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Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions

World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 402-415页

作者： hussein Hassan Okasha Abeer Abdellatef Shaimaa Elkholy Mohamad-Sherif Mogawer Ayman Yosry Magdy Elserafy Eman Medhat Hanaa Khalaf Magdy Fouad Tamer Elbaz Ahmed Ramadan Mervat E Behiry Kerolis Y William Ghada Habib Mona Kaddah Haitham Abdel-Hamid Amr Abou-Elmagd Ahmed Galal Wael A Abbas Ahmed Youssef Altonbary Mahmoud El-Ansary Aml E Abdou Hani Haggag Tarek Ali Abdellah Mohamed A Elfeki Heba Ahmed Faheem Hani M Khattab Mervat El-Ansary Safia Beshir Mohamed El-Nady Department of Internal Medicine and Hepatogastroenterology Kasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic Diseases Cairo UniversityCairo 11451Egypt Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61511Egypt Department of Internal Medicine Kasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Gastroenterology Armed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center Alexandria 35516Egypt Department of Internal Medicine Faculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35511Egypt Department of Gastroenterology and Hepatology Theodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and Immunology Faculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal Medicine Faculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal Medicine Bani-suef UniversityBani-suefBani-suef 62511Egypt Department of Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical Pathology National Research CentreCairo 11451Egypt

BACKGROUND Pancreatic cystic lesions(PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant *** To evaluate the role of cyst fluid analysis of different tumor markers such as cancer antigens [e.g., cancer antigen(CA)19-9, CA72-4], carcinoembryonic antigen(CEA), serine protease inhibitor Kazal-type 1(SPINK1), interleukin 1 beta(IL1-β), vascular endothelial growth factor A(VEGF-A), and prostaglandin E2(PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign *** This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound(EUS) and EUS-fine needle aspiration(EUS-FNA) for characterization and sampling of different *** The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance(59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively(P < 0.001). We found that positive mucin stain, cyst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance(P < 0.0001). In contrast, IL-1β, CA 72-4, VEGF-A, VEGFR2, and PGE2 did not show any statistical significance. Univariate regression analysis for prediction of malignancy in PCLs showed a statistically significant positive correlation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINK1 were independent predictors of malignancy in cystic pancreatic *** EUS examination of cyst morphology with cytopathological analysis and cyst fluid ana

关键词： Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase

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p53和bcl-2蛋白在非肿瘤性、癌前性及肿瘤性高度增殖角化性皮损中的表达分析

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世界核心医学期刊文摘（皮肤病学分册） 2005年第3期1卷 25-25页

作者： hussein M.R. Al-Badaiwy Z.H. Guirguis M.N. 马慧群 Department of Pathology Faculties of Medicine Assuit and South Valley Universities Assuit Egypt Dr.

Background: The hyperproliferative keratinocytic lesions encompass a wide ran ge of non-tumorigenic, pretumorigenic, and tumorigenic conditions. The aim of this work was to examine the expression patterns of apoptosis-linked molecules (bcl-2 and p53) in these lesions. Methods: Immunoperoxidase staining methods were applied to analyze p53 and bcl- 2 protein expression in a total of 66 case s, including 12 squamous cell carcinomas (both in situ and invasive SCC), 11 act inic keratoses(AK), 13 psoriasis vulgaris(PV), eight verruca vulgaris(VV), six c hronic dermatitis(CD), five seborrheic keratosis(SK), four lichen planus(LP),thr ee epidermodysplasia verruciformis (EDV), two condyloma acuminata(CA),two lichen simplex chronicus (LSC), and 10 specimens from normal skin. Results: As compare d to normal skin (0.70 ± 0.26), the bcl- 2 average weighted scores in the non -tumorigenic (0.76 ± 0.16), pretumorigenic (1.45 ± 0.28), and tumorigenic lesions (2.83 ± 0.50 and 2.92 ± 0.50 for in situ and invasive SCC, respectiv ely) showed significant up-regulation (P = 0.001). In the non-tumorigenic lesions, the bcl- 2 expression values decreased in the following order: SK > EDV > CD > LP > CA > PV > VV (1.40 ± 0. 24 > 1.33 ± 0.67 > 0.83 ± 0.40 > 0.67 ± 0.21 > 0.50 ± 0.20 > 0.46 ± 0. 22 > 0.13 ± 0.01, respectively). As compared to normal skin (1.10 ± 0.23), t he p53 average weighted scores in the non-tumorigenic (1.86 ± 0.18), pretumo rigenic (3.64 ± 0.53), and tumorigenic lesions (5.00 ± 1.00 and 5.08 ± 0.8 6 for in situ and invasive SCC, respectively) showed significant up-regulation (P = 0.021). In the non-tumorigenic lesions, p53 average weighted scores decr eased in the following order: SK > PV > CA > LP > CD > VV > EDV (3.20 ± 0.49 > 2.38 ± 0.27 > 2.0 ± 0.0 > 1.83 ± 0.48 > 1.0 ± 0.37 > 1.0 ± 0.33 > 1.0 ± 0.0, respectively). There was a positive correlation between bcl- 2 and p5 3 protein expression in normal skin (r=0.966, P=0.0001), non-tumorigenic (r=0. 775, P= 0.0001), pretu

