Molecular Pathology

分子病理学
  • 文章类型: Journal Article
    表皮生长因子受体(EGFR)在胶质瘤的发生和发展中起关键作用。特别是,在胶质母细胞瘤中,EGFR扩增成为入侵的催化剂,扩散,以及对放疗和化疗的抵抗力。目前的方法不能提供分子病理学的快速诊断结果。在这项研究中,我们首次提出了一种预测胶质瘤EGFR扩增状态的太赫兹光谱方法。利用测得的神经胶质瘤组织的太赫兹响应构建了机器学习模型,包括吸收系数,折射率,和介电损耗角正切。我们模型的新颖之处在于集成了三个经典的基分类器,即,支持向量机,随机森林,和极端梯度提升。集成学习方法结合了各种基分类器的优点,该模型具有更强的泛化能力。通过应用单个测试集验证了该方法的有效性。曲线下面积(AUC)最大值为85.8%,验证了集成算法的最佳性能。这标志着朝着更有效,更快速的诊断工具迈出了重要的一步,以指导神经胶质瘤的术后治疗。
    Epidermal growth factor receptor (EGFR) plays a pivotal role in the initiation and progression of gliomas. In particular, in glioblastoma, EGFR amplification emerges as a catalyst for invasion, proliferation, and resistance to radiotherapy and chemotherapy. Current approaches are not capable of providing rapid diagnostic results of molecular pathology. In this study, we propose a terahertz spectroscopic approach for predicting the EGFR amplification status of gliomas for the first time. A machine learning model was constructed using the terahertz response of the measured glioma tissues, including the absorption coefficient, refractive index, and dielectric loss tangent. The novelty of our model is the integration of three classical base classifiers, i.e., support vector machine, random forest, and extreme gradient boosting. The ensemble learning method combines the advantages of various base classifiers, this model has more generalization ability. The effectiveness of the proposed method was validated by applying an individual test set. The optimal performance of the integrated algorithm was verified with an area under the curve (AUC) maximum of 85.8 %. This signifies a significant stride toward more effective and rapid diagnostic tools for guiding postoperative therapy in gliomas.
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  • 文章类型: Journal Article
    前列腺腺泡腺癌约占前列腺癌(CaP)病例的95%。已知其余5%的CaP组织学亚型更具侵略性,最近引起了广泛关注。这些组织学亚型-即,前列腺导管腺癌(PDA),前列腺导管内癌(IDC-P),和前列腺的筛状癌(CC-P)-通常表现出不同的生长特征,基因组特征,和独特的肿瘤学结果。例如,PTEN突变,导致不受控制的细胞生长,经常出现在IDC-P和CC-P中。同源DNA重组修复(HRR)基因中的种系突变(例如,BRCA1,BRCA2,ATM,PALB2和CHEK2)在40%的IDC-P患者中发现,而无导管受累的患者中只有9%有种系突变。CC-P与常见抑癌基因的缺失有关,包括PTEN,TP53、NKX3-1、MAP3K7、RB1和CHD1。有证据表明,阿比特龙作为IDC-P患者的一线治疗方法可能优于多西他赛。为了解决这些和其他关键的病理属性,这篇综述探讨了分子病理学,遗传学,治疗,和与CC-P相关的肿瘤学结果,PDA,和IDC-P,目的是在PDA上创建具有集中式信息库的综合资源,IDC-P,和CC-P
    Prostatic acinar adenocarcinoma accounts for approximately 95% of prostate cancer (CaP) cases. The remaining 5% of histologic subtypes of CaP are known to be more aggressive and have recently garnered substantial attention. These histologic subtypes - namely, prostatic ductal adenocarcinoma (PDA), intraductal carcinoma of the prostate (IDC-P), and cribriform carcinoma of the prostate (CC-P) - typically exhibit distinct growth characteristics, genomic features, and unique oncologic outcomes. For example, PTEN mutations, which cause uncontrolled cell growth, are frequently present in IDC-P and CC-P. Germline mutations in homologous DNA recombination repair (HRR) genes (e.g., BRCA1, BRCA2, ATM, PALB2, and CHEK2) are discovered in 40% of patients with IDC-P, while only 9% of patients without ductal involvement had a germline mutation. CC-P is associated with deletions in common tumor suppressor genes, including PTEN, TP53, NKX3-1, MAP3K7, RB1, and CHD1. Evidence suggests abiraterone may be superior to docetaxel as a first-line treatment for patients with IDC-P. To address these and other critical pathological attributes, this review examines the molecular pathology, genetics, treatments, and oncologic outcomes associated with CC-P, PDA, and IDC-P with the objective of creating a comprehensive resource with a centralized repository of information on PDA, IDC-P, and CC-P.
