study, 26 male and 27 female, aged (57±3) years on average. Abdominal pain was observed in 28 cases, abdominal distension or upper abdominal discomfort in 5, fever in 1, abdominal mass in 1, lumbago in 1, costal region pain in 1, cough complicated with chest tightness and shortness of breath in 1, and no evident clinical symptoms in 15. 37 cases were diagnosed with single onset and 16 cases of multiple onset. The tumors of 12 cases were located in the left lobe, 32 in the right lobe, 1 in the middle lobe, 3 in the bilateral lobes, 2 in the whole lobe, and tumor location in 3 cases was not described. The maximum diameter of tumor was ranged from 1.7 to 25.0 cm. The tumor was solid, moderate texture and encapsulated. The tumor cells presented in oval or short-spindle shape, arranged in lamellar or staggered pattern, with significant cellular atypia. Immunohistochemical staining showed that the positive rate of CD31 was 78%(21/27), CD34 was 78%(21/27), Vimentin 58%(21/36), FⅧ 44%(12/27) and Ki-67 30%(8/27). Among 49 patients undergoing surgical resection, 13 cases were treated with preventive intravenous chemotherapy and 6 cases received preventive interventional therapy. 4 patients in our hospital were not treated with chemotherapy or interventional therapy. During the follow-up, 1 patient recurred, 2 cases developed liver failure and 1 metastasis.Conclusions:PHA is rarely seen in clinical practice and is lack of specific clinical manifestations and diagnosis parameters. It is difficult to deliver prompt diagnosis and easily misdiagnosed as other liver tumors. Surgical resection is the main treatment. The diagnostic confirmation relies on the pathological examination. Surgical resection combined with regular postoperative follow-up can yield definite efficacy and improve the clinical prognosis.

目的:探讨脑梗死组织周围半暗区星形胶质细胞增生及形态学定量分析及意义.方法:回顾性分析临床病理资料完整的高血压引起脑梗死伴继发出血的患者行小骨窗微创开颅手术、石蜡包埋及切片标本63例,以每例梗死伴出血旁正常脑组织为对照组.采用免疫组织化学法检测人体脑梗死周围半暗区胶质纤维酸性蛋白(GFAP)的表达,用图像分析测定GFAP表达的星形胶质细胞数目、细胞体面积、突起长度的变化.结果:在周围正常脑组织中,GFAP标记的阳性星形细胞均匀分布,胞体较小,突起呈分支状较纤细,呈放射状分布;在梗死灶周围半暗区,GFAP标记的阳性星形胶质细胞数目增多,细胞体面积增大,突起增长、互相交织成网,聚集在病灶边缘,并可见少量深入梗死灶.与周围正常脑组织比较,在脑梗死周围半暗区GFAP表达的星形胶质细胞阳性细胞数显著升高、星形胶质细胞体面积明显增大、突起明显增长,差异均有统计学意义(均P<0.01).直线相关分析显示,在脑出血梗死周围半暗区,GFAP表达的星形胶质细胞阳性细胞数与星形胶质细胞体面积及细胞突起长度无相关性(均P>0.05).结论:脑梗死组织半暗区星形胶质细胞反应性增生,这些反应性增生的星形胶质细胞形态学特征多样,可表现为细胞体积增大,或仅表现为细胞突起的伸长.间接说明星形胶质细胞参与了梗死灶神经修复和再生的过程.

OBJECTIVES:The soaring demand for endometrial cancer screening has exposed a huge shortage of cytopathologists worldwide. To address this problem, our study set out to establish an artificial intelligence system that automatically recognizes and diagnoses pathological images of endometrial cell clumps (ECCs).METHODS:We used Li Brush to acquire endometrial cells from patients. Liquid-based cytology technology was used to provide slides. The slides were scanned and divided into malignant and benign groups. We proposed two (a U-net segmentation and a DenseNet classification) networks to identify images. Another four classification networks were used for comparison tests.RESULTS:A total of 113 (42 malignant and 71 benign) endometrial samples were collected, and a dataset containing 15,913 images was constructed. A total of 39,000 ECCs patches were obtained by the segmentation network. Then, 26,880 and 11,520 patches were used for training and testing, respectively. On the premise that the training set reached 100%, the testing set gained 93.5% accuracy, 92.2% specificity, and 92.0% sensitivity. The remaining 600 malignant patches were used for verification.CONCLUSIONS:An artificial intelligence system was successfully built to classify malignant and benign ECCs.

