慢性髓细胞白血病急变期MICM分型回顾性分析

目的：探讨慢性髓细胞白血病急变期（CML-Be）患者的细胞形态学（M）、免疫学（I）、细胞遗传学（C）和分子生物学（M）的特征及应用价值。方法：对38例CML．BC患者的MICM分型进行回顾性分析。结果：以FAB分型为基础的形态学确诊率达94．7％;免疫分型结果为：38例CML-BC中CML-AML占71．0％,其中37．0％伴淋系表达;CML-ALL占23．7％,均为B细胞性,其中66．67％伴髓系表达;CML-MAL（混合性白血病）占5．3％,均为B系和髓系混合表达;CD34＋26例（68．4％）,cD7＋10例（26．3％）,均与CD34共表达。细胞遗传学结果显示：CML特征性Ph染色体检出率为94．3％（36／38）,附加异常染色体检出率为60．5％（23／38）,发生频率较高的类型是＋Ph、＋8和i（17q）;FISH检测BCR／ABL融合基因阳性率为100％,der（9）缺失占14．7％。RT—PCR检测20例患者BCR／ABL融合基因均为阳性,其中b2a2型（12／20）,b3a2型（8／20）,1例（1／20）,b2a2和b3a2双阳性（1／20）。结论：CML—BC是造血干细胞疾病,原始细胞分化阻滞在早期阶段,预后差。MICM分型对CML-BC的诊断、治疗和预后判断均有重要价值。     

鼻NK／T细胞淋巴瘤间质清道夫受体A的表达及意义

目的 观察清道夫受体A（scavenger receprorA,SR-A）在鼻NK／T细胞淋巴瘤间质中的表达,探讨其意义。方法 对鼻NK／T细胞淋巴瘤,鼻B细胞淋巴瘤以及鼻部炎症的石蜡标本进行HE染色和SP免疫组织化学染色检测SR-A的表达。结果 SR-A蛋白在鼻NK／T细胞淋巴瘤,鼻B细胞淋巴瘤和鼻部炎症中阳性率分别为92．7％,29．2％和6．25%。统计学分析发现,鼻NK／T细胞淋巴瘤中SR-A的表达与B细胞淋巴瘤和炎症中SR-A的表达均有显著差异（P〈0．001）。结论 SR-A可能在鼻NK／T细胞淋巴瘤的诊断及鉴别诊断中有一定的参考价值。     

应用T细胞酶联免疫斑点法诊断人类免疫缺陷病毒感染合并结核潜伏感染的实验研究

目的探讨T细胞酶联免疫斑点法(TSPOT)在我国人类免疫缺陷病毒(HIV)感染人群中用于诊断结核潜伏感染的应用价值。方法应用TSPOT-TB试剂盒对68例明确诊断的HIV感染者血液标本进行结核分枝杆菌(Mtb)特异性T细胞的检测,同时对所有病例做结核菌素纯蛋白生物(PPD)试验。结果在HIV感染者总体、CD4<200/μl和CD4>200/μl各组中,TSPOT检测阳性率分别为67.65%、44.44%和70.69%,PPD试验阳性率分别为41.18%、11.11%和46.55%,其中在HIV感染者总体及CD4>200/μl组中TSPOT检测阳性率均高于PPD试验,差异有统计学意义(P均<0.005)。TSPOT检测在CD4<200/μl组中的阳性率低于CD4>200/μl组,但差异无统计学意义(P>0.05);PPD试验在CD4<200/μl组中的阳性率远低于CD4>200/μl组,差异有统计学意义(P<0.05)。结论TSPOT检测在我国HIV感染合并结核潜伏感染的早期快速诊断中有较大应用价值,尤其是在CD4细胞计数>200/μl的HIV感染人群中,阳性率高于目前常用的PPD试验。PPD试验阳性率受CD4细胞计数水平的显著影响,而T SPOT检测不首次此因素影响。     

