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Diyora B, Devani K, Epari S, Deshpande G, Purandare A, Wankhade R. Mature Teratoma with Somatic-Type Malignancy: An Entity of Unacquaintance-A Case Report. Asian J Neurosurg 2023; 18:366-371. [PMID: 37397059 PMCID: PMC10313429 DOI: 10.1055/s-0043-1768603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Primary intracranial teratomas are nongerminomatous germ cell tumors. They are infrequent lesions along the craniospinal axis, with their malignant transformation extremely uncommon. A 50-year-old-male patient presented with one episode of generalized tonic-clonic seizure (GTCS), without any neurological deficit. Radiological imaging revealed a large lesion in the pineal region. He underwent gross total excision of the lesion. Histopathological examination was representative of teratoma with adenocarcinomatous malignant transformation. He underwent adjuvant radiation therapy and had an excellent clinical outcome. The present case highlights the rarity of malignant transformation of the primary intracranial mature teratoma.
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Affiliation(s)
- Batuk Diyora
- Department of Neurosurgery, LTMG Hospital, Mumbai, Maharashtra, India
| | - Kavin Devani
- Department of Neurosurgery, LTMG Hospital, Mumbai, Maharashtra, India
| | - Sridhar Epari
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Tata Memorial Hospital and ACTREC, Mumbai, Maharashtra, India
| | - Gauri Deshpande
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Tata Memorial Hospital and ACTREC, Mumbai, Maharashtra, India
| | - Anup Purandare
- Department of Neurosurgery, LTMG Hospital, Mumbai, Maharashtra, India
| | - Ravi Wankhade
- Department of Neurosurgery, LTMG Hospital, Mumbai, Maharashtra, India
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202
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Duve R, Robillard K, Kanehira K. Therapeutic Banding for Bleeding Duodenal Lymphangiectasias: A Novel Approach. ACG Case Rep J 2023; 10:e01087. [PMID: 37342653 PMCID: PMC10278729 DOI: 10.14309/crj.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023] Open
Abstract
With endoscopic advancements, the number of detected intestinal lymphangiectasias has been on the rise. They are generally considered benign and incidental; occasionally, these lesions carry complications, and best management options need to be established. Bleeding intestinal lymphangiectasias should be considered a rare cause in the differential diagnosis for gastrointestinal bleeding. References in the literature primarily indicate surgical treatment in these situations. In this study, we report an uncommon case of a man with esophageal adenocarcinoma who developed acute gastrointestinal bleeding from duodenal lymphangiectasias that were successfully banded.
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Affiliation(s)
- Robert Duve
- Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Kevin Robillard
- Division of Gastroenterology, Roswell Park Cancer Institute, Buffalo, NY
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
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203
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Désage AL, Picot T, Forest F. Towards a clinically applicable histomolecular classification of lung adenocarcinomas? Transl Lung Cancer Res 2023; 12:953-956. [PMID: 37323165 PMCID: PMC10261858 DOI: 10.21037/tlcr-23-68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Anne-Laure Désage
- Department of Pneumology, North Hospital, University Hospital of Saint Etienne, Saint Etienne, France
| | - Tiphanie Picot
- Department of Pathology and Molecular Pathology, North Hospital, University Hospital of Saint Etienne, Saint Etienne, France
| | - Fabien Forest
- Department of Pathology and Molecular Pathology, North Hospital, University Hospital of Saint Etienne, Saint Etienne, France
- Unité de Recherche en Cancérologie du CHU de Saint-Etienne (URCAS), Saint Etienne, France
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204
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Cowzer D, Keane F, Ku GY. Clinical Utility of 18F-2-Fluoro-deoxy-d-glucose PET Imaging in Locally Advanced Esophageal/Gastroesophageal Junction Adenocarcinoma. Diagnostics (Basel) 2023; 13:1884. [PMID: 37296735 PMCID: PMC10252409 DOI: 10.3390/diagnostics13111884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Esophageal adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, is uncommon in the United States, but is associated with a rising incidence in young adults, and has a traditionally poor prognosis. Despite the incremental benefits that have been made with multimodality approaches to locally advanced disease, most patients will go on to develop metastatic disease, and long-term outcomes remain suboptimal. Over the last decade, PET-CT has emerged as a key tool in the management of this disease, with several prospective and retrospective studies evaluating its role in this disease. Herein, we review the key data pertaining to the use of PET-CT in the management of locally advanced esophageal and GEJ adenocarcinoma, with a focus on staging, prognostication, PET-CT adapted therapy in the neoadjuvant setting, and surveillance.
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Affiliation(s)
- Darren Cowzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (D.C.); (F.K.)
| | - Fergus Keane
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (D.C.); (F.K.)
| | - Geoffrey Y. Ku
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (D.C.); (F.K.)
- Department of Medicine, Weill Cornell University, New York, NY 10065, USA
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205
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AbuDalu M, Munz Y, Ohana G. Pancreatico-gastric fistula arising from IPMN associated with ductal adenocarcinoma of the pancreas: a case report and a literature review. Front Surg 2023; 10:1171234. [PMID: 37292487 PMCID: PMC10244506 DOI: 10.3389/fsurg.2023.1171234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction An intraductal papillary mucinous neoplasm (IPMN) is a potentially malignant cystic tumor that is characterized by an excessive papillary proliferation of mucin-producing epithelial cells. The IPMN usually exhibits different degrees of dysplasia and is accompanied by cystic dilation of the main pancreatic duct (MPD) or side branch. We report a case of an IPMN that has penetrated the stomach and has differentiated into an adenocarcinoma. Case presentation A 69-year-old female, suffering from chronic pancreatitis of unknown etiology, visited our outpatient clinic with complaints of sudden weight loss, diarrhea, and abdominal pain. She underwent several examinations to evaluate the reasons for her sudden onset of symptoms. A gastroscopy showed an ulcerated lesion covered with mucus. CT and magnetic resonance cholangiopancreatography images revealed that the MPD was dilated to 1.3 cm with a fistula formation between the MPD and the stomach. After a multidisciplinary discussion of this case, a total pancreatectomy was proposed. An en bloc total pancreatectomy with gastric wedge resection including the fistula together with splenectomy was carried out. A Roux-en-Y choledochojejunostomy and gastrojejunostomy were performed. Histology results revealed the association of IPMN with invasive carcinoma. Discussion Many reports on IPMN of the pancreas have been published recently. Fistula formation between IPMN and adjacent organs is possible. Given the CT and endoscopic ultrasonography findings, it shows that in our case a main duct IPMN (MD-IPMN) formed a pancreatico-gastric fistula. We point out that the adherence of invasive cancer cells contributed to the fistula formation between the pancreas and the stomach. Conclusion This case report provides evidence for the possibility of IPMN becoming complicated with pancreatico-gastric fistula. Thus, we suggest that surgical resection should be considered in the case of MD-IPMN because of its high propensity for malignant transformation.
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206
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Rompen IF, Nienhüser H, Crnovrsanin N, Musa J, Haag GM, Longerich T, Fiedler T, Müller-Stich BP, Sisic L, Billeter AT. Clinical Characteristics and Oncological Outcomes of Surgically Treated Early-Onset Gastric Adenocarcinoma - a Retrospective Cohort Study. J Cancer 2023; 14:1470-1478. [PMID: 37325055 PMCID: PMC10266247 DOI: 10.7150/jca.82876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/15/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction: The incidence of early-onset gastric adenocarcinoma (patients <50 years, EOGA) is rising. Tumors in younger patients are associated with prognostically unfavorable features. The impact of EOGA on patient survival, however, remains unclear. The aim of this study is to evaluate early-onset age as a prognostic factor compared to late-onset gastric adenocarcinoma (LOGA, >50years) in a surgical cohort and assess treatment options. Methods: We analyzed 738 patients (129 early-onset/609 late-onset) operated in curative intent from 2002 to 2021. Data was extracted from a prospectively managed database of an academic tertiary referral hospital. Differences in perioperative as well as oncological outcomes were calculated by chi-square test. Cox regression analysis was performed to assess disease-free survival (DFS) and overall survival (OS). Results: EOGA patients were more often treated with neoadjuvant therapy (62.8% vs. 43.7%, p<0.001) and extended surgical resections e.g. through additional resections (36.4% vs. 26.8%, p=0.027). EOGA was more often metastasized into regional lymph nodes (pN+ 67.4% vs. 55.3%, p=0.012) and to distant sites (pM+: 23.3% vs. 12.0%, p=0.001) and was more often poorly differentiated (G3/G4: 91.1% vs. 67.2%, p<0.001). There were no significant differences in overall complication rates (31.0% vs. 36.6%, p=0.227). Survival analysis showed shorter DFS (median DFS 25.6 months vs. not reached, p=0.006) but similar OS (median OS: 50.5 months vs. not reached, p=0.920) in EOGA compared to LOGA. Conclusions: This analysis confirmed that EOGA is associated with more aggressive tumor characteristics. Early-Onset was not a prognostic factor in the multivariate analysis. EOGA patients may be more capable to undergo intensive multimodal therapy including perioperative chemotherapy and extended surgery.
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Affiliation(s)
- Ingmar F. Rompen
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Henrik Nienhüser
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Nerma Crnovrsanin
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Musa
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Division of Translational Pediatric Sarcoma Research (B410), German Cancer Research Center (DKFZ) & Hopp-Children's Cancer Center (KiTZ), Heidelberg, Germany
| | - Georg Martin Haag
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Longerich
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Timon Fiedler
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Beat P. Müller-Stich
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Leila Sisic
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Adrian T. Billeter
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
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207
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Wu X, He H, Zhao L, Zeng Z, Yuan J. Case Report: Gastric cancer with chondromyxoid matrix similar matrix-producing metaplastic breast carcinoma: report of an undescribed entity. Front Oncol 2023; 13:1087241. [PMID: 37274268 PMCID: PMC10235811 DOI: 10.3389/fonc.2023.1087241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/24/2023] [Indexed: 06/06/2023] Open
Abstract
Gastric cancer is a malignant epithelial neoplasm of the stomach, including adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, undifferentiated carcinoma, gastroblastoma and neuroendocrine neoplasms, without gastric metaplastic carcinoma. We describe a 69-year-old male patient with gastric cancer who presented with a novel, biphasic histologic morphology with one component consisting of poorly differentiated adenocarcinoma and the other component consisting of chondromyxoid matrix with adenocarcinoma transition to, between the two components without a spindle cell component. The histological morphology of this case is similar to matrix-producing metaplastic breast carcinoma. Therefore, we diagnose this case as gastric carcinoma with chondromyxoid matrix similar matrix-producing metaplastic breast carcinoma.
