Objective: To identify biomolecular markers closely related to the occurrence of kidney renal clear cell carcinoma (KIRC) and verify their expression levels in clinical samples. Methods: Stage Ⅰ KIRC mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA).Principal component analysis (PCA) was used for dimensionality reduction to screen differentially expressed genes (DEGs)，which then underwent GO and KEGG analyses.Weighted gene co-expression network analysis (WGCNA) was used to screen genes significantly related to KIRC，and a protein-protein interaction (PPI) network was constructed to screen hub genes.The diagnostic value of hub genes was evaluated with receiver operating characteristic (ROC) curve，and their prognostic value was analyzed using survival curve plots.The correlation between the mRNA expressions of hub genes and the pathological stages of KIRC was analyzed.Clinical samples of 20 patients with stage Ⅰ KIRC treated in our hospital were included，and the expressions of the hub genes in cancerous and adjacent tissues were detected with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR)，Western blotting，and enzyme-linked immunosorbent assay (ELISA). Results: A total of 8223 DEGs were screened out，including 4092 up-regulated ones and 4131 down-regulated ones.GO analysis showed that DEGs were related to bioadhesion，plasma membrane composition，and transporter activity.KEGG analysis showed that DEGs were related to pathways such as cell adhesion molecules，cytokine-cytokine receptor interactions，and interactions between viral proteins and cytokines and cytokine receptors.WGCNA analysis obtained 171 genes that were significantly related to stage Ⅰ KIRC.The hub gene，lymphocyte cytosolic protein 2 (LCP2)，screened out by the PPI network，was significantly related to stage Ⅰ KIRC.The area under the ROC curve was 0.96.The expression level was negatively correlated with the overall survival rate of patients.The expression of LCP2 was related to the stage and lymph node metastasis.Clinical verification showed that the mRNA and protein relative expressions of LCP2 in KIRC tissues were significantly higher than those in adjacent tissues (P<0.000 1). Conclusion: LCP2 is significantly up-regulated in stage Ⅰ KIRC tissues and can be used as a potential biomarker for the early diagnosis and treatment of KIRC.

【Objective】 To analyze the clinical characteristics of children with ammonium urate stones in Xinjiang, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The clinical data of all children with ammonium urate stones admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region from 2016 to 2021 were retrospectively analyzed, including age, sex, body mass index, stone site, stone size, stone component, urine pH, urine culture and biochemical examination results. The serum total protein, albumin, sodium, potassium, calcium, magnesium, uric acid and urine pH were compared between the pure and mixed groups. 【Results】 A total of 61 children (31.6%) had ammonium urate stones, their average age was (4.05±3.37) years, and the male to female ratio was 2.21∶1. Among them, there were 37 cases (60.7%) of renal calculi and 50 cases (82.0%) of upper urinary calculi. The most common component of mixed ammonium urate stones was calcium oxalate, including calcium oxalate monohydrate, calcium oxalate monohydrate and calcium oxalate dihydrate. Compared with mixed type, children with pure stone type had a younger age (P=0.001) and a smaller stone size (P=0.003). Positive urine culture was detected in 14 cases (23.0%), 7 of which (50% were infected with Escherichia coli, and 11 (78.6%) with non-urease bacteria. 【Conclusion】 Non-urease bacteria are the main pathogens of urinary tract infection in children with ammonium urate stones. The incidence is higher in boys, and the most common stone location is upper urinary tract. Calcium oxalate is the most common mixed component. Pure type is more common in young children and the stones are relatively small.

