Abstract:Objective To investigate the pathological features of cases with discordance between endoscopic ultrasound(EUS)staging and postoperative pathological staging in colorectal carcinoma.Methods A retrospective study was conducted on 60 patients with colorectal carcinoma who underwent preoperative EUS and radical resection.Postoperative pathological staging was used as the gold standard.Clinicopathological characteristics were compared between the concordant group and the discordant group using the chi-square test or Fisher's exact test.Results Among the 60 patients,32 cases(53.3%)had consistent EUS and pathological staging,and 28 cases(46.7%)had inconsistent staging.In the discordant group,T stage was underestimated in 13 cases(59.1%)and overestimated in 9 cases(40.9%),while N stage was underdiagnosed in 19 cases(31.7%).Pathological comparison revealed that the discordant group showed significantly higher proportions of mucinous component(χ2=4.512,P=0.034),inflammatory/fibrotic response(χ2=3.873,P=0.049),and lymph node micrometastasis(χ2=4.512,P=0.034)than the concordant group.Although submucosal infiltration pattern and tumor budding were more commonly found in the discordant group,the differences were not statistically significant(P>0.05).Conclusions Mucinous component,inflammatory/fibrotic response,and lymph node micrometastasis are key pathological factors contributing to discrepancies between EUS staging and postoperative pathological staging in colorectal carcinoma.Recognition of these features may help clinicians interpret EUS results more accurately and optimize individualized treatment strategies.

Abstract:Objective To explore the application value of the intelligent cell block system in preparing cell blocks from pleural effusion and peritoneal effusion.Methods Pleural and peritoneal effusion samples were collected to compare the hematoxylin-eosin(HE)staining quality of the intelligent cell block system at different rotational speeds.Cell blocks were prepared from samples of the same source using the traditional centrifugal precipitation method and the intelligent cell block system,and their HE staining results were compared.The excellence rates of cell blocks prepared by the two methods were compared.Pleural and peritoneal effusion samples from patients with lung adenocarcinoma and ovarian serous carcinoma were selected,cell blocks were prepared by both methods,and HE staining,immunohistochemical(IHC)staining,as well as genetic testing for 10 gene mutations in the blocks of lung adenocarcinoma patients were performed to evaluate the efficacy of cell block preparation.Results When the intelligent cell block system was operated at 3000 r/min for preparing pleural and peritoneal effusion cell blocks,HE staining showed characteristics of uniform sheet-like cell distribution,well-preserved morphology,and moderate cell quantity under medium-power microscope.Cell blocks prepared by the intelligent cell block system showed minimal cell damage,distinct morphology,and ease of observation in HE staining.The excellence rates of cell blocks prepared by the traditional centrifugal precipitation method versus the intelligent system were 30%vs.90%for pleural effusion and 40%vs.90%for peritoneal effusion,respectively,showing statistically significant differences(P＜0.001).Compared with the traditional centrifugal precipitation method,pleural and peritoneal effusion cell blocks from lung adenocarcinoma and ovarian serous carcinoma patients prepared by the intelligent cell block system showed accurate positive localization,moderate staining intensity,and no non-specific staining in IHC staining;there was no statistically significant difference in the detection rates of 10 gene mutations in pleural effusion cell blocks of lung adenocarcinoma patients between the two methods.Conclusion The intelligent cell block system exhibits a high excellence rate in preparing pleural and peritoneal effusion cell blocks.Both the HE staining and IHC staining quality of cell blocks prepared by the intelligent system are significantly superior to those of the traditional centrifugal precipitation method,demonstrating good diagnostic efficiency and warranting promotion in clinical practice and research.