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Affiliation(s)
- Xiaoyan Wu
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Huihua He
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lina Zhao
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhi Zeng
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jingping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
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208
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Woo W, Cha YJ, Park CH, Moon DH, Lee S. Predictive scoring of high-grade histology among early-stage lung cancer patients: The MOSS score. Thorac Cancer 2023. [PMID: 37201906 DOI: 10.1111/1759-7714.14932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Poor prognosis associated with adenocarcinoma of International Association for the Study of Lung Cancer (IASLC) grade 3 has been recognized. In this study we aimed to develop a scoring system for predicting IASLC grade 3 based before surgery. METHODS Two retrospective datasets with significant heterogeneity were used to develop and evaluate a scoring system. The development set was comprised of patients with pathological stage I nonmucinous adenocarcinoma and they were randomly divided into training (n = 375) and validation (n = 125) datasets. Using multivariate logistic regression, a scoring system was developed and internally validated. Later, this new score was further tested in the testing set which was comprised of patients with clinical stage 0-I non-small cell lung cancer (NSCLC) (n = 281). RESULTS Four factors that were related to IASLC grade 3 were used to develop the new scoring system the MOSS score; male (M, point 1), overweight (O, point 1), size>10 mm (S, point 1), and solid lesions (S, point 3). Predictability of IASLC grade 3 increased from 0.4% to 75.2% with scores from 0 to 6. The area under the curve (AUC) of the MOSS was 0.889 and 0.765 for the training and validation datasets, respectively. The MOSS score exhibited similar predictability in the testing set (AUC: 0.820). CONCLUSION The MOSS score, which combines preoperative variables, can be used to identify high-risk early-stage NSCLC patients with aggressive histological features. It can support clinicians in determining a treatment plan and surgical extent. Further refinement of this scoring system with prospective validation is needed.
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Affiliation(s)
- Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Jin Cha
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Hwan Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Duk Hwan Moon
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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209
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Vadhwana B, Tarazi M, Boshier PR, Hanna GB. Evaluation of the Oesophagogastric Cancer-Associated Microbiome: A Systematic Review and Quality Assessment. Cancers (Basel) 2023; 15:2668. [PMID: 37345006 PMCID: PMC10216300 DOI: 10.3390/cancers15102668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE Oesophagogastric cancer is the fifth most common cancer worldwide, with poor survival outcomes. The role of bacteria in the pathogenesis of oesophagogastric cancer remains poorly understood. DESIGN A systematic search identified studies assessing the oesophagogastric cancer microbiome. The primary outcome was to identify bacterial enrichment specific to oesophagogastric cancer. Secondary outcomes included appraisal of the methodology, diagnostic performance of cancer bacteria and the relationship between oral and tissue microbiome. RESULTS A total of 9295 articles were identified, and 87 studies were selected for analysis. Five genera were enriched in gastric cancer: Lactobacillus, Streptococcus, Prevotella, Fusobacterium and Veillonella. No clear trends were observed in oesophageal adenocarcinoma. Streptococcus, Prevotella and Fusobacterium were abundant in oesophageal squamous cell carcinoma. Functional analysis supports the role of immune cells, localised inflammation and cancer-specific pathways mediating carcinogenesis. STORMS reporting assessment identified experimental deficiencies, considering batch effects and sources of contamination prevalent in low-biomass samples. CONCLUSIONS Functional analysis of cancer pathways can infer tumorigenesis within the cancer-microbe-immune axis. There is evidence that study design, experimental protocols and analytical techniques could be improved to achieve more accurate and representative results. Whole-genome sequencing is recommended to identify key metabolic and functional capabilities of candidate bacteria biomarkers.
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Affiliation(s)
- Bhamini Vadhwana
- Department of Surgery and Cancer, Imperial College London, 7th floor Commonwealth building, Hammersmith Hospital, London W12 0HS, UK
| | - Munir Tarazi
- Department of Surgery and Cancer, Imperial College London, 7th floor Commonwealth building, Hammersmith Hospital, London W12 0HS, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, 7th floor Commonwealth building, Hammersmith Hospital, London W12 0HS, UK
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, 7th floor Commonwealth building, Hammersmith Hospital, London W12 0HS, UK
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210
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Upadhyay P, Jadhav U, Wagh P, Ghewade B, Ledwani A. A Case of Paraneoplastic Dermatomyositis Presenting With Malignant Pleural Effusion. Cureus 2023; 15:e39070. [PMID: 37378107 PMCID: PMC10291910 DOI: 10.7759/cureus.39070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Dermatomyositis is an uncommon inflammatory condition characterized by proximal muscle weakness with distinct cutaneous manifestations. Like any other systemic disease, it affects multiple organs, the lungs being one of them. Common pulmonary manifestations of dermatomyositis (DM) include interstitial lung disease (ILD), primary lung malignancy, and aspiration pneumonia. The involvement of the pleura is not commonly seen, and pleural effusion is rarely reported in DM. Its presence should prompt further workup, especially for malignancy. An association between dermatomyositis and malignancy has been studied widely and is well established. Here, we report a 37-year-old female with classical cutaneous manifestations and myopathy of dermatomyositis presenting with a malignant left-sided pleural effusion.
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Affiliation(s)
- Puja Upadhyay
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ulhas Jadhav
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Wagh
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Babaji Ghewade
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anjana Ledwani
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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211
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Provenzano N, Forker L, Trimble ET, Lyang M, Morginstin M. An Unusual Cause of Digit Pain: Acrometastasis From Lung Adenocarcinoma. Cureus 2023; 15:e38475. [PMID: 37284370 PMCID: PMC10241530 DOI: 10.7759/cureus.38475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Acrometastasis accounts for 0.1% of all cases of metastatic cancer, with the most common primary tumor being lung cancer. Since acrometastasis is extremely rare and it generally has a nonspecific clinical presentation, it provides a diagnostic dilemma. We present a case of a 70-year-old female with a painful swollen right index finger which was found to be a metastatic lesion from adenocarcinoma of the lung. The patient expired within one month of diagnosis due to complications from her rapidly progressive metastatic cancer.
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Affiliation(s)
- Noelle Provenzano
- Internal Medicine, Einstein Medical Center Montgomery, East Norriton, USA
| | - Lindsey Forker
- Internal Medicine, Einstein Medical Center Montgomery, East Norriton, USA
| | - Emerson T Trimble
- Family Medicine, Touro College of Osteopathic Medicine, New York, USA
| | - Mimi Lyang
- Surgery, Touro University California, Vallejo, USA
| | - Mark Morginstin
- Hematology, Oncology, Einstein Medical Center Montgomery, East Norriton, USA
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212
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Lamba M, Khaing MM, Ma X, Ryan K, Appleyard M, Leggett B, Grimpen F. Post-colonoscopy cancer rate at a tertiary referral hospital in Australia: A data linkage analysis. J Gastroenterol Hepatol 2023; 38:740-746. [PMID: 36436544 DOI: 10.1111/jgh.16077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/06/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Colorectal cancer (CRC) diagnosed following a cancer-negative colonoscopy is termed as post-colonoscopy CRC (PCCRC). The World Endoscopy Organization has recently standardized the definition of PCCRC-3Y (CRC developing within 3 years of a cancer-negative colonoscopy). In the present study, we sought to assess PCCRC-3Y rate, perform root-cause analyses, and identify factors associated with development of PCCRC at a tertiary referral hospital in Australia. METHODS All patients undergoing colonoscopy from 2011 to 2018 were matched to a population-based cancer register. PCCRC-3Y rate was assessed for years 2011-2015. All PCCRC cases that developed within 6-48 months after a cancer-negative colonoscopy underwent root-cause analyses. Descriptive statistics were used to summarize data. RESULTS Among 17 828 patients undergoing colonoscopy, 367 CRC cases were diagnosed during the study period. This included nine PCCRC cases, which developed at a median of 14 months (range 7-34 months) after cancer-negative colonoscopy. The PCCRC-3Y rate for years 2011-2015 was 2.16% (95% CI 0.91-5.15). All nine PCCRC cases were moderately or poorly differentiated adenocarcinomas; seven of nine were early-stage CRC (stages I and II) and six of nine probably represented missed lesions at index colonoscopy despite an apparently adequate examination. History of inflammatory bowel disease (IBD) (odds ratio [OR] 21.9, 95% confidence interval [CI] 4.6-103.7, P < 0.001) and diverticulosis (OR 5.4, 95% CI 1.4-20.5, P = 0.01) were significantly associated with development of missed CRC. CONCLUSIONS In our tertiary referral colonoscopy cohort, PCCRC-3Y rate was 2.16% (95% CI 0.91-5.15). IBD and diverticulosis were significantly associated with risk of PCCRC. The majority of PCCRC lesions were likely missed at index colonoscopy, despite an apparently adequate examination.
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Affiliation(s)
- Mehul Lamba
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Myat Myat Khaing
- Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Xiaomin Ma
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Kimberley Ryan
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Mark Appleyard
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Barbara Leggett
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Florian Grimpen
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Aleman Espino A, Bernal IC, Guarecuco JE, El-Tawil R, Masri MM. Adenocarcinoma of the Breast Presenting as Occult Breast Cancer With Axillary and Supraclavicular Lymph Node Metastasis: A Case Report. Cureus 2023; 15:e39583. [PMID: 37384084 PMCID: PMC10293480 DOI: 10.7759/cureus.39583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/27/2023] [Indexed: 06/30/2023] Open
Abstract
Breast cancer is a leading cause of cancer-related mortality in women, with over 250,000 new cases diagnosed annually in the United States. Although mortality rates have decreased, breast cancer remains the second most common cause of cancer death in women. Occult breast cancer (OBC), a rare form of breath cancer that typically presents as axillary lymphadenopathy with no evidence of primary disease, accounts for less than 1% of all breath cancer diagnoses. To date, only three cases of OBC treated with radical mastectomy have been documented in the literature. This case presents a 76-year-old female with a benign left breast mass who was subsequently diagnosed with metastatic estrogen receptor/progesterone receptor (ER/PR)-positive ductal cell breast carcinoma after a visible axillary lymph node was detected on follow-up imaging. Due to the rarity of OBC, standardized treatment guidelines have not been established. Our patient underwent a left radical mastectomy with axillary and cervical lymph node dissection. Clinicians should maintain a high index of suspicion for biopsying axillary lymph nodes in females without evidence of breast malignancy, even though OBC has a low incidence rate. This case report aims to present a documented case of OBC and comprehensibly review the existing literature, discussing the available diagnostic and treatment approaches for this condition. We describe the case of a 76-year-old woman referred to surgery consultation due to a mammographic finding of a left superior lateral mass. The mass was biopsied and found to have no malignancy. On follow-up imaging, she was found to have a left axillary lymph node visible. Her only complaints at this time were breast tenderness and swelling. She underwent fine needle aspiration of the mass, which showed atypical cells that led to an excisional biopsy of the detected axillary node. The biopsy pathology report showed ER/PR-positive ductal cell breast carcinoma. The patient underwent left modified radical mastectomy with left axillary and cervical lymph node dissection. It was during this procedure that the pathology report revealed a 2 cm lesion on the left breast that showed ER/PR-positive infiltrating ductal carcinoma with 32 out of the 37 lymph nodes positive for metastatic disease. This case illustrates the importance of having a low imaging threshold in patients with vague breast symptoms. Surgeons should have a high level of suspicion when metastatic breast cancer is found, even if there is no clinical or radiographic evidence of a primary lesion. This includes conducting lymph node biopsies in patients who present with lymphadenopathy without the initial presence of primary breast cancer. Many studies agree that a modified radical mastectomy with lymph node recession is the treatment of choice for metastatic breast cancer without evidence of primary lesion. However, the efficacy of adjuvant treatments like radiation therapy or chemotherapy should be further studied.
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Affiliation(s)
- Andy Aleman Espino
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Isabel C Bernal
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | | | - Rana El-Tawil
- General Surgery, Larkin Community Hospital, South Miami, USA
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214
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Kerrouch H, Danset M, Hjira N, Kanitakis J. Metastatic Adenocarcinoma of the Lung Presenting as a Presternal Cutaneous Mass: Case Report and Brief Literature Review. Anticancer Res 2023; 43:2367-2370. [PMID: 37097655 DOI: 10.21873/anticanres.16402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Cutaneous metastases from lung cancer are uncommon; they can be the presenting sign of an unknown malignancy. CASE REPORT We present a 53-year-old man with a presternal mass that proved to be a cutaneous metastasis revealing an underlying lung adenocarcinoma. We searched the relevant literature and present a review of the main clinical and pathological features of this type of cutaneous metastasis. CONCLUSION Skin metastases are a rare manifestation of an underlying lung cancer, of which they can be the initial manifestation. Recognition of these metastases is important to promptly introduce an appropriate treatment.