Objective To evaluate the clinical efficacy of Radical TUR-BT combined with intra-arterial chemotherapy in the treatment of stage T2 N0 M0 localized muscle-invasive bladder cancer (MIRC).Methods The clinical data of 91 patients with T2 N0 M0 localized myometrial invasive bladder cancer admitted from January 2010 to December 2015 in the people's Hospital of Xinjiang Uyghur Autonomous Region were retrospectively analyzed,76 cases were males,15 cases were female,average age was 63.2 years old,age range 39-91 years old.Patients were divided into BPT group (n =34) and RC group (n =57) according to different surgical methods.Patients in the BPT group underwent Radical TUR-BT + intra-arterial chemotherapy,and patients in the RC group underwent radical cystectomy + urinary diversion.The median follow-up time,2-year progression-free survival,5-year disease-specific survival rate,overall survival and Karnofsky performance status (KPS) were compared between the two groups.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;and Chi-square test was used to compare the count date between groups.Using KaplanMeier method to depict disease-specific survival time in two groups.Quality of life evaluation using Karnofsky score,Evaluate the quality of life and health status of the two groups 3 months before and after treatment.Results The median follow-up time of BPT group and RC group were 35 months and 33 months.The 2-year progression-free rates in the BPT and RC groups were 73.5％ and 75.4％,respectively,and the difference was not statistically significant (P =0.758).The 5-year disease-specific survival rates of the two groups were 72.4％ and 74.8％,respectively,and the difference was not statistically significant (P =0.780).The overall survival rates of the two groups were 61.8％ and 63.2％,respectively,and the difference was not statistically significant (P =0.103).There was no significant difference in preoperative KPS score between the two groups (P =0.652).The KPS score of the BPT group was significantly higher than that of the RC group at 3 months after surgery.The difference was statistically significant(P =0.034).Conclusions For patients with localized MIBC with clinical stage of T2 N0M0.Radical TUR-BT combined with intra-arterial chemotherapy has similar effects to RC.This treatment can effectively improve the prognosis,preserve the bladder,and improve the quality of life for patients.

Objective: To investigate the clinical manifestations, imaging features, clinicopathologic features, and differential diagnosis of solitary fibrous tumors/anginoblastomas (SFT/HPCs) originating in the central nervous system. Methods: Sixty cases of SFT/HPCs originating in the central nervous system were collected at Nanjing Jinling Hospital, from January 1, 2008 to December 31, 2016. The clinical data, imaging data, histomorphologic changes and immunohistochemical finding were analyzed in the sixty cases. Results: The 60 cases included 26 males and 34 females, aged 14 to 85 (median 49) years. The main clinical manifestations were headache, dizziness with nausea and vomiting. Radiologically, the tumors were large, enhancing, solid and cystic masses attached to the dura. Histopathologically, the neoplasms were composed of spindle cells with oval nuclei, inconspicuous nucleoli and moderate amount of eosinophilic cytoplasm arranged in fascicles with areas of hyalinized stroma, myxoid changes and a staghorn vascular pattern. Immunohistochemically, tumor cells of all cases were positive for vimentin (100.0%, 60/60), STAT6 (98.3%, 59/60), CD34 (61.7%, 37/60), and the tumor cells were typically positive for CD99, bcl-2, EMA and SSTR2 as well.Negative for S-100 protein, SOX10, E-cadherin, GFAP. Ki-67 index ranged from 1% to 50%. Forty cases were followed up for 6 to 82 months with average of 40 months, 30 patients were alive and 10 patients died. Conclusions Central nervous system SFT/HPCs can be aggressive and relapses may occur several years after diagnosis. STAT6 is highly sensitive and specific for the diagnosis. Complete tumor resection is optional treatment followed by radiotherapy and chemotherapy. There is a correlation between the prognosis and the location of the disease, the histological grade, Ki-67 index, and fusion gene variants.

