Objective To investigate the clinical pathological features and prognosis of gastric carcinoma with neu-roendocrine differentiation (NED) and mixed gonadal neuroendocrine carcinoma of the stomach (MANECs). Methods A retrospective analysis of 61 cases of gastric carcinoma with NED and 34 cases of MANECs and their histochemistry and im-munohistochemistry were also observed. Prognosis of the 2 groups were compared by the Kaplan-Meiers survival analysis. Prognostic factors associated with patients with gastric cancer were analyzed by COX proportional hazards model. Results Tumor location, distant metastasis and lymph node metastasis were statistically different between these 2 groups (P<0.05). Syn positive expression rate is higher than CgA and CD56 in the gastric carcinoma with NED group;Postoperative survive pe-riod of the gastric carcinoma with NED is shorter than that of MANECs (P<0.05). Lymph node metastasis and distant region-al transfer is obviously correlated with prognosis (P<0.05). Conclusion Immunohistochemistry is important for the diag-nosis of these two tumor. The number of neuroendocrine cells can help to assess prognosis and guide treatment.

Objective To investigate the pathologic characteristics of skip metastases of mediastinal lymph node in lung cancer. Methods Of 398 lung cancer patients who underwent radical resection and extensive lymph node dissection. 47 patients were diagnosed as with skip N 2 metastases, and their mediastinal lymph nodes were analyzed. Results The skip N 2 metastases of lung cancer appeared as single group or multi-group. The commonest metastatic site was the 7th group lymph node (28.4%), then the 4th, 3rd and 5th group, rating 24.2%, 15.8% and 10.5%, respectively. For cases with squamous cell carcinoma or adenocarcinoma, no any skip N 2 metastasis occurred for the tumor less than 1 cm in diameter, for tumor greater than 1 cm in diameter, the skip N 2 metastasis increased with tumor size. The incidence skip N 2 metastasis of low-grade differentiated adenocarcinoma was significantly higher than high-grade differentiated adenocarcinoma (P

Objective To analyze the clonal gene rearrangement and complementarity determining region 3 (CDR3) repertoire of TCR β-chain in fine needle aspiration biopsy (FNAB) specimens of lymph node metastasis in patients with breast cancer. Methods The TCR CDR3 region genes of 24 TCR Vβ subfamilies were amplified by utilizing RT-PCR technology, and the CDR3 lengths of TCR β-chain were analyzed with gene scan technology for 2 cases with lymph node reactive hyperplasia and 3 patients with lymph node metastasis of breast cancer. The clonality of T cells presumed by spectra typing was further confirmed by CDR3 sequencing. Results TCR β-chain presented specific repertoire skewing in metastatic lymph node,and only 3-5 TCR Vβ subfamily of T cells were identified, respectively. Clonal expanded T cells, including oligoclonal, polyclonal patterns, in one or more Vβ subfamilies were found in all cases. The oligoclonal expanded T cells had different CDR3 amino acid sequences. Conclusion There are characteristic T cells cloning proliferation and selected usage of TCR Vβ subfamily T cells could be found in metastatic lymph node.The sequences of CDR3 in different TCR clone proliferation are mostly different.

Objective To detect the expression of tumor‐associated macrophages(TAM) in esophageal squamous cell carci‐noma ,and to study the clinical pathological characteristics of T AM in the esophageal squamous cell carcinoma .Methods Patients with esophageal squamous cell carcinoma who accepted operation were chosen as study subjects ,and tissue samples of esophagus were collected ,including 90 squamous cell carcinoma tissues ,20 paracancerous atypical hyperplasia and 20 normal mucosa tissues , and the expression of CD206 ,MCP‐1 were detected by immunohistochemisty .Results The positive expression of CD206 was sig‐nificantly increased in tissues of esophageal squamous cell carcinoma (P<0 .01) ,and it was positively correlated with clinical stage , invasion depth and lymph node metastasis in esophageal squamous cell carcinoma (P<0 .05) .The expression of MCP‐1 was signifi‐cantly increased in esophageal squamous carcinoma tissues (P<0 .05) ,and its positive expression was closely correlated with depth of invasion and lymph node metastasis in esophageal squamous cell carcinoma (P< 0 .05) .There was a positive relation between ATM infiltration quantity and the expression of MCP‐1(r=0 .617 ,P<0 .05) .Conclusion The positive expression of TAM was up‐regulated in esophageal squamous cell carcinoma tissues ,and its number was positively correlated with clinical stage ,invasion depth and lymph node metastasis .