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Affiliation(s)
- Hasna Kerrouch
- Department of Dermatology, Edouard Herriot Hospital, University of Lyon, Lyon, France
- Dermatology Venerology Department, Military Hospital Instruction Mohammed V, University Mohammed V, Rabat, Morocco
| | - Marie Danset
- Department of Dermatology, Edouard Herriot Hospital, University of Lyon, Lyon, France
| | - Naoufal Hjira
- Dermatology Venerology Department, Military Hospital Instruction Mohammed V, University Mohammed V, Rabat, Morocco
| | - Jean Kanitakis
- Department of Dermatology, Edouard Herriot Hospital, University of Lyon, Lyon, France;
- Pathology Laboratory, Centre Hospitalier Lyon Sud, Pierre Bénite, France
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215
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Amleh A, Mubarak R, Ayesh HJ, Al-Karaja L, Ayyad M, Allan MA, Natsheh M. A Rare Case of Primary Clear Cell Adenocarcinoma of the Urinary Bladder. Cureus 2023; 15:e39575. [PMID: 37378101 PMCID: PMC10292830 DOI: 10.7759/cureus.39575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Adenocarcinoma is a rare form of urinary bladder cancer, comprising only 2% of cases, with various histological patterns and levels of differentiation. Among these, clear cell adenocarcinoma is the least common. Contrary to other subtypes, clear cell adenocarcinoma of the bladder has been shown to have a female predominance, and typically presents at the age of 60 after being incidentally discovered on radiological and urinary studies. However, signs and symptoms such as visible and non-visible hematuria, and signs and symptoms of urinary tract infection refractory to antibiotic treatment could occur and clue into the diagnosis. Although imaging can reveal and characterise the lesion, definitive diagnosis requires cystoscopy with biopsy. The treatment of adenocarcinoma of the bladder often requires surgical resection, with adjuvant chemotherapy being utilized in a subset of patients. We report a 79-year-old patient complaining of gross hematuria. Ultrasound was performed and showed a calcified mass at the dome of the urinary bladder, which was confirmed by computerized tomography of the abdomen and pelvis. Subsequent cystoscopy confirmed the diagnosis of clear-cell adenocarcinoma and the tumor was resected using a trans-urethral approach. Radical cystectomy with regional lymphadenectomy and adjuvant chemotherapy were used as the primary therapeutic modality.
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Affiliation(s)
| | | | | | | | | | | | - Motaz Natsheh
- Pathology, National Pathology Laboratory, Hebron, PSE
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216
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Ali R, Hawramy OHG, Kakamad FH, Hamasaeed D, Tahir SH, Ismaeil DA, Awalmohammed BA, Ali HHK, Mohammed BJ, Abdullah HO, Abdalla BA. Gastroesophageal adenocarcinoma metastasizing to the chest wall: A case report and mini‑review of the literature. Med Int (Lond) 2023; 3:31. [PMID: 37359054 PMCID: PMC10288431 DOI: 10.3892/mi.2023.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
Subcutaneous metastasis from esophageal cancer (EC), particularly to the chest wall, is a very rare phenomenon. The present study describes a case of gastroesophageal adenocarcinoma that metastasized to the chest wall, invading the fourth anterior rib. A 70-year-old female presented with acute chest pain 4 months after undergoing Ivor-Lewis esophagectomy for gastroesophageal adenocarcinoma. A chest ultrasound revealed a solid hypoechoic mass on the right side of the chest. A contrast-enhanced computed tomography scan of the chest revealed a destructive mass on the right anterior fourth rib (7.5x5 cm). Fine needle aspiration revealed a metastatic moderately differentiated adenocarcinoma to the chest wall. Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography revealed a large FDG avid deposit on the right side of the chest wall. Under general anesthesia, a right-side anterior chest incision was made and the second, third and fourth ribs were resected with overlying soft tissues, including the pectoralis muscle and overlying skin. The histopathological examination confirmed a metastasized gastroesophageal adenocarcinoma to the chest wall. There are two common assumptions regarding chest wall metastasis from EC. The first one states that this metastasis can occur due to the implantation of the carcinoma during tumor resection. The latter supports the notion of tumor cell dissemination along the esophageal lymphatic and hematogenous systems. Chest wall metastasis from EC invading ribs is an extremely rare incident. However, its likelihood of occurrence should not be neglected following primary cancer treatment.
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Affiliation(s)
- Rebaz Ali
- Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | | | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46000, Iraq
| | - Dlshad Hamasaeed
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Soran H. Tahir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Deari A. Ismaeil
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Bahra A. Awalmohammed
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Hemn H. Kaka Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Bruj Jamil Mohammed
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
- Department of Medicine, Shar Hospital, Sulaimani, Kurdistan 46000, Iraq
| | - Hiwa O. Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46000, Iraq
| | - Berun A. Abdalla
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46000, Iraq
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217
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He X, Ying R, Jia L, Li Y, Li R. Retrospective study of characteristics and hyperthermia intraperitoneal perfusion in mucinous borderline ovarian tumor and mucinous ovarian carcinoma. Gland Surg 2023; 12:453-464. [PMID: 37200926 PMCID: PMC10186160 DOI: 10.21037/gs-23-45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/30/2023] [Indexed: 05/20/2023]
Abstract
Background Previous clinical trials regarding the therapy in epithelial ovarian tumors have involved patients with all types of ovarian tumors. Mucinous borderline tumors may progress to invasive carcinoma even after therapy and Patients with mucinous ovarian cancer (MOC) often have a worse prognosis. Our objectives were to investigate the use of hyperthermic intraperitoneal perfusion therapy (HIPE) and the clinicopathological features of mucinous borderline ovarian tumor (MBOT) and MOC. Methods A retrospective study was conducted on 240 patients with MBOT or MOC. The clinicopathologic feature included age, preoperative serum tumor markers, surgical procedures, surgical and pathological staging, frozen pathology, treatment, and recurrence. The effect of HIPE in MBOT and MOC were examined and the occurrence of adverse events was analyzed. Results The median age was 34 years in 176 MBOT patients. Some 40.1% of patients had elevated CA125, 40.2% had elevated CA199, and 5.6% had elevated HE4. The accuracy rate for frozen pathology of resected specimen was 43.8%. The was no statistical difference in the recurrence rate between fertility-sparing and non-fertility-sparing surgery. Due to a short follow-up time in the HIPE group, no significant recurrence rate was found. The median age was 59 years in 64 MOC patients. Some 90.5% patients had elevated CA125, 95.3% had elevated CA199, and 75% had elevated HE4. There were 28 patients diagnosed with Federation International of Gynecology and Obstetrics (FIGO) stage I or II. For FIGO stage III and IV patients, the median progression-free survival (PFS) was 27 months in the HIPE group and the median overall survival (OS) in patients treated with HIPE was 53 months, which was significantly longer than that the other group (19 and 42 months). There was no severe fatal complication in all HIPE group. Conclusions MBOT was usually diagnosed at an early stage and has a good prognosis. Hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) can improve the survival of patients with advanced MOC and is safety. Combined use of CA125, CA199, HE4 can assist in the differential diagnosis of mucinous borderline neoplasms and mucinous carcinoma. Randomized studies evaluating dense HIPEC in the management of advanced ovarian cancer should be warranted.
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Affiliation(s)
- Xiaoli He
- Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Ruiqiong Ying
- Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Linlin Jia
- Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Yali Li
- Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Rui Li
- Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
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218
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Ergun P, Kipcak S, Bor S. Epigenetic Alterations from Barrett's Esophagus to Esophageal Adenocarcinoma. Int J Mol Sci 2023; 24:ijms24097817. [PMID: 37175524 PMCID: PMC10178512 DOI: 10.3390/ijms24097817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/17/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
Barrett's esophagus (BE) is a disease entity that is a sequela of chronic gastroesophageal reflux disease that may result in esophageal adenocarcinoma (EAC) due to columnar epithelial dysplasia. The histological degree of dysplasia is the sole biomarker frequently utilized by clinicians. However, the cost of endoscopy and the fact that the degree of dysplasia does not progress in many patients with BE diminish the effectiveness of histological grading as a perfect biomarker. Multiple or more quantitative biomarkers are required by clinicians since early diagnosis is crucial in esophageal adenocancers, which have a high mortality rate. The presence of epigenetic factors in the early stages of this neoplastic transformation holds promise as a predictive biomarker. In this review, current studies on DNA methylations, histone modifications, and noncoding RNAs (miRNAs) that have been discovered during the progression from BE dysplasia to EAC were collated.
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Affiliation(s)
- Pelin Ergun
- Ege Reflux Study Group, Division of Gastroenterology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye
- Department of Medical Biochemistry, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye
| | - Sezgi Kipcak
- Ege Reflux Study Group, Division of Gastroenterology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye
- Department of Medical Biology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye
| | - Serhat Bor
- Ege Reflux Study Group, Division of Gastroenterology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye
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219
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Ferrari M, Alessandrini L, Savietto E, Cazzador D, Schiavo G, Taboni S, Carobbio ALC, Calvanese L, Contro G, Gaudioso P, Emanuelli E, Sbaraglia M, Zanoletti E, Marioni G, Dei Tos AP, Nicolai P. The Prognostic Role of the Immune Microenvironment in Sinonasal Intestinal-Type Adenocarcinoma: A Computer-Assisted Image Analysis of CD3 + and CD8 + Tumor-Infiltrating Lymphocytes. J Pers Med 2023; 13:jpm13050726. [PMID: 37240896 DOI: 10.3390/jpm13050726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
The prognostic value of conventional histopathological parameters in the sinonasal intestinal-type adenocarcinoma (ITAC) has been debated and novel variables should be investigated. Increasing evidence demonstrated that the evolution of cancer is strongly dependent upon the complex interactions within tumor microenvironment. The aim of this retrospective study was to assess the features of immune microenvironment in terms of CD3+ and CD8+ cells in a series of ITAC and explore their prognostic role, as well as their relations with clinicopathological variables. A computer-assisted image analysis of CD3+ and CD8+ tumor-infiltrating lymphocytes (TIL) density was conducted on surgical specimens of 51 patients with ITAC that underwent a curative treatment including surgery. ITAC displays variable TIL density, which is associated with OS. In a univariate model, the density of CD3+ TIL was significantly related to OS (p = 0.012), whereas the association with CD8+ TIL density resulted in being non-significant (p = 0.056). Patients with intermediate CD3+ TIL density were associated with the best outcome, whereas 5-year OS was the lowest for intermediate CD8+ TIL density. CD3+ TIL density maintained a significant association with OS in the multivariable analysis. TIL density was not significantly related to demographic and clinicopathological variables. CD3+ TIL density was independently associated with OS in a non-linear fashion and patients with intermediate CD3+ TIL density had the best outcome. Though based on a preliminary analysis on a relatively small series of patients, this finding makes TIL density a potential independent prognostic factor of ITAC.
