Objective: To investigate the clinicopathological features and differential diagnosis of eosinophilic vacuolated tumor (EVT). Methods: Seven cases of EVT with characteristic morphology and unequivocal diagnosis from the Affiliated Hospital of Qingdao University (6 cases), Qingdao, China and the 971 Hospital of PLA Navy (1 case), Qingdao, China between January 2010 and December 2021 were subject to morphological and immunohistochemical analyses. Additionally, whole exome sequencing (WES) was performed in two cases. Twenty-two cases of renal oncocytoma (RO) and 17 cases of eosinophilic chromophobe renal cell carcinoma (eChRCC) diagnosed at the same time were used as controls. Results: Four males and three females with a mean age of 42 years (range: 29-61 years) were included in the study. The tumors were nodular and well-circumscribed, with sizes ranging from 1.5 to 4.5 cm. On cross-section, they appeared gray-red or gray-white, solid, and soft. Tumor cells were arranged in nests, solid sheets, and acinar or small vesicular structures. These cells exhibited eosinophilic cytoplasm with large, prominent clear vacuoles and round nuclei with prominent nucleoli. Perinuclear halos were focally present in four cases, while small tumor cells with sparse cytoplasm and hyperchromatic nuclei were seen in one case. No necrosis or mitosis was noted. Edematous stroma was detected in three cases. All tumors were positive for CD117 and Cathepsin K, but negative for vimentin and CK7. CK20 was positive in scattered individual cells, and Ki-67 positivity ranged from 1% to 4%. Point mutations in MTOR were identified in both patients who were subject to the molecular analysis. Statistical differences in the expression of Cathepsin K, CD10, S-100A1, and Cyclin D1 between EVT and RO (P<0.05) were significant, so were the differences in the expression of Cathepsin K, CD10, CK7 and claudin 7 between EVT and eChRCC (P<0.001). Seven patients were followed up for 4 to 96 months (mean, 50 months), with no recurrences or metastases. Conclusions: EVT is a rare renal tumor that shares morphological and immunophenotypic features with RO and eChRCC, and it is closely linked to the TSC/MTOR pathway. The presence of large prominent transparent vacuoles in eosinophilic cytoplasm along with conspicuous nucleoli is its key morphological characteristics. The use of combined immunohistochemical stains greatly aids in its diagnosis. Typically, the tumor exhibits indolent biological behaviors with a favorable prognosis.

Objective To investigate the pathological features of Epstein-Barr virus (EBV)-associated lymphoepithelioma-like intrahepatic cholangiocarcinoma (EBVaLELICC), and to improve the understanding of this disease in clinical practice. Methods Clinical and pathological data were collected from one patient with EBVaLELICC, and immunohistochemistry, in situ hybridization, and gene rearrangement test were performed for the paraffin-embedded tissue sample of this patient. The pathological features of this disease were analyzed, and a literature review was performed. Results The female patient, aged 56 years, had the tumor located in the left lateral lobe of the liver, with a clear boundary and a size of 1.8 cm×1.5 cm×1.2 cm. The patient underwent laparoscopic left lateral segment liver resection in Department of Hepatobiliary Surgery. Postoperative pathology showed that tumor cells had a glandular tubular structure, and some cells had an irregular, fused or sieve-like shape, with large nuclei, fine chromatin, small nucleoli, and no mitotic figures; proliferation of lymphocytes and plasma cells was observed with the formation of lymphoid follicles in the stroma. Immunohistochemical staining showed that CK7, CK19, and P53 had an expression rate of 10% in tumor cells, with wild type and a Ki-67 proliferation index of 5%; stromal lymphocytes showed the expression of CD3, CD4, CD8, and CD20, lymphoid follicular germinal center cells showed the expression of BCL-6 and CD10 and had no expression of BCL-2, and plasma cells showed the expression of CD38, Kappa, and Lambda; PD-L1 (22C3) was expressed in both tumor cells and interstitial lymphocytes, with a combined positive score of 30. EBER in situ hybridization assay showed diffuse positivity of tumor cells. Polymerase chain reaction detected multiple clones of lymphocyte immunoglobulin and T cell receptor genes. The patient did not receive any treatment before and after surgery and was alive after 8 months of follow-up, without tumor recurrence or metastasis. Conclusion EBVaLELICC is a rare subtype of cholangiocarcinoma with unique pathological features. Patients can benefit from immunotherapy, and EBVaLELICC tends to have a better prognosis than common cholangiocarcinoma.