Abstract:Objective To investigate the androgen receptor(AR)expression in human epidermal growth factor receptor 2(HER2)-low-expressing breast cancer tissues and to explore its relationship with clinicopathological features,recurrence,and metastasis of patients,so as to provide a theoretical basis for the detection and treatment of breast cancer.Methods Ninety-eight patients with HER2-low-expressing breast cancer diagnosed and treated at Tangshan Maternal and Child Health Hospital from April 2018 to June 2021 were selected.Patients were followed up until June 30,2024.The expression of AR in patients with HER2-low-expressing breast cancer and its correlation with clinicopathological features were analyzed.Then multivariate Cox regression model was utilized to verify the correlation of AR expression with recurrence and metastasis of HER2-low-expressing breast cancer.Results Among patients with HER2-low-expressing breast cancer,AR-negative expression was observed in 29 cases(29.59%),and AR-positive expression was found in 69 cases(70.41%).Significant differences in tumor diameter and Ki-67 expression were observed between AR-positive and AR-negative patients with HER2-low-expressing breast cancer(P＜0.05).The difference in AR positive expression rate between patients with recurrence/metastasis and those without was statistically significant(P＜0.05),and the proportion of AR-positive patients in the recurrence/metastasis group was significantly higher than that of AR-negative patients(P＜0.05).Multivariate Cox proportional hazards regression model denoted that positive AR expression(HR:1.568,95%CI:1.226-2.028),postmenopausal status(HR:1.297,95%CI:0.940-1.519),tumor diameter>2 cm(HR:2.882,95%CI:1.454-5.714),and Ki-67≥30%(HR:3.004,95%CI:1.553-5.967)were independent risk factors for recurrence and metastasis of patients with HER2-low-expressing breast cancer(P<0.05).Conclusion The proportion of positive AR expression is elevated in HER2-low-expressing breast cancer patients,and positive AR expression is a risk factor for recurrence and metastasis of patients.

Abstract:Objective To detect the expression of tumor associated macrophages(TAM)markers CD163 and CD68 in head and neck squamous cell carcinoma(HNSCC),and to analyze their relationship with the clinicopathological characteristics and prognostic value of HNSCC.Methods A total of 76 HNSCC specimens with complete clinicopathological data were selected,immunohistochemistry was used to detect the expression of CD163 and CD68 in tumor stroma and their correlation with clinical pathological features such as patient gender,age,tumor differentiation degree,maximum tumor size,lymph node metastasis,T stage,and Ki-67 proliferation index.Results The 76 cases of HNSCC were divided into high-density and low-density groups based on the median expression of CD163 and CD68 as critical values.The median expression of CD163 positive TAMs was 26/0.24 mm2 HPF,and the median expression of CD68 positive TAMs was 53/0.24 mm2 HPF.The high-density expression rate of CD163 was higher in the lymph node metastasis group compared to the non-metastasis group,and higher in TⅢ-Ⅳ stage compared to TⅠ-Ⅱ stage(P<0.05).The expression rate of CD163 was not related to patient gender,age,tumor differentiation degree,Ki-67 expression,and tumor maximum diameter(all P>0.05).Similarly,the high-density expression rate of CD68 was higher in the lymph node metastasis group compared to the non-metastasis group,and higher in TⅢ-Ⅳ stage compared to TⅠ-Ⅱ stage(P<0.05).Additionally,the high-density expression rate of CD68 was higher in cases with tumor size>2 cm compared to≤2 cm.The expression rate of CD68 was not associated with patient gender,age,tumor differentiation degree,or Ki-67 expression(P>0.05).Conclusion The high expression of CD163 and CD68 in head and neck squamous cell carcinoma tissues is associated with lymph node metastasis and tumor staging.The assessment of the expression of TAM markers such as CD163 and CD68 with the immunomicroenvironment of HNSCC tumors contributes to the prognostic evaluation of HNSCC patients.

Abstract:Objective Analysis of BATF gene expression patterns in tumor-infiltrating Tregs and association with clinicopathological parameters in prostate cancer.Methods The Human Protein Atlas database and GEPIA2 tools were utilized to analyze cell populations and BATF expression patterns across immune cell types in prostate cancer.Performed single-cell RNA sequencing on 4 prostate cancer specimens and 1 benign prostate specimen for immune cell clustering and BATF expression profiling.Thirty radical prostatectomy specimens were obtained for immunohistochemical(IHC)analysis of BATF and Foxp3 expression in both tumor and adjacent normal tissues.Multiplex immunofluorescence(mIF)was conducted to quantify BATF+regulatory T cell infiltration and evaluate its correlation with clinicopathological characteristics.Results BATF was highly expressed in T cells,particularly in Treg subsets.Elevated BATF+Tregs infiltration significantly correlated with:poor differentiation(Gleason score≥7)、advanced stage(T3-T4)、lymph node metastasis(P<0.001).Conclusions Prostate cancer exhibits upregulated BATF expression predominantly in T cells,with the highest levels in Tregs.An increase in BATF+regulatory T cells may suggest an association with poor tumor differentiation,higher tumor stage,and lymph node metastasis.Targeting BATF may represent a novel immunotherapeutic strategy for prostate cancer.

