乳腺导管内乳头状瘤、非典型乳头状瘤与导管内乳头状癌诊断与鉴别诊断

目的:探讨乳腺导管内乳头状癌和导管内乳头状瘤、非典型乳头状瘤的病理表现及诊断与鉴别诊断.方法:对20例乳腺导管内乳头状癌及23例导管内乳头状瘤、5例非典型导管内乳头状瘤进行大体及镜下病理学分析及免疫组化分析,并结合文献对其病理表现、病理形态特点及鉴别诊断进行探讨.结果:20例乳腺导管内乳头状癌HE染色表现为导管明显扩张,有真性乳头,乳头之轴心由纤维血管束组成,乳头覆盖细胞有多种形式,但真正的肌上皮是缺如的.免疫组化SMA/p63显示局部或完全的肌上皮细胞消失,CEA85%的乳头状癌阳性.23例导管内乳头状瘤乳头存在肌上皮层,免疫组化结果与导管内乳头状癌相反.5例非典型乳头状瘤局部(＜1/3的区域)显示有不典型上皮增生,局部有肌上皮缺失.结论:乳腺导管内乳头状癌是一种具有乳头状癌样结构基础上的原位恶性上皮增生,但无浸润的癌.预后好于其他型导管原位癌,免疫标记SMA、p63和CEA可以帮助该肿瘤的诊断及与乳腺导管内乳头状瘤、非典型导管内乳头状瘤鉴别诊断.     

高频超声对乳腺导管内乳头状瘤的诊断价值分析

目的探讨高频彩色多普勒超声对导管内乳头状瘤的诊断价值。方法回顾性分析36例39个病变经手术和病理证实为导管内乳头状瘤的超声图像表现及特征,并与病理结果比较。结果高频超声对Ⅰ型导管内乳头状瘤的诊断准确率为92.8%,Ⅱ型为90.9%,Ⅲ型为50%,Ⅳ型为80%,Ⅴ型为60%。结论高频多普勒超声可作为导管内乳头状瘤首选的检查方法之一。     

乳腺癌组织中FOXO1蛋白表达与细胞增殖和细胞凋亡的相关性

目的研究乳腺癌组织中FOXO1蛋白表达与细胞增殖和细胞凋亡的相关性。方法利用免疫组织化学技术检测60例乳腺浸润性导管癌、21例导管内癌、30例导管内乳头状瘤及15例正常乳腺组织中FOXO1、Ki-67及活化Caspase-3蛋白的表达。结果FOXO1及活化Caspase-3蛋白在乳腺浸润性导管癌和导管内癌中的阳性表达率和阳性表达强度均显著低于导管内乳头状瘤和正常乳腺组织。Ki-67蛋白在乳腺浸润性导管癌和导管内癌中的阳性表达率和阳性表达强度均显著高于导管内乳头状瘤和正常乳腺组织;浸润性导管癌中FOXO1、Ki-67及活化Caspase-3的表达强度与癌组织的病理学分级无关;在浸润性导管癌、导管内癌、导管内乳头状瘤及正常乳腺组织中,FOXO1蛋白的表达强度与Ki-67呈显著负相关,而与活化Caspase-3的表达强度呈显著正相关。结果 FOXO1蛋白的表达下调可能与乳腺导管癌的发生密切相关;该蛋白可能是一种细胞增殖的负性调节因子,同时亦是一种细胞凋亡促进因子,FOXO1基因有可能成为乳腺浸润性导管癌基因治疗的有效靶点。     