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  • 文章类型: Systematic Review
    多形性胶质母细胞瘤(GBM)是成人原发性脑肿瘤中最常见和最恶性的类型。尽管在过去的十年中在了解这种肿瘤的分子发病机制和生物学方面取得了重要进展,GBM患者的预后仍然较差。GBM的特征是侵袭性生物学行为以及高度的肿瘤间和肿瘤内异质性。增加对GBM分子和细胞异质性的了解可能不仅有助于更准确地定义特定亚组以进行精确诊断,而且为成功实施靶向治疗奠定基础。在这里,我们系统地回顾了GBM分子发病机制认识的主要成就,机制,和过去十年的生物标志物。我们讨论了GBM分子病理学的进展,包括遗传学,表观遗传学,转录组学,和信号通路。我们还回顾了具有潜在临床作用的分子生物标志物。最后,新战略,当前的挑战,并将讨论发现GBM新的生物标志物和治疗靶点的未来方向。
    Glioblastoma multiforme (GBM) is the most common and malignant type of primary brain tumor in adults. Despite important advances in understanding the molecular pathogenesis and biology of this tumor in the past decade, the prognosis for GBM patients remains poor. GBM is characterized by aggressive biological behavior and high degrees of inter-tumor and intra-tumor heterogeneity. Increased understanding of the molecular and cellular heterogeneity of GBM may not only help more accurately define specific subgroups for precise diagnosis but also lay the groundwork for the successful implementation of targeted therapy. Herein, we systematically review the key achievements in the understanding of GBM molecular pathogenesis, mechanisms, and biomarkers in the past decade. We discuss the advances in the molecular pathology of GBM, including genetics, epigenetics, transcriptomics, and signaling pathways. We also review the molecular biomarkers that have potential clinical roles. Finally, new strategies, current challenges, and future directions for discovering new biomarkers and therapeutic targets for GBM will be discussed.
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  • 文章类型: Journal Article
    世界卫生组织更新了诊断胶质瘤的分类系统,结合组织学特征和分子数据,包括异柠檬酸脱氢酶1和染色体臂1p和19q的共缺失。1p/19q共缺失分析通常通过荧光原位杂交(FISH)进行。在这项研究中,我们开发了一个57基因靶向下一代测序(NGS)小组,包括1p/19q共缺失检测,主要用于评估黑色素瘤的诊断和潜在治疗反应,胃肠道间质瘤,还有神经胶质瘤患者.使用NGS方法对37个福尔马林固定的石蜡包埋的神经胶质瘤组织进行杂合性丢失分析,这些组织显示通过FISH确定的1p和/或19q丢失。常规方法用于验证一些神经胶质瘤相关基因突变。在81.1%(37个中的30个)和94.6%(37个中的35个)的病例中,发现1p和19q一致,而在94.7%(19个中的18个)和94.4%(18个中的17个)的病例中发现1p/19q共缺失和1p/19q共缺失的一致性,分别。总的来说,将NGS结果与常规方法的结果进行比较显示出高度一致性。总之,NGS面板允许同时可靠地分析1p/19q共缺失和突变.
    The World Health Organization has updated their classification system for the diagnosis of gliomas, combining histological features with molecular data including isocitrate dehydrogenase 1 and codeletion of chromosomal arms 1p and 19q. 1p/19q codeletion analysis is commonly performed by fluorescence in situ hybridization (FISH). In this study, we developed a 57-gene targeted next-generation sequencing (NGS) panel including 1p/19q codeletion detection mainly to assess diagnosis and potential treatment response in melanoma, gastrointestinal stromal tumor, and glioma patients. Loss of heterozygosity analysis was performed using the NGS method on 37 formalin-fixed paraffin-embedded glioma tissues that showed 1p and/or 19q loss determined by FISH. Conventional methods were applied for the validation of some glioma-related gene mutations. In 81.1% (30 of 37) and 94.6% (35 of 37) of cases, 1p and 19q were found to be in agreement whereas concordance for 1p/19q codeletion and no 1p/19q codeletion was found in 94.7% (18 of 19) and 94.4% (17 of 18) of cases, respectively. Overall, comparing NGS results with those of conventional methods showed high concordance. In conclusion, the NGS panel allows reliable analysis of 1p/19q codeletion and mutation at the same time.
