Purpose To explore the correlation of Noxa gene with clinical pathology and its effect on proliferation and apoptosis of HepG2 cells.Methods Noxa protein in 100 hepatocellular carcinoma tissues and 100 paracancerous tissues were detected by imnunohistochemical technique,clinicopathological parameters and follow-up data were statistically analyzed.The recombinant eukaryotic expression plasmid pIRES2-EGFP-Noxa was transiently transfected into HepG2 cells with lipofectamine.Both Noxa mRNA and protein were detected by RT-PCR and Western blot respectively.The inhibition of cell proliferation was evaluated by MTT assay.The cell apoptosis was detected by flow cytometry (FCM).Results Immunohistochemistry showed that in tumor tissue of hepatocellular carcinona the positive rate of Noxa protein expression was 50％,while it was 78％ in cancer adjacent normal mucosal tissue,with statistically significant difference (P ＜ 0.05).The expression of Noxa was related to TNM staging and the tumor differentiation.Exotic Noxa gene was expressed successfully in HepG2 cells after transfected with lipofectamine.The expression of Noxa mRNA and protein of HepG2 cells was significantly up-regulated after transfected 24 h,48 h and 72 h (P ＜ 0.05).MTT assay showed that the Noxa expression inhibited HepG2 cell proliferation in a time-dependent manner for 24 h,48 h and 72 h (P ＜ 0.05),which was significantly different from that of the control group (P ＜ 0.05).Apoptosis rate after transfected 24 h,48 h and 72 h was (15.5 ± 0.9)％,(24.6 ±0.8) ％ and (35.4 ±0.7) ％,respectively.There were significant difference between Noxa and the control group (P ＜ 0.05).Conclusion The expression of Noxa in hepatocellular carcinoma tissue is closely related to TNM stage and the tumor differentiation.Noxa gene overexpression is able to effectively inhibit the proliferation and promote the apoptosis of HepG2 cell line.

To improve the quality of medical postgraduate students in our school and to meet the needs of basic medicine and the development of personalized medicine , we opened the course“molecular pathology” to medical graduates. To make the molecular pathology the true bridge course between basic medicine and clinical medicine, we optimized the content of molecular pathology, cre-ated diagnostic technical platform matched with molecular pathology, rationalized management system worked in the basic pathology and clinical pathology. Practice has proved that “molecular pathology”curriculum promotes medical postgraduate students' transformation of medical philosophy, cultivates their innovation ability in scientific research and clinical practice ability etc.

Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma (SMZL) with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination (LDH),patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.

Objective To explore CT,MRI findings of extraskeletal mesenchymal chondrosarcoma (EMC).Methods Imaging information of all 8 cases of EMC verified by pathology were retrospectively analyzed.Results The location of lesions included lower extremity in 4 cases,forearm in 1 case,trunk in 2 cases and right lung in 1 case.The CT examination was performed in 7 cases,and 5 cases contained different patterns of ring-and-arc,granular,clump or irregular streaky mineralization.Dense calcification was detected in 3 cases,and focal in 2 cases.The nonmineralized component had slightly lower attenuation on CT scans than adjacent muscle.Four cases of peripheral located EMC demonstrated isointense on T1 WI,and mixed signal intensity on T2WI.For the cases of fine and dense calcification in 2 cases,numbers of dot-like low-intensity signals were detected resembling “pepper sign”; while for the cases of focal mineralization in 1 case,the low intensity area was located centrally in the high intensity area.Heterogeneous enhancement was found both in the calcified and uncalcified areas.One case of central located tumor exhibited low and high intensity on T1 and T2 weighted images,and nodual enhancement was observed.Conclusion EMC has several characteristic imaging features,including various mineralization pattern,enhancement of calcified area and signal intensity,which might have diagnostic value for this rare tumor.

Purpose To investigate relationship between PD-L1 molecule expression and Treg infiltration in non-small cell lung cancer ( NSCLC) tissue and to explore their clinical significance. Methods Immunohistochemistry was used to detect the PD-L1 molecules expression and Treg infiltration of 78 NSCLC tissues. The relationship among PD-L1 expression, Treg infiltration and clinic-pathological parameters was analyzed in the patients. Results PD-L1 molecule was highly expressed in lung cancer tissues than adjacent tissues (52. 5% vs 6. 4%), and same to Foxp3 +Treg (18. 63 ± 16. 67)/HPF vs (2. 96 ± 2. 97)/HPF. There was close relationship between PD-L1 expression and Treg infiltration with lymph node metastasis and clinical stage of patients, but was no statistical correlation with patient’ s age, gender, histological type and degree of differentiation of the tumor cells. PD-L1 expression was significantly higher in advanced stage than that in early stage (70. 0% vs 41. 7%) and same to Treg infiltration (73. 3% vs 35. 4%). There were also signif-icantly higher infiltration with lymph node metastasis than that without metastasis. In addition, PD-L1 molecule expression and Foxp3 +Treg infiltration were positively correlated (rs =0. 611, F=78. 82, P=0. 023). Conclusion There was strong relationship among PD-L1 expression, Treg infiltration and disease progress in lung cancer patients, and they possibly participate in the progression and immune escape of lung cancer.