目的 探讨非典型梭形细胞/多形性脂肪瘤样肿瘤(ASLT/APLT)临床特征、病理学形态、免疫组化特点及鉴别诊断.方法 回顾性分析2例ASCL/APL患者的临床资料并复习国内外相关文献.结果 2例患者,其中1例为男性,49岁,肿物位于头皮下,大小为1.5cm×1.3 cm×1cm.另1例为女性,72岁,肿物位于大腿,大小为13 cm×11.5cm×7 cm.2例肿物肉眼均未见包膜.显微镜下:2例肿瘤边界均不清,局灶呈浸润性生长.在纤维及黏液的背景下,肿瘤由不同比例的非典型梭形细胞、脂肪细胞、脂肪母细胞及多核细胞组成.免疫组化:2例梭形细胞均弥漫表达CD34、P16,1例S-100阳性,1例CDK4阳性,2例MDM2均阴性.视网膜母细胞瘤基因蛋白(Rb)1例阴性,1例阳性.Ki-67增殖指数1％～2％.MDM2基因荧光原位杂交检测2例肿瘤均为阴性.2例患者均只做了肿瘤切除,随访至2022-04,均未见复发及转移.结论 ASLT/APLT为同一谱系的少见类型的良性肿瘤,细胞形态存在非典型性,易与其他良恶性软组织肿瘤相混淆,鉴别诊断需要结合免疫组化及分子检测.

Objective: To investigate the clinicopathological features, immunophenotype, and genetic alterations of rectal adenocarcinoma with enteroblastic differentiation. Methods: Four cases of rectal adenocarcinoma with enteroblastic differentiation were collected at the Affiliated Hospital of Qingdao University, Qingdao, China (three cases) and Yantai Yeda Hospital of Shandong Province, China (one case) from January to December 2022. Their clinical features were summarized. Hematoxylin and eosin stain and immunohistochemical stain were performed, while next-generation sequencing was performed to reveal the genetic alterations of these cases. Results: All four patients were male with a median age of 65.5 years. The clinical manifestations were changes of stool characteristics, bloody stools and weight loss. All cases showed mixed morphology composed of conventional adenocarcinoma and adenocarcinoma with enteroblastic differentiation. Most of the tumors consisted of glands with tubular and cribriform features. In one case, almost all tumor cells were arranged in papillary structures. The tumor cells with enteroblastic differentiation were columnar, with relatively distinct cell boundaries and characteristic abundant clear cytoplasm, forming fetal gut-like glands. Immunohistochemically, the tumor cells were positive for SALL4 (4/4), Glypican-3 (3/4) and AFP (1/4, focally positive), while p53 stain showed mutated type in 2 cases. The next-generation sequencing revealed that 2 cases had TP53 gene mutation and 1 case had KRAS gene mutation. Conclusions: Rectal adenocarcinoma with enteroblastic differentiation is rare. It shows embryonal differentiation in morphology and immunohistochemistry, and should be distinguished from conventional colorectal adenocarcinoma.

This study aims to analyze whether there are any differences in clinicopathological features and prognosis between HER2 ultra-low, HER2-null, and HER2-low expression in Chinese breast cancer (BC) patients. The clinicopathological data of 1363 HER2-negative BC patients were retrospectively collected (from January 2018 to December 2019). HER2 status was further classified into HER2-null, HER2 ultra-low, and HER2-low. HER2-null expression is defined as infiltrating cancer cells completely free of staining. HER2 ultra-low expression is defined as ≤10

