Background Colorectal cancer (CRC) is the third most common malignancy worldwide, and lymph node metastasis is considered to be a risk factor for local recurrence and a poor prognosis in colorectal cancer. However, there remains a lack of reliable and non-invasive biomarkers to identify the lymph node status of CRC patients preoperatively. The purpose of this study was to explore the ability of dual-energy computed tomography (DECT) to differentiate metastatic from non-metastatic lymph nodes in colorectal cancer. Methods Seventy-one patients with primary colorectal cancer underwent contrast-enhanced dual-energy computed tomography imaging preoperatively. The colorectal specimen was scanned postoperatively, and lymph nodes were matched to the pathology report. The following dual-energy computed tomography quantitative parameters were analyzed: dual-energy curve slope value (λHU), standardized iodine concentration (n△HU), iodine water ratio (nIWR), electron density value (nρeff), and effective atom-number (nZ), based on metastatic and non-metastatic lymph node differentiation. Also, sensitivity and specificity analyses were performed using receiver operating characteristic curves. Results In all patients, one hundred and fifty lymph nodes, including 66 non-metastatic and 84 metastatic lymph nodes, were matched using the radiological-pathological correlation. Metastatic nodes had significantly greater λHU, n△HU, and nIWR values than non-metastatic nodes in both the arterial and venous phases (P<0.01). The area under curve (AUC), sensitivity, and specificity were 0.80, 80%, and 66% for λHU; 0.86, 70%, and 95% for n△HU; and 0.88, 71%, and 95% for nIWR in the arterial phase. There was no significant difference in electron density and effective Z values between metastatic and non-metastatic lymph nodes. Conclusions DECT quantitative parameters may help differentiate between metastatic and normal lymph nodes in patients with CRC.

Background: BRAF mutations have been detected in a high proportion of melanoma, papillary thyroid carcinoma, and various primary brain tumors. But the sensitivity and specificity of immunohistochemical detection of BRAF-V600E mutant protein were not evaluated in brain tumors. The aim of this study was to assess the utlity of BRAF-V600E IHC compared to molecular biology on a large series of brain tumors, in order to provide a useful reference for the use of BRAF-V600E IHC in clinical practice.Methods and results: We analyzed the BRAF-V600E immunoreactivity pattern and its expression profile by immunohistochemistry (IHC) in 122 patients diagnosed with different tumors of brain including gangliocytoma/ganglioma(GC/GG), pleomorphic xanthoastrocytomas(PXA), epithelioid glioblastoma(E-GBM), dysembryoplastic neuroepithelial tumour(DNT), pilocytic astrocytoma(PA), and papillary craniopharyngioma(p-CPG). VE1 immunostaining of 52 cases showed clear cytoplasmic diffuse positive pattern in majority tumor cells. 14 cases were presented with clear granular cytoplasmic positive pattern in single tumor cell or tumor cell cluster. 22 cases displayed equivocal positive with undefined location. 34 cases were negative. Including 81 immunopositive cases and 29 immunonegative cases were further confirmed by Real-time PCR. And 63 of 81 immunopositive cases were confirmed with BRAF-V600E mutation (77.8%), and all of 29 negative cases were confirmed to have wild-type BRAF (100%). Interestingly, only the cases showing clear immunoreactivity patterns (e.g cytoplasmic) with clean background had immunostaining results consistent with the molecular detection results, regardless of the number of positive cells (61/61,100%). However, samples with indeterminate immunoreactivity patterns were most likely to have false positive results (18/20, 90%). Conclusions: VE1 immunostaining could replace molecular detection to some extent, on the premise of mastering the key points in the interpretation of BRAF VE1 immunostaining: 1) As long as the positive signal was accurately located in the cytoplasm of tumor cells, the sample was considered to have BRAF V600E mutation, disregarding the number of positive cells; 2) Tissue samples that had no signal of BRAF VE1 expression with clear background could be confirmed with wild-type BRAF-V600E; 3) Some equivocal positive with uniform “coating” or nucleus positive cases were often considered as false-positive and usually required further molecular detection.