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Affiliation(s)
- Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G1L7, Canada
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Lara Alessandrini
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Enrico Savietto
- Unit of Otolaryngology, Hospital of Treviso AULSS 2-Marca Trevigiana, 31100 Treviso, Italy
| | - Diego Cazzador
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Gloria Schiavo
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G1L7, Canada
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology, Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy
| | - Andrea L C Carobbio
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Leonardo Calvanese
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Giacomo Contro
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Enzo Emanuelli
- Unit of Otolaryngology, Hospital of Treviso AULSS 2-Marca Trevigiana, 31100 Treviso, Italy
| | - Marta Sbaraglia
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Gino Marioni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Angelo P Dei Tos
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
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220
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Wen HK, Valle SJ, Morris DL. Bromelain and acetylcysteine (BromAc ®): a novel approach to the treatment of mucinous tumours. Am J Cancer Res 2023; 13:1522-1532. [PMID: 37168359 PMCID: PMC10164791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/07/2023] [Indexed: 05/13/2023] Open
Abstract
Mucins are a significant extracellular component of neoplastic entities such as pseudomyxoma peritonei and several gastrointestinal adenocarcinomas. Mucinous tumours present a challenge for systemic treatments due to poor drug penetrance and increased resistance. Therefore, the development of an effective mucolytic therapy has significant therapeutic implications for these tumour types. BromAc® is a novel mucolytic agent consisting of bromelain and acetylcysteine. It has demonstrated significant mucolysis and antitumour effects in vitro and in vivo for several mucinous tumours. It has also exhibited a synergistic potentiation of the effect of several cytotoxic agents on mucinous tumours in preclinical studies. Furthermore, it demonstrates locoregional safety and efficacy in animal and clinical studies. This literature review will summarise the history of BromAc® for mucinous tumours, including its conception, preclinical development in vitro and in vivo, and clinical evidence. The implications of current data and directions for future research are then discussed.
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Affiliation(s)
- Henry K Wen
- St George and Sutherland Clinical School, University of New South WalesKogarah, Sydney, NSW, Australia
| | - Sarah J Valle
- Mucpharm Pty Ltd, KogarahSydney, NSW, Australia
- Intensive Care Unit, St George HospitalKogarah, NSW, Australia
| | - David L Morris
- St George and Sutherland Clinical School, University of New South WalesKogarah, Sydney, NSW, Australia
- Mucpharm Pty Ltd, KogarahSydney, NSW, Australia
- Department of Surgery, St George HospitalKogarah, NSW, Australia
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221
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Wei Y, Khalaf AT, Rui C, Abdul Kadir SY, Zainol J, Oglah Z. The Emergence of TRP Channels Interactome as a Potential Therapeutic Target in Pancreatic Ductal Adenocarcinoma. Biomedicines 2023; 11:biomedicines11041164. [PMID: 37189782 DOI: 10.3390/biomedicines11041164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023] Open
Abstract
Integral membrane proteins, known as Transient Receptor Potential (TRP) channels, are cellular sensors for various physical and chemical stimuli in the nervous system, respiratory airways, colon, pancreas, bladder, skin, cardiovascular system, and eyes. TRP channels with nine subfamilies are classified by sequence similarity, resulting in this superfamily's tremendous physiological functional diversity. Pancreatic Ductal Adenocarcinoma (PDAC) is the most common and aggressive form of pancreatic cancer. Moreover, the development of effective treatment methods for pancreatic cancer has been hindered by the lack of understanding of the pathogenesis, partly due to the difficulty in studying human tissue samples. However, scientific research on this topic has witnessed steady development in the past few years in understanding the molecular mechanisms that underlie TRP channel disturbance. This brief review summarizes current knowledge of the molecular role of TRP channels in the development and progression of pancreatic ductal carcinoma to identify potential therapeutic interventions.
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Affiliation(s)
- Yuanyuan Wei
- Basic Medical College, Chengdu University, Chengdu 610106, China
| | | | - Cao Rui
- Basic Medical College, Chengdu University, Chengdu 610106, China
| | - Samiah Yasmin Abdul Kadir
- Faculty of Medicine, Widad University College, BIM Point, Bandar Indera Mahkota, Kuantan 25200, Malaysia
| | - Jamaludin Zainol
- Faculty of Medicine, Widad University College, BIM Point, Bandar Indera Mahkota, Kuantan 25200, Malaysia
| | - Zahraa Oglah
- School of Science, Auckland University of Technology (AUT), 55 Wellesley Street, Auckland 1010, New Zealand
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222
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Pál D, Tóth G, Sugár S, Fügedi KD, Szabó D, Kovalszky I, Papp D, Schlosser G, Tóth C, Tornóczky T, Drahos L, Turiák L. Compositional Analysis of Glycosaminoglycans in Different Lung Cancer Types-A Pilot Study. Int J Mol Sci 2023; 24:ijms24087050. [PMID: 37108213 PMCID: PMC10138872 DOI: 10.3390/ijms24087050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/26/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Lung cancer is one of the most commonly diagnosed cancer types. Studying the molecular changes that occur in lung cancer is important to understand tumor formation and identify new therapeutic targets and early markers of the disease to decrease mortality. Glycosaminoglycan chains play important roles in various signaling events in the tumor microenvironment. Therefore, we have determined the quantity and sulfation characteristics of chondroitin sulfate and heparan sulfate in formalin-fixed paraffin-embedded human lung tissue samples belonging to different lung cancer types as well as tumor adjacent normal areas. Glycosaminoglycan disaccharide analysis was performed using HPLC-MS following on-surface lyase digestion. Significant changes were identified predominantly in the case of chondroitin sulfate; for example, the total amount was higher in tumor tissue compared to the adjacent normal tissue. We also observed differences in the degree of sulfation and relative proportions of individual chondroitin sulfate disaccharides between lung cancer types and adjacent normal tissue. Furthermore, the differences in the 6-O-/4-O-sulfation ratio of chondroitin sulfate were different between the lung cancer types. Our pilot study revealed that further investigation of the role of chondroitin sulfate chains and enzymes involved in their biosynthesis is an important aspect of lung cancer research.
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Affiliation(s)
- Domonkos Pál
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
- Doctoral School of Pharmaceutical Sciences, Semmelweis University, H-1085 Budapest, Hungary
| | - Gábor Tóth
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
| | - Simon Sugár
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
- Doctoral School of Pharmaceutical Sciences, Semmelweis University, H-1085 Budapest, Hungary
| | - Kata Dorina Fügedi
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
- Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
| | - Dániel Szabó
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
| | - Ilona Kovalszky
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary
| | - Dávid Papp
- MTA-ELTE Lendület Ion Mobility Mass Spectrometry Research Group, ELTE Eötvös Loránd University, H-1117 Budapest, Hungary
- Hevesy György PhD School of Chemistry, ELTE Eötvös Loránd University, H-1117 Budapest, Hungary
| | - Gitta Schlosser
- MTA-ELTE Lendület Ion Mobility Mass Spectrometry Research Group, ELTE Eötvös Loránd University, H-1117 Budapest, Hungary
| | - Csaba Tóth
- Teaching Hospital Markusovszky, University of Pécs, H-9700 Szombathely, Hungary
| | - Tamás Tornóczky
- Department of Pathology, Faculty of Medicine and Clinical Center, University of Pécs, H-7624 Pécs, Hungary
| | - László Drahos
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
| | - Lilla Turiák
- MS Proteomics Research Group, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
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223
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Mora A, Ghavamrevaii A, Antabli O, Vaziri A. A Challenging Case of Metastatic Non-Small Cell Carcinoma of the Lung. Cureus 2023; 15:e38319. [PMID: 37261190 PMCID: PMC10227671 DOI: 10.7759/cureus.38319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 06/02/2023] Open
Abstract
Primary lung carcinoma with distant metastasis is a life-threatening diagnosis that presents many unique challenges due to the severity of the disease at the time of presentation. We investigated a life-threatening primary lung carcinoma with distant metastasis in a 73-year-old transgender woman, which posed unique challenges due to the advanced stage of the disease at presentation. The patient exhibited nonspecific musculoskeletal and neurological symptoms resulting from the primary lung carcinoma metastasizing to her liver, bones, and brain. We evaluated various imaging modalities that aided in determining the disease's severity and identifying complications related to metastasis. Although these efforts can offer symptomatic relief, the overall prognosis remains poor when metastasis spreads to multiple organs, particularly the brain, as remission may no longer be attainable.
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Affiliation(s)
- Annalee Mora
- Internal Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida (USF) Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA
| | - Amirali Ghavamrevaii
- Internal Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida (USF) Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA
| | - Omar Antabli
- Internal Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida (USF) Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA
| | - Ali Vaziri
- Internal Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida (USF) Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA
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224
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Carr SR, Wang H, Hudlikar R, Lu X, Zhang MR, Hoang CD, Yan F, Schrump DS. A Unique Gene Signature Predicting Recurrence Free Survival in Stage IA Lung Adenocarcinoma. J Thorac Cardiovasc Surg 2023; 165:1554-1564. [PMID: 37608989 PMCID: PMC10442056 DOI: 10.1016/j.jtcvs.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective Resected stage IA lung adenocarcinoma (LUAD) has a reported 5-year recurrence free survival (RFS) of 63-81%. A unique gene signature stratifying patients with early stage LUAD as high or low-risk of recurrence would be valuable. Methods GEO datasets combining European and North American LUAD patients (n=684) were filtered for stage IA (n=105) to develop a robust signature for recurrence (RFSscore). Univariate Cox proportional hazard regression model was used to assess associations of gene expression with RFS and OS. Leveraging a bootstrap approach of these identified upregulated genes allowed construction of a model which was evaluated by Area Under the Received Operating Characteristics. The optimal signature has RFSscore calculated via a linear combination of expression of selected genes weighted by the corresponding Cox regression derived coefficients. Log-rank analysis calculated RFS and OS. Results were validated using the LUAD TCGA transcriptomic NGS based dataset. Results Rigorous bioinformatic analysis identified a signature of 4 genes: KNSTRN, PAFAH1B3, MIF, CHEK1. Kaplan-Meier analysis of stage IA LUAD with this signature resulted in 5-year RFS for low-risk of 90% compared to 53% for high-risk (HR 6.55, 95%CI 2.65-16.18, p-value <0.001), confirming the robustness of the gene signature with its clinical significance. Validation of the signature using TCGA dataset resulted in an AUC of 0.797 and 5-year RFS for low and high-risk stage IA patients being 91% and 67%, respectively (HR 3.44, 95%CI 1.16-10.23, p-value=0.044). Conclusions This 4 gene signature stratifies European and North American patients with pathologically confirmed stage IA LUAD into low and high-risk groups for OS and more importantly RFS.
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Affiliation(s)
- Shamus R Carr
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Haitao Wang
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Rasika Hudlikar
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Xiaofan Lu
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Mary R Zhang
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Chuong D Hoang
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Fangrong Yan
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - David S Schrump
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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225
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AlMadan NM, Almohammed A, Bardisi M, AlGhamdi D. Sinonasal Renal Cell-Like Adenocarcinoma: A Report of a Rare Entity With Emphasis on Its Association With Von Hippel Lindau Syndrome. Cureus 2023; 15:e38321. [PMID: 37261186 PMCID: PMC10227673 DOI: 10.7759/cureus.38321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 06/02/2023] Open
Abstract
Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a rare malignant sinonasal tumor with relatively indolent clinical course. Clinically, it could be asymptomatic or show non-specific symptoms such as epistaxis, nasal obstruction, or hyposmia. Diagnosis of the lesion is challenging, especially in small biopsies, and requires clinical, radiological, histopathological, and ancillary tests to characterize the lesion accurately. We herein report a case of a 41-year-old female with a nasal mass noted two years ago, which presented initially as frequent epistaxis from the right side. Histopathological examination revealed proliferation of clear cells associated with hemorrhagic background forming follicular and glandular structure and dense eosinophilic secretion. Tumor cells were diffusely positive for CK7, EMA, and inhibin, while they were negative for CK20, P63, CK 5/6, CD10, renal cell carcinoma (RCC), TTF1, PAX8, CEA, and GATA3. The proliferation index (KI67) was less than 5%. The diagnosis was consistent with SNRCLA. The patient has no recurrence and no symptoms after one year. Thus, our study reports a rare case of SNRCLA with a discussion of the histological features and its association with von Hippel Lindau syndrome.
