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The Advances in Molecular Biology of Hepatoblastoma: Implications for Diagnostic Pathology 肝母细胞瘤分子生物学研究进展:对病理诊断的意义
Pub Date : 2012-10-29 DOI: 10.7156/NAJMS.2012.054217
Weiwei Chen, R. Kozielski, C. LeVea, Frank Chen
As the most common pediatric liver malignancy, hepatoblastoma (HB) accounts for more than 90% of primary hepatic malignant tumors in children less than five years of age in the US, and its incidence has been increasing in the past decades. Despite extensive studies, the pathogenesis of HB remains to be elucidated. Multiple signaling pathways may be involved in the oncogenic process of HB. The best characterized pathways include the canonical Wnt/beta-catenin pathway, the hepatocyte growth factor (HGF)/c-Met signaling pathway, the Notch pathway and the Hedgehog pathway. In addition, signaling molecules associated with these signaling pathways have been shown to be potential novel tumor markers for HB. Preoperative chemotherapy is the current standard of care for HB. Highly sensitive and specific tumor markers are not only important for the accurate diagnosis of HB but are also essential for predicting its clinical behaviors and prognosis. This review summarizes the recent advances in the molecular aspects of HB with a focus on the pathogenic signaling pathways and tumor markers. Their implications for diagnostics and prognostics are also discussed from a pathologist’s point of view.
肝母细胞瘤(hepatoblastoma, HB)是最常见的儿童肝脏恶性肿瘤,在美国5岁以下儿童原发性肝脏恶性肿瘤中占90%以上,近几十年来发病率呈上升趋势。尽管进行了广泛的研究,但HB的发病机制仍有待阐明。多种信号通路可能参与了HB的致癌过程。最具特征的通路包括典型的Wnt/ β -catenin通路、肝细胞生长因子(HGF)/c-Met信号通路、Notch通路和Hedgehog通路。此外,与这些信号通路相关的信号分子已被证明是HB潜在的新型肿瘤标志物。术前化疗是目前治疗乙肝的标准。高敏感性和特异性的肿瘤标志物不仅对HB的准确诊断很重要,而且对预测其临床行为和预后也很重要。本文综述了近年来HB分子方面的研究进展,重点介绍了HB的致病信号通路和肿瘤标志物。它们对诊断和预后的影响也从病理学家的角度进行了讨论。
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引用次数: 3
Weekly Biological Variability of Urinary Organic Acids 每周尿有机酸生物学变异
Pub Date : 2012-07-31 DOI: 10.7156/V5I3P148
R. Lord, C. Nelson-Dooley, B. C. Morris, J. Bralley
Use of LC-MS/MS methods has improved sample preparation and increased throughput for the measurement of 40 or more organic acids in urine. In order to assess the significance of abnormalities that might be attributed to nutritional inadequacies or other metabolic disturbances, the week-to-week variation of results due to normal physiological responses needs to be established. This study determined the biological variability for 37 organic acids plus hippuric acid, D-arabinitol and 8-hydroxy-2’deoxyguanosine in overnight urine specimens from eight weekly samples submitted by 22 healthy adults. For the 40 analytes, CVb values varied from 12.3 to 74.3. Fourteen of the analytes had CVb values less than 30 and another 19 of them were less than 50. Multiple analytes displayed the property of increasing variability with concentration that may be characteristic of most intermediary metabolites. Linear regression line slopes for CVb vs. concentration were tabulated to assist the use of this information. The 40 analytes display biological variability in the range of disease risk markers such as serum lipoprotein cholesterol concentrations, cancer markers and thyroid hormones. The likelihood of a single measurement being representative of the true mean concentration varies with the analyte and the level found. Data reported here demonstrate reliability of results of urinary organic acid profiling performed under the reported analytical conditions. [N A J Med Sci. 2012;5(3): 148-156.]