Objective In order to play the role of pathological network management system better in pathological examination, this study explore the present status of new pathology network management system, give an objective evaluation for the operation condition, reveal the effectiveness and the existing problems of this system, and provide reference for its development and improvement.Methods The software of pathological network management system was applied to the pathological specimen reception, patient information and examination status query, pathological diagnosis and technology process, as well as the paraffin block archive, statistical analysis, data recording, and so on.At last, we recorded all the information and made a classification and arrangement.Results Pathological network management system was running normally through the whole process of pathologic examination, including specimen receiving, all examinations, print of pathological applications and spontaneous print of pathological reports in ward, which really achieve one-stop services.But the system has unstable phenomenon occasionally.Conclusion Pathological network management system links each examination process closely, which can improve the work efficiency, and provide scientific basis for pathology quality control.

Objective At present, there are few studies about myelolipoma within adrenal cortical adenoma.Our aim was to provide more basis for correct diagnosis and treatment by investigation into its clinical and pathological features.Methods The clinical and pathological data were retrospectively reviewed in 11 patients of myelolipoma within adrenal cortical adenoma, along with relative literature reviews.Results The median age of 11 patients (7 females, 4 males) was 49±9.5 years, among whom 3 patients presented Cushing's syndrome, 1 patient with more than 10 years' recurrent dizzy with hypertension, other 7 patients were found coincidently by routine examination.Adrenal mass were found by imaging examination.Pathologically, myelolipomas were in solitary nodule distribution and/or admixed with adrenal cortical adenomas.Myelolipomas were composed of variable admixture of mature adipose tissue and hematopoietic elements.Surgical treatment was performed for all 11 patients, and no relapse was found in 2 months' to 11 years' follow-up.Conclusion Myelolipoma within adrenal cortical adenoma is extremely rare, which is common in females.The patients may present with Cushing's syndrome, hypertension or without obvious clinical syndrome.All the patients are in favorable prognosis after surgical resection.

Objective: To study the clinicopathologic characteristics and diagnostic criteria of primary mediastinal B-cell lymphoma (PMBL), and to distinguish PMBL from classic Hodgkin lymphoma(CHL) and systemic diffuse large B-cell lymphoma(DLBCL). Methods: The clinical features, histologic findings, results of immunohistochemical study and prgnosis in 27 PMBL cases were analyzed, with review of literature. Results: The age of patients ranged from 19 to 82 years (median age 34 years). All cases were located in the mediastinum and frequently accompanied by superior vein cava syndrome. Histologically, the tumor cells were pleomorphic and diffusely distributed. Clear cytoplasm and spindle tumor cells were seen in some cases. Varying amount of sclerosing stroma with collagen deposition was seen.Immunohistochemical study showed that the tumor cells were positive for CD20(100%, 27/27), CD30 (64.0%, 16/25), CD23 (77.3%, 17/22) and p63 (16/19). Clonal B cell gene rearrangement was seen. Conclusions PMBL is a subtype of diffuse large B-cell lymphoma with various histomorphology. Immunohistochemistry can help to confirm the diagnosis, and the prognosis is better than diffuse large B cell lymphoma, not otherwise specified.

