唾液腺良、恶性多形性腺瘤172例临床病理分析

目的:探讨唾液腺良恶性多形性腺瘤临床病理特点.方法:对经病理复片诊断为唾液腺良、恶性多形性腺瘤的172例临床病理材料进行回顾性分析.结果:良性多形性腺瘤163例,腺瘤型52例(31.9%),肌上皮型60例(36.8%),粘液型51例(31.3%).恶性多形性腺瘤9例,恶变均为上皮性,腺癌3例,腺样囊性癌3例,粘液表皮样癌2例,腺鳞癌1例.颈淋巴结转移2例,局部复发2例,均为侵袭性癌,恶性成分都超过50%,组织学表现为高度恶性.结论:良性多形性腺瘤不同亚型预后无明显差异,恶性多形性腺瘤侵袭性癌多见,恶性成分常多于良性成分,侵袭性癌、组织学分级高度恶性者易发生颈淋巴结转移和复发.     

涎腺嗜酸细胞腺瘤临床研究

探讨涎腺嗜酸细胞腺癌的临床特征、诊断与治疗。对21例涎腺嗜酸细胞腺瘤的临床资料进行统计分析,其中嗜酸细胞腺瘤12例,占57.14％;恶性嗜酸细胞腺瘤9例,占42.86％。发病年龄以青壮年多见。良性病例生长缓慢,病程长,极易误诊为多形性腺瘤;恶性病例病程短,原发瘤呈迅速浸润性生长。由于该瘤是多中心性生长,术后极易复发;恶性者颈淋巴和脑、肺转移率高。确切诊断须依赖组织病理学检查,首次彻底手术切除是治疗成功的关键,恶性瘤体>2cm者应作选择性淋巴结清扫术,术后酌情实施局部放疗和全身化疗。     

12种凝集素受体在涎腺混合瘤及恶性混合瘤组织中的分布及意义

本文应用 ABC 免疫酶标记技术分析了51例正常涎腺及涎腺良恶性混合瘤中12种凝集素受体的分布。结果发现,ConA、PSA、PHA、RCA、UEA—I 受体在混合瘤及恶性混合瘤的良性组织中分布不同,推论部分恶性混合瘤为原发性恶性肿瘤。DBA 受体在恶性混合瘤组织中明显增多,提示 DBA 可能为恶性混合瘤的标记。这将有助于对涎腺肿瘤的发生、诊断及恶变机制的进一步研究。此结果如结合临床可为混合瘤的恶变、复发、诊断提供早于形态学改变的生化指标。     

涎腺粘液表皮样癌术后生存的临床病理因素分析

目的：探讨影响涎腺粘液表皮样癌患者术后生存的相关病理因素。方法：对98例涎腺粘液表皮样癌患者进行回顾性研究,分析影响患者术后生存的相关临床病理因素。通过SPSS10.0软件分析,筛选出影响粘液表皮样癌患者术后生存的主要临床病理因素。结果：与术后生存率相关的主要临床病理因素包括：临床分期、患者年龄、镜下是否发现坏死。结论：临床分期、患者年龄是影响涎腺粘液表皮样癌术后生存的主要临床因素,镜下坏死是影响涎腺粘液表皮样癌患者术后生存的主要病理因素。     

E-cadherin在涎腺粘液表皮样癌的表达及其与浸润转移的关系

目的:细胞粘附功能下降是恶性肿瘤发展的关键因素,为探讨E-cadherin在涎腺粘液表皮样癌发病机制中的作用,我们研究了E-cadherin在涎腺粘液表皮样癌的表达情况,并分析其与临床病理特征的关系。方法:采用免疫组织化学S-P法对46例涎腺粘液表皮样癌进行E-cadherin的检测。结果:E-cadherin在涎腺粘液表皮样癌中的表达强弱与癌组织的分化程度及淋巴结转移有关(P<0.05),而与患者的性别、年龄无关(P>0.05)。结论:E-cadherin表达与涎腺粘液表皮样癌的浸润转移有关,可作为一种新的肿瘤标志物,其表达对判断预后有一定的价值。     

涎腺粘液表皮样癌术后转移的临床病理因素分析

目的:对经额面外科手术治疗的59例涎腺粘液表皮样癌患者进行回顾性研究,分析影响患者术后转移的相关临床病理因素.方法:通过SPSS 10.0软件分析,筛选出影响涎腺粘液表皮样癌术后转移的主要临床病理因素.结果:粘液表皮样癌低分化,癌巢边界形态为Ⅲ型,镜下坏死患者术后易发生转移.结论:分化程度,癌巢边界形态和镜下坏死是影响术后转移的主要临床病理因素.     

