A unique fusion between the TMPRSS2 gene and the Ets genes ERG,ETV1、ETV4 or ETV5 has been described in prostate cancer, TMPRSS2-ERG is the most high frequency of all. Until now more than 20 kinds of TMPRSS2- ERG hybrid transcripts are found, and they encode 9 kinds of proteins. Deletion is the main mechanism of fusion. Fusion gene can be used to make a diagnosis of prostate cancer , direct clinical medication , then fusion type, fusion number and transcriptive type are also associated with prognosis of dis-ease. So, besides of serum PSA, Gleason score, TMPRSS2- ERG is expected to be another important predicator of prognosis.

Objective To study clinicopathologic features of ALK-positive large B-cell lymphoma.Methods The clinical data,histopathological characteristics,immunophenotype and fluorescence in situ hybridization (FISH) result of a patient with ALK-positive large B-cell lymphoma were analyzed and discussed combined with related literatures.Results A 30-years-old male patients with the left neck lymphadenectasis was studied.Histological evaluation revealed the tumor grew in sheets in the nodal,with round nuclei,dispersed chromatin,a single prominent central nucleolus and moderate amounts of eosinophilic to amphophilic cytoplasm.The neoplastic cells exhibited immunoblastic/plasmablastic morphology.Immunohistochemistry measurement showed that the tumor cells were marked positively by CD138,ALK-1,CD45RO,CD4,Perforin,CD117 and Kappa proteins,while negatively by CD3,CD8,CD20,CD30,CD38,CD57,CD79a,Pax-5,EMA and AE1/AE3 proteins.FISH test demonstrated the presence of ALK gene translocation.The patient was given 4 cycles of CHOP chemotherapy after surgery.However,the conditions deteriorated after 4 months.Now the patient continued to receive treatment.Conclusion ALK-positive large B-cell lymphoma represents a distinct variant of diffuse large B-cell lymphoma,and the tumor has special histological features along with a distinct immunophenotype and ALK gene rearrangement.

Purpose To ana1yze the expression features of 5-F1uorouraci1(5-FU)metabo1ic enzyme thymidy1ate synthetase(TS),thy-midine phosphory1ase( TP),dihydropyrimidine dehydrogenase( DPD)and its re1ationship with c1inicopatho1ogica1 factors and progno-sis in co1orecta1 cancer,in order to further exp1ore its potentia1 significance in guiding co1orecta1 cancer chemotherapy. Methods Es-tab1ishment of a tissue microarray containing 72 patients with co1orecta1 cancer,and 56 norma1 tissue( dista1 cut edge tissue near carci-noma)was used to detect TS,TP,and DPD by immunohistochemistry,and to ana1yze its re1ationship with c1inicopatho1ogica1 factors and prognosis of co1orecta1 cancer through statistica1 method. Results The expression of TS in co1orecta1 cancer was 1ower than that in norma1 tissue(P=0. 876),which was associated with TNM(P=0. 043)and positive1y corre1ated with patients’overa11 surviva1(P=0. 027),the expression of TP in co1orecta1 cancer was higher than that in norma1 tissue(P=0. 315)that was associated with 1ymph node metastasis(P=0. 009)and negative1y corre1ated with the prognosis of patients(P=0. 040),DPD expression in co1orecta1 canc-er was higher than that in norma1 tissue(P=0. 071),which was re1ated to the histo1ogic type(P=0. 029). Overa11 surviva1 was sig-nificant1y shortened in co1orecta1 cancer with DPD high expression( P=0. 011). Conclusions TS,TP and DPD might be app1ied as important index of prognosis in co1orecta1 cancer patients using 5-FU adjuvant chemotherapy. The expression of TS re1ated c1ose1y with the c1inica1 stage is a bio1ogica1 marker of tumor progression. TP expression is c1ose1y re1ated to 1ymph nodes metastasis and recur-rence,which is an important factor of postoperative recurrence and metastasis.

Objective NKT cells are very important as a kind of non-specific immune cells. Much attention in antitumor significance has been received in the study of its effect on malignant diseases. The aim of this study was to detect the expression of NKT cells and its CD+8 NKT subsets in peripheral blood of esophageal patients and normal person, and to analyze the changes in the expression of NKG2D and NKG2A receptorsand its clinical pathological factors. Methods By flow cytometric analysis, 53 patients with esophageal carcinoma and 39 normal controls were analysed for peripheral blood of NKT cells and CD+8 NKT subsets, and the expression of NKT cells NKG2A and expression of NKG2D receptor. The clinical pathological factors were collected for the comparative analysis. Results Compared with the normal control group, the expression of NKT cells in peripheral blood of esophageal patients increased [(4.32±0.73) %, (5.97±1.29) %] (t =3.562, P <0.01), and the expression level of its surface receptor NKG2D reduced [(17.56±5.92) %, (15.12±1.56) %] (t =3.892, P <0.05), but the express levels of NKG2A [(4.02±1.41) %, (5.99±4.59) %] in creased (r = 4.015, P <0.05), those expression change with the development of the esophageal cancer. Conclusion The increased expression of NKT cells and CD+8 NKT subsets in the peripheral blood of patients with esophageal carcinoma refletcs that the immune feedback of patients' antineoplastic effect is strengthened. The decresed expression of the active receptor NKG2D and the increased expression of the inhibitory receptor NKG2A on NKT cells might be one of mechanisms leading to the reduction of NKT cell activity and immune escape of patients with esophageal carcinoma. The changes of surface receptors of NKT cells may be associated with the development of the esophageal cancer.

