SATB2是成骨细胞分化的敏感但不特异的标记

目的探讨SATB2免疫组织化学表达在原发性骨肿瘤病理鉴别诊断中的意义。方法收集65例骨肉瘤、9例骨母细胞瘤、39例软骨肉瘤、10例内生软骨瘤、9例软骨母细胞瘤、9例软骨黏液样纤维瘤、10例纤维结构不良、9例骨性纤维结构不良、8例动脉瘤样骨囊肿、12例骨巨细胞瘤、9例脊索瘤、7例未分化多形性肉瘤、3例纤维肉瘤,采用EnVision两步法进行免疫组织化学染色检测SATB2在这些肿瘤中表达的情况。结果 100%的骨肉瘤、骨母细胞瘤、骨巨细胞瘤、动脉瘤样骨囊肿、纤维结构不良、骨性纤维结构不良表达STAB2;软骨肉瘤阳性比为15/39,软骨母细胞瘤阳性比为1/3,未分化多形性肉瘤阳性比为5/8;其余肿瘤均不表达STAB2。结论 SATB2是成骨细胞敏感但不特异的标记,对原发性骨肿瘤中成骨性肉瘤与非成骨性肉瘤的鉴别诊断意义有限。     

p21WAFl/CIPl、PCNA在骨巨细胞瘤中的表达及意义

目的探讨p21WAF1/CIP1、PCNA在骨巨细胞瘤中的表达特点及其与骨巨细胞瘤的分化和复发的关系.方法应用LSAB免疫组织化学方法对38例骨巨细胞瘤中的p21WAF1/CIP1、PCNA的表达进行检测.结果66.8%的骨巨细胞瘤中可检测到p21WAF1/CIP1的阳性表达,其阳性表达主要位于分化好的多核巨细胞的细胞核内,分化好的骨巨细胞瘤(Ⅰ级)中p21WAF1/CIP1的表达明显高于分化差组(Ⅱ、Ⅲ级)(P<0.01).38例骨巨细胞瘤均可检测到PCNA的阳性表达,其阳性表达主要位于单核基质细胞的细胞核内;未复发组及复发组中p21WAF1/CIP1、PCNA的表达无显著性差异(P>0.05).结论骨巨细胞瘤中p21WAF1/CIP1的表达与骨巨细胞瘤的分化相关,可作为骨巨细胞瘤分化的参考指标.     

骨巨细胞瘤的免疫组织化学特征及其与组织发生和病理分级的关系

应用免疫组织化学技术, 对３２ 例骨巨细胞瘤 （ＧＣＴ） 进行了８ 种抗体标记检测。结果显示： ３２例骨巨细胞瘤中,多核巨细胞和单核基质细胞ＣＤ６８ 均为阳性反应,α１ 抗胰糜蛋白酶和溶菌酶两种抗体的阳性反应均较弱; 所有病例第Ⅷ因子相关抗原、上皮膜抗原和细胞角蛋白标记在瘤细胞中无阳性表达; 全部病例单核基质细胞波形蛋白和增殖细胞核抗原（ＰＣＮＡ） 均为阳性反应, 而多核巨细胞几乎都为阴性反应; ＰＣＮＡ增殖指数在骨巨细胞瘤虽随Ｊａｆｆｅ 病理分级增高而呈递增趋势, Ⅰ级骨巨细胞瘤的ＰＣＮＡ增殖指数与Ⅱ级和Ⅲ级之间的ＰＣＮＡ增殖指数有显著性差异（Ｐ＜ ００１）, 但Ⅱ级与Ⅲ级之间无显著性差异（Ｐ＞ ００５）, 各级相互之间有交叉重叠现象。本文结果提示,骨巨细胞瘤可能起源于骨髓干细胞,并向成纤维细胞和单核巨噬细胞分化;Ｊａｆｆｅ病理分级与免疫组化的表达不完全一致,但ＰＣＮＡ 增殖指数对判断骨巨细胞瘤细胞增殖活性和肿瘤的预后有重要的参考意义。     