使用LC-MS/MS方法改进了样品制备,提高了尿液中40种或更多有机酸的测量通量。为了评估可能归因于营养不足或其他代谢紊乱的异常的重要性,需要确定正常生理反应导致的每周结果变化。本研究确定了22名健康成人8周的夜间尿液样本中37种有机酸、马尿酸、d -阿拉伯糖醇和8-羟基-2 '脱氧鸟苷的生物学变异性。对于40种分析物,CVb值从12.3到74.3不等。14个分析物的CVb值小于30,另外19个分析物的CVb值小于50。多种分析物显示出随浓度增加的变异性,这可能是大多数中间代谢物的特征。CVb与浓度的线性回归线斜率被制成表格,以帮助使用该信息。这40种分析物在疾病风险标记物(如血清脂蛋白胆固醇浓度、癌症标记物和甲状腺激素)范围内显示出生物学变异性。一次测量代表真实平均浓度的可能性随分析物和发现的水平而变化。这里报告的数据证明了在报告的分析条件下进行的尿有机酸谱分析结果的可靠性。[J] .中华医学杂志,2012;5(3):148-156。
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引用次数: 2
Biomarkers of Abnormal Energy Metabolism in Children with Autism Spectrum Disorder 自闭症谱系障碍儿童异常能量代谢的生物标志物
Pub Date : 2012-07-31 DOI: 10.7156/V5I3P141
R. Frye
Biomarkers of mitochondrial disease were studies in 133 consecutive autism spectrum disorder patients to determine the prevalence of abnormalities in biomarkers of mitochondrial disease. Biomarkers included traditional biomarkers of mitochondrial disease (lactate, alanine), fatty-acid oxidation defects (acyl-carnitine panel) and recently described novel biomarkers of detecting mitochondrial dysfunction in individuals with autism spectrum disorder (alanine-to-lysine ratio, creatine kinase, aspartate transaminase). Biomarkers were collected in the morning fasting state. Abnormal biomarker values were verified by repeat testing. For those with abnormal acyl-carnitine panels, secondary disorders of fatty acid metabolism were ruled out. Abnormalities in lactate, alanine-to-lysine ratio and acyl-carnitine panels occurred in over 30% of children on initial testing. Among the patients with abnormal biomarkers who had repeated testing, abnormalities were confirmed about half of the time except for alanine which was only confirmed 20% of the time. Elevation in alanine-to-lysine ratio was associated with epilepsy and elevation in multiple acyl-carnitines was associated with regression. In order to confirm the significance of certain biomarkers, a wide variety of mitochondrial biomarker values were compared between specific subgroups of children with abnormal biomarkers and matched children without any abnormalities in biomarkers. Lactate, alanine-to-lysine ratio and acyl-carnitine panel groups demonstrated abnormalities in multiple mitochondrial biomarkers, confirming the validity of these biomarkers of mitochondrial dysfunction. This study demonstrates that multiple biomarkers of mitochondrial dysfunction are elevated in a significant portion of children with autism spectrum disorder and lend support to the notion that disorders of energy production may affect a significant subset of children with autism.
线粒体疾病的生物标志物在133名连续的自闭症谱系障碍患者中进行研究,以确定线粒体疾病生物标志物异常的患病率。生物标志物包括线粒体疾病的传统生物标志物(乳酸,丙氨酸),脂肪酸氧化缺陷(酰基-肉碱面板)和最近描述的检测自闭症谱系障碍个体线粒体功能障碍的新生物标志物(丙氨酸-赖氨酸比率,肌酸激酶,天冬氨酸转氨酶)。在早晨禁食状态采集生物标志物。通过重复检测来验证异常的生物标志物值。对于酰基-肉碱组异常的患者,排除了继发性脂肪酸代谢紊乱。在最初的测试中,超过30%的儿童出现了乳酸、丙氨酸-赖氨酸比率和酰基-肉碱面板的异常。在反复检测生物标志物异常的患者中,除丙氨酸异常仅为20%外,约有一半的时间被证实异常。丙氨酸与赖氨酸比值升高与癫痫有关,而多重酰基肉碱升高与衰退有关。为了确认某些生物标志物的意义,在生物标志物异常的特定亚组儿童和生物标志物无异常的匹配儿童之间比较了各种线粒体生物标志物值。乳酸、丙氨酸-赖氨酸比率和酰基-肉碱面板组显示多个线粒体生物标志物异常,证实了这些线粒体功能障碍生物标志物的有效性。这项研究表明,线粒体功能障碍的多种生物标志物在很大一部分自闭症谱系障碍儿童中升高,并支持能量产生障碍可能影响很大一部分自闭症儿童的观点。
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引用次数: 51
A Mouse Model of Timothy Syndrome: a Complex Autistic Disorder Resulting from a Point Mutation in Cav1.2. Timothy综合征小鼠模型:由Cav1.2点突变引起的复杂自闭症。
Pub Date : 2012-07-25 DOI: 10.7156/najms.2012.053135
