Purpose To investigate the value of cytopathological diagnosis in combination with histopathological diagnosis for peripherial and diffuse lung diseases by biopsy specimens under CT guidance.Methods A total of 370 cases of lung biopsy specimens under CT guidance were reviewed.The correlation between cytopathological diagnosis and histopathological diagnosis was analyzed.The sensitivity and false negative rate of cytopathological diagnosis,histopathological diagnosis and the combinational diagnosis method were calculated,and the accordance rate of cytopathological diagnosis with histopathological diagnosis was analyzed.Results Among the 370 cases,histopathological diagnosis revealed 177 (47.84％) cancers,22 (5.95 ％) malignant tumors,16 (4.32％) suspicious malignancy,12 (3.24％) atypical cells and 143 (38.65 ％)negative findings,whereas the corresponding number for cytopathological diagnosis were 166(44.87％),10(2.70％),16(4.32％),49(13.24％)and 129(34.87％).The two diagnosis methods were correlated (P ＜ 0.001).The sensitivity of cytopathological diagnosis,histopathological diagnosis and the combinational method were 80.00％ (192/240),89.58％ (215/240) and 98.33％ (236/240),respectively.The eytopathologieal diagnosis and the histopathologieal diagnosis had a statistically significant difference in the sensitivity (P ＜ 0.05).The difference in sensitivity between the combinational method and the histopathological diagnosis was statistically significant(P ＜ 0.05).Overall,66.15％ (127/192) of the cytopathogically positive cases were precisely typed by cytopathological diagnosis.Complications during or after the operation were found in 14.59％ of cases,among which 31 had pneumothorax and 23 had bleeding in the needle passage or bloody sputum,all improving after appropriate treatment.Conclusion Percutaneous lung biopsy under CT guidance is a safe,sensitive and accurate method for diagnosis of lung diseases,and the combinational use of cytopathological diagnosis and histopathological diagnosis significantly increases the rate of diagnosis and has a favorable clinical application value.

Purpose To investigate the clinicopathologic and immunohistochemical features,and differential diagnosis of nephrogenic metaplasia (NM).Methods The clinical data,histological and immunohistochemical characteristics of 6 cases of NM were analyzed,with review of the literature.Results There were 1 case of female,5 cases of male,aged from 31 to 81 years,with average of 58.1 years.The history revealed lithiasis of urologic tact in 2 cases,previous transurethral resection for benign prostatic hyperplasia or cystitis glandularis in 3 cases,and concurrent urothelial carcinoma in 1 case.The lesion involved in the ureter in 3 cases,prostatic urethra in 2 cases,and bladder trigone in 1 case.Cystoscopic examination demonstrated mucosal rough or low villous protrude.Microscopically,the lesion was consisted of tubules,cysts,small nests and papillary structures with basement membrane-like eosinophilic sheath,and lined by cuboidal,or low column epithelial cells with cytological atypia in some area,and shown inflammation in stroma.Immunohistochemically,there was positive staining for PAX2,PAX8,CK7 and P504S,negative for p63,CD10,and PSA.Conclusion NM is a rare tumor-like lesion often with injure of urologic tract,and should be differential with urothelial carcinoma,prostatic carcinoma,clear cell adenocarcinoma and endometriosis.It's important to know the clinicopathological and immunohistochemical features of NM for the correct interpretation.

Purpose To assess the clinical and pathological features of small gastrointestinal stromal tumours (sGIST).Methods To reevaluated the clinical,histological and immunohistochemical parameters of 21 sGISTs.The standard immunohistochemical panel antibodies were studied on the tumor sections.All data were compared with clinical sGIST.Results There were a total of 7 females and 14 males of sGISTs.The median age was 63 years old.The tumors were predominantly located in the stomach showing a spindle cell morphology and the tumor sizes ranged from 0.5 cm to 1.5 cm.9 sGISTs combined with malignant tumors,which were gastric cancer have been incidentally detected during surgery.As the lesions were small in size,with infrequent bleeding,necrosis,mucosal invasion,ulceration and less mitotic index,sGISTs reoccurred less compared with clinical sGIST.p53,Ki-67 labeling index and microvascular density (MVD) in sGIST were significantly lower than clinical sGIST (P ＜ 0.05).Conclusion sGIST may occure with digestive tract cancer synchronously.p53,Ki-67 labeling index and MVD were lower than clinical GIST,which means better prognosis.