OBJECTIVE: To investigate the role and significance of CD45RO in occurance and development in laryngeal squamous carcinoma, and to provide some valuable clues for searching new approaches to assess prognosis and theoretical basis for tumor biotherapy. METHOD: The expression of CD45RO protein in 50 cases of laryngeal squamous carcinoma and 10 cases normal mucos was detected by immunohistochemical S-P method. RESULT: The positive rate of CD45RO was 30% and 86% respectively in normal tissue and laryngeal squamous cell carcinoma tissue. The expresion of CD45RO was significantly and negatively associated with local metastatic of lymph nodes 0.713, P < 0.05) and tumor sites (r = -0.750, P < 0.05), but it have no notable difference with pathology differentiation, age, infiltrating depth and clinical stages in 50 cases of laryngeal squamous cell cancer. CONCLUSION (1) The expresion of CD45RO in laryngeal squamous cell cancer is more than that in normal tissue. (2) It is possible that overexpresion of CD45RO in laryngeal squamous cell carcinoma cut local metastatic lymph nodes. (3) It is probable that overexpresion of CD45RO in laryngeal squamous cell cancer made for prognosis of patients. (4) Other than UICC-TNM stage, pathology differentiation, it provide valuable clues for searching new approaches to assess prognosis of laryngeal squamous cell carcinoma.
Carcinoma, Squamous Cell ; blood ; pathology ; secondary ; Female ; Humans ; Laryngeal Neoplasms ; blood ; pathology ; Leukocyte Common Antigens ; blood ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Prognosis

Purpose To study the clinicopathologic features and differential diagnosis of serous microcystic adenoma of pancreas ( SMAP) . Methods Immunohistochemical study was carried out, and the clinical and pathologic features were evaluated in 11 cases of SMAP, and review the literatures. Results The age of onset of 11 cases of SMAP ranged from 41~68 years ( average=55 years) . All of them were females. The clinical presentations were right upper abdominal pain, nausea, vomiting and weight loss. Five tumors located in the pancreas head (45. 5%). Grossly, ten cases were solitary, one case was multiple. The boundary of tumor was clear, the cut surface of tumor was honeycomb. Histologic examination showed that the tumors were made up of small sized capsule wall lining of single-layer flat or cube epithelial cell. The cytoplasm was clear, nucleus was small and no atypical features. Immunohistochemical study showed that all of the 11 cases were positive for CK, CK7, CK18, CK19, EMA, 3 cases were positive for NSE,α-ACT, all of the 11 cases were negative for CgA, Syn, vimentin, TG, Calretinin. Ki-67<1%. Vascular vessels were positive for D2-40 and CD34. Conclusions SMAP is a very rare benign tumor of pancreas. It should be distinguished from oligo-cystic cystadenoma, pseudocyst, mucinous cystadenoma, lymphangioma and capillary hemangioma, mesothelioma.

Purpose To examine the clinicopathologic,immunohistochemical,and molecular genetic characteristics and differential diagnosis of low-grade oncocytic tumor(LOT)of kidney with CK7 positive and CD117 negative,so as to enhance the understanding of this tumor among pathologists.Methods A total of five cases of renal LOT from the First Affiliated Hospi-tal of Soochow University between December 2016 and February 2023 were included in this analysis.The clinicopathological fea-tures,immunophenotype,genetic characteristics,and prognosis were evaluated using HE staing,immunohistochemical staining,and Sanger sequencing.Additionally,relevant literature was re-viewed to supplement the findings.Results Among the cohort of five patients,four were female and one was male,aged 57-70 years with a median age of 65 years and an average age of 64.8 years.Clinical presentation revealed that only the first case exhibited frequent urination accompanied by intermittent lumba-go,while the remaining cases were asymptomatic and incidental-ly discovered.Imaging studies demonstrated space-occupying le-sions with clear boundaries and even internal echoes on B-ultra-sonography,and patchy low-density shadows in the center with obvious edge enhancement on CT.Grossly,the tumor was nodu-lar,with a maximum diameter ranging from 2.1 to 7.6 cm,and an average diameter of 4.04 cm,with a solid section.Micro-scopically,the boundary of LOT was consistently well-defined,with a thick capsule.The arrangement of tumor cells was ob-served to be both dense and sparse,accompanied by fresh bleed-ing foci and proteinoid secretions.Focal lymphocyte aggrega-tion,hepatic plate like and hepatic sinusoid like structures,thick-walled blood vessels,false nodules of tumor cells,and old hemorrhage were also noted.The tumor cells exhibited uniformi-ty in shape,appearing round or polygonal,with eosinophilic and fine granular cytoplasm.The nuclei were of similar size and shape,appearing round or oval with a clear nuclear membrane.The histological features of the tumor included 2-grade small nu-cleoli,perinuclear halos,binuclear cells,and nuclear shrink-age,but no mitotic figures were detected.The immunophenotyp-ic analysis revealed strongly diffuse expression of CK7 in the tumor cells,while CD117 was negative.The Ki67 proliferation index was low.Sanger sequencing identified mutations in mTORC1 pathway genes in four cases,including three mutations in MTOR and one mutation in RHEB.The patients underwent either local or radical nephrectomy,and were followed up for a period ranging from 2 to 52 months,during which all patients re-mained free of recurrence.Conclusion The low-grade,eosino-philic,and rare renal tumor known as LOT exhibits inert behav-ior.At present,the follow-up results show that complete resec-tion of local operation is sufficient,and the prognosis is good.It is important to distinguish this lesion from other eosinophilic re-nal tumors.