Abstract:Objective To investigate the diagnostic criteria and differential diagnosis of gastric hamartomatous inverted polyp(GHIP)and to conduct a literature review.Methods The clinical data and pathological specimens of three patients with GHIP from the Second Affiliated Hospital of Xuzhou Medical University and the First People's Hospital of Xuzhou from 2019 to 2024 were collected,and HE and immunohistochemical sections were prepared,and morphological observation and analysis were performed.Results There were 2 females and 1 male,and the age of onset was 52～63 years(mean 57 years).The site was located in the gastric body in 2 cases,the fundus in 1 case;the pedunculated polypoid bulge in 1 case under endoscope,juvenile polypoid manifestation in 1 case,and the bulge(mass)of the sessile submucosal mass in 1 case.The pathological features under light microscope were mainly lesions located in the submucosa,the surface was covered with normal gastric mucosa,lobulated/clustered gastric glandular epithelium(fundus gland,pyloric gland,foveolar epithelium)could be seen in the submucosa;some glands were significantly cystic dilated,some glands were disorderly distributed,lacking normal gastric gland differentiation,but cells were not atypical,lobulated/clusters of hyperplastic glands were surrounded by smooth muscle tissue with varying degrees of hyperplasia,disordered arrangement,and inverted growth to the submucosa.Immunohistochemistry showed that the glands expressed MUC5AC,MUC6,pepsinogen I,H/K ATPaseβ and smooth muscle markers were positive.Conclusion GHIP is a rare gastric polyposis lesion with a special morphology of hyperplastic mucosal inversion to submucosa,which is easy to cause misdiagnosis or overdiagnosis by clinicians and pathologists due to its extremely low incidence.It should be pathologically distinguished from gastritis cystica profunda(GCP),juvenile polyps,Peutz-Jeghers polyps,gastric adenomyomas,and gastric well-differentiated tubular adenocarcinoma.

Abstract:Objective To explore the clinical and pathological features,immunophenotype,and differential diagnosis of multicentric plasma cell type Castleman disease(PC-MCD)with elevated IgG4,aiming to enhance the understanding of the disease.Methods The clinical data of one patient diagnosed with PC-MCD were retrospectively analyzed,the tissue structure and cell morphology of lymph nodes were analyzed by routine hematoxylin-eosin(HE)staining,the immunophenotype and Epstein-Barr virus(EBV)infection status were analyzed by immunohistochemical staining and in situ hybridization,and the differential diagnosis of Epstein-Barr virus(EBV)infection status was discussed in combination with literature analysis.Results The patient was an 18-year-old male who presented with a two-year history of multiple lymphadenopathies in the cervical region.Laboratory serological tests showed elevated IL-6(265.8 pg/mL),IgG and IgA levels,significantly elevated serum IgG4(30.100 g/L).Free light chain kappa and free light chain lambda were also abnormally elevated.Histopathological examination demonstrated the disappearance of the subcapsular sinus in the lymph nodes,along with follicular hyperplasia of varying sizes.Some germinal centers exhibited atrophy with eosinophilic deposition,while the follicular mantle zone was expanded.A small number of peripherally arranged lymphocytes exhibited a concentric pattern,forming an"onion skin"appearance.The interfollicular and paracortical areas showed diffuse infiltration of plasma cells,small blood vessel proliferation,occasional intrafollicular invasion,and hyalinization.Immunohistochemical staining revealed that the majority of follicular cells were positive for CD20 and CD79a.Germinal center cells were positive for CD10 and Bcl-6 but negative for Bcl-2,with a high Ki-67 proliferation index(90%+).Marginal zone cells were positive for MNDA and negative for cyclin D1.Interfollicular cells were positive for CD3 and Bcl-2,with plasma cells showing positivity for MUM1.Kappa and lambda light chains were partially expressed in plasma cells,exhibiting a polyclonal pattern without light chain restriction.IgG4-positive plasma cells were observed,but the IgG4+/IgG+ratio was<40%.Ki-67 staining indicated high proliferative activity in the germinal centers and approximately 10%positivity in the interfollicular areas.Follicular dendritic cells were positive for CD21 and CD23.EBER in situ hybridization was negative.No clonal rearrangements were detected in IGH,IGK,or IGL gene analyses.Conclusion PC-MCD with elevated IgG4 exhibits the histopathological features similar to those of IgG4-related disease.Differentiation based solely on histological and immunophenotypic findings is challenging.Accurate diagnosis requires a comprehensive assessment incorporating the diagnostic criteria and exclusion criteria for IgG4-related disease,along with clinical manifestations and laboratory findings.