塔里木兔与家兔胰腺水通道蛋白表达的比较

通过检测塔里木兔（Lepus yarcandensis）胰腺中水通道蛋白（aquaporin,AQP）1和4的表达及分布情况,以探讨水通道蛋白在塔里木兔适应干旱缺水环境中的作用。采用常规 H.E染色观察塔里木兔胰腺组织学结构,采用免疫组织化学法检测AQP1和AQP4在胰腺中的分布位置及表达,并与家兔（Oryctolagus curiculus）进行比较。结果显示,AQP1在胰腺微血管内皮细胞、血细胞、泡心细胞和小叶内导管上皮细胞均有表达;AQP4在小叶间导管基底膜和胰岛细胞膜上有表达。与家兔相比,AQP1 在塔里木兔胰腺外分泌部的表达较弱,而在小叶内导管的表达较强;AQP4在塔里木兔胰腺内分泌部的表达较低。以上结果说明,AQP1在塔里木兔胰腺小叶内导管的表达上调,推测可能加强了浓缩胰液的能力,以尽量保住体内的水分,这是塔里木兔对干旱缺水环境的适应性调节。与家兔相比,塔里木兔胰腺AQP1和AQP4的表达均较低,说明塔里木兔胰腺水液代谢能力比家兔低,这可能与塔里木兔所食食物营养匮乏有关。     

胰腺导管单克隆上皮样干细胞的蛋白表达特征

该文研究1例源于成年大鼠的胰腺导管单克隆上皮样干细胞系的蛋白表达特征、染色体核型及致瘤性。RPMI-1640有血清扩增培养源于成年大鼠的胰腺导管单克隆上皮样干细胞至单层,分别采用流式细胞术或免疫荧光反应检测干细胞蛋白水平的表达特征。常规法制备染色体标本,采用Adobe Photoshop CS6软件进行核型分析。将干细胞移植在裸鼠体内,观察其致瘤性。结果显示,该源于成年大鼠的胰腺导管单克隆上皮样干细胞在蛋白水平表达CK19、Neuro D2、Oct4、PCNA及Nanog,不表达Pdx1、Pax4、Pax6、Maf A、Ptf1a、Ngn3、nestin、Sox2、CD34、CD45、insulin、glucagon、ghrelin、somatostatin及secretin。细胞是正常的二倍体细胞(2n=42),无致瘤性。这表明,该源于成年大鼠的胰腺导管单克隆上皮样干细胞系共表达CK19、Neuro D2、Oct4、PCNA及Nanog蛋白。     

塔里木兔胰腺水通道蛋白的表达和作用

通过检测塔里木兔(Lepus yarcandensis)胰腺中水通道蛋白（aquaporin,AQP）1和4的表达和分布情况,以探讨水通道蛋白在塔里木兔适应干旱缺水环境中的作用,采用常规 H.E.染色观察塔里木兔胰腺组织学结构,采用免疫组织化学检测AQP1和AQP4在胰腺中的分布位置及表达,并与家兔进行比较。结果显示,AQP1在微血管内皮细胞,血细胞,泡心细胞和小叶内导管上皮细胞均有表达;AQP4在小叶间导管基底膜和胰岛细胞膜上有表达。与家兔相比,AQP1 在塔里木兔胰腺外分泌部的表达较弱,而在小叶内导管的表达较强;AQP4在塔里木兔胰腺内分泌部的表达较低。以上结果说明,AQP1在塔里木兔胰腺小叶内导管的表达上调,推测可能加强了浓缩胰液的能力,以尽量保住体内的水分,是塔里木兔对干旱缺水环境的适应性调节。与家兔相比,塔里木兔胰腺AQP1和AQP4的表达均较低,说明塔里木兔胰腺水液代谢能力比家兔低,这可能与塔里木兔所食食物营养匮乏有关。     