目的:探究RNA干扰RhoBTB1基因表达对结肠癌HT29细胞增殖、凋亡的影响.方法:采用Lipofectamine 2000将siRNA RhoBTB1或siRNA NC转入HT29细胞中,实验分为Control组、转染对照组和siRNARho组,噻唑蓝(MTT)和流式细胞术分别检测细胞的的活力和凋亡率,蛋白质印迹法(Western Blot)检测细胞中RhoBTB1、活化的含半胱氨酸的天冬氨酸蛋白水解酶3(Cleaved Caspase-3)、B细胞淋巴瘤/白血病-2(Bcl-2)、Bcl-2相关X蛋白(Bax)的表达量.结果:与对照组相比,HT29细胞转染siRNA RhoBTB1后,细胞中RhoBTB1蛋白的表达量显著低于对照组(P＜0.05),细胞活力显著升高(P＜0.05),凋亡率显著降低(P＜0.05),Cleaved Caspase-3、Bax蛋白水平明显降低(P＜0.05),Bcl-2蛋白水平显著增加(P＜0.05).结论:RNA干扰RhoBTB1表达促进结肠癌HT29细胞增殖,抑制其凋亡,可能通过调节线粒体凋亡通路相关蛋白的表达量发挥作用.

Basal cell carcinoma arising in ovarian mature cystic teratoma is extremely rare. First Affiliated Hospital of Ji’nan University received a young woman with an abdominopelvic mass. Tumor resection was performed through laparoscopic surgery. Pathology examination showed basal cell carcinoma arising in ovarian mature cystic teratoma. The patient gave birth to a baby 2 years later, still in a disease-free survival now. The prognosis is good.

目的 研究胰岛素样生长因子1受体(IGF-1R)对视网膜母细胞瘤细胞增殖和凋亡的影响及机制.方法 视网膜母细胞瘤细胞WERI-Rb-1转染siRNA对照和IGF-1R siRNA;RT-qPCR和Western blot检测转染后细胞中IGF-1R水平;噻唑蓝(MTT)检测细胞增殖;平板克隆实验检测细胞克隆形成能力;流式细胞计量术检测细胞凋亡水平;Western blot检测细胞中活化的含半胱氨酸的天冬氨酸蛋白水解酶3(cleaved caspase-3)、Bcl-2相关X蛋白(Bax)、p38丝裂原活化蛋白激酶(p38MAPK)和磷酸化的p38MAPK(p-p38MAPK)水平.结果 转染IGF-1R siRNA后细胞中IGF-1R mRNA和蛋白水平下降(P<0.05).转染IGF-1R siRNA后细胞增殖和克隆形成能力下降(P<0.05),细胞凋亡率及细胞中cleaved caspase-3、Bax、p-p38MAPK水平升高(P<0.05).结论 下调IGF-1R抑制视网膜母细胞瘤细胞增殖,促进视网膜母细胞瘤细胞凋亡,作用机制可能与cleaved caspase-3、Bax和p-p38MAPK有关.

目的 探讨结节性硬化症之皮质结节病理学和分子遗传学特征.方法与结果 2例女性患儿,2岁9个月和15岁,临床表现为发作性双眼斜视和间断性惊恐发作伴四肢抽搐,头部MRI仅表现为局灶性皮质信号异常或多灶性皮质信号可疑异常,临床考虑局灶性皮质发育不良(FCD).遂采用脑深部电极植入术定位致(癎)灶,手术切除多脑叶致(癎)灶.大体标本观察可见灰质结节和白质内带状灰质异位.组织学形态,皮质薄厚不均且灰质异位,部分皮质全层可见胞核大、核仁明显、体积巨大的异形细胞,累及白质深部伴钙化,其内可见畸形核神经元和巨大细胞,胶质细胞增生明显.免疫组织化学染色,畸形核神经元胞质神经微丝蛋白呈阳性;巨大细胞胞质胶质纤维酸性蛋白(GFAP)和波形蛋白呈阳性,大畸形核神经元和巨大细胞增生的皮质区域GFAP呈弥漫性阳性,提示胶质细胞增生明显.结合临床资料,例1为多脑叶皮质发育不良和肾脏错构瘤、例2为多脑叶皮质结节病变和灰质异位,诊断为疑似的结节性硬化症.进一步行基因检测,例1存在TSCI基因c.647 648del杂合突变(无义突变)、例2存在TSC2基因c.,4672G＞A杂合突变(错义突变),最终诊断为确诊的结节性硬化症.结论 结节性硬化症临床表现多样,皮质结节组织学形态与FCD Ⅱb型有众多重叠之处,仅关注组织学形态和免疫表型易误诊为FCDⅡb型,明确诊断应结合临床表现、影像学和基因检测结果综合判断.