Glenna Cl Bett, Agnieszka Lis, Scott R Wersinger, Joan S Baizer, Michael E Duffey, Randall L Rasmusson

Timothy Syndrome (TS) arises from a point mutation in the human voltage-gated L-type Ca2+ channel (Cav1.2). TS is associated with cardiac arrhythmias and sudden cardiac death, as well as congenital heart disease, impaired cognitive function, and autism spectrum disorders. TS results from a de novo gain-of-function mutation which affects the voltage dependent component of Cav1.2 inactivation. We created a knock-in TS mouse. No homozygous TS mice survived, but heterozygous TS2-NEO mice (with the mutation and the neocassette in situ) had a normal outward appearance and survived to reproductive age. Previously, we have demonstrated that these mice exhibit the triad of Autistic traits. In this paper we document other aspects of these mice including Cav1.2 isoform expression levels, normal physical strength, brain anatomy and a marked propensity towards self-injurious scratching. Gross brain anatomy was not markedly different in TS2-NEO mice compared to control littermates, and no missing structures were noted. The lack of obvious changes in brain structure is consistent with theTS2-NEO mice may provide a significant tool in understanding the role of calcium channel inactivation in both cardiac function and brain development.

Timothy综合征(TS)起源于人类电压门控l型Ca2+通道(Cav1.2)的点突变。TS与心律失常、心源性猝死、先天性心脏病、认知功能受损和自闭症谱系障碍有关。TS是由从头开始的功能获得突变引起的,该突变影响Cav1.2失活的电压依赖性成分。我们创造了一个敲入式TS鼠标。没有纯合子TS小鼠存活,但杂合子TS2-NEO小鼠(突变和新盒原位)外观正常,存活到生殖年龄。之前,我们已经证明这些老鼠表现出自闭症的三联征。在本文中,我们记录了这些小鼠的其他方面,包括Cav1.2异构体表达水平、正常的体力、大脑解剖和明显的自伤性抓挠倾向。与对照组相比,TS2-NEO小鼠的大体脑解剖结构没有显著差异,也没有发现缺失的结构。ts2 - neo小鼠脑结构没有明显变化,这可能为理解钙通道失活在心功能和脑发育中的作用提供了重要的工具。
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引用次数: 28
Value of Testing at 30°C for the Identification of Cold Alloantibodies in the Presence of Cold Autoantibodies 在存在冷自身抗体的情况下,在30°C下检测冷同种抗体的价值
Pub Date : 2012-04-30 DOI: 10.7156/V5I2P131
D. W. Wu, P. Hsu, J. Freeman
Acute hemolytic transfusion reaction due to hemolytic anti-Lea is a rare phenomenon. We present here a case report of an acute hemolytic transfusion reaction, and demonstrated that an additional procedure of incubation at 30˚C facilitated the identification of a hemolytic anti- Lea in this diagnostic challenged case. A 46 year old man with a history of AIDS and dementia presented with symptomatic anemia. During transfusion of the 2nd unit of packed RBCs, the patient experienced high fever, back pain and dark brown urine. The blood bank and laboratory workup revealed evidence of a quickly resolved acute intravascular hemolysis. Other causes of intravascular hemolysis were ruled out with various laboratory tests. Initial blood bank antibody workup revealed a cold auto-anti-I, and a cold allo-antibody of undetermined specificity. Tests at 30˚C were described by Lawrance Petz and George Garratty for workup of cold autoantibodies at 30˚C. We extrapolated their method to clearly identify a hemolytic anti-Lea with broad thermal amplitude. Phenotyping and crossmatching at 30˚C revealed that the 1st unit was implicated in the acute hemolytic transfusion reaction. This is the first report to successfully identify a hemolytic antiLea using the method at 30˚C for cold allo-antibody workup. [N A J Med Sci. 2012;5(2):131-134.]