CD44及CD24在乳腺癌组织中的表达及与临床病理特征的关系研究

目的:探讨肿瘤标志因子CD44及CD24在乳腺癌组织中的表达及与临床病理特征的关系。方法:选择从2015年1月到2017年1月在我院接受手术治疗的乳腺癌患者80例纳入本次研究,另选同期在我院治疗的导管原位癌患者30例,小叶增生患者20例及导管单纯增生患者20例的组织提取标本进行对照,分析CD44及CD24在乳腺癌组织和不同病变类型中的表达,并分析CD44~+/CD24~-细胞在癌症免疫分型中的表达以及CD44~+/CD24~-细胞与乳腺浸润导管癌相关病理特征的关系。结果:乳腺癌组织内的CD44阳性率为52.50%,CD24的阳性率为57.50%,均显著高于癌旁组织的11.25%和15.00%,差异均有统计学意义(均P0.05)。CD44及CD24在导管原位癌及乳腺浸润导管癌中的阳性率高于小叶增生和导管单纯增生,导管原位癌的阳性率高于乳腺浸润导管癌,差异均有统计学意义(均P0.05),且CD44在乳腺浸润导管癌不同分化类型中的阳性率差异有统计学意义(P0.05)。CD24在乳腺浸润导管癌不同分化类型中的阳性率差异不显著(P0.05)。CD44~+/CD24~-细胞在不同癌症免疫分型以及不同分化中的阳性率比较差异均有统计学意义(P0.05)。CD44~+/CD24~-细胞与乳腺浸润导管癌患者的年龄、月经状态、肿瘤直径、淋巴结转移以及远处转移之间均无明显关系(均P0.05)。结论:CD44及CD24在乳腺癌组织内存在较高的阳性率,且CD44~+/CD24~-在乳腺原位癌及低分化的乳腺癌组织内具有更高的阳性率,临床上可尝试通过监测CD44~+/CD24~-的阳性表达情况评价患者的病情及预后。     

E-cadherin在胰腺癌中的表达及其对预后的影响

目的：探讨钙粘蛋白E-cadherin的表达与胰腺导管腺癌临床病理特征及预后的关系。方法：利用组织芯片,采用免疫组织化学En Vision二步法检测106例胰腺导管腺癌组织和12例正常胰腺组织E-cadherin的表达情况。结果：E-cadherin在胰腺导管腺癌组织中表达部分缺失率为53.8%（57/106）,完全缺失率11.3%（12/106）,正常组织中的缺失率为0%,差异有统计学意义（P〈0.01）;E-cadherin的表达与患者性别、年龄,临床分期、神经浸润和淋巴结转移无关,与肿瘤分化程度有关。106例胰腺导管腺癌患者E-cadherin表达完全缺失、部分缺失和完整表达的中位总生存期分别为7个月、19个月和25个月,两者差异有统计学意义（P〈0.01）。单因素分析显示,肿瘤分化程度、淋巴结转移、切缘情况和E-cadherin表达缺失水平与预后相关;多因素分析显示,切缘情况和E-cadherin表达缺失水平与预后相关。结论：E-cadherin可以作为胰腺导管腺癌患者预后的独立指标。     

胰腺的病理生理学

本文主要论述胰腺的外分泌并着重于胰腺的炎症。在阐明胰腺炎发病学方面以及改善胰腺诊断方面的进步,使这一疾病症状表现的机制得以相当明了,并使治疗变得更加合理而有效。胰腺的生理学我们对胰腺生理学的知识是在研究了下列问题后获得的:胰腺外分泌及其调节机制;胆管和胰腺导管系统的解剖学和生理学;胰腺的蛋白质代谢以及胰腺导管压力改变对胰腺刺激所引起的反应。胰腺的外分泌胰液是一种主要由重碳酸     

