1. Application of sentinel lymph node biopsy in patients with melanoma
Min REN ; Yunyi KONG ; Xu CAI ; Xuxia SHEN ; Jiaojie LYU
Chinese Journal of Pathology 2018;47(5):360-365
Objective:
To investigate the difference between routine hematoxylin-eosin (HE) staining and immunohistochemistry in diagnosing metastatic melanoma in sentinel lymph node (SLN) metastases, and to evaluate the association of SLN tumor burden with the status of non-sentinel lymph nodes (NSLN).
Methods:
126 melanoma patients were treated with SLN biopsy and further examined with immunohistochemistry at Fudan University Shanghai Cancer Center between 2010 and 2016, and the status of SLN was respectively estimated by HE stain and immunohistochemistry (S-100 protein, HMB45, Melan A and SOX10). In 39 patients who were treated with complete lymph node dissection, characteristics of SLN tumor burden (maximum diameter of the tumor deposit, tumor penetrative depth and the microanatomic location of the metastasis) and the associations of SLN tumor burden with the involvement of NSLN were all evaluated.
Results:
Of the total 126 cases, 33 (26.2%) were positive by HE staining and 49 (38.3%) were positive by immunohistochemistry. S-100 protein was positive in 48 out of 49 cases (98.0%). HMB45 was positive in 46 out of 49 cases (93.9%). Melan A was positive in 47 out of 49 cases (96.0%). SOX10 was positive in 8 out of 8 cases. The outcome indicated that the application of immunohistochemistry identified positive SLN missed by HE stain in about 12.1% of cases. Of the 39 patients who were treated with complete lymph node dissection, six showed metastases in NSLN. The frequency of metastases in NSLN was 15.4% (6/39) when SLN was positive. Additionally, the frequency of metastases in NSLN in cases with SLN metastatic deposits ≤2 mm was significantly lower than that in cases with SLN metastatic deposits >2 mm; eight cases with SLN metastatic deposits <0.2 mm had no additional positive NSLN.
Conclusions
The findings suggest that immunohistochemistry could effectively improve the detection of positive SLN in melanoma. Cases with SLN metastatic deposits ≤2 mm are less likely to have further metastases in NSLN. There is a need for prospective large-population based studies to identify a subgroup of SLN positive patients who can safely be spared complete lymph node dissection.
2. Utility and evaluation of immunohistochemical detection of BRAF V600E mutation in melanoma
Jiaojie LYU ; Yunyi KONG ; Xu CAI ; Xuxia SHEN ; Yawen LU ; Min REN
Chinese Journal of Pathology 2017;46(8):548-552
Objective:
To evaluate the sensitivity, specificity and clinical value of anti-BRAF V600E antibody (clone VE1) in detection of the BRAF V600E mutant in formalin-fixed and paraffin-embedded (FFPE) melanoma specimens by immunohistochemical (IHC) methods.
Methods:
A total of 50 melanoma samples collected between 2008 and 2016 from 40 patients were analyzed for BRAF mutation (exon 15) by DNA sequencing using FFPE. These tissues were immunostained with VE1 antibody, and the results were analyzed and compared with those by DNA sequencing.
Results:
By DNA sequencing, 36 cases showed BRAF mutation while others were BRAF wild type. Among the 36 cases with BRAF mutation, 32 harbored BRAF V600E, two harbored BRAF V600K, one had BRAF K601E and one had BRAF D594N, respectively. IHC staining showed 30 specimens were VE1 positive, while 19 were negative. The determination of IHC result for one case was obscured by heavy pigments. Of the BRAF-mutated specimens, four specimens with BRAF mutation other than V600E were all negative for VE1. The sensitivity and specificity of the VE1 immunostaining was 96.8% and 100.0% respectively.Concordance of BRAF V600E detection between immunostaining and DNA sequencing was 98.0%(48/49).
Conclusions
High sensitivity and specificity for VE1 immunostaining in detecting BRAF V600E in melanomas are demonstrated. It is a rapid and cost-effective method for detecting BRAF V600E mutations in melanoma patients. Hence, VE1 immunostaining can be used as an important screening method for BRAF mutation in laboratories.
3.A study to identify obstructive sleep apnea syndrome based on 24 h ambulatory blood pressure data.
Jian ZHANG ; Jiaojie REN ; Shuchen SUN ; Zhengbo ZHANG
Journal of Biomedical Engineering 2022;39(1):1-9
Sleep apnea causes cardiac arrest, sleep rhythm disorders, nocturnal hypoxia and abnormal blood pressure fluctuations in patients, which eventually lead to nocturnal target organ damage in hypertensive patients. The incidence of obstructive sleep apnea hypopnea syndrome (OSAHS) is extremely high, which seriously affects the physical and mental health of patients. This study attempts to extract features associated with OSAHS from 24-hour ambulatory blood pressure data and identify OSAHS by machine learning models for the differential diagnosis of this disease. The study data were obtained from ambulatory blood pressure examination data of 339 patients collected in outpatient clinics of the Chinese PLA General Hospital from December 2018 to December 2019, including 115 patients with OSAHS diagnosed by polysomnography (PSG) and 224 patients with non-OSAHS. Based on the characteristics of clinical changes of blood pressure in OSAHS patients, feature extraction rules were defined and algorithms were developed to extract features, while logistic regression and lightGBM models were then used to classify and predict the disease. The results showed that the identification accuracy of the lightGBM model trained in this study was 80.0%, precision was 82.9%, recall was 72.5%, and the area under the working characteristic curve (AUC) of the subjects was 0.906. The defined ambulatory blood pressure features could be effectively used for identifying OSAHS. This study provides a new idea and method for OSAHS screening.
