Background: Aberrant Bcl-2 transcription is closely related with nodal diffuse large B-cell lymphoma (DLBCL), however, the relationship between Bcl-2 and primary gastrointestinal DLBCL (PGI-DLBCL) was not fully studied.Aims: To investigate the relationship between Bcl-2 gene amplification and protein expression and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL.Methods: Clinical data was collected from 136 PGI-DLBCL patients receiving surgical treatment, and a telephone interview was conducted for survival information.Bcl-2 gene amplification and protein expression in tumor tissue were determined by fluorescence in situ hybridization and immuno-histochemistry, respectively, and relationships between Bcl-2 and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL were analyzed.Results: Among 136 PGI-DLBCL patients, 33 (24.3%) showing gene amplification and 90 (66.2%) showing protein expression of Bcl-2;gene amplification was correlated with primary tumor location, Ann Arbor stage, serum lactate dehydrogenase level, B symptom and International Prognostic Index (IPI) score (P<0.05), while protein expression was correlated with primary tumor location and immunophenotype (P<0.05).5-year overall survival (OS) in patients positive for Bcl-2 gene amplification and patients with non-GCB immunophenotype and positive for Bcl-2 protein expression were inferior to those negative ones (41.5%vs.71.5%, P<0.05;54.6% vs.84.6%, P<0.05).In Bcl-2 gene amplification or protein expression positive patients, 5-year OS of CHOP chemotherapy was inferior to that of rituximab combined with CHOP chemotherapy (48.6%vs.80.3%, P<0.05;66.4%vs.83.4%, P<0.05).Conclusions: Detection of Bcl-2 gene amplification is useful for prediction of prognosis in PGI-DLBCL.Both patients with Bcl-2 gene amplification and non-GCB patients with Bcl-2 protein expression have a poorer prognosis.Rituximab may improve the prognosis in patients with Bcl-2 gene amplification or protein expression.

Castleman's disease is a rare benign lymphoproliferative disorder that frequently affects lymph nodes of the mediastinal thorax and the neck. It very rarely affects the renal sinus. We report a case of Castleman's disease arising in the renal sinus in a 64-year-old man. The patient visited the hospital with the chief complaint of hematuria. Abdominal computed tomography revealed a homogeneous mass in the sinus of the left kidney, radiologically interpreted as a malignant urothelial tumor. Subsequently, nephroureterectomy was performed, after which microscopic examination of the specimen revealed a diffuse lymphoproliferative lesion with reactive lymphoid follicles of various sizes and prominent plasma cell infiltration of interfollicular spaces, highlighted by immunohistochemical staining for CD138. The lesion was diagnosed as Castleman's disease of the plasma cell type. Although preoperative diagnosis of Castleman's disease is difficult and the incidence is exceedingly rare, it should be considered in the differential diagnosis of renal sinus tumors.
Diagnosis, Differential ; Giant Lymph Node Hyperplasia ; Hematuria ; Humans ; Incidence ; Kidney ; Lymph Nodes ; Lymphoproliferative Disorders ; Middle Aged ; Neck ; Plasma Cells ; Thorax

No abstract available.
Kidney Pelvis*

Carcinosarcoma of the salivary glands is a rare malignant tumor showing both malignant epithelial and mesenchymal components. Herein, we present a carcinosarcoma of the parotid gland in a 67-year-old man consisting of osteosarcoma and adenocarcinoma components with fine needle aspiration cytological findings. The tumor was composed predominantly of osteosarcoma and small areas of adenocarcinomatous components and a hyalinized nodule reminiscent of pleomorphic adenoma. The tumor showed infiltrative growth features with perineural, lymphatic, and vascular invasion. Despite postoperative adjuvant radiation therapy, multiple metastatic lesions occurred in the both lungs 5 months after surgery. As salivary gland carcinosarcoma has been known to demonstrate highly aggressive behavior, an accurate pathological diagnosis is prerequisite for appropriate treatment.
Adenocarcinoma ; Adenoma, Pleomorphic ; Aged ; Biopsy, Fine-Needle ; Carcinosarcoma ; Humans ; Hyalin ; Lung ; Osteosarcoma ; Parotid Gland ; Salivary Glands

