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Cytology and histology of endocervical glandular lesions: a review with emphasis on recent developments 宫颈内腺体病变的细胞学和组织学:综述,重点是最近的发展。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-15 DOI: 10.1016/j.pathol.2025.08.001
Natalie Banet , Karen L. Talia
In recent years, there has been vast change in the field of cervical pathology, most notably in the classification and approach to cervical glandular lesions. The publication of the 5th edition of the World Health Organization Classification of Tumours of Female Reproductive Organs in 2020 signalled a paradigm shift away from morphology-based categorisation towards an aetiology-based system linked to lesional human papilloma virus (HPV) status. This includes several newly described entities such as HPV-associated micropapillary and stratified mucin-producing carcinomas, and gastric-type adenocarcinoma in situ and atypical lobular endocervical glandular hyperplasia, both regarded as precursors to HPV-independent carcinoma of gastric type. Simultaneously, cervical screening programs in resource-rich nations have undergone major renewal, with transition to more sensitive primary HPV-based molecular screening. Diagnostic methods have also been expanded in recent years, including the availability of sensitive, immunohistochemically based in situ hybridisation testing for HPV on tissue samples. The rate of change has been rapid, exposing pathologists to potential knowledge gaps. In this review, many of the key changes pertinent to reporting these lesions are addressed.
近年来,宫颈病理领域发生了巨大的变化,最显著的变化是在宫颈腺病变的分类和入路方面。2020年世界卫生组织第五版《女性生殖器官肿瘤分类》的出版标志着从基于形态学的分类向与病变性人乳头瘤病毒(HPV)状态相关的基于病因学的分类系统的范式转变。这包括几种新描述的实体,如hpv相关的微乳头状癌和分层黏液产生癌,胃型原位腺癌和非典型小叶宫颈内腺增生,两者都被认为是不依赖hpv的胃型癌的前体。与此同时,资源丰富国家的子宫颈筛查项目经历了重大更新,过渡到更敏感的基于hpv的初级分子筛查。近年来,诊断方法也得到了扩展,包括对组织样本的HPV进行敏感的、基于免疫组织化学的原位杂交检测。变化的速度很快,使病理学家面临潜在的知识缺口。在这篇综述中,许多与报告这些病变相关的关键变化都得到了解决。
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引用次数: 0
A review of albuminuria testing rates in people with diabetes mellitus: poor guideline adherence 糖尿病患者蛋白尿检测率综述:指南依从性差。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-15 DOI: 10.1016/j.pathol.2025.08.002
Samuel F. McCormick , Glenn M. Ward , Christina M. Trambas , Richard J. MacIsaac
Diabetes mellitus and chronic kidney disease (CKD) are prevalent conditions affecting a significant portion of the Australian population. Urinary albumin testing, particularly through the urine albumin-to-creatinine ratio (uACR), is essential for screening, prognostication, and guiding treatment in patients with diabetes and CKD. Despite recommendations for annual screening among high-risk populations such as those with diabetes, recent studies indicate disturbingly low rates of albuminuria testing. This narrative literature review aims to examine rates of uACR testing in these populations, focusing on recent studies across various clinical settings and geographical regions. A systematic search was conducted using Ovid MEDLINE, PubMed, and the Cochrane Library, yielding 13 observational studies published from 2016 onward. These studies consistently reported suboptimal uACR testing rates, ranging from 1.5% to 76.6%, with populations affected by diabetes demonstrating testing rates generally below 50%. The review highlights the global issue of low adherence to testing guidelines and emphasises the need for improved clinical practices and policy incentives to enhance uACR testing.