185例儿童急性白血病流式细胞术免疫分型研究

目的：探讨儿童急性白血病流式细胞术免疫分型的意义。方法：采用流式细胞术三色荧光标记技术和CD45／SSC双参数散点图设门,检测185例儿童急性白血病的免疫表型,对抗原表达情况进行分析。结果：流式细胞术免疫分型和FAB分型的符合率为89．19％。185例儿童急性白血病中,ALL为121例,占AL的65．41％,B—ALL为113例,主要表达B系的CD19（99．12％）、CD22（98．13％）、CD79a（96．19％）、CD10（86．73％）。T—ALL占8例;主要表达CD5（100％）、CD7（100％）、cCD3（100％）、CD8（87．5％）。AML为47例,占25．41％,主要表达CD33（93．62％）、CD15（78．72％）、CD64（76．6％）、MPO（76．6％）、CD13（74．47％）。在B—ALL,AML,T—ALL中,敏感性最高的抗体分别是CD19,CD33,CD5和CD7,特异性最强的抗体分别是CD79a,MPO,cCD3。AMLL为17例,占9．19％,其中B／M为9例,T／B为5例,T／M为3例。My＋-ALL为54例,占ALL的44．63％,表达的髓系抗原为CD13、CD15、CD33、CD64。Ly＋-AML为18例,占AML的38．30％,表达的淋系抗原为CD19、CD4、CD7。系列非相关抗原CD34的表达率为67．57％,HLA—DR的表达率为85．41％,CD38的表达率为80．59％,TdT的表达率为62．59％。结论：流式细胞术免疫分型在白血病分型中起重要作用,是FAB分型的补充和修正,提高了儿童急性白血病诊断的准确率。有必要进一步加强流式细胞术免疫分型的标准化工作。     

肺癌性胸腔积液中生存素基因检测的诊断意义探讨

目的：生存素基因（survivin）是一种新近发现的抗凋亡基因,在肿瘤组织中呈现表达。本文旨在探讨和比较肺癌性胸腔积液和结核性胸腔积液中生存素基因的表达情况,以及其联合细胞学检查对判断肺癌性胸腔积液的敏感度。方法：应用逆转录酶-聚合酶链反应法（RT-PCR）检测2007年06月～2008年03月42例肺癌患者癌性胸腔积液标本,及同时期28例结核性胸腔积液标本的生存素mRNA表达情况,并联合细胞学检查结果进行对比分析。结果：42例肺癌患者胸腔积液标本中生存素mRNA的阳性率为52138％（22／42）;癌细胞的检出率为30．95％（13／42）;生存素mRNA检测联合细胞学检查诊断肺癌的敏感性为61．90％（26／42）,显著高于单独胸腔积液细胞学检测的敏感性（P〈0．001）。28例结核性胸腔积液标本的生存素mRNA阳性率为7．14％（2／28）,显著低于肺癌患者胸腔积液标本生存素mRNA的阳性率（P〈0．001）。结论：运用RT—PCR方法检测胸腔积液中生存素mRNA的表达在判断肺癌性胸腔积液中具有一定的敏感性和特异性,可能作为肺癌辅助诊断的一个新检测指标。     

免疫细胞化学方法对胸腔积液中恶性肿瘤细胞的分类与诊断

目的应用免疫细胞化学对胸腔积液中的肺非小细胞癌分类与恶性间皮瘤的鉴别诊断。方法利用液基薄层细胞学自动涂片技术方法对筛查出的胸腔积液可疑瘤细胞及瘤细胞标本1158例进行细胞包埋连续切片,分别作肺非小细胞癌（NSCLC）肿瘤细胞标记物CK7、CK5＆6、TTF-1、E—Ca及恶性间皮瘤标记物MC（MesothelialCell,MC）、CR（Calfetinin,CR）、P53、Vimentin免疫细胞化学染色。结果1158例胸腔积液患者确诊为肺腺癌581例,鳞癌509例,腺鳞癌48例,恶性间皮瘤20例。TTF-1在腺癌中有明显高表达,阳性表达率为92．43％;CK58L6在鳞癌中有明显高表达,阳性表达率为97．45％;MC、CR在恶性间皮瘤中有明显高表达,阳性表达率为100．00％和95．00％。结论液基细胞学与免疫细胞化学技术相结合在胸腔积液鉴别诊断中有很重要的临床意义,CK7、CK58L6、TTF-1、E—ca联合应用可用于胸腔积液中NSCLC之间的分类与诊断,CK58L6、MC、CR、P53、Vimentin联合应用可用于胸腔积液中间皮瘤的定性诊断,值得在临床细胞病理学诊断中推广应用。     