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226
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Shariati MM, Khazaei S. Choroidal metastasis and bilateral optic nerve involvement as presenting sign of metastatic lung adenocarcinoma: A case report. Clin Case Rep 2023; 11:e7172. [PMID: 37006849 PMCID: PMC10062305 DOI: 10.1002/ccr3.7172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
A 49‐year‐old male presented with a gradually progressive loss of vision in both eyes. Funduscopic examination revealed bilateral optic disc swelling and two yellowish elevated choroidal lesions in the left eye. Ophthalmic imaging raised suspicion of choroidal metastasis. Adenocarcinoma of the lung was detected in further systemic evaluation.
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Affiliation(s)
| | - Sahel Khazaei
- Eye research centerMashhad University of medical sciencesMashhadIran
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227
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Li D, Zhang W, Wang J, Wang A, Wu M, Wei Y. Nephron-sparing surgery for primary mucinous adenocarcinoma of renal pelvis in horseshoe kidney: A case report. Medicine (Baltimore) 2023; 102:e33410. [PMID: 36961136 PMCID: PMC10035991 DOI: 10.1097/md.0000000000033410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE Mucinous adenocarcinoma of the renal pelvis is extremely rare in malignancy of the renal pelvis, and <100 cases have been reported so far. However, horseshoe kidneys appear to be more prone to this mucinous gland metaplasia. Due to the lack of a specific diagnostic basis, it is difficult to confirm the diagnosis before surgery, which is easy to cause misdiagnosis. PATIENT CONCERNS We report a 64-year-old male patient who found a cystic mass in the left kidney during physical examination. CT examination showed a horseshoe kidney with a cystic mass 9.5 × 8.0 cm in front of the left kidney, lacking obvious diagnostic features. DIAGNOSIS It was misdiagnosed as cystic teratoma before the operation, and was diagnosed as mucinous adenocarcinoma of the renal pelvis through pathological examination after the operation. INTERVENTIONS Resection of the tumor by nephron-sparing surgery and postoperative chemotherapy. OUTCOMES No tumor recurrence was found at 6 years of follow-up. After 7 years, the patient had multiple metastases in the abdominal wall and peritoneum, and no tumor recurrence was found in the urinary system. The patient received chemotherapy again and survived well. LESSONS The prognosis of nephron-sparing tumor resection for MRAP is not significantly different from that of radical nephroureterectomy + bladder cuff excision. Because it can reduce the risk that patients can not tolerate follow-up chemotherapy due to abnormal renal function after surgery, which may be more beneficial in patients with kidney abnormalities or chronic disease.
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Affiliation(s)
- Dapeng Li
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Wei Zhang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Jun Wang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - An Wang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Mingming Wu
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Yangguang Wei
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
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228
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Wu X, Li B, Hong T, Liu W, He X, Zheng C. Neuroendocrine neoplasm of the gallbladder: Clinical features, surgical efficacy, and prognosis. Cancer Med 2023. [PMID: 36952352 DOI: 10.1002/cam4.5846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/06/2023] [Accepted: 03/12/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Neuroendocrine neoplasm (NEN) of the gallbladder is rare. It is usually asymptomatic and occurs in older adults. Its clinicopathological characteristics remain controversial, and the diagnosis and treatment strategies are usually based on models of adenocarcinoma. The present study aimed to investigate the clinical characteristics and prognosis of gallbladder NEN. METHODS The data of patients with gallbladder NEN admitted to Peking Union Medical College Hospital was reviewed, and a database was established for retrospective analysis. Clinicopathological features were analyzed descriptively and the prognosis was studied according to different factors. The Kaplan-Meier curve was used to describe the cumulative survival rate. RESULTS In total, 22 patients with gallbladder NEN were included in this study. There were 10 male (45.5%) and 12 female (54.5%) patients with a median age of onset of NEN at 57.5 (49.0, 62.3) years. Abdominal discomfort was the most common symptom. Twenty patients (90.9%) underwent surgery, and two patients (9.1%) with unresectable lesions underwent a biopsy. Twenty-one patients were followed up. The 1-, 2-, and 3-year cumulative overall survival rates of all patients and patients with resectable lesions were 65.9%, 54.9%, and 48.1%, and 72.9%, 60.7%, and 53.1%, respectively. Patients with resectable lesions had a better cumulative overall survival rate than those who with unresectable lesions (p < 0.001). CONCLUSION Gallbladder NEN is more common in the elderly and has a slight female predominance. The most common symptom is abdominal discomfort. Surgery is the first choice of treatment for this rare disease. The prognosis of gallbladder NEN is generally poor. Patients with resectable lesions have a better prognosis.
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Affiliation(s)
- Xin Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Binglu Li
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tao Hong
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaodong He
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chaoji Zheng
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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229
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Bosland MC, Vega K, Horton L, Schlicht MJ. Hormonal and genotoxic estrogen-androgen carcinogenesis in the NBL rat prostate: A role for aromatase. Prostate 2023; 83:823-830. [PMID: 36938936 DOI: 10.1002/pros.24522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND Androgens are generally thought to cause prostate cancer, but the data from animal studies suggest that they must be aromatized to estrogen and act in concert with genotoxic estrogen metabolites. The objective of this study was to determine whether treatment with testosterone (T) combined with a nonestrogenic estrogen metabolite and a nongenotoxic estrogenic compound would all be necessary and sufficient for the induction of a high incidence of prostate cancer in the susceptible NBL rat strain. METHODS NBL rats were treated with low-dose testosterone via slow-release Silastic implants and with the marginally estrogenic genotoxic catechol estrogen 4-hydroxyestradiol (4OH-E2) and the nongenotoxic estrogen 2-fluoroestradiol (2F-E2) and in one experiment the aromatase inhibitor letrozole via custom-made slow-release pellets. Animals were euthanized 52 weeks after implantation and their pituitaries and prostate complexes weighed and fixed in formalin. Hematoxylin and eosin (H&E)-stained step sections were prepared and examined microscopically for proliferative lesions. RESULTS Animals treated with 2F-E2, with or without the other compounds, had enlarged pituitaries demonstrating its estrogenicity. Animals treated with T, with or without the other compounds, had enlarged prostates consistent with its androgenicity. Rats treated with T plus 2F-E2 and 4OH-E2 developed a high incidence of prostatic cancer (89%), while, surprisingly, rats treated with T plus only 2F-E2 also had a high incidence of prostate cancer (95%) contradicting our initial hypothesis. To test whether the formation of E2 from T by aromatase could lead to estrogen genotoxicity and prostate carcinogenesis we then rats treated with T and 2F-E2 also with letrozole and found that it reduced prostate cancer incidence by about 50%. CONCLUSIONS These findings indicate that long-term treatment with a nongenotoxic estrogen (2F-E2) and T as well as uninhibited prostatic aromatase activity generating genotoxic E2 are all required for induction of a high incidence of prostatic adenocarcinomas in NBL rats. These and previous data indicate that androgen receptor-mediated action, estrogen receptor mediation, and estrogen genotoxicity are all required and sufficient for hormonal carcinogenesis in the NBL rat prostate. Interference with the estrogen genotoxicity is a potential approach to prostate cancer chemoprevention.
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Affiliation(s)
- Maarten C Bosland
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Katherine Vega
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Lori Horton
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Michael J Schlicht
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
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230
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Janjigian YY, Shitara K, Moehler M, Garrido M, Salman P, Wyrwicz L, Yamaguchi K, Skoczylas T, Bragagnoli AC, Liu T, Schenker M, Yanez P, Tehfe M, Kowalyszyn R, Karamouzis MV, Bruges R, Zander T, Pazo-Cid R, Hitre E, Feeney K, Cleary JM, Poulart V, Cullen D, Lei M, Xiao H, Kondo K, Li M, Ajani JA. A plain language summary of the CheckMate 649 study: nivolumab in combination with chemotherapy compared to chemotherapy alone for untreated advanced or metastatic cancer of the stomach or esophagus. Future Oncol 2023. [PMID: 36919706 DOI: 10.2217/fon-2022-1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This is a summary of the 1-year results of a clinical research study known as CheckMate 649 published in The Lancet in June 2021. The 2-year results on the participants' health and overall quality of life from the same study are in a second publication in Nature in March 2022. Until recently, chemotherapy was the only first treatment option for people with advanced or metastatic gastroesophageal adenocarcinoma who had not been treated before. Patients receiving chemotherapy lived on average for less than 1 year. Nivolumab is an immunotherapy that works by activating a person's immune system to fight back against cancer cells. The goal of CheckMate 649 was to find out if the combination of nivolumab and chemotherapy would help patients with advanced or metastatic gastroesophageal adenocarcinoma live longer and without their cancer getting worse. WHAT WERE THE RESULTS? Results from the final analysis are reported here. Of 1581 people who took part in the study, 789 received nivolumab and chemotherapy and 792 received chemotherapy. Researchers found that, on average, participants who received nivolumab and chemotherapy lived longer overall than those who received chemotherapy alone. The length of time participants lived without their cancer getting worse was also longer on average with nivolumab and chemotherapy than chemotherapy treatment alone. However, more participants in the nivolumab and chemotherapy group had side effects than those in the chemotherapy group. The three most common side effects in both types of treatment were nausea (urge to vomit), diarrhea and peripheral neuropathy. Participants who received nivolumab and chemotherapy had a lower risk of their cancer symptoms worsening and reported that they were 'less bothered' from side effects of treatment than those receiving chemotherapy alone. WHAT DO THE RESULTS MEAN? The nivolumab and chemotherapy combination is considered a new standard treatment option and is approved in several countries as a treatment for adults who have not been treated before for their advanced or metastatic gastroesophageal cancer based on results from CheckMate 649. Clinical Trial Registration: NCT02872116 (ClinicalTrials.gov).
