Objective To explore the diagnosis value of 320-row detector dynamic volume CT in complex congenital heart disease (CCHD)with double outlet right ventricle(DORV).Methods Seventy-eight patients who proveed DORV by surgery in Xinqiao Hospital of Third Military Medical University were reviewed.Thirty-six patients of group A performed 320-row detector dynamic volume CT by using segmental analysis,and were compared with the group B(42 Cases) performed conventional 64-slice CT respectively.Results In 36 cases of DORV confirmed by surgery in group A,MSCT provided accurate qualitative diagnosis in all cases.The accuracy rate of diagnosis of the group B was 90.7％.There was no significant differences compared with the group A (P＞0.05).There were ventricular septal defect in all the 78 cases,pulmonary stenosis in 56 cases,atrial septal defect in 34 cases,pulmonary hypertension in 21 cases,patent ductus arteriosus in 16 cases,coarctation of aorta in 9 cases.Conclusion The 320-row detector dynamic volume CT has important diagnostic value for DORV of the anatomical diagnosis.

OBJECTIVETo investigate the infection rate and subtypes of human papilloma virus(HPV) in patients with oropharyngeal squamous cell carcinoma (OSCC) and analyze the clinicopathologic features of patients with or without HPV infection.

METHODSA total of 66 biopsy or surgical specimens of OSCC archived in the Pathology Department of Chinese Academy of Medical Sciences were analyzed by polymerase chain reaction (PCR), and the generic amplification products were detected by DNA enzyme immunoassay (DEIA) and typed by reverse hybridization line probe assay.

RESULTSHPV-DNA was detected in 11 (16.7%) of all specimens. Among them, 7 were infected with HPV-16,and the remaining 4 patients were infected with HPV-16/11, HPV-35, HPV-58/52, and HPV-33/52/54, respectively. HPV-16 was detected in 72.7% of all positive specimens. There were more females in HPV-positive group than HPV-negative group (36.4% vs. 1.8%,P=0.002). Patients with HPV-positive tumors were more likely to be non-smokers (36.4% vs. 0,p=0.001) and non-drinkers (45.5% vs. 1.8%,p=0.001) than those with HPV-negative tumors. The proportion of moderately or poorly differentiated tumors was higher in HPV-positive patients than HPV-negative patients (81.8% vs. 63.7%), although without statistical significance (p=0.409). No difference was observed in T classification, N classification, and overall tumor stage.

CONCLUSIONSHPV infection rate was 16.7% in this cohort. HPV-positive OSCC has its unique etiologic and clinicopathological characteristics.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; virology ; DNA, Viral ; isolation & purification ; Female ; Humans ; Male ; Middle Aged ; Oropharyngeal Neoplasms ; virology ; Papillomaviridae ; classification ; isolation & purification ; Papillomavirus Infections ; virology

OBJECTIVETo explore the characteristics of 3.0T dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging of lung cancer and its correlation with microvessel density (MVD).

METHODSThirty-seven patients with pathologically proven lung cancer underwent DCE-MR with liver acquisition with volume acceleration sequence. DCE-MR images were acquired intermittently for a total of 4 minutes on a 3.0T MR scanner. The relative enhancing percentage (SI%) at each time point was measured. The shapes of T-SI% curves were defined as A (rapidly ascending followed by a descending branch) and B (rapidly ascending branch followed by a plateau). The early peak enhancement (SIEP%), early peak time (TEP), maximum enhancement (SIpeak%), and peak time (Tpeak) were recorded and compared according to different dimensions, locations, histological types, and differentiation grades of lung cancer. Tumour specimens were immunostained for CD31 and CD34 in ten patients who had undergone surgical resections. The enhancement values were correlated with MVD. Results The SIEP% and SIpeak% of tumors with smaller dimensions (< or = 5 cm) were significantly higher than those with larger dimensions (> 5 cm) (P = 0.014, P = 0.024). The SIEP% and SIpeak% were positively correlated with the tumor MVD. Conclusion The SIEP% and SIpeak% of lung cancer correlate with tumor dimension and can reflect MVD in tumor.

