Outcomes of endoscopic ultrasound‐guided pancreatic FNAC diagnosis for solid and cystic lesions at Manchester Royal Infirmary based upon the Papanicolaou Society of Cytopathology pancreaticobiliary terminology classification scheme

Objective

To compare endoscopic ultrasound (EUS)‐FNAC diagnosis of pancreatic lesions with patient outcome based upon the Papanicolaou Society of Cytopathology pancreaticobiliary terminology classification scheme diagnostic categories: Panc 1 (non‐diagnostic); Panc 2 (negative for malignancy/neoplasia); Panc 3 (atypical); Panc 4B (neoplastic, benign); Panc 4O (neoplastic, other); Panc 5 (suspicious of malignancy); and Panc 6 (positive/malignant).

Methods

All EUS‐FNA pancreas specimens taken at Manchester Royal Infirmary in 2015 were prospectively classified according to the above scheme at the time of cytology reporting and data recorded prospectively. Subsequently, outcomes based on clinical follow‐up or histopathology diagnosis were compared with the cytology diagnosis.

Results

120 EUS‐FNA pancreas specimens from 111 patients were received, of which 112 (93.3%) specimens had follow‐up data. There were 79 and 41 EUS‐FNA pancreas specimens from solid and cystic lesions, respectively. Based on the cytology diagnosis the specimens were classified as Panc 1 (7.5%), Panc 2 (33.3%), Panc 3 (2.5%), Panc 4B (2.5%), Panc 4O (15.0%), Panc 5 (3.3%) and Panc 6 (35.9%). The performance indicators for diagnosis of malignancy or neoplasia with malignant potential, included sensitivity (95.4%), specificity (100%), positive predictive value (100%), negative predictive value (92.3%), false positive rate (0%) and false negative rate (4.6%).

Conclusions

The Papanicolaou Society of Cytopathology pancreaticobiliary terminology classification scheme is a logical system that can easily be introduced in a diagnostic cytopathology service. This classification scheme acts as an aid to diagnostic reporting, clear communication of significant results including risk of neoplasia/malignancy to clinicians, clinical audit and comparison of results with other centres.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

角结膜缘上皮良、恶性病变细胞核DNA原位图像定量分析

应用真彩色医学图像分析技术,对５１例角结膜缘上皮良、恶性病变（其中上皮增生１９例,不典型增生６例,原位癌１４例,鳞状细胞癌１２例）进行了ＤＮＡ原位定量分析研究．结果显示：原位癌和鳞状细胞癌ＤＮＡ含量明显增加,多为高倍异倍体细胞,ＤＮＡ直方圆明显右移,峰值主要位于＞５Ｃ处,≥５Ｃ细胞分别占７８．８９％和７８．３１％;上度增生病变ＤＮＡ含量较低,多为低倍整倍体细胞,ＤＮＡ直方图峰值位于２Ｃ～４Ｃ处,２Ｃ～４Ｃ细胞占８８．５９％;上皮不典型增生病变ＤＮＡ含量介于良性病变和癌之间,ＤＮＡ直方图逐渐右移,２Ｃ～４Ｃ细胞占５８．６２％,≥５Ｃ细胞占４１．３８％。以上数据经统计学处理各组间有显著性差异。表明ＤＮＡ倍性程度与肿瘤的增殖程度呈正相关,高倍异倍体细胞随肿瘤恶性程度的增高而增多。作者认为ＤＮＡ原位图像定量分析可为角结膜缘上皮良、恶性病变的诊断、分级及早期发现癌变趋势提供一个可靠的参考指标。     