利用谱系追踪方法探究Lgr5在胰腺组织及其类器官中的表达

富含亮氨酸重复序列G蛋白偶联受体5 (leucine-rich repeat containing G protein-coupled receptor 5, Lgr5)在体内分布广泛,可以作为多种上皮组织(包括小肠、结肠、胃和毛囊)中干细胞的标记物。为了探究小鼠(Mus musculus)胰腺发育过程中导管上皮细胞及体外培养的胰腺导管类器官中Lgr5的表达情况,本研究利用Lgr5-Cre^ERT2+/–和Rosa26-mTmG杂交后的转基因小鼠,经Tamoxifen(他莫昔芬)诱导后,观察不同发育阶段胰腺组织切片的荧光表达情况,并通过三维培养建立成体小鼠胰腺导管类器官,观察诱导后类器官细胞中的荧光变化。结果显示：Tamoxifen诱导的正常成体转基因小鼠胰腺导管内未检测到表达Lgr5的细胞;通过对孕鼠及哺乳母鼠注射Tamoxifen,在胚胎发育15.5d和新生小鼠胰腺中也未发现Lgr5阳性细胞;但是将4-hydroxyTamoxifen (4-羟基–他莫昔芬)添加到培养基中,在Lgr5-Cre^ERT2+/–;Rosa26-mTmG转基因小鼠胰...     

Clinical and Molecular Attributes and Evaluation of Pancreatic Cystic Neoplasm

Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are all considered “Pancreatic cystic neoplasms (PCNs)” and show a varying risk of developing into pancreatic ductal adenocarcinoma (PDAC). These lesions display different molecular characteristics, mutations, and clinical manifestations. A lack of detailed understanding of PCN subtype characteristics and their molecular mechanisms limits the development of efficient diagnostic tools and therapeutic strategies for these lesions. Proper in vivo mouse models that mimic human PCNs are also needed to study the molecular mechanisms and for therapeutic testing. A comprehensive understanding of the current status of PCN biology, mechanisms, current diagnostic methods, and therapies will help in the early detection and proper management of patients with these lesions and PDAC. This review aims to describe all these aspects of PCNs, specifically IPMNs, by describing the future perspectives.     

Cytologic diagnosis of a solitary brain metastasis from papillary carcinoma of the thyroid. A case report.

BACKGROUND: Papillary carcinoma of the thyroid metastasizes to the brain in rare instances. In published series and case reports of metastatic papillary thyroid carcinoma, diagnosis of central nervous system (CNS) metastases has been determined by histologic methods. We present a case of papillary carcinoma metastatic to brain diagnosed by cytologic methods. CASE: A 43-year-old female, initially diagnosed at age 12 with papillary carcinoma of the thyroid metastatic to regional lymph nodes and lung, presented with head aches of increasing frequency and severity. A computed tomography scan confirmed a 1-cm nodule in the right inferior frontal lobe of the brain. For clinical reasons, the patient was followed with serial imaging for five years. At age 48 there was significant progression of the CNS disease, and the patient underwent stereotactic biopsy with drainage of cyst fluid. Cytologic examination of the cyst fluid and immunocytochemical studies confirmed the typical features of papillary thyroid carcinoma, including papillary clusters of cells with finely granular chromatin, micronucleoli, nuclear grooves and an associated psammoma body. CONCLUSION: Neurocytology is a useful technique in the examination of cystic lesions of the brain and may be the sole technique for determination of diagnosis.     

A Genome-Wide Investigation of MicroRNA Expression Identifies Biologically-Meaningful MicroRNAs That Distinguish between High-Risk and Low-Risk Intraductal Papillary Mucinous Neoplasms of the Pancreas

Background

Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic ductal adenocarcinoma (PDAC) precursors. Differentiating between high-risk IPMNs that warrant surgical resection and low-risk IPMNs that can be monitored is a significant clinical problem, and we sought to discover a panel of mi(cro)RNAs that accurately classify IPMN risk status.