目的 探讨S100A1、HSP60在透明细胞肾细胞癌(clear cell renal cell carcinoma,CCRCC)中的表达及在CCRCC高级别转化中的作用.方法 应用组织芯片及免疫组化法检测100例单一核级别和22例高、低核级别并存的CCRCC中S100A1和HSP60的表达,分析其表达与CCRCC临床病理特征的关系.电镜下观察4例S100A1表达高低不同的CCRCC细胞超微结构特征.结果 100例单一核级别CCRCC中,S100A1和HSP60的高表达率分别为43％(43/100)和27％(27/100),两者高表达均与肿瘤坏死、组织学类型及WHO/ISUP核分级相关,两者在单一核级别CCRCC中的表达呈正相关;生存分析显示,S100A1或HSP60高表达组患者术后生存期低于低表达组.22例高、低核级并存的CCRCC中,S100A1、HSP60在高、低级别成分中的表达差异有统计学意义(63.64％vs27.27％,54.55％vs 18.18％).电镜下见S100A1高表达肿瘤细胞常染色质丰富,胞质内见多少不一的脂滴空泡;S100A1蛋白阴性肿瘤细胞异染色质增多,块状或边聚,胞质内见较多脂滴空泡及脂质溶酶体.结论 S100A1和HSP60在CCRCC中高表达是患者预后不良的重要指标;高、低核级成分并存的CCRCC中两种蛋白的表达与核分级密切相关;S100A1高表达细胞常染色质增多、转录活性增高;S100A1和HSP60表达呈正相关,两者可能对CCRCC的高级别转化具有共同驱动作用,S100A1和HSP60有可能成为肾细胞癌靶向治疗的候选基因.

We aimed to construct and validate a deep learning (DL) radiomics nomogram using baseline and restage enhanced computed tomography (CT) images and clinical characteristics to predict the response of metastatic lymph nodes to neoadjuvant chemotherapy (NACT) in locally advanced gastric cancer (LAGC). We prospectively enrolled 112 patients with LAGC who received NACT from January 2021 to August 2022. After applying the inclusion and exclusion criteria, 98 patients were randomized 7:3 to the training cohort (n = 68) and validation cohort (n = 30). We established and compared three radiomics signatures based on three phases of CT images before and after NACT, namely radiomics-baseline, radiomics-delta, and radiomics-restage. Then, we developed a clinical model, DL model, and a nomogram to predict the response of LAGC after NACT. We evaluated the predictive accuracy and clinical validity of each model using the receiver operating characteristic curve and decision curve analysis, respectively. The radiomics-delta signature was the best predictor among the three radiomics signatures. So, we developed and validated a DL delta radiomics nomogram (DLDRN). In the validation cohort, the DLDRN produced an area under the receiver operating curve of 0.94 (95

Objective: To investigate the clinicopathological characteristics, immunophenotype, and molecular signatures of oncocytic papillary renal cell carcinoma (OPRCC), and to compare these findings with those in type 1 papillary renal cell carcinoma (PRCC 1). Methods: The clinicopathologic data of 19 patients with OPRCC from the Affiliated Hospital of Qingdao University (16 patients) and the 971 Hospital of People's Liberation Army Navy (3 patients) from October 2003 to February 2021 were collected. Histologic, immunohistochemical (IHC) and molecular analyses, together with a control group of 15 cases of PRCC I diagnosed in the same period, were assessed. Results: The cohort included 15 males and 4 females, with a median age of 61 years (range, 47-78 years). In 13 patients the tumors were found at physical examination; four presented with painless gross hematuria and two with low back pain. As for the pathologic stage, 14 patients were pT1, one patient was pT2a, three patients were pT3a and one patient was pT4. The tumor size ranged from 1.7-14.0 cm, with clear boundary and soft texture. The cut surface was grayish-yellow and grayish-red. Microscopically, the tumor cells were mainly arranged in papillary (10%-100%) and acinar (tubular) patterns, with strongly eosinophilic cytoplasm, round or irregular nuclei, and prominent nucleoli (WHO/ISUP grade Ⅲ). Two cases showed sarcomatoid differentiation. Stromal foamy macrophages were visible in all cases. IHC staining showed diffuse strong positivity for AMACR in all cases. RCC (18/19), CD10 (17/19), vimentin (16/19) and PAX8 (17/19) were positive in most tumors. CK7 was expressed in about 50% of cases. Fluorescence in situ hybridization identified trisomy 7 in eight patients, trisomy 17 in seven patients, and the two aberrations occurred simultaneously in seven cases. Eight of 13 men had Y chromosome deletion. All patients were followed up for 8-120 months. Three patients died of metastases at 8, 62 and 82 months postoperatively, respectively, and one patient relapsed 36 months after surgery. Compared with PRCC1, OPRCC tended to have higher nuclear grade, and stromal foam cell aggregation was more commonly found (P<0.05). The expression of CD10 and EMA were different (P<0.01). There was no significant difference in the survival rate between the two groups (P=0.239). Conclusions: OPRCC has unique morphologic features, and its immunophenotype overlaps but differs from PRCC1. The molecular results support that it belongs to a morphologic variation of PRCC. This tumor has similar biologic behavior to PRCC1, and has a poor prognosis when sarcomatoid differentiation occurs.

