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Significance of standardized special staining technology for pathological diagnosis of pulmonary fungal infectious diseases

Feifei LIU ; Xue LI ; Mulan JIN

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):653-658. doi:10.13315/j.cnki.cjcep.2017.06.013

To explore the significance of the application of standardized special staining technique in pathologic diagnosis of pulmonary fungal infectious diseases.Methods Final pathologic diagnosis of 104 cases pulmonary fungus infection disease in Beijing Chaoyang hospital from September 2011 to March 2016 were selected;HE staining only,HE staining combined with the traditional manual special staining method PAS and hexamine silver,and HE staining combined with automatic special staining PAS and hexamine-silver were used and compared.The two kinds of special staining technology were compared;the microscopic observation,analysis results (all the first staining results,not including the results of complex staining),the results on the basis of final pathologic diagnosis were also compared with the clinical preliminary diagnosis.Results Lung fungal infectious disease diagnosis rate and fungal classification rate,from low to high order consistence,showed that for the primary clinical diagnosis (29.8％ and 19.2％),HE staining (32.7％ and 32.7％),HE staining combined with traditional manual special staining method PAS and hexamine silver (90.4％ and 87.5％),and HE staining combined with automatic special staining PAS and hexamine-silver (98.1％ and 94.2％).The four methods were statistically significant on two aspects (P ＜ 0.01,P ＜ 0.01);the fourth method was significantly different from the first two (P ＜ 0.01,P ＜ 0.01).The fourth method was significantly different from the third kind of diagnosis rate (P ＜ 0.05),typing rate was no significant difference (P ＞ 0.05).But automatic special dyeing method of PAS and hexamine silver steps were more simple,with standardized chemical reagents,no artificial and environmental factors,short time-consuming,and less number of dropping-off and restaining of the section.Conclusion HE staining and its combination with automatic special staining of PAS and hexamine silver are much more standardized,and help to improve the diagnosis of pulmonary fungal infectious diseases and fungal classification rate.

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Clinical significance of CMIP expression in human laryngeal squamous cell carcinoma

Dangjun WEI ; Chaobing GAO ; Zhengsheng WU

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):649-652. doi:10.13315/j.cnki.cjcep.2017.06.012

To investigate the expression of CMaf inducing protein(CMIP) in human laryngeal squamous cell carcinoma and polyps tissues,and to analyze their association with clinicopathological parameters and survival of patients with laryngeal squamous cell carcinoma.Methods Real-time PCR assay was used to detect the expression of CMIP mRNA in 28 cases of laryngeal squamous cell carcinoma and 23 cases of polyp fresh tissue specimen.Immunohistochemical staining was used to detect the expression of CMIP in 86 cases of formalin-fixed and parrffin-embedded laryngeal squamous cell carcinoma and 29 cases of polyp tissue specimens.The clinicopathological and prognostic significance of CMIP expression was investigated in laryngeal squamous cell carcinoma.Results The expression of CMIP mRNA and protein was both significantly increased in laryngeal squamous cell carcinoma compared with polyp tissue specimens.The expression of CMIP was significantly associated with tumor lymph node metastasis and late clinical stage of laryngeal squamous cell carcinoma.Furthermore,the expression of CMIP was significantly correlated with poor relapse-free survival and overall survival in laryngeal squamous cell carcinoma.Conclusion CMIP might play an important role in the development and progression of laryngeal squamous cell carcinoma and increased expression of CMIP might imply disease progression and poor outcome in patient with laryngeal squamous cell carcinoma.

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Abnormal distribution of laminin α2 chain in glomerular basement membrane in membranous nephropathy

Xiaoqing YANG ; Yanjie HUANG ; Weigang Lǖ ; Jing LI ; Liangliang BI ; Xiaofeng MEI ; Jingang LI

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):636-640. doi:10.13315/j.cnki.cjcep.2017.06.009

