Objective To study the risk factors affecting neoplasm recurrence and survival of hepatocellular carcinoma(HCC)following liver transplantation(LT).Methods The clinicopatholo gic data,neoplasm recurrence and survival results of 118 patients with HCC receiving LT were retro- spectively analyzed and various clinicopathologic risk factors for neoplasm recurrence and survival were evaluated by univariate and multivariate analysis.Results The follow-up time ranged from 1 to 32 months.The recurrence rate was 37.3% and the mortality was 35.5%.The 12-,18-,24-month survival rate was 84.55%,70.30% and 62.24%,respectively.The 12-,18-,24-month neoplasm free survival rate was 69.05%,66.93% and 61.38%,respectively.In the univariate analysis,por- tal vein neoplasm thrombus(PVTT),Milan-criteria,neoplasm size,histological differentiation and pTNM stage were associated significantly with neoplasm recurrence,and PVTT,Milan-criteria,pre- operative alpha-fetoprotein(AFP),histological differentiation and pTNM stage were associated signif- icantly with survival rate;In the multivariate Logistic regression analysis,PVTT and histological dif- ferentiation were independent predictive factors of neoplasm recurrence,and multivariate Cox regres- sion analysis showed that PVTT and AFP independently associated with prognosis.Conclusions PVTT and histological differentiation are the most important predictive factors of neoplasm recur- rence,and PVTT and AFP independently predict the survival of patients undergoing LT.

Objective To detect the Yersinia pestis plasmid and molecular weight along the Qinghai-Tibet Railway.Methods Yersinia pestis plasmids molecular weight detected and analyzed using alkaline lysis,phenol-chloroform extraction of Yersinia pestis plasmid by agarose gel electrophoresis.Results The 18 Yersinia pestis strains of Qinghai-Tibet Railway contained 6×106,45×106,52×106,65×106,92×106plasmid,varing in the range of the 52×106-92×106.Conclusions The Yersinia pestis of Qinghai-Tibet Railway has a standardplasmid graphics,with the biggest Yersinia pestis plasmid changing in a certain regular degree,which providessignificance in the study of plague natural foci of the spatial structure and the genetic.characteristics of Yersiniapestis.

BACKGROUND AND OBJECTIVEEpstein-Barr virus (EBV) has been detected in about 10% of gastric carcinomas. However, the pathogenetic role of EBV in gastric carcinoma is uncertain. This study was to explore the correlation of Fas/FasL expression to the apoptosis of tumor cells and tumor-infiltrating lymphocytes (TIL) in EBV-associated gastric carcinoma (EBVaGC).

METHODSFas/FasL expression in 49 specimens of EBVaGC, 20 specimens of EBV-negative gastric carcinoma (EBVnGC) and 12 specimens of normal gastric mucosa was detected by immunohistochemistry. The apoptotic index (AI) of cells was determined by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL).

RESULTSThe positive rates of Fas were 91.7% in normal gastric mucosa and 76.8% in gastric carcinoma (P < 0.05); those of FasL were 16.7% in normal gastric mucosa and 58% in gastric carcinoma (P < 0.05). The positive rate of Fas was significantly lower in EBVaGC than in EBVnGC (71.4% vs. 90.0%, P < 0.05). The positive rate of FasL in EBVaGC was significantly higher than that in EBVnGC (63.2% vs. 45%, P < 0.05). The AI of EBVaGC cells was significantly lower than that of EBVnGC cells (P = 0.002). The number and AI of TIL in EBVaGC were higher than those in EBVnGC (P < 0.05). The AI of TIL was positively correlated with the level of FasL expression in tumor cells (r=0.237, P = 0.028).

CONCLUSIONUp-regulation of FasL expression and decrease of TIL apoptosis in EBVaGC may facilitate the escape of tumor cells from the host immunosurveillance, and it might contribute to the development and progression of carcinoma.