Objective: To study the molecular features of metanephric adenoma (MA) and discuss their values in differential diagnosis. Methods: BRAF V600E immunohistochemistry (IHC) using the mutation-specific VE1 monoclonal antibody and Sanger sequencing of BRAF mutations were performed on 21 MAs, 16 epithelial-predominant Wilms tumors (e-WT) and 20 the solid variant of papillary renal cell carcinomas (s-PRCC) respectively. p16 protein was detected by IHC also. Fluorescence in situ hybridization (FISH) analyses using centromeric probes for chromosome 7 and 17 were performed on the three renal tumors in parallel. Results: Fourteen (14/21, 66.7%) of 21 MA cases demonstrated diffuse, moderate to strong cytoplasmic BRAF V600E IHC staining and the BRAF V600E protein expression was detected in 2 (2/16) of 16 e-WT cases for the first time, whereas all s-PRCCs were negative (P<0.05). All cases (including 14 MAs and 2 e-WTs) with diffuse, moderate to strong cytoplasmic BRAF V600E IHC staining were confirmed to harbor BRAF V600E missense mutations using Sanger sequencing, and no BRAF mutations were detected in cases with negative BRAF V600E protein expression. One case (1/21, 4.8%) showed trisomy of chromosome 7 alone, and another one (1/21, 4.8%) showed trisomy of chromosome 17 alone in 21 MAs. Two cases (2/16) of 16 e-WTs showed trisomy of chromosome 17 alone. In 20 s-PRCCs, trisomy of chromosomes 7 alone was reported in 2 cases (2/20), trisomy of chromosome 17 alone in 3 cases (3/20) and trisomy of chromosome 7 and 17 in 14 cases (14/20). The total positive rates of trisomy of chromosome 7 and/or 17 in MAs, e-WTs and s-PRCCs were 9.6% (2/21), 2/16 and 95.0% (19/20). p16 protein was positive in 81.0% (17/21) MAs, whereas the positive rates in e-WTs and s-PRCCs were 2/16 and 5.0% (1/20). Conclusions Most MAs harbor BRAF V600E mutations, and MAs lack the gains of chromosome 7 and 17 that are characteristic of papillary renal cell carcinoma. These molecular features can be used to distinguish MA from its mimics. BRAF V600E IHC using the mutation-specific VE1 monoclonal antibody provides an effective method in BRAF V600E mutations detection of renal tumors. p16 is overexpressed in MA, and the finding suggests that the low proliferative rate of the tumor might be attributed to BRAF V600E-induced senescence mediated by p16.

Objective When pathologists from hospitals at various levels encounters pathological sections diffcult to make clear diagosis, it is necessary to invite pathologists from higher hosiptals or special hospitals for pathologic consultation.In the study, we compared the pathological diagnosis of cases sent to other hospitals for pathological consultation with the original diagnostic result to analyze the differences by the evaluation on the impact of these differences on the treatment and prognosis of these patients, which would provide an effective evidence for the quality control of pathological diagnosis. Methods Cases initially diagnosed at the de-partment of Nanjing General Hospital and later sent to other hospitals for pathological consultation from 2010 to 2014 were collected. All the diagnostic results were examined by at least 3 senior pathologists to find exact diffrences between consultation results and origi-nal diagnostic results. Results Among 2055 cases, it was found that there were 1813 cases (88.2%) without diagnostic discrepan-cy, while 218 cases (10.6%) with minor diagnostic discrepancy and 24 cases (1.2%) with completely distinct diagnostic results. Conclusion The diagnostic results of the vast majority of consultation cases are in accordance with the original results, despite of di-agnostic discrepancies in some cases due to the complexity of disease. Expert consultation has reference for the pathological diagnosis of complicated cases, which also plays a potent supervisory role on the quality control of original pathologic results.

Objective To investigate the clinicopathologic characteristics, differential diagnosis and prognosis of pulmonary epithelioid hemangioendotheliomas (PEHs).Methods The clinical symptoms and imaging findings of 6 cases of PEHs were investigated and pathologic analyses including histomorphologic and immunohistochemical studies were performed.Results Clinical symptoms of the patients were nonspecific and insidious.The typical radiological manifestation was characterized by multiple small pulmonary nodules. The pathological findings were well-demarcated hypocellular hyalinized nodules with more cellularity at the periphery of the nodule. The neoplastic cells showed mild nuclear atypia and prominent eosinophilic cytoplasm with vacuoles, attempting to form primitive vasculature.Immunohistochemically, tumor cells were positive to CD31, CD34 and ERG.Follow-up data from 8 months to 5 years showed no tumor progression, except for the development of bone metastases in one case at 6 months.Conclusions PEHs are uncommon vascular tumors with low-intermediate malignancy. Using H&E and immunohistochemistry, the final pathological diagnosis can be made and misdiagnosed as a benign fibrotic nodule or other malignant tumors can be avoided. The most effective treatment is surgical resection, if necessary, combined with chemotherapy or radiotherapy.