Bone sialoprotein (BSP) is a non-collagenous phosphorylated glycoprotein secreted by bone matrix and tumor cells, and exists in extracellular matrix (ECM). By binding to integrin avβ3, it can mediate the adhesion between tumor cells and ECM, promote the degradation of ECM, participate in angiogenesis and humoral immunity, etc. It plays a key role in the process of malignant tumor proliferation, invasion, and metastasis, and is considered as a new tumor marker. This paper summarizes the biological characteristics of BSP and the recent studies on the correlation between BSP and malignant tumors, and evaluates the clinical significance of BSP in the early diagnosis, efficacy evaluation, and prognosis monitoring of malignant tumors.

患者女性,53岁,绝经4年,性生活后阴道流血约10天.MRI检查提示右侧壁近内膜处病灶,肌瘤可能,未除外其他,既往无肿瘤病史.患者遂行全子宫切除+附件切除术,术后标本送病理检查. 病理检查 眼观:全切子宫一个,大小9cm×7cm×4cm,子宫颈管长1.0cm,外口径2.0cm,子宫腔右侧见一灰白色质韧区域,大小2cm×1cm×1cm,肌壁厚2～4cm,肌壁间见结节数个,最大径0.5～3cm,切面灰白色,实性,质韧,编织状.

婴儿型纤维肉瘤( Infantile fibrosarcoma,IFS)也称为先天性纤维肉瘤(Congenital fibrosarcoma,CFS),是一种较少见的儿童软组织肿瘤,发生于5岁以下新生儿、婴儿和幼童,常见于四肢远端.在组织形态学上与成人纤维肉瘤相似,生物学行为却呈惰性经过,局部复发率高和转移率低,临床预后较好.目前国内外对于IFS/CFS的报道较少,以个案为主.本文通过对3例IFS/CFS病例进行回顾性分析,结合近年来国内外文献报道,旨在加强对该疾病的认识.

目的 探讨子宫颈原位腺癌(adenocarcinoma in situ,AIS)的临床病理学特征.方法 回顾性分析65例子宫颈AIS的临床表现、HPV类型、细胞学结果、手术方式及术后病理学特征.结果 患者中位年龄38岁,年龄以30～39岁居多;41％患者有阴道流血、白带异常及阴道排液等症状,59％患者无临床表现;HPV感染阳性率为94％,其中主要型别为HPV18型,占46％,HPV16型、45型及其它型别分别占29％、5％和5％,HPV阴性占6％;细胞学结果提示腺上皮异常占32％,49％患者表现为鳞状上皮病变,14％患者未见上皮内病变;子宫颈活检及锥切术后病理结果显示单纯AIS仅为34％,同时合并高级别鳞状上皮内病变占66％,其中产生黏液的复层上皮内病变(stratified mucin-producing intraepi-thelial lesion,SMILE)亚型占14％;49例患者行根治术,术后微浸润癌占8％,浸润性腺癌占12％,未发现淋巴结转移,余16例患者行子宫颈锥切术保守治疗,术后随访3～48个月,未见复发.结论 子宫颈AIS患者发病年龄呈年轻化趋势,细胞学筛查敏感性不高,HPV检测存在一定阴性值,细胞学筛查联合HPV检测可提高阳性检出率,AIS亚型SMILE易误、漏诊.

目的 探讨子宫血管周上皮样细胞肿瘤(perivascular epithelioid cell tumor,PEComa)的临床病理特征、诊断及鉴别诊断等.方法 采用免疫组化EnVision两步法对3例子宫PEComa进行检测,并复习相关文献.结果 3例肿瘤由梭形细胞和上皮样细胞构成,胞质透明至嗜酸性,间质血管丰富,其中1例肿瘤细胞异型性显著,并见出血、坏死.免疫表型:3例HMB-45阳性,2例SMA、Caldesmon阳性,Melan-A、rFE-3、desmin、CD10、CD117和S-100蛋白均阴性,Ki-67增殖指数5％～30％.随访4 ～55个月,患者均存活.结论 子宫PEComa是一种少见的间叶源性肿瘤,结合组织学形态及免疫表型可辅助诊断.