溶血性抗lea引起的急性溶血性输血反应是一种罕见的现象。我们在此报告了一例急性溶血性输血反应,并证明在30˚C的额外孵育过程有助于在诊断困难的病例中识别溶血性抗Lea。46岁男性,有艾滋病和痴呆病史,表现为症状性贫血。在输注第二单位红细胞时,患者出现高热、背部疼痛、尿呈深褐色。血库和实验室检查显示急性血管内溶血迅速消退。通过各种实验室检查排除了血管内溶血的其他原因。最初的血库抗体检查显示一种冷自体抗i和一种特异性不确定的冷同种异体抗体。lawrence Petz和George Garratty描述了30˚C下冷自身抗体的检测。我们推断了他们的方法,以清楚地识别溶血性抗lea具有广泛的热振幅。表型分析和在30℃下的交叉配型表明,第1个单位与急性溶血性输血反应有关。这是首次使用该方法在30˚C下成功鉴定出溶血抗体lea进行冷同种异体抗体检测的报道。[J] .中华医学杂志,2012;5(2):131-134。
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引用次数: 0
Recent Progress of DeSUMOylation in Biological Processes: A Mini Review 生物过程中去硫酰基化研究进展综述
Pub Date : 2012-04-30 DOI: 10.7156/V5I2P071
Bs Wang, Wei-Hsiung Yang
Post-translational modifications to proteins are essential mechanisms for controlling functions of proteins and subsequently for regulating cell fate. SUMO modification (SUMOylation) has emerged as a critical regulatory pathway in cellular function and biological processes. DeSUMOylation (removal of SUMO conjugation) by members of SUMO-specific proteases (SENPs) family makes SUMO modification highly dynamic. In this mini-review, we briefly introduce the current knowledge regarding the regulatory pathway of deSUMOylation and focus on the recent progress of functions of SENPs in biological progresses. [N A J Med Sci. 2012;5(2):71-77.]
蛋白质的翻译后修饰是控制蛋白质功能和随后调节细胞命运的重要机制。SUMO修饰(SUMOylation)已成为细胞功能和生物过程的重要调控途径。SUMO特异性蛋白酶(SENPs)家族成员的去summoylation(去除SUMO偶联)使SUMO修饰高度动态。在这篇综述中,我们简要介绍了目前关于deSUMOylation调控途径的知识,并重点介绍了SENPs在生物学进展中的功能的最新进展。[J] .中华医学杂志,2012;5(2):71-77。
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引用次数: 0
Pattern and Evolution of C4d Staining of Ischemic Myocardial Injury: Implications for the Interpretation of Post-Transplant Endomyocardial Biopsies 缺血性心肌损伤的C4d染色模式和进化:移植后心肌内膜活检的意义
Pub Date : 2012-04-30 DOI: 10.7156/V5I2P064
R. Hudacko, Sumi Varghese, B. Fyfe
C4d immunohistochemical staining is a marker of recent classical pathway complement activation that is useful for evaluation of antibody-mediated rejection in transplant biopsies. C4d also stains areas of myocyte necrosis. We describe the pattern and intensity of myocyte, interstitial, and microvascular staining at different stages of ischemic injury/infarction in the non- transplant setting. Thirty autopsies with ischemic injury were reviewed. Nine acute myocardial infarction, 3 contraction band necrosis, 9 subendocardial ischemic, and 9 chronic ischemic injury/scarring cases were stained with polyclonal antibody for C4d. Results: Acute myocardial infarction and subendocardial ischemic injury cases showed strong staining of necrotic myocytes; larger infarcts showed more intense peripheral versus central staining. Subendocardial ischemic injury was easier to quantify versus HE5(2):64-70.]