Purpose To investigate the mutation status of KRAS and PIK3CA gene in colorectal cancer (CRC) primary lesions and corresponding liver metastasis and its clinical significance.Methods The gene mutations of KRAS and PIK3CA were detected in 58 cases of primary lesions of CRC and corresponding liver metastasis tissue by real-time PCR.Results The mutation rates of KRAS were 31.03％ (18/58) and 25.86％ (15/58) in primary lesions of CRC and corresponding liver metastasis tissue,respectively,in which G12D was most commonly detected.The mutation rates of PIK3CA were 8.62％ (5/58) and 10.34％ (6/58) respectively,in which the most common mutation site was E545K.Only one case carried simultaneously both mutations of KRAS (G12D) and PIK3CA (E545K).The mutation of KRAS and PIK3CA had a good consistency between primary lesions and liver metastasis.Univariate analysis showed that the mutation of KRAS was related to the primary lesion of tumor location,the quantity of metastasis and the types of tumor (P ＜ O.05),PIK3 CA mutation was associated with the synchronous/metachronous liver metastasis and the quantity of metastasis (P ＜ 0.05).Multivariate Cox regression analysis showed that synchronous/metachronous liver metastasis and the mutation of KRAS were influencing factors for prognosis of CRC.The overall survival of patients with CRC who had simultaneous liver metastases was longer than those with heterotopic liver metastases;the overall survival of KRAS wild-type mutant patients was longer than those of mutant patients (P ＜ 0.05).Conclusion The G12D site of KRAS gene has the highest mutation frequency in CRC,KRAS/PIK3CA mutation has a good consistency of the primary lesions of CRC and corresponding liver metastasis.Primary lesions can be as the source of molecular detection.To achieve individualized treatment,we need to reassess the genetic status of metastasis based on the choice of targeted therapy for precision medicine.

Objective To analyze and summarize the clinical-pathological features,immunophenotype and prognosis of the lymphoepithelioma-like gastric carcinoma (LELGC).Methods The clinical,radiographic and histological data of four patients with LELGC were retrospectively analyzed.The expression of cytokeratin (CK),CD20,CD3,CD4,CD8,E-cadherin,β-catenin,bcl-2,p16,p53,p63,c-erbB-2,cyclin D1,Ki67 and DNA methyl-transferase 1 (DNMT1) in tumor was detected by Epstein-Barr virus-encoded small RNA (EBER) in situ hybridization and immunohistochemical methods.Results The size of four tumor was 1.8 cm× 1.6 cm,1.5 cm× 2.0 cm,2.5 cm× 2.0 cm and 4.0 cm× 2.5 cm.Under light microscope,tumor cells appeared like cords,small lumps or scattered single infiltration with vacuolized nucleus; clear nucleoli and obvious interstitial lymphocytic infiltration.The results of immunohistochemical examination indicated that in four tumors CK was positive in membrane of all the tumor cells,while EBER was positive in all cell nucleus.The number of lymphocytes with CD3 positive was over those with CD20 positive,which was mainly CD8 positive lymphocytes.The percentage of E cadherin and β-catenin positive in the cell membrane of four tumors was between 10 ％ and 90 ％,and two cases with β-catenin positive in cytoplasm.The expressions of DNMT1,cyclin D1 and bcl-2 were all positive,while p16 and c-erbB-2 were all negative.The expression of p63 was positive in only one case,and p53 was negative in one case.The percentage of Ki67 positive was 40％,15％,60％ and 40％,respectively.Conclusions LELGC is a rare neoplasm with better prognosis.The features of clinical pathology and immunohistology may help to make a correct diagnosis.

Objective To investigate the correlation of pathology factors and prognosis of gastrointestinal stroma tumors (GIST). Methods The expression of CD117, CD34, SMA, S-100 and Ki-67 in 91 GIST cases were studied by Envision method of immunohistocbemistory;Sequently, the relationship of the location, the size, the hemorrhage, cellular necrosis, stroma mucus, the mitosis, Ki-67 expression and the prognosis were analyzed by SPSS 12.0. Results The positive rate of CD117, CD34, SMA, S-100 were 80.21%, 73.63 %, 34.07 %, 7.69 % respectively. There had significant difference between the location, the mitosis, Ki-67 expression and the prognosis; but no significant difference between the location, the hemorrhage, cellular necrosis, stroma mucus, CD117 expression and the prognosis. Conclusion The tumor's size, mitosis, and Ki-67 expression are associated with prognosis; CD117 expression and prognosis. Even more, Ki-67 expression may be a more precise factor to judge the tumor's biological behaviour compared to the mitosis. As a wally classified method, the Flecther classification is worth to spread.