微波高温灭活及自体髂骨异体骨粒复合骨水泥修复 治疗长骨骨巨细胞瘤骨缺损

目的:探讨微波高温灭活及自体髂骨、异体骨粒复合骨水泥修复骨巨细胞瘤病灶刮除后骨缺损的临床应用效果。方法:应用原位分离插入式微波天线高温灭活技术,自体髂骨、异体骨粒复合骨水泥修复21例长骨骨巨细胞瘤术后骨缺损,从手术技术、肿瘤复发情况、肢体关节功能等方面全面综合评价此方法临床应用效果。结果:21例患者均获得骨性愈合,无骨折及内固定断裂发生,2例复发,复发率9.8%;肢体关节功能优18例(85.7%)、良3例(14.3%)、中差0例。结论:微波高温能彻底杀灭肿瘤组织降低复发率,自体髂骨保证与近关节软骨下骨愈合,异体骨粒复合骨水泥能良好充填残余瘤腔、且具有良好的生物力学性能,以防发生关节软骨面塌陷。     

MMP-16与骨巨细胞瘤临床相关性的初步研究

目的:研究复发与未复发骨细胞瘤细胞中MMP-16的变化,初步探索MMP-16与骨巨细胞瘤复发之间的联系,进而讨论MMP-16对于骨巨细胞瘤的临床意义。方法:对临床中复发和未复发共50例骨巨细胞瘤患者切除的骨巨细胞瘤组织进行标本采集。首先应用免疫组化荧光染色直观观察复发组和未复发组骨巨细胞瘤组织中MMP-16的表达情况,再运用real-time PCR技术检测MMP-16 mRNA的表达情况,最后应用western blot技术测定MMP-16的含量。从形态、基因表达和蛋白三个方面全面比较复发组和未复发组骨巨细胞瘤组织中MMP-16的表达情况。结果:免疫组化结果显示复发组中MMP-16的表达要明显高于未复发组;real-timePCR结果显示复发组中的MMP-16 mRNA的表达量要明显高于未复发组;western blot结果显示复发组中MMP-16蛋白的表达量要高于未复发组(P0.05)。结论:MMP-16与骨巨细胞瘤存在密切联系,MMP-16的表达增强是骨巨细胞瘤的复发的重要标志,通过对MMP-16的测定对骨巨细胞瘤的预后判断和治疗方法的选择具有指导意义。     

微波高温灭活及自体髂骨异体骨粒复合骨水泥修复治疗长骨骨巨细胞瘤骨缺损

目的：探讨微波高温灭活及自体髂骨、异体骨粒复合骨水泥修复骨巨细胞瘤病灶刮除后骨缺损的临床应用效果。方法：应用原位分离插入式微波天线高温灭活技术,自体髂骨、异体骨粒复合骨水泥修复21例长骨骨巨细胞瘤术后骨缺损,从手术技术、肿瘤复发情况、肢体关节功能等方面全面综合评价此方法临床应用效果。结果：21例患者均获得骨性愈合,无骨折及内固定断裂发生,2例复发,复发率9.8%;肢体关节功能优18例（85.7%）、良3例（14.3%）、中差0例。结论：微波高温能彻底杀灭肿瘤组织降低复发率,自体髂骨保证与近关节软骨下骨愈合,异体骨粒复合骨水泥能良好充填残余瘤腔、且具有良好的生物力学性能,以防发生关节软骨面塌陷。     

挂榜山小鲵成体和亚成体舌器的形态特征

以透明骨骼双色法对挂榜山小鲵(Hynobius guabangshanensis)成体和亚成体舌器的形态特征进行观察和详细描述。结果表明,在成体中,下舌软骨中部交叉;角舌软骨末端被第一下鳃骨和第一角鳃骨的愈合体遮盖;具有基鳃软骨角状突;第二角鳃骨骨化;尾舌骨骨化,呈"一"字形。在亚成体中,下舌软骨中部未交叉;第一下鳃骨和第一角鳃骨单独存在;无基鳃软骨角状突;第二角鳃骨未骨化;具有第三、第四对角鳃骨,且均为软骨;尾舌骨未骨化,成"1"字形。这些形态特征的改变可能由舌器在成体和亚成体阶段的功能所引起。     