关键词：非肿瘤性 bcl-2蛋白角化性 p53 凋亡相关分子寻常型银屑病脂溢性角化病表皮发育不全侵袭性癌前病变

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脉络膜黑素瘤蛋白表达错配修复的改变和微卫星不稳性

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美国医学会眼科杂志（中文版） 2006年第4期18卷 253-253页

作者： Mahmoud R. hussein, MScPath Anna K Haemel Daniel M. Albert Gary S.Wood 刘亮（译）

目的：通过蛋白质微卫星不稳性（MSI）和错配修复（MMR）的改变证明脉络膜黑素瘤基因组的不稳定性，评估这些变化对肿瘤的临床病理特征有无关联。

关键词：错配修复不稳性微卫星黑素瘤脉络膜蛋白表达临床病理特征不稳定性

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单纯超声引导下经股静脉封堵筛孔型房间隔缺损的疗效评价

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中国胸心血管外科临床杂志 2019年第9期26卷 889-894页

作者：孙保程端李波贺贵宝王海峰阿哈提伊力亚斯盛唏李金鹏萨达姆·胡赛因俞国军詹树生张玲新疆心脑血管病医院心外科乌鲁木齐830011 新疆心脑血管病医院超声科乌鲁木齐830011

目的介绍超声引导下经皮由股静脉入路应用多孔筛状房间隔封堵器(amplatzer cribriform occluder,ACO)及房间隔缺损封堵器(atrial septal defect occluder,ASDO)封堵筛孔型房间隔缺损(atrial septal defect,ASD)的经验,评估其可行性、有效性及安全性。方法回顾性分析我院 2015 年 12 月至 2018 年 5 月 48 例在超声引导下经股静脉封堵筛孔型 ASD 患者的临床资料,其中男 17 例、女 31 例,年龄 10 个月至51 岁,平均年龄(11.50±13.86)岁,体重 6~79(27.00±20.14)kg。48 例筛孔型 ASD 患者中 12 例为双孔型,13 例为房间隔膨胀瘤并缺损,23 例为多孔型 ASD。所有患者均在经胸超声心动图(transthoracic echocardiography,TTE)或经食管超声心动图(transesophageal echocardiography,TEE)引导下完成筛孔型 ASD 的封堵。术后次日复查超声、心电图及胸部 X 线片以评价疗效。结果 48 例筛孔型 ASD 患者共使用 49 枚封堵器,1 例置入 2 枚封堵器,其余置入 1 枚封堵器。ASDO 29 枚,ACO 20 枚,ASDO 大小为 8~26 mm,ACO 大小为 18~34 mm。术中 TTE/TEE 检查显示 48 例均完全封堵成功,13 例在释放推送杆前可见细束分流,释放推送杆后 9 例有细束分流,术后 24 h 复查 8 例有细束分流,1 年后复查 3 例微量分流。所有随访患者封堵器位置形态良好,右心不同程度缩小,胸部 X 线片显示肺血不同程度减少,术后心电图未见心律失常。结论单纯超声引导下经股静脉入路选用 ACO 及 ASDO 封堵筛孔型 ASD,是一种安全有效的方法。

关键词：超声心动图股静脉房间隔缺损房间隔缺损封堵器

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