To study the abnormal distribution of type Ⅳ collagen and laminin chains in glomerular basement membrane (GBM) in membranous nephropathy (MN).Methods 52 cases of MN were collected and staged according to electron microscopic morphological characteristics,and 10 cases of kidney tissues of minimal change disease were used as normal GBM control.Distribution pattern of or5 (Ⅳ) chain,laminin α5and β2 chains,and laminin α2 and β1 chains were detected using immunofluorescence method.Results In minimal change disease,α5 (Ⅳ) chain,laminin α5 and β2 chains all showed continuously linear positive expression along GBM,and laminin α2 and β1 chains were negatively expressed in GBM.In stage Ⅰ MN,α5 (Ⅳ) chain,laminin α.5 and β2 chains all showed continuous linear positive expression along GBM.In stage ⅡMN,the expression of α5 (Ⅳ) chain was increased and showed abundant spikes on the basis of continuous linear positive staining along GBM,and the expression of laminin α5 and β2chains was increased,and segmental spikes were seen on the basis of continuous linear positive staining along GBM.In stage ⅢMN,the expression of α5 (Ⅳ),laminin α5 and β2 chains was also enhanced and segmental double tracks were seen.The expression of laminin α2 chain was negative in GBM in stage ⅠMN,but granular positive expression along GBM was seen in stage Ⅱ and stage Ⅲ MN.No positive expression of laminin β1chain was seen in GBM in different stages in MN.Conclusion The GBM thickness in MN originates not only from intrinsic type Ⅳ collagen chains and laminin chains,but also from laminin α2chain,which only exist in glomerulus mesangium in normal condition.

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Expression of Snail in IgA nephropathy and its relationship with renal tubular epithelial mesenchymal transition

Jing LI ; Huimin GAO ; Xian WANG ; Rong QIN

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):629-635. doi:10.13315/j.cnki.cjcep.2017.06.008

To investigate the relationship between Snail and renal tubular epithelial-mesenchymal transition (EMT) or tubulointerstitial fibrosis (TIF) at tissue and cellular levels and to observe the changes of miRNA profile after transfecting Snail gene into human renal tubular epithelial cells (HK-2),to further elucidate the importance of miRNA in the pathogenesis of renal fibrosis.Methods The expression of Snail and EMT-related proteins vimentin,SMA,E-cadherin was detected by immunohistochemistry in renal tissues of 40 patients with IgA nephropathy.The expression of Snail,E-cadherin and SMA in normal control group,empty transfection group and Snail gene transfection group was detected by Western blot and RT-PCR.Furthermore,differentially expressed miRNAs were screened by gene chip.Results By immunohistochemistry,Snail expression was positively correlated with vimentin and SMA,negatively correlated with E-cadherin in IgA nephropathy.The higher degree of the TIF,the stronger the expression of Snail.Compared with the control group,the expression of Snail,vimentin and SMA in the snail transfected group increased.However,E-cadherin decreased at gene and protein level by the RT-PCR and Western blot (P ＜ 0.05).The difference was statistically significant.Five distinctly different miRNAs were screened by gene chip after Snail gene was transfected into HK-2 cells,and then 5 026 potential target genes were predicted.Conclusion Snail expression is closely related with renal tubular epithelial mesenchymal transition and tubulointerstitial fibrosis,and it may be used as a new target in EMT prevention.Differentially expressed miRNAs may be involved in the development of EMT and TIF.

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Gastrointestinal stromal tumor with synchronous carcinoma features: a clinicopathologic analysis of 9 cases

Wensheng LIN ; Fang ZHANG ; Li REN ; Dechang LI ; Jichun ZHENG ; Jianping ZHU

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):613-617. doi:10.13315/j.cnki.cjcep.2017.06.005

To explore the differentiation of gastrointestinal stromal tumor(GIST) with synchronous carcinoma clinical and pathological features,diagnosis and differential diagnosis.Methods Clinical characteristics,pathological morphology and immunohistochemical staining were observed in 9 cases of GIST with synchronous carcinoma,with review of the relevant literature.Results Microscopically,in 4 cases GIST with esophageal carcinoma,most of tumor cells in central focus were squamous cells and keratin pearls which were well differentiated and the rest of tumor cells are basal like cells on the edge.In the other 5 cases (4 of them with gastric carcinoma and 1 with rectal cancer).Microscopically,the tumors were composed of dysplastic glands which presented as adenoid structures and poorly differentiated.The majority of gastric GIST were spindle cell tumors,which resembled smooth muscle tumors histologically and showed a variety of histological pattern,such as lace like pattern,palisading pattern,antique coins like pattern and eddy pattern.And a perinuclear vacuolization pattern was common.Immunohistochemistry showed that the tumor cells were positive for CK5/6,CK14 and p53,but negative for S-100,CK7 of the 4 cases GIST with esophageal carcinoma.In the other 5 cases (4 of them with gastric carcinoma and 1 with colorectal cancer),showed that CK7,CK20,CEA and HER-2 were positive and negative for S-100.In all the 9 case of GIST,the tumor cells were positive for CD34,CD117 (+),DOG1 and SMA,but negative for S-100,desmin,etc.Conclusion There are no special clinical symptoms in most of GIST with synchronous carcinoma,because these GISTs are generally incidental findings.The proliferative index of GIST with synchronous carcinoma is observably lower than that of GIST without synchronous carcinoma.Most GISTs with synchronous carcinoma can be treated by the standard treatment for the accompanying carcinoma,and do not need specific additional treatments.

