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Objectives: To review the clinicopathologic features of perivascular epithelioid cell tumor (PEComa) of the urinary bladder.Methods: Seven cases of bladder PEComa were studied by light microscopy, immunohistochemistry, and fluorescence in situ hybridization (FISH).Results: In our 7 cases, 5 patients were female and 2 were male, with ages between 26 and 78 years. Patients presented with hematuria and recurrent abdominal discomfort as the main clinical symptoms. Microscopically, the epithelioid and spindle-shaped tumor cells with clear to granular eosinophilic cytoplasm were arranged in fascicular, acinar, or nested patterns. The tumor cells were positive for HMB45, melan-A, and SMA, but no TFE3 gene rearrangement was detected in any of the 7 samples by FISH. The analysis of all 35 cases from the literature and ours showed a patient age range from 16 to 78 years (mean age, 39 years), a male-to-female ratio of 1:1.3, maximal tumor diameters from 0.6 to 18.8 cm (mean, 4.5 cm). With a mean follow-up of 27 months, the recurrence, metastasis, and mortality rates were 10.7%, 10.7%, and 7.1%, respectively.Conclusions: Bladder PEComa is extremely rare, remains a diagnostic challenge, and needs more attention. Strengthening the understanding of this tumor will improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is an uncommon primary liver malignancy and little known about the clinical and imaging characteristics of cHCC-CC. We aim to define the demographics, imaging features of cHCC-CC on contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CT) in this study.Methods: From January 2005 to December 2014, 45 patients with pathologically proven cHCC-CC who underwent preoperative CEUS and 43 patients who had additional CT scan in our institution were included. A retrospective review of the imaging studies and clinical data in these patients was conducted.Results: In our series, cHCC-CC accounted for 1.6 % of all primary liver malignancy. Mean age of patient with cHCC-CC was 52.8 year (range: 28-74 year) and 88.9 % (40/45) of patients were male. Thirty of forty five patients (66.7 %) had cirrhosis and 20 % (9/45) of patients had chronic hepatitis B without cirrhosis. Alpha--fetoprotein (AFP) was elevated in 62.2 % (28/45) of patients and carbohydrate antigen 19-9 (CA19-9) elevated in 22.2 % (10/45) of patients). Both AFP and CA19-9 were simultaneously elevated in 15.6 % (7/45) of patients. Enhancement pattern resembling cholangiocarcinoma (CC) was noted in 53.3 % (24/45) of patients (on CEUS and in 30.2 % (13/43) of patients at CT. Enhancement pattern resembling hepatocellular carcinoma (HCC) was observed in 42.2 % (19/45) of patients on CEUS and in 58.1 % (25/43) of patients at CT. The percentage of tumors showing CC enhancement pattern (27.9 %, 12/43) was comparable with that of tumors showing HCC enhancement pattern (44.2 %, 19/43) on both CEUS and CT (p = 0.116). Simultaneous elevation of tumor markers (AFP and CA19-9) or tumor marker elevation (AFP or CA19-9) in discordance with enhancement pattern on CEUS was demonstrated in 51.1 % (23/45) of patients and on CT in 53.5 % (23/43) of patients, which was significantly more than simultaneous elevation of tumor markers (AFP and CA19-9) alone (p = 0.000).Conclusions: The clinical characteristics of cHCC-CC are similar to those of HCC. The cHCC-CC tumors display enhancement patterns resembling CC or HCC in comparable proportion on both CEUS and CT. Combination of simultaneous elevation of tumor makers (AFP and CA19-9) and tumor mark elevation (AFP or CA19-9) in discordance with presumptive imaging findings on CEUS or CT may lead significantly more patients to be suspicious of the diagnosis of cHCC-CC. [ABSTRACT FROM AUTHOR]

Objective: To investigate the distribution patterns and proliferative activity of lymphatic vessels in colorectal carcinomas (CRC) and their relationship with tumor metastasis and disease prognosis., Methods: The microlymphatic density (MLD) and microvascular density in tumoral and non-tumoral areas of 96 cases of CRC were evaluated by immunohistochemistry, using monoclonal antibodies for podoplanin and CD34 respectively. The Ki-67 expression of the lymphatic and blood vessels was detected by double-labeling immunohistochemistry. The relationship between MLD and clinicopathologic features and prognosis was analyzed., Results: The lymph vessels at central and superficia1 portions of CRC often had a reticular architecture with numerous tiny and ill-defined lumina, while those at the tumor borders had large and open lumina. The MLD at tumor borders (51.2 +/- 25.5) was significantly higher than that in normal colorectal mucosa (29.4 +/- 9.0) and other portions of CRC (P < 0.01). The Ki-67 labeling index of the lymphatic lining cells at tumor borders (0.23 +/- 0.17) was significantly higher than that in other portions of CRC (P < 0.05). The MLD significantly correlated with lymphatic involvement by tumor cells, regional lymph node metastasis and distant metastasis (P < 0.01). The 5-year survival rate was also significantly lower in patients with high MLD (P < 0.05)., Conclusions: Neolymphatic vessels are commonly seen in CRC, especially at tumor borders. High MLD at tumor borders is associated with metastasis. The detection of MLD at tumor borders may thus be useful in predicting lymph node metastasis and prognosis in patients with CPC.