目的 分析肿瘤相关淋巴管生成与葡萄膜黑色素瘤预后危险因素的关系,探讨其在患者预后评估中的应用价值.方法 收集2011年12月至2016年12月在该院眼科就诊且临床资料完整的24例葡萄膜黑色素瘤患者眼球标本.免疫组化染色检测标本中淋巴管生成情况,分析其与预后危险因素的相关性;统计并分析标本中微淋巴管密度与CD-34检测微血管密度的相关性.结果 24例葡萄膜黑色素瘤组织中17例(70.83％)可见球内瘤旁D2-40染色呈阳性的淋巴管.预后相关危险因素中,上皮样细胞类型、球外蔓延、最大基底直径＞16 mm、累及睫状体者的肿瘤相关淋巴管阳性率均明显高于未发生者,差异均有统计学意义(均P＜0.01).17例D2-40染色呈阳性的淋巴管微淋巴管密度平均(22±7)个/光学界面;24例葡萄膜黑色素瘤组织中均可见呈弥散性分布的CD34染色呈阳性的微血管结构,微血管密度平均(16±5)个/光学界面;微淋巴管密度与微血管密度之间存在正相关(r=0.928,P=0.001).结论 葡萄膜黑色素瘤中存在肿瘤相关淋巴管且与预后危险因素之间存在明显关联;通过免疫组化染色[淋巴管内皮透明质酸受体-1(LYVE-1)/D2-40抗体]检测淋巴管生成在评估该类患者预后方面具有重要价值.

腺泡状软组织肉瘤( alveolar soft part sarcoma,ASPS)是一种极为罕见的肿瘤,仅占全部软组织肿瘤的0.5％～1.0％[1].ASPS首先由Christopherson等人报道[2]. 该病的主要特点是起病隐匿,表现为无痛性深部缓慢生长的包块,转移早、传播快,肺或脑转移为首发症状[3]. APSP的确诊需要基于典型的病理学特征和其他相关试验. 本文以1例腺泡状软组织肉瘤伴脑转移为报告内容,回顾相关文献介绍其临床和病理特征.

Objective To investigate the clinicopathological and molecular genetic features of cortical tubers in tuberous sclerosis complex (TSC). Methods and Results Two girls, one was 33 months old and the other was 15 years old, presented paroxysmal strabismus and intermittent panic with convulsion of limbs. Head MRI revealed focal cortical abnormal signal and multifocal cortical suspected abnormal signals indicating focal cortical dysplasia (FCD). The implantation of intracranial electrode indicated epileptogenic zones, and multi-lobectomy was conducted to remove the epileptogenic zones. From the gross specimen, gray matter nodule and banded heterotopic gray matter were observed. Histological examination showed uneven cortical thickness and heterotopic gray matter. Part of the cortex showed giant heterocyst proliferation with big nuclei and obvious nucleoli, and involved deep white matter with calcification. Neurons with deformed nuclei, giant cells and obvious proliferation of glial cells could be seen. Immunohistochemically, the dysmorphic neurons were positive for neurofilament protein (NF) in ytoplasm, giant cells were positive for glial fibrillary acidic protein (GFAP) and vimentin (Vim) in cytoplasm, and the diffuse positivity of GFAP in cortex indicated obvious proliferation of glial cells. Combined with clinical data, Case 1 was diagnosed as cortical dysplasia in multiple lobes and one renal hamartoma, and Case 2 was diagnosed as cortical tubers in multiple lobes and heterotopic gray matter. They were diagnosed as suspected TSC. Genet detection found TSC1 gene in Case 1 had c.647_648del heterozygous mutation (nonsense mutation) and TSC2 in Case 2 had c.4672G>A heterozygous mutation (missense mutation). The diagnosis of TSC was confirmed. Conclusions TSC presents variable clinical features. There are several overlapping features in the aspect of histological orphology between cortical tubers and FCD Ⅱ b. The confirmed diagnosis of TSC should consider clinical manifestations, imaging and genetic testing, not only the histological and immunohistochemical features which easily led to misdiagnosis of FCD Ⅱb. DOI: 10.3969/j.issn.1672-6731.2018.06.007

