Objective To investigate the expression and clinical significance of tumor-associated macrophages (TAMs) in invasive micropapillary carcinoma (IMPC) of breast.Methods Immunohistochemical streptavidin-biotin method(LSAB) method for CD68 and CD163 were performed on 68 cases of IMPC and 72 cases of invasive ductal carcinoma,not otherwise specified(IDC-NOS).Results CD68 and CD163 were mainly expressed in IMPC interstitial macrophages in the cytoplasm or on the membrane,and occasionally expressed in tumor nest.CD68 positive rate in tumor stroma in IMPC (47/68,69.1％) was higher than in IDC-NOS group (37/72,51.5％),and the difference between the two groups was statistically significant (P =0.022).CD163 positive rate in tumor stroma between the two groups was not statistically significant(P =0.682).CD68 + macrophages in IMPC stroma were positively correlated with pathological stage,histological grade,lymph node metastasis,vascular invasion,and Ki67 expression(P ＜ 0.05),and inversely correlated with the expression of ER(P =0.037).Univariate analysis showed that CD68 + macrophages in the stroma of IMPC were significantly associated with progression-free survival(P =0.027),Conclusion The expression of TAMs was different in different types of breast carcinoma and widely expressed in IMPC,which may play a significant role in high invasion and metastasis behavior of IMPC.

Objective To analyze the characteristics of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in hypovascular renal tumors,and to explore the application value of combining the 2 methods in diagnosing benign and malignant hypovascular renal tumors.Methods The conventional ultrasound and CEUS data of 104 hypovascular renal tumors(76 benign lesions[benign group]and 28 malignant lesions[malignant group])from 99 patients,who were confirmed by postoperative pathology,biopsy pathology or computed tomography(CT)/magnetic resonance imaging(MRI)enhancement combined with long-term follow-up in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine and its Wuxi Branch from Oct.13,2009 to Oct.26,2022,were retrospectively analyzed.The location,size,internal echo,morphology,internal and peripheral blood supply of the lesions were observed by conventional ultrasound,and the perfusion mode,regression pattern,perfusion uniformity and ring enhancement signs were observed by CEUS.Taking the pathological results or confirmed results of CT/MRI enhancement combined with long-term follow-up as the gold standard,the value of conventional ultrasound combined with CEUS in the differential diagnosis of benign and malignant hypovascular renal tumors was analyzed.Results There were significant differences in gender,age of patients and internal echo,contrast agent regression and ring enhancement signs of lesions between the 2 groups(all P＜0.05).The malignant tumors were mostly found in males(78.6％,22/28)with an average age of(58.29±11.76)years old;the masses were mostly hypoechoic(64.3％,18/28),and rapid washout was predominant with CEUS(60.7％,17/28).In the benign group,most of the patients were female(55.3％,42/76),with an average age of(50.64±14.88)years old;the majority of the masses were hyperechoic(64.5％,49/76),and CEUS showed simultaneous washout as the main lesion(56.6％,43/76).Three patients(10.7％,3/28)with ring enhancement signs were all malignant.The diagnostic accuracy(82.7％)and specificity(88.2％)for benign and malignant hypovascular renal tumors were relatively high when combining the diagnostic indicators of ring enhancement signs and hypoechoic.The diagnostic sensitivity(85.7％)and negative predictive value(92.3％)were relatively high when combining the 3 diagnostic indicators of ring enhancement,hypoechoic,and rapid washout.Conclusion Conventional ultrasound combined with CEUS has significant clinical practical value in the differential diagnosis of benign and malignant hypovascular renal tumors.The ring enhancement sign is highly specific in the diagnosis of malignant hypovascular renal tumors.However,if this sign is not significant and conventional ultrasound shows hypoechoic or CEUS exhibits rapid washout,there is a strong suggestion that the mass may be a malignant lesion.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS)in differential diagnosis between benign and malignant gallbladder lesions which diameter more than 1 cm.Methods A retrospective analysis included CEUS data of 142 cases with gallbladder lesions diameter more than 1 cm.All lesions were confirmed by surgical pathology,enhanced CT/MRI or clinical diagnosis with following up more than 2 years.To summarize the CEUS characteristics of benign and malignant gallbladder lesions over 1 cm in diameter,the CEUS characteristics of benign and malignant gallbladder lesions diameter more than 1 cm were analyzed,referring to the gallbladder CEUS guidelines.The contrast medium washout before 35 s and 60 s were used as the combined diagnosis with CEUS standard to identify gallbladder cancer,and the diagnostic efficiency was calculated respectively.Results There were statistical differences between the malignant group and the benign group in terms of CEUS enhancement pattern,contrast arrival time,washout time,and gallbladder wall continuity,as well as enhancement levels(P<0.001).The sensitivity,specificity,accuracy in the diagnosis of gallbladder malignant lesions were 93.0%,83.8%,and 86.6%based on CEUS standard.The sensitivity,specificity and accuracy of diagnosis gallbladder malignant lesions were increased to 93.0%,92.9%and 93.0%when combined with washout before 35 s of contrast medium.Conclusions CEUS is highly valuable in differentiating benign and malignant gallbladder lesions diameter more than 1 cm.Combined with contrast medium washout before 35 s is helpful to improve the ability of differentiating benign and malignant gallbladder lesions.