前哨淋巴结是原发肿瘤引流区域中的一组淋巴结,对腋窝淋巴结状态的预测、指导手术方案及评估预后有重要意义[1].虽然冰冻切片诊断其转移情况存在局限性,但仍是目前较快捷的诊断方式,临床仍依据其结果决定腋窝淋巴结清扫术[2].一张高质量冰冻切片对确保术中病理诊断的准确性具有极重要作用,而前哨淋巴结细胞丰富,质地较脆,周围脂肪组织丰富,易出现误诊或漏诊.本研究通过对前哨淋巴结的冷冻切片制作进行总结,不断提高制片质量及诊断准确率.

Objective To explore the expression of fibrinogen-like protein 1 (FGL1), the distribution of tumor-infiltrating lymphocytes (TILs), and their relationship with the prognosis of esophageal squamous-cell carcinoma (ESCC) patients. Methods We analyzed retrospectively the clinical data of 120 ESCC patients. The expression of FGL1 was detected through immunohistochemistry. The distributions of intratumoral TILs (iTILs) and stromal TILs (sTILs) were evaluated under a microscope. Survival analysis was used to evaluate the patient outcomes. Results The positive rate of FGL1 in ESCC was 18.3% (22/120), and it was connected to the TNM stage, lymph node status, and TILs. A total of 73 cases (60.8%) showed low levels of iTILs (iTILs≤10%), and 47 cases (39.2%) exhibited high iTIL levels (iTILs > 10%). Similarly, 82 cases (68.3%) presented low levels of sTILs (sTILs≤10%), and 38 cases (31.7%) manifested high sTIL levels (sTILs > 10%). The distribution of iTILs was associated with FGL1, tumor differentiation, and TNM stage, whereas the distribution of sTILs was associated with FGL1, tumor location, and TNM stage. The Kaplan–Meier survival analysis showed that tumor diameter, TNM stage, lymph node status, FGL1, and TILs were associated with the prognosis of patients with ESCC (P < 0.05). Multivariate Cox regression revealed that FGL1, TILs and TNM stage were the influencing factors of prognosis. Conclusion FGL1 expression is associated with the poor prognosis and may be a prognostic biomarker of ESCC. FGL1 combined with TILs can be used as a biomarker to predict ESCC.

目的 探讨转钴胺1(transcobalamin 1,TCN1)在结直肠癌(colorectal cancer,CRC)及其肺转移组织中的表达状况及其临床意义.方法 收集2009年5月～2019年1月我院收治的42例CRC肺转移病人的结肠镜活检组织、CRC及癌旁正常黏膜组织、肺转移癌组织、正常肺组织蜡块病理标本,用免疫组化法检测以上组织中TCN1表达状况,分析TCN1表达水平与CRC病人临床特点及与新辅助化疗的关系.结果 CRC及其肺转移癌组织中TCN1表达水平高于癌旁结直肠黏膜组织及正常肺组织(P<0.01).CRC肺转移癌组织中TCN1表达水平与CRC组织中TCN1表达水平相似,两组之间TCN1表达强弱比较,差异无统计学意义(P=0.588).肠镜活检CRC组织中TCN1表达水平与手术切除CRC组织中表达水平一致(P<0.01),接受新辅助化疗后CRC组织中TCN1表达水平降低.结论 TCN1在CRC及CRC肺转移癌组织中高表达,在肠镜活检组织中与手术切除组织中表达水平一致,新辅助化疗可以降低CRC组织中的TCN1表达水平,有望作为预测CRC肺转移和化疗敏感性的生物学标志物.

随着病理新技术的不断进展,胸、腹水等液体的诊断也需要通过免疫组化或分子病理检测来进行判读,为下一步的精准治疗提供依据.因此细胞蜡块的制作就尤为重要,细胞蜡块可以很好地保持组织细胞的完整性,细胞蜡块中细胞的分布保留与实体组织有类似的排列结构,可提高诊断的准确性,并可以重复切片进行多项组织检测.但由于胸、腹水等液体的细胞成分有限,离心后细胞经多道脱水处理细胞分散不易包埋制作蜡块,为了最完整的保持细胞成分,有效防止细胞的丢失或与包埋纸的粘连,提高细胞蜡块的制作质量及提高肿瘤细胞的检出率,我们试验了多种办法,最终摸索出最简单有效的使用截断的一次性试管(或滴管)来完整保存细胞成分的方法,在此与大家共享.

HE染色是最基本也是最重要的病理学染色技术[1].质量优良和规范化的HE染色切片是病理医生做出正确诊断的基础[2].随着电子信息技术的飞速发展及现代病理诊断的精细化要求,HE染色技术已由传统的手工操作模式转为全自动染色工作系统,目前全自动染色主要用浸染式与单独滴染式染色平台,全自动浸染平台因成本相对较低、试剂开放及出片效率高等特点,在病理科应用较普遍;而全自动单独滴染平台则更具交叉污染低、染色稳定均一、有效降低诊断误诊率的优势,真正实现了全过程无人干预的全自动染色平台模式而受到病理技术人员的青睐.