甘草酸二铵对于HCV相关性B—NHLCD25-和CD25＋T细胞增殖影响研究

目的：本研究初步探究甘草酸二铵（Diammonium Glycyrrihizinate,DG）对HCV相关性B细胞非霍奇金淋巴瘤（B-cellnon-Hodgkin-Slymphoma,B-NHL）CD25-T细胞、CD25＋T细胞的免疫调控作用。方法：应用流式细胞分析仪检测HCV相关性B-NHLCD4＋CD25＋T细胞占CD4＋1r细胞的比例、CD25＋细胞占总PBMC比例,并与单纯HcV感染患者、健康人检测结果相对照。应用免疫磁珠分离法（MACS）分选获得CD25-和CD25＋细胞,将两者和未分选的外周血单个核细胞（peripheralblood mononuclear cell。PBMC）以CFSE标染孵育72小时后,应用流式细胞分析仪将APCCD3阳性细胞设定为门检测CD25T细胞、未分选T细胞、CD25＋T细胞的增殖情况,及甘草酸二铵干预后的CD25-T细胞、CD25＋T细胞增殖情况。结果：应用流式细胞分析仪检测健康人、单纯HCV感染者和HCV相关性B—NHL患者在CD4＋CD25＋占总CD4＋细胞比例和CD25＋占总细胞比例上均呈现逐步递增的关系（分别为33．94％±2．18％,57．95％±1．77％,70．24％±12．75％,P〈0．05;18．16％±2．23％,33．45％±1132％,54.69％±8．66％,P〈0．05）。CFSE标染后孵育72小时检测（MI＋M2）分裂相百分比呈现CD25-T细胞最高、未分选T细胞其次、CD2YT细胞最低的表现（分别为74．4％±1．2％,63．1％±5．4％,47．2％±5．9％,P〈0．05）。甘草酸二铵干预后CD25-T细胞较未干预CD25T细胞M1分裂相百分比增加（分别为57．7％±4．2％,46．5％±5．6％,P〈0．05）。甘草酸二铵干预后CD25＋T细胞较未干预cD25＋1r细胞M1分裂相百分比减少（分别为14．7％±1．3％,22．1％±4．1％,P〈0．05）。结论：HCV相关性B-NHLCIM＋CD25＋、CD25＋细胞百分比较单纯HCV感染者、健康人明显增加,提示存在T细胞免疫抑制,且抑制程度重于单纯HCV感染。去除CD25＋细胞后CD25T细胞增殖较未去除CD25＋的T细胞增殖活跃,说明HCV相关性B-NHL患者的CD25＋细胞能够抑制CD25-T细胞增殖。而DG干预后HCV相关性B-NHLCD25＋T细胞增殖M1分裂相减少,而CD25T细胞增殖M1分裂相增加,表明DG对HCV相关性B-NHL具有抑制CD25＋T细胞增殖而促进CD25-T细胞增殖的积极免疫调节作用。     