目的 探讨肾脏双相型乳头状肾细胞癌(biphasic papillary renal cell carcinoma,BPRCC)的临床病理、免疫表型及分子遗传学特点.方法 收集6例BPRCC的临床资料,行组织形态学观察和免疫组化染色,并应用FISH检测7、17号和Y染色体异常.结果 6例患者中男性4例,女性2例,发病年龄32～67岁.4例为体检发现(7天～1年),2例分别因腰痛和血尿就诊.眼观:瘤体直径1.4～6.5 cm,平均3.0 cm,结节状,切面灰白、灰黄色,质软,边界清楚.镜检:瘤组织边界清楚,均可见大小不等的两种瘤细胞,呈肾小球样、腺泡状、微结节状、实性片状或紧密狭长的小管状排列,1例边缘合并小片状典型Ⅰ型乳头状肾癌结构.4例间质内可见灶状泡沫样巨噬细胞聚集.免疫表型:大、小两种瘤细胞vimentin(6/6)、EMA(6/6)、CK7(6/6)、P504s(6/6)均呈弥漫强阳性,Ki-67增殖指数1％～20％;Cyclin D1仅在较大的瘤细胞中表达,4例RCC仅在较小的细胞表达,而CD10、WT-1、CD117、CA9、p63、CK(34βE12)、GATA3和BRAF V600E均阴性.FISH检测显示:3例存在7号染色体三体、1例存在17号染色体三体,3例男性患者中有2例存在Y染色体缺失.6例患者随访时间3～66个月,均无复发和转移.结论 BPRCC是一种具有独特形态学和免疫表型特点的罕见乳头状肾细胞癌亚型,Cyclin D1和RCC在大小不等两种瘤细胞中的表达差异对该肿瘤的诊断具有重要提示作用.BPRCC预后良好,罕见复发、转移.

目的 探讨肾癌胃转移的临床特征、病理学形态、免疫组化特点及鉴别诊断.方法 回顾性分析1例肾癌胃转移患者的临床资料并复习国内外相关文献.结果 患者男性,84岁,因乏力、贫血就诊,CT及胃镜检查均显示胃底隆起性病变,病理活检示固有层内弥漫片状或巢状增生的肿瘤细胞,细胞形态温和,核小、核膜不规则,可见核仁,胞质透明或嗜酸,免疫组化表达CK、EMA、PAX-8、CD10及CAⅨ.结合患者17年前因肾透明细胞癌行右肾切除术史,病理诊断为胃转移性肾细胞癌.结论 肾癌胃转移非常罕见,细胞形态相对温和,加上肾细胞癌的诊断到发现胃转移的平均时间较长,影像学和内镜表现无特殊性,因此病理诊断中极易误诊和漏诊,全面了解病史对正确的病理诊断至关重要.

Background: This study aimed to compare the detection efficacy of transrectal ultrasound -guided systematic prostate biopsy (TR-SB) and transperineal cognitive fusion targeted +systematic biopsy (TP-SB+COG-TB) in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated. Methods: 385 patients were enrolled in this study, who underwent transrectal (n=275) or transperineal (n = 110) cognitive fusion biopsy. Relative factors of PCa including age, prostate volume and PSA level were collected for multivariable analysis. The cancer detection rates were compared, and logistic regression was used to assess the impact of patient characteristics on PCa detection Results: For all patients, the overall detection rates of TR-SB and TP-SB+COG-TB were 121/275(40%) and 67/110（60.91%）, respectively. TP-SB+COG-TB detected a higher rate of PCa (P =0.003) and more clinically significant prostate cancers (csPCa) (P=0.001) than TR-SB. Logistic regression analyses revealed that age、TPSA（total prostate specific antigen）and PV were related to the detection rate of PCa (P≤0.05). Conclusion ： TP-SB+COG-TB could find more clinically significant PCa than TR-SB. Due to the high detection rate at certain ages, PSA levels and PV, patents’ clinical characteristics should be considered in biopsy.