Adenocarcinoma ; blood supply ; diagnosis ; Adult ; Aged ; Carcinoma, Squamous Cell ; blood supply ; diagnosis ; Contrast Media ; Female ; Humans ; Image Enhancement ; methods ; Lung Neoplasms ; blood supply ; diagnosis ; Magnetic Resonance Imaging ; methods ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; diagnosis

OBJECTIVETo assess the diagnostic value of core needle biopsy (CNB) before neoadjuvant chemotherapy for breast cancer.

METHODSOne hundred and nineteen breast cancer cases underwent neoadjuvant chemotherapy in our hospital during the period from June, 2005 to January, 2007 were analyzed. CNB was carried out before starting chemotherapy. The hematoxylin and eosin-stained slides of CNB taken before and after neoadjuvant chemotherapy were reviewed independently by two pathologists, and the rate of consistency was verified.

RESULTSAmongst the 119 cases studied, 110 cases were confirmed to be carcinoma, including 105 cases of invasive carcinoma and 5 cases of ductal carcinoma-in-situ. The rate of consistency was 97.22% (105/108).

CONCLUSIONCNB has important value in distinguishing benign from malignant lesions, as well as in confirming the diagnosis of invasive carcinoma before starting neoadjuvant chemotherapy.

Biopsy, Needle ; methods ; utilization ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; drug therapy ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Female ; Humans ; Neoadjuvant Therapy ; methods

OBJECTIVETo detect the expression of thyroid transcription factor 1 (TTF-1) and study its application in the diagnosis of lung carcinomas.

METHODSOf 134 specimens from lung lobectomy, 105 were primary lung carcinomas including 76 non-small cell carcinomas (NSCLCs), 28 small cell lung cancers (SCLCs) and 1 complex carcinoma (SCLC and SCC), and 29 were metastatic carcinomas. Expression of TTF-1 was detected by immunohistochemistry. The expression level of TTF-1 was graded as, +:6% to 25% of tumor cells positive, ++:26% to 50%, +++:51% to 75%, and ++++:> 76%.

RESULTSThe positive nuclear immunoreactivity of TTF-1 was identified in 23 of 28 SCLCs (82.1%), but none in squamous cell cancer (SCC) (P < 0.001). The positive expression rate of TTF-1 in lung adenocarcinomas (ACs) was 73.8% (31/42). There was no correlation between TTF-1 expression and ACs differentiation or ACs subtypes (P > 0.05). All but one (thyroid follicular carcinoma) metastatic ACs were TTF-1-positive. Mesenchymal component and lymphoid or inflammatory cells were consistently TTF-1-negative.

CONCLUSIONA significant difference of TTF-1 expression may assist in distinguishing SCLC from SCC, lymphoma or inflammatory lesions. Owing to its restrictive expression in lung tissue, TTF-1 might be used to differentiate primary from metastatic adenocarcinoma of the lung.

Adenocarcinoma ; diagnosis ; metabolism ; Breast Neoplasms ; pathology ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; metabolism ; Colorectal Neoplasms ; pathology ; Diagnosis, Differential ; Humans ; Lung Neoplasms ; diagnosis ; metabolism ; secondary ; Nuclear Proteins ; biosynthesis ; Thyroid Nuclear Factor 1 ; Transcription Factors ; biosynthesis

OBJECTIVETo study the clinicopathological features of gastric neuroendocrine tumors.

METHODSTwenty cases were reviewed. The specimens were formalin-fixed, paraffin-embedded and immunostained by S-P method.

RESULTSAmong the twenty cases, one case was carcinoid, three were malignant carcinoids, six had small cell carcinomas and ten had mixed extocrine--endocrine carcinomas. Immunohistological examination of tumor cells found 80% positive for S-100, NSE (85%), CgA (50%), SY (50%), gastrin (30%), serotonin (65%), AE1/AE3 (50%), and CEA (80%).

CONCLUSIONSIn the WHO classification, there are five histological types in endocrine tumors of gastrointestinal tract. They are carcinoid, malignant carcinoid, small cell carcinoma, mixed exocrine--endocrine carcinoma and tumor-like lesions. But some cases in our paper were so different that they could not be classified. The gastric endocrine tumors are different from intestinal endocrine tumors and in classification, treatment and prognosis.

Adult ; Aged ; Carcinoembryonic Antigen ; metabolism ; Carcinoid Tumor ; metabolism ; pathology ; Carcinoma, Small Cell ; metabolism ; pathology ; Female ; Gastrins ; metabolism ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neuroendocrine Tumors ; metabolism ; pathology ; Phosphopyruvate Hydratase ; metabolism ; Prognosis ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo discuss the clinicopathological features and prognostic factors of gastric lymphoma.