目的:间充质干细胞移植作为具有发展前景的脊髓损伤治疗方法之一,目前大多集中于小动物模型相关研究,大动物实验开展较少,并且对干细胞的种类选择与治疗效果仍存在争议。文章通过Meta分析间充质干细胞对大动物模型脊髓损伤相关指标的影响,评价其对脊髓损伤修复的作用。方法:计算机检索PubMed、Cochrane、OVID、Web of Science和中国知网,检索时限从建库起至2019年12月,收集关于间充质干细胞治疗大动物脊髓损伤的系列研究。由2位研究者按照纳入标准独立完成文献筛选、资料提取及方法学质量评价,采用Stata16.0进行Meta分析。结果:最终10篇文献纳入研究,Meta分析结果显示:①间充质干细胞可显著改善脊髓损伤后运动功能[I2=97.73%,MD=3.94,95%CI （2.15,5.72）,P ＜0.01],并根据细胞来源、观察时间、移植时机、移植方式和移植类型分不同进行亚组分析:骨髓间充质干细胞组、非骨髓间充质干细胞组、短时间观察组（＜2个月）、长时间观察组（≥2个月）、急性期移植组、非急性期移植组、单纯细胞移植组、异种移植组的运动评分明显高于对照组（P ＜0.01）;而支架复合移植组运动评分相较对照组,差异无显著性意义（P＞ 0.05）;②间充质干细胞治疗组的损伤面积明显小于对照组[I2=98.05%,MD=-1.00,95%CI （-1.95,-0.04）,P=0.04];③间充质干细胞治疗组与对照组之间胶质纤维酸性蛋白相对表达量差异无显著性意义[I2=99.48%,MD=80.61,95%CI （-27.48,188.70）,P=0.14]。结论:间充质干细胞移植治疗对大动物脊髓损伤的运动功能和损伤修复有明显改善作用,且安全性较高。受纳入文献质量的限制,以上结论需更高质量、更大样本的随机对照实验加以验证。

Induced pluripotent stem cells (iPSCs) were generated from peripheral blood mononuclear cells (PBMCs) obtained from a 60-year-old female diagnosed with sporadic amyotrophic lateral sclerosis (sALS). The iPSCs shared the same karyotype with the parent PBMCs, expressed pluripotency stem cell markers, and demonstrated trilineage differentiation potential. This cell line could serve as an ideal model to investigate the mechanisms underlying amyotrophic lateral sclerosis (ALS).

由于乳腺癌治疗观念和方法的变化,保乳治疗成为越来越多乳腺癌患者的选择,而保乳手术的关键之一是术中快速冷冻切片能否对切缘性质作出准确判断,需要确定手术切缘有无癌浸润及前哨淋巴结是否有癌转移.冷冻切片完成的时间和质量不仅直接影响着病理诊断的及时性、准确性,而且对临床医师的确定手术范围及患者预后起着至关重要的作用.保乳术中冷冻由于需要的冷冻切片数量多、技术流程多、切片困难等原因,需要在人力、设备条件有限的情况下不断优化送检及技术流程,保证冷冻切片质量的同时提高速度,这就要求病理技术人员能够熟练地掌握冷冻切片技术,为病理医师快速诊断提供可靠保证.

Objective To investigate the diagnostic efficiency of P63/smooth muscle actin ( SMA) double labeled im-munochemistry in lesion tissues of breast cancer.Methods A total of 150 cases of patients with breast disease were select-ed as the subjects.Needle aspiration was performed to attain the breast specimens.HE staining and double labeled immu-nohistochemical staining of P63 and SMA were used.The results were observed and analyzed by using light microscope. Results Both P63 and SMA were positive in the vast majority of breast myoepithelial cells and P63 was negative in non-myoepithelial cells.Thirty-two cases by HE staining and 20 cases by double labeled immunohistochemical staining were di-agnosed with benign breast lesions, respectively;and 119 cases by HE staining and 121 cases by double labeled immuno-histochemical staining of suspicious carcinoma cells or carcinoma cell were found.When we compared the pathological re-sults, the accuracy rates in diagnosis of benign breast lesions with HE staining and double labeled immunohistochemical staining were 91%and 97%, respectively.The diagnostic accuracy rates of malignant breast lesions were 100% by both HE and double labeled immunohistochemical staining.Conclusion P63 and SMA double labeled immunohistochemical staining has higher accuracy rate in diagnosis of breast cancer and it could effectively diagnose the benign breast lesions.

常规组织石蜡制片技术中组织透明、切片脱蜡、透明、封固剂制备都离不开透明剂的使用.二甲苯由于价格便宜、透明效果好、作用时间短而被广泛采用,但其刺激性强,对人的神经系统、呼吸系统、造血系统、免疫系统及生殖系统具有毒害作用,是致癌物质,长期接触不利身体健康.若在无专用处理管道的单位,其废液直接进入下水道,对环境及人体造成极大危害.其在使用过程中时间掌握不当易使组织收缩、变脆.环保透明剂作为新开发的替代剂,不仅具有与二甲苯同等的功效,且性质温和,无味、无毒、无害、无污染,符合实验室环保要求.我们应用环保透明剂替代二甲苯进行组织透明、切片脱蜡均得到了满意的效果,现报告如下.