Blood Pressure
;
Blood Pressure Monitoring, Ambulatory
;
Humans
;
Hypertension/complications*
;
Polysomnography
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Sleep Apnea, Obstructive/diagnosis*
4.Direct interaction of DNMT inhibitors to PrP suppresses pathogenic process of prion.
Dae-Hwan KIM ; Chunyan REN ; Chongsuk RYOU ; Jiaojie LI
Acta Pharmaceutica Sinica B 2019;9(5):952-959
The conversion of the normal cellular prion protein (PrP) to the misfolded pathogenic scrapie prion protein (PrP) is the biochemical hallmark of prion replication. So far, various chemical compounds that inhibit this conformational conversion have been identified. Here, we report the novel anti-prion activity of SGI-1027 and its meta/meta analogue (M/M), previously known only as potent inhibitors of DNA methyltransferases (DNMTs). These compounds effectively decreased the level of PrP in cultured cells with permanent prion infection, without affecting PrP at the transcriptional or translational levels. Furthermore, SGI-1027 prevented effective prion infection of the cells. In a PrP aggregation assay, both SGI-1027 and M/M blocked the formation of misfolded PrP aggregates, implying that binding of these compounds hinders the PrP conversion process. A series of binding and docking analyses demonstrated that both SGI-1027 and M/M directly interacted with the C-terminal globular domain of PrP, but only SGI-1027 bound to a specific region of PrP with high affinity, which correlates with its potent anti-prion efficacy. Therefore, we report SGI-1027 and related compounds as a novel class of potential anti-prion agents that preferentially function through direct interaction with PrP.
5.Spiradenocarcinoma, cylindrocarcinoma and spiradenocylindrocarcinoma: a clinicopathological study of seven cases
Jiaojie LYU ; Xu CAI ; Na LYU ; Yan ZHANG ; Xuebing JIANG ; Min REN ; Yunyi KONG
Chinese Journal of Pathology 2024;53(12):1224-1230
Objective:To investigate the clinicopathological characteristics of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma, and to understand the correlations between their morphological patterns and clinical behaviors.Methods:Seven cases of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma diagnosed at Fudan University Shanghai Cancer Center, Shanghai, China from 2015 to 2021 were collected. The clinicopathological characteristics and follow-up data were retrospectively analyzed. Histopathologic evaluation and immunohistochemical studies were carried out.Results:There were four men and three women in the cohort, with ages ranging from 46 to 75 years (mean, 61 years). The tumors were located on the head and neck (four cases), extremities (two cases), and trunk (one case). Histologically, the residuum of a benign neoplasm was present in all cases. One case presented salivary gland-type basal cell adenocarcinoma-like pattern, low-grade (BCAC-LG). Another case showed salivary gland-type basal cell adenocarcinoma-like pattern, high-grade (BCAC-HG). The remaining five cases were invasive adenocarcinoma, not otherwise specified (IAC-NOS). One of IAC-NOS contained a mucinous adenocarcinoma component. Immunohistochemically, BCAC-LG and BCAC-HG predominantly expressed basal cell markers such as p63 and p40, whereas IAC-NOS primarily exhibited positivity for CK7, a glandular epithelial marker. Follow-up was available for six patients, ranging from 1 to 9 years (mean, 4.5 years). Among the four patients of IAC-NOS with follow-up, three showed recurrences, two had regional lymph node metastases, and one died.Conclusions:The malignant components of spiradenocarcinomas, cylindrocarcinomas, and spiradenocylindrocarcinomas in this cohort contain BCAC-LG, BCAC-HG and IAC-NOS. This study also shows the presence of mucinous adenocarcinoma components in IAC-NOS. The tumors with IAC-NOS have a relatively poorer prognosis than those without.
6.Expert consensus on the evaluation and rehabilitation management of shoulder syndrome after neek dissection for oral and maxillofacial malignancies
Jiacun LI ; Moyi SUN ; Jiaojie REN ; Wei GUO ; Longjiang LI ; Zhangui TANG ; Guoxin REN ; Zhijun SUN ; Jian MENG ; Wei SHANG ; Shaoyan LIU ; Jie ZHANG ; Jicheng LI ; Yue HE ; Chunjie LI ; Kai YANG ; Zhongcheng GONG ; Qing XI ; Bing HAN ; Huaming MAI ; Yanping CHEN ; Jie ZHANG ; Yadong WU ; Chao LI ; Changming AN ; Chuanzheng SUN ; Hua YUAN ; Fan YANG ; Haiguang YUAN ; Dandong WU ; Shuai FAN ; Fei LI ; Chao XU ; Wei WEI
Journal of Practical Stomatology 2024;40(5):597-607
Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.