C4d免疫组织化学染色是最近经典途径补体激活的标志,可用于评估移植活检中抗体介导的排斥反应。C4d也可染色肌细胞坏死区域。我们描述了心肌细胞、间质和微血管染色在非移植情况下不同阶段缺血性损伤/梗死的模式和强度。回顾了30例缺血性损伤尸检。用C4d多克隆抗体对9例急性心肌梗死、3例收缩带坏死、9例心内膜下缺血、9例慢性缺血性损伤/瘢痕形成进行染色。结果:急性心肌梗死和心内膜下缺血性损伤患者心肌坏死细胞染色强烈;较大梗死灶的外周染色比中央染色更强烈。与HE5相比,心内膜下缺血性损伤更容易量化(2):64-70。
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引用次数: 3
Acute Erythroid Leukemia: A Review 急性红细胞白血病的研究进展
Pub Date : 2012-04-30 DOI: 10.7156/V5I2P110
Fcap Daniela Mihova, F. L. Zhang
Acute erythroid leukemia is a rare form of acute myeloid leukemia. It accounts for <5% of all acute myeloid leukemia cases. According to the World Health Organization 2008  classification, it falls under the category of acute myeloid leukemia, not otherwise specified and is further divided into two subtypes: erythroid leukemia (erythroid/myeloid) and pure erythroid leukemia. Currently, erythroleukemia (erythroid/myeloid) is defined as 50% or more erythroid precursors and ≥20% blasts of the non-erythroid cells. By definition, pure erythroid leukemia is composed of ≥80% erythroid precursors. Acute erythroid leukemia is a diagnosis of exclusion and difficulty. This review discusses its differential diagnoses, which present with erythroid proliferation, such as myelodysplastic syndrome with erythroid proliferation, acute myeloid leukemia with myelodysplasia related changes, therapy related acute myeloid leukemia, myeloproliferative neoplasms with erythroblast transformation, acute myeloid leukemia with recurrent genetic abnormalities and other types of hematologic neoplasms. Additionally, reactive conditions such as erythropoietin treatment, vitamin B12 and folate deficiency, toxin exposure and congenital dyserythropoiesis should be excluded. As a result, the frequency of acute erythroid leukemia diagnosis has been reduced. Important adverse prognostic factors will be summarized, including presence of complex cytogenetic karyotype as the most important one. Additional larger studies are needed to better understand acute erythroid leukemia, with a focus on diagnostic tools, its heterogeneity and cytogenetic and molecular characteristics for potential therapeutic targets.
急性红系白血病是一种罕见的急性髓系白血病。它占所有急性髓系白血病病例的<5%。根据世界卫生组织2008年的分类,它属于急性髓系白血病的范畴,没有特别说明,并进一步分为两个亚型:红系白血病(红细胞/髓系)和纯红系白血病。目前,红细胞白血病(红细胞/髓细胞)被定义为50%或以上的红细胞前体和≥20%的非红细胞母细胞。根据定义,纯红细胞白血病由≥80%的红细胞前体组成。急性红系白血病是诊断的难点和难点。本文就以红细胞增生为表现的骨髓增生异常综合征、骨髓增生异常相关改变的急性髓性白血病、治疗相关的急性髓性白血病、伴红细胞转化的骨髓增生性肿瘤、伴复发性遗传异常的急性髓性白血病及其他血液学肿瘤的鉴别诊断作一综述。此外,应排除反应性疾病,如促红细胞生成素治疗、维生素B12和叶酸缺乏、毒素暴露和先天性红细胞生成障碍。因此,急性红细胞白血病的诊断频率已经降低。本文将总结重要的不良预后因素,其中最重要的是存在复杂的细胞遗传学核型。需要更多的大规模研究来更好地了解急性红细胞白血病,重点是诊断工具,其异质性以及潜在治疗靶点的细胞遗传学和分子特征。
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引用次数: 21
Primary Sclerosing Cholangitis: From Pathogenesis to Medical Management 原发性硬化性胆管炎:从发病机制到医疗管理
Pub Date : 2012-04-30 DOI: 10.7156/V5I2P082
C. Bunchorntavakul, T. Tanwandee, P. Charatcharoenwitthaya, K. Reddy
Primary sclerosing cholangitis (PSC) is a cholestatic liver disease characterized by progressive inflammatory destruction of intrahepatic and extrahepatic bile ducts. It is strongly associated with inflammatory bowel disease, particularly ulcerative colitis. The pathogenesis of PSC remains unclear, however several hypotheses have been proposed that suggest roles for autoimmunity, genetic susceptibility, and the interaction between microorganisms and host immune response directed at the biliary system. A diagnosis of PSC is based on a constellation of clinical, biochemical, and typical cholangiographic features and usually without the need for liver histopathology. Complications of PSC include pruritus, portal hypertension, bone disease, end-stage liver disease, and cancers. Cholangiocarcinoma eventually develops in 8-15% of PSC patients. A variety of drugs have been evaluated as therapy for PSC, but no therapy has yet been proven to prolong survival or improve outcomes in PSC. Ursodeoxycholic acid (UDCA) has been intensively investigated to address its efficacy in PSC. A recent investigation noted that high-dose UDCA therapy in PSC did not confer benefit on combined clinical and survival endpoints. . Immunosuppressive agents are generally ineffective. Liver transplantation remains the only proven long-term treatment for advanced PSC, with approximately 20-25% risk of disease recurrence. Cancer surveillance, management of cirrhotic complications, and treatment of manifestations of cholestasis in those with PSC are clinically relevant. Further understanding of the pathogenesis of PSC is desperately required in order to effectively improve our current approaches to the management of this disease. [N A J Med Sci. 2012;5(2):82-93.]
