T lymphoblastic leukemia/lymphoma (T-ALL/LBL) is a kind of lymphoblastic malignant tumors orientated in T-cell line with poor clinical effects. Its molecular genetics is mainly correlated with antigen receptor gene, abnormal chromosome, oncogene activation, tumor-suppressor gene inactivation and molecular pathways. This article will review the latest research progress of the molecular genetics in T-ALL/LBL to explore the index of prognosis and possible therapeutic targets.

Objective To study the expression of miR-320d in diffuse large B cell lymphoma (DLBCL),and its correlation with prognosis of DLBCL.Methods Sixty cases of DLBCL with the follow-up data were collected from Shanxi Cancer Hospital,and were examined by immunohistochemical EnVision method for CD3,CD10,CD20,bcl-6 and Mum-1.The DLBCL were classified into germinal center B cell-like (GCB) and non-germinal center B cell-like (non-GCB) subtypes according to Hans' algorithm.Agilent Human miRNA Microarray 16.0 was used to select the miRNAs on 24 cases paraffin-embedded tissue of DLBCL.The expression levels of miR-320d in 62 cases were examined by TaqMan real-time polymerase chain reaction.Eleven cases of reactive hyperplasia of lymph node were selected as control.Results In 62 cases of DLBCL,22 cases (35.5 ％) were GCB and 40 cases (64.5 ％) were non-GCB subtypes.The expression of miR-320d in GCB was 3.43 times as much as non-GCB subtypes (P =0.034),and in reactive hyperplasia of lymph node it was 5.65 times as much as in DLBCL (P ＜ 0.001).The low expression groups of miR-320d was significantly correlated with shorter overall survival (P =0.021).Multivariate Cox proportional hazard regression analysis (including the IPI scores) revealed that the down-regulated miR-320d was the independent predictor in DLBCL (RR =2.434,95 ％ CI 1.148-5.159,P =0.020).Conclusions The down-regulated expression of miR-320d might be considered as a distinct subgroup with poor prognosis.

Objective To study the expression of PTEN et al and their significance in T lymphoblastic lymphoma/leukaemia (T-LBL/ALL). Methods Seventy-six cases of T-LBL/ALL were studied by using immunohistochemistry (EnVision method) for CD3, CD7, CD10, CD20, CD23, CD43, CD45RO, CD99, TdT, MPO and PTEN. Follow-up was included. Results In the Seventy-six cases of T-LBL/ALL, the percentages of tumor cells expressing TdT, CD99, CD3, CD7, CD45RO and CD43 were 93.42%, 94.74%, 67.12%, 92.11%, 36.85%,and 51.33%, respectivly while MPO, CD20 and CD23 were all negative. The index of Ki-67 expression higher than 80 % was found in 27 and ≤80% in 49 cases. The expression of PTEN (64.47 %) in T-LBL/ALL was lower than that of in reactivated lymphoid tissue (100%, P<0.05). PTEN was reversely correlated with stage,Ki-67 expression and LDH level (P<0.05). CD3-positive cases were more than CD3-negative cases in abnormal LDH level (P<0.05). Follow-up data was obtained in 50 cases, ranging from 1 to 108 months. The overall survival rate was 35.8 %, with median survival time 330 days. No prognostic significance was found in the expression of PTEN, CD3, CD7, CD10, CD43, Ki-67 and CD45RO (P >0.05). Conclusion The antibodies of CD3,CD7, CD10, CD20, CD43, CD45RO, CD99, TdT, MPO and Ki-67 were very helpful for the diagnosis of T-LBL/ALL.Down-regulation of PTEN may play an important role on the development of T-LBL/ALL.

