目的 研究人体血清铁代谢异常与口腔念珠菌病之间的相关性。方法 收集 2020 年 8 月至 2021 年 8 月就诊于南京医科大学附属口腔医院口腔黏膜病科的 678 例患者的基本信息及实验室检查指标,统计患者念珠菌感染例数及感染阳性率,运用 SPSS 20.0 软件对收集的数据进行独立样本 t 检验分析。结果 678 例患者中,念珠菌培养阳性 156 例,阴性522 例,阳性率为 23.00%,其中女性培养阳性数为 102 例,男性感染例数为 54 例。念珠菌培养阳性组的血清铁蛋白和血清转铁蛋白水平明显低于阴性组,差异有统计学意义(P < 0.05)。结论 人体血清铁代谢异常与口腔念珠菌的发病具有相关性,与其他的文献资料相符。
目的 探讨朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)的临床病理学特征、免疫表型和鉴别诊断,分析丝氨酸/苏氨酸激酶v-RAF鼠肉瘤病毒致癌基因同源物B1 (the serine threonine kinase v-RAF murine sarcoma viral oncogene homologue B1,BRAF)抗体的表达与临床的相关性.方法 回顾性分析31例LCH的临床资料、病理学形态和免疫学表型.分析BRAF抗体免疫组化方法表达情况与患儿性别、年龄和预后的关系.结果 31例LCH中,28例为单系统LCH(single-system Langerhans cell histiocytosis,SS-LCH),3例为多系统LCH (multi-system Langerhans cell histiocytosis,MS-LCH).镜下可见朗格汉斯细胞.免疫组织标记染色显示瘤细胞主要表达朗格汉斯细胞特异蛋白(Langerin),CD1a,CD68等标记.15例BRAF抗体阳性.31例均行手术切除,其中一例复发,另一例多系统LCH预后较差,其他病例均预后良好.LCH病例BRAF阳性表达情况在性别、年龄、预后方面的比较差别无统计学意义(P值均>0.05).结论 LCH是一种罕见的临床症状复杂的疾病,免疫组化Langerin、CD1a、S100阳性有助于其诊断和鉴别诊断,BRAF基因状态与性别、年龄及预后均不相关.
目的 研究口腔扁平苔藓发病过程中人体外周血细胞免疫以及体液免疫指标的变化,探讨口腔扁平苔藓的发病机制,为临床诊和治疗断提供帮助。方法 回顾收集2019年1月至2019年12月就诊于南京医科大学附属口腔医院口腔黏膜病科123例口腔扁平苔藓患者的资料纳入OLP组,同时选取100例无口腔扁平苔藓患者作为对照组,收集T淋巴细胞CD3+、T辅助细胞CD3+CD4+、T抑制细胞CD3+CD8+、NK细胞CD3-CD(16+56)+、CD4/CD8比值、B细胞抗原CD19、免疫球蛋白IgG、IgE、IgM、IgA、补体C3、C4的结果,利用SPSS 20.0统计软件进行数据分析,统计两组之间的差异。结果 OLP组T抑制细胞CD3+CD8+平均比例为25.13%,明显高于对照组的22.97%;T辅助细胞CD3+CD4+平均比例为35.62%,明显低于对照组的37.55%;NK细胞CD3-CD(16+56)+平均比例为28.75%,明显高于对照组的23.56%,差异具有统计学意义(P<0.05),OLP组总T淋巴细胞CD3+、CD4/CD8比值、B细胞抗原CD19平均水平与对照组比较,差异无统计学意义(P>0.05)。OLP组免疫球蛋白IgE平均水平为34.86 kU/L,明显高于对照组的31.29 kU/L;免疫球蛋白IgM平均水平为1.30 g/L,明显高于对照组的1.08 g/L;免疫球蛋白IgA平均水平为1.95 g/L,明显低对照组的2.37g/L,差异均具有统计学意义(P<0.05)。OLP组免疫球蛋白IgG、补体C3、补体C4的平均水平与对照组比较,差异无统计学意义(P>0.05)结论 目前口腔扁平苔藓发病机制尚未完全明确,可能与人体自身免疫系统有关,本研究发现口腔扁平苔藓患者发病过程中外周血中部分免疫指标的变化与正常人群指标存在明显差异,说明口腔扁平苔藓的发病与人体自身免疫系统的紊乱存在一定的相关性。
OBJECTIVE:To study the clinicopathologic characteristics of extrarenal malignant rhabdoid tumor (E-MRT) with emphasis on diagnosis and differential diagnosis.METHODS:The clinical and pathologic data of 8 E-MRT cases were reviewed. The outcome was analyzed.RESULTS:There were four males and four females. The age at presentation ranged from 3 days to 8 years (mean, 2.6 years; median, 3 years). The tumors were located in the extremities (n = 1), head and neck (n = 2), trunk (n = 2), cervical cord (n = 1), liver (n = 1) and retroperitoneum (n = 1). Histologically, the tumors were composed of a diffuse proliferation of rounded or polygonal cells with eccentric nuclei, prominent nucleoli, and glassy eosinophilic cytoplasm containing hyaline-like inclusion bodies, arranged in sheets and nests. Cellular atypia was easily observed and mitotic activity was high. Necrotic and hemorrhagic areas were abundant. On immunohistochemistry, the tumor cells expressed vimentin and epithelial marker such as EMA, AE1/AE3, and CAM5.2. The absence of INI1 protein expression was a distinctive feature. Follow-up of all eight cases revealed five deaths in one year and the other three were disease-free at last follow-up of one month, three months and seven months.CONCLUSIONS:E-MRT is a rare and highly aggressive tumor of infancy and childhood. Recurrence and distant metastasis was common and the 5-year survival rate is low. Increased awareness of the clinocopathologic features and immunophenotypes of E-MRT is helpful for correct diagnosis and effective treatment.