Objective To investigate the neuroimaging and pathological features of epithelioid glioblastoma (EGBM) to improve the diagnosis.Methods The clinical and pathological features of 4 E-GBM cases were analyzed retrospectively.Results E-GBMs occurred predominantly in young adults.MRI examination showed irregular solidcystic lesion with heterogeneous or ring enhancement in 4 cases.Histological examination revealed uniform population of epithelioid or rhabdoid cells with prominent nucleoli and mitotic activity as well as geographic necrosis..Immunohistochemical staining showed various positive signals of Vimentin and S-100 protein in 4 cases,positive signal of BRAF (VE1) in 3 cases and focal positive signal of GFAP in 1 case.However,IDH-1 was negative and 1p/19q codeletion was lack.All patients were followed-up for 2-6 months.One patient had tumor recurrence 3 months and one patient died of disease 6 months after surgical excision.Conclusion E-GBM has a poor outcome and is closely associated with pleomorphic xanthoastrocytoma.MRI and epithelioid histological features are very important for the differential diagnosis.

患者,男,29岁. 因间歇腹痛1 d于2017年2月23日到我院就诊. 发病后疼痛持续加重,伴发热. 无恶心、呕吐、腹泻,无放射痛、转移性腹痛. 发病1d未排气、排便. 体格检查:左下腹腹肌紧张,伴压痛及反跳痛,肠鸣音亢进. 腹部 B 超显示:降结肠段混合回声团,性质待定(肠套叠?). CT检查提示结肠癌( T3 期).结肠镜检查示:降乙交界见一隆起性病变,环绕 1/2 肠壁生长,表面见一溃疡,肠腔明显狭窄,取肿物溃疡面活检. 病理检查提示:黏膜慢性炎.后外科行腹腔镜探查 +肠粘连松解+左半结肠切除术,术中取肿物冰冻切片诊断为:结肠恶性肿瘤. 术后病理大体观:结肠一段,长18 cm,周径3~6.5 cm,距一端切缘2 cm处黏膜下见一结节状肿物,大小约6 .2 cm × 5.4 cm ×5 cm,肿物相应的黏膜面的皱襞消失,见小灶性糜烂,肿物切面灰白色,质中,伴有坏死,肿物浸润至外膜层,肠系膜纤维脂肪组织中查见结节 12 粒,直径 0.1 ~0.8 cm. 镜下:肿瘤位于肠黏膜下,由大小不一,外形不规则的小圆细胞巢组成,可见坏死及核分裂象;瘤细胞巢之间及其周围为大量增生的致密纤维结缔组织,伴有黏液样变性,肠周查见淋巴结12粒,均未见肿瘤转移,见图1;免疫组化:P-CK/CK8部分( +) , Vim-entin ( +) , Desmin ( +) , Syn 部分( +),CD57( +),WT-1( +),CK7/CK20( -), P63( -),CDX-2( -), S-100/CgA/CD99/( -) , SMA/Myo-globin/MyoD1/Myogenin ( -) , CD34/CD117 ( -) , PLAP ( -) , Inhibin -α( -) ,Ki-67 约15%( +) ,见图 2;Fish检测EWS-WT1 融合基因呈阳性;符合:促结缔组织增生性小圆细胞肿瘤( DSRCT).