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Early esophageal cancer or precancerous lesions treated by endoscopic resection: a single-center retrospective study of 368 cases

Yalan LIU ; Dongxian JIANG ; Yingyong HOU ; Jieakesu SU ; Haiying ZENG ; Jie HUANG ; Yifan XU ; Chen XU

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):606-612. doi:10.13315/j.cnki.cjcep.2017.06.004

To investigate the clinicopathological features as well as prognosis of early esophageal squamous cell neoplasm (ESCN) treated with endoscopic resection (ER).Methods 368 patients were collected from 2007 to 2013.Clinicopathological features including invasion depth and margin were evaluated.Survival curves were constructed by using the Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.Results There were 252 males and 116 females with a median age of 61 (16-84) years.Patient numbers of hyperplasia,low grade intraepithelial neoplasia,high grade intraepithelial neoplasia,m1,m2,m3,sm1 and sm2 were 47(12.8％),61 (16.6％),61 (16.6％),54(14.7％),38(10.3％),63(17.1％),12(3.3％) and 32(8.7％),respectively.The cumulative overall 1-year,3-year,and 5-year rates of survival in the metachronous esophageal lesions were 4.1％,12.9％ and 32.6％,respectively.The incidence of lymph node/distant metastasis was 1.54％ in m3,6.25％ in sm2,and 0 in other subgroups.The overall 1-year,3-year,and 5-year survival rates were 99.5％,97.3％,and 87.5％,respectively.Significant difference was identified between sm2 and non-sm2 patients in metastatic rate (P =0.021),however,no significant difference existed between m3 patients and sm2 patients (P =0.252).Metachronous esophageal lesion and survival between sm2 and non-sm2 patients demonstrated no statistical difference (P =0.401 and P =0.634).Conclusion ER is an effective and relatively safe treatment for superficial ESCN.The procedure is still appropriate in selecting sin2 patients.It is necessary to monitor the second primary cancer in sm2 patients during follow-up.

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Congenital mesoblastic nephroma: clinicopathological features and molecular genetic analyses

Tianping YU ; Xiaoxue YIN ; Min CHEN ; Ling NIE ; Qiao ZHOU ; Ni CHEN

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):645-648. doi:10.13315/j.cnki.cjcep.2017.06.011

To discuss clinicopathological features and molecular genetic change of congenital mesoblastic nephroma (CMN).Methods Nine cases diagnosed as CMN were analyzed retrospectively in this study.Histological features,immunohistochemical profiles and ETV6 gene rearrangement status were assessed.Results All patients were within two years of age and eight of them were within one year.The average diameter of tumors was 9.5 cm (3.2-15.0 cm).These series cases included 3 classic CMN,5 cellular CMN and 1 mixed CMN.Cystic degeneration was found in 5 cases,and cartilage islands were observed in 2 cases.Compared with classic CMN,tumor size was bigger,and hemorrhage,necrosis and mitotic figures were easily to see in cellular CMN.All the tumor cells were positive for vimentin and negative for WT-1 by immunohistochemistry.ETV6 gene rearrangement was detected in 5 cases (including 4 cellular CMN and 1 classic CMN).Three cellular CMN harbored ETV6 gene translocation,1 mixed CMN and 1 cellular CMN were negative for ETV6 gene translocation by FISH analysis.The follow up data were obtained in 7 cases and 2 cases were lost.All the 7 patients were alive without evidence of recurrence and metastasis from 5 to 46 months.Conclusion CMN is a rare infant renal tumor with unique clinicopathological characteristics.Most of cellular CMNs harbor ETV6 gene translocation.The prognosis of CMN is relative good and needs to be differentiated from other malignant renal tumors.

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Renal inflammatory lesions clinically presenting as masses: a clinicopathologic analysis

Hong XU ; Shuhong YU ; Yingmei WANG ; Ru ZHOU ; Jing ZHANG

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):640-644. doi:10.13315/j.cnki.cjcep.2017.06.010