糖尿病和慢性肾脏疾病(CKD)是影响澳大利亚人口很大一部分的普遍疾病。尿白蛋白检测,特别是尿白蛋白与肌酐比值(uACR),对于糖尿病和CKD患者的筛查、预后和指导治疗至关重要。尽管建议对糖尿病等高危人群进行年度筛查,但最近的研究表明,蛋白尿检测率低得令人不安。这篇叙述性文献综述旨在检查这些人群的uACR检测率,重点关注不同临床环境和地理区域的最新研究。使用Ovid MEDLINE、PubMed和Cochrane图书馆进行了系统搜索,获得了2016年以来发表的13项观察性研究。这些研究一致报告uACR检测率不理想,从1.5%到76.6%不等,糖尿病患者的检测率通常低于50%。该综述强调了对检测指南遵守程度低的全球性问题,并强调需要改进临床实践和政策激励,以加强uACR检测。
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引用次数: 0
Questioning the proper comparison of QConnect limits to quality control: rebuttal to Dimech et al. 质疑QConnect限制对质量控制的适当比较:对Dimech等人的反驳。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-13 DOI: 10.1016/j.pathol.2025.08.003
Sten Westgard , Hassan Bayat , Anthony Orzechowski
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引用次数: 0
Questioning the proper comparison of QConnect limits to quality control: authors' reply to Westgard et al. 质疑QConnect限制对质量控制的适当比较:作者对Westgard等人的答复。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-13 DOI: 10.1016/j.pathol.2025.09.001
Wayne Dimech , Giuseppe Vincini , Patricia Mitchell
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引用次数: 0
An oesophagus primary mucoepidermoid carcinoma without MAML2 gene rearrangement 食管原发性粘液表皮样癌无MAML2基因重排。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.pathol.2025.07.001
Yanling Jin , Yuming Bai , Xiang Wu , Yan Shao
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引用次数: 0
Progressive histiocytosis in Tangier disease: a 17-year follow-up 丹吉尔病的进行性组织细胞增多症:17年随访
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.pathol.2025.06.012
Francesco Sbrana , Luca Emanuele Pollina , Beatrice Dal Pino , Tiziana Sampietro , Raffaele Gaeta
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引用次数: 0
Clinicopathological features of primary epidural B-cell lymphoma: a study of 14 cases 原发性硬膜外b细胞淋巴瘤14例临床病理特征分析。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.pathol.2025.07.002
Wei J. Wang , Zhihong Hu , Brandon T. Gehris , Udit Naik , Meenakshi B. Bhattacharjee , Md Amer Wahed , Shimin Hu , M. James You , Lei Chen , Wei Wang , L. Jeffrey Medeiros
Primary epidural B-cell lymphoma (PEBL) is a rare neoplasm that presents initially with involvement of the epidural space. This study aimed to characterise the clinicopathological features of PEBL through a retrospective analysis of cases diagnosed at two institutions over a 15-year period. A total of 14 patients were identified, including seven women and seven men, with a median age of 63.5 years (range 21–76 years). These patients most often presented with symptoms of spinal cord compression, such as extremity paraesthesias, pain, and weakness. The thoracic region or thoracolumbar region was commonly involved in 10 (71%) patients. Eight (57%) patients had Lugano stage I disease, and 6six (43%) had stage II disease. Nine (64%) patients had a low or low-intermediate International Prognostic Index (IPI) score, and four (29%) patients had a high-intermediate or high score. All patients underwent surgical excision of the epidural mass, and histological analysis showed diffuse large B-cell lymphoma (DLBCL) in eight patients, follicular lymphoma in five patients, and high-grade B-cell lymphoma (HGBL) in one patient. Immunohistochemical analysis showed that all 14 cases were positive for pan B-cell markers and negative for CD3. Using the Hans algorithm, seven DLBCL cases had a germinal centre B-cell (GCB) immunophenotype and one case had a non-GCB immunophenotype. Fluorescence in situ hybridisation (FISH) analysis performed on eight cases showed one case of HGBL with MYC and BCL6 rearrangements, four cases of DLBCL with isolated BCL2 (n=2) or BCL6 (n=2) rearrangements, and one case of DLBCL with BCL2 and BCL6 rearrangements. All 14 patients were treated with excision, 12 of whom were also treated with chemotherapy; three of these patients also received radiation therapy. One patient was treated with an autologous stem cell transplant and subsequently CAR-T therapy. Clinical follow-up was available for all patients with a median of 39.5 months (range 1–123 months). At the last follow-up, 13 patients were alive and in complete remission and one patient with HGBL died 9 months after diagnosis. We conclude that PEBL predominantly arises in older adults and most often affects the thoracolumbar region. Patients usually have a low or low-intermediate IPI score. The most frequent type of lymphoma is DLBCL with a GCB immunophenotype. In this cohort, most patients received chemotherapy and had a favourable prognosis.