Aim:Paget's disease,also called eczematoid carcinoma of breast,has a relatively high misdiagnosis rate and delayed diagnosis,then influenced patient prognosis.The objective of this study is to summarize the clinical characteristics and treatment experience of Paget's disease in order to gain a better acknowledge of this rare disease and improve early diagnosis and reduce misdiagnose rate.Methods:The clinical records of 7 cases of Paget's disease in the First Affiliated Hospital of Jinan University were retrospectively analyzed and the related literature was retrieved.Results:The median age of 7 patients was 60-year,most of them were postmenopausal (5/7),and the median time from the onset of the disease to diagnosis was 12 month.The main clinical manifestation was eczematoid appearance in the nipple and areola complex (6/7).Pathologically,invasive ductal carcinoma was the commonest simultaneous disease (5/7).Five of the patients were treated with modified radical mastectomy (5/7).With the median follow-up of 27 month,one PD patient presenting with invasive ductal carcinoma suffered with cervical lymph nodes metastases until 20 months after operation,another PD underlying invasive ductal carcinoma patient died of other etiology,the other 5 cases achieved long-term disease free survival.Conclusion:The major presentation of Paget's disease is an ealy eczematoid lesion of nippleareolar complex with a high misdiagnosis rate.Among different imaging methods,magnetic resonance imaging (MRI) has a relatively high detection rate,and the skin biopsy is essential for accurate diagnosis.The prognosis of Paget's disease only was favorable in those without ductal cancer.However,PD combined with invasive ductal carcinoma or ductal carcinoma in situ have a higher rate of lymph node metastases and a worse prognosis thus the treatment should be given according to clinicopathologic parameters and molecular.

Objective To explore the current prevalence of female breast cancer in four cities around the Pearl-River Delta and to comment upon the validity of breast cancer screening protocol.Methods The candidates were randomly collected by cluster sampling through multistage samplings.The program included initial screening and early recall incident assessment by questionnaire,clinical breast examination,mammography,B-ultrasound and histopathology study.The histopathology evidence was the golden standard for diagnosis and the detection rate of breast cancer was the endpoint of this study.The partition of x2 method was adapted for the statistical analysis.Results 217 077 women from various communities in the cities Shenzhen,Zhuhai,Foshan and Guangzhou were screened with a median age 36 years old (20-69).The average uptake rate of the screening was 75.23％.The total average breast cancer detection rate was 76.47/105 (166/217 077).The high breast cancer crude detection rates of 96.44/105 (94/97 473) from Shenzhen and 95.14/105 (55/57 811)from Zhuhai were explored,whereas 23.91/105 (14/58 541) from Foshan was the lowest one (x2 =27.808,P =0.000;x2 =24.895,P =0.000).Presenting as an age distribution,the age-bracket 30 to 39 had the highest standardized detection rate of 84.62/105 (99/92679),followedby 57.16/105(10/16 489) from the 50-59 aged group as the second(x2 =2.992,P =0.084).None of them was found as stage Ⅱ a and above.Conclusion The current detection rate of female breast cancer in some cities around the Pearl-River Delta is rather high and the victims of the disease tend to shifting to younger women.The protocol of mammography screening associated with B-ultrasound and clinical breast examination for this study could contribute to the early diagnosis,and then is applicable to metropolitan population-based breast cancer screening.

患者女性,53岁,因“头痛伴多饮、多尿3个月余”入院。既往体健,入院查体无明显阳性体征。头颅MRI平扫可见垂体柄肿物,肿物大小0．8 cm ×2．0 cm,约1/5生长在垂体窝,延鞍隔孔垂体柄(图1),病变灰白色,质中,血供较丰富,无包膜。临床诊断为垂体柄占位,考虑为垂体腺瘤收入院,在全麻下行经额前纵裂垂体瘤切除术。

乳腺神经内分泌癌是一种十分少见的乳腺肿瘤， Up-alakalin等［1］统计其发病率约占所有乳腺癌总数的1％；由于报道少、病例不多，目前尚缺乏规范化的诊治指南。乳腺神经内分泌癌分为原发性癌及转移癌2种。原发性癌的临床表现缺乏特异性，往往通过病理确诊，国内外虽有文献报道该病的各种发病特点，但未见有合并性激素改变者。本文结合暨南大学附属第一医院1例合并有高泌乳素血症的原发性神经内分泌癌病例进行文献复习，探讨该病的诊断及其与高泌乳素血症的相关性供临床参考。

