Objective To investigate the expression levels of thyroid transcription factor-1 （TTF-1） and CyclinD1 in ovarian cancer and analyze their relationship with lymphangiogenesis. Methods The ovarian cancer tissue samples were collected from 60 patients with ovarian cancer and corresponding ovarian tissue samples from 20 patients pathologically diagnosed with benign ovarian tumors and normal ovarian tissue were collected as the control group. Tissue sections were prepared for immunohistochemical staining of TTF-1， CyclinD1 and D2-40. The staining results of TTF-1 and CyclinD1 were evaluated based on semi-quantitative integration method. D2-40 staining results were assessed according to Weidner evaluation method. Lymphatic vessel density （LVD） was calculated. Results The positive expression rates of TTF-1 and CyclinD1 were 58% and 83% in the ovarian cancer tissues， which were higher than 5% and 10% in the normal cancer tissues（all P < 0.001）， respectively. The positive expression rates of TTF-1 and CyclinD1 were significantly increased in the ovarian cancer tissues with pathological stageⅢ-Ⅳ， lymph node metastasis， peritoneal metastasis， T3-T4 stage， N1 stage and M1 stage （all P < 0.05）. Age and histological type were not correlated with the positive expression rates of TTF-1 and CyclinD1 （all P > 0.05）. The LVD of ovarian cancer tissues with pathological stageⅢ-Ⅳ， lymph node metastasis and peritoneal metastasis was significantly increased （all P < 0.05）. The LVD of ovarian cancer tissues with positive expression of TTF-1 and CyclinD1 was significantly higher than that of ovarian cancer tissues with negative expression （both P < 0.05）. Conclusions TTF-1 and CyclinD1 are highly expressed in ovarian cancer tissues. Patients with severe ovarian cancer， lymphangiogenesis and metastasis have high expression of TTF-1 and CyclinD1， which may be potential new targets for ovarian cancer interventions.

目的 探讨肾上腺皮质癌(adrenocortical carcinoma,ACC)的临床病理学特征、免疫表型、鉴别诊断及生物学行为.方法 回顾性分析19例ACC患者的临床资料,总结其临床和形态学特征、免疫表型及预后.另选60例肾上腺皮质腺瘤作为对照,采用免疫组化EnVision法和网状纤维染色比较两者的差异.结果 ACC低级别13例,高级别6例.普通型13例、嗜酸型3例、黏液型1例、肉瘤样型2例.免疫表型:SF-1(100％,19/19)均阳性,α-inhibin(52.9％,9/17)强阳性,Melan-A(73.7％,14/19)局灶或部分阳性,α-in-hibin 和 Melan-A 共阳性(47.1％,8/17);Ki-67增殖指数5％～50％,60例皮质腺瘤Ki-67增殖指数均＜3％.ACC网状结构评分2分者2例,3分者11例,4分者6例;皮质腺瘤评分均为1分.结论 ACC中Ki-67增殖指数明显高于皮质腺瘤,网状结构评分明显高于皮质腺瘤,联合Ki-67增殖指数与网状纤维染色可与皮质腺瘤进行鉴别.

目的 探讨血管紧张素Ⅱ受体拮抗剂(ARB)和血管紧张素转换酶抑制剂(ACEI)对子宫内膜癌(EC)移植瘤生长的影响.方法 建立裸鼠人EC移植瘤模型.随机分为对照组、ARB组、ACEI组.饲养28 d处死小鼠,测量体质量、肿瘤体积和质量,计算肿瘤抑制率.检测移植瘤的微血管密度变化和细胞凋亡水平变化.蛋白免疫印迹检测EC组织血管紧张素Ⅱ受体1(AT1R)和血管紧张素转换酶(ACE1)的表达.结果 AT1R和ACE1在EC组织中表达增加(t=39.631、64.313,P均<0.05);与对照组比较,ARB组与ACEI组在21、28、35 d的肿瘤体积降低(t=9.534～13.226,P均<0.05),微血管密度减小(t=10.944、11.563,P均<0.05),血管内皮生长因子表达下降(t=11.523、12.076,P均<0.05),细胞凋亡率上调(t=12.209、14.782,P均<0.05).结论 ARB和ACEI均可以抑制EC移植瘤的生长.

