International journal of clinical and experimental pathology最新文献

Plasma cell myeloma (PCM) is a bone marrow based neoplastic disorder of plasma cells. The presence of intracytoplasmic Auer rod-like inclusions (ARLIs) in PCM is exceedingly rare. To the best of our knowledge, approximately 40 cases have been published since its first description in 1940. These inclusions are predominantly observed in kappa-restricted, IgG-producing PCM. Only 7 cases of kappa-restricted, IgA-producing PCM with intracytoplasmic ARLIs have been documented in the literature. Here, we reported a rare case of recurrent kappa-restricted, IgA-positive PCM exhibiting intracytoplasmic ARLIs both before and after autologous hematopoietic stem cell transplantation (HSCT). The clinical features, laboratory studies, diagnosis, and management of this case were described. A comprehensive review of the literature was also provided to explore the origin and pathogenesis of these inclusions, and to examine their prognostic implications.

The differentiation of stem cells into tendon cells plays a crucial role in the repair of rotator cuff injuries. Long non-coding RNAs (lncRNAs) are known to regulate tendon-derived stem cell (TDSC) differentiation during tendon injury; however, the specific mechanisms involving the lncRNA colorectal neoplasia differentially expressed (CRNDE) have not been fully elucidated. In this study, we successfully isolated and cultured TDSCs, and established a tenogenic differentiation model through ascorbic acid treatment. RNA sequencing analysis showed that ascorbic acid significantly upregulated CRNDE expression. Furthermore, CRNDE overexpression in TDSCs markedly enhanced tenogenic differentiation. Using bioinformatics analysis in combination with luciferase reporter assays, we demonstrated that CRNDE and transforming growth factor beta receptor 2 (TGFBR2) contain shared binding sequences for miR-337, suggesting a competitive regulatory interaction. Overexpression of miR-337 was found to inhibit CRNDE-induced tenogenic differentiation and reduce both TGFBR2 mRNA and protein levels. In contrast, CRNDE knockdown decreased TGFBR2 protein expression and impaired tenogenic differentiation of TDSCs. In a rat model of rotator cuff tear (RCT), transplantation of CRNDE-overexpressing TDSCs significantly enhanced functional recovery, an effect associated with upregulation of TGFBR2. Taken together, these results demonstrate that CRNDE promotes tenogenic differentiation and tendon-bone healing through modulation of the miR-337/TGFBR2 signaling axis.

Bladder urothelial carcinoma (BLCA) is a prevalent urinary malignancy that complicates diagnosis and treatment. This study investigates the diagnostic and prognostic utility of COL11A1, a gene implicated in tumor progression and immune modulation, by analyzing its association with clinicopathological features, tumor progression, and immune infiltration dynamics. Using statistical methods, including Kaplan-Meier survival analysis and immune infiltration profiling, we evaluated COL11A1 expression in 407 BLCA patients and 28 normal controls. Results demonstrated significant COL11A1 overexpression in BLCA tissues versus controls (P < 0.001), with elevated expression correlating with poorer survival outcomes (hazard ratio = 1.53, P = 0.005). Immune infiltration analysis revealed robust positive associations between COL11A1 levels and macrophages, Th1 cells, natural killer (NK) cells, and neutrophils (P < 0.001), alongside significant links to advanced T stage (P < 0.001) and N stage (P = 0.030). These findings establish COL11A1 as a multifaceted biomarker for BLCA, offering critical insights into diagnosis, prognosis, and therapeutic strategies. Further research should elucidate its mechanistic roles in tumorigenesis and immune regulation, with potential applications across malignancies to advance personalized oncology.

[This corrects the article on p. 10325 in vol. 10, PMID: 31966367.].

Objective: Cardiovascular and metabolic diseases, including both obesity and blood pressure, have been previously implicated in observational studies as having some association with the occurrence of adrenal tumors. This study aims to evaluate the causal relationships of these high-risk factors with the disease using a Mendelian randomization approach with two-sample data. Single nucleotide polymorphisms (SNPs) for blood pressure, body mass index (BMI), blood glucose, and cardiovascular diseases were extracted from publicly available whole-genome databases. They were then compared separately with benign adrenal tumors. It was found that only BMI was associated with the occurrence of benign adrenal tumors, and this process may be mediated by C-reactive protein (CRP). We explored whether C-reactive protein (CRP) can mediate the causal relationship between body mass index (BMI) and benign adrenal tumors, further investigating the mechanism and the proportion of CRP involved in this process.

Methods: Utilizing a two-sample Mendelian randomization approach, comparisons were made between BMI, blood pressure, cardiovascular diseases, blood glucose, and the outcome. Subsequently, both two-sample Mendelian randomization and multivariable Mendelian randomization (MVMR) analyses were conducted to investigate whether CRP serves as a mediator in the causal relationship between BMI and benign adrenal tumors, while calculating the proportion of mediation involved.