To analyze and summarize the clinicopathological features of renal inflammatory lesions which were easily misdiagnosed as renal tumors.Methods The cases from March 2006 to August 2015 in the Department of Pathology at Xijing Hospital were analyzed,retrospectively.Due to the diagnosis made by clinicians that these were renal (including renal pelvic) tumors,all cases had undergone radical nephrectomy or tumor enucleation.Among them,several inflammatory lesions were confirmed,and were combined with the patients' clinicopathological data and literature review to investigate the diagnosis and differential diagnosis.Results Of the 1 195 cases,only 6 cases (less than 1％) were renal inflammatory lesions,named as xanthogranulomatous pyelonephritis (2 cases),renal malakoplakia (1 case),renal tuberculosis (1 case),IgG4-related tubulointerstitial nephritis (1 case),and renal Wegener's granulomatosis (1 case).These diseases occurred in two males and four females (aged 14 to 55 years).All patients underwent radical nephrectomy due to the detected unilateral solitary renal mass in the imaging examination.Conclusion Renal inflammatory lesions are very rare,which show masses that are easily misdiagnosed as neoplastic lesions.Some of them have similar histological features.As the differences of treatment,a sufficient understanding of the clinicopathological features of these diseases is important to make a correct diagnosis.

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Effect of matrix metalloproteinase-26 on human glioma angiogenesis

Yuhui ZHANG ; Wei LI ; Xiangxiang LI ; Bo FANG ; Xiaona CHANG ; Chenchen TANG ; Lihong ZHANG ; Yilei LI

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):623-628. doi:10.13315/j.cnki.cjcep.2017.06.007

To investigate the effect of MMP-26 on human glioma angiogenesis and the possible mechanism.Methods The MMP-26 plasmid and empty plasmid pcDNA3.1 were stably transfected into U251 cells to establish a nude mice xenograft model,and then an in vitro human tumor tissue-based three-dimensional angiagenic model.Tissue disks were visually assessed over time to determine the percentage of wells that developed an angiogenic response(I％) and the density and length of neovessel growth were graded at intervals using a semiquantitative visual growth-rating scheme (angiogenic index,AI,0-16scale) in groups of MMP-26 transfected U251 cells (U251-MMP-26),pcDNA3.1 vector-transfected U251 cells (U251-pcDNA3.1) and non-transfected U251 cells (U251).RT-PCR and immunohistochemistry were used to detect the expression of mRNA and protein of MMP-26 and VEGF in groups of U251-MMP-26,U251-pcDNA3.1 and U251.Immunohistochemical localization of CD31 was determined in the endothelial tubes invading the fibrin-thrombin clot matrix.Results Immunohistochemical endothelial cell markers CD31 was positive in the vascular tubes invading the fibrin-thrombin clot matrix,confirming their endothelial origin.The angiogenesis results showed that difference of length of micro capillaries,density of branches,and the area occupied between U251-MMP-26 groups and control groups were significant.The percentage of tumor implants that developed invasion (I％) and the angiogenic index AI in U251-MMP-26 group on day 14 were higher than those of U251-pcDNA3.1 group and U251 group (P ＜ 0.05).The trends of I％ and AI in 14 days were significant compared with those in control groups.The expression of mRNA and protein of MMP-26and VEGF in U251-MMP-26 group was significantly higher in U251-MMP-26 group than those in U251-pcDNA3.1 group and U251 group(P ＜0.01).Conclusion The effect of MMP-26 on promoting glioma angiogenesis may be related to the increased expression of VEGF,which can be used as targets for anti-tumor therapy.

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HER-2 gene amplification and protein expression in esophageal squamous cell carcinoma

Jie HUANG ; Dongxian JIANG ; Yingyong HOU ; Yuan JI ; Chen XU ; Yalan LIU ; Jia LIU ; Jieakesu SU

Chinese Journal of Clinical and Experimental Pathology.2017;33(6):618-622,628. doi:10.13315/j.cnki.cjcep.2017.06.006

To explore the status of HER-2 gene amplification and protein expression in Chinese esophageal squamous cell carcinoma patients and its relationship with the clinicopathological parameters.Methods The HER-2 gene amplification was detected by FISH and protein expression by IHC in 96 patients with esophageal squamous cell carcinoma that would be followed up for 3 years.Results Three cases presented with 3 +,15 cases with 2 +,11 cases with 1 +,and 67 with negative by HER-2 immunohistochemical staining;2 of 3 cases presented with HER-2 amplification in in 3 +,1 case presented with over 6 HER-2 copy numbers.HER-2 amplification and HER-2 overexpression had significant correlation (P ＜ 0.000 1).HER2 amplification or overexpression was associated with clinicopathological parameters,such as,carcinomas without necrosis (P =0.012) and lower stage (P =0.040).There was better DFS or OS trend in patients with HER-2 overexpression or amplification,but the significant difference did not reached.Conclusion This research has demonstrated the correspondence between gene amplification and protein overexpression of HER-2 in ESCC.HER-2 gene overexpression or amplification is a potential better predictive parameter in ESCC,but needs further study.

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