Purpose To investigate the expression of TRPS1 in synovial sarcoma(SS)and its significance.Methods Twenty-one cases of synovial sarcoma diagnosed by SS1 8(18q11)(SYT)fluorescence in situ hybridization(FISH)or SS18-SSX immunohistochemistry were collected.The expression of TRPS1 was detected by immunohistochemistry EnVision two-step staining,and the relevant literature was reviewed.Results There were 21 cases of synovial sarcoma,including 9 females and 12 males,aged 17-79 years,with a median age of 50 years and an average age of 47.1 years.The tumors occurred in the lung(3 cases),legs(3 cases),kidney(3 cases),feet(2 cases),psoas major muscle(2 cases),rectum(1 case),tho-racic cavity(1 case),ankle canal(1 case),inguinal area(1 case),knee(1 case),palm(1 case),nasal cavity(1 case),and forearm(1 case).The maximum diameter of the tumor was 1.2-13 cm.Grossly,the tumor section was grayish-white,grayish-yellowish solid,and the lesion with hemorrhage was dark red.Microscopically,there were monophasic fibrous SS(16/21,76.2％),poorly differential SS(small cell)(3/21,14.3％),and biphasic SS(2/21,9.5％).Immunophenotypi-cally,tumor cells expressed SS18-SSX(18/18,100％),TLE1(12/12,100％),BCL2(18/18,100％),partially expressed EMA(10/16,62.5％),CK(12/18,66.7％),CD99(4/10,40.0％),SMA(3/16,18.6％),S-100(3/19,15.8％),and desmin(0/21).The proliferation index of Ki67 ranged from 3％-80％,with an average of 39.9％.FISH test showed that all 11 cases were positive for SS18(18q11)split-ting.All 21 cases of SS expressed TRPS1 to varying degrees and intensities(21/21,100％),of which 19 cases(19/21,90.5％)had a positive range of＞50％.There were 19 cases(19/21,90.5％)with a positive intensity of 2+or above.All the 21 patients underwent surgical resection of the tumor,and 20 patients received follow-up visits.3 patients treated with postop-erative combination of radiotherapy and chemotherapy,18 pa-tients treated with postoperative chemotherapy,and 7 patients showed different degrees of recurrence or metastasis,and 9 pa-tients who received follow-up visits died(45％,9/20).Con-clusion Although TRPS1 is regarded as a highly sensitive and specific marker of breast tumor origin,it is also highly expressed in synovial sarcoma,and it is necessary to be vigilant at its pit-falls in the pathological diagnosis.

Objective To compare the efficacy of tibial tuberosity osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) with simple TTO in treatment of recurrent patella dislocation associated with patella alta.Methods From July 2010 to December 2015,50 patients with recurrent patella dislocation and patella alta were included in this study.There were 15 males and 35 females with an average age of 20.6 years.These patients received surgical treatment and their clinical data were collected and retrospectively analyzed by case-control study.According to surgical methods,patients were divided into TTO group (32 cases) and MPFLR + TTO group (18 cases).The differences between preoperative status and postoperative status were evaluated by knee function scores including Tegner,international knee documentation committee (IKDC),Kujala scores,knee injury and osteoarthritis outcome score (KOOS).Patellar stability was checked at the last follow-up visit.Results The TTO group and MPFLR + TTO group were followed up for (50.9 ± 17.8) months and (22.3± 10.1)months,respectively.Two patients occurred recurrent dislocation in TTO group,who showed positive in both extrapolation test and extrapolation apprehension test at 0°flexions of knee.All patients in MPFLR + TTO group did not occur recurrent dislocation,who showed negative in both extrapolation test and extrapolation apprehension test at 0° flexions of knee.There was no significant difference between preoperative and postoperative results in TTO group in Tegner score (P ＞ 0.05),KOOS scores in pain and daily life activities subdomains (P ＞ 0.05),while differences in the rest of scores were statistically significant (P ＜ 0.05).Compared with TFO group,the differences of all scores were statistically significant (P ＜ 0.05) and KOOS scores in the pain and daily life activities subdomains were significantly improved postoperatively in MPFLR + TTO group P ＜0.05).Conclusions For patients with recurrent patellar dislocation associated with patella alta,both surgical methods are found to be effective.Postoperative improvements in pain and daily life activities are less obvious in TTO.While postoperative improvements in pain and daily life activities in MPFLR + TTO are superior to those of TTO.