Objective To evaluate the gene amplification and protein expression of HER-2 in gastric carcinoma with or without neuroendocrine differentiation (NED), and to explore the difference in HER-2 gene profile between these two neo?plasms. Methods Cases of gastric carcinoma with NED (n=70) and cases of gastric carcinoma without NED (n=150) were retrospectively reviewed. Gene amplification and protein expression of HER-2 genes in gastric carcinoma with or without NED were detected by combination of immunohistochemical method (IHC) and double color silver dye for in situ hybridiza?tion (DISH). Prognosis of gastric cancer patients with NED were predicted using Kaplan-Meiers survival analysis. Results Expression rates of HER-2 in gastric cancer with and without NED are 20.00%and 21.33%respectively. Amplification of HER-2 in gastric cancer with and without NED are 8.57%and 14.67%respectively. Gene amplification and protein expres?sion of HER-2 between gastric cancer with NED and without NED showed no statistical difference. Chromosome 17 multi-body positively correlated with gene HER-2 amplification in Gastric carcinoma with NED. Postoperative survival period in patients of gastric carcinoma with NED and HER-2 amplification was shorter than that in patients of gastric carcinoma with?out NED but with HER-2 amplification. Gastric carcinoma with or without NED, HER-2 gene amplification, lymph node me?tastasis and operation method obviously correlate with prognosis of gastric carcinoma patients (P<0.05). Conclusion The gastric cancer with NED is a special type of gastric cancer, there was no difference of gene amplification and protein expres?sion of HER-2 gene between gastric carcinoma with NED and without NED. Poor prognosis would be expected in gastric can?cer patients with NED and HER-2 amplification.

Objective To analyze the restricted usage of TCRβ V/J subfamily and CDR3 repertoire in patients with peripheral T-cell lymphoma unspecified (U-PTL).Methods The total RNA was respectively extracted from lymph node of U-PTL and reverse transcriptase,then multi-PCR was used to amplify the complete DNA sequence(CDS) of TCR β-chain.The recombinant plasmids were sequenced and sequence was analyzed by using online TCR resources.Results There were 9 TCR β chain CDS obtained from four patients.TCRβ-chain presented specific repertoire skewing in patients with U-PTL.There were restricted usage of BV2,BV4S2,BV14,BV29S1 of BV subfamily and BJ1S4,BJ2S3,BJ2S5,BJ2S7 of BJ subfanily.The clonal proliferation T cells had different CDR3 amino acid sequences.Conclusions There are restricted usage of TCR β V/J subfamily in patients with U-PTL.The sequences of CDR3 in different TCR clone proliferation are mostly different.

Objective To analyze the restricted usage of TCR BV,BJ subfamily and their sequences in patients with breast cancer.Methods The total RNA was extracted from tissues of lymph node metastasis,then reverse transcripted.The complete DNA sequence of TCR β-chain was amplified by multi-PCR.The recombinant plasmids were sequenced by using online TCR resources.Results 5 TCR β-chain CDS were obtained in two patients.TCR β-chain presented specific repertoire skewing in metastatic lymph node.There were selected usage of BV 2,BV 14,BV 29S1 of BV subfamily and BJ1S1,BJ2S2,BJ2S3,BJ2S5 of BJ subfamily.The clonal proliferation T cells had different CDR3 amino acid sequences.Conclusions There are selected usages of TCR BV,BJ subfamily in patients with breast cancer.The sequences of CDR3 are mostly different in TCR clone proliferation.