目的 探讨盆腔孤立性纤维瘤(solitary fibrous tumor,SFT)临床病理特点、诊治现状及预后.方法 复习国内外文献,回顾性分析2010年1月至2019年7月西安交通大学第一附属医院5例经手术切除及病理确诊为盆腔SFT的病人病例资料,采用HE和免疫组织化学SP法检测Vim、CD34、CD99、Ki-67、bcl-2和S-100的表达,分析其临床病理特点及预后.结果 5例SFT病人平均年龄54岁,分别发生于腹膜后、骶前、膀胱等盆腔位置.早期SFT病人无任何典型临床表现,随着肿瘤体积增大,病灶局部逐渐出现肿块压迫症状.大体标本组织学示肿瘤内为伴血管外皮瘤样和黏液样变性的成束梭形细胞,其间隔不同范围的胶原纤维.免疫组化染色结果:Vim阳性率100％(5/5)、CD34100％(5/5)、CD9980％(4/5)、Ki-6760％(3/5)、bcl-260％(3/5)、S-100、SMA、Des、NSE均为20％(1/5).均获有效随访,平均随访37.4个月,均无复发及转移.结论 作为一种特殊且少见的梭形细胞肿瘤,SFT的常规影像学和实验室检查特异性均较低,临床诊断需结合病理和免疫组化结果进行,根治性切除为首选治疗方法,也是影响SFT预后的最重要因素.

Objective:To investigate the value of paraffin-embedded section of cell block in the diagnosis of lung adenocarcinoma in bloody pleural effusion.Methods:The data of 60 patients with lung adenocarcinoma diagnosed by bloody pleural effusion and confirmed by pathological biopsy in the First Affiliated Hospital of Xi'an Jiaotong University from June 2018 to June 2019 were retrospectively analyzed. Cell smears and paraffin-embedded sections of cell blocks using removed red blood cells sedim entation method were used to make cytological examination in bloody pleural effusion. The expressions of carcinoembryonic antigen (CEA), cytokeratin 7 (CK7), NapsinA, thyroid transcription factor 1 (TTF-1), cytokeratin 5/6 (CK5/6), calretinin, P63 and P40 in the specimens were detected by using immunohistochemistry. The results of histopathological examination were used as the gold standard, and the diagnostic values of cell block paraffin-embedded sections and cell smears for lung adenocarcinoma in bloody pleural effusion were evaluated and compared.Results:The cell block sections had a clear background, clear and easy to distinguish cell morphology, and can be made into permanent specimens. The bloody pleural effusion cell smears results of 60 cases of lung adenocarcinoma showed that 21 cases were diagnosed as atypical cells, 39 cases were diagnosed as adenocarcinoma, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 65% (39/60); the immunohistochemistry results of cell block paraffin-embedded sections of bloody pleural effusion showed that CK7, NapsinA, TTF-1 and CEA were positive, and P40, P63, CK5/6 and calretinin were negative, all 60 cases were diagnosed as adenocarcinoma according to the results, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 100% (60/60), which was significantly higher than that of cytological smears ( χ2 = 23.088, P < 0.01). Conclusions:The technique of paraffin-embedded section of cell block using removed red blood cells sedim entation method has a high diagnostic rate for lung adenocarcinoma in bloody pleural effusion, and it has a high coincidence rate with histopathological diagnosis. It can improve the accuracy of diagnosis of lung adenocarcinoma in bloody pleural effusion, and it also has a good reference value for cytological typing.