METHODS83 gastric lymphoma cases were analyzed retrospectively in accordance to the criteria of the new World Health Organization classification for neoplastic diseases of the hematopoietic and lymphoid tissues. The correlations between clinicopathological features, therapeutic measures and survival were discussed.

RESULTSThe age of patients ranged from 25 to 77, with a median of 52. The number of males were similar to that of females. There were no specific symptoms. The most common symptoms were stomach ache (60 cases, 72%) or discomfort. The duration of symptoms was often long and with a history of chronic gastric diseases (21 cases, 25%). 13 cases had multiple lesions in the gastrointestinal mucosa. 51 cases (61%) were accompanied by lymph node involvement. According to the new World Health Organization classification for neoplastic diseases of the hematopoietic and lymphoid tissues, 57 cases were extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT)-type (MALT lymphoma), 23 were diffuse large B cell lymphoma accompanying MALT lymphoma, 2 were diffuse large B cell lymphoma and 1 was follicular lymphoma. Of all the cases, 31 were stage I E, 38 stage II E, 8 stage III E and 6 stage IV by the Ann Arbor staging system (1972). The total 5-year and 10-year survival rates were 77.8% and 70.1% respectively, with the mean survival time of 146 months. The 5-year and 10-year survival rates of MALT lymphoma were 77.4% and 72.3%, the 5-year and 10-year survival rates of diffuse large B cell lymphoma accompanying MALT lymphoma were 81.8% and 68.2%, the 5-year survival rate of diffuse large B cell lymphoma was 50.0%.

CONCLUSIONSThere are no specific symptoms in gastric lymphoma patients. Extranodal marginal zone lymphoma of MALT-type is the main histopathological type of gastric lymphoma, often accompanied by multiple mucosa involvement and also often accompanied by a history of chronic gastric disease. The lesion is usually localized for a long time, with a very good prognosis. Survival rate has a significant correlation with lymph node involvement and clinical stage. No correlations were found between the survival rates with age, gender, B symptoms, invasive depth of the wall of stomach, the size and range of the tumors or different therapeutic measures.

Adult ; Aged ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Lymphatic Metastasis ; Lymphoma ; pathology ; surgery ; therapy ; Lymphoma, B-Cell ; pathology ; surgery ; therapy ; Lymphoma, B-Cell, Marginal Zone ; pathology ; surgery ; therapy ; Lymphoma, Large B-Cell, Diffuse ; pathology ; surgery ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; therapy ; Survival Rate

Previous studies have shown that the expressions of the γ2 chain of laminin-5 and secreted protein acidic and rich in cysteine (SPARC) play important roles in oncogenesis and the development of carcinoma. To assess the expressions of laminin-5 γ2 chain and SPARC in esophageal squamous cell carcinoma (SCC), and to clarify the prognostic significance of the expressions of laminin-5 γ2 chain and SPARC in esophageal SCC, we detected the expressions of laminin-5 γ2 chain and SPARC in cancer tissue and corresponding normal mucosa from 116 patients with advanced (stages II-IV) esophageal SCC using the tissue microarray-based immunohistochemistry and analyzed the correlation of the expressions with clinicopathologic characteristics and survival. We found that in normal esophageal tissues, laminin-5 γ2 chain was expressed in the basement membrane, whereas in esophageal SCC tissues, laminin-5 γ2 chain was expressed in the cytoplasm of carcinoma cells, with a positive rate of 72.4%. SPARC was not detected in normal esophageal mucosa, but was expressed in stromal fibroblasts in 84.6% of esophageal SCC cases and in cancer cells in 7.8% of esophageal SCC cases. There was a significant correlation between laminin-5 γ2 chain and stromal SPARC expression in esophageal SCC (Spearman's rho=0.423, P<0.001). The expressions of both laminin-5 γ2 chain and stromal SPARC were correlated with survival (P=0.032 and P=0.034, respectively). In stage-II esophageal SCC, the expression of laminin-5 γ2 chain was significantly correlated with survival (P=0.023), while the expression of SPARC was not significantly correlated with survival (P=0.154). Patients with elevated levels of laminin-5 γ2 chain and SPARC expressions had a poorer prognosis than did those lacking elevated levels of laminin-5 γ2 chain expression and/or elevated levels of SPARC expression (P=0.001). In stage-II esophageal SCC, patients with elevated levels of laminin-5 γ2 chain and SPARC expressions had a poorer prognosis (P<0.001). These results suggest that laminin-5 γ2 chain and SPARC may play roles in the progression of esophageal SCC and their simultaneous expression is correlated with poorer prognosis, especially in patients with stage-II SCC.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Laminin ; metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Staging ; Osteonectin ; metabolism ; Survival Rate