Objective To analyze the elonal gene rearrangement and complementarity determining region 3 (CDR3) Repertoire of TCR β-chain in fine needle aspiration biopsy (FNAB) specimens of peripheral T-cell lymphoma. Methods The TCR CDR3 region genes of 24 TCR Vβ subfamilies were amplified by utilizing RT-PCR technology, and the CDR3 size lengths of TCR β-chain were analyzed with genesean technology for 4 healthy individuals and 4 patients with peripheral T-cell lymphoma. The clonality of T cells presumed by spectratyping was further confirmed by CDR3 sequencing. Results TCR β-chain presented specific repertoire skewing in 4 cases with peripheral T-cell lymphoma, and only 1-4 TCR Vβ subfamily T cells were identified, respectively. Clonal expanded T cells, including mono, bioclonal and oligoclonal trend patterns, in one or more Vβ subfamilies were found in all cases. The mono expanded T cells have different CDR3 amino acid sequences. Conclusion Characteristic T cells cloning proliferation and selected usage of TCR Vβ subfamily T cells were found in 4 cases with peripheral T-cell lymphoma. The sequences of CDR3 in different TCR clone proliferation are different.

BACKGROUNDTo investigate pathologically the characteristics of proximal bronchial invasion of lung cancer, and to provide the theoretic basis for the selection of a proper operation mode.

METHODSA total of 398 patients with lung carcinoma underwent radical pulmonectomy and systematic lymphadenectomy. The proximal bronchi and the hilar and mediastinal lymph nodes of their operatively resected specimens were selected for pathological study.

RESULTS(1)The direct invasion of cancerous cells through mucous, submucous or multiple layers was the most frequent way during lung cancer spread, rating 9.3%, 21.8% and 68.9% respectively. 96.4% of the cancerous invasion occurred at the proximal bronchial wall less than 1.5 cm apart from the cancer margin. The extension of invasion correlated with the histopathologic type of cancer, mode of invasion and TNM classification. (2)The cancer infiltration by the nodes metastasizing into the bronchus wall (bronchial external tunica or cartilage) was also an important way for the cancer to spread, especially in adenocarcinoma. The poor differentiated adenocarcinoma has significantly higher metastatic rate and infiltration rate than the well differentiated ( P < 0.01, P < 0.01). There were 22 such cases, including 3 of lobar bronchus wall invaded by N1 metastasis and 19 of main bronchus wall by N2 metastasis.

CONCLUSIONSFor radical removal of tumor, the key point for selecting a rational operation mode is to keep a distance of 1.5 cm or more between the excision margin of the bronchus and the tumor, to pay attention to the bronchial wall invasion caused by the metastatic lymph nodes, even in peripheral adenocarcinoma, and to dissect extensively and completely the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity.

【Objective】 To compare the results by minipool and individual NAT on blood samples with HBsAg detection S/CO value between 0.25-0.90 by ELISA, in order to re-evaluate the safety of NAT for such negative samples with high HBsAg S/CO value and provide references for the optimization of detection process. 【Methods】 A total of 30 blood samples which were non-reactive for HBsAg by ELISA twice and with the S/CO value of any reagent between 0.25-0.90 (defined as " high S/CO value negative" ) from our center from February to October 2020 were collected, and minipool test of 6 samples and individual test were performed in parallel. 11 samples which were negative by minipool tests but positive by individual test were submitted to repeated NAT minipool tests, and the results of each test were recorded and analyzed. 【Results】 The median S/CO values of the 30 samples by two ELISA reagents were 0.565 and 0.320, respectively, and the differences were statistically significant (P<0.01). The NAT yield of primary minipool and individual NAT was 13.33% (4/30) and 76.67% (23/30), respectively, and the differences were statistically significant (P<0.05). Eleven samples, minipool NAT negative but individual NAT positive, were subjected to repeated minipool NAT. One remained negative throughout the 10 times of repeated minipool NAT test, and 10 (90.91%) presented positive results at least once. The repeated positive rate was 5.88% (1 /17) -70.00% (7/10). The Ct value of NAT ranged 34.4-38.5 (median 36.76) in the primary minipool test, 29.6-42.8 (median 36.50) in the individual test, and 36.1-56.0 (median 37.75) in repeated minipool test afterwards. The Ct value was significantly different between repeated minipool tests and individual tests (P<0.01), but not between repeated minipool tests and primary ones (P> 0.05). 【Conclusion】 The NAT-yield of samples with high ELISA HBsAg S/CO value was high in individual test and low in minipool test, and the NAT-yield in minipool test could be improved by repetitive test. Therefore, the safety of NAT for samples with high HBsAg S/CO value should be re-evaluated as minipool test is dominant in blood stations. Individual NAT test is recommended for such samples currently as there is no any other more sensitive detection approaches.