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  • 文章类型: Case Reports
    Caroli综合征是一种先天性疾病,主要表现为肝内胆管扩张和先天性肝纤维化。这是临床工作中的罕见情况。通常,这种疾病的诊断是通过医学影像学证实的。这里,我们报告了一例反复上消化道出血的非典型Caroli综合征。患者接受影像学检查,肝活检和全外显子组测序。影像学检查结果无特异性。然而,在病理检查的帮助下,患者被诊断为Caroli综合征。总之,对于Caroli综合征的影像学表现不确定的病例,准确的诊断应该依靠病理学。通过讨论这个具体案例,我们的目标是增强读者对这种疾病的理解,提供有价值的信息,可以帮助早期发现和适当管理的卡罗利综合征,最终改善患者预后。
    Caroli\'s syndrome is a congenital disease characterized by dilation of intrahepatic bile ducts and congenital hepatic fibrosis. It is a rare condition in clinical work. Typically, the diagnosis of this disease is confirmed through medical imaging. Here, we report a case of atypical Caroli\'s syndrome in a patient who presented with recurrent upper gastrointestinal tract bleeding. The patient underwent imaging examinations, liver biopsy and whole exome sequencing. The results of the imaging examination were non-specific. However, with the aid of pathological examination, the patient was diagnosed with Caroli\'s syndrome. In conclusion, for cases where the imaging presentation of Caroli\'s syndrome is inconclusive, an accurate diagnosis should rely on pathology. By discussing this specific case, our aim is to enhance readers\' understanding of this disease, provide valuable information that can aid in the early detection and appropriate management of Caroli\'s syndrome, ultimately improving patient outcomes.
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  • 文章类型: Journal Article
    胆道恶性肿瘤约占胃肠道恶性肿瘤的3%。根据解剖位置,胆道恶性肿瘤可分为胆囊癌,肝内胆管癌(ICC),肝门部胆管癌,和远端胆管癌.手术治疗是早期胆道恶性肿瘤的主要治疗手段,这种疾病的阴险性质通常会导致晚期诊断,导致许多患者错过了手术干预的窗口。吉西他滨联合顺铂可作为晚期或不可切除病变患者的一线治疗,然而,二线治疗的明确标准尚未建立.近年来,在对胆道恶性肿瘤发生和发展的分子机制的研究中取得了许多进展,为疾病的靶向治疗提供基础。这篇综述总结了现有文献,并基于我们对分子发病机制和肿瘤病理的理解,探讨了晚期胆道恶性肿瘤的潜在二线治疗选择。
    Biliary tract malignant tumors account for about 3% of gastrointestinal malignancies. Based on anatomical location, biliary tract malignant tumors can be divided into gallbladder carcinoma, intrahepatic cholangiocarcinoma (ICC), hilar cholangiocarcinoma, and distal cholangiocarcinoma. Surgical treatment is the main treatment for early-stage biliary malignant tumors, the insidious nature of the disease often leads to late diagnoses, causing many patients missing the window for surgical intervention. Gemcitabine combined with cisplatin serves as a first-line treatment for patients with advanced or unresectable lesions, however, a definitive standard for second-line treatment has not yet been established. In recent years, many advances have occurred in the study of the molecular mechanisms contributing to the occurrence and development of biliary malignancies, providing a foundation for targeted treatments of the disease. This review summarizes the existing literature and explores potential second-line treatment options for advanced biliary malignancies based on our understanding of the molecular pathogenesis and tumor pathology.