原发性硬膜外b细胞淋巴瘤(PEBL)是一种罕见的肿瘤,最初表现为累及硬膜外腔。本研究旨在通过回顾性分析在两个机构诊断的病例超过15年的时间来描述PEBL的临床病理特征。共确定14例患者,包括7名女性和7名男性,中位年龄63.5岁(21-76岁)。这些患者最常表现为脊髓受压症状,如四肢感觉异常、疼痛和虚弱。10例(71%)患者常累及胸椎或胸腰椎。8例(57%)患者为Lugano I期疾病,66例(43%)患者为II期疾病。9例(64%)患者的国际预后指数(IPI)评分为低或中低,4例(29%)患者的评分为中高或高。所有患者均行手术切除硬膜外肿块,组织学分析显示8例弥漫性大b细胞淋巴瘤(DLBCL), 5例滤泡性淋巴瘤,1例高级别b细胞淋巴瘤(HGBL)。免疫组化分析显示,14例患者pan b细胞标记物阳性,CD3阴性。采用Hans算法,7例DLBCL患者具有生发中心b细胞(GCB)免疫表型,1例患者具有非GCB免疫表型。荧光原位杂交(FISH)分析8例患者,1例HGBL合并MYC和BCL6重排,4例DLBCL合并BCL2 (n=2)或BCL6 (n=2)重排,1例DLBCL合并BCL2和BCL6重排。14例患者均行手术切除,其中12例同时行化疗;其中3名患者还接受了放射治疗。一名患者接受了自体干细胞移植和随后的CAR-T治疗。所有患者均获得临床随访,中位时间为39.5个月(范围1-123个月)。在最后一次随访中,13例患者存活并完全缓解,1例HGBL患者在诊断后9个月死亡。我们的结论是,PEBL主要发生在老年人,最常影响胸腰椎区域。患者通常有低或中低的IPI评分。最常见的淋巴瘤类型是具有GCB免疫表型的DLBCL。在这个队列中,大多数患者接受了化疗,预后良好。
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引用次数: 0
Landscape of TP53 abnormalities and IGHV mutational profile in untreated Australian patients with chronic lymphocytic leukaemia 未经治疗的澳大利亚慢性淋巴细胞白血病患者的TP53异常和IGHV突变特征
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.pathol.2025.06.013
Sally M. Hunter , Lana Radulovic , Ella R. Thompson , Michelle McBean , John F. Seymour , David Westerman , Piers Blombery
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引用次数: 0
Validation and optimisation of a commercial cell-based assay for detection of nodo-paranodal antibodies 验证和优化一种基于商业细胞的检测nod - parodal抗体的方法。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-08-29 DOI: 10.1016/j.pathol.2025.06.009
Julian Leto , Judith Spies , Linda Tran , Irene Luo , Alex Stoyanov , Peter Bradhurst , Nicolás Urriola
A minority of patients fulfilling diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have been found to have autoantibodies against components of nodal and paranodal structures in peripheral nerves. These autoantibodies may confer distinct clinical features, including a lower likelihood of response to treatment with intravenous immunoglobulin (IVIg). There are currently limited options available for the detection of these autoantibodies in the diagnostic setting. We tested serum samples from 30 patients with CIDP, 40 disease controls [20 with myasthenia gravis and 20 with systemic lupus erythematosus (SLE)] and 52 healthy controls for the presence of antibodies against neurofascin 155 (NF155), neurofascin 186 (NF186), contactin-1 (CNTN1) and the contactin-1/contactin-associated protein 1 (CNTN1/CASPR1) complex using a commercial transfected HEK293 cell-based indirect immunofluorescence immunoassay (EUROImmun). We detected nodo-paranodal antibodies in six of 30 CIDP patients, including five who had previously tested positive for nodo-paranodal antibodies using enzyme-linked immunosorbent assay (ELISA). There was one positive test for anti-CNTN1 in a disease control with SLE and membranous glomerulonephritis, with no positive tests in healthy controls. We modified the manufacturer's staining protocol by using biotinylated anti-IgG and streptavidin-FITC labelling, which increased the analytical sensitivity of the assay. Our modified assay retained its robustness in the presence of interfering substances (haemolysed, lipaemic and icteric samples) and serum with high non-specific background immunofluorescent staining. We successfully modified and validated a commercial indirect immunofluorescence immunoassay for the qualitative detection of antibodies against NF155, NF186, CNTN1 and CNTN1/CASPR1. This could lead to more rapid diagnosis of patients with these autoantibodies, avoiding costly and ineffective treatments.
