Objective To evaluate the barium meal radiography and CT scans in diagnosing malignant gastrointestinal stromal tumors (GIST) of small intestine. Methods The clinical and imaging data of 16 patients with GISTs of small intestine which were diagnosed surgically and pathologically were analyzed and summarized. In this group CT scan and gastrointestinal barium exam(GI) was performed. Results The tumors included 6 low-malignant GISTs of small intestine and 10 high-malignants. The diameter varied from 3.2 cm to 7.2 cm, the average size was 5.6 cm. The main signs of barium meal of malignant GIST of small intestine included flattened or destroyed mucosa runae, partial lumen stenosis, and barium fleck and fistula in the tumor. On CT scans, the main manifestation was an extraluminal mass with multiple necrosis areas of low density. Conclusion Barium examination and helical CT scan are the major imaging techniques in the determination of the location of GIST of small intestine. The appearance of imperfect lumen and the irregular tumor with multiulcerations or low density regions and inhomoneneous enhancement may lead to the correct diagnosis of malignant GIST.

Objective To investigate the clinicopathological characteristics and immunopheotype of diffuse large B-cell lymphoma (DLBCL) in order to improve diagnosis and therapy efficacy. Methods The clinical, immunophenotypical and histopathological features of 22 cases of DLBCL patients were studied retrospectively. The expressions of CD20, CD30, CD10, bcl-6, MUM-1, Ki-67 and CD3o of all patients, and CD5,CyclinD1, Lysozyme,AE1/3 and PLAP of patients with differential cancer, seminoma, anaplastic large cell lymphoma and blastic variant of mantle cell lymphoma were detected by EnVision Immunohistochemical technique. Results All patients were primary systemic DLBCL. All of 22 patients, 14 males and 8 females,average 48(21-71) years old, were primary DLBCL, including 13 cases of germinal centre B-cell-like(GCB) (7 cases of intra-node and 6 extra-node) and 9 cases non-GCB (6 intra-node and 3 extra-node). Conclusion The favorable diagnosis of DLBCL may be achieved by combination of clinical histological and immunological features.

Objective To investigate the clinicopathology characteristics, immunopheotypic of anaplastic large cell lymphoma (ALCL) in order to improve its diagnostic and therapeutic accuracy. Methods The clinical, immunophenotypic and histopathologie features of 19 cases ALCL were retrospectively studied. The expression of CD30, ALK, CD43, CD45RO, EMA and TIA-1 was detected using EnVision immunohistochemical technique. Results All patients were primary systemic ALCL. Among the 19 patients, 11 were males and 8were females. The age ranged from 2 to 71 years, average age 26 years old. It shows a broad morphologic spectrum of the tumor cell and the hallmark cells characterized by sheets of large lymphoid cells withchromatin-poor horseshoe-shaped nuclei containing multiple nucleoli were encountered in all ALCL variants. 16patients (84.2 %) showed B-symptoms, and extranodal involvement was present in 14 (73.7 % ).Immunohistochemical study showed that the tumor cells expressed CD30 (100 %), ALK (78.9 %), EMA(52.6 %), TIA-1 (73.7 %) and 2 cases (10.5 %) neither expressed ALK, nor EMA,TIA-1.17 cases were reached the correct diagnosis according to combination of clinic, histological and immunological features.Conclusion The correct diagnosis of ALCL may be reached by combination of clinic, histological and immunological features according to WHO classification. Immunohistoehemical staining for CD30, ALK, EMA and TIA-1 is useful in making a correct diagnosis.

