目的 探讨乳腺脂肪肉瘤的临床病理特点及鉴别诊断。 方法 分析2010年3月收治的1例乳腺多形性脂肪肉瘤的临床表现、组织病理学特征及免疫表型特点，并复习相关文献。 结果 肿瘤由高级别多形性肉瘤和数量不等的多形性脂肪母细胞组成。免疫组织化学：肿瘤细胞呈S-100蛋白阳性表达、CD34灶性阳性表达，细胞角蛋白、上皮膜抗原、巨噬细胞表面抗原、结蛋白、平滑肌肌动蛋白、肌调节蛋白、肌浆蛋白、CD31均呈阴性表达。结论 乳腺脂肪肉瘤是一种少见的原发于乳腺的间叶源性肿瘤，诊断上应首先排除乳腺化生性癌和恶性叶状肿瘤伴脂肪肉瘤分化，应依据形态学特点和免疫组织化学结果进行鉴别。
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 研究细胞视黄酸结合蛋白（CRABP）Ⅱ、表皮型脂肪酸结合蛋白（E-FABP）和Ki-67在乳腺浸润性导管癌中的表达情况及三者的相关性。 方法 采用免疫组织化学检测2001年1月－2007年12月手术切除的152例乳腺浸润性导管癌中CRABPⅡ、E-FABP和Ki-67的表达。 结果 在浸润性导管癌中，CRABPⅡ在Ki-67阴性组的阳性率高于Ki-67阳性组（P＜0.05），相反地，E-FABP在Ki-67阳性组的阳性率高于Ki-67阴性组（P＜0.05）。CRABPⅡ和Ki-67表达呈负相关（rS=?0.432，P＜0.05）；E-FABP和Ki-67表达呈正相关（rS=0.842， P＜0.05）。E-FABP和Ki-67的表达具有协同性，E-FABP和Ki-67共同表达与肿瘤的转移有关（P＜0.05）。单因素生存分析显示，E-FABP的阳性表达患者、Ki-67的阳性表达患者以及E-FABP和Ki-67的共同阳性表达患者的预后差（P＜0.05）。多因素生存分析提示E-FABP的表达（RR=4.223，P=0.012）和TNM分期（RR=8.412，P=0.000）是影响浸润性导管癌患者预后的独立危险因素。 结论 在乳腺浸润性导管癌中，CRABPⅡ和E-FABP与肿瘤细胞的增殖有关，CRABPⅡ抑制细胞增殖，E-FABP促进细胞增殖。E-FABP和Ki-67在浸润性导管癌的发生、发展中起协同作用，两者的阳性表达可能对评估肿瘤的转移和患者的预后有一定价值。