OBJECTIVE:To explore the mechanism by which ginsenoside 20(S)-Rg3 upregulates the expression of tumor suppressor von Hippel-Lindau (VHL) gene in ovarian cancer cells.METHODS:Ovarian cancer cell line SKOV3 treated with 20(S)-Rg3 were examined for mRNA and protein levels of VHL, DNMT1, DNMT3A and DNMT3B by real-time PCR and Western blotting, respectively. The changes in VHL mRNA expression in SKOV3 cells in response to treatment with 5-Aza-CdR, a DNA methyltransferase inhibitor, were detected using real-time PCR. VHL gene promoter methylation was examined with methylation-specific PCR and VHL expression levels were determined with real-time PCR and Western blotting in non-treated or 20(S)-Rg3-treated SKOV3 cells and in 20(S)-Rg3-treated DNMT3A-overexpressing SKOV3 cells. VHL and DNMT3A protein levels were detected by immunohistochemistry in subcutaneous SKOV3 cell xenografts in nude mice.RESULTS:Treatment of SKOV3 cells with 20(S)-Rg3 significantly upregulated VHL and downregulated DNMT3A expressions at both the mRNA and protein levels (P < 0.05) and upregulated DNMT3B expression only at the mRNA level, but did not cause significant changes in either the mRNA or protein level of DNMT1. Treatment of the cells with 2 and 5 μmol/L 5-Aza-CdR obviously increased VHL mRNA expression by by over 3 folds (P < 0.05). 20(S)-Rg3 significantly decreased the methylation level in the promoter region of VHL gene, and this effect was abrogated by DNMT3A overexpression in the cells (P < 0.05). Immunohistochemisty showed a significantly increased VHL expression but a lowered DNMT3A expression in subcutaneous SKOV3 cell xenografts in 20 (S)-Rg3-treated nude mice.CONCLUSIONS:Ginsenoside 20(S)-Rg3 upregulates VHL expression in ovarian cancer cells by suppressing DNMT3A-mediated DNA methylation.

目的明确人参皂苷20（S）-Rg3促进卵巢癌细胞抑癌基因von Hippel-Lindau（VHL）表达的机制。方法 Real-time PCR和Western blotting检测20（S）-Rg3处理前后卵巢癌细胞SKOV3中的VHL、DNA甲基转移酶DNMT1、DNMT3A和DNMT3B的mRNA和蛋白水平。Real-time PCR检测甲基转移酶抑制剂5-氮杂-2-脱氧胞苷（5-Aza-CdR）处理卵巢癌细胞SKOV3前后VHL的mRNA水平变化。甲基化特异性PCR（MSP）检测20（S）-Rg3单纯处理组和20（S）-Rg3处理且过表达DNMT3A组的VHL基因启动子区的甲基化水平,并检测VHL的mRNA和蛋白表达水平。免疫组化检测课题组前期获得的20（S）-Rg3处理组及对照组的裸鼠皮下移植瘤组织中VHL和DNMT3A的蛋白表达。结果 20（S）-Rg3处理后,卵巢癌细胞SKOV3中VHL的mRNA水平升高到阴性对照细胞的2倍以上,蛋白水平亦上调（P＜0.05）;DNMT3A的mRNA水平和蛋白水平均下降（P＜0.05）,DNMT3B的mRNA水平略有升高但蛋白水平无明显变化（P＞0.05）,DNMT1的mRNA和蛋白水平均无变化（P＞0.05）。2μmol/L和5μmol/L的5-Aza-CdR处理后,SKOV3细胞的VHL m RNA水平升高到阴性对照细胞的3倍以上（P＜0.05）。20（S）-Rg3使VHL基因启动子区的甲基化水平降低（P＜0.05）,在20（S）-Rg3处理的同时过表达DNMT3A,则VHL基因启动子甲基化水平再次升高,同时VHL mRNA和蛋白水平均降低（P＜0.05）。免疫组织显示,相对于对照组,20（S）-Rg处理组的裸鼠皮下移植瘤组织中VHL的表达上调、DNMT3A的表达下调。结论 20（S）-Rg3通过抑制DNMT3A介导的启动子甲基化而促进卵巢癌细胞中VHL的表达。

目的 探讨腹膜后孤立性纤维瘤(SFT)的临床病理特点及预后.方法 分析西安交通大学第一附属医院2007年1月至2017年12月间收治的9例手术切除并行病理检查确诊为SFT的临床及预后资料,采用HE和免疫组织化学SP法检测9例腹膜后SFT肿瘤细胞Vimintin(Vim)、CD34、CD99、Ki-67、Bcl-2和S-100的表达,分析其临床病理特点及预后.结果 9例中,男性4例,女性5例,年龄37～69岁,5例表现为腹胀,4例无明显临床症状,肿瘤大小(1.0cm×1.0cm×2.0cm)～(30.0cm×25.0cm×10.0cm),单发7例,多发2例.组织学表现为束状、编织状排列的梭形细胞和不同程度的胶原纤维,伴有黏液变性及血管外皮瘤样形态.免疫组化阳性率结果:Vim、CD34、CD99100％(9/9),Ki-6777％(7/9)、Bcl-267％(6/9)、S-10022％(2/9).均获有效随访,2例死亡,均与研究疾病不相关,术后存活时间分别为6.5、8.3年,存活病例中有1例在术后3年复发,二次手术后未再复发,其余病例均未见复发转移.结论 腹膜后SFT临床少见,早期无典型临床症状,多于查体发现,超声、CT检查是主要术前检查方法,但对SFT诊断无特异性,根治性切除是治疗首选,病理检查是确诊的唯一方法,早期行根治性手术治疗及术后定期复查的疗效确切.