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Affiliation(s)
- Yelena Y Janjigian
- Memorial Sloan Kettering Cancer Center & Weill Cornell Medical College, New York, NY, USA
| | - Kohei Shitara
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Marcelo Garrido
- Clinica San Carlos de Apoquindo, Pontificia Universidad Católica, Santiago, Chile
| | | | - Lucjan Wyrwicz
- Klinika Onkologii i Radioterapii, Narodowy Instytut Onkologii, Warszawa, Poland
| | | | - Tomasz Skoczylas
- II Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego, Medical University of Lublin, Lublin, Poland
| | | | - Tianshu Liu
- Zhongshan Hospital Fudan University, Shanghai, China
| | | | - Patricio Yanez
- Universidad de La Frontera, James Lind Cancer Research Center, Temuco, Chile
| | - Mustapha Tehfe
- Oncology Center - Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
| | - Ruben Kowalyszyn
- Instituto Multidisciplinario de Oncologia, Clinica Viedma S.A., Viedma, Argentina
| | | | - Ricardo Bruges
- Instituto Nacional de Cancerologia E.S.E., Bogotá, Colombia
| | - Thomas Zander
- University of Cologne, Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düesseldorf; Gastrointestinal Cancer Group Cologne (GCGC), Cologne, Germany
| | | | - Erika Hitre
- National Institute of Oncology, Budapest, Hungary
| | - Kynan Feeney
- St John of God Murdoch Hospital, Murdoch, WA, Australia
| | | | | | | | - Ming Lei
- Bristol Myers Squibb, Princeton, NJ, USA
| | - Hong Xiao
- Bristol Myers Squibb, Princeton, NJ, USA
| | | | | | - Jaffer A Ajani
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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231
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Aloufi D, Baradwan S, AlTurkistany S, Hakeem G. Successful Pregnancy in a 29-Year-Old G3P2 Shortly After Unilateral Pneumonectomy and Systemic Chemotherapy for Lung Cancer: A Case Report. Am J Case Rep 2023; 24:e939227. [PMID: 36906799 PMCID: PMC10018441 DOI: 10.12659/ajcr.939227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND The incidence of tumors during pregnancy, generally, is very uncommon. The incidence of lung cancer during pregnancy, specifically, is exceedingly rare. Several investigations have documented favorable maternal-fetal outcomes for later pregnancies after pneumonectomy due to non-cancer-related causes (mostly progressive pulmonary tuberculosis). However, very little is known about maternal-fetal outcomes for future conceptions after pneumonectomy due to cancer-related causes and subsequent chemotherapy cycles. This is an important knowledge gap in the literature that needs to be filled. CASE REPORT A 29-year-old woman (non-smoker) had adenocarcinoma of the left lung, which was discovered during her pregnancy at 28 weeks of gestation. She underwent an urgent lower-segment transverse cesarean section at 30 weeks and subsequently underwent unilateral pneumonectomy and then completed her planned adjuvant chemotherapy. The patient was incidentally found to be pregnant at 11 weeks of gestation (roughly 5 months after the completion of her adjuvant chemotherapy cycles). Hence, the conception was estimated to have happened roughly 2 months after the completion of her chemotherapy cycles. A multidisciplinary team was formed and it was decided to keep her pregnancy as there was no clear medical reason to terminate it. The pregnancy was carried out to term gestation at 37+4 weeks with close monitoring, and she delivered a healthy baby via lower-segment transverse cesarean section. CONCLUSIONS Successful pregnancy after unilateral pneumonectomy and adjuvant systematic chemotherapy is rarely reported. The maternal-fetal outcomes after unilateral pneumonectomy and systematic chemotherapy need expertise and a multidisciplinary approach to prevent complications.
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Affiliation(s)
- Daniah Aloufi
- Department of Obstetrics and Gynecology, Maternity and Children Hospital, King Salman Medical City, Madinah, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Samira AlTurkistany
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Ghaidaa Hakeem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
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Mantziari S, St Amour P, Abboretti F, Teixeira-Farinha H, Gaspar Figueiredo S, Gronnier C, Schizas D, Demartines N, Schäfer M. A Comprehensive Review of Prognostic Factors in Patients with Gastric Adenocarcinoma. Cancers (Basel) 2023; 15:cancers15051628. [PMID: 36900419 PMCID: PMC10000968 DOI: 10.3390/cancers15051628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Gastric adenocarcinoma remains associated with a poor long-term survival, despite recent therapeutical advances. In most parts of the world where systematic screening programs do not exist, diagnosis is often made at advanced stages, affecting long-term prognosis. In recent years, there is increasing evidence that a large bundle of factors, ranging from the tumor microenvironment to patient ethnicity and variations in therapeutic strategy, play an important role in patient outcome. A more thorough understanding of these multi-faceted parameters is needed in order to provide a better assessment of long-term prognosis in these patients, which probably also require the refinement of current staging systems. This study aims to review existing knowledge on the clinical, biomolecular and treatment-related parameters that have some prognostic value in patients with gastric adenocarcinoma.
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Affiliation(s)
- Styliani Mantziari
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), 1015 Lausanne, Switzerland
- Correspondence: ; Tel.: +41-21-3141-111
| | - Penelope St Amour
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Francesco Abboretti
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Hugo Teixeira-Farinha
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Sergio Gaspar Figueiredo
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Caroline Gronnier
- Oeso-Gastric Surgery Unit, Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600 Pessac, France
- Faculty of Medicine, Bordeaux Ségalen University, 33000 Bordeaux, France
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Markus Schäfer
- Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), 1015 Lausanne, Switzerland
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Janikowska G, Janikowski T, Plato M, Mazurek U, Orchel J, Opiłka M, Lorenc Z. Histaminergic System and Inflammation-Related Genes in Normal Large Intestine and Adenocarcinoma Tissues: Transcriptional Profiles and Relations. Int J Mol Sci 2023; 24:ijms24054913. [PMID: 36902343 PMCID: PMC10002554 DOI: 10.3390/ijms24054913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
Transcriptional analyses such as microarray data have contributed to the progress in the diagnostics and therapy of colorectal cancer (CRC). The need for such research is still present because of the disease being common in both men and women with a high second position in cancer rankings. Little is known about the relations between the histaminergic system and inflammation in the large intestine and CRC. Therefore, the aim of this study was to evaluate the expression of genes related to the histaminergic system and inflammation in the CRC tissues at three cancer development designs: all tested CRC samples, low (LCS) and high (HCS) clinical stage, and four clinical stages (CSI-CSIV), to the control. The research was carried out at the transcriptomic level, analysing hundreds of mRNAs from microarrays, as well as carrying out RT-PCR analysis of histaminergic receptors. The following histaminergic mRNAs: GNA15, MAOA, WASF2A, and inflammation-related: AEBP1, CXCL1, CXCL2, CXCL3, CXCL8, SPHK1, TNFAIP6, were distinguished. Among all analysed transcripts, AEBP1 can be considered the most promising diagnostic marker in the early stage of CRC. The results showed 59 correlations between differentiating genes of the histaminergic system and inflammation in the control, control and CRC, and CRC. The tests confirmed the presence of all histamine receptor transcripts in both the control and colorectal adenocarcinoma. Significant differences in expression were stated for HRH2 and HRH3 in the advanced stages of CRC adenocarcinoma. The relations between the histaminergic system and inflammation-linked genes in both the control and the CRC have been observed.
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Affiliation(s)
- Grażyna Janikowska
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jagiellońska 4 Street, 41-200 Sosnowiec, Poland
- Correspondence:
| | - Tomasz Janikowski
- Silesian College of Medicine in Katowice, Mickiewicza 29 Street, 40-085 Katowice, Poland
| | - Marta Plato
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8 Street, 41-206 Sosnowiec, Poland
| | - Urszula Mazurek
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8 Street, 41-206 Sosnowiec, Poland
- The Karol Godula Upper Silesian Academy of Entrepreneurship in Chorzów, Racławicka 23 Street, 41-506 Chorzów, Poland
| | - Joanna Orchel
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8 Street, 41-206 Sosnowiec, Poland
- Katalyst Laboratories, London W1D 3QL, UK
| | - Mieszko Opiłka
- Clinical Department of General, Colorectal and Multiple Organ Trauma Surgery, Faculty of Health Sciences, Medical University of Silesia, Medyków 1 Square, 41-200 Sosnowiec, Poland
| | - Zbigniew Lorenc
- Clinical Department of General, Colorectal and Multiple Organ Trauma Surgery, Faculty of Health Sciences, Medical University of Silesia, Medyków 1 Square, 41-200 Sosnowiec, Poland
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234
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Widiasari NPA, Rai IBN, Dwi Kusumawardani IAJ, Sajinadiyasa IGK, Candrawati NW, Arisanti NLPE. Pre-treatment Neutrophil-to-Lymphocyte Ratio significantly affects progression free survival in positive EGFR mutation advanced lung adenocarcinoma with EGFR-TKI treatment in Bali, Indonesia. Rom J Intern Med 2023; 61:63-71. [PMID: 36453446 DOI: 10.2478/rjim-2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Indexed: 12/03/2022]
Abstract
Introduction: Today, recommendations about initial Response Evaluation Criteria in Solid Tumor (RECIST) and its frequency still vary, while early diagnosis of progression affects patient's prognosis and subsequent treatment options. Methods: This study aims to examine Progression Free Survival (PFS) of positive EGFR mutations advanced lung adenocarcinoma receiving Tyrosine Kinase Inhibitor (TKI) and factors that influence it. This was an observational study with retrospective cohort design conducted at Prof IGNG Ngoerah Hospital from January to December 2021. Sample was data from Epidermal Growth Factor Receptor (EGFR) positive mutation advanced lung adenocarcinoma patient who were treated with EGFR-TKI at Prof IGNG Ngoerah Hospital, Denpasar, Bali from January 2017 to February 2021. Total sample was 63. Results: Median PFS was 12 months (95% CI 10.28-13.71) and minimum PFS was 3 months. In univariate analysis, Hazard Ration (HR) of older age, smoker, distant metastasis, brain metastasis, increased Neutrophil-to-Lymphocyte Ration (NLR), and exon 21 mutation to shorter PFS was 0.99 (95% CI 0.95-1.02); 1.03 (95% CI 0.57-1.85); 1.45 (95% CI 0.85-2.49); 2.14 (95% CI 1.02-4.49); 1.08 (95% CI 1.03-1.13); and 1.21 (95% CI 0.67-2.18). Multivariate analysis showed only increased NLR affected PFS significantly with HR 1.06 (95% CI 1.007-1.13). Conclusion: Median PFS of EGFR positive mutation advanced lung adenocarcinoma patients who received TKI was 12 months and minimum value was 3 months. Increased age, smoking, distant metastases, brain metastases, and exon 21 mutations were not associated with PFS. NLR significantly affected PFS.
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235
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Chen J, Zhang Y, Huang R, Cao L, Zhang Y, Lian M, Wang Z, Jin J, Tang C, Chen T, Yan L, Yu L, Tian R, Xiang X, Luo L, Yu C. Alantolactone inhibits oesophageal adenocarcinoma cells through nuclear factor erythroid 2-related factor 2-mediated reactive oxygen species increment. Basic Clin Pharmacol Toxicol 2023; 132:253-262. [PMID: 36507595 DOI: 10.1111/bcpt.13824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oesophageal adenocarcinoma (EAC) is a highly lethal cancer associated with a rapidly rising incidence and a poor prognosis. Alantolactone, a sesquiterpene lactone isolated from inula helenium, has anti-inflammatory, antimicrobial, neuroprotective activities, and anticancer properties. OBJECTIVE In the present study, the anticancer effects of alantolactone on the human EAC cells were investigated in vitro and in vivo. METHODS AND FINDINGS After treated with alantolactone, the cell viability of KYAE-1, KYAE-2, OE19, and OE33 cells reduced significantly compared with that of the control cells. Alantolactone induced apoptosis of the EAC cell lines by inhibiting the protein expression levels of nuclear factor erythroid2-related factor 2 (Nrf2). Furthermore, the apoptosis-inducing effect of alantolactone was enhanced by Nrf2 knockdown while reduced by overexpression of Nrf2. Antioxidant α-tocopherol and glutathione can protect EAC cell lines against alantolactone. A xenograft nude mice model showed that alantolactone can inhibit EAC growth in vivo. CONCLUSIONS Alantolactone inhibits oesophageal adenocarcinoma cells through Nrf2-mediated reactive oxygen species (ROS) increment. Alantolactone maybe a potential therapeutical candidate for treating EAC.