Purpose Investigating the significance of ZO-1 different domains in the invasion and metastasis of gastric carcinoma (GC).Methods A tissue microarray that simulates the invasion and metastasis process of GC was created,and immunohistochemistry was performed to detect the expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5).Results The GC cell exhibited aberrant expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5) from membrane translocated to cytoplasm or no expression.The aberrant degree was increased with the invasion,however,was decreased in metastatic lymph node.The aberrant expression was associated with histological types.Conclusion The aberrant expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5),from membrane translocated to cytoplasm or no expression suggest that domains of PDZ3,GUK,SH3,ZU5 and alpha motif in ZO-1 might be involved in the invasion and metastasis of GC and maintaining of GC phenotype.The aberrant expression of these domains may be the one mechanism of ZO-1 involved in EMT or MET.

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis of myxoid synovial sarcoma (MSS).Methods Clinicopathological changes and immunophenotype were retrospectively evaluated in two MSS cases collected from Fujian Provincial Hospital,conbined with genetic mutation analysis.The relevant literatures were reviewed to explore its clinical and pathological features of this tumor.Restilts The two cases,one man and one woman,aged 71 and 15years,respectively.Tumor was located in the left down abdomen in case 1,and left frontal temporal lobe in case 2.Histopathologically,at low magnification in case 1,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In some areas of hypocellularity,the tumor cells were arranged in fascicular,story-form,sheet arrangements with mucoid degeneration.In hypercellularity area,the tumor cells were arranged in fascicular,fish bone-liked arrangenents.At low magnification in case 2,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In hypocellularity area,the tumor cells were arranged in net-like,sheet arrangements,and fascicular,sheet arrangements in case 2.In some area,the tumor cells were epithelioid with cluster distribution,without infringing brain tissue.Immunohistochemically,the tumor cells were diffusely positive for BCL-2,vimentin,and α-SMA and EMA were partially positive,while CD34,CD57,S-100,CD117,PLAP were negative.However,in case 2,only BCL-2 was positive,and MyoD1,GFAP,Olig-2,EMA,Syn,CD99,CgA,S-100,Myogenin,STAT6,CD34,desmin and α-SMA were negative.Molecular detection SYT-SSX fusion gene was detected in both cases.Conclusion MSS is a rare malignancy of soft tissue.The diagnosis of MSS depends on molecular pathology.The clinical and pathological findings are different from mucinous fibrosarcoma and solitary fibrous tumor.The treatment is surgical resection,combined with radiotherapy,with poor prognosis.

Purpose To study the expression of HK2 in human prostate cancer (PCa) tissues and its effect on malignant phenotype of prostate cancer cells.Methods HK2 expression in PCa tissues was determined by microarray database and immunohistochemical staining.Subsequently,the change of cellular phenotype was detected by glycometabolism kit,CCK-8 kit,and flow cytometry after HK2 knockdown.Results HK2 expression was elevated followed by prostate cancer development.HK2 depletion inhibited cellular proliferation and aerobic glycolysis,and increased the ratio of early apoptosis.Conclusion HK2 expression increases in the process of PCa malignant progression.It plays a critical role in cellular proliferation,glycometabolism,and apoptosis,the mechanism of which needs further exploration.

To explore the significance of the application of standardized special staining technique in pathologic diagnosis of pulmonary fungal infectious diseases.Methods Final pathologic diagnosis of 104 cases pulmonary fungus infection disease in Beijing Chaoyang hospital from September 2011 to March 2016 were selected;HE staining only,HE staining combined with the traditional manual special staining method PAS and hexamine silver,and HE staining combined with automatic special staining PAS and hexamine-silver were used and compared.The two kinds of special staining technology were compared;the microscopic observation,analysis results (all the first staining results,not including the results of complex staining),the results on the basis of final pathologic diagnosis were also compared with the clinical preliminary diagnosis.Results Lung fungal infectious disease diagnosis rate and fungal classification rate,from low to high order consistence,showed that for the primary clinical diagnosis (29.8％ and 19.2％),HE staining (32.7％ and 32.7％),HE staining combined with traditional manual special staining method PAS and hexamine silver (90.4％ and 87.5％),and HE staining combined with automatic special staining PAS and hexamine-silver (98.1％ and 94.2％).The four methods were statistically significant on two aspects (P ＜ 0.01,P ＜ 0.01);the fourth method was significantly different from the first two (P ＜ 0.01,P ＜ 0.01).The fourth method was significantly different from the third kind of diagnosis rate (P ＜ 0.05),typing rate was no significant difference (P ＞ 0.05).But automatic special dyeing method of PAS and hexamine silver steps were more simple,with standardized chemical reagents,no artificial and environmental factors,short time-consuming,and less number of dropping-off and restaining of the section.Conclusion HE staining and its combination with automatic special staining of PAS and hexamine silver are much more standardized,and help to improve the diagnosis of pulmonary fungal infectious diseases and fungal classification rate.