胸腔积液中肺腺癌细胞发生胶原化的形态观察与研究

目的胶原蛋白是细胞外基质的主要成分之一,我们在临床数千例恶性胸水转移的非小细胞肺癌细胞胞浆中常见到围绕细胞核或局灶状葱皮排列的纤维样结构,由此我们假设肺腺癌细胞在侵袭转移形成胸腔积液过程中发生与细胞外基质相同的结构变化,即肿瘤细胞胶原化形成“盔甲”式保护膜起到对肿瘤细胞结构及功能的支撑,达到抵御化疗药物、毒素的穿透和放射线的轰击,提高了自我保护能力,适应新的肿瘤细胞增生微环境。方法TCT方法选取224例肺腺癌细胞学标本,其中胸腔积液标本144例,肺泡灌洗液40例,痰液标本40例,24例为良性胸腔积液作为对照。常规制成细胞包埋块,切片、HE染色及CK7、TTF-l、vimintin的免疫细胞化学染色。透射电镜观察肿瘤细胞内部结构。Masson特殊染色,胶原蛋白工、Ⅱ、Ⅲ亚型染色,Western-blot蛋白检测。观察肺腺癌细胞是否存在胶原蛋白亚型及肺腺癌不同标本的表达情况。结果Masson细胞化学染色显示胶原纤维在恶性胸腔积液、支气管肺泡灌洗液及痰肺腺癌标本中的表达率分别为59．7％（sG／144）、0％（0／40）、o％（0／40）,在良性标本中不表达均为阴性（0／24）。免疫细胞化学结果显示：COLlAl、COL2Al和COL3Al在肺腺癌细胞中的阳性表达率分别为22．6％（38／1G8）,5．4％（9／1G8）,22．6％（38／168）,阳性表达主要定位于胞浆,而在增生的上皮细胞中不表达,统计学分析结果显示COLlAl、COL3Al的表达率要显著高于COL2Al的表达率（P=0．024）,并且我们发现COLlAl与COL3A1的表达成正相关性（r=0．886,P=0．000）。透射电镜可观察到在肿瘤细胞胞浆中可见多量纤维状物质。结论本研究从形态学上观察到在转移的肺腺癌细胞胞浆内有一些围绕胞核呈葱皮样改变的纤维样结构,结果表明肺腺癌细胞可以产生胶原蛋白,     

凝集素芯片对体液细胞进行检测方法的建立和初步应用

建立对体液细胞进行自动捕获的凝集素芯片体系,利用凝集素对糖链的特异亲和作用捕获细胞,提取白血病患者外周血、肺癌胸水和肝腹水中细胞进行荧光标记,凝集素芯片捕获,激光扫描仪检测捕获细胞的荧光信号,常规HE染色后光学显微镜下观察细胞的形态并进行免疫化学反应,流式细胞仪验证凝集素芯片的特异性．结果表明：凝集素芯片可以对体液中的癌细胞进行自动捕获,对癌细胞膜表面糖链进行识别．芯片检测的细胞浓度最少可达每mL10^4个左右．芯片有较好的重复性和特异性．这种凝集素芯片可用于临床体液中癌细胞的检测分析,对癌细胞膜表面凝集素亲和位点进行即时、高通量的检测,为了解细胞膜表面聚糖在癌变过程中的变化提供了一个技术平台．     

血管内皮标记物及血管内皮生长因子在胸水细胞中的表达和意义

探讨CD31、CD34、CD105及VEGF在胸水中的表达.应用免疫细胞化学染色,免疫荧光染色,Western-blot技术检测200例非小细胞肺癌患者胸水、30例增生胸水和20例炎性胸水中CD31、CD34、CD105及VEGF的表达.CD31、CD34、CD105及VEGF在非小细胞肺癌胸水中的表达量明显高于增生和炎性胸水表达(P＜0.05).非小细胞肺癌胸水患者CD31、CD34、CD105及VEGF高表达,并且在存在着肿瘤细胞血管样管型结构中表达量明显高于未发现肿瘤细胞血管样管型的胸腔积液.检测CD31、CD34、CD105及VEGF在胸腔积液中的表达情况可能对判断患者的预后有一定价值.     