Background & Objective: Expression of survivin, an apoptosis suppressor gene, in colorectal cancer(CRC), and its relationship with pathologic factors, cell apoptosis, and angiogenesis are unclear. This study aimed to investigate the effect of survivin on cell apoptosis, and its relation with angiogenesis, and to further explore the effects of survivin on development and prognosis of CRC., Methods: Protein expression of survivin, and vascular endothelial growth factor (VEGF) in 91 specimens of CRC was detected by immunohistochemistry, apoptosis index (AI) of tumor cells was detected by TUNEL method., Results: Positive rate of survivin in CRC with distant metastasis was 56.0% (14/25), significantly higher than that in CRC without metastasis (48.5%, 32/66) (P<0.05); and that in 5-year survival patients(42.9%,30/70) was lower than that in patients died within 5 years (76.2%,16/21) (P<0.01). The average survival time of patients with positive expression of survivin was 91.3 months, and that of patients with negative expression of survivin was 116.4 months; 5-year survival rate of the former (65.2%, 30/46) was significantly lower than that of the latter (88.9%, 40/45) (P<0.01). The average AI of patients with positive expression of survivin was lower than that of patients with negative expression of survivin [(0.74+/-0.19)% vs. (1.07+/-0.24)%, P<0.01]; the expression of survivin significantly correlated with that of VEGF (pearson: 0.721)., Conclusion: Survivin may promote metastasis, and affect prognosis of CRC through inhibiting cell apoptosis, and regulating angiogenesis of CRC.

Objective: To investigate the relationship between beta-catenin and matrix metalloproteinase-7 (MMP-7) expression and development/biologic behavior of human colorectal cancer., Methods: Immunohistochemical study for beta-catenin and MMP-7 was carried out on colorectal adenoma-carcinoma tissue microarrays and results analyzed., Results: The nuclear beta-catenin expression rate was 35.9% in adenoma with malignant transformation, significantly higher than that in adenoma (16.7%) and carcinoma (19.7%) (both P < 0.05). The cytoplasmic and nuclear beta-catenin expression rate in adenoma with severe dysplasia was significantly higher than that in adenoma with mild dysplasia (both P < 0.05). The nuclear beta-catenin expression rate in adenocarcinomas of the ulcerative type, with lymph node metastasis and in the late tumor stages were all significantly higher than that in adenocarcinomas of the polypoid type, with negative lymph node and in the early tumor stages (P < 0.05 or P < 0.01). The MMP-7 expression rate in adenocarcinoma (69.2%) was significantly higher than that in normal colorectal mucosa (15.0%), adenoma (35.0%) and adenoma with malignant transformation (46.2%, P < 0.05 or P < 0.01). The MMP-7 expression rate in ulcerative type adenocarcinoma with lymph node metastasis and in late tumor stages was significantly higher than that in polypoid type adenocarcinoma with negative lymph node and in early tumor stages (all P < 0.05). The cytoplasmic and nuclear beta-catenin expression was thus in positive correlation with the expression of MMP-7 (both P < 0.01)., Conclusions: The cytoplasmic and nuclear beta-catenin expression, probably an early event, was related to the development of colorectal cancer. beta-catenin may enhance the degradative function of the target gene MMP-7 through nuclear translocation and may further facilitate local invasion and metastasis by the colorectal cancer cells.