目的 分析不同分子分型乳腺癌临床病理特征与预后的相关性.方法 回顾80例乳腺癌患者临床资料,根据病理特征进行分子分型及预后分析.结果 80例乳腺癌患者中,LuminalA型占52.5％、LuminalB型占16.25％、HER-2过表达型占7.5％、三阴型占23.75％,不同分子型乳腺癌患者在肿瘤直径、淋巴结转移数量、临床分期存在明显差异(P<0.05),HER-2过表达型的局部复发率>HER-2过表达型>LuminalB型>LuminalA型,三阴型的远处转移率>HER-2过表达型>LuminalA型>LuminalB型,而LuminalA型的2年内生存率>LuminalB型>HER-2过表达型>三阴型,且P<0.05.结论 针对乳腺癌患者,其分子分型不同,相应的病理特征及预后也不同,可以将其作为临床上针对乳腺癌患者的制定治疗方案的参考依据.

目的 比较分析乳腺浸润癌患者中HER-2蛋白表达与基因扩增的差异性和相关性.方法 利用免疫组织化学(IHC)与荧光原位杂交(FISH)技术分别检测乳腺浸润癌患者HER-2蛋白表达和基因扩增情况,并对结果进行相关性分析.结果 乳腺浸润癌中HER-2蛋白表达及基因扩增结果具有较好的一致性,总体一致率为91％,IHC结果(+++)中二者结果一致率最高,结果(++)中二者结果一致率最低.结论 FISH与IHC两项技术在检测HER-2基因扩增及蛋白表达方面具有较好的一致性.乳腺癌患者应常规进行HER-2的IHC检查,当IHC阳性结果不明确时需进一步行FISH检测HER-2基因的扩增情况,从而为临床综合治疗方案提供更可靠的依据.

通过分析4例雄激素不敏感综合征(androgen insensitivity syndrome,AIS)的临床病例特点、鉴别诊断、治疗及预后,综合复习相关文献.4例患者均为完全型AIS,年龄15～33岁,其中2例存在性腺肿瘤,均位于腹腔,肿瘤类型包括精原细胞瘤、Sertoli-Leydig细胞肿瘤(高分化)及纤维瘤(1例),Sertoli细胞腺瘤(1例).所有患者均行性腺切除手术.AIS的诊断需要结合临床特征、影像学检查及染色体核型分析等方面综合考虑.

Objective To investigate the clinical manifestations and imaging and pathological features of intradiaphragmatic extralobar pulmonary sequestrations(IDEPSs),and to improve clinician and pathologist understandings about the disease. Methods The clinical and imaging data of 28 children diagnosed with IDEPSs by operation and pathology in Guangdong Provincial Maternal and Child Health Hospital were retrospectively analyzed,and the pathological analysis was performed. Results The average age of the 28 patients was(4±0.9)months old. The clinical manifestations were not specific. The CT findings were intradiaphragmatic solid or cystic-solid masses. Abnormal blood supply in the arteries of systemic circulation was found in 25 patients(89.3%). The histopathological examination showed disordered structure of lung tissues and malformation of thick-walled vessels in interstitial tissues,with chronic inflammatory changes,including 5 (17.9%) cases complicated with congenital intrapulmonary airway malformation. Conclusion The clinical symptoms of IDEPSs are barely characteristic. CT scan is an important tool for its preoperative diagnosis,whereas postoperative histopathology may provide definite evidence for the confirmed diagnosis.

危急值也称为警告值,是指危及生命的检验结果,如果不给予及时治疗,患者将处于危险状态[1-2]。现在各个医院根据具体情况,已经普遍建立了危急值制度。本文希望通过对本院检验科生化室2015年全年的危急值数据进行回顾分析,查漏补缺,进一步完善危急值制度。1资料与方法1.1一般资料本院检验科生化室2015年全年的危急值数据。1.2方法1.2.1建立危急值项目表根据卫生部的相关制度,同时参

Objective To analyze the critical value items of hematology laboratory during 2015 in order to further perfect the critical values reporting system.Methods The critical value items of hematology laboratory during 2015 were collected from the Laboratory Information System (LIS)of this hospital and perform the statistical analysis on the occurrence rate of critical value,de-partment distribution and specimen source.Results The critical value items included 8 items of RBC,WBC,PLT,etc.There were 9 235 cases of critical value report in 2015 with the incidence rate of 1.74%.PLT had the largest proportion of critical values cases (30.62%),followed by PT (22.27%);PT had the highest rate of critical value(7.27%),followed by PLT(2.67%).The depart-ment of the highest occurrence rate in critical value was the hematology department,followed by the oncology department.Conclu-sion Some problems are exist reporting system,certain problems exist in setting the hematological critical item and threshold value setting .Various laboratories should formulate the critical value limit suitable for the hospital by positively consulting with clinic un-der the basis the setting of critical value items and critical limits.Laboratories should actively consult with clinicians to formulate the critical value limit that is suitable for the hospitals on the basis of reference literatures at home and abroad.