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Affiliation(s)
- Jianhua Chen
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Yunxiang Zhang
- School of Basic Medical Sciences & Forensic Medicine, North Sichuan Medical College, Nanchong, China.,Medical imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China
| | - Rong Huang
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Lihua Cao
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Ying Zhang
- Department of Anesthesiology, School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Maowei Lian
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China.,Institute of Tissue Engineering and Stem Cells, Cancer Biotherapy Key Laboratory of Nanchong, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Zuo Wang
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China.,Institute of Tissue Engineering and Stem Cells, Cancer Biotherapy Key Laboratory of Nanchong, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Jiajia Jin
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China.,Institute of Tissue Engineering and Stem Cells, Cancer Biotherapy Key Laboratory of Nanchong, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Chu Tang
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China.,Institute of Tissue Engineering and Stem Cells, Cancer Biotherapy Key Laboratory of Nanchong, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Tingting Chen
- Medical imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China
| | - Linli Yan
- Department of Anesthesiology, School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Linze Yu
- Medical imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China
| | - Ruimin Tian
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Xiaocong Xiang
- Institute of Tissue Engineering and Stem Cells, Cancer Biotherapy Key Laboratory of Nanchong, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Lijun Luo
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Chunlei Yu
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, China
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Wang M, Li J, Xu S, Li Y, Li J, Yu J, Tang X, Zhu H. Immunotherapy combined with chemotherapy improved clinical outcomes over bevacizumab combined with chemotherapy as first-line therapy in adenocarcinoma patients. Cancer Med 2023; 12:5352-5363. [PMID: 36271595 PMCID: PMC10028054 DOI: 10.1002/cam4.5356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/18/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE No definite conclusion has yet to be reached for the first-line treatment combined with chemotherapy for advanced adenocarcinoma NSCLC patients with negative driver genes. This study sought to compare the clinical outcomes of Beva+ChT and IO+ChT as first-line treatment for this population and investigated whether the statuses of BM, PD-L1 expression, and KRAS and TP53 mutations could influence the results. PATIENTS AND METHODS The clinical data of patients with adenocarcinoma NSCLC who received first-line therapy were retrospectively collected and the patients were assigned to the IO+ChT and Beva+ChT groups. The disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were evaluated between the two groups. The survival effects of BM, PD-L1 expression, and KRAS and TP53 mutations were also evaluated. RESULTS From April 2018 to October 2020, a total of 105 patients with first-line therapy were included in our analysis; 54 (51.4%) patients were included in the IO+ChT group and 51 (48.6%) patients were included in the Beva+ChT group. The results showed that OS (NR vs. 18.3 m, p = 0.011) and PFS (14.9 m vs. 6.3 m, p < 0.001) were superior in patients in the IO+ChT group than in patients in the Beva+ChT group. Further analysis revealed that the OS (median OS: NR vs. 14.7 months, p = 0.039) and PFS (median PFS: 18.5 vs. 5.5 months, p < 0.001) advantages of the IO+ChT group were also seen in the PD-L1 > 1% subgroup but were not seen in the PD-L1 < 1%, BM or KRAS mutation subgroups. CONCLUSIONS ICIs combined with ChT improved clinical outcomes over Beva combined with ChT as first-line therapy for adenocarcinoma patients without driver gene alterations, especially in patients with PD-L1 ≥ 1%.
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Affiliation(s)
- Min Wang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Ji Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Shuhui Xu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yuying Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jiatong Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaoyong Tang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute affiliated of Shandong University, Jinan, Shandong, China
| | - Hui Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute affiliated of Shandong University, Jinan, Shandong, China
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Sei Y, Feng J, Zhao X, Dagur P, McCoy JP, Merchant JL, Wank SA. Tissue- and cell-specific properties of enterochromaffin cells affect the fate of tumorigenesis toward nonendocrine adenocarcinoma of the small intestine. Am J Physiol Gastrointest Liver Physiol 2023; 324:G177-G189. [PMID: 36537709 PMCID: PMC9925174 DOI: 10.1152/ajpgi.00205.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 01/31/2023]
Abstract
Small intestinal neuroendocrine tumors (SI-NETs) are serotonin-secreting well-differentiated neuroendocrine tumors of putative enterochromaffin (EC) cell origin. However, EC cell-derived tumorigenesis remains poorly understood. Here, we examined whether the gain of Myc and the loss of RB1 and Trp53 function in EC cells result in SI-NET using tryptophan hydroxylase 1 (TPH1) Cre-ERT2-driven RB1fl Trp53fl MycLSL (RPM) mice. TPH1-Cre-induced gain of Myc and loss of RB1 and Trp53 function resulted in endocrine or neuronal tumors in pancreas, lung, enteric neurons, and brain. Lineage tracing indicated that the cellular origin for these tumors was TPH1-expressing neuroendocrine, neuronal, or their precursor cells in these organs. However, despite that TPH1 is most highly expressed in EC cells of the small intestine, we observed no incidence of EC cell tumors. Instead, the tumor of epithelial cell origin in the intestine was exclusively nonendocrine adenocarcinoma, suggesting dedifferentiation of EC cells into intestinal stem cells (ISCs) as a cellular mechanism. Furthermore, ex vivo organoid studies indicated that loss of functions of Rb1 and Trp53 accelerated dedifferentiation of EC cells that were susceptible to apoptosis with expression of activated MycT58A, suggesting that the rare dedifferentiating cells escaping cell death went on to develop adenocarcinomas. Lineage tracing demonstrated that EC cells in the small intestine were short-lived compared with neuroendocrine or neuronal cells in other organs. In contrast, EC cell-derived ISCs were long-lasting and actively cycling and thus susceptible to transformation. These results suggest that tissue- and cell-specific properties of EC cells such as rapid cell turnover and homeostatic dedifferentiation, affect the fate and rate of tumorigenesis induced by genetic alterations and provide important insights into EC cell-derived tumorigenesis.NEW & NOTEWORTHY Small intestinal neuroendocrine tumors are of putative enterochromaffin (EC) cell origin and are the most common malignancy in the small intestine, followed by adenocarcinoma. However, the tumorigenesis of these tumor types remains poorly understood. The present lineage tracing studies showed that tissue- and cell-specific properties of EC cells such as rapid cell turnover and homeostatic dedifferentiation affect the fate and rate of tumorigenesis induced by genetic alterations toward a rare occurrence of adenocarcinoma.
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Affiliation(s)
- Yoshitatsu Sei
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Jianying Feng
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Xilin Zhao
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Pradeep Dagur
- Flow Cytometry Core Facility, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - J Philip McCoy
- Flow Cytometry Core Facility, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Juanita L Merchant
- Department of Internal Medicine-Gastroenterology, University of Arizona, Tuscan, Arizona
| | - Stephen A Wank
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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Jones AE, Wustefeld-Janssens BG. A relatively high proportion of dogs with small apocrine gland anal sac adenocarcinoma (AGASACA) primary tumours present with locoregional lymph node metastasis. Vet Comp Oncol 2023; 21:327-331. [PMID: 36861227 DOI: 10.1111/vco.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/09/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly relevant disease in dogs, with a high rate of lymph node (LN) metastasis during the course of disease. A recent study showed that risk for death and disease progression was significantly associated with primary tumour size less than 2 and 1.3 cm, respectively. The objective of this study was to report the proportion of dogs that have primary tumours less than 2 cm in diameter, that are diagnosed with LN metastasis at presentation. This was a single site retrospective study of dogs that underwent treatment for AGASACA. Dogs were included if physical examination primary tumour measurements were available, abdominal staging was performed, and confirmation of abnormal lymph nodes by cytology or histology was done. Over a 5-year period, 116 dogs were included for review with 53 (46%) having metastatic LN at presentation. The metastatic rate for dogs with primary tumours <2 cm was 20% (9 of 46 dogs) compared to 63% (44 of 70 dogs) in dogs with primary tumours ≥2 cm. The association between tumour size group (<2 vs. ≥2 cm) and the presence of metastasis at presentation was significant (P < .0001) with an OR of 7.0 (95% CI: 2.9-15.7). Primary tumour size was significantly associated with LN metastasis at presentation but the proportion of dogs that presented with LN metastasis in the <2 cm group was relatively high. This data suggests that dogs with small tumours may still have aggressive tumour biology.
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Affiliation(s)
- Anna E Jones
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Brandan G Wustefeld-Janssens
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Yang CY, Yeh YC, Wang LC, Lin YY, Lin SY, Wang SY, Chu PY, Liu ZY, Su YC, Ho HL, Chou TY. Genomic Profiling With Large-Scale Next-Generation Sequencing Panels Distinguishes Separate Primary Lung Adenocarcinomas From Intrapulmonary Metastases. Mod Pathol 2023; 36:100047. [PMID: 36788096 DOI: 10.1016/j.modpat.2022.100047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/09/2022] [Accepted: 10/24/2022] [Indexed: 01/11/2023]
Abstract
The distinction between different separate primary lung cancers (SPLCs) and intrapulmonary metastases (IPMs) is a challenging but clinically significant issue. Histopathology-based classification is the current practice; however, it is subjective and affected by interobserver variability. Recently, next-generation sequencing (NGS) panels have been used in lung cancer diagnostics. This study aimed to investigate the value of large-scale NGS panels for distinguishing between SPLCs and IPMs. A total of 32 patients with 69 lung adenocarcinomas were included. Comprehensive histopathologic assessments of multiple pulmonary adenocarcinomas were performed independently by 3 pathologists. The consensus of histopathologic classification was determined by a majority vote. Genomic analysis was performed using an amplicon-based large-scale NGS panel, targeting single-nucleotide variants and short insertions and deletions in 409 genes. Tumor pairs were classified as SPLCs or IPMs according to a predefined molecular classification algorithm. Using NGS and our molecular classification algorithm, 97.6% of the tumor pairs can be unambiguously classified as SPLCs or IPMs. The molecular classification was predictive of postoperative clinical outcomes in terms of overall survival (P = .015) and recurrence-free interval (P = .0012). There was a moderate interobserver agreement regarding histopathologic classification (κ = 0.524 at the tumor pair level). The concordance between histopathologic and molecular classification was 100% in cases where pathologists reached a complete agreement but only 53.3% where they did not. This study showed that large-scale NGS panels are a powerful modality that can help distinguish SPLCs from IPMs in patients with multiple lung adenocarcinomas and objectively provide accurate risk stratification.
