1.Nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in Guangzhou
Rongshao TAN ; Haiyan MAI ; Feng YAN ; Tongmei ZENG ; Yuqin HE ; Shi FANG
Chinese Journal of Clinical Nutrition 2010;18(6):334-338
Objective To investigate the nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in some hospitals in Guangzhou, with an attempt to provide evidences for the nutritional support of patients with kidney diseases. Methods Totally 378 adult patients in departments of nephrology in Guangzhou were enrolled in this study by fix-point consecutive sampling. Nutritional Risk Screening 2002 (NRS 2002) was applied for nutritional risk assessment. Nutrition risk was defined by NRS score ≥3 and undernutrition by BMI < 18.5 kg/m2 or serum albumin < 30 g/L. Nutritional interventions were also evaluated in all patients. The relationship between nutritional risk and nutritional support was analyzed. Results The overall prevalence of undernutrition was 21.7% and the nutritional risk was 41.3%. They were especially high among patients with chronic kidney dysfunction (24. 3% and 60. 7% , respectively). The nutritional risk was 42. 3% in patients accompanied with diabetes (P>0. 05). Of these 378 patients, 102 (27.0%) received nutritional interventions, in which the nutritional support rate was 50. 0% (78/156) for patients with nutritional risks and 10. 8% (24/222) for those without nutritional risks. Conclusions The nutritional risks and prevalence of undernutrition are high among inpatients in the departments of nephrology in hospitals in Guangzhou. Proper application of nutritional interventions remains a concern. Evidence-based guidelines are required to improve this situation.
2. Clinicopathologic features and expression of OCT4 protein in testicular diffuse large B cell lymphoma
Yanping CHEN ; Weifeng ZHU ; Lifang CHEN ; Jianping LU ; Tongmei HE ; Wenda FU ; Chunwei XU ; Gang CHEN
Chinese Journal of Pathology 2017;46(6):383-387
Objective:
To evaluate the expression of OCT4 and SALL4 in testicular diffuse large B-cell lymphoma (DLBCL), and the utility of an immunohistochemical (IHC) panel of OCT4, SALL4 and CD20 in the differential diagnosis of DLBCL and GCT of the testis.
Methods:
Eighteen cases of testicular DLBCL were selected.IHC method was used to detect the protein expression of CD20, CD3, CD5, CD10, bcl-6, MUM1, Ki-67, bcl-2, c-MYC, OCT4 and SALL4.
Results:
Among the 18 cases, CD20 and PAX5 were strongly and diffusely expressed in all cases, while CD21, CD3, cyclinD1, SALL4, CD117 and PLAP were all negative. CD5, bcl-2 and c-myc were expressed in 3, 16 and 8 cases, respectively. Ki-67 proliferation index ranged from 40%-95%. Bcl-2 and c-MYC were co-expressed in seven cases. Four cases were GCB-DLBCL and the remaining 14 cases were non-GCB-DLBCL, according to Hans algorithm. Nuclear OCT4 expression was present in two cases, which demonstrated moderate expression in >50% of neoplastic cells. Univariate analysis showed that clinical stage, CD5 and OCT4 expression were relevant to prognosis. Multivariate Cox regression analysis further confirmed that clinical stage, CD5 and OCT4 were independent prognostic factors in patients with testicular DLBCL.
Conclusions
Care should be exercised in using OCT4 as the sole marker of germ cell differentiation in the testis. The association of OCT4 and CD5, bcl-2 co-expression raises the question of whether OCT4 expression in DLBCL may reflect more aggressive biology.