Human herpesvirus 8 in primary effusion lymphoma in an HIV-seronegative male. A case report

BACKGROUND: AIDS-related body cavity-based lymphoma, or primary effusion lymphoma (PEL), is a distinct clinicopathologic entity that occurs predominantly in immunosuppressed patients infected with human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus. Although it rarely occurs in human immunodeficiency virus (HIV)-negative patients, we report such a case here. CASE: A 74-year-old male, who was HIV and Epstein-Barr virus (EBV) negative, was admitted to the hospital with dyspnea and chest pain. Chest radiography and computed tomography showed right pleural effusion. Cytologic analysis of the pleural effusion revealed a high grade lymphoma with round nuclei, prominent nucleoli and abundant cytoplasm. Polymerase chain reaction performed on the pleural effusion was positive for HHV-8 and negative for EBV. On molecular studies, the immunoglobulin heavy and kappa light chains were rearranged. Flow cytometry revealed a hyperploid fraction with DNA index of 1.29 expressing CD30. Immunostaining for HHV-8 from a cell block was positive. Electron microscopy revealed lymphomalike cells, many in various stages of apoptosis, with large nucleoli and clusters of viruslike particles in the nucleoplasm. CONCLUSION: A firm diagnosis of PEL can be established by the examination of cells from the lymphomatous effusion by a combination of cytology, molecular genetics, phenotypic features, immunostaining and electron microscopy. To our knowledge, this is the first case in which immunostaining for anti-HHV-8 monoclonal antibodies was used to support the diagnosis.     

Cytomorphological and immunocytochemical study of non-Hodgkin''s lymphoma in pleural effusion and ascitic fluid

INTRODUCTION: Non-Hodgkin's lymphoma (NHL) is often complicated by pleural effusion and ascites. The present study is an attempt to categorize the lymphomatous effusions according to the WHO classification, using archival material. METHODS: May-Grünwald-Giemsa and Papanicolaou-stained smears of 31 lymphomatous effusion specimens were reviewed. Of these, detailed cytological assessment was done on 12 pleural effusions and ten ascitic fluid specimens from 22 patients using the WHO lymphoma classification system. Immunocytochemical studies were performed in 21 specimens. RESULTS: Based on cytomorphological features, the 22 lymphomatous effusion specimens were categorized into lymphoplasmacytoid lymphoma (1), follicle centre cell (FCC) grade-1 (centrocytic) lymphoma (3), FCC grade-2 (centrocytic-centroblastic) lymphoma (3), FCC grade-3 (centroblastic) lymphoma (4), large cell immunoblastic lymphoma (4), lymphoblastic lymphoma (2), anaplastic large cell lymphoma (3) and miscellaneous types (2). Immunocytochemically, the lymphoma cells were T-cell (positive for CD3) and B-cell type (CD20 positive) in five and six cases respectively. CONCLUSION: Cytological examination of pleural effusion and ascitic fluid samples, supported by immunocytochemical studies, may be useful for the classification of lymphomas under the WHO system.     

MMP-2 VEGF在肺腺癌细胞中的表达及其意义

目的研究探讨基质金属蛋白酶2(MMP-2)及血管内皮生长因子(VEGF)在胸腔积液、痰液中肺腺癌细胞的不同表达及二者在肺癌细胞侵袭转移过程中的相互关系。方法选择胸腔积液、痰液共计264例癌性及异型增生细胞标本经免疫细胞化学方法分别检测MMP-2 VEGF的表达情况。结果免疫细胞化学结果显示:MMP-2在胸腔积液中腺癌细胞、异型增生上皮细胞的表达率分别为71.7%(99/138)、16.7%(6/36),在胸膜炎和结核病变典型良性胸腔积液增生上皮细胞中不表达;在痰腺癌细胞中的表达率为39.1%(27/69),统计结果显示MMP-2在恶性胸腔积液腺癌细胞中的表达率明显高于在异型增生的上皮、增生的上皮及痰腺癌细胞的表达率(P均0.05)。VEGF在胸腔积液中腺癌细胞、异型增生上皮细胞的表达率分别为89.1%(123/138)、33.3%(12/36),在胸膜炎和结核病变典型良性胸腔积液增生上皮细胞中不表达;在痰腺癌细胞中的表达率为47.8%(33/69),VEGF在恶性胸腔积液腺癌细胞中表达率明显高于在异型增生的上皮细胞、增生的上皮细胞及痰腺癌细胞的表达率(P均0.05),且MMP-2同VEGF总阳性表达率之间成正相关(r=0.867,P=0.049)。结果 MMP-2 VEGF在胸水腺癌细胞中高表达,可能与肺腺癌的转移、侵袭有关;两者联合做免疫细胞化学检查对肺腺癌细胞病理诊断有辅助意义。     