Objective To investigate the significance and expression of PTEN, MLL in T lymphoblastic lymphoma/leukaemia(T-LBL/ALL). Methods Seventy-six cases of T-LBL/ALL were studied by using immunohistochemical EnVision method for PTEN. Fluorescence in-situ hybridization (FISH) for MLL gene (located on chromosome 11q23) was performed to detect its breakage and amplification. Results Among the 76 cases ofT- LBL/ALL, the positive rate of PTEN was 64.47 % (49/76), lower than that in reactivated lymphoid tissue (100 %, 20/20) (λ2= 19.220, P ＜0.05). PTEN expression was reversely correlated to theclinical stage, Ki-67 index and LDH level (P ＜0.05). Among the 76 cases, MLL gene with breakage of 11q23 was detected in 13 cases (17.11%), and amplification in 18 cases (23.68 %). Survival rate ot MLL gene breakage group was lower than that of non-breakage group (25.0 %, 43.6 %). Survival rate of MLL gene amplification group was lower than that of non-amplification group too (17.1%, 42.7 %). Both of breakage and amplification were related to prognosis ( λ 2 = 11.357, λ 2 = 4.533; P ＜0.05). Conclusion Anti-oncogene PTEN down-regulation may play an important role on the development and proceeding of T-LBL/ALL. MLL gene with breakage and amplification of 11q23 are helpful to predict prognosis of T-LBL/ALL. The case with MLL gene breakage and amplification of T-LBL/ALL may have a poor prognosis. It hints this group maybe a subtype of T-LBL/ALL.

Objective To investigate the protein and gene expression of bcl-2, bcl-6 in diffuse large B-cell lymphoma (DLBCL). Methods 73 cases of DLBCL were selected for study using the Envision immunohistochemistry method with a panel of antibodies CD3, CD10, CD20, bcl-6, bcl-2, MUM-1. The bcl-2gene expression in 57 of 73 cases with chromosome translocation t (14; 18), breakage and amplification of 3q27 chromosome in 54 of 73 cases were detected by fluorescence in situ hybridization (FISH) method. Results The percentages of tumor cells expressing CD10, bcl-6, MUM-1, bcl-2 were separately 15.1%, 38.4 %, 71.2 %, 79.2 %. t (14;18) chromosomes were detected in 16 of 57 cases (28.1%). The expression of bcl-2 protein have significantly correlated with immunophenotype subtype (P=0.035), and t (14;18) was significantly correlated with the prognosis (P=0.045). There were no association between the expression of bcl-2 protein and t (14;18)(P=0.710). 11 of 54 cases were presented with 3q27 chromosomal breakage (20.4 %), and 14 cases were chromosomal amplification (25.9 %). The prognosis of cases with positive bcl-6 protein was better than that with negative protein obviously. There was no relationship between bcl-6 and 3q27 chromosomal breakage or amplification (P=1.000). Conclusion The expression of bcl-2, bcl-6 protein and gene were different events and had the different significance on DLBCL. The expression of bcl-2 protein was a prognostic marker correlated with immunophenotype subtype, and GCB type with the positive expression of bcl-2 protein had the poor prognosis. Conversely, t(14;18) was an independent event for the prognosis, and the positive expression have the poor prognosis. Patients who require the target therapy should be detected for the t(14;18). The expression of bcl-6 protein was beneficial to the judgment of DLBCL prognosis, it could be an independent factor of the prognosis. 3q27 chromosomal breakage may be a hint to the poor prognosis.

Objective To investigate the association of Her-2 protein expression and gene expression in gastric cancer by different methods,and to explore the effective approaches of Her-2 in gastric cancer detection.Methods Immunohistochemistry (IHC) was used to mark Her-2 protein in 68 cases of gastric cancer,and fluorescence in situ hybridization(FISH)wasused to detect the Her-2 gene amplification.Results Among 68 cases,IHC Her-2 protein in 12 cases(17.65 ％)was positive expression,including ++ 3 cases ++ 9 cases,+ 7 cases and-49 cases.By FISH,Her-2 gene in 11 cases(16.17 ％)was overexpression.Corresponding to the IHC results,FISH results was 3 cases(100 ％),8 cases(88.89 ％),0 cases,0 cases,respectively.Conclusion Her-2 protein expression and gene overexpression occur in gastric cancer.Her-2 protein expression in gastric cancer shows significant heterogeneity.Her-2 gene overexpression and Her-2 protein expression is correlated (P＜0.05).The differences of Her-2 expression in gastric cancer by IHC and FISH mostly occur in IHC++ groupe.Suggestion of Her-2 gene test should be given for patients with IHC++ who will be undertaken Her-2 gene therapy.