目的 探討乳腺脂肪肉瘤的臨床病理特點及鑒別診斷。 方法 分析2010年3月收治的1例乳腺多形性脂肪肉瘤的臨床表現、組織病理學特征及免疫表型特點，并復習相關文獻。 結果 腫瘤由高級別多形性肉瘤和數量不等的多形性脂肪母細胞組成。免疫組織化學：腫瘤細胞呈S-100蛋白陽性表達、CD34灶性陽性表達，細胞角蛋白、上皮膜抗原、巨噬細胞表面抗原、結蛋白、平滑肌肌動蛋白、肌調節蛋白、肌漿蛋白、CD31均呈陰性表達。結論 乳腺脂肪肉瘤是一種少見的原發于乳腺的間葉源性腫瘤，診斷上應首先排除乳腺化生性癌和惡性葉狀腫瘤伴脂肪肉瘤分化，應依據形態學特點和免疫組織化學結果進行鑒別。
Objective To analyze morbility，risk factors，etiology，treatment and outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit（RICU）.Methods Forty-seven respiratory RICU patients with nosocomial pulmonary fungal infections between July 2000 and June 2005 were retrospectively analyzed.Results All of the 47 cases were clinically diagnosed as probable nosocomial pulmonary fungal infections，with the morbidity of 10.8% significantly higher than general wards（1.8%，Plt;0.005）.COPD and bacterial pneumonia were the major underlying diseases of respiratory system with a percent of 38.30% and 36.17%，respectively.Forty-one patients (87.2%) had risk factors for fungal infections.Compared with general wards，the proportion of Aspergillosis was higher in RICU without significant difference (Pgt;0.1)；the proportions of Candida glabrata and Candida tropicalis were higher too，but that of Candida krusei was relatively low.The effective rate of antifungal treatment was 79.1% and fluconazol was the most common used antifungal agents.The mortality of fungal infection in RICU was higher than that of general wards but without significant difference（Pgt;0.1）.Conclusion The morbidity of nosocomial pulmonary fungal infection in respiratory RICU is higher than that in general wards.The proportions of infection caused by Aspergilli and some Candida resistant to fluconazol is relatively high.Early and effective treatment is needed in these patients considering the poor prognosis.
目的 研究細胞視黃酸結合蛋白（CRABP）Ⅱ、表皮型脂肪酸結合蛋白（E-FABP）和Ki-67在乳腺浸潤性導管癌中的表達情況及三者的相關性。 方法 采用免疫組織化學檢測2001年1月－2007年12月手術切除的152例乳腺浸潤性導管癌中CRABPⅡ、E-FABP和Ki-67的表達。 結果 在浸潤性導管癌中，CRABPⅡ在Ki-67陰性組的陽性率高于Ki-67陽性組（P＜0.05），相反地，E-FABP在Ki-67陽性組的陽性率高于Ki-67陰性組（P＜0.05）。CRABPⅡ和Ki-67表達呈負相關（rS=?0.432，P＜0.05）；E-FABP和Ki-67表達呈正相關（rS=0.842， P＜0.05）。E-FABP和Ki-67的表達具有協同性，E-FABP和Ki-67共同表達與腫瘤的轉移有關（P＜0.05）。單因素生存分析顯示，E-FABP的陽性表達患者、Ki-67的陽性表達患者以及E-FABP和Ki-67的共同陽性表達患者的預后差（P＜0.05）。多因素生存分析提示E-FABP的表達（RR=4.223，P=0.012）和TNM分期（RR=8.412，P=0.000）是影響浸潤性導管癌患者預后的獨立危險因素。 結論 在乳腺浸潤性導管癌中，CRABPⅡ和E-FABP與腫瘤細胞的增殖有關，CRABPⅡ抑制細胞增殖，E-FABP促進細胞增殖。E-FABP和Ki-67在浸潤性導管癌的發生、發展中起協同作用，兩者的陽性表達可能對評估腫瘤的轉移和患者的預后有一定價值。