涎腺粘液表皮样癌相关生物标志物研究进展

涎腺粘液表皮样癌（mucoepidermoid carcinoma）是口腔颌面部常见恶性肿瘤之一,它危害人类健康、威胁人类生命。根据国内六院校统计资料,在11947例涎腺上皮肿瘤中约占30％,可见于任何年龄,40～60岁为发病高峰。根据癌细胞分化程度和生物学特点,分为高分化（低度恶性）、中分化（中度恶性）和低分化（高度恶性）三型。当前,涎腺粘液表皮样癌的组织学诊断主要依靠HE染色切片,还没有一种用于诊断或估计预后的特异性标志物,因此研究用于涎腺粘液表皮样癌的诊断、预后和治疗特异性标志物就显得非常重要,随着肿瘤分子生物学领域的研究进展,一些新的生物标志物不断出现,不仅对涎腺粘液表皮样癌的病理诊断提供了帮助,并为其预后、治疗方案的选择提供了理论依据,在一定程度上发挥了独特作用。     

47例甲状腺微小癌诊治分析

目的：探讨甲状腺微小癌的临床诊断和治疗方法。方法：对诊断明确的47例甲状腺微小癌进行回顾性分析。结果：术前仅12例疑为甲状腺癌．余35例均于术中冰冻和术后病理确诊。34例合并甲状腺良性疾病，伴颈淋巴结转移3例。47例中有11例术后无瘤生存时间≥10年，24例术后无瘤生存时间≥5年。结论：甲状腺微小癌术前不易确诊，且易漏诊，对甲状腺良性疾病手术时应仔细触诊，对可疑结节行冰冻切片。首次手术应行患侧腺叶及峡部切除术．有淋巴结转移者行功能性淋巴结清扫术可取得较好疗效。     

乳腺良性肿块的临床病理分析

目的 :通过临床病理分析 ,为临床治疗提供依据。方法 :对本院 10年间收治的经病理诊断为良性肿块的 171例患者进行临床、病理特点、预后分析及随访。结果 :171例中 ,119例经中西药治疗无显著疗效。手术行肿块切除 76例 ,区段切除 88例 ,单纯乳房切除 3例。有 1例 6年后转变为乳癌而行乳癌根治术。结论 :乳腺良性肿块中以囊性增生多见 ,其中乳管上皮增生和乳头状瘤病与乳癌关系密切。临床治疗应进行必要和区段切除 ,重度非典型增生必要时行全乳房切除术。     

PTEN和HIF-1α在卵巢浆液性肿瘤中的表达及其相关性的研究

目的：检测卵巢浆液性肿瘤中PTEN和HIF-1α表达及其与临床病理参数的关系．方法：应用SP免疫组织化学法分别检测17例卵巢浆液性腺瘤和19例卵巢交界性浆液性腺瘤、37例卵巢浆液性腺癌组织中PTEN和HIF-1α表达状况,并分析其与卵巢浆液性腺癌主要临床病理参数之间的关系．结果：PTEN蛋白在卵巢浆液性腺瘤表达较高,在卵巢交界性浆液性腺瘤组织中表达下降,而在卵巢浆液性腺癌中表达量最低,与前两组比较有统计学意义（P〈0．05）,而HIF-1α在各组的表达趋势与PTEN相反．卵巢浆液性腺癌组与前两组比较有统计学意义（P〈0．05）．卵巢浆液性腺癌组织中HIP-1α的表达与组织分化程度、临床病理分期、淋巴结转移及肿瘤体积明显相关;随着肿瘤分级、分期的增加PTEN的表达显著降低（P〈0．05）．两者表达之间呈负相关（P〈0．05）．结论：PTEN表达缺失而HIF-1α表达明显增强,与卵巢浆液性腺癌临床病理特征有密切关系。可以推测PTEN表达的缺失诱导了HIF-1α的表达,二者在卵巢浆液性腺癌的肿瘤形成和预后判断中呈负相关．     

Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease

The coexistence of thyroid diseases with primary hyperparathyroidism （PHPT） can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision （about 3 cm）, while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter （32.7%）, 2 thyroiditis （3.8%）, 2 thyroid adenoma （3.8%） and 1 thyroid carcinoma （1.9%） coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra- sonography （US） and methoxy-isobutyl-isonitrile （MIBI） scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography （CT） and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.     

抑癌基因WWOX在结直肠癌中的表达

检测WWOXmRNA及其编码蛋白在结直肠癌中的表达,分析其临床病理学意义。用半定量RT-PCR方法定量和免疫组化染色(EliVision plus法)分析45例结直肠癌、45例结直肠腺瘤及20例正常组织中WWOXmRNA及其编码的蛋白质表达量,并比较两者在不同组织中的表达差异。半定量RT-PCR和免疫组化结果显示,45例结直肠癌组织中WWOXmRNA表达水平低于结直肠腺瘤组及正常结直肠组,差异有统计学意义(P<0.05)。结果表明,WWOX的低表达与结直肠癌的发展、生物学行为和预后有相关性。     

Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions

Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12-15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner's gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner's gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1-3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions.     

Pathological Voice Classification Based on Features Dimension Opti mization

The classification of pathological voice from healthy voice was studied based upon 27 acoustic features derived from a single sound signal of vowel /a:/. First, the feature space was transferred to reduce the data dimension by principle component analysis (PCA). Then the voice samples were classified according to the reduced PCA parameters by support vector machine (SVM) using radial basis function (RBF) as a kernel function. Meanwhile, by changing the ratio of opposite class samples, the accuracy under different features combinations was tested. Experimental data were provided by the voice database of Massachusetts Eye and Ear Infirmary (MEEI) in which 216 vowel /a:/ samples were collected from subjects of healthy and pathological cases, and tested with 5 fold cross-validation method. The result shows the positive rate of pathological voices was improved from 92% to 98% through the PCA method. STD, Fatr, Tasm, NHR, SEG, and PER are pathology sensitive features in illness detection. Using these sensitive features the accuracy of detection of pathological voice from healthy voice can reach 97%.     

220例大肠癌的临床和病理学特征分析

[目的]分析大肠癌的临床和病理学特征.[方法]收集220例大肠癌患者的临床病理资料并进行回顾性分析.[结果]大肠癌发病率有随年龄增长而递增趋势,血便是大肠癌最常见的临床表现,以直肠检出率最高,病理类型以溃疡型和高分化腺癌最多,绝大多数患者发现时就已经是中晚期.[结论]大肠癌是临床上常见的恶性肿瘤,必须加强对大肠癌早期临床症状的宣传和对高危人群的普查,从而提高生存率.     

血管内皮生长因子在乳腺良、恶性肿瘤表达的临床意义

目的：探讨血管内皮生长因子（VEGF）在乳癌中过表达的临床意义。方法：取乳腺腺瘤47例,乳腺癌95例,利用SABC法检测VEGF阳性率。结果：VEGF在腺瘤中阳性率为25.53%（12/47）,在乳癌中阳性率为54.75%（52/95）;在浸润性癌和有淋巴结转移组阳性率明显高于非浸润性组和无淋巴结转移组（P〈0.05）。结论：VEGF过表达提示患者预后不良,检测VEGF对化疗方案选择有指导意义。     