少数符合慢性炎症性脱髓鞘性多根神经病变(CIDP)诊断标准的患者被发现具有针对周围神经淋巴结和副神经结构成分的自身抗体。这些自身抗体可能具有不同的临床特征,包括对静脉注射免疫球蛋白(IVIg)治疗反应的可能性较低。目前在诊断环境中检测这些自身抗体的方法有限。我们使用商业转染HEK293细胞的间接免疫荧光免疫分析法(EUROImmun)检测了30例CIDP患者、40例疾病对照[20例重症肌弱和20例系统性红斑狼疮(SLE)]和52例健康对照的血清样本中针对神经束蛋白155 (NF155)、神经束蛋白186 (NF186)、接触蛋白1 (CNTN1)和接触蛋白1/接触蛋白1/CASPR1复合物的抗体的存在。我们在30例CIDP患者中检测到6例淋巴结副结抗体,其中5例患者先前使用酶联免疫吸附试验(ELISA)检测出淋巴结副结抗体阳性。在SLE和膜性肾小球肾炎的疾病对照中,有一个抗cntn1阳性试验,而在健康对照中没有阳性试验。我们通过使用生物素化抗igg和链亲和素- fitc标记修改了制造商的染色方案,这增加了该试验的分析灵敏度。我们改进的检测方法在存在干扰物质(溶血、血脂和黄疸样本)和具有高非特异性背景免疫荧光染色的血清时保持其稳健性。我们成功修改并验证了用于定性检测NF155、NF186、CNTN1和CNTN1/CASPR1抗体的商业间接免疫荧光免疫分析法。这可以更快地诊断出患有这些自身抗体的患者,避免昂贵而无效的治疗。
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引用次数: 0
Perinatal autopsy reporting practices in Australian stillbirths: a quality review 澳大利亚死产的围产期尸检报告实践:质量回顾。
IF 3 3区 医学 Q1 PATHOLOGY Pub Date : 2025-08-29 DOI: 10.1016/j.pathol.2025.06.010
Tania Marsden , Teck Yee Khong , Jane E. Dahlstrom , Frances M. Boyle , Mu Cheng , Yin Ping Wong , Stacey Prystupa , Gretchen Pomare , Joanna Perry-Keene , Vicki Flenady , Jessica Sexton
Stillbirth continues to pose a significant public health challenge. Determining the cause of death is crucial for both prevention and providing closure to families, yet many stillbirths are not adequately investigated. Autopsy and placental assessments are recognised as the gold standard for stillbirth investigation. The utility of these procedures can vary based on the quality of the examination. The aim of this study was to determine the quality of autopsy reporting in Australia in the context of stillbirth. A total of 284 stillbirths with accompanying autopsy reports from 18 maternity hospitals across Australia between 2013 and 2018 were included. Autopsy and placental pathology reports were scored against accepted standards using a modified Vujanic–Khong tool to produce an autopsy quality score (AQS), by a double-blinded panel of assessors to the cause of death. Outcome measures were the number of autopsy reports achieving the score range, with a minimal acceptable score (MAS) of 75%. Reports were assessed based on the type of investigation (full or external), presenting clinical scenario, maceration status, and gestational age. A secondary outcome was to review the format of the autopsy reports. In total, 248 (87%) autopsy reports achieved a MAS, with 166 (58%) of reports achieving 90% of an AQS; 37 (13%) cases did not achieve a MAS, including 14 external examinations, one partial autopsy examination and 23 full autopsy examinations. Full autopsy achieved a higher score than external examinations only. External autopsy examinations were more likely not to have requested medical imaging (59%), cytogenetics (72%), or microbiology (of the placenta, 72%) when thought to be clinically indicated. There was no difference in the MAS according to clinical scenario, gestational age or degree of maceration. There was no consistent autopsy report format in this study. The overall quality of autopsy reports across Australia is high, providing confidence in the use of these reports for classifying a cause of stillbirth. Development of a structured protocol for autopsy reporting to ensure all investigations deemed clinically appropriate are performed and formatting is harmonised across the country is recommended.
死产继续对公共卫生构成重大挑战。确定死亡原因对于预防和为家庭提供解决方案至关重要,但许多死产没有得到充分调查。尸检和胎盘评估被认为是死产调查的金标准。这些程序的效用可以根据检查的质量而变化。本研究的目的是确定澳大利亚在死产背景下尸检报告的质量。2013年至2018年期间,澳大利亚18家妇产医院共有284例死产,并附有尸检报告。死因评估双盲小组使用改进的Vujanic-Khong工具对尸检和胎盘病理报告进行评分,以产生尸检质量评分(AQS)。结局指标是达到评分范围的尸检报告数量,最低可接受评分(MAS)为75%。根据调查类型(全面或外部)、临床情况、浸渍状态和胎龄对报告进行评估。第二个结果是审查尸检报告的格式。共有248份(87%)尸检报告达到了MAS, 166份(58%)报告达到了90%的AQS;37例(13%)未达到MAS,包括14例外部检查,1例部分尸检和23例完全尸检。全面尸检的评分高于单纯的外部检查。当认为有临床指征时,外部尸检检查更有可能没有要求医学影像学(59%)、细胞遗传学(72%)或微生物学(胎盘,72%)。根据临床情况、胎龄或浸渍程度,MAS无差异。在本研究中没有一致的尸检报告格式。尸检报告的整体质量在澳大利亚是高的,为使用这些报告分类死产的原因提供了信心。建议制定尸检报告的结构化协议,以确保所有临床认为适当的调查都得到执行,并在全国范围内统一格式。
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引用次数: 0
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Pathology
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