具有血管周上皮细胞分化的肿瘤(neoplasms with perivascular epithelioid cell differention，PEComas)是一种罕见疾病，目前文献报道较少，本文报道1例肺PEComa自发破裂出血患者因突发胸痛入院，检查提示右中肺占位伴大量血胸，经急诊手术治疗后顺利出院，病理提示肺部良性PEComas。

目的 探讨颗粒细胞瘤(GCT)的临床及病理学特征.方法 回顾性分析37例颗粒细胞瘤的临床资料、组织学形态及免疫组化染色结果,收集随访资料并复习文献.结果 37例中女性23例,男性14例,年龄13～74岁,平均42岁,以食管、胸腹壁等部位好发,多无明显症状;组织学上瘤细胞多边形或卵圆形,胞质丰富,嗜酸性颗粒状,可见脓疱卵形小体,核小而圆,排列呈巢状或片状,细胞巢间为宽窄不等的胶原化纤维性间隔.免疫组化示S-100、CD68和NSE(+).参照Fanburg-Smith等提出的6项诊断标准判断,良性颗粒细胞瘤34例、不典型颗粒细胞瘤1例、恶性颗粒细胞瘤2例,其中多发性颗粒细胞瘤3例.25例有随访资料,23例无复发,1例肝、淋巴结转移,1例多次复发后肝转移.结论 颗粒细胞瘤大多属于良性肿瘤,少数为多发性,恶性罕见.恶性颗粒细胞瘤的诊断可采用Gamboa分型结合Fanburg-Smith标准.

目的 分析影响子宫内膜不典型增生(AEH)诊断及病理升级的相关因素.方法 选取2015年12月～2018年12月广东省佛山市第一人民医院妇科收治的88例初诊为AEH的患者的临床资料进行回顾性分析,并按照术后病理诊断结果将其分为子宫内膜样癌(EC)组(31例)和AEH组(57例),分析影响AEH病理升级的相关因素.结果 两组患者的高密度脂蛋白(HDL-C)水平及高血压发生率比较,差异无统计学意义(P＞0.05);EC组患者的年龄、子宫内膜厚度高于AEH组,三酰甘油(TG)、总胆固醇(CHOL)、低密度脂蛋白(LDL-C)、体重指数(BMI)、绝经率、糖尿病发生率均高于AEH组,差异有统计学意义(P＜0.05);年龄≥50岁(β=1.05,OR=2.88,95％CI 1.11～7.62)、BMI＞25 kg/m2(β=1.35,OR =3.96,95％CI 1.27～12.66)、绝经(β=2.72,OR=15.59,95％CI 2.04～118.52)、糖尿病(β=1.62,OR=5.97,95％CI 2.75～16.32)、子宫内膜增厚(β=1.12,OR=3.49,95％CI 0.76～6.33)和血脂代谢异常(β=1.79,OR =6.13,95％CI 2.04～17.92)均属于AEH患者术后病理升级为EC的危险因素(P＜0.05).结论 50岁以上(尤其是绝经状态下)的女性,且伴有子宫异常出血、血脂代谢异常、子宫内膜增厚、肥胖、糖尿病等症状的AEH患者术后病理升级为EC的概率更高,建议采用宫腔镜辅助诊刮术,必要时术中快速冰冻病理检查来减少其漏诊或误诊率,以便对患者正确诊断并及早治疗.

目的 探讨超声TI-RADS分级对甲状腺结节良恶性的鉴别诊断价值.方法 回顾性分析2014年10月至2017年10月佛山市妇幼保健院接诊的186例甲状腺结节患者的病历资料,对其超声TI-RADS分级与病理穿刺结果进行比较分析.结果 186例甲状腺结节患者共检出266个结节,病理穿刺结果示:良性结节112个,恶性结节154个;超声TI-RADS分级诊断甲状腺结节良性140个、恶性126个.以病理穿刺结果为金标准,超声TI-RADS分级诊断的敏感度、特异性、准确性分别为77.27％、81.25％、78.95％.在结节边界规则、纵横比>1、低回声或极低回声及微钙化等超声征象方面,良恶性甲状腺结节比较,差异有统计学意义(P<0.05).结论 超声TI-RADS分级对甲状腺结节良恶性的鉴别具有较好的应用价值,值得临床推广.

Objective To investigate the clinicopathological features of multilocular cystic renal cell carcinoma (MCRCC), and to improve the clincopathological features of this disease. Methods 13 cases MCRCC data, clinical characteristics, pathological features and also immuniophenotype were collected. Results In 13 patients: 9 of them were males and 4 were females, the ratio is 2.25: 1. The prevalence o age was at a range of 26-68 years, mean age is 47.2 years. Mostly of them were found by incidental or only back pain symptoms occasionally. Morphological examination:maximum of tumors is at a range of 1.7-6cm. They were cystic or focal cystic solid, have a clear boundary. They showed as multilocular or honeycomb, part of them containing yellow or bloody fluid. Microscopic observation:Most cysts lined by a single layer of tumor cells, multi-part perhaps , with clear cytoplasm, and the nuclear small, have no obvious nucleoli. According to Fuhrman nuclear grade,they were level I;also,we can see focal cystic with small papillary structures. Most cases can be seen and cysts lined by cells similar to clear cell groups, mostly nested within the fibrous septa. Immunohistochemical staining: tumor cells markered with AE1/3, EMA, Vimetin showed diffuse expression, CD10 cells were eight cases of tumor and 10 cases of CK7 positive or focally positive, P504S has three were positive or focally positive expression, CK20, CD117, CD163 were negative, Ki-67 index of 1%-5%. P53 negative expression in 11 cases, two cases have positive 1%of tumor cells. Conclusion MCRCC is a rare histologic subtypes of renal cell carcinoma, the prognosis is good, immunohistochemical markers AE1/3, EMA, Vimetin, CK7, CK20, CD10 and other help for its diagnosis and differential diagnosis.