Results: There was no causal relationship observed between blood pressure (OR = 0.976, 95% CI = 0.931-1.024, P = 0.339), blood glucose (OR = 0.960, 95% CI = 0.648-1.422, P = 0.840), cardiovascular diseases (OR = 0.724, 95% CI = 0.244-2.142, P = 0.559), and benign adrenal tumors. However, a positive causal relationship was found between BMI and benign adrenal tumors (OR = 1.20, 95% CI = 1.06-1.35, P = 0.003). There was also a positive causal relationship observed between BMI and CRP (OR = 1.07, 95% CI = 1.06-1.08, P < 0.01), as well as between CRP and benign adrenal tumors (OR = 1.350, 95% CI = 1.058-1.722, P = 0.001). After adjusting for CRP, the causal relationship between BMI and benign adrenal tumors diminished (OR = 1.044, 95% CI = 0.911-1.970, P = 0.067). Even after controlling for BMI, a causal relationship between CRP and benign adrenal tumors persisted (OR = 1.32, 95% CI = 1.035-1.693, P = 0.025). The proportion of mediation by CRP was calculated to be 10.4%.

Conclusion: Using Mendelian genetic research methods, this study provides evidence that elevated levels of C-reactive protein may serve as a crucial mediating factor in BMI-induced benign adrenal tumors. Therefore, clinicians should pay particular attention to monitoring and managing levels of C-reactive protein when dealing with obese patients, to more effectively prevent the development of adrenal tumors.

Objective: To compare the effectiveness of β-glucan functional dressing and interferon-α2a (IFN-α2a) plug in promoting high-risk human papillomavirus (HR-HPV) clearance and restoring vaginal microecology in women with bacterial vaginosis (BV) or aerobic vaginitis (AV).

Methods: This prospective-retrospective study enrolled 44 women diagnosed with BV or AV. Participants were evaluated for vaginal ecological indicators including pH, cleanliness, hydrogen peroxide (H₂O₂), sialidase, leukocyte esterase (LE), microbial diversity, lactobacilli proportion, and standard diagnostic scores (Nugent and AV). HPV status and squamous intraepithelial lesion (SIL) grade were assessed via cytology and colposcopy. Subjects were randomly divided into Group A (n=22), treated with β-glucan dressing, and Group B (n=22), treated with IFN-α2a plug for 14 days (excluding menstruation). Clinical and virological parameters were re-evaluated after three months.

Results: Both groups were comparable at baseline. No adverse effects were reported. Post-treatment analysis showed that β-glucan dressing significantly improved markers of inflammation (LE, H₂O₂), increased lactobacilli abundance, and reduced pathogenic bacteria. IFN-α2a treatment improved vaginal pH and diagnostic scores but was less effective in microbiota restoration. The HPV-negative conversion rate was higher in the β-glucan group (87%) than that in the IFN-α2a group, and the difference was statistically significant (P<0.05).

Conclusion: Both β-glucan and IFN-α2a dressings were safe and showed clinical benefits in women with BV or AV and HR-HPV infection. However, β-glucan demonstrated superior outcomes in restoring vaginal microecology and enhancing HPV clearance. These findings suggest that β-glucan may serve as a more effective intravaginal immunomodulatory therapy. Further multicenter studies with larger samples are needed to confirm these results.

Objective: To compare the effects of three ventilation modes - pressure-controlled ventilation (PC), volume-controlled ventilation (VC), and pressure-regulated volume control ventilation (PRVC) - on postoperative cognitive dysfunction (POCD) in elderly patients undergoing laparoscopic abdominal wall hernia repair.

Methods: In this prospective study, 485 elderly patients undergoing laparoscopic abdominal wall hernia repair were randomly assigned to one of three ventilation groups: PC, VC, or PRVC. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) at baseline (D0), and on postoperative days 1 (D1) and 3 (D3). Intraoperative physiological indicators, including mean arterial pressure (MAP), heart rate (HR), PaCO₂, central venous pressure (CVP), dynamic lung compliance (Cdyn), and optic nerve sheath diameter (ONSD), were recorded at five perioperative time points (T1-T5). Plasma concentrations of brain injury biomarkers (Aβ1-40, S-100β) and inflammatory cytokines (IL-1β, IL-6, TNF-α) were measured at baseline and serial postoperative time points (TI-TV).

Results: The incidence of POCD differed significantly among the three ventilation groups on both postoperative day 1 (P = 0.040) and day 3 (P = 0.034). On day 3, post-hoc analysis revealed that the POCD rate in the PRVC group was significantly lower than in the PC group (P < 0.0167). Regarding potential mechanisms, PRVC was associated with improved dynamic lung compliance and a lower optic nerve sheath diameter compared to both PC and VC groups. Furthermore, PRVC significantly reduced plasma concentrations of the inflammatory cytokines IL-1β and IL-6 (all P < 0.05).

Conclusion: In elderly patients undergoing abdominal wall hernia repair, PRVC ventilation reduced the incidence of early POCD, particularly compared to PC ventilation. This neuroprotective effect appears to be linked to improved respiratory mechanics and an attenuated systemic inflammatory response. Therefore, PRVC represents a preferable ventilation strategy for this vulnerable patient population.