Objective: To investigate the clinicopathologic features,diagnosis and prognosis of pericytic tumor of the kidney. Methods: Three cases of pericytic tumor of the kidney (two cases were diagnosed as glomangiomyomas and one case as pericytic tumor,unclassified) were collected from the affiliated Hospital of Qingdao University between January 2014 to May 2021; the clinical and morphologic features, immunohistochemical and molecular characteristics were analyzed and the relevant literature was reviewed. Results: The three patients included one male and two females, with ages ranging from 21 to 70 years. In two patients the tumors were detected incidentally at physical examination and one patient presented with low back discomfort. Imaging showed a rounded nodular soft tissue density shadow in renal parenchyma, and enhancement scan showed uneven delayed enhancement. Grossly, two tumors were located in the renal hilum and one in the renal parenchyma; all were nodular. The tumors were measured in size from 1.6 cm to 5.1 cm (mean 4.1 cm) and showed gray or gray-red cut surface. Histologic examination showed the tumor cells were arranged in solid sheets or small nodules, closely related to vascular wall. Tumor cells were mostly epithelial-like with abundant cytoplasm, light eosinophilia, obscure boundary and round nuclei with visible nucleoli. Vague bundles and fascicular arrangements of smooth muscle component were noted in some areas, with transition of both components. There was no necrosis. By immunohistochemistry, the tumor cells strongly and diffusely expressed vimentin, SMA and collagen Ⅳ, two cases expressed CD34, all three cases expressed PDGFRB to varying extent, and the Ki-67 index was 2%-3%. PCR tests showed absent K-RAS, BRAF V600E gene mutation in all three cases. PDGFRB mutations in exons 3 and 18, respectively were found in two of the three cases by high-throughput sequencing, and no NOTCH 1/2/3 gene fusions were found in any of them. Follow-up information (range: 6-92 months) showed no evidence of local recurrence or distant metastasis in all three patients. Conclusions: Pericytic tumor of the kidney is a rare mesenchymal tumor originating in the kidney with differentiation to smooth muscle, most commonly glomus tumor. The mild pleomorphism, close relationship with vascular wall and spindled smooth muscle components suggest the diagnosis of the tumor. Expression of both epithelial and muscle-associated markers aids the diagnosis. PDGFRB gene mutations may have an important role in the development of this tumor. Most patients have a good prognosis, and a few cases have malignant biological behavior.

目的 探讨肾上腺碰撞瘤(ACTs)的临床病理特征,进一步认识此类病变.方法 回顾性分析青岛大学附属医院及海军第九七一医院2009-2019年手术切除标本诊断ACTs 12例,采用HE观察组织形态学及免疫表型,并进行随访及复习相关文献.结果 12例ACTs者中,男7例,女5例,发病年龄44～73岁(中位年龄58岁).9例无症状,为体检时CT偶然发现,2例有高血压病史,1例有糖尿病病史.影像学检查均提示肾上腺占位.组织学上,11例为肾上腺皮质腺瘤分别合并髓脂肪瘤(7例)、嗜铬细胞瘤(3例)、血管瘤(1例),1例为髓脂肪瘤并节细胞神经瘤.12例患者均行肿物手术切除,术后随访4～ 120个月,均无复发、转移.结论 ACTs少见,临床和影像学检查无特异性.大多为肾上腺皮质腺瘤和其他不同组织类型的良性肿瘤的混合,以皮质腺瘤合并髓脂肪瘤最多见,手术完整切除后,预后良好.

Tian Xia Shihezi University School of Medicine Lian Meng Shihezi University School of Medicine Zhijuan Zhao Shihezi University School of Medicine Yujun Li Shihezi University School of Medicine Hao Wen Shihezi University School of Medicine Hao Sun Shihezi University School of Medicine Tiantian Zhang Shihezi University School of Medicine Jingxian Wei Shihezi University School of Medicine Feng Li Beijing Chaoyang Hospital Chunxia Liu (  liuliu2239@sina.com ) Guangzhou Medical University Second A liated Hospital https://orcid.org/0000-0002-7687-5917

MicroRNA (miRNA) plays a pivotal role in the regulation of cancer developments and could potentially work as an important biomarker candidate for the early-diagnosis, therapy and prognosis of lung cancer. Accurate and sensitive quantification of miRNA extracted from clinical samples in a stable and label-free way remain a huge challenge. Herein, we propose here a novel fluorescence assay for accurate analysis of miRNA via duplex specific nuclease (DSN) signal amplification. Highlights of the methods could be depicted as: i) a favorable detection sensitivity through the DSN enzyme based signal amplification; ii) fluorescence signal generation in a label-free way based on MG/G-quadruplex complex; iii) a stable signal generation even in complicated experimental conditions based on the tetrahedral structure. Eventually, we believe that this proposed sensitive and specific assay has great potential as a miRNA quantification method for use in biomedical research and clinical diagnosis.