Methodology/Principal Findings

In a discovery phase, genome-wide miRNA expression profiling was performed on 28 surgically-resected, pathologically-confirmed IPMNs (19 high-risk, 9 low-risk) using Taqman MicroRNA Arrays. A validation phase was performed in 21 independent IPMNs (13 high-risk, 8 low-risk). We also explored associations between miRNA expression level and various clinical and pathological factors and examined genes and pathways regulated by the identified miRNAs by integrating data from bioinformatic analyses and microarray analysis of miRNA gene targets. Six miRNAs (miR-100, miR-99b, miR-99a, miR-342-3p, miR-126, miR-130a) were down-regulated in high-risk versus low-risk IPMNs and distinguished between groups (P<10⁻³, area underneath the curve (AUC) = 87%). The same trend was observed in the validation phase (AUC = 74%). Low miR-99b expression was associated with main pancreatic duct involvement (P = 0.021), and serum albumin levels were positively correlated with miR-99a (r = 0.52, P = 0.004) and miR-100 expression (r = 0.49, P = 0.008). Literature, validated miRNA:target gene interactions, and pathway enrichment analysis supported the candidate miRNAs as tumor suppressors and regulators of PDAC development. Microarray analysis revealed that oncogenic targets of miR-130a (ATG2B, MEOX2), miR-342-3p (DNMT1), and miR-126 (IRS-1) were up-regulated in high- versus low-risk IPMNs (P<0.10).

Conclusions

This pilot study highlights miRNAs that may aid in preoperative risk stratification of IPMNs and provides novel insights into miRNA-mediated progression to pancreatic malignancy. The miRNAs identified here and in other recent investigations warrant evaluation in biofluids in a well-powered prospective cohort of individuals newly-diagnosed with IPMNs and other pancreatic cysts and those at increased genetic risk for these lesions.     

GNAS and KRAS Mutations are Common in Intraductal Papillary Neoplasms of the Bile Duct

Intraductal papillary neoplasms of the bile duct (IPNB) shows favorable prognosis and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Although activating point mutations of GNAS at codon 201 have been detected in approximately two thirds of IPMNs of the pancreas, there have been few studies on GNAS mutations in IPNBs. This study investigates the status of GNAS and KRAS mutations and their association with clinicopathological factors in IPNBs. We examined the status of GNAS mutation at codon 201 and KRAS mutation at codon 12&13, degree of mucin production and immunohistochemical expressions of MUC mucin core proteins in 29 patients (M/F = 15/14) with IPNB in intrahepatic and perihilar bile ducts (perihilar IPNB) and 6 patients (M/F = 5/1) with IPNB in distal bile ducts (distal IPNB). GNAS mutations and KRAS mutations were detected in 50% and 46.2% of IPNBs, respectively. There was no significant correlation between the status of GNAS mutation and clinicopathological factors in IPNBs, whereas, the status of KRAS mutation was significantly inversely correlated with the degree of MUC2 expression in IPNBs (p<0.05). All IPNBs with GNAS mutation only showed high-mucin production. Degree of mucin production was significantly higher in perihilar IPNBs than distal IPNBs (p<0.05). MUC2 and MUC5AC expression was significantly higher in IPNBs with high-mucin production than those with low-mucin production (p<0.01 and p<0.05, respectively). In conclusions, this study firstly disclosed frequent GNAS mutations in IPNBs, similarly to IPMNs. This may suggest a common histopathogenesis of IPNBs and IPMNs. The status of KRAS mutations was inversely correlated to MUC2 expression and this may suggest heterogeneous properties of IPNBs. IPNBs with high-mucin production are characterized by perihilar location and high expression of MUC2 and MUC5AC, irrespective of the status of GNAS and KRAS mutations.     