检测pT_(1-4a)N_(1-3)M_0期胃癌淋巴结微转移检测的临床意义

目的:探讨胃癌淋巴结微转移及临床病理因素对p T1-4aN1-3M0期胃癌患者术后5年无瘤生存率的影响。方法:选取我院2009年1月至12月期间胃肠外科单一手术组行D2胃癌根治术p T1-4aN1-3M0期患者63例1427枚HE染色阴性淋巴结,应用免疫组化法检测这些淋巴结中CK19表达,观察微转移的情况并分析发生微转移的胃癌患者临床病理特征及对患者5年无瘤生存率的影响。结果:临床病理分期p T1-4aN1-3M0胃癌患者中,经免疫组化染色,1427枚HE常规染色阴性淋巴结中CK19阳性表达率为15.49%(221/1427);63例胃癌患者中CK19表达阳性率39.68%(25/63);术后随访时间5.6~68.5月(平均时间43.88月),淋巴结中CK19阴性表达、阳性表达患者的总5年生存率分别为52.63%、28.00%;两者无瘤生存率差异有统计学意义(x2=8.677,P=0.003)。淋巴结CK19阳性表达与胃癌患者的肿瘤直径(P0.05)、浸润胃壁深度(P0.05)有关。COX生存回归分析显示淋巴结微转移为独立预后因素。25例患者发现淋巴结微转移并推荐再分期,再分期率39.68%(25/63)。结论:p T1-4aN1-3M0期胃癌病人,CK-19免疫组化法染色能检出常规HE染色阴性淋巴结中的微转移,有助于细化分期、判断预后及指导治疗。     

乙状结肠锯齿状腺癌伴异位骨化生1例临床病理特征及文献复习

目的探讨乙状结肠锯齿状腺癌伴异位骨化生l例的临床病理特征及意义。方法回顾性分析1例乙状结肠锯齿状腺癌伴有异位骨化生的病例并复习文献。结果病理巨检见肠腔内菜花样肿物,大小4.7cm×3.4cm×3.1cm,切面灰白色、质地偏硬。镜下中分化腺癌具有锯齿状结构,胞浆丰富、呈嗜酸性或嗜中性,有黏液、筛状、花边状和小梁状区域,侵犯深度达浆膜层。肿瘤间质中可见岛状化生骨,周边被覆骨母细胞,骨岛周围见明显成纤维细胞增生及玻璃样变,与成骨细胞移行的现象。肿瘤与相对正常黏膜交界处可见锯齿状腺瘤结构。肿瘤未见出血或坏死,间质中较多淋巴细胞浸润,可见少数淋巴管癌栓,肠系膜淋巴结未见癌转移。免疫组织化学染色显示CEA、CK8/18、CK19、β-catenin和E-cadherin均阳性表达,CK20部分阳性表达,CK7、CDX-2、Vimentin、bcl-2、S-100、CD56、p16均为阴性,Ki-67约为80%阳性。结论肠锯齿状腺癌中异位骨化生只是一个组织学现象,没有临床预后意义,发生的机制尚无确切定论。     

1,25（OH）2D3缺失对膜内和软骨内成骨影响的比较研究

目的:比较1,25(OH)2D3缺失对膜内成骨和软骨内成骨影响的不同。方法:用免疫组织化学染色、HE染色和Western-blot等方法检测6周龄的野生型(wild type,WT)和1琢(OH)ase-/-小鼠的颅骨和股骨干骺端骨组织中I型胶原和甲状旁腺素受体(parathyroid hormone receptor,PTHR)的表达水平。结果:和WT小鼠相比较,1 ase-/-小鼠颅骨的I型胶原阳性面积明显减少,但是干骺端I型胶原阳性面积明显增加,差异有显著性(P<0.01);1琢(OH)ase-/-小鼠颅骨成骨细胞计数明显减少,差异存在统计学意义(P<0.05);但是干骺端成骨细胞计数明显增加,差异有显著性(P<0.01);1琢(OH)ase-/-小鼠颅骨的PHTR表达水平明显减少,但是在干骺端PHTR表达水平明显增加,差异均有显著性(P<0.01)。结论:1,25(OH)2D3缺乏导致小鼠膜内成骨方式骨形成减少,而软骨内成骨骨形成增加。     

