Objective: To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis.Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffi-nembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously.Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54.2 years and a median age of 55 years.Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations.Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter.Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens.Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas.Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells.Both types of cells absented cytologic atypia.Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1.These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls.Conclusion: LCA is a benign lesion, which frequently occurs in the elderly.Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases.The littoral cells in LCA show a hybrid endothelial-histiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes.Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.

Objective:To investigate the expression and diagnostic values of CD200 and insulinoma associated protein 1 (INSM1) in gastrointestinal and pancreatic neuroendocrine neoplasm (GIP-NEN).Methods:The expression of CD200, INSM1, Syn and CgA was detected in 69 cases of GIP-NEN, 66 cases of gastrointestinal and pancreatic non-neuroendocrine neoplasm (GIP-nonNEN) and 16 cases of metastatic neuroendocrine neoplasm by immunohistochemistry, to compare the values of CD200, INSM1, Syn, CgA and their combinations in diagnosing GIP-NEN. Receiver operating characteristics (ROC) curve was used.Results:The immunoreactivity of CD200 was present in the cytoplasma and/or membrane of the neoplasms cells, the positive expression rates in GIP-NEN and GIP-nonNEN were significantly different ( P<0.01). The sensitivity and specificity of CD200 for diagnosing GIP-NEN were 95.7% and 78.8%, respectively. There was significant difference of the positive rates of CD200 between neuroendocrine tumor and neuroendocrine carcinoma ( P=0.05). The immunoreactivity of INSM1 was present in the nuclei of neoplasms cells. The positive expression rates in GIP-NEN and GIP-nonNEN were significantly different ( P<0.01). The sensitivity and specificity of INSM1 for diagnosis of GIP-NEN were 85.5% and 95.5%, respectively. There were also significantly different positive rates of INSM1 between neuroendocrine tumor and neuroendocrine carcinoma, as well as between G1 and G3 neuroendocrine tumors ( P<0.05). There was no difference in the area under ROC curve (AUC) of single stain of CD200, INSM1, Syn or CgA (0.857, 0.907, 0.890 and 0.833, respectively, P>0.05). The sensitivity of combined CD200+INSM1 stains for diagnosing GIP-NEN was significantly higher than that of Syn+CgA (85.5% vs. 63.8%, P<0.05). The AUC of two combinations were 0.962 and 0.925, respectively, which were not statistically different ( P>0.05). Conclusions:CD200 and INSM1 are two novel markers of neuroendocrine neoplasm, which aid to diagnosis for GIP-NEN and exclude its mimickers. They are associated with tumor grades. Combining both as an immunohistochemical panel shows high sensitivity and specificity. Thus, the combined panel can be utilized as useful supplement for Syn and CgA.

Objective To detect the expression of acrosin binding protein(ACRBP)in serum and tumor tissue of patients with epithelial ovarian cancer(EOC),and to investigate the relationship between the expres-sion of acrosin binding protein(ACRBP)in serum and tumor tissue of patients with epithelial ovarian cancer(EOC)and first-line chemotherapy effect and prognosis.Methods The expression and prognostic effects of ACRBP mRNA in OC were analyzed using data obtained from Gene Expression Profiling Interactive Analysis Database.Then,tissue specimens and serum samples were collected from 95 patients with EOC who under-went surgery at the hospital between October 2019 and December 2021.In addition,30 samples of ovarian be-nign tumor tissue were selected as the benign tumor control group and 30 serum samples from healthy volun-teers were selected as the normal control group.The expression of ACRBP was detected by immunohisto-chemical staining.After first-line chemotherapy was completed,solid tumor efficacy evaluation criteria version 1.1 was used to evaluate chemotherapy effects,and the patients were divided into sensitive group and drug-re-sistant group.The sensitive group included complete response(CR)and partial response(PR)patients,and the drug-resistant group included stable disease(SD)and progressive disease(PD)patients.Results In the public database,ACRBP mRNA expression was significantly increased in OC patients(P＜0.05),and its high expression was associated with poor overall survival(OS).In clinical samples,ACRBP was mainly expressed in the cytoplasm of EOC tumor cells,while no ACRBP was detected in the ovarian tissues of benign tumor control group.The expression of ACRBP in first-line chemotherapy resistant group was significantly higher than that in sensitive group,and the difference was statistically significant(P＜0.001).The area under receiv-er operating characteristic(ROC)curve of ACRBP expression for predicting first-line chemotherapy resistance was 0.830(95％CI:0.743-0.916),the cut off value was 8.65 points,and the sensitivity and the specificity were 80.0％and 77.1％,respectively.High expression of ACRBP was an independent risk factor for the prog-nosis of OS and PFS in patients with EOC(P＜0.05).According to the median expression of ACRBP,pa-tients with EOC were divided into low ACRBP expression group(＜8.27 points)and high ACRBP expression group(≥8.27 points).The OS and progression-free survival(PFS)of patients with high expression of ACRBP were significantly shorter(P＜0.05).Conclusion High expression of ACRBP in EOC patients is closely related to first-line chemotherapy resistance and poor prognosis.ACRBP has the potential to be a new biomarker for the prediction of first-line chemotherapy effect and prognosis.