3.Expression of PDGFRA and CMYC in extranodal NK/T-cell lymphoma and their prognostic implications
Yanping CHEN ; Weifeng ZHU ; Jianyang LIN ; Tongmei HE ; Haiming MA ; Jianping LU ; Xingan YE ; Chunwei XU ; Gang CHEN
Chinese Journal of Pathology 2016;45(12):825-830
Objective To investigate the relationship between expression of PDGFRA /CMYC and clinicopathologic features of extranodal NK/T-cell lymphoma .Methods Fifty-four cases of extranodal NK/T-cell lymphoma were included in the study .Immunohistochemistry was used to detect the expression of CD20, CD2, CD3, CD56, TIA1,GrB, Ki-67, PDGFRA and CMYC.In situ hybridization was performed to detect the presence of EBV encoded small RNA ( EBER).Fifty cases of nasopharyngeal mucosal lymphoid tissue hyperplasia were used as normal control .Results Among 54 cases of ENKTL,CD2, CD3, GrB, and TIA1 were expressed in all the tumors .CD56 was expressed in 47 cases ( 81.0%) and CD20 was not detectable in any cases.Ki-67 proliferative index expression of >60%was found in 45 cases (83.3%).In situ hybridization for EBER was positive in all cases (100%).The positive expression rates of PDGFRA and CMYC in extranodal NK/T-cell lymphomas were 51.9%(28/54) and 53.7%(29/54), respectively, much higher than those in nasopharyngeal mucosal lymphoid tissue hyperplasia ( 0, P <0.05 ) .There was a positive correlation between PDGFRA and CMYC (r=0.295, P<0.05).The expression of CMYC was correlated with clinical efficacy (P<0.05), but not with gender, age, Ann Arbor stage, B symptoms and therapeutic regimen ( all P >0.05 ) .The expression of PDGFRA was correlated with B symptoms ( P <0.05), while not with gender, age, Ann Arbor stage, therapeutic regimen and clinical efficacy (all P>0.05).The co-expression of PDGFRA and CMYC was not correlated with gender , age, Ann Arbor stage, B symptoms, therapeutic regimen and clinical efficacy (P>0.05).Univariate analysis showed that the stage , clinical efficacy , CMYC protein and the co-expression of PDGFRA and CMYC were significantly correlated with the prognosis.The overall survival of the patients with CMYC positive expression was shorter than of that of the patients with negative expression ( P <0.05 ) .Multivariable Cox regression analysis further confirmed that clinical stage , CMYC protein expression , and the co-expression of PDGFRA and CMYC were independent prognostic factors in patients with extranodal NK /T-cell lymphoma .Conclusion CMYC protein, and the co-expression of PDGFRA and CMYC can be as an independent prognostic factor in patients with extranodal NK/T-cell lymphoma and influence the prognosis of patients .
4.Dedifferentiated endometrial carcinoma/undifferentiated endometrial carcinoma with loss of expression of SMARCA4: clinicopathological features analysis
Wei LIU ; Yi SHI ; Xiaojiang WANG ; Yanmei CUI ; Tongmei HE ; Jingcheng LIU ; Weifeng ZHU ; Qin XU ; Dan HU
Chinese Journal of Obstetrics and Gynecology 2024;59(11):856-863
Objective:To investigate the clinicopathological characteristics of dedifferentiated endometrial carcinoma/undifferentiated endometrial carcinoma (DDEC/UDEC) with loss of expression of SMARCA4.Methods:A total of 10 cases with loss of expression of SMARCA4 were diagnosed at Fujian Cancer Hospital between January 2019 and December 2023. A retrospective analysis was conducted on the clinical characteristics, morphology, immunophenotype, molecular classification, and prognosis.Results:(1) Clinical characteristics: among 10 cases of DDEC/UDEC with loss of expression of SMARCA4, the patients′ age ranged from 48 to 65 years, with a median age of 56 years.Five cases were classified as International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ-Ⅱ, while the remaining five were categorized as stages Ⅲ-Ⅳ. (2) Pathological features: tumor cells exhibited poor cell adhesion, with common intravascular tumor emboli (8/10), occasional vacuolated nuclei (6/10), rhabdoid cells (4/10), and starry sky phenomenon formed by tissue cell phagocytosis apoptosis bodies or fragments (4/10). Six cases (6/10) showed loss of mismatch repair (MMR) protein expression, two cases (2/10) exhibited p53 mutant expression, and five cases (5/10) tested positive for programmed cell death ligand 1 (PD-L1). (3) Molecular subtyping: molecular subtyping revealed POLEmut in 1 case (1/10), mismatch repair deficient (MMR-d) in 5 cases (5/10), p53 abn in 1 case (1/10), and no specific molecular profile (NSMP) in 3 cases (3/10). (4) Prognosis: the follow-up period ranged from 7 to 42 months, with a median of 20 months. Five patients succumbed to the tumor, whereas the remaining five exhibited no recurrence during subsequent postoperative evaluations. The 2-year progression-free survival rates and overall survival rates were 58.3% and 52.5%, respectively.Conclusions:Loss of expression of SMARCA4 occurs in approximately 1/5 of DDEC/UDEC, which presents with an aggressive clinical course and a poor prognosis. About half of them show MMR protein loss expression and PD-L1 positive expression, suggesting that there might be benefit from treatment with immune checkpoint inhibitors.