大鼠诱发型肝癌发生发展过程中SonicHedgehog、Ptc和Gli1表达的改变

目的 观察大鼠诱发肝癌过程中Sonic Hedgehog（Shh）信号通路相关基因的表达变化,探讨其在肝癌发生发展过程中的作用.方法 雄性Wistar大鼠48只,随机分成4组,利用二乙基亚硝胺（DEN）制备诱发性大鼠肝癌模型,应用原位核酸杂交技术检测Shh、Ptc、Gli1 mRNA在对照组、模型组（6w）、模型组（14w）、模型组（22w）大鼠肝脏癌变过程中的表达变化.结果 在模型组（6w）大鼠肝脏的肝小叶周边可见嗜酸性、气球样变性等肝细胞损伤的表现,模型组（14w）大鼠肝脏中可见肝假小叶和非典型增生结节,模型组（22w）大鼠肝脏中可见到高分化的肝细胞癌结节.Shh、Ptc、Gli1 mRNA阳性表达细胞主要分布在大鼠肝脏中的肝细胞损伤区、增生结节、癌结节、小叶间胆管上皮和癌旁组织中,Shh、Ptc、Gli1 mRNA在模型组的大鼠肝组织中表达的平均光密度值均高于对照组.结论 Shh信号通路在诱癌过程中异常激活,可能促进肝损伤后的正常修复、异常增殖及肝细胞癌变过程.     

RAB5A基因表达改变对人肺腺癌细胞系GLC-82和SPC-a1的分化和侵袭特性影响

为探讨RAB5A基因对两种人肺腺癌细胞系GLC－82和SPC－al分化及侵袭特性的影响。利用细胞转染技术将构建的RAB5A反义RNA重组质粒（pcDNA3-AntiRAB5A)和RAB5A正义真核表达载体分别转染入低分化人肺腺癌细胞系GLC－82和低转移人肺腺癌细胞系SPC－al中,在稳定筛选后,通过裸鼠体内实验和体外人工基底膜侵袭和细胞趋化运动实验,观察观察转染后细胞分化和转移特性的改变,观察转染前后细胞,发现转染后GLC－82细胞体外侵袭重组基底膜能力及趋化运动能力降低（t检验P＜0．02）;裸鼠体内成瘤实验,瘤块切片病理观察转染后GLC－82细胞出现腺腔样及基底模样结构,分化程度增高,转染后SPC－al细胞体外趋化运动能力,侵袭重组基底膜能力均增强(t检验P＜0．02）。RAB5A基因通过影响细胞的体外趋化运动能力,侵袭重组基底膜能力等对GLC－82和SPC－al细胞的侵袭表型形成及GLC－82细胞的分性发挥重要作用。     

hMSH2、PCNA和结核菌L型感染与前列腺癌的相关性研究

【摘 要】 目的 探讨hMSH2(human muts homolog2)基因、增殖细胞核抗原（proliferating cell nuclear antigen,PCNA）和结核菌L型感染在前列腺癌中的表达及相关性研究。方法 应用免疫组化和抗酸染色等方法检测了65例前列腺癌（carcinoma of prostate,PCa）和30例良性前列腺增生(benign prostatic hyperplasia,BPH)中的hMSH2、PCNA蛋白的表达以及结核菌L型的检出率,并对前列腺癌主要临床资料和病理分级参数进行比较,用卡方（χ2）检验进行统计学处理。结果 hMSH2、PCNA蛋白在PCa中的表达明显高于BPH（P<0.01）。前列腺癌中临床分期Ⅲ、Ⅳ期hMSH2、PCNA蛋白的表达明显高于Ⅰ、Ⅱ期（P<0.01）;随着病理分级增高而显著增加（P<0.01）。结核菌L型的检出率与PCa的病理分级、临床分期差异具有统计学意义（P<0.01～0.05 ）。结核菌L型阳性患者中hMSH2表达率[97.2%（35/36）]明显高于结核菌L型阴性患者中hMSH2阳性表达率[31.0%(9/29)];结核菌L型阳性患者中PCNA表达率[94.4%（35/36）]明显高于结核菌L型阴性患者中PCNA阳性表达率[55.2%(16/29)]。结论 hMSH2、PCNA基因在前列腺肿瘤中有不同程度的异常表达,在前列腺癌的发生和发展中起重要的促进作用。结核菌L型感染极有可能导致基因的突变或过表达,因此L型感染可能成为诱发肿瘤形成的原因之一,它们相互协同在前列腺肿瘤发生和发展过程中起重要作用。     