Background Papillary tumor of the pineal region (PTPR) is a newly recognized distinct entity in the 2007 WHO nomenclature. This tumor is characterized by epithelial-appearing areas with papillary features and more densely cellular areas that often display ependymal-like differentiation, which is likely to originate from the specialized ependymocytes of subcommissural organ near the Sylvian cerebral aqueduct. Due to its rarity and non-specific appearance in radiological exanimation, it is a diagnostic challenge for radiologists and histopathologists to differentiate PTPR from other primary or metastatic lesions located in the pineal region because of their similarities in radiological and histological findings. The aim of this study is to summarize the clinicopathological features of PTPR and discuss the differential diagnosis of histologically similar papillary tumors in pineal region. Methods The clinical manifestations of a patient with PTPR occurring in supratentorial pineal region were presented retrospectively. Resected mass was routinely paraffin-embedded and stained with hematoxylin and eosin. Dako EnVision immunohistochemical staining system was used to detect the tumor antigen expressions, including vimentin (Vim), glial fibrillary acidic protein (GFAP), S-100 protein (S-100), pan cytokeratin (PCK), cytokeratin 7 (CK7), CK20, epithelial membrane antigen (EMA), neuronal nuclear antigen (NeuN), synaptophysin (Syn), neuron-specific enolase (NSE), and Ki-67 labeling index (MIB-1). Results A 57-year-old male patient presented with 6-month history of mild headache, and became severe in last one month. MRI revealed a solid well-circumscribed lesion in supratentorial midline near the pineal region and the posterior third ventricle with mild heterogeneous enhancement. Craniotomy was performed and the tumor was removed totally. Histological examination revealed that the lesion contained papillary areas lined by columnar epithelioid tumor cells with eosinophilic cytoplasm and more cellular areas with cells exhibiting clear or eosinophilic cytoplasm. Perivascular pseudorosettes and ependymal rosettes may be identified. The tumor cells were observed to invade the surrounding brain parenchymal. Immunohistochemical staining showed that the tumor cells were diffusely positive to Vim, PCK and S-100, but negative to GFAP, EMA, CK7 and CK20. Syn and NSE were observed to be focally weak positivity. Ki-67 labeling index was approximately 5%. Based on clinical presentations and histological findings, a final histological diagnosis of PTPR, WHO grade Ⅱ-Ⅲ, was made according to the criteria of WHO classification. The patient did not receive chemotherapy or radiotherapy, and was followed-up for 12 months, without any neurological deficit or signs of recurrence. Conclusions PTPR is a rare tumor of central nervous system with aggressive clinical behaviors. Due to the relative paucity of reported cases of PTPR, its natural history is unknown. Histological grading criteria remain undefined, and the prognosis of tumor is uncertain. Due to similarities in histological findings, it may be difficult to differentiate PTPR from other primary or metastatic tumors with prominent papillary feature occurring in central nervous system. Thorough inspection under the microscopy and appropriate immunohistochemical profile are necessary for correct diagnosis. doi: 10.3969/j.issn.1672-6731.2014.07.010

AIM: To investigate the expression of GATA3 in human breast carcinoma and its clinical significance.METHODS: The expression level of GATA3 in breast cancer tissues from 124 patients was detected by the method of immunohistochemistry and the relationships between GATA3 expression and other clinicopathological factors were analyzed.RESULTS: Low expression of GATA3 in breast cancer tissues was associated with estrogen receptor(ER) / progesterone receptor(PR) negative,high histological tumor grade,p53 mutation and vascular invasion(P < 0.05),but not with age,tumor size,human epidermal growth factor receptor 2(HER-2) expression and lymph node metastasis(P > 0.05).In all breast cancer tissues,the positive expression rate of GATA3 was 56.4%.The positive expression rate of GATA3 in luminal breast cancer is 68.4%,higher than that in non-luminal breast cancer(32.6%,P < 0.05).In all breast cancer tissues,the expression of GATA3 in middle recurrence risk group was higher than that in high recurrence risk group(P < 0.05).CONCLUSION: GATA3 expression in breast cancer is related to differentiation and biological characteristics of the tumor,which can be a factor for evaluation of the treatment and prognosis.

