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Purpose To investigate the clinicopathological characteristics and prognostic correlation of the WHO(2021)new grading system of invasive pulmonary adenocarcinoma in stageⅠ pulmonary adenocarcinoma.Methods The clinical data of 447 patients with stage Ⅰ pulmonary adenocarcinoma were collect-ed,and all cases were evaluated according to the new grading system for invasive pulmonary adenocarcinoma.The immunohis-tochemical EnVision two-step method and elastic fiber staining were used to analyze the clinicopathological features with review of the relevant literature.Results In 447 patients with stage Ⅰlung adenocarcinoma,Napsin A and TTF-1 expression were posi-tive,p40 expression was negative,and Ki-67 proliferation index was higher than 5％in 177 patients(39.6％).There were 39 cases(8.7％)of positive pleural invasion in the visceral layer revealed by elastic fiber staining.The pleural invasion in stage Ⅰpulmonary adenocarcinoma patients was significantly higher than that in grades 2 and 3,the difference was statistically significant(P＜0.05).Patients with different grades of stage Ⅰ pulmonary adenocarcinoma were associated with gender,smoking history,surgical mode,chemotherapy,targeted medication,clinical stage,pathological classification,degree of differentiation,tumor size,vascular invasion,visceral pleural invasion,spread through air space(STAS)and Ki-67 index(P＜0.05).Survival analy-sis showed that there were statistically significant differences in disease free survival(DFS)and overall survival(OS)among different grades(grade 1＞grade 2＞grade 3)(P＜0.05).Cox regression analysis showed that WHO(2021)new grading of invasive pulmonary adenocarcinoma,visceral pleural invasion and Ki-67 proliferation index were independent risk factors for prognosis of patients with stage Ⅰ pulmonary adenocarcinoma.Conclusion The WHO(2021)new grading system of invasive pulmonary adenocarcinoma has good prognostic significance for stage Ⅰ pulmonary adenocarcinoma,and appropriate intervention for high-risk patients.It can effectively assist its postoperative treatment and has application value.

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OBJECTIVE: To evaluate the diagnostic value of tumor M2-pyruvate kinase (TuM2-PK) and carcinoembryonic antigen (CEA) levels in both pleural effusion and serum in the differential diagnosis of benign and malignant pleural effusion. METHODS: This prospective study was conducted among 80 patients with benign pleural effusion (BPE group) and 125 patients with malignant pleural effusion associated with lung cancer (MPE group). The levels of TuM2-PK and CEA were measured by using sandwich enzyme-linked immunosorbent assay and electrochemiluminescence. The receiver-operating characteristic curve (ROC) analysis was used to confirm the cutoff value to evaluate the diagnostic efficiency of TuM2-PK and CEA. RESULTS: The TuM2-PK and CEA levels in pleural effusion and serum, and their ratio (P/S) were higher in MPE group than that in BPE group (P < 0.05). In pleural effusion and serum, the diagnostic efficiency of combined TuM2-PK and CEA for MPE was superior to either single detection. CONCLUSIONS: The combined detection of TuM2-PK and CEA has a high sensitivity for diagnosis of MPE and might provide method for rapid and accurate diagnosis of patients.

Asunto(s)

Neoplasias Pulmonares , Derrame Pleural Maligno , Derrame Pleural , Biomarcadores de Tumor/análisis , Antígeno Carcinoembrionario , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patología , Derrame Pleural/diagnóstico , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/patología , Estudios Prospectivos , Piruvato Quinasa

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Objective To summarize the expression of CK19, HBME-land 34βE12 in papillary carcinoma of the thyroid (PCT) and their differential diagnostic value. Methods Clinical data of papillary carcinoma of the thyroid,nodular goiter and paraeareinoma were reviewed. All HE slides were reexamined and immunostains for CK19, HBME-land 34βEI2 were performed in selected case. Staining results were evaluated. Results Those cases typically showed complex papillary structures and interstitial fibrosis, while nuclear features included ground class appearance, grooves and nuclear pseudoinelusion. The positive rates for CKI9, HBME-1 and 34βE12 in PCT were 100.0 %, 89.4 % and 42.6 % respectively, the differences were statistically significant(P <0.01). Conclusion PCT occurs preferentially in the group of middle-aged women. The diagnosis of PCT should be distinguished from other plesiomorphous benign papillary lesions. Combined detection of CK19, HBME-1, 34βE12 can be most helpful for diagnosis for of PCT.