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  • 文章类型: Journal Article
    背景:胎盘结核的病理诊断研究并不多见。目的分析妊娠合并结核(TB)胎盘的病理形态学特点及其临床意义。
    方法:收集2015年6月至2022年2月上海市公共卫生临床中心妊娠期胎盘组织标本19例。上海唯一的结核病孕妇住院中心,中国。苏木精-伊红染色,耐酸染色,并结合临床资料对其进行分子检测综合分析。
    结果:在19例中,7例宫内死胎,3例孕妇要求进行人工流产,其他9例接受标准分娩,婴儿存活,然而,其中3人是低体重早产儿,另有1例轻度宫内窒息。对9名幸存的婴儿进行了随访,其中3例患有先天性结核病。对于光镜下胎盘组织的病理特征,有3例上皮样肉芽肿形成,急性胎膜炎13例,4例干酪样坏死,7例炎性坏死,凝固性坏死10例,局灶性小钙化6例。所有胎盘组织的抗酸染色和聚合酶链反应(PCR)均为阳性。分子病理诊断结核分枝杆菌阳性18例,1例没有接受检查。
    结论:抗酸染色与分子病理检测相结合有助于胎盘结核的准确诊断。
    BACKGROUND: The study of pathologic diagnosis of placental TB is rare. The aim of this study is analyzing the pathomorphological characteristics of tuberculosis (TB) placenta during pregnancy and its clinical significance.
    METHODS: Nineteen cases of placental tissue specimens during pregnancy were collected from June 2015 to February 2022 at Shanghai Public Health Clinical Center, the only inpatient center for pregnant women with TB in Shanghai, China. Hematoxylin-eosin staining, acid-fast staining, and molecular testing were applied to analyze them comprehensively in combination with clinical information.
    RESULTS: Among the 19 cases, 7 cases caused intrauterine stillbirth, 3 cases received artificial abortion required by the pregnant woman, the other 9 cases received standard delivery and the infants survived, however, 3 of them were low-weight preterm infants, and another 1 case suffered mild intrauterine asphyxia. The 9 surviving infants were followed-up, of which 3 cases got congenital TB. For pathological characteristics of placental tissues under light microscopy, there were 3 cases of epithelioid granuloma formation, 13 cases of acute fetal membranitis, 4 cases of caseous necrosis, 7 cases of inflammatory necrosis, 10 cases of coagulative necrosis, and 6 cases with small focal calcifications. All placental tissues were positive for acid-fast staining and polymerase chain reaction (PCR). Molecular pathological diagnosis showed that 18 cases were positive for Mycobacterium tuberculosis, with 1 case not having received examination.
    CONCLUSIONS: Combining acid-fast staining and molecular pathological testing is helpful for accurately diagnosing placental TB.
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  • 文章类型: Journal Article
    本研究检查了肉瘤样肝内胆管癌(S-iCCA)。S-iCCA是一种更具侵袭性的肝内胆管癌(iCCA)亚型。肿瘤的早期发现和完全切除非常重要。这里报道的是S-iCCA的案例,并对S-iCCA的诊断和治疗进行了讨论。患者接受了肿瘤切除术,手术后接受了化疗和分子靶向药物治疗。在文献的基础上讨论了S-iCCA的临床病理特征和治疗。免疫组织化学检查显示细胞角蛋白7(CK7)阳性,CK-Pan,波形蛋白,和CK19和肉瘤样细胞中肝细胞石蜡1(HepPar-1)的阴性。此病例提示肉瘤样细胞的特殊分子特征具有较大的临床诊断价值,阐述了以手术为基础的S-iCCA综合治疗方法。
    The current study examined sarcomatoid intrahepatic cholangiocarcinoma (S-iCCA). S-iCCA was a more aggressive subtype of intrahepatic cholangiocarcinoma (iCCA). Early detection and complete resection of tumors are very important. Reported here is a case of S-iCCA, and the diagnosis and treatment of S-iCCA are discussed. The patient underwent a tumor resection and was treated with chemotherapy and molecularly targeted drugs after surgery. The clinical pathologic features and treatment of S-iCCA are discussed based on the literature. An immunohistochemical examination revealed positivity for cytokeratin 7 (CK7), CK-pan, vimentin, and CK19 and negativity for hepatocyte paraffin 1 (HepPar-1) in sarcomatoid cells. This case suggests that the particular molecular characteristics of sarcomatoid cells have great clinical diagnostic value, and comprehensive treatment of S-iCCA based on surgery is described.
