Monitoring the long-term radiotherapy-associated molecular changes in low-grade gliomas(LGGs) facilitates the understanding of LGG response to radiotherapy.In this study,we used immunohistochemistry to analyze the exp...Monitoring the long-term radiotherapy-associated molecular changes in low-grade gliomas(LGGs) facilitates the understanding of LGG response to radiotherapy.In this study,we used immunohistochemistry to analyze the expression of Ki-67,tumor protein P53(TP53),P21,and P27 in 8 paired WHO grade II astrocytoma samples.The interval between radiotherapy(RT) and the second surgery was more than 3 months in all cases.The average Ki-67 labeling index(LI) was 5.3% in pre-RT samples and 11.54% in post-RT samples.Ki-67 LI was higher in the primary tumors that underwent malignant transformation observed at the second surgery after radiation.Post-RT Ki-67 LI decreased in 2 cases with an interval of less than 12 months between RT and the second surgery.TP53 expression was found in 3 out of 4 pre-RT samples with malignant transformation and in 1 out of 4 pre-RT samples without malignant transformation.Post-RT TP53 increased in 2 cases in which increased expression of P21 or P27 was also observed.Our study suggests that radiotherapy can inhibit WHO grade II astrocytoma proliferation as reflected by Ki-67 LI,but the effect attenuates with time.In addition,there is a tendency of malignant transformation for WHO grade II astrocytomas with a high Ki-67 level or TP53 expression in initial samples.展开更多
由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜...由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜、胸腺和心脏肿瘤分类与2004 WHO分类相比有很多重要变化。新版分类在促进学科领域发展、影响学科研究、优化患者治疗和辅助评估预后方面都有显著提升。文章简要介绍重要变化如下:(1)2011国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society,IASLC/ATS/ERS)分类推荐的腺癌分类主要变化;(2)将鳞状细胞癌重新分类为角化型、非角化型和基底样亚型,非角化型需免疫组化证明有鳞状分化;(3)严格限定大细胞癌的诊断只能在切除标本中做出,并对其进行瘦身,原大细胞癌分类中仅保留缺乏任何明确形态和免疫组化分化的部分;(4)将神经内分泌肿瘤划分到同一分类下;以及(5)目前对肺癌组织学分级的观点。展开更多
目的探讨WHO组织学分类和国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)分级系统与肺浸润性腺癌临床病理特征的关系,比较两种分类方法对预测肺浸润性腺癌生物学行为的价值。方法收集148例手术切除...目的探讨WHO组织学分类和国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)分级系统与肺浸润性腺癌临床病理特征的关系,比较两种分类方法对预测肺浸润性腺癌生物学行为的价值。方法收集148例手术切除的肺浸润性腺癌标本,根据WHO组织学分类和IASLC分级系统的诊断标准进行分类和分级。ROC曲线分析两种分类方法对肺浸润性腺癌淋巴结转移、脉管侵犯、神经侵犯、胸膜侵犯、气腔内扩散以及pTNM分期的预测价值。结果根据WHO组织学结构为主的分类:148例肺浸润性腺癌中贴壁型28例、腺泡型101例、乳头型7例、微乳头型2例、实体型10例;以组织学分类对应的病理分级:高分化28例、中分化108例、低分化12例。根据IASLC分级系统进行分类:148例肺浸润性腺癌中高分化26例、中分化56例、低分化66例。WHO组织学分类和IASLC分级系统与患者性别、肿瘤大小、脉管侵犯、淋巴结转移、气腔内扩散、胸膜侵犯和pTNM分期均相关。ROC曲线显示IASLC分级系统对脉管侵犯、淋巴结转移、气腔内扩散、胸膜侵犯的预测效能优于WHO组织学分类;在pTNM分期上,IASLC分级系统比WHO组织学分类差。结论IASLC分级系统与WHO组织学分类相比,其具有较好地预测肺腺癌临床生物学行为,应在临床实践中推广使用。展开更多
Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objecti...Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.展开更多
文摘Monitoring the long-term radiotherapy-associated molecular changes in low-grade gliomas(LGGs) facilitates the understanding of LGG response to radiotherapy.In this study,we used immunohistochemistry to analyze the expression of Ki-67,tumor protein P53(TP53),P21,and P27 in 8 paired WHO grade II astrocytoma samples.The interval between radiotherapy(RT) and the second surgery was more than 3 months in all cases.The average Ki-67 labeling index(LI) was 5.3% in pre-RT samples and 11.54% in post-RT samples.Ki-67 LI was higher in the primary tumors that underwent malignant transformation observed at the second surgery after radiation.Post-RT Ki-67 LI decreased in 2 cases with an interval of less than 12 months between RT and the second surgery.TP53 expression was found in 3 out of 4 pre-RT samples with malignant transformation and in 1 out of 4 pre-RT samples without malignant transformation.Post-RT TP53 increased in 2 cases in which increased expression of P21 or P27 was also observed.Our study suggests that radiotherapy can inhibit WHO grade II astrocytoma proliferation as reflected by Ki-67 LI,but the effect attenuates with time.In addition,there is a tendency of malignant transformation for WHO grade II astrocytomas with a high Ki-67 level or TP53 expression in initial samples.
文摘由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜、胸腺和心脏肿瘤分类与2004 WHO分类相比有很多重要变化。新版分类在促进学科领域发展、影响学科研究、优化患者治疗和辅助评估预后方面都有显著提升。文章简要介绍重要变化如下:(1)2011国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society,IASLC/ATS/ERS)分类推荐的腺癌分类主要变化;(2)将鳞状细胞癌重新分类为角化型、非角化型和基底样亚型,非角化型需免疫组化证明有鳞状分化;(3)严格限定大细胞癌的诊断只能在切除标本中做出,并对其进行瘦身,原大细胞癌分类中仅保留缺乏任何明确形态和免疫组化分化的部分;(4)将神经内分泌肿瘤划分到同一分类下;以及(5)目前对肺癌组织学分级的观点。
文摘目的探讨WHO组织学分类和国际肺癌研究协会(International Association for the Study of Lung Cancer,IASLC)分级系统与肺浸润性腺癌临床病理特征的关系,比较两种分类方法对预测肺浸润性腺癌生物学行为的价值。方法收集148例手术切除的肺浸润性腺癌标本,根据WHO组织学分类和IASLC分级系统的诊断标准进行分类和分级。ROC曲线分析两种分类方法对肺浸润性腺癌淋巴结转移、脉管侵犯、神经侵犯、胸膜侵犯、气腔内扩散以及pTNM分期的预测价值。结果根据WHO组织学结构为主的分类:148例肺浸润性腺癌中贴壁型28例、腺泡型101例、乳头型7例、微乳头型2例、实体型10例;以组织学分类对应的病理分级:高分化28例、中分化108例、低分化12例。根据IASLC分级系统进行分类:148例肺浸润性腺癌中高分化26例、中分化56例、低分化66例。WHO组织学分类和IASLC分级系统与患者性别、肿瘤大小、脉管侵犯、淋巴结转移、气腔内扩散、胸膜侵犯和pTNM分期均相关。ROC曲线显示IASLC分级系统对脉管侵犯、淋巴结转移、气腔内扩散、胸膜侵犯的预测效能优于WHO组织学分类;在pTNM分期上,IASLC分级系统比WHO组织学分类差。结论IASLC分级系统与WHO组织学分类相比,其具有较好地预测肺腺癌临床生物学行为,应在临床实践中推广使用。
文摘Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.