Adult ; Apoptosis ; Epstein-Barr Virus Infections ; Fas Ligand Protein ; metabolism ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunohistochemistry ; Immunologic Surveillance ; In Situ Nick-End Labeling ; Lymphocytes, Tumor-Infiltrating ; pathology ; Male ; Middle Aged ; Stomach Neoplasms ; metabolism ; pathology ; virology ; Tumor Escape ; fas Receptor ; metabolism

OBJECTIVETo investigate the expression of matrix metalloproteinase 9 (MMP9) in mucosal natural killer/T cell and mature T cell lymphomas and its relation to Epstein-Barr virus (EBV) infection.

METHODSThe expression of MMP9 and EBV-encoded RNA (EBER) were detected by immunohistochemistry and in situ hybridization in 59 cases of mucosal natural killer/T cell and mature T cell lymphomas.

RESULTSThe positivity rates of MMP9 and EBERs were 83.05% and 72.88% respectively. The positivity rate of EBERs was correlated with histopathological subtype (P<0.05), but not with clinical stage, vascular invasion or the patients' survival time (P>0.05). The expression level of MMP9 was not correlated with the clinical stage, vascular invasion or survival time (P>0.05). No significant correlation was found between MMP9 expression and EBV infection.

CONCLUSIONEBV may play an important role in the development of mucosal natural killer/T cell and mature T cell lymphomas and promote disease progression by up-regulating MMP9 expression indirectly. Elimination of EBV infection may be helpful to prevent the development of lymphoma.

Female ; Gene Expression Regulation, Neoplastic ; Herpesvirus 4, Human ; physiology ; Humans ; Lymphoma, T-Cell ; genetics ; pathology ; virology ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Mucous Membrane ; pathology ; virology ; Natural Killer T-Cells ; pathology ; virology

OBJECTIVETo investigate the prevalence of Epstein-Barr virus (EBV)-associated gastric carcinomas in Guangzhou, their clinicopathologic features and related protein expressions including DNMT1, p16, and cyclin D1.

METHODA total of 676 cases of EBV-associated gastric carcinoma were included in the study. The presence of EBV-encoded small RNA1 (EBER1), a marker for EBV infection, was analyzed by in-situ hybridization using formalin-fixed and paraffin-embedded tumor samples. Expression of EBV-encoded proteins, DNMT1, p16 and cyclin D1 were detected by immunohistochemistry.

RESULTSForty-five of 676 gastric carcinomas showed EBER intranuclear positivity in all tumor cells. EBV involvement was significantly more frequent among the male than the female patients, especially in tumors of less differentiated types (diffuse type) and involving the upper stomach (P < 0.05). EBNA1 and LMP2A expression were detected in 42 (93.3%) and 24 (53.3%) cases, respectively. None expressed EBNA2, LMP1, and ZEBRA. Among 45 cases of EBV associated gastric carcinomas, DNMT1, p16 and cyclin D1 expression were seen in 35 (77.8%), 10 (22.2%), and 29 (64.4%) cases, respectively. In contrast, among 40 EBV negative gastric carcinomas, expression of the three proteins were 20 (50.0%), 25 (62.5%) and 12 (30.0%), respectively. The difference of expression of the three proteins between the two groups was significant (P < 0.05). Expression of p16 correlated with the depth of the tumor invasion. Correlated protein expression was seen between LMP2A and DNMT1, between DNMT1 and p16, and between p16 and cyclin D1 (P < 0.05).

CONCLUSIONSEBV associated gastric carcinoma accounts for 6.7% of gastric carcinomas in Guangzhou with the Latency I pattern in some cases and between Latency I and II in others. The correlated expression of LMP2A, DNMT1, p16 and cyclin D1 may contribute to the pathogenesis of EBV associated gastric carcinomas.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; metabolism ; Epstein-Barr Virus Infections ; virology ; Epstein-Barr Virus Nuclear Antigens ; metabolism ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; RNA, Viral ; metabolism ; Sex Factors ; Stomach Neoplasms ; metabolism ; pathology ; virology ; Viral Matrix Proteins ; metabolism ; Young Adult

OBJECTIVETo analyze the clinical and pathological features of patients with liver retransplantation.