目的 探讨肺非典型类癌伴异位促肾上腺皮质激素(ACTH)综合征的临床病理特征及诊断标准与鉴别诊断.方法 回顾性分析1例肺非典型类癌伴异位ACTH综合征临床病理特征及免疫组织化学表型,并文献复习.结果 患者,女性,60岁,颜面浮肿潮红,双下肢无力症就诊.血ACTH 73.04pg/ml.CT示右肺下叶后基底段结节影.病理特征:"右肺下叶"周围型肿物,最大径2.1 cm,切面灰粉色,质软,周界较清;镜下观察,肿瘤细胞呈巢团状、小梁状或菊形团样排列,细胞中等或偏小,细胞核深染,形态略不规则,核分裂象平均3个/1OHPF.免疫组化:CK、ACTH、NSE、Syn、CgA(+),Ki-67约10％(+).病理诊断:肺非典型类癌伴异位ACTH综合征.结论 肺非典型类癌伴异位ACTH综合征少见,需结合临床病史、血清学检查、病理学特征及免疫组化表型综合分析诊断,该病变患者预后良好.

Objective:To investigate the clinicopathological characteristics and surgical efficacy of liver solitary fibrous tumor (SFT).Methods:Clinical data of 2 patients diagnosed with liver SFT who underwent radical resection in the First Affiliated Hospital of Xi'an Jiaotong University from January 2001 to December 2018 were retrospectively analyzed. In addition, 49 cases with liver SFT were included by literature searching. The informed consents of 2 patients of our hospital were obtained and the local ethical committee approval was received. Baseline data, clinical manifestations and histological types of the patients were analyzed. The expression levels of Vim, CD34, CD99, desmin, Bcl-2 and STAT6 of tumors were detected by immunohistochemical staining. Clinicopathological characteristics and surgical efficacy were summarized.Results:A total of 51 patients pathologically diagnosed with liver SFT and complete follow-up data were included in this study. 23 cases were male and 28 female, aged (52±3) years on average. The clinical manifestations included abdominal distension in 11 cases, hypoglycemia in 7 cases, abdominal pain in 4 cases, epilepsy in 1 case, and no obvious clinical symptoms were observed in 28 cases. All the tumors were solitary with complete capsule, abundant blood supply, tough texture, clear boundary and yellow cross-section. The tumor diameter was (15.4±2.3) cm. Histological manifestations were spindle-shaped or ovoid tumor cells, irregular arrangement and uneven density, ovoid nucleus, small nucleoli, and a large amount of collagen fibers between tumor cells. Immunohistochemical staining revealed that the positive rate of CD34 was 94% (48/51), 77% (39/51) for Vim and 55% (28/51) for Bcl-2. The median survival time of patients in this group was 17.4 months. No recurrence was reported.Conclusions:Liver SFT is rarely seen in clinical practice. No evident symptom is noted in the early stage. Large lesions may cause abdominal distension and pain, accompanied by hypoglycemia. Pathological examination is the gold standard for diagnosis. Radical resection is the primary choice of treatment. Surgical resection combined with regular follow-up yield exact clinical efficacy.