Objective:To investigate the correlation between mental health and symptom distress in breast cancer patients.Methods:The clinical data of 110 female breast cancer patients at Shanxi Bethune Hospital from June 2017 to March 2018 were collected. The patients were assessed for symptomatic distress with depression self-rating scale (SDS). Functional assessment of cancer therapy-breast (FACT-B) and the functional assessment of chronic illness therapy-spiritual well-being (FACIT-SP) were used to make the mental assessment. Multiple linear regression analysis was used to analyze the effect of symptom distress on the mental health of the patients.Results:The scores of symptom distress, mental health, FACT-B and FACIT-SP were (19.94±5.78), (50.68±10.64), (16.85±4.75), (33.83±8.33), respectively. Multivariate analysis showed that mental health score of the patients with symptom distress > 18 scores was reduced by 5.15 points ( P=0.01) compared with the patients with symptom distress≤18 scores. Compared with the patients with annual household income < 50 000 yuan, the mental health score of patients with annual household income of 50 000-79 000 yuan was increased by 9.46 points ( P < 0.01), and the mental health score of patients with annual family income ≥ 80 000 yuan was increased by 5.92 points ( P < 0.01); compared with the patients in phase I, the mental health score of the patients in phaseⅡwas decreased by 2.62 points ( P=0.02), and the mental health score of the patients in phase Ⅲ was decreased by 4.98 points ( P < 0.01). Conclusions:Symptom distress is an independent risk factor for affecting mental health of breast cancer patients. Solving symptom distress of patients can improve mental health status of the patients.

An ectopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We report herein a rare case of malignant transformation of ectopic pancreas in the stomach, associated with gastric outlet obstruction. A 69-year-old woman was admitted to our hospital, complaining of vomiting. Esophagogastroduodenoscopy revealed an encircling submucosal tumor-like lesion on the prepyloric antrum showing outlet obstruction. Abdominal CT showed an enhancing mass on the antrum and PET CT showed hypermetabolic wall thickening. So we performed a subtotal gastrectomy. Surgical specimens showed a moderately differentiated ductal adenocarcinoma, and the tumor cells were strongly positive for cytokeratin 7. The tumor was located close to the ectopic pancreas tissue. The tumor showed subserosal and omental invasion. There was one lymph node metastasis and no distant metastasis. The patient is being followed up in the outpatient department.
Adenocarcinoma ; Aged ; Carcinoma, Pancreatic Ductal ; Endoscopy, Digestive System ; Female ; Gastrectomy ; Gastric Outlet Obstruction ; Gastrointestinal Tract ; Humans ; Keratin-7 ; Lymph Nodes ; Neoplasm Metastasis ; Outpatients ; Pancreas ; Stomach ; Stomach Neoplasms ; Vomiting

OBJECTIVE: Systemic sclerosis is a connective tissue disease characterized by vasculopathy, excessive accumulation of extracellular matrix, and fibrosis of the skin and internal organs. The dietary flavonoid apigenin has been shown to reduce expression of the myofibroblast phenotype and to inhibit contraction of collagen gels. We investigated the effect of apigenin on the prevention and treatment of a modified bleomycin-induced animal model of scleroderma. METHODS: Recently, we successfully induced scleroderma by weekly subcutaneous injections of bleomycin using a thermo-reversible combination gel composed of low molecular weight methylcellulose. A weekly subcutaneous injection of methylcellulose gel loaded with bleomycin induced focal skin fibrosis on the back skin and fibrotic phenotype of lung tissue in mice. The histologic examination of skin and lungs, collagen assay of lungs, and expression of connective tissue growth factor were investigated. RESULTS: Daily intra-peritoneal injection of 1.0 mg/kg or 2.5 mg/kg of apigenin starting a week before the bleomycin injections failed to prevent the development of skin fibrosis and reduce the fibrotic phenotypes of skin and lung tissue. CONCLUSION: Although some in vitro experiments have supported a potential role of apigenin in the treatment of fibrosis, dietary flavonoid apigenin is not effective in preventing development of a bleomycin-induced murine model of scleroderma.
Animals ; Apigenin ; Bleomycin ; Collagen ; Connective Tissue Diseases ; Connective Tissue Growth Factor ; Contracts ; Extracellular Matrix ; Fibrosis ; Gels ; Injections, Subcutaneous ; Lung ; Methylcellulose ; Mice ; Models, Animal ; Molecular Weight ; Myofibroblasts ; Phenotype ; Scleroderma, Systemic ; Skin