Objective To study the clinicalpathological features of intestinal lymphangioma, provide more data for the diagnosis and clinical treatment. Methods Review the clinical data of 12 with intestinal lymphangioma cases, general form,also all of the biopsy slides and immunohistochemical markers, combined with the existing literature,in order to summarize clinical pathologic features of this tumor. Results In this paper,, 4 of 12 cases were pediatric patients, 8 of 12 cases were adult patients. Pediatric patients with clinical symptoms start to varying degrees of abdominal pain, with or without associated with gastrointestinal symptoms such as nausea, vomiting, and the clinical diagnosis could be intestinal obstruction or tumor;And adult patients were found by chance usually , clinical diagnosis could be xanthoma or mucosal patch to be determined. Pathological examination showed mucosa, submucosa or serosal of intesine would be discovered multiple expansion, different sizes, different thickness of capsule wall of lymphatic vessels, lined with simple squamous epithelium cells, can be seen in the lumen of the red lymphatic fluid, with varying amounts of lymphocytes. Immunohistochemical markers D2-40, CD31 always would be positive, part of CD34 positive,Calratinin and WT 1 showed negetive. Conclusion Lymphangioma of intestinal is very rare in clinical work , and surgical removal will have a good prognosis.

Objective:Purpose To explore the histological immunohistochemical characters and prognosis of anaplastic large cell lymphoma(ALCL).Methods Histology and immunohistochemical markers of 10 ALCL cases were analyzed and the correlated literature was reviewed.Results The ALCL of 10 patients had 9:1 male/fe-male ratio with an average age of 38.7.4 cases were located in the lymph node of neck,2 in small intestine,2 in epicranium,1 in mediastina and 1 in bronchus.The ALCL showed distinctive morphological characters.The tumors were mainly composed of large and pleomorphic cells with abundant cytoplasm.The nuclei were large and irregular with shape of twist horseshoed and wreath like.Multiple nuclei or huge nuclei were seen sometimes.All 10 cases expressed CD30and partly expressed CD3,EMA and CD45RO.All cases were negative for AE1/AE3,CD20,HMB45,S100,CD68,CD15.Conclusions ALCL is extremely rare.It is necessary to differentiate from other type of tumors such as the Hodgkin lymphoma,diffuse large B cell lymphoma,poor differentiated carcinomas and malignant melanoma.

Purpose To explore the expression of PTEN,Her-2 and Glut-1 in endometrioid adenocarcinoma and their role in tumorigenesis.Methods EnVision immunohistochemistry was used to detect the protein expression of PTEN,Her-2 and Glut-1 in 40 cases of complex endometrial hyperplasia,44 cases of atypical endometrial hyperplasia and 60 cases of endometrioid adenocarcinoma.Results The negative expression rate of PTEN in complex endometrial hyperplasia,endometrial atypical hyperplasia and endometrial carcinoma were 42.5%,61.4% and 66.7%,respectively;there were not significant differences between complex endometrial hyperplasia and atypical endometrial hyperplasia(P0.05),but that between endometrioid adenocarcinoma and complex endometrial hyperplasia had significant differences(P0.05).The positive expression rate of Her-2 and Glut-1 in complex endometrial hyperplasia,endometrial atypical hyperplasia and endometrial carcinoma were 0%,29.5% and 61.7%,and 5%,93.2% and 100%,respectively.Her-2 and Glut-1 expression had significant differences among complex endometrial hyperplasia,atypical endometrial hyperplasia and endometrioid adenocarcinoma(P0.05).The expression of Her-2 was correlated with muscle invasion,nationality and vessel invasion(P0.05).The expression of Glut-1 had significant differences in histological grade,clinical stage,vessel invasion and tumor′s size(P0.05).Conclusion PTEN,Her-2 and Glut-1 may play a significant role in the development of endometrioid adenocarcinoma.The combined use of them and the histologic features are valuable in distinguishing endometrioid adenocarcinoma from endometrial precancerous lesions.The positive expression of Her-2 and Glut-1 is correlated with the poor prognosis of endometrioid adenocarcinoma.