METHODSThe clinical and pathological data of 22 patients who had liver retransplantation at our center from October 2003 to June 2006 were retrospectively analyzed.

RESULTSAmong the 523 patients who underwent liver transplantation, 22 (4.4%) had liver retransplantation. The causes of liver retransplantation were biliary tract complications (13/22), hepatic artery thrombosis (3/22), recurrence of hepatocellular carcinoma (5/22) and nonfunctional primary graft (1/22). The pathological changes in the livers of patients with biliary complications were intrahepatic cholestasis, primary bile duct hyperplasia and neutrophil infiltrations.

CONCLUSIONBiliary tract complications are the main cause of liver retransplantation. Differential diagnosis of various complications through early liver puncture biopsy and imaging examination will contribute to guide clinical treatment and may help in avoiding liver retransplantation.

Adult ; Aged ; Female ; Graft Survival ; Humans ; Liver ; pathology ; Liver Transplantation ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Transplants

OBJECTIVETo investigate the expressions of human telomerase reverse transcriptase (h-TERT), c-myc, and proliferating cell nuclear antigen (PCNA) in chronic viral hepatitis (CVH), liver cirrhosis and primary hepatocellular carcinoma (HCC) and understand their possible role in liver carcinogenesis.

METHODSTotally 157 liver disease specimens were collected, including 56 CVH, 52 liver cirrhosis and 49 primary HCC specimens. In situ hybridization was performed on these specimens to examine the expressions of h-TRET and c-myc mRNA, and immunohistochemistry carried out for PCNA detection, with the cell apoptosis detected with in situ ending labeling.

RESULTSIn the CVH, liver cirrhosis and primary HCC specimens, h-TERT expression was detected at the frequencies of 11/56 (19.6%), 43/52 (82.7%) and 44/47 (93.6%), c-myc expression at 7/56 (12.5%), 21/52 (40.4%) and 26/47 (55.3%), with apoptotic index of (27.3-/+4.7)%, (16.5-/+2.6)% and (8.7-/+1.3)% and PCNA expression rate of (17.1-/+2.9)%, (49.3-/+7.8)% and (62.5-/+9.1)%, respectively. Correlations among h-TERT, c-myc, and PCNA expressions and the apoptotic index were not found in the examined tissues (P>0.05).

CONCLUSIONLiver carcinogenesis may involve increased h-TERT, c-myc, and PCNA expressions and suppressed cell apoptosis.

Adult ; Apoptosis ; Carcinoma, Hepatocellular ; genetics ; metabolism ; pathology ; Cell Transformation, Neoplastic ; Female ; Hepatitis B, Chronic ; genetics ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver Cirrhosis ; genetics ; metabolism ; pathology ; Liver Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Proto-Oncogene Proteins c-myc ; genetics ; RNA, Messenger ; genetics ; metabolism ; Telomerase ; genetics