PURPOSE: Dual-specificity protein phosphatase 4 (DUSP4), also known as mitogen-activated protein kinase phosphatase (MKP) 2 is a member of the inducible nuclear MKP group. The role of DUSP4 in cancer development and progression appears to vary with the type of malignancy. The purpose of this study was to investigate DUSP4 expression in a case series of invasive ductal carcinoma of the breast. METHODS: We constructed tissue microarrays consisting of 16, 14, 47, and 266 cases of normal breast tissue, usual ductal hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma, respectively. DUSP4 expression was investigated by immunohistochemistry. RESULTS: Cytoplasmic DUSP4 expression was observed. DUSP4 was more frequently expressed in malignant than in benign cases (p=0.024). The mean DUSP4 expression score was significantly higher in malignant tumors than in benign lesions (p=0.019). DUSP4 expression was significantly correlated with a larger tumor size (>2 cm, p=0.015). There was no significant correlation between overall survival or disease-free survival and DUSP4 expression in all 266 patients. We evaluated the impact of DUSP4 expression on the survival of 120 patients with T1-stage tumors. Interestingly, Kaplan-Meier survival curves revealed that DUSP4 expression had a significant effect on both overall patient survival (p=0.034, log-rank test) and disease-free survival (p=0.045, log-rank test). In early T-stage breast cancer, DUSP4 expression was associated with a worse prognosis. CONCLUSION: DUSP4 is frequently upregulated in breast malignancy, and may play an important role in cancer development and progression. In addition, it may be a marker of adverse prognosis, especially in patients with early T1-stage cancer.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Cytoplasm ; Disease-Free Survival ; Humans ; Hyperplasia ; Immunohistochemistry ; Kaplan-Meier Estimate ; Prognosis ; Protein Kinases

PURPOSE: Glucose uptake and glycolytic metabolism are enhanced in cancer cells, and increased expression of glucose transporter 1 (GLUT1) has also been reported. The aim of this study was to investigate GLUT1 expression in human breast tissues and invasive ductal carcinomas. METHODS: We used tissue microarrays consisting of normal breast tissue, ductal hyperplasia, ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastases. We examined GLUT1 expression in the microarrays by immunohistochemistry, reviewed the medical records and performed a clinicopathological analysis. RESULTS: Membranous GLUT1 expression was observed in normal and tumor cells. GLUT1 expression was higher in ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastasis than in normal tissue and ductal hyperplasia (p=0.002). Of 276 invasive ductal carcinomas, 106 (38.4%) showed GLUT1 expression. GLUT1 expression was correlated with higher histologic grade (p<0.001), larger tumor size (p=0.025), absence of estrogen receptor (p<0.001), absence of progesterone receptor (p<0.001), and triple-negative phenotype (p<0.001). In univariate survival analysis, patients with GLUT1 expression had poorer overall survival and disease-free survival (p=0.017 and p=0.021, respectively, log-rank test). In multivariate survival analysis with the Cox proportional hazards model, GLUT1 expression was an independent prognostic factor of poorer overall survival and disease-free survival (p=0.017 and p=0.019, respectively). CONCLUSION: GLUT1 expression seems to play an important role in malignant transformation, and the glycolytic phenotype in invasive ductal carcinoma may indicate aggressive biological behavior and a worse prognosis.
Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Estrogens ; Glucose ; Glucose Transport Proteins, Facilitative ; Humans ; Hyperplasia ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Proportional Hazards Models ; Receptors, Progesterone