Abstract:Objective To observe the expression of long non-coding RNA(LncRNA)colon cancer associated transcript-1(CCAT1)and high mobility group protein A2(HMGA2)in prostate cancer tissues and analyze their correlation with metastasis.Methods A total of 52 cases of prostate cancer tissue and 23 cases of prostate tissues with benign hyperplasia were selected from June 2015 to December 2019 in our hospital.The expression of HMGA2 protein was detected by immunohistochemistry,and the expression of LncRNA CCAT1 and HMGA2 mRNA was detected by RTq-PCR.Prostate cancer cells PC-3 were cultured in vitro and transfected with CCAT1 siRNA,and metastasis and invasion of PC-3 cells were detected in each group by Transwell assay.The Pearson method was used to analyze the correlation between LncRNA CCAT1 and HMGA2 mRNA expression.The Kaplan-Meier method was used to analyze the relationship between LncRNA CCAT1 and HMGA2 expression and prognosis in prostate cancer patients.Results HMGA2 positive expression rate and LncRNA CCAT1 and HMGA2 mRNA levels were higher in prostate cancer tissues than in benign hyperplasia tissues(χ2=20.532,P<0.05).LncRNA CCAT1 was positively correlated with HMGA2 mRNA(r=0.432,P<0.05).Compared with the negative control and blank control groups,the expression levels of LncRNA CCAT1,HMGA2 mRNA,migration rate and invasion rate in PC-3 cells in the siRNA transfection group were significantly reduced(P<0.05).The 3-year overall survival rate was higher in patients with negative expression of LncRNA CCAT1 and HMGA2 than in those with positive expression(Log Rank χ2=4.182,5.031,P<0.05).Conclusion LncRNA CCAT1 and HMGA2 expression are upregulated in prostate cancer tissues,which are correlated with patients'lymph node or bone metastasis,and clinical stage.Knockdown of CCAT1 can inhibit cancer cell migration and invasion,and the expression of LncRNA CCAT1 and HMGA2 is associated with patient prognosis,suggesting that they may be potential targets for prostate cancer treatment.

Abstract:Objective To compare the effects of using acidic decalcification solution and EDTA decalcification solution on the subsequent molecular pathological detection results of bone tumor tissue specimens,and to explore the ideal decalcification treatment plan for clinical application.Methods A total of 18 bone tumor specimens clinically diagnosed with chondrosarcoma and sent for pathological diagnosis after surgery from June 2022 to May 2024 were collected.Standardized sampling was performed for initial pathological examination,and the collected bone tumor tissues were randomly divided into an acidic decalcification solution group and an EDTA decalcification solution group.Compare the required time for decalcification and the staining effect of hematoxylin eosin(HE)between two groups of specimens,with a focus on comparing the results of molecular pathological detection items:fluorescence in situ hybridization(FISH)and first-generation sequencing analysis.Results The duration of decalcification was shorter in the acidic decalcification solution group than in the EDTA decalcification solution group;HE staining effect:The EDTA decalcification solution group was significantly better than the acidic decalcification solution group(P<0.001);FISH detection:The EDTA decalcification solution group was significantly better than the acidic decalcification solution group(P<0.001).First generation sequencing analysis showed that the acidic decalcification solution group did not meet the quality control standards,resulting in detection failure.The EDTA decalcification solution group met the quality control standards,and the analysis results showed that 10 out of 18 bone tumor tissues(56%)had gene mutations.Conclusion EDTA decalcification solution can effectively preserve the integrity of nucleic acids and cell structures in tissues,providing guarantees for molecular detection and clinical treatment of bone tumors.