EBV编码miRNAs在病毒感染和肿瘤发生中的功能和意义

EB病毒(Epstein-Barr virus,EBV)是一种172 kb大小的线性双链DNA病毒,与鼻咽癌、淋巴瘤、胃癌等恶性肿瘤的发生密切相关. EBV编码的微小RNAs (miRNAs)可以调节病毒和宿主细胞基因的表达,并且在癌症发生发展中起着多种作用.本文综述了EBV编码的miRNAs (EBV-encoded miRNA,EBV miRNAs)在病毒感染和肿瘤发生、侵袭转移、抗凋亡、信号通路等方面的生物学功能,以及对于EBV相关肿瘤诊断标志物的潜在意义. EB病毒编码的miRNAs也可能成为进一步研究EBV相关肿瘤治疗的一个候选靶点.     

An aptasensor for rapid and sensitive detection of estrogen receptor alpha in human breast cancer

The analysis of estrogen receptor (ER) expression in breast carcinomas plays a crucial role in determining the endocrine responsiveness of tumors for systemic adjuvant therapy. Conventionally, the ER levels in breast carcinomas had been detected using the dextran-coated charcoal assay and radioimmunoassay, which are now substituted with safer and economic antibody-based assays such as immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA). Despite a gold (Au) standard method, the IHC has been criticized for factors such as tissue fixation, antibody selection, and threshold staining for result interpretation that could falsify test accuracy and reproducibility. The quest for alternative methods of ER quantification in tissue samples paved the way for aptamer-based diagnostics. Previously, we have isolated a DNA aptamer against human ER alpha (ERα) using an in vitro evolution system. In this study, we developed an electrochemical sensor using the 76-nucleotide DNA ERα- aptamer for rapid, precise, and cost-effective detection of ERα expression in human breast cancer patients. The aptasensor was constructed by covalently immobilizing the thiolated ERα- aptamer onto a screen-printed Au electrode. Construction of aptasensors was confirmed through atomic force microscopy and differential pulse voltammetry measurements. A detection limit of 0.001 ng/ml was calculated for full-length ERα (66.2 kDa) in a detection time of 10 min. Analysis of the cancerous breast tissue samples using the ELISA and aptasensor methods enabled distinctive classification of samples into the categories of ER −ve, weak ER +ve, and strong ER +ve samples. The current change of this aptasensor lies within 5% after a storage of 60 days at 4°C. Further studies on a reasonably large sample size are required to realize the clinical potential of the sensor.     

Targeting human CALR‐mutated MPN progenitors with a neoepitope‐directed monoclonal antibody

Calreticulin (CALR) is recurrently mutated in myelofibrosis via a frameshift that removes an endoplasmic reticulum retention signal, creating a neoepitope potentially targetable by immunotherapeutic approaches. We developed a specific rat monoclonal IgG2α antibody, 4D7, directed against the common sequence encoded by both insertion and deletion mutations. 4D7 selectively bound to cells co‐expressing mutant CALR and thrombopoietin receptor (TpoR) and blocked JAK‐STAT signalling, TPO‐independent proliferation and megakaryocyte differentiation of mutant CALR myelofibrosis progenitors by disrupting the binding of CALR dimers to TpoR. Importantly, 4D7 inhibited proliferation of patient samples with both insertion and deletion CALR mutations but not JAK2 V617F and prolonged survival in xenografted bone marrow models of mutant CALR‐dependent myeloproliferation. Together, our data demonstrate a novel therapeutic approach to target a problematic disease driven by a recurrent somatic mutation that would normally be considered undruggable.