Aim:To observe the association between the human telomerase RNA component(hTERC) amplification degree and cervical intraepithelial neoplasia with the technology of fluorescence in situ hybridization(FISH) and discuss the application of hTERC genetic testing in cervical intraepithelial neoplasia.Methods: Respectively,63 cases of cervical liquid-based cell and 50 cases of cervical bioptic paraffin sections were detected the hTERC gene amplification by FISH.the positive rate of hTERC gene amplification increased with increasing TBS classification or pathologic grading.Results: In the both group,it was positively correlated between the proportion of the hTERC abnormal cells and the grade of cervical intraepithelial neoplasia(P0.05).The correlation coefficient was 0.413/0.612.Conclusion:It's reflected that the extent of cervical intraepithelial neoplasia lesions,assisted to judge the pathological grade accurately,determined further to guide the clinical treatment of cervical precancerous lesions program formulation.

【Objective】 To explore retrospectively the difference of therapeutic efficacy and side effect between subcapsular orchiectomy and medical castration in prostate cancer Patients-Ⅳ.【Methods】 In the retrospective study,132 consecutive Patients-Ⅳ were evaluated,the operation group(n =70) had primarily been treated by subcapsular bilateral orchiectomy and the medicine group(n =62) had received medical castration from Jan 2005～Oct 2011.Response to therapy,time of tumor remission,overall survival time,psychological disorders due to loss of organ and postoperative surgical complications were recorded.【Results】 The follow up time was 1～59 months.Median time of tumor remission of the operation group and medicine group were 18 and 17 months.The difference was statistically insignificant(χ2=0.166,P =0.682).Median times of overall survival were 33 and 31 months respectively.The difference was statistically insignificant(χ2=0.080,P =0.778).10% of the operation group showed minor postoperative complications.No psychological disease occurred following bilateral orchiectomy.【Conclusion】 Due to an effective and persistent oncological effectiveness,absence of psychological complications and cost-effective,bilateral subcapsular orchiectomy seems to be a practicable and advisable alternative in the first-line therapy of prostate cancer Patients-Ⅳ.

AIM: To investigate the expression of forkhead box protein A1(FOXA1) BRCA1 protein,P53 and vascular endothelial growth factor(VEGF) in triple negative breast cancer(TNBC) and non-TNBC,and the relevance with the clinicopathological parameters for evaluating the prognosis.METHODS: The tumor samples were collected from 113 cases of breast cancer patients in the First Affiliated Hospital of Jinan University,and divided into TNBC group,luminal subtype group and HER-2 overexpression subtype group by the immunohistochemical results of estrogen receptor,progesterone receptor and HER-2.EnVision two-step method was used to detect the expression of FOXA1,BRCA1,P53 and VEGF in the tumor samples.RESULTS: Total FOXA1 positive expression rate was 63.7%(72/113),with 45.2%(19/42) in TNBC,88.0%(44/50) in luminal subtype and 42.9%(9/21) in HER-2 overexpression subtype.The statistically sigfnificant difference among the 3 groups was observed(P0.01).Total BRCA-1 positive expression rate was 47.8%(54/113),with 66.7%(28/42) in TNBC,44.0%(22/50) in luminal subtype and 19.0%(4/21) in HER-2 overexpression subtype.The statisticallysignificant difference among the 3 groups was also observed(P0.01).In the cases of clinical stages Ⅰ～Ⅱand histological grades 1～2,FOXA1 positive rate was higher than the FOXA1 negative rate(P0.01).Negative correlations between FOXA1 positive rate and expression of P53/VEGF,and between FOXA1 positive rate and the recurrence rate were found(P0.05).In the cases of clinical stages Ⅱ～Ⅲ and histological grades 2～3,the BRCA1 positive rate was higher than the BRCA1 negative rate(P0.05).Positive correlations between BRCA-1 positive rate and the expression of P53/VEGF,and between BRCA1 positive rate and the recurrence rate were also observed(P0.05).CONCLUSION: Expression of FOXA1 and BRCA1 in breast cancer is different.BRCA1 may be an adverse prognostic indicator for triple negative breast cancer.