Pleural effusions in non-Hodgkin's lymphoma. A cytomorphologic, cytochemical and immunologic study

Review of the records of 243 cases of cytologically diagnosed non-Hodgkin's lymphomas (NHL) revealed pleural effusions in 21 (8.6%). Cytologic examination of pleural fluid was done in 17 cases, of which 16 were reported as positive. Cytologic examination was supplemented with cytochemical staining (acid phosphatase, alpha naphthyl acetate esterase and periodic-acid-Schiff reactions) and E-rosetting studies in 12 cases. Of the 16 positive cases, 11 were malignant lymphomas consisting of convoluted lymphocytes. Acute lymphatic leukemia of the prothymocytic type (T-ALL) and chronic lymphocytic leukemia of the T-cell type (T-CLL) comprised one case each, and there were three cases of follicular center cell lymphomas, two of the cleaved-cell type and one of the Burkitt-type. Comparison of the cytomorphology of the tumor cells in the pleural effusion with those in fine needle aspiration smears from the solid tumors in 14 cases showed an identical appearance in 13 cases; in one, the Burkitt-type lymphoma, the cells were larger and more pleomorphic in the pleural effusion. This study indicates that the cytologic diagnosis and categorization of NHL of the convoluted-cell type is greatly enhanced by the study of neoplastic lymphocytes in a pleural effusion.     

Anaplastic large cell lymphoma presenting as a pleural effusion and mimicking primary effusion lymphoma. A report of 2 cases

BACKGROUND: Systemic anaplastic large cell lymphoma (ALCL) is predominantly a nodal disease, but extranodal involvement can occur during the disease course or as the primary presentation. We report two rare cases of ALCL presenting with a pleural effusion, mimicking primary effusion lymphoma (PEL). CASES: Two patients, a 47-year-old woman and an 81-year-old man, presented with a pleural effusion for investigation. The pleural fluid contained abundant, large, lymphoid cells with marked nuclear atypia. These neoplastic cells strongly expressed CD30 and EMA and showed a T-cell phenotype (CD3+CD45RO+ for case 1 and CD4+ for case 2). Case 1, in addition, showed ALK1 expression. The tumor cells in both cases were negative for human herpes virus type 8 (HHV8) and Epstein-Barr virus (EBV). ALCL shows overlapping cytologic features with PEL, but the T-cell phenotype, ALK1 expression in case 1, lack of association with HHV8 and EBV, HIV seronegativity and subsequent discovery of nodal disease in case 2 were all in favor of ALCL over PEL. CONCLUSION: In rare cases a pleural effusion is the presenting feature of ALCL, and distinction from PEL depends on correlation with clinical findings, detailed immunophenotyping and study of the status of HHV8 and EBV.     

Cell origins and diagnostic accuracy of interleukin 27 in pleural effusions

The objective of the present study was to investigate the presence of interleukin (IL)-27 in pleural effusions and to evaluate the diagnostic significance of pleural IL-27. The concentrations of IL-27 were determined in pleural fluids and sera from 68 patients with tuberculous pleural effusion, 63 malignant pleural effusion, 22 infectious pleural effusion, and 21 transudative pleural effusion. Flow cytometry was used to identify which pleural cell types expressed IL-27. It was found that the concentrations of pleural IL-27 in tuberculous group were significantly higher than those in malignant, infectious, and transudative groups, respectively. Pleural CD4(+) T cells, CD8(+) T cells, NK cells, NKT cells, B cells, monocytes, macrophages, and mesothelial cells might be the cell sources for IL-27. IL-27 levels could be used for diagnostic purpose for tuberculous pleural effusion, with the cut off value of 1,007 ng/L, IL-27 had a sensitivity of 92.7% and specificity of 99.1% for differential diagnosing tuberculous pleural effusion from non-tuberculous pleural effusions. Therefore, compared to non-tuberculous pleural effusions, IL-27 appeared to be increased in tuberculous pleural effusion. IL-27 in pleural fluid is a sensitive and specific biomarker for the differential diagnosing tuberculous pleural effusion from pleural effusions with the other causes.     