OBJECTIVETo investigate the histological criteria of breast cancer response to neoadjuvant therapy.

METHODSOne hundred and fifty-four cases of breast cancer receiving neoadjuvant therapy were collected from June, 2005 to June, 2007 and the clinical data were analyzed. All patients were operated on within 4 weeks after neoadjuvant therapy. All specimens were assessed by the standard method of Miller and Payne (MP) grading system. The response to neoadjuvant therapy were assessed by two pathologists independently, using MP grading system and common grading system separately.

RESULTSThe response rate using the MP grading system were grade 1 in 12 cases (7.8%), grade 2 in 33 cases (21.4%), grade 3 in 64 cases (41.6%), grade 4 in 31 cases (20.1%) and grade 5 in 14 cases (9.1%). Using the common grading system, the response were mild in 51 cases (33.1%), moderate in 71 cases (46.1%) and severe in 32 cases (20.8%). MP grading system may be related to common grading system (chi2 = 186.660, P < 0.01). Follow up information were available in 147 cases, with 14 cases showing recurrence, metastasis or death from the disease. The MP grading system may be related to the outcome (chi2 = 11.612, P = 0.020), but not the common grading system (chi2 = 0.881, P = 0.644).

CONCLUSIONMP grading system may be one of the prognostic factors in the neoadjuvant therapy of breast cancer.

Biopsy, Needle ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Preoperative Period

OBJECTIVETo investigate and analyze the expression of fascin and CK14 in multiple histological types of cancer and to explore the potential value of the two proteins as markers in diagnosis and differential diagnosis of various cancer types.

METHODSTissue microarray containing esophageal squamous cell carcinoma (SCC), lung SCC, larynx SCC, uterine cervical SCC, SCC of external genital organs, lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, heptocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating ductal carcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, 30 cases each, as well as corresponding normal controls was constructed. The expression of fascin and CK14 among different types of carcinoma and corresponding normal controls was detected by immunohistochemistry.

RESULTSIn normal esophagus, bronchus, larynx, uterine cervix and skin, fascin was mainly expressed in the basal cells or reserve cells, but the expression was diffuse in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, with a positive rate of 90.0%, 90.0%, 96.7%, 78.6% and 89.7%, respectively. In the normal tissue of other organs, except breast and uterine endometrium, fascin was negative. In lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, the positive rates were 38.0%, 23.3%, 14.3%, 10.3%, 73.3%, 13.3%, 6.7%, 60.0%, 66.7% and 10.0%, respectively. The difference between fascin expression in SCC and in other histological types was statistically significant (P < 0.001). CK14 was mainly expressed in the basal cells, reserve cells or myoepithelia of normal tissues. The positive rates of CK14 were 76.7%, 36.7%, 83.3%, 60.7% and 96.3% in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, respectively. It was weak and focal in lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma, and renal clear cell carcinoma, with a positive rate of 13.3%, 13.3%, 20.7%, 41.4%, 46.7%, 6.7%, 40.0%, 13.3%, 20.0% and 6.7%, respectively. The difference between CK14 expression in SCC and in other histological types was statistically significant (P < 0.001). The difference between co-expression of fascin/CK14 in SCC and in other histological types was also statistically significant (P < 0.001).

CONCLUSIONFascin and CK14 are highly expressed in SCC, compared with other histological types of carcinoma. Combination of fascin and CK14 should be a valuable marker in diagnosis and differential diagnosis of carcinoma.

Adenocarcinoma ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Carrier Proteins ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Keratin-14 ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Lung Neoplasms ; metabolism ; pathology ; Male ; Microfilament Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology ; Uterine Cervical Neoplasms ; metabolism ; pathology