原发性硬化性胆管炎(PSC)是一种胆汁淤积性肝病,其特征是肝内和肝外胆管的进行性炎症破坏。它与炎症性肠病,特别是溃疡性结肠炎密切相关。PSC的发病机制尚不清楚,但已经提出了几种假说,认为其与自身免疫、遗传易感性以及针对胆道系统的微生物与宿主免疫反应之间的相互作用有关。PSC的诊断是基于临床、生化和典型的胆管造影特征,通常不需要肝脏组织病理学检查。PSC的并发症包括瘙痒、门静脉高压、骨病、终末期肝病和癌症。8-15%的PSC患者最终发展为胆管癌。多种药物已被评估为PSC的治疗方法,但尚未证实任何治疗可以延长PSC的生存期或改善预后。熊去氧胆酸(UDCA)已被深入研究,以解决其在PSC中的功效。最近的一项研究指出,在PSC中,高剂量UDCA治疗在临床和生存终点上并没有带来益处。免疫抑制剂通常是无效的。肝移植仍然是晚期PSC唯一被证实的长期治疗方法,其疾病复发风险约为20-25%。PSC患者的癌症监测、肝硬化并发症的管理和胆汁淤积症状的治疗具有临床相关性。迫切需要进一步了解PSC的发病机制,以便有效地改进我们目前对这种疾病的治疗方法。[J] .中华医学杂志,2012;5(2):82-93。
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引用次数: 1
Pathology Imaging Informatics for Clinical Practice and Investigative and Translational Research. 病理成像信息学的临床实践和调查和转化研究。
Pub Date : 2012-04-01 DOI: 10.7156/v5i2p103
Evita T Sadimin, David J Foran

Pathologists routinely interpret gross and microscopic specimens to render diagnoses and to engage in a broad spectrum of investigative research. Multiple studies have demonstrated that imaging technologies have progressed to a level at which properly digitized specimens provide sufficient quality comparable to the traditional glass slides examinations. Continued advancements in this area will have a profound impact on the manner in which pathology is conducted from this point on. Several leading institutions have already undertaken ambitious projects directed toward digitally imaging, archiving, and sharing pathology specimens. As a result of these advances, the use of informatics in diagnostic and investigative pathology applications is expanding rapidly. In addition, the advent of novel technologies such as multispectral imaging makes it possible to visualize and analyze imaged specimens using multiple wavelengths simultaneously. As these powerful technologies become increasingly accepted and adopted, the opportunities for gaining new insight into the underlying mechanisms of diseases as well as the potential for discriminating among subtypes of pathologies are growing accordingly.

病理学家通常会解释大体和显微镜下的标本来进行诊断,并从事广泛的调查研究。多项研究表明,成像技术已经发展到一个水平,适当的数字化标本提供足够的质量,可与传统的玻片检查相媲美。这一领域的持续进步将对病理学的开展方式产生深远的影响。一些领先的机构已经开展了雄心勃勃的项目,旨在数字化成像、存档和共享病理标本。由于这些进展,信息学在诊断和调查病理学应用中的应用正在迅速扩大。此外,多光谱成像等新技术的出现使得同时使用多个波长可视化和分析成像标本成为可能。随着这些强大的技术被越来越多地接受和采用,获得对疾病潜在机制的新见解以及区分病理亚型的潜力的机会也相应增加。
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引用次数: 12
期刊
North American journal of medicine & science
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