Clinical and cytologic features of papillary neoplasms of the breast

OBJECTIVE: To compare the cytologic features benign and malignant papillary breast lesions. STUDY DESIGN: We reviewed the clinical and cytologic features in 29 cases of intraductal papilloma and 26 cases of atypical papilloma or papillary carcinoma that had been diagnosed by histologic examination. The diameter of the mass was examined as a clinical feature. The cytologic features evaluated were as follows: bloody background, row of tall columnar cells, naked bipolar nuclei, hemosiderin-laden macrophages, myoepithelial cells, single scattered atypical cells, cellularity, nuclear atypia, nuclear grade, apocrine metaplasia, eosinophilic cytoplasmic granules, papillary clusters, small papillae, cell balls and large sheets. RESULTS: Of the features evaluated, the diameter of the mass, naked bipolar nuclei and cell balls differed significantly between benign and atypical or malignant papillary neoplasms. The average diameter of a benign papillary neoplasm was 1.8 cm, and that of an atypical or malignant papillary neoplasm was 2.2 cm (p = 0.042). Naked bipolar nuclei were found in 27 cases of benign papillary neoplasm (93.1%) versus 19 cases of atypical or malignant papillary neoplasm (73.1%) (p = 0.050). Cell balls were found in 14 (48.3%) and 21 (80.8%) cases, respectively (p = 0.012). All 6 cases in which cell balls were present and naked bipolar nuclei were absent proved to be atypical or malignant papillary neoplasms. Of 17 cases in which cell balls were absent and naked bipolar nuclei present, 13 (76.5%) were benign papillary neoplasms. CONCLUSION: Most cytologic features overlapped in benign and atypical or malignant papillary neoplasms. Although they were not pathognomonic, naked bipolar nuclei and cell balls were cytologic features that differed significantly between benign and atypical or malignant papillary neoplasms. When papillary neoplasms of the breast are suspected in a cytologic smear, the combination of clinical examination, mammography and cytologic features should be considered to make the correct diagnosis.     

Claudin-18 Is an Early-Stage Marker of Pancreatic Carcinogenesis

Pancreatic ductal neoplasms exhibit gastric epithelium–like characteristics. In this study, we evaluated the expression of claudin-18 (CLDN18), a gastric epithelium–associated claudin, in pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), mucinous cystic neoplasms (MCNs), and pancreatic ductal adenocarcinomas (PDACs) using immunohistochemistry. We observed a high level of expression of CLDN18 in PanINs (31/32, 97%), IPMNs (61/65, 95%), and MCNs (4/5, 80%) using ordinary tissue section analysis. Furthermore, we observed a high level of CLDN18 expression in PDACs (109/156, 70%) using tissue microarray analysis. However, the normal pancreatic duct or the ductal metaplasia of the acinar cells was not immunoreactive. Comparative analysis of CLDN18 and phenotypic markers in IPMNs revealed that simultaneous expression of CLDN18 and intestinal markers frequently occurred, even in intestinal-type IPMNs. CLDN18 variant 2 mRNA was expressed and was similarly upregulated by phorbol 12–myristate 13–acetate (PMA) treatment in pancreatic cancer cell lines and in a gastric cancer cell line. An inhibitor of pan-PKC (GF109203X) completely suppressed this upregulation in pancreatic cancer cells. These results indicate that CLDN18, a marker for the early carcinogenetic process, is commonly expressed in precursor lesions of PDAC. Activation of the PKC pathway might be involved in CLDN18 expression associated with pancreatic carcinogenesis.     

偏振光成像技术用于肿瘤病变检测的研究进展

偏振光成像是一种非标记、无损伤检测技术,它与现有非偏振光学方法硬件兼容,但能提供更丰富的样品结构和光学信息,并且对亚波长微观结构变化十分敏感.最近,偏振光成像方法在生物医学,特别是肿瘤癌症检测领域显示出很好的应用前景.本文介绍了常用的偏振光散射成像方法,包括偏振差、偏振度、旋转线偏振成像、偏振显微、穆勒矩阵成像等,并展示这些偏振方法在生物医学领域,特别是癌症检测方面的最新研究进展.目前偏振差、偏振度等成像方法已被初步用于皮肤癌的诊断,而穆勒矩阵包含更为丰富的组织微观结构信息,因而具有更好的诊断应用前景.通过对穆勒矩阵进行分解、变换等处理,可获得具有明确物理意义的成像参数,并发展为针对不同应用的特异性方法.目前,随着新型光源、偏振器件和探测器的出现,特别是数据计算处理能力的急剧提升,偏振成像在数据解释和测量方法方面的研究快速发展,已经在生物医学领域显示出很好的应用前景.     

