目的 分析甲状腺乳头状癌颈淋巴结转移与临床病理因素之间的关联.方法 随机选取62例2020年1月—2022年9月厦门长庚医院收治的甲状腺乳头状癌患者,对患者一般临床资料进行回顾性分析.根据患者是否发生颈淋巴结转移分为两组,对比颈淋巴结转移阳性组(n=39)与颈淋巴结转移阴性组(n=23)临床资料,对甲状腺乳头状癌颈淋巴结转移阳性组与阴性组患者差异有统计学意义单因素实施多因素Logistic回归分析,分析甲状腺乳头状癌淋巴结转移影响因素.结果 颈淋巴结转移阳性患者占62.90％,颈淋巴结转移阴性患者占37.10％.颈淋巴结转移阳性组与颈淋巴结转移阴性组患者肿瘤直径、被膜侵犯、脉管侵犯、病灶数目以及微钙化差异有统计学意义(P<0.05).多因素Logistic回归分析研究结果表明,甲状腺乳头状癌被膜侵犯、脉管侵犯、病灶数目、微钙化为甲状腺乳头状癌颈淋巴结转移影响因素(P<0.05).结论 甲状腺乳头状癌颈淋巴结转移与多种临床病理因素存在关联,为了保证手术治疗效果,临床制定手术治疗方案前应明确患者是否存在颈淋巴结转移以明确是否需要进行淋巴结清扫以及清扫范围,有效降低患者术后病情复发率以及再手术率.

目的 探讨结肠未分化癌(UC)的临床解剖病理学特征.方法 回顾性分析华侨大学附属厦门长庚医院2020-2021年确诊的2例结肠未分化癌的临床解剖病理学特征及免疫表型等,并复习相关文献.结果 2例患者均为男性,病例1和2分别为27岁和69岁.临床症状均为腹痛腹胀明显伴症状加重来诊,CT均显示肿物伴有肠梗阻.肿物分别位于右半结肠及横结肠,肉眼观均为浸润溃疡型,界不清,最大径6.6～7.5 cm.镜下肿瘤形态均复杂多样,呈梁索状、实性巢团状、弥漫片状,瘤细胞呈梭形、圆形、多核单核瘤巨细胞样,核仁明显,见坏死及较多核分裂像,腺样结构不明显.免疫表型:肿瘤细胞CKp、CDX2阳性,P53部分阳性,CD 117、Dog-1 小灶阳性,Vimentin、CD45、MyoD1、CD56、CgA、Syn、CK20、P40、AFP 阴性,Ki-67 为85％-90％阳性.病例1:MLH1阳性,PMS2阳性,MSH2阳性,MSH6阳性,提示错配修复蛋白完整(PMMR),微卫星稳定型(MSS)或低水平微卫星不稳定型(MSI-L);病例2:MLH1阴性,PMS2阴性,MSH2阳性,MSH6阳性,提示错配修复蛋白缺失(dMMR),高水平微卫星不稳定型(MSI-H).结论 结肠未分化癌较少见,其病理组织学形态复杂多样,属于排除性诊断,尤其在肠镜活检或穿刺小标本中,极易发生漏诊和误诊,以至于对病人的后续治疗用药及预后发生巨大影响.为避免以上情况,临床病理诊断中需结合免疫组化检查排除腺癌、鳞癌、神经内分泌癌、淋巴瘤、恶性间皮瘤及间质瘤等,必要时需进一步加做基因检测,做到精准诊断.

患儿男性,13岁,反复头痛3个月余,加重半个月.头颅后枕部触及肿物.2018年8月CT示右侧斜坡、枕骨基底部及枕骨大孔右侧壁不规则形虫蚀状骨质破坏伴软组织肿块,大小4.8 cm ×2.5 cm ×2.3 cm,病灶内见多发细小钙化,边界不清(图1),考虑颅底软骨肉瘤.9月入院,全麻下行肿瘤切除术.取少量组织送检,术中冷冻病理报告:成骨性肿瘤.

目的 探讨液基薄层细胞学(TCT)、活检病理在宫颈上皮内瘤变(CIN)及早期宫颈癌诊断分析.方法 回顾性分析2018年9月—2019年9月在该院妇科治疗的413例宫颈上皮内瘤变及26例早期宫颈癌患者的临床资料,均经手术病理检查确诊.以此作为金标准,分析术前TCT及活检病理两种检查方法 的诊断准确率.结果 TCT检测结果 显示,ASC-US 212例、ASC-H 46例、LSIL 93例、HSIL 19例、SCC 2例、反应性改变67例.活检病理结果 显示,CIN 1级281例、CIN 2级40例、CIN 3级92例、SCC 26例.TCT在CIN与SCC的诊断学评价中的灵敏度为83.78％(346/413)、特异度为7.69％(2/26)、准确度为79.27％(348/439).活检病理的灵敏度为100％(413/413)、特异度为96.15％(25/26)、准确度为99.77％(438/439).活检病理的灵敏度、特异度和准确度明显高于TCT(χ2=12.374,25.978,11.893,P<0.05).结论 活检病理在宫颈上皮内瘤变及早期宫颈癌诊断效果优于TCT,与术后病理检查结果 的符合率更高,但两者各具优缺点,临床工作中可互补使用,以提升整体诊断效果.

Objective To investigated green tea polyphenol epigallocatechin-3-gallate(EGCG) against nasopharyngeal car- cinoma in vitro. Methods HNE1 cell line was used. EGCG in various concentrations was applied to HNE1 growth. The MTT stain method and trypan blue method were used as markers to evaluate the effect of EGCG on HNE1. Results EGCG inhibits HNE1 cell growth in a dose-dependent and time-dependent manner according to MTT and trypan blue methods. These two methods can be used to detect EGCG against HNE1 cell in vitro. Conclusion EGCG can be used for the prevention and treatment of nasopharyngeal car- cinoma.

Glucose-regulated protein 78 (GRP78) is one of the most important responders to disease-related stress. We assessed the association of the promoter polymorphisms of GRP78 with risk of hepatocellular carcinoma (HCC) and GRP78 expression in a Chinese population. We examined 1007 patients undergoing diagnostic HCC and 810 unrelated healthy controls. Mechanisms by which the GRP78 promoter polymorphism modulates HCC risk and GRP78 levels were analyzed. The promoter haplotype and diplotype carrying rs391957 (-415bp) allele G and genotype GG was strongly associated with HCC risk. Luciferase reporter assays indicated that the promoter carrying rs391957 allele G (haplotype GCCd) showed increased activity in HepG2 cells and Hela cells. rs391957 was also shown to increase the affinity of the transcriptional activator Ets-2, the resistance to apoptosis, as well as cell instability in stressful microenvironment. Furthermore, compared with allele A, rs391957 allele G was associated with higher levels of GRP78 mRNA and protein in HCC tissues. These findings provided new insights into the pathogenesis of HCC and an unexpected effect of the interaction between rs391957 and Ets-2 on hepatocarcinogenesis, and especially supported the hypothesis that stress-related and evolutionarily conserved genetic variant(s) influencing transcriptional regulation could predict susceptibilities.