Objective: To investigate the clinical features and changes in the incidence of skin cancer in two hospitals located in western China., Methods: The patients diagnosed pathologically as skin cancer from 1981 to 2000 were retrospectively collected from the two hospitals. Clinical data of patients with skin cancer were collected and analyzed., Results: (1) Of the 1 905 patients with skin cancer, squamous cell carcinoma accounted for 29.4%(560 patients), basal cell carcinoma 28.0% (534), and cutaneous malignant melanoma(CMM) 16.0% (305). (2) There were 591 patients with skin cancer diagnosed between 1980 and 1990, and 1 314 between 1991 and 2000, and accounted for 0.34% and 0.58% of all biopsy cases, respectively. The number of total biopsy patients increased 1.6% every year during the 20 years. The number of biopsy patients with skin cancer and with CMM increased 3.5% and 3.9% every year,respectively. (3) Of the 305 CMM patients, 63.3% located on the acra. These patients were elder, and have a higher rate of trauma and a higher incidence in the male than that in patients with CMM located on the other sites. (4) Of the 305 CMM patients, 64 (21%) had history of trauma at the primary onset sites, and 47 (15.4%) had history of small congenital nevi at the primary sites., Conclusion: There are some differences in the clinical features such as location and age between the skin cancer patients in our study and those in white population. The incidence of skin cancer in the two hospitals had been increasing in the 20 years (between 1981 and 2000). Both trauma and small congenital nevi are important risk factors of CMM.

Survivin, a novel inhibitor of apoptosis, expressing in a cell cycle-dependent manner,regulates the G(2)/M phase of the cell cycle by associating with mitotic spindle microtubules; it directly inhibits caspase-3 and caspase-7activity. During tumorigenesis, survivin expression is inversely correlated with apoptosis and is positively correlated with proliferation and angiogenesis. Survivin expression up-regulation predicts short survival and poor prognosis in human cancers. Survivin targeting antisense nucleotide and survivin mutants induce apoptosis, reduce tumor growth potential, and sensitize tumor cells to chemotherapeutic drugs and X-irradiation in vitro and in vivo. These results suggest that survivin may has the potential function as a new target for the diagnosis and treatment of cancer.

Background & Objective: The study of tumor metastasis suppressor gene KAI1 in colorectal cancer (CRC) is limited nowadays. There are some controversies about the expression of KAI1 and its relationship with pathologic classification of CRC, and up today, the reports of the correlation between KAI1 and the prognosis of CRC still be few. This study was designed to investigate the role of KAI1 in development of CRC and its value in predicting the prognosis of CRC., Methods: The expression of KAI1 in 91 cases of primary CRC and 25 cases of lymph node metastases were determined using immunohistochemistry., Results: The positive cases of KAI1 in primary CRC were 54 (59.3%), the weak positive cases were 22 (24.2%), the negative cases were 15 (16.5%). KAI1 expression reduced significantly in the cases with low differentiation, lymph node metastasis and distant metastatic tumor (P< 0.01). The positive expression rate of KAI1 in the patients who survived more than 5 years (67.14%) was higher than that in the patients who survived less than 5 years (33.33%) (P< 0.05). The 5-year survival rates of the patients with positive, weak positive, and negative expression of KAI1 decreased in turn (87.04%, 63.34%, 60.00%; P< 0.05). KAI1 expression in lymph node metastases was lower than that in primary locus (P< 0.05)., Conclusion: The abnormal expression of KAI1 participates in malignant progression of CRC. Detecting the expression of KAI1 probably possesses clinical significance in evaluating the differentiation, lymph node metastasis,and distant metastasis of CRC, and predicting the prognosis of CRC.

Background & Objective: The recurrence and metastasis after treatment of adenoid cystic carcinoma was usually observed in the clinical practice. There is no good indicator to evaluate the prognosis of ACC at present. This study was designed to investigate the relationship between the expression of cell adhesion molecules E-cadherin (E-cad) and proliferating cell nuclear antigen (PCNA) and prognosis in the patients with ACC., Methods: The expression of E-cad and PCNA in 34 patients with ACC were detected by immunohistochemical staining., Results: The 5-year survival rate of the patients was significantly lower in solid type of ACC than in cribriform or tubular type (P < 0.01). Clinical stages were significantly related to local recurrence and/or distant metastasis of the tumor (P < 0.01) and to 5-year survival rate of the patients with ACC (P < 0.01). Absent or low E-cad expression (50.0%) was observed more frequently in ACC with local recurrence and/or distant metastasis and with less than 5-year survival period (P < 0.05). The rate of local recurrence and/or distant metastasis of the tumor was significantly higher in high PCNA expression group (P < 0.005) than in low PCNA expression group, while the 5-year survival rate of the former was significantly lower (P < 0.005). The expression of E-cad was in high correlation with that of PCNA (P < 0.005)., Conclusions: E-cad, PCNA expression, and clinical stages could be regarded as effective indices for evaluating the prognosis of ACC. E-cad may cooperate with PCNA in the malignant development of ACC.