Emerging evidence suggests that miR-143 plays an important role in the regulation of tumor sensitivity to chemotherapeutic agents. The study explores the underlying mechanism of miR-143 in reversing cisplatin resistance in ovarian cancer. The cisplatin-resistant ovarian cancer cell line A2780/CDDP was induced and established via treating A2780 cells by gradually increasing cisplatin concentrations. The IC50 values of A2780/CDDP and A2780 to cisplatin were 218.10 ± 1.12 and 21.99 ± 1.12 μM, respectively. Quantitative real-time polymerase chain reaction (qRT-PCR) results showed that miR-143 was significantly decreased in A2780/CDDP cells compared with A2780 cells. miR-143 overexpression decreased cisplatin resistance in A2780/CDDP, and miR-143 inhibition decreased A2780 sensitivity to cisplatin. Results of qRT-PCR, Western blot analysis, and luciferase reporter assay indicated that the direct target of miR-143 was DNMT3A, which, in turn, was upregulated in A2780/CDDP. DNMT3A overexpression antagonized the sensitizing effect of miR-143 on A2780/CDDP to cisplatin. Knocking down of DNMT3A reduced cisplatin resistance in A2780/CDDP, while overexpression of DNMT3A increased cisplatin resistance in A2780. Methylation-specific polymerase chain reaction results showed that the methylation level in the promoter region of the miR-143 precursor gene was higher in A2780/CDDP cells than in A2780 cells. DNMT3A mediated the hypermethylation of the miR-143 precursor gene, resulting in miR-143 downregulation in A2780/CDDP. miR-143 inhibited cell growth of A2780/CDDP cell in nude mice. Our findings indicated the negative feedback between miR-143 and DNMT3A as a crucial epigenetic modifier of cisplatin resistance in ovarian cancer.

Purpose Cytopathology detecting for endometrial cancer is becoming accepted, and Tao Brush is the most widely used sampler for endometrial cells. This study aims to compare the effectiveness between Li brushes and Tao brushes for the diagnosis of endometrial lesions and to evaluate the diagnostic accuracy of endometrial cytology compared with histology. Methods There were 109 patients needing dilation and curettage (D&C) and 21 patients needing hysterectomies included from November 2017 to April 2018. Every patient was sampled by Tao brush and Li brush before D&C or hysterectomy performed. The cytological results were compared based on the gold standard histological results of D&C or hysterectomy. Results The sensitivity of Li brush cytology for detecting endometrial cancer and atypical hyperplasia was estimated at 83.33%, specificity at 100%, positive predictive value (PPV) at 100%, and negative predictive value (NPV) at 98.02%, respectively. While for the Tao brush, it was 91.67% of sensitivity, 96.04% of specificity, 73.33% of PPV, and 98.98% of NPV, respectively. The kappa value was 0.767, which indicated a substantial agreement. Cytology by both two brushes had a lower insufficient sample rate (2.75% of Tao brush, 4.59% of Li brush) than did D&C (11.93%). Discussion Endometrial cytology is a reliable approach for evaluating endometrium with a lower insufficient sample rate. Cytology sampled by both Li brushes and Tao brushes has a high accuracy with histological diagnosis in detecting endometrial cancer and atypical hyperplasia. Combining social and economic benefits, the Li brush may be a better endometrial cell collector.

Objectives: To compare the effectiveness between Qi brush and Cervex-Brush® Combi for the diagnosis of cervical lesions. Methods: After we registered a random-control clinical trial on the Chinese Clinical Trial Registry (No. XJTU1AF2017LSK-25), cervical cell samples were successively collected with both Qi brush and Cervex-Brush® Combi before undergoing colposcope. Colposcopy with biopsy was performed later. Histological diagnosis was regarded as the gold standard in this study. The following indices of the two brushes were compared: sampling degree of satisfaction and presence rate of metaplastic cells, together with sensitivity (Se), specificity (Sp), false positives (FP), false negatives (FN), positive predictive value (PPV), and negative predictive value (NPV). The kappa value was used to measure the inter-rater agreement of the Qi brush and Cervex-Brush® Combi in diagnosing cervical lesions. Results: In total, 74 patients were enrolled in this study. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Qi brush were 57.14, 86.84, 76.19, and 73.33%, respectively. For the Cervex-Brush® Combi, they were 26.92, 88.89, 63.63, and 62.75%, respectively. In addition, the Qi brush had a higher satisfied sampling rate (89.19%) than the Cervex-Brush® Combi (83.78%), and the P-value was 0.336 using Chi-square test. The kappa value was 0.444, which indicated a medium agreement between these two brushes, and the sensitivity of the Qi brush was higher than that of the Cervex-Brush® Combi, with significant statistical difference (P = 0.039<0.05). Conclusions: The Qi brush was more effective than the Cervex-Brush® Combi for sampling and also had a slightly higher accuracy in diagnosing in cytology. In terms of social and economic benefits, the Qi brush may be a better cervical cytology collector.