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  • 文章类型: Journal Article
    心功能障碍是2019年冠状病毒病(COVID-19)引起的最危及生命的器官功能障碍之一。心肌或心血管损害是危重患者最常见的肺外器官并发症。了解心肌和血管损伤的发病机制和病理特点,对改进临床诊断和治疗方法具有重要意义。在这里,综述了严重急性呼吸综合征冠状病毒2对心脏的直接损害和病毒驱动的炎症引起的继发性损害的机制。微血栓形成和炎症损伤引起的缺血缺氧的病理机制以及周细胞或巨噬细胞病毒感染引发的组织炎症和单个心肌细胞坏死的损伤机制,缺氧,并对能量代谢紊乱进行了描述。后者可以提供新的诊断,治疗,以及由COVID-19或Omicron变体引起的心脏功能障碍的调查策略。
    Heart dysfunction is one of the most life-threatening organ dysfunctions caused by coronavirus disease 2019 (COVID-19). Myocardial or cardiovascular damage is the most common extrapulmonary organ complication in critically ill patients. Understanding the pathogenesis and pathological characteristics of myocardial and vascular injury is important for improving clinical diagnosis and treatment approach. Herein, the mechanism of direct damage caused by severe acute respiratory syndrome coronavirus 2 to the heart and secondary damage caused by virus-driven inflammation was reviewed. The pathological mechanism of ischemia and hypoxia due to microthrombosis and inflammatory injury as well as the injury mechanism of tissue inflammation and single myocardial cell necrosis triggered by the viral infection of pericytes or macrophages, hypoxia, and energy metabolism disorders were described. The latter can provide a novel diagnosis, treatment, and investigation strategy for heart dysfunctions caused by COVID-19 or the Omicron variant.
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  • 文章类型: Journal Article
    转谷氨酰胺酶2(TGase2)已被证明有助于IgA肾病(IgAN)的人源化小鼠模型中的系膜IgA1沉积,但机制还不完全清楚。在这项研究中,我们发现抑制TGase2活性可以显著降低从IgAN患者中分离出的与人肾小球系膜细胞(HMC)相互作用的多聚IgA1(pIgA1)的量.TGase2在HMC的胞质溶胶和膜上均有表达。在用pIgA1处理后,有更多的TGase2募集到膜。使用pIgA1系膜沉积的细胞模型,我们在胞质部分中鉴定了253种潜在的TGase2相关蛋白,并观察到pIgA1刺激后HMC中更高浓度的细胞囊泡和Ras同源家族成员A(RhoA)的表达增加。通过抑制囊泡运输途径,沉积在HMC上的pIgA1量和膜TGase2水平均降低。机械上,发现TGase2在细胞囊泡中与RhoA共沉淀。膜TGase2表达通过RhoA的过表达而大大增加,虽然它被击倒了RhoA。我们的体外方法表明,TGase2通过RhoA介导的囊泡运输途径从细胞质转运到膜,该途径可以促进IgAN中pIgA1与系膜的相互作用。
    Transglutaminase 2 (TGase2) has been shown to contribute to the mesangial IgA1 deposition in a humanized mouse model of IgA nephropathy (IgAN), but the mechanism is not fully understood. In this study, we found that inhibition of TGase2 activity could dramatically decrease the amount of polymeric IgA1 (pIgA1) isolated from patients with IgAN that interacts with human mesangial cells (HMC). TGase2 was expressed both in the cytosol and on the membrane of HMC. Upon treatment with pIgA1, there were more TGase2 recruited to the membrane. Using a cell model of mesangial deposition of pIgA1, we identified 253 potential TGase2-associated proteins in the cytosolic fraction and observed a higher concentration of cellular vesicles and increased expression of Ras homolog family member A (RhoA) in HMC after pIgA1 stimulation. Both the amount of pIgA1 deposited on HMC and membrane TGase2 level were decreased by inhibition of the vesicle trafficking pathway. Mechanistically, TGase2 was found to be coprecipitated with RhoA in the cellular vesicles. Membrane TGase2 expression was greatly increased by overexpression of RhoA, while it was reduced by knockdown of RhoA. Our in vitro approach demonstrated that TGase2 was transported from the cytosol to the membrane through a RhoA-mediated vesicle-trafficking pathway that can facilitate pIgA1 interaction with mesangium in IgAN.
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