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ABSTRACT: The purpose of this study was to evaluate gene amplification by chromogenic in situ hybridization (CISH) and the protein expression of Her-2/neu gene in patients with uterine papillary serous carcinoma (UPSC) and to determine its prognostic value.
Thirty-six patients with confirmed pathologic diagnosis of UPSC in Cancer Hospital of Fudan University from Jan. 1996 to Jan. 2006, were analysed retrospectively. CISH was performed to assess Her-2/neu gene amplification, and protein expression was evaluated by immunohistochemistry (IHC). The prognostic factors were analyzed by log-rank test or Cox proportional hazard model.
Among 36 cases with UPSC, 13 patients (36.1%) showed moderate staining (++) to strong staining (+++) for Her-2/neu protein, while amplification of the Her-2/neu gene by CISH was observed in 4 of the 36 (11.1%) cases. Her-2/neu protein over-expression was significantly associated with advanced surgical stage and worse prognosis by univariate analysis (P=0.030 and P=0.002, respectively), while the multivariate analysis shown that only Her-2/neu protein over-expression and deep myometrial invasion were associated with a poor prognosis (P<0.05). In 13 patients with Her-2/neu protein over-expression, the mean survival period with chemotherapy was shorter than those without chemotherapy (20 vs. 42 months, P=0.370).
Her-2/neu protein over-expression is significantly associated with advanced surgical stage UPSC and poor survival outcome, and might reduce the chemotherapy sensitivity.
Zhonghua fu chan ke za zhi 05/2010; 45(5):367-71.
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ABSTRACT: Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is defined as a rare cytotoxic alpha/beta T-cell lymphoma characterized by primary involvement of subcutaneous tissue mimicking panniculitis and a predominant CD3+/CD4-/CD8+ phenotype in 2005 World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification for cutaneous lymphomas. We presented a detailed study of SPTL, describing clinicopathologic, immunophenotypic, and molecular features of 22 cases in China. Strict diagnostic criteria according to the WHO-EORTC definition were applied to the diagnosis of all SPTL cases. Besides the common features described before, unusual CD4+/CD8- and CD4-/CD8- T-cell phenotypes were noted in 2 of our cases, respectively. CD30 was negative in all cases and CD56 was focally positive in 2 cases. Mortality in cases with angioinvasion (75%) was significantly higher than that in cases without angioinvasion (14.3%). Epstein-Barr virus (EBV) infection was detected in 1 immunocompetent patient by in situ hybridization. The frequency of rearranged TCRB, TCRG, and TCRD genes detected by BIOMED-2 multiplex polymerase chain reaction tubes was 80%, 67%, and 13%, respectively, with a total clonality detection rate of 100%. Clinical follow-up was available in 18 patients, ranging from 6 to 80 months. Most patients obtained complete or partial remission after therapy including one accompanied with EBV infection; 5 patients died: 3 of disease progression, 1 of severe infection, and 1 of complications caused by diabetes and hypertension. We conclude that SPTL as a cytotoxic lymphoma derived from alpha/beta T cell has a predominant CD4-/CD8+ phenotype, but unusual CD4+/CD8- and CD4-/CD8- phenotypes do exist. Owing to its indolent clinical course and relatively high survival rate, SPTL should be differentiated from cutaneous gamma/delta T-cell lymphoma. EBV is generally absent in SPTL but can rarely be detected especially in Asian population. Angioinvasion is a poor prognostic factor in SPTL.
The American journal of surgical pathology 09/2008; 32(10):1495-502. · 4.06 Impact Factor
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ABSTRACT: To analyze the clinico-pathological characteristics, prognostic factors and the rational therapy for the uterine papillary serous carcinoma (UPSC).
Thirty-three cases of UPSC were treated in our hospital between January 1996 and December 2005. The clinico-pathologic characteristics, treatment and prognosis were retrospectively analyzed.
The three-year overall survival for patients with stage I, III and IV was 77.4%, 53.3% and 12.1%, respectively. Patients with late stages and deep myometrial invasion were associated with a worse prognosis by univariate analysis (P < 0.05), while in a multivariate analysis only late stages and poor differentiation were associated with a poor prognosis (P < 0.05). The prognosis of patients in late stages treated with postoperative chemotherapy was significantly better than those without chemotherapy (P = 0.014).
Most UPSC patients are in late stages at diagnosis. They often have extra-uterine metastasis and have a poor prognosis. Complete surgical staging is recommended, and postoperative chemotherapy seems to improve the prognosis.
Zhonghua fu chan ke za zhi 12/2006; 41(12):817-21.
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ABSTRACT: To evaluate the effectiveness and safety of fertility-sparing treatment with progestins in patients with well-differentiated endometrial adenocarcinoma in women 40 years old or younger.
Six patients before the age of 40 diagnosed with grade I endometrial adenocarcinoma, who had undergone primary progestin treatment, were retrospectively studied. The clinical records and pathologic slides and the follow-up information were reviewed. Relevant articles describing patients with endometrial adenocarcinoma who were treated with hormonal therapy were searched. A total of 56 cases were found and used in integrated analysis.
Four of six cases responded to treatment with normal pathology on follow-up endometrial samplings. Two patients had a recurrence within a period between 10 and 12 months. No response was noted in the other two cases, who were offered surgery. Therefore, a total of 4 patients ultimately underwent hysterectomy. None of these four patients had extrauterine metastasis on postoperation pathologic examination. All these six patients were alive without evidence of disease at last follow-up. According to literatures, 46 of 56 cases responded to hormonal treatment and 11 cases had a recurrence. Seven of the 11 patients who recurred were re-treated with progesterone. Five patients had a second complete response. Sixteen of the 56 patients underwent hysterectomy. One of the patients had a pelvic recurrence after operation. The others remained without evidence of disease. Six patients in author's group had neither pregnancy nor delivery. Among 56 patients described in literatures, there were 41 person-times pregnancies and 40 infants were delivered, including 4 twins and 2 triples.
Progestin treatment is proved a safe and feasible therapy in well-differentiated endometrial adenocarcinoma in women 40 years old or younger. This approach may provide the possibility of conceiving and carrying a pregnancy with the aid of assisted reproduction technology.
Zhonghua fu chan ke za zhi 05/2006; 41(4):237-41.