To investigate the expression of CMaf inducing protein(CMIP) in human laryngeal squamous cell carcinoma and polyps tissues,and to analyze their association with clinicopathological parameters and survival of patients with laryngeal squamous cell carcinoma.Methods Real-time PCR assay was used to detect the expression of CMIP mRNA in 28 cases of laryngeal squamous cell carcinoma and 23 cases of polyp fresh tissue specimen.Immunohistochemical staining was used to detect the expression of CMIP in 86 cases of formalin-fixed and parrffin-embedded laryngeal squamous cell carcinoma and 29 cases of polyp tissue specimens.The clinicopathological and prognostic significance of CMIP expression was investigated in laryngeal squamous cell carcinoma.Results The expression of CMIP mRNA and protein was both significantly increased in laryngeal squamous cell carcinoma compared with polyp tissue specimens.The expression of CMIP was significantly associated with tumor lymph node metastasis and late clinical stage of laryngeal squamous cell carcinoma.Furthermore,the expression of CMIP was significantly correlated with poor relapse-free survival and overall survival in laryngeal squamous cell carcinoma.Conclusion CMIP might play an important role in the development and progression of laryngeal squamous cell carcinoma and increased expression of CMIP might imply disease progression and poor outcome in patient with laryngeal squamous cell carcinoma.

To study the abnormal distribution of type Ⅳ collagen and laminin chains in glomerular basement membrane (GBM) in membranous nephropathy (MN).Methods 52 cases of MN were collected and staged according to electron microscopic morphological characteristics,and 10 cases of kidney tissues of minimal change disease were used as normal GBM control.Distribution pattern of or5 (Ⅳ) chain,laminin α5and β2 chains,and laminin α2 and β1 chains were detected using immunofluorescence method.Results In minimal change disease,α5 (Ⅳ) chain,laminin α5 and β2 chains all showed continuously linear positive expression along GBM,and laminin α2 and β1 chains were negatively expressed in GBM.In stage Ⅰ MN,α5 (Ⅳ) chain,laminin α.5 and β2 chains all showed continuous linear positive expression along GBM.In stage ⅡMN,the expression of α5 (Ⅳ) chain was increased and showed abundant spikes on the basis of continuous linear positive staining along GBM,and the expression of laminin α5 and β2chains was increased,and segmental spikes were seen on the basis of continuous linear positive staining along GBM.In stage ⅢMN,the expression of α5 (Ⅳ),laminin α5 and β2 chains was also enhanced and segmental double tracks were seen.The expression of laminin α2 chain was negative in GBM in stage ⅠMN,but granular positive expression along GBM was seen in stage Ⅱ and stage Ⅲ MN.No positive expression of laminin β1chain was seen in GBM in different stages in MN.Conclusion The GBM thickness in MN originates not only from intrinsic type Ⅳ collagen chains and laminin chains,but also from laminin α2chain,which only exist in glomerulus mesangium in normal condition.

To investigate the relationship between Snail and renal tubular epithelial-mesenchymal transition (EMT) or tubulointerstitial fibrosis (TIF) at tissue and cellular levels and to observe the changes of miRNA profile after transfecting Snail gene into human renal tubular epithelial cells (HK-2),to further elucidate the importance of miRNA in the pathogenesis of renal fibrosis.Methods The expression of Snail and EMT-related proteins vimentin,SMA,E-cadherin was detected by immunohistochemistry in renal tissues of 40 patients with IgA nephropathy.The expression of Snail,E-cadherin and SMA in normal control group,empty transfection group and Snail gene transfection group was detected by Western blot and RT-PCR.Furthermore,differentially expressed miRNAs were screened by gene chip.Results By immunohistochemistry,Snail expression was positively correlated with vimentin and SMA,negatively correlated with E-cadherin in IgA nephropathy.The higher degree of the TIF,the stronger the expression of Snail.Compared with the control group,the expression of Snail,vimentin and SMA in the snail transfected group increased.However,E-cadherin decreased at gene and protein level by the RT-PCR and Western blot (P ＜ 0.05).The difference was statistically significant.Five distinctly different miRNAs were screened by gene chip after Snail gene was transfected into HK-2 cells,and then 5 026 potential target genes were predicted.Conclusion Snail expression is closely related with renal tubular epithelial mesenchymal transition and tubulointerstitial fibrosis,and it may be used as a new target in EMT prevention.Differentially expressed miRNAs may be involved in the development of EMT and TIF.