目的研究zeste基因增强子人类同源物2（EZH2）、胰岛素样生长因子ⅡmRNA结合蛋白3（IMP3）、葡萄糖转运蛋白1（Glut1）在恶性间皮瘤（MM）组织中的表达及临床意义。方法以50例MM患者为观察组,20例反应性间皮细胞增生（RMH）患者为对照组,应用免疫组织化学SP法检测两种组织中EZH2、IMP3、Glut1蛋白表达,分析在良恶性间皮组织中表达的差异,并分析MM中3种抗体的表达及与临床病理参数的关系。结果两种组织中3种抗体的表达率比较,差异有显著性（χ~2=15.36～35.19,P＜0.05）。EZH2、IMP3、Glut1对MM诊断的灵敏度分别为88%、60%和68%,特异度分别为90%、95%和100%;EZH2并IMP3、EZH2并Glut1、IMP3并Glut1、EZH2并IMP3并Glut1对MM诊断的灵敏度分别为90%、98%、84%、98%。IMP3在MM腹膜组及胸膜组中阳性表达率比较,差异有显著性（χ~2=5.22,P＜0.05）;IMP3的表达与MM患者其他临床病理学特征无关（P＞0.05）;EZH2、Glut1的表达与MM临床病理学特征无关（P＞0.05）。IMP3阳性表达的MM患者生存率显著低于阴性表达者,差异有显著性（χ~2=10.35,P＜0.05）。结论 EZH2、IMP3、Glut1联合检测对提高MM和RMH的鉴别诊断有重要临床价值。IMP3是影响MM患者预后的风险因素。

Objective:To investigate the molecular mechanisms of clear cell renal cell carcinoma (CCRCC) with sarcomatoid differentiation (CCRCCS) and to explore new therapeutic targets for CCRCCS.Methods:Whole exome sequencing was performed on the carcinomatous and sarcomatoid components of five CCRCCS cases collected from January 2017 to October 2018. A highly frequent non-synonymous mutation of cadherin 23 (CDH23) was revealed by whole exome sequencing and further studied in additional samples. The sequencing of CDH23 in 40 specimens with CCRCCS and 50 specimens with CCRCC collected from January 2008 to October 2018 were conducted using Sanger sequencing. Immunohistochemistry was carried out to detect the protein expression of CDH23 in the additional 90 cases.Results:Carcinomatous and sarcomatoid components of CCRCCS shared most of the somatic single-nucleotide variants (SSNVs) as revealed through whole exome sequencing, while the sarcomatoid component had higher overall SSNVs than carcinomatous component. A highly frequent non-synonymous mutation of CDH23 (p.Arg1804Gln) was observed both in carcinomatous and sarcomatoid components of CCRCCS that resulted in the alteration in the highly conserved calcium-binding site mediating the functions of cadherins. In the additional 90 specimens, CDH23 mutation was much frequently detected in CCRCCS than that in CCRCC samples and even the high grade CCRCC. CDH23 protein was not or weakly expressed in most CCRCCS specimens with CDH23 mutation. There was an correlation between CDH23 gene mutation and negative expression of its protein ( r=0.598, P<0.01). Conclusions:The present study reveals, for the first time, that the mutation of CDH23 (p.Arg1804Gln) is a genetic risk factor for CCRCCS. It is associated with the decreased expression of CDH23 protein, resulting in the absence of cadherin function of CDH23, indicating that CDH23 mutation may be involved in the sarcomatoid transformation in CCRCCS. Thus, CDH23 might be a potential therapeutic target for CCRCCS.

