RESUMEN
The purpose of this study was to explore the histopathological staging and differential diagnosis of marginal zone lymphoma in gastric mucosa-associated lymphoid tissue (MALT lymphoma). We performed detailed histomorphology and immunohistochemistry investigations as well as genetic testing on endoscopic biopsy and endoscopic mucosal resection specimens from 18 patients with gastric MALT lymphoma. We found that gastric MALT lymphoma typically begins as a small, isolated area outside the lymphoid follicular mantle zone or proliferates in a multifocal, patchy manner, gradually spreads to the interfollicular zone, forming diffuse proliferation, invades the gastric mucosal glands, and infiltrates or proliferates into the center of peripheral reactive lymphoid follicles. Abnormally proliferating lymphocytes invade the surrounding lymphoid follicles, resulting in damage, atrophy, and disappearance of their normal follicles as well as of the gastric mucosa glands, forming diffuse proliferation. Redifferentiation and proliferation lead to the transformation of lymphocytes; that is, MALT transitions into highly invasive lymphoma. Based on our findings in this study, we propose the following five stages in the process of development and progression of gastric MALT lymphoma: the stage of cell proliferation outside the lymphoid follicular mantle zone; the stage of heterogeneous proliferative lymphoepithelial lesion; the stage of reactive lymphoid follicular implantation; the stage of lymphoid follicular clonal proliferation; and the stage of MALT transforming into highly invasive lymphoma. We examined the differential diagnosis of histopathological features at each stage. The clinicopathological staging of gastric MALT lymphoma can help clinicians provide accurate treatment and track malignant cell transformation, thus playing a significant role in controlling its development and progression.
Asunto(s)
Mucosa Gástrica , Linfoma de Células B de la Zona Marginal , Estadificación de Neoplasias , Neoplasias Gástricas , Humanos , Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/diagnóstico , Neoplasias Gástricas/patología , Neoplasias Gástricas/diagnóstico , Diagnóstico Diferencial , Femenino , Mucosa Gástrica/patología , Persona de Mediana Edad , Masculino , Anciano , Adulto , Biopsia , Inmunohistoquímica , Proliferación Celular , Anciano de 80 o más Años , Gastroscopía , Resección Endoscópica de la Mucosa , Biomarcadores de Tumor/análisis , Invasividad NeoplásicaRESUMEN
Water security is essential for sustainable economic and social development. To ensure water security, water engineering projects play an important role in regional developing program. The coastal city-Zhuhai City suffers a challenge from both future increasing water demand and salinity intrusion, To keep water security of the city, several alternative projects are designed. However, as the high cost of the projects and the potential adverse influence, a final projects portfolio, as well as their construction order has not be decided. To assist a proper decision of projects portfolio for local water security, this study proposed a combined method with one-vote veto and Analytic Hierarchy Process, to evaluate every projects portfolio from various perspectives. The results show: 1) to satisfy future water demand of 150 thousands m3/h, it is recommended to adopt a projects portfolio including expanding existing reservoirs and constructing new reservoirs, as its higher capacity utilization (96.87%), relatively lower construction and operation costs (8.59 billion and 57 million respectively), and lower ecological impact; 2) to satisfy future water demand of 160 thousands m3/h or more, transferring water from other cities should be an indispensable part for water security; 3) channel reservoir is not recommended as its high construction and operation costs, and high ecological impact. This study evaluated different alternative projects for cities' water security and provided a strong support for local government to decide their long-term projects portfolio and their construction order. The proposed method may be readily applied in other regions.
Asunto(s)
Conservación de los Recursos Naturales , Agua , China , Ciudades , Ecosistema , Salinidad , Abastecimiento de AguaRESUMEN
Water resources allocation is very important for water resources management. However, it is subject to the uncertainty in water availability (WA) or water demand (WD), as well as the pressure exerted by multi-stakeholders. Therefore, we propose a general framework as following: (i) applying Bayes theorem to develop a forecasting model for WA and WD probability distributions; (ii) constructing the matching matrix showing matching degree between WA and WD and assessing the probabilistic behavior of water resources allocation solutions based on the matching matrices; and (iii) performing the trade-off analysis among the solutions under different stakeholders' objectives to meet requirements of multi-stakeholders. Longgang River basin is selected as a case study area to demonstrate the proposed framework. Results show that, the forecast probability distributions of WA and WD may be updated timely with newly introduced data, and reflect their statistical characters well. Furthermore, the matching matrices illustrate the probabilities of the possible outcomes of each allocation solution clearly. From the probabilistic assessment; the results suggest: 21160×104 m3 diverted water are required to surely satisfy the current water demands, which is exactly the amount currently diverted for the study area. The proposed framework provides the updated probabilistic assessment for the possible outcomes, contributing to stakeholders to perform the tradeoff with each other. It makes significant contributions to address water allocation issues under uncertainty and is worthy to be applied broadly.