Background and Objective:Epstein-Barr virus(EBV)has been detected in about 10% of gastric carcinomas.However.the pathogenetic role of EBV in gastric carcinoma is uncertain.This study was to explore the correlation of Fas/FasL expression with the apoptosis of tumor cells and tumor-infiltrating lymphocytes(TIL)in EBV-associated gastric carcinoma (EBVaGC).Methods:Fas/FasL expression in 49 specimens of EBVaGC,20 specimens of EBV-negative gastric carcinoma(EBVnGC)and 12 specimens of normal gastric mucosa was detected by immunohistochemistry.The apoptotic index(Al)of cells was determined by terminal deoxynucleotidyl transferase(TdT)-mediated dUTP-biotin nick end labeling(TUNEL).Results:The positive rates of Fas were 91.7%in normal gastric mucosa and 76.8%in gastric carcinoma(P＜0.05);those of FasL were 16.7%in normal gastric mucosa and 58%in gastric carcinoma(P＜0.05).The positive rate of Fas was lower in EBVaGC than in EBVnGC(71.4%vs.90.O%,P＞0.05).The positive rate of FasL in EBVaGC was significantly higher than that in EBVnGC(63.2%vs.45%.P＜0.05).The Al of EBVaGC cells was significantly lower than that of EBVnGC cells(P=0.002).The number and Al of TIL in EBVaGC were higher than those in EBVnGC(P＜0.05).The Al of TIL was positively correlated with the level of FasL expression in tumor cells(r=0.237,P=0.028).Conclusion:Up-regulation of FasL expression and decrease of TIL apoptosis in EBVaGC may facilitate the escape of tumor cells from the host immunosurveillance,and it might contribute to the development and progression of carcinoma.

Acute Disease ; Adolescent ; Adult ; Aged ; Biopsy, Needle ; Endothelial Cells ; metabolism ; Female ; Graft Rejection ; diagnosis ; Hepatocytes ; metabolism ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; metabolism ; Liver ; metabolism ; pathology ; Liver Transplantation ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Young Adult

OBJECTIVETo study the clinicopathologic features of follicular dendritic cell sarcoma (FDCS) and its differential diagnosis.

METHODSTen cases of FDCS were studied by light microscopy, immunohistochemistry and in-situ hybridization. The clinical features and follow-up information were analyzed.

RESULTSAmongst the 10 cases of FDCS studied, the male-to-female ratio was 1:1. The mean age of the patients was 42 years. Six of them were located in cervical and peritoneal lymph nodes and four in extranodal sites (including tonsil, pelvic cavity, tail of pancreas and spleen). Histologically, the tumor cells had whorled, storiform or diffuse growth patterns. They were spindle in shape and contained syncytial eosinophilic cytoplasm, with round or oval nuclei, vesicular chromatin, distinct nucleoli and a variable number of mitotic figures. Multinucleated tumor giant cells and intranuclear pseudoinclusions were occasionally seen. There was a sprinkling of small lymphocytes and neutrophils within the tumor as well as in the perivascular region. Immunohistochemical study showed that the tumor cells were diffusely or focally positive for CD21, CD23, CD35 and D2-40, but negative for LCA, CD20, CD3, CD1a, HMB45 and CK. Some of them showed EMA, CD68 and S-100 reactivity. In-situ hybridization for Epstein-Barr virus-encoded RNA (EBER) showed positive signals in only one case (which was diagnosed as inflammatory pseudotumor-like FDCS). Of the 7 patients with follow-up information available (duration: 2 months to 39 months; mean: 14 months), 2 cases with paraneoplastic pemphigus died of pulmonary infection at 5 and 7 months respectively. The remaining 5 patients were alive and disease-free after surgical excision (+/- chemotherapy and radiotherapy).

CONCLUSIONSFDCS is a rare low to intermediate-grade malignant tumor. Appropriate application of FDC markers, such as CD21, CD35 and D2-40, would be helpful for arriving at a correct diagnosis. Most cases are associated with good prognosis after surgical treatment, with or without chemotherapy and radiotherapy. Patients with paraneoplastic pemphigus carry a less favorable prognosis.

Adult ; Antibodies, Monoclonal, Murine-Derived ; metabolism ; Dendritic Cell Sarcoma, Follicular ; complications ; metabolism ; pathology ; surgery ; Dendritic Cell Sarcoma, Interdigitating ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Male ; Meningioma ; pathology ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Paraneoplastic Syndromes ; complications ; Pemphigus ; complications ; Receptors, Complement 3b ; metabolism ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Tonsillar Neoplasms ; metabolism ; pathology ; surgery ; Young Adult