Objective To study the value of tumor markers of CA153,CEA and CA125 in nipple discharge of breast intraductal papillary leision on detection of breast carcinoma.Methods 154 cases of breast intraductal papillary leision with nipple discharge were studied.Among them there were 58 cases with breast intraductal papillary carcinoma and 96 cases with intraductal papilloma.The nipple discharged and serum from the 154 cases were collected and CA153,CEA and CA125 levels were measured both in nipple discharge and serum with electrochemiluminescence method,and were compared with the results of ER,PR,HIF-1α and Ki-67 detected by SP method in breast tissue.Results The CA153,CEA and CA125 levels of nipple discharge in intraductal papillary carcinoma [(130.1 1±29.62) U/ml,(89.23±28.94) ng/ml,(41.29±16.61) U/ml]were significantly higher than those of the contrast groups,and had a positive correlation with the Ki-67,HIF-1αand lymphnode metastas (P ＜ 0.05),and negative correlation with the level of ER,PR and Her-2 (P ＜ 0.05).The positive rate of CA153,CEA or CA125 in nipple discharge (62.07 ％,46.55 ％,55.17 ％) were significantly higher than that in serum (P ＜ 0.05).The sensitivity of the combined detection of the three tumor markes both in discharge and serum was 96.55 ％,and the negative predictive value was 97.30 ％,which were significantly higher than that in other detection (P ＜ 0.05).Conclusions The positive rate of CA153,CEA and CA125 in nipple discharge were significantly higher than that in serum.The dynamic combined detection of CA153,CEA and CA125 both in nipple discharge and in serum could increase the diagnosis rate of breast intraductal papillary carcinoma.

A male patient, 67 years old, was admitted with the left auricle neoplasm over two months, increased rapidly for 10 days, on November 5, 2013. The tumer is about 2. 0 cm ×× 2. 0 cm size, smooth surface, no burst, hard, painless, and immobilization. After admission biopsy, the pathological report: "spindle cell sarcoma", thin a total resection of the left auricle under local anesthesia was made, postoperative pathological report: tumor by short of spindle cells, arranged in bunchiness, a small number of seats is arrangeA striate;The nuclei are hyperchromatic and part of the visible nucleoli and empty bright cytoplasm, pathological nuclear fission was visible. "Scar" on the matrix of collagen, hardening, and change the glass samples. The tumor destruction of cartilage. immunohistochemical stainin : Vimentin (+), CD99 (-), Bcl-2 (-), CD34 (-), SMA (-), Des (-), HMB45 (-), MelanA(-), S-100(-), CK(-). Diagnosis as fibrosarcoma. The patient refused any radiation or chemotherapy. Postoperative follow-up of 8 months, no local recurrence and distant metastasis.
Aged ; Ear Neoplasms ; diagnosis ; Fibrosarcoma ; diagnosis ; Humans ; Male ; Neoplasm Recurrence, Local

Objective To study the clinicopathology characteristics of chronic lymphocytic thyroiditis (Hashimoto's thymiditis, HT) with occult papillary thyroid carcinoma (occult PTC) in order to improve its diagnostic and therapeutic accuracy. Methods A restrospective analysis was done on the clinical materials of 28 cases of HT with occult PTC from July 1999 to July 2005. All cases were confirmed by operation and pathologic biopsy. Clinical and gross findings were collected. All HE slides were reexamined and immunostains for CK19, galectin-3,and bcl-2 were performed (Envision method). Results In total 189 cases of chronic lymphocytic thyroiditis,28cases (14.8%,28/189)had coexistent occult papillary thyroid carcinoma. There were 19 females and 9 males with median age of 36.7 years old. Normal TSH presented in 11cases (39.3%), high in 8 cases(28.6%), and low in 9cases (32.1%). All tumor diameter was counted for <0.8 cm, 16 cases (57.1%) tumor diameter 0.2～0.5 cm, 12 cases (42.9%) >0.5 cm. Coarse calcification was seen in 6 cases(21.4%) in color ultrasonic exam and CT scans. Follow-up data showed that 28 patients were all alive with no evidence of recurrence or metastasis for 2 to 7 years by December 2007. Conclusion There are no special clinical characteristics in coexistent HT with occult PTC.Coarse calcification in HT in the group of middle-aged women increase the likelihood of the diagnosis. But the diagnosis depends on pathology. Because of the high incidence of occult PTC in HT population, it would be necessary to keep an eye on this particular type of thyroid carcinoma, and multiple sampling in suspected area of HT specimen is advised in the hope not to miss any small tumor in clinical practice.