The expression of Met/hepatocyte growth factor receptor gene in giant cell tumors of bone and other benign musculoskeletal tumors

Overexpression of the hepatocyte growth factor receptor (Met/HGF receptor), a transmembrane tyrosine kinase encoded by the MET proto-oncogene, is involved in transformation and invasive behavior of human carcinomas and sarcomas. We have previously found that bone sarcomas express high levels of Met/HGF receptor while in some cases the ligand HGF is co-expressed with the receptor, activating an autocrine loop. In this study, we analyzed 40 biopsy samples of a collection of giant cell tumors and other rare benign tumors of bone for expression of the MET proto-oncogene. These included nonossifying fibromas, osteoblastomas, desmoplastic fibromas of bone, chondroblastomas, and giant cell tumors of bone. Snap frozen samples were tested for the MET and HGF gene expression by immuno-histochemistry and Western blotting with anti-MET antibodies and RT-PCR. Over 50% of all cases scored positive for MET expression being constantly positive in recurrent or locally aggressive lesions. Sporadic co-expression of the Met/HGF receptor and ligand is also demonstrated. Met/HGF receptor expression in benign bone neoplasms suggests its early involvement in sarcomagenesis.     

Fine needle aspiration cytology of bone tumors

OBJECTIVE: To study the role of fine needle aspiration cytology (FNAC) in the diagnosis of bone tumors and its impact on therapeutic decisions. STUDY DESIGN: A group of 122 cases of bone tumor were evaluated by FNAC. Detailed diagnoses were compared with the available histology. RESULTS: Diagnostic accuracy of FNAC was 90.5% in this study. FNAC could differentiate between various round cell tumors such as Ewing's sarcoma and myeloma, among various giant cell-rich lesions of bone and between the benign and malignant chondroid bone tumors. Some uncommon variants were also correctly diagnosed. In metastatic bone tumors, the source of primary malignancy could not be indicated in the majority (52.9%) because of the poorly differentiated morphology. Osteoid or osteoid-like material was demonstrable in 63.6% cases of osteogenic sarcoma. A case of chondroblastic osteogenic sarcoma that was reported as chondrosarcoma was the only diagnostic error in the study. FNAC obviated the need of open biopsy in 63.8% patients, and therapeutic decisions were made according to the cytologic diagnoses. CONCLUSION: FNAC plays an important role in the early diagnosis of bone tumors by its accuracy, ease of use and rapidity and is helpful in making the therapeutic decisions.     

p53 immunohistochemistry for distinguishing reactive mesothelium from low grade ovarian carcinoma

OBJECTIVE: To determine the utility of immunohistochemical staining for p53 in cell block material for distinguishing reactive mesothelium from borderline or low grade ovarian carcinoma. STUDY DESIGN: Paraffin-embedded cell blocks from paracentesis and pelvic wash fluid of 44 cases of ovarian carcinoma and 20 cases containing only reactive mesothelium were immunostained for p53 using monoclonal antibody DO-7. Tumor grades ranged from borderline to high grade and were serous papillary (33), clear cell (3), mucinous (2), endometrioid (2), mixed serous papillary/clear cell (3) and undifferentiated (1). The three authors independently evaluated the staining, including estimation of the percentage and intensity of positive nuclear staining. RESULTS: A separation of positive from negative cases was seen when staining intensity was considered the critical parameter; moderate to strong staining was considered truly positive. Seventy-three percent (8/11) of borderline tumors, 80% (8/10) of low grade tumors and 65% (15/23) of intermediate to high grade tumors showed moderate to strong positivity. Percentage of staining was a less-reliable parameter as 25% of negative cases were positive by this assessment. CONCLUSION: p53 Immunohistochemistry, using monoclonal antibody DO-7 combined with standard morphologic evaluation, may be useful in distinguishing benign reactive mesothelium from borderline or low grade ovarian carcinoma.     