Cytologic diagnosis of the papillary variant of renal-cell carcinoma

The papillary variant of renal-cell carcinoma is characterized by distinctive histologic, clinical and angiographic features. A study was undertaken to delineate the cytologic features of this tumor as it is encountered in cellular samples. Cytologic specimens containing tumor cells from eight patients who underwent resection for papillary renal-cell carcinoma were examined and compared to corresponding cytologic samples obtained from ten other patients who had nonpapillary renal-cell carcinoma. The cytologic appearance of papillary renal-cell carcinoma, which is deceptively benign, is marked by distinctive papillary structures that often resemble branched chains. The cells are usually small and contain uniform nuclei; numerous macrophages with foamy cytoplasm are often found in the background. These cytologic features were not observed in the cellular specimens from the nonpapillary renal carcinomas. We conclude that papillary renal-cell carcinoma can be confidently recognized in cytologic specimens.     

Diagnosis of Pancreatic Neoplasms Using a Novel Method of DNA Methylation Analysis of Mucin Expression in Pancreatic Juice

Mucins (MUC) play crucial roles in carcinogenesis and tumor invasion in pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasms (IPMNs). Our immunohistochemistry (IHC) studies have shown a consensus position on mucin expression profiles in pancreatic neoplasms as follows: MUC1-positive but MUC2-negative expression in PDACs; MUC1-negative but MUC2-positive expression in intestinal-type IPMNs (dangerous type); MUC1-negative and MUC2-negative expression in gastric-type IPMNs (safe type); High MUC4 expression in PDAC patients with a poor outcome; and MUC4-positive expression in intestinal-type IPMNs. We also showed that three mucin genes (MUC1, MUC2 and MUC4) expression in cancer cell line was regulated by DNA methylation. We have developed a novel ‘methylation-specific electrophoresis (MSE)’ method to analyze the DNA methylation status of mucin genes by high sensitivity and resolution. By using the MSE method, we evaluated pancreatic juice samples from 45 patients with various pancreatic lesions. The results were compared with final diagnosis of the pancreatic lesions including IHC of mucin expression in the paired pancreatic tissues. The results indicated that the DNA methylation status of MUC1, MUC2 and MUC4 in pancreatic juice matched with the mucin expression in tissue. Analyses of the DNA methylation status of MUC1, MUC2 and MUC4 were useful for differential diagnosis of human pancreatic neoplasms, with specificity and sensitivity of 87% and 80% for PDAC; 100% and 88% for intestinal-type IPMN; and 88% and 77% for gastric-type IPMN, respectively. In conclusion, MSE analysis of human pancreatic juice may provide useful information for selection of treatment for pancreatic neoplasms.     

超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值

目的:探讨超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值。方法:2010年1月至2014年12月选择来我院进行诊治的结节性甲状腺肿患者80例,病理诊断为结节性甲状腺肿合并甲状腺微小乳头状癌30例(恶性组)和单纯结节性甲状腺肿50例(良性组),都进行常规二维超声、超声弹性成像和超声造影检查。结果:恶性组结节多呈现单发、内部低回声、钙化形态不规则特征,与良性组对比差异有统计学意义(P0.05)。恶性组病灶内的血流最小流速明显小于良性组(P0.05),阻力指数与搏动指数明显高于良性组(P0.05)。良性组弹性成像多为2~3分,恶性组多为4~5分,组间对比差异都有统计学意义(P0.05)。恶性组的造影剂平均通过时间明显少于对照组(P0.05),两组的显影时间、达峰时间、峰值强度对比差异无统计学意义(P0.05)。结论:常规超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的良恶性有一些特异性的征象,超声弹性成像与超声造影可为临床诊断提供补充,有助于提高甲状腺微小乳头状癌的诊断准确率。