Objective To study the relationship between clinical-biological significance and the expression of CD44v6 and Survivin in multifocal papillary thyroid carcinoma (PTC). Methods Immunohistochemical SP method was used to investigate the expression of CD44v6 and Survivin in 47 cases of multifocal PTC and adjacent tissues, and 122 cases of single focal PTC tissues. The expression of CD44v6 and Survivin and the risk factors among different clinical factors were analyzed between solitary PTC and multifocal PTC group. Results Tumor foci were found in 27.8 % (47/169) patients. The patients with multifocal were characterized by a higher ratio of family history of thymid tumor, lymph node metastasis and extra-thymidal extension (χ2 = 4.189, 6.159, 4.079, P ＜0.05), and not related with sex, age, size and the number of the tumors (P ＞0.05).The positive rates of CD44v6 and Survivin were 70.2 % (33/47) and 66.0 %(31/47), respectively, in multifocal PTC, both of which were significantly higher than that in nodular goiter,Hashimoto' s thyroiditis and normal thyroid tissues (χ2 =47.184, P ＜0.05). Overexpressions of CD44v6 and Survivin in multifocal PTC were related to the degree of the infiltration(χ2 = 4.723, P =0.030; χ2 =4.023,P =0.045) and lymph node metastasis (χ2 =5.771, P =0.016; χ2 =5.686, P =0.017), and not related with sex,age, family history and the number of the tumors (P ＞0.05).The expression of CD44v6 was correlated positively with Survivin (r =0.514, χ2 =10.15, P ＜0.01).There was no significant difference in expressions of CD44v6 and Survivin between multifocal and single focal PTC (P ＞0.05).By the sept.2010, the patients with single and mutiple focal PTC were all survival.Conclusion Multifocus is one of the clinical features of PTC.The high expressions of CD44v6 and Survivin in multifocal PTCs relate to the development, invasion and metastasis.

Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective To investigate the value of combined detection of serum tumor biomarkers including alpha-fetoprotein (AFP),tumor specific growth factor (TSGF),golgi protein 73 (GP73) and osteopontin (OPN) in diagnosis of primmy hepatic carcinoma.Methods AFP,TSGF and GP73 levels were measured by electro-chemiluminescence immunoassay,and OPN levels by enzyme-linked immunosorbent assay (ELISA) in 122 cases of primary hepatic carcinoma,50 cases of liver benign lesions and 50 cases of healthy control.The biological parameters and the levels of AFP,TSGF,GP73 and OPN were studied.Results The serum levels of AFP,TSGF,GP73 and OPN in primary hepatic carcinoma were higher than those in the liver benign disease group and the normal control group (all P ＜ 0.01).Sex and age of the patients at diagnosis showed no significant association with the levels of the four serum tumor biomarkers in the primary hepatic carcinoma groups (all P ＞ 0.05).But the tumor size,amount,tumor stage,metastasis and recurrence showed significant association with the levels of those in the primary hepatic carcinoma groups (all P ＜ 0.05).The sensitivity,specificity and veracity of serum AFP,TSGF,GP73 and OPN as individual diagnostic marker was only 57.38 ％,68.85 ％,70.49 ％ and 69.67 ％,respectively.The sensitivity of combined detection of AFP and TSGF was 80.33 ％,and that of combined detection of AFP,TSGF and GP73 was 85.25 ％.While,the sensitivity of the four serum tumor markers in combination was 98.36 ％,the accuracy was 95.65 ％.The sensitivity and accuracy of combined detection with the four serum tumor markers were significantly higher than those of the individual markers and other combination detection methods (all P ＜ 0.05).Conclusions Serum markers of AFP,TSGF,GP73 and OPN can serve as a means for diagnosis of primary hepatic carcinoma.Combined detection of the four serum tumor biomarkers can improve the sensitivity,accuracy and the negative predictive value,which is benefit to early diagnosis and interference.

Objective To study the expression of Galectin-3,CK19 and Ki-67 in the papillary thyroid carcinoma and papillary thyroid hyperplasia and to find the differential diagnostic makers. Methods A total of 200 cases, including 100 with papillary thyroid carcinoma and 100 papillary thyroid hyperplasia by Immunohistochemistry. Results The positive rates for Galectin-3,CK19 and Ki-67 in the papillary thyroid carcinoma were 100 %, 97 % and 93 %, which were significantly higher than those in the papillary thyroid hyperplasia (13 %, 31 %, 1 %) (P