Different expression of cyclooxygenase-2 (COX-2) in selected nonmelanocytic human cutaneous lesions

The aim of our study was to elucidate the possible involvement of COX-2 in the development and/or progression of nonmelanocytic skin lesions. To evaluate the usefulness of that enzyme as a potential molecular marker, we examined the intensity and spatial distribution of COX-2 expression in selected types of such tumors using the same immunohistochemical procedure as in our earlier studies of melanocytic cancers. We examined 20 benign epithelial lesions, 11 precancerous lesions, 21 basal cell carcinomas (BCC), 14 squamous cell carcinomas (SCC) and eight fibromas. The levels of COX-2 expression detected in benign lesions and in normal skin were comparable. Elevated expression of this protein may play a role in the development of SCC, as indicated by strong immunostaining both in SCCs and precancerous lesions. Significantly stronger staining in SCCs compared to BCCs may indicate a role of COX-2 in cancer malignancy and serve as an indicator useful for differential diagnostics of the two types of cancer. Strong staining in all skin layers of SCC may help in detecting cancer cells infiltrating surrounding skin layers.     

Comparsion of staining characteristics of Toto bodies

Toto bodies are eosinophilic structures that resemble the cells of the superficial cell layer of the oral epithelium. Toto bodies commonly are associated with inflammatory gingival and other mucosal lesions including pyogenic granuloma, irritational fibroma, epulis fissuratum, peripheral giant cell granuloma and inflammatory hyperplastic gingivitis. We evaluated staining characteristics of Toto bodies to establish their origin and to identify their significance in lesions. We investigated pyogenic granuloma, fibroma and leukoplakia with epithelium that exhibited Toto bodies after hematoxylin and eosin (staining. Sections were stained with Alcian blue, periodic acid-Schiff and Ayoub-Shklar stains to evaluate staining intensity and distribution. More Toto bodies were found in pyogenic granuloma than in fibroma and leukoplakia. PAS and Alcian blue staining exhibited mild intensity and did not establish the origin of Toto bodies. High staining intensity and diffuse distribution of stain was observed using Ayoub-Shklar staining, which indicated that Toto bodies originate from keratin.     

Primary giant cell tumor of soft tissue. Report of a case with fine needle aspiration cytologic and histologic findings

BACKGROUND: So-called primary giant cell tumor of soft tissue of low malignant potential is the rare soft tissue analogue of giant cell tumor of bone, occurring primarily in superficial soft tissue. To our knowledge, the cytologic findings in bulky giant cell tumor of deep soft tissue were described only once, and no further report on the subcutaneous giant cell tumor could be retrieved from the literature. CASE: A 58-year-old woman presented with a well-demarcated, 1.5-cm-diameter dermal tumor. Fine needle aspiration smears contained numerous osteoclastlike giant cells and mononuclear cells showing bland and vesicular nuclei. A small fragment of branching vasculature and 1 mitosis were found. Those cytologic findings were enough to suggest a diagnosis of giant cell tumor of soft tissue, confirmed as a deep dermal giant cell on surgical resection. CONCLUSION: Primary giant cell tumor of soft tissue of low malignant potential should be considered in the differential diagnosis of bland-looking giant cell-rich lesions. Awareness of its existence and knowledge of its cytologic features are important for a correct preoperative cytologic diagnosis.     

Expression of cytokeratin 19 and protein p63 in fine needle aspiration biopsy of papillary thyroid carcinoma

OBJECTIVE: To analyze the immunocytochemical distribution of CK19 and p63 on archival cytologic smears of 27 papillary thyroid carcinomas (PTCs), 22 benign thyroid lesions and 5 malignant non-PTC lesions. STUDY DESIGN: Archival cytologic smears of 27 papillary carcinomas, 22 benign thyroid lesions and 5 malignant nonpapillary carcinomas were processed for immunocytochemical detection of CK19 and p63, and results were compared. RESULTS: CK19 showed strong cytoplasmic staining in 22/27 fine needle aspiration biopsies (FNABs) of PTCs, in 5 benign lesions and in 4 malignant lesions of the control group. p63 Positivity was present in FNABs of 20/27 PTC and in 1 FNAB of nodular hyperplasia. Eighteen FNABs of PTC (66.6%) showed both strong CK19 staining and p63-positive cells, whereas none of the control cases showed coexpression of CK19 and p63. CONCLUSION: Coexistence of strong CK19 positivity and p63-positive cells can enhance the cytologic diagnosis of PTC.