Granulomatous hypophysitis: two case reports and literature review

Granulomatous hypophysitis (GRH) is extremely rare and commonly presents with chronic inflammatory of the enlarged pituitary gland. In our study, 66-year-old and 57-year-old women, both Chinese, were diagnosed with GRH presenting preoperatively definite imageology characters as pituitary adenoma. The 66-year-old woman presented with a year of headache,half a year of gradual decrease of visual acuity, and one month of right ptosis. Serum prolactin level was slightly elevated.Screening computed tomography (CT) scanning revealed typical low density mass found on the enlarged sella, which demonstrated invasive extension from the sella to the right cavernous sinus by contrast enhanced magnetic resonance imaging (MRI).Consequently, the patient was diagnosed with probable invasive pituitary adenoma. The other 57-year-old woman complained a light headache and had been previously treated as nonfunctional pituitary adenoma in other hospital. Finally these two patients underwent transsphenoidal microsurgery and were diagnosed with GRH according to postoperative histopathology. They then were treated with steroid. During the follow-up, the clinical symptoms such as headache, visual damage, and ptosis vanished, and the mass of the sellae dramatically shrank on repeated MR images. Clinically and radiologically, GRH is a rare sellar entity easily to be misdiagnosed as a pituitary adenoma. Trans-sphenoidal surgery can decompress the optical nerve or oculomotornerve as a therapeutic strategy, and support biopsy or further pathological diagnosis. However, the hormonal therapy should be emphasized both as diagnostic and therapeutic strategies. Conservative and tentative steroid treatment should be performed in preoperative period without acute nerve damage.     

胸苷酸合成酶和雌激素受体在乳腺癌中的表达意义及相关性

目的:探讨胸苷酸合成酶(TS)和雌激素受体(ER)在乳腺癌中的表达及它们的相关性.方法:采用免疫组织化学SP法检测111例乳腺癌和38例乳腺腺瘤组织中TS和ER的表达情况.结果:乳腺腺瘤的TS和ER阳性率分别为10.53%(4/38)和36.84%(14/38),差异有显著性(P<0.05);乳腺癌病人中TS和ER的阳性率分别为31.53%(35/111)和40.54%(45/111),差异无显著性(P>0.05).乳腺癌中TS和ER的表达水平与患者年龄、发生部位、组织学类型、淋巴结转移相关性不明显(P>0.05).TS和ER在乳腺腺瘤组呈正向相关(r=0.077),而在乳腺癌组呈负向相关(r=-0.016).结论:TS在乳腺癌组表达率明显高于腺瘤(P<0.0 5);ER在良、恶性乳腺肿瘤内表达率差异无显著性(P>0.05).检测TS、ER对化疗药物选择有指导意义.     

子宫恶性肿瘤血清标志物CA125,CA199,CA153检测的临床意义

目的通过检测子宫恶性肿瘤患者血清中标志物CA125,CA199,CA153含量,探讨其能否作为评价治疗效果及预后中的一项检测指标.方法对103例子宫恶性肿瘤治疗前检测血清中CA125,CA199,CA153含量,部分患者治疗后追踪检测血清中CA125,CA199,CA153含量.结果治疗前血清中CA125,CA199,CA153在Ⅰ、Ⅱ期子宫内膜腺癌及腺鳞癌的阳性率明显低于Ⅲ、Ⅳ期(P<0.01).肿瘤切除后,CA125,CA199,CA153转为阴性,肿瘤复发或转移时标志物又复阳性.结论CA125,CA199,CA153的检测有助于治疗效果的评价、病情监测及预后的估计.     

Skp2在膀胱上皮癌中的表达及意义

目的：探讨细胞周期蛋白Skp2表达与膀胱移形细胞癌生物学行为的关系。方法：对73例膀胱移形细胞癌进行组织学分级及分期，另取22例正常膀胱组织作为对照。采用免疫组织化学方法S-P法检测各例组织中Skp2蛋白表达水平。并分析其表达水平与临床病理特征的关系。结果：Skp2蛋白阳性表达率为50．7％（37／73），Skp2蛋白表达与肿瘤组织学分级、病理分期显著相关。结论：Skp2是评估膀胱移形细胞癌恶性程度,估计预后有价值的指标。