恶性肿瘤胸腹水细胞学检验的探讨

目的探讨胸腹水细胞学检验在恶性肿瘤细胞诊断中的应用价值。方法回顾我院2014年1月~2016年6月376例胸腹水脱落细胞学的检验结果,分析胸腹水细胞学检验在恶性肿瘤诊断中的应用价值。结果 376例胸腹水脱落细胞学检验患者中,发现疑似肿瘤细胞3例,恶性肿瘤细胞74例,病理组织学证实恶性肿瘤患者79例,胸腹水细胞学检验的正确率高达97.47%,假阴性率为2.53%,假阳性率为0%。结论胸腹水脱落细胞学检验在恶性肿瘤诊断中具有重要的临床价值,值得临床推广。     

Hyaluronan synthesis by anaplastic large cell lymphoma with massive lymphomatous effusion. A case report

BACKGROUND: Hyaluronan (HA) synthesis is frequently observed in malignant mesothelioma cells, whereas it is rarely found in lymphoma cells. Previous studies have reported that a high HA concentration in the serum was related to poor prognosis in lymphomas, although the mechanism was not elucidated. We recently encountered a case of anaplastic large cell lymphoma with an HA-rich, massive, lymphomatous effusion. Several studies were performed to clarify the character of this unusual lymphoma and to observe whether the lymphoma cells synthesized HA. CASE: A 59-year-old female was admitted with abdominal pain. Radiologic studies revealed a pleural effusion and paraaortic lymph node swelling. A biopsied specimen was compatible with anaplastic large cell lymphoma. Detailed cytologic observations revealed that the lymphoma cells in the pleural effusion had alcian blue-positive, productive material in the prominent Golgi area and microvillous structures on the surface. Further studies found that most of the lymphoma cells had HA-binding protein and expressed CD44 antigen, a receptor for HA. In addition, the HA concentration in the supernatant of the primary culture cells was extremely high and increased time dependently. CONCLUSION: These observations suggest that the lymphoma cells synthesized and released HA. Interactions of the released HA and CD44 on the surface might play an important role in the peculiar serosal growth of lymphoma cells.     

缺氧诱导因子-1在非小细胞肺癌胸水中的表达及其与肿瘤血管生成的关系

目的探讨缺氧诱导因子-1(hypoxia inducible factor-1,HIF-1)在非小细胞肺癌胸水细胞中的表达及其与肿瘤血管生成的关系。方法利用免疫组织化学、免疫细胞化学分别检测1180例非小细胞肺癌标本中HIF-1α和HIF-1β蛋白的表达以及非小细胞肺癌胸水细胞中血管生成标记物CD34和VEGF的表达情况,其中包括1060例非小细胞肺癌胸水标本以及用于对照的120例肺穿刺非小细胞肺癌组织标本。结果 HIF-1α在非小细胞肺癌穿刺组织中的表达率72.50%(87/120)明显高于非小细胞肺癌胸水中表达率17.55%(186/1060),差异有统计学意义(P0.05);HIF-1β在非小细胞肺癌穿刺组织中的表达率为77.50%(93/120),而在非小细胞肺癌胸水中表达率为81.42%(863/1060),差异无统计学意义(P0.05);CD34、VEGF在非小细胞肺癌胸水细胞中阳性表达率分别为77.92%(826/1060)、82.92%(879/1060)。HIF-1α与HIF-1β的表达呈显著正相关(r=0.093,P=0.002),HIF-1α与VEGF的表达呈显著正相关(r=104,P=0.001),HIF-1β与VEGF的表达无相关性(P0.05)。结论 HIF-1α在非小细胞肺癌穿刺组织与非小细胞肺癌胸水中的差异性表达,可能与非小细胞肺癌胸水细胞缺氧适应性调节有关,HIF-1与肿瘤血管生成密切相关。