Objective To analyse the clinicopathological characteristics of synovial sarcoma (SS) from histomorphology,immunohistochemical (IHC) and fluorescence in situ hybridization (FISH),and to investigate the related factors influencing the prognosis of SS patients.Methods 94 cases were collected,including 60 SS cases and 34 in dined to SS cases.The expressions of common antibodies related to the diagnosis of SS Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were detected by IHC,and the SYT-SSX fusion gene was detected by FISH.The clinical pathologic factors that affecting the prognosis of patients were analyzed through the statistical method.Results The positive rates of Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were 100.00 ％,74.47 ％,36.17 ％,28.72 ％,17.02 ％,90.43 ％ and 60.64 ％ respectively.FISH results showed that 81 patients were tested with SYT gene translocation,including 54 cases who were considered as SS,and 27 cases who were suspected/inclined to SS,and the number of positive cells surpassed 80 ％.The gene translocation was not related with the patient' s age,sex,tumor position,histological type,differentiation of the cancer (all P ＞ 0.05).Single factor survival analysis showed that the degree of differentiation,tumor diameter,the recurrence and metastasis had certain influences on patients' survival time (all P ＜ 0.05).Multiple factors regression analysis showed that the degree of differentiation and tumor diameter were the risk factors influencing the prognosis of SS (risk coefficients ＞ 1,P ＜ 0.05).Conclusions IHC combined with FISH SYT-SSX fusion gene detection have the vital significance in the diagnosis of SS.The degree of differentiation and tumor size are the risk factors influencing the prognosis of SS.

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.

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 explore the clinical value of diffusion weighted imaging (DWI) in the diagnosis of breast disease ,and compared with ultrasound and mammography .Methods The clinical data of 28 patients who were pathologically confirmed with breast cancer were retrospectively reviewed .The diagnostic accuracy of DWI ,mammogra-phy and ultrasound , the surface diffusion coefficients ( ADC value ) were statistically analyzed .Results ( 1 ) DWI scan:the diagnostic accuracy of malignant tumor was 90.9%(20/22),the ADC value of malignant tumor was (0.955 ±0.199) ×10 -3mm2/s;the diagnostic accuracy of benign lesions was 83.3%(5/6),the average ADC value of benign lesions was (1.660 ±0.339) ×10 -3 mm2/s,there were statistically significant differences ( t=2.371,P<0.05).(2)Mammography:the diagnostic accuracy of malignant tumor was 81.8%(18/22),the diagnostic accuracy of benign lesions was 33.3%(2/6).(3) Ultrasound:the diagnostic accuracy of malignant tumor was 86.4%(19/22),the diagnostic accuracy of benign lesions was 50.0%(3/6).The diagnostic accuracy of malignant tumor had no significant difference among three techniques (χ2 =0.752,P>0.05),but for the diagnostic accuracy of benign lesions,DWI was better than ultrasound and mammography ,the difference was statistically significant (χ2 =6.146, P<0.05).Conclusion For the diagnosis of malignant breast tumors and benign lesions ,DWI is better than ultra-sound and mammography ,which has high clinical application value .

ObjectiveTo investigate the expression and the clinical significance of diacylglycerol kinase α (DGKα) and protein kinase C (PKC) in human hepatocellular carcinoma (HCC).MethodsDGKα and PKC expressions in the samples from 60 pathologically confirmed HCC patients were analyzed by immunohistochemistry. The relationship between DGKo expression and clinical pathology factors was analyzed.ResultsThe expression positive rates of DGKo and PKC were highest in normal liver tissues [90.0％ (9/10) and 100.0％ (10/10)].The positive rates were 81.7 ％ (49/60) and 71.7 ％ (43/60) in HCC tissues,respectively,and were 58.3 ％ (35/60) and 61.7 ％ (37/60) in carcinoma adjacent tissues,respectively.In three liver tissues,the positive rates of DGKα and PKC were significantly different (P ＜0.05).The location of both kinases in hepatocytes translocated from cytoplasm/nucleus to membrane.The expressions of DGKα and PKC were positively correlation(r =0.495, P ＜ 0.05), The DGKα expression was correlated to differentiation type,portal venous tumor thrombus and TNM staging(all P ＜ 0.05).ConclusionDGKa is expressed with high activity in advanced stage and poorly differentiated HCC. It may be promote the pathological process of HCC.

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.