目的研究细胞色素P450 4A11（CYP4A11）及Ki-67在肾透明细胞癌中的表达及相关性,并探讨其与患者临床病理特征的关系。方法采用免疫组织化学染色方法检测我院2010—2015年收治的行肾癌切除术并经病理诊断的151例肾透明细胞癌组织中CYP4A11及Ki-67的表达情况,分析CYP4A11及Ki-67的表达与患者临床病理特征的相关性。同时取48例癌旁组织作为对照。结果 CYP4A11在肾透明细胞癌中的表达水平低于癌旁组织（Z=-2.100,P＜0.05）,高级别肾透明细胞癌组织中CYP4A11的高表达率显著高于低级别肾透明细胞癌（χ~2=11.072,P＜0.05）。CYP4A11在肾透明细胞癌中的表达程度与患者性别及肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变、远处转移有关（χ~2=4.438～10.930,P＜0.05）。Ki-67在肾透明细胞癌组织中表达程度与肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变及远处转移有关（χ~2=4.365～10.833,P＜0.05）。Spearman相关性分析显示,肾透明细胞癌组织中CYP4A11与Ki-67表达呈正相关（r s =0.231,P＜0.05）。单因素Cox回归分析显示,性别与肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变、远处转移以及CYP4A11、Ki-67表达水平对患者总生存时间有影响。多因素Cox回归分析显示,临床分期、远处转移为影响肾透明细胞癌患者总生存时间的独立危险因素（P＜0.05）。结论 CYP4A11可能参与肾透明细胞癌的恶性生物学行为过程,并对患者的生存及预后具有提示意义,可作为判断肾透明细胞癌生物学行为及预后的指标。

目的 探讨膀胱混合性小细胞癌(MSmCC)的临床病理特点、组织发生和预后.方法 采用HE、免疫组化染色及电镜观察对14例膀胱MSmCC进行组织形态学、免疫表型、超微结构观察并进行随访,同时与单纯性小细胞癌(PSmCC)、浸润性高级别尿路上皮癌(IHGUC)进行生存比较.结果 14例MSmCC中,男性12例,女性2例,年龄48～89岁.13例表现为肉眼血尿,1例因尿频、尿痛就诊.12例切除标本中8例为隆起型肿物,4例为溃疡型;2例为双灶性;2例经尿道膀胱肿瘤电切术为碎组织.合并成分为尿路上皮癌(11例)、腺癌(1例),2例为三种成分的混合.SmCC成分对CD56、Syn、CgA、Ckpan、CK7、P16的阳性表达率分别为100％、79％、36％、55％、15％、90％.MSmCC中位生存期11个月.生存分析提示MSmCC与PSmCC生存差异无统计学意义(P=0.364),MSmCC的预后较IHGUC差,但差异尚不显著(P=0.051).结论 膀胱MSmCC中非小细胞癌成分以尿路上皮癌最多见;MSmCC中PSmCC成分与上皮成分可能共同起源于尿路上皮干细胞;MSmCC与PSmCC生存预后无明显差异,但较IHGUC中位生存期更短,预后更差,SmCC成分是影响该类肿瘤预后的重要因素.

目的 探讨特殊富含AT序列结合蛋白2(SATB2)和S100钙结合蛋白P(S100P)在人结直肠癌组织中的表达与临床病理学特征的关系,以及其与上皮-间充质转化(EMT)相关蛋白β-catenin、E-cadherin之间的相关性.方法 随机选取100例结直肠癌术后癌组织标本及其癌旁正常黏膜组织标本,采用免疫组织化学方法检测SATB2、S100P、β-catenin、E-cadherin表达,并分析SATB2、S100P表达与结直肠癌临床病理学特征的关系,以及与β-catenin、E-cadherin表达之间的相关性.结果 SATB2在结直肠癌组织中的阳性表达率为90.0％,低于癌旁正常黏膜组织(98.0％)(χ2=5.674,P<0.05),且SATB2的表达与肿瘤大小、分化程度、淋巴结转移有关(χ2=14.733～19.424,P<0.05).S100P在结直肠癌组织中的阳性表达率为65.0％,高于癌旁正常黏膜组织(4.0％)(χ2=82.332,P<0.01),且S100P的表达与肿瘤分化程度、淋巴结转移有关(χ2=13.298、14.945,P<0.05).结直肠癌组织中SATB2与S100P表达呈负相关(r=-0.254,P<0.05);SATB2、S100P表达与β-catenin的异常表达有关(r=-0.258、0.284,P<0.05),与E-cadherin的表达无关(r=-0.045、0.128,P>0.05).结论 结直肠癌组织中SATB2低表达、S100P高表达与肿瘤的浸润转移密切相关,可能通过引起β-catenin蛋白异常表达而介导结直肠癌E MT的发生.