Ameloblastoma with adenoid features is characterized by the formation of cribriform or glandular tubular structures in addition to the conventional ameloblastoma; however, many aspects of the clinical and histologic characteristics are unclear. We report a case of ameloblastoma with adenoid features that occurred in the mandible and had multiple recurrences. The patient was a 54-year-old woman who presented with a chief complaint of painless swelling in the left mandibular molar region. On the first visit, a bone expansion was noted in the lingual alveolar region of the left mandibular molar. Panoramic radiograph and computed tomography revealed a unilocular radiolucent finding extending from the left mandibular first molar to the anterior edge of the left mandibular ramus. A biopsy was performed and the diagnosis was ameloblastoma. Therefore, we performed left mandibular tumor resection. Histopathologic findings showed that tissue corresponding to the conventional ameloblastoma had proliferated, and the tumor nests had a duct-like and cribriform structure. However, no whorl/morula-like structure or dentinoid was observed, leading to a diagnosis of ameloblastoma with adenoid features. Thereafter, the tumor recurred twice, and resection surgery was performed, but both cases showed the same histopathologic findings as the initial surgery. Morphologic features are important to distinguish between ameloblastoma with adenoid features and conventional ameloblastoma. In addition, ameloblastoma with adenoid features has a stronger tendency to recur than conventional ameloblastoma, and surgical resection with a sufficient margin of safety and strict postoperative follow-up are necessary.

Objective: Lupus nephritis (LN) is among the most severe complications of systemic lupus erythematosus and is associated with increased mortality. The aim of this study was to explore the value and clinical utility of repeat renal biopsies in patients with LN.

Methods: We conducted a retrospective study of patients with biopsy-proven LN who had undergone at least two renal biopsies at First Affiliated Hospital of Guangxi Medical University from June 1, 2012 to March 31, 2024. A comparative analysis was conducted on the clinical data obtained from both renal biopsies, including demographic information, clinical manifestations, laboratory results, and pathological findings collected at the time of each biopsy. Paired sample T-test and chi-square test were used for statistical analysis.

Results: A total of 82 patients met the inclusion criteria. The male-to-female ratio of our study cohort was 1:5.83. At the first biopsy, the predominant pathological types were class IV (23.2%) and class III+V (24.4%) lupus nephritis (LN). In contrast, at the repeat biopsy, class IV (25.6%) and class IV+V (24.4%) were the most common types. Among the 82 patients included in the study, 51 (62.2%) exhibited worsening pathological types, while 24 (29.3%) showed no improvement. Compared with results obtained at the first biopsy, the prevalence of crescents increased significantly from 19.5% to 45.1%, the prevalence rates of proteinuria, pyuria, and cellular casts, as well as pathological findings of global sclerosis, tubular atrophy, interstitial fibrosis, and inflammatory cell infiltration were increased at the second biopsy (P<0.05). Estimated glomerular filtration rates were lower at the second than those at the first biopsy (P<0.05).

Conclusion: Renal biopsy should be repeated in patients with LN who have undergone treatment if urinalysis results and renal function worsen or do not improve to determine whether the pathological class of LN has changed and whether LN is in the active phase. Repeat renal biopsies show increased chronicity, the pathological types are predominantly non-remitting or worsening, with a considerable proportion of patients also presenting with crescentic glomerulonephritis. Repeat renal biopsy is necessary for the diagnosis of LN patients and may inform the design of subsequent treatment plans.

Objective: Dysbiosis of intestinal microbiome is an important colorectal cancer (CRC) pathogenetic mechanism. Lactobacillus-based probiotic cocktail could inhibit colitis-associated cancer (CAC) by alleviating intestinal dysbiosis. The intestinal microbial metabolites have been linked with CRC etiology. However, the link between Lactobacillus-based probiotic cocktail and the alteration of intestinal metabolism and their functional mechanisms during CAC process is still poorly understood.

Methods: For assessing protective effects of the probiotic cocktail, azomethanes/dextran sodium sulfate (AOM/DSS) induced CAC mice were pretreated with the probiotic cocktail. Colon of C57BL/6 mice were used to assess inflammation and tumorigenesis. Comparative analysis was performed for determining how the probiotic altered intestinal metabolism and gene expression. Meanwhile, intestinal microbiota alterations were analyzed. The concluding integrated analysis of intestinal metabolism and gene expression as well as intestinal microbiota was presented.

Results: Pretreatment with the probiotic alleviated intestinal inflammation and limited the formation of tumors. Oncogenes were down-regulated and cancer suppressor genes were up-regulated after probiotic pretreatment. Pretreatment with the probiotic induced a rise of Lactobacillus-dominated genera and a reduction of potential pathogenic bacteria Parasutterella, Helicobacter and Muribaculum, and affected expression of intestinal metabolites that involved 37 metabolic pathways. Lactobacillus-associated intestinal metabolite variations involve five metabolic pathways - arginine and proline metabolism, histidine metabolism, pyrimidine metabolism, purine metabolism, and tyrosine metabolism.

Conclusions: Pretreatment with Lactobacillus-based probiotic cocktail protected mice from CAC by interfering with intestinal metabolites that affected the cancer suppressor genes and oncogenes' expression. Furthermore, Lactobacillus affected five metabolite pathways, which was important mechanism for probiotic anti-inflammatory and anti-tumorigenesis.