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Affiliation(s)
- Ching-Yeuh Yang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Lei-Chi Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Yu Lin
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shin-Ying Lin
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Ying Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ping-Yuan Chu
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Zih-Yu Liu
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Chi Su
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Ling Ho
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Teh-Ying Chou
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Now with Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
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Metaxas GI, Tsiambas E, Marinopoulos S, Adamopoulou M, Spyropoulou D, Falidas E, Davris D, Manaios L, Fotiades P, Mastronikoli S, Peschos D, Dimitrakakis C. DNA Mismatch Repair System Imbalances in Breast Adenocarcinoma. Cancer Diagn Progn 2023; 3:169-174. [PMID: 36875308 PMCID: PMC9949550 DOI: 10.21873/cdp.10197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/28/2022] [Indexed: 03/07/2023]
Abstract
DNA mismatch repair system (MMR) is considered a leading genetic mechanism in stabilizing DNA structure and maintaining its function. DNA MMR is a highly conserved system in bacteria, prokaryotic, and eukaryotic cells, and provides the highest protection to DNA by repairing micro-structural alterations. DNA MMR proteins are involved in the detection and repair of intra-nucleotide base-to-base errors inside the complementary DNA strand recognizing the recently synthesized strand from the parental template. During DNA replication, a spectrum of errors including base insertion, deletion, and miss-incorporation negatively affect the molecule's structure and its functional stability. A broad spectrum of genomic alterations such as promoter hyper methylation, mutation, and loss of heterozygosity (LOH) in MMR genes including predominantly hMLH1, hMSH2, hMSH3, hMSH6, hPMS1, and hPMS2 lead to their loss of base-to-base error repairing procedure. Microsatellite instability (MSI) refers to the DNA MMR gene alterations that are observed in a variety of malignancies of different histological origins. In the current review, we present the role of DNA MMR deficiency in breast adenocarcinoma, a leading cancer-based cause of death in females worldwide.
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Affiliation(s)
- Georgios I Metaxas
- Breast Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Spyridon Marinopoulos
- Breast Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Adamopoulou
- Department of Education, Molecular Lab, Deere American College of Greece (AGC), Athens, Greece
| | - Despoina Spyropoulou
- Department of Radiation Oncology, Medical School, University of Patras, Patras, Greece
| | | | - Dimitrios Davris
- Department of Surgery, Halkida General Hospital, Halkida, Greece
| | - Loukas Manaios
- Department of Surgery, Bioclinic Medical Center, Athens, Greece
| | | | | | - Dimitrios Peschos
- Department of Physiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Constantine Dimitrakakis
- Breast Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Carvalho CF, Costa LBE, Sanches NC, Damas II, Andrade LALDA, Vale DB. Prognosis determination of endocervical adenocarcinomas morphologically reclassified as HPV associated or HPV independent. Int J Gynaecol Obstet 2023; 160:993-1000. [PMID: 36074054 DOI: 10.1002/ijgo.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/27/2022] [Accepted: 08/22/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To evaluate the prognosis of endocervical adenocarcinomas after reclassification according to the morphologic type based on the 2020 World Health Organization Classification. METHODS A retrospective longitudinal study with cases admitted at the University of Campinas, Brazil, from 2013 to 2020. The sample included 140 cases morphologically reclassified: 100 cases as adenocarcinoma HPV-associated (HPVA), 17 as HPV-independent (HPVI), and 23 non-HPVA/HPVI. Clinic and pathologic variables were evaluated. Analyses were performed by χ2 , Fisher exact, and Mann-Whitney U tests, Kaplan-Meier curves, Log-rank test, and Cox regression. RESULTS Compared with the HPVA group, advanced stage (FIGO Stage II+) was more frequent in the HPVI group (P = 0.009), which also showed older patients (P = 0.032), and a higher proportion of deaths (P = 0.006). The median overall survival (OS) differed between groups: 73.3 months in HPVA and 42.4 months in HPVI (P = 0.005). At the multivariate analysis, the risk of death was 6.7 (95% confidence interval 1.9-23.0) times higher in patients diagnosed in advanced stages. CONCLUSION HPVI cases were more frequent in older patients, presenting at more advanced stages and with worse OS. The morphology-based approach of the new WHO classification appears to be prognostically valuable and applicable in lower- and middle-income settings.
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Affiliation(s)
- Carla Fabrine Carvalho
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, São Paulo, Brazil
| | | | | | - Ingrid Iara Damas
- Department of Pathology, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Diama Bhadra Vale
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, São Paulo, Brazil
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Popov H, Stoyanov GS, Ghenev P. Intestinal-Type Adenocarcinoma of the Urinary Bladder With Coexisting Cystitis Cystica et Glandularis and Intestinal Metaplasia: A Histopathological Case Report. Cureus 2023; 15:e36554. [PMID: 37102004 PMCID: PMC10123225 DOI: 10.7759/cureus.36554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
Adenocarcinomas of the urinary bladder are exceedingly rare and present in various morphological forms. Virtually all of these are identical to glandular malignant neoplasia native to topographically neighboring organs, where the incidence of adenocarcinoma is also much more common, such as the large intestine. Cases of glandular malignancies of the urinary bladder, therefore, require not only a detailed histopathological evaluation and interpretation but also a detailed clinical and radiological one. These should be performed with the goal of proving the origin of the tumor as one arising from the urinary bladder and not an entry originating from another organ and invading or producing metastasis to it. A controversial etiopathogenic link to urinary bladder adenocarcinoma is that of cystitis cystica et glandularis, which often coexists with the condition. Herein, we present a case report of non-muscle-invasive urinary bladder adenocarcinoma in a previously healthy male patient in his forties with a known history of cystitis cystica et glandularis. The patient presented with gross hematuria, and based on his known urological condition, a cystoscopy with biopsy was performed, showing submucosal proliferation of atypical glands. The detailed clinical and radiological evaluation showed no evidence of malignancy at other sites. As the malignancy was non-muscle-invasive, an intravesical dose of the Bacillus Calmette-Guérin vaccine was administered. The patient was followed up with cystoscopy, and a biopsy showed no evidence of residual malignancy, with cystitis cystica et glandularis persisting. A year following the diagnosis, the patient is still actively monitored, and no recurrence is noted.
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Affiliation(s)
- Hristo Popov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | | | - Peter Ghenev
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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243
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Collins-Webb AG, Löhr CV, Stieger-Vanegas SM. CT features of malignant tubular genital tract tumors in seven goats. Vet Radiol Ultrasound 2023; 64:253-261. [PMID: 36383072 DOI: 10.1111/vru.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/13/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022] Open
Abstract
Neoplasia of the tubular genital tract in goats, while rarely described, is most commonly reported as uterine adenocarcinoma, leiomyoma, or leiomyosarcoma. In this retrospective, single-center, case series, medical records were searched for goats with a computed tomography (CT) diagnosis of tubular genital mass and a definitive histologic (surgical biopsy or necropsy) diagnosis of malignant neoplasia. Data recorded from CT images were presence of peritoneal/retroperitoneal fluid, urinary tract obstruction, abdominal lymphadenomegaly, additional abdominal nodules/masses, and pulmonary nodules. For masses, maximum cross-sectional area, contrast enhancement, and uterine luminal fluid accumulation were also recorded. Seven goats met the inclusion criteria (leiomyosarcoma n = 5, adenocarcinoma n = 2). Both goats with adenocarcinoma had upper urinary tract obstruction, moderate to severe regional lymphadenopathy, peritoneal fluid, and peritoneal or hepatic nodules/masses; one goat with adenocarcinoma was discharged and subsequently euthanized, and the other had palliative mass debulking and was lost to follow up. Goats with leiomyosarcoma had infrequent, mild peritoneal fluid and mild sublumbar lymphadenopathy. Of the goats with leiomyosarcoma, two were euthanized at or near the time of CT imaging, two were euthanized at the time of surgery due to perceived mass non-resectability, and one had mass regression approximately four months post ovariohysterectomy but was subsequently lost to follow up. Five goats had pulmonary nodules, three of which had pathologic confirmation (pulmonary metastasis in a single patient with adenocarcinoma, and lungworm granulomas in two goats with leiomyosarcoma). Severe sublumbar lymphadenopathy and obstructive uropathy were sequelae in the two caprine patients with genital adenocarcinoma, and in none with leiomyosarcoma.
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Affiliation(s)
- Alexandra G Collins-Webb
- Department of Clinical Sciences, Oregon Veterinary Diagnostic Laboratory, Corvallis, Oregon, USA
| | - Christiane V Löhr
- Department of Biomedical Sciences, Oregon State University, 700 SW 30th Street, Corvallis, Oregon, USA
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244
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Tanaka T, Wada Y, Noguchi S, Nishida H, Akiyoshi H. Contrast-enhanced CT features of pyloric lesions in 17 dogs: Case series. Vet Radiol Ultrasound 2023; 64:262-270. [PMID: 36571176 DOI: 10.1111/vru.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/06/2022] [Accepted: 10/15/2022] [Indexed: 12/27/2022] Open
Abstract
Pyloric outflow obstructions can be caused by several types of lesions. When a thickened gastric wall and pyloric mass are detected, malignant neoplasia must be differentiated from chronic hypertrophic pyloric gastropathy. CT can characterize gastric tumors. However, based on the authors' review of the literature, there is limited information about the CT findings of pyloric lesions. The purpose of this retrospective case series study was to assess the CT findings of canine pyloric lesions. The following CT parameters were recorded: anatomical area, involved area, lesion shape, growth patterns of wall thickening lesions, enhancement pattern of the lesion in the early and delayed phases, lymphomegaly, and pulmonary metastasis. Seventeen dogs were included in this study and had the following final diagnoses: hyperplasia (five dogs), adenoma (five dogs), adenocarcinoma (three dogs), gastrointestinal stromal tumor (GIST; two dogs), polyposis (one dog), and pyogenic granuloma (one dog). Hyperplasia, adenoma, and polyposis formed mass lesions that involved the mucosal layer. Lymphomegaly was detected in two Jack Russell terriers with hyperplasia; however, the causes were unknown because we did not perform biopsies. All adenocarcinomas formed wall-thickened lesion that involved the outer layer, with lymphomegaly. All GISTs formed mass lesion that involved the outer layer. The pyogenic granulomas formed symmetric wall-thickened lesion that involved the mucosal and outer layers. CT facilitated the characterization of canine pyloric lesions using contrast enhancement, based on the involved area and lesion shape. However, polyposis may require caution in diagnosis based on CT findings alone.
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Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan.,Kinki Animal Medical Training Institute & Veterinary Clinic, Higashiosaka, Osaka, Japan
| | - Yusuke Wada
- Veterinary Medical Center, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
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245
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Zhao Y, Zhou T, Li Z. A rare case of gastric adenocarcinoma with enteroblastic differentiation presenting as pancreatic hepatoid adenocarcinoma metastases. J Hepatobiliary Pancreat Sci 2023; 30:e12-e14. [PMID: 35749218 DOI: 10.1002/jhbp.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Yusha Zhao
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China
| | - Tao Zhou
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China
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246
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Cox KE, Liu S, Lwin TM, Hoffman RM, Batra SK, Bouvet M. The Mucin Family of Proteins: Candidates as Potential Biomarkers for Colon Cancer. Cancers (Basel) 2023; 15:cancers15051491. [PMID: 36900282 PMCID: PMC10000725 DOI: 10.3390/cancers15051491] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Mucins (MUC1-MUC24) are a family of glycoproteins involved in cell signaling and barrier protection. They have been implicated in the progression of numerous malignancies including gastric, pancreatic, ovarian, breast, and lung cancer. Mucins have also been extensively studied with respect to colorectal cancer. They have been found to have diverse expression profiles amongst the normal colon, benign hyperplastic polyps, pre-malignant polyps, and colon cancers. Those expressed in the normal colon include MUC2, MUC3, MUC4, MUC11, MUC12, MUC13, MUC15 (at low levels), and MUC21. Whereas MUC5, MUC6, MUC16, and MUC20 are absent from the normal colon and are expressed in colorectal cancers. MUC1, MUC2, MUC4, MUC5AC, and MUC6 are currently the most widely covered in the literature regarding their role in the progression from normal colonic tissue to cancer.
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Affiliation(s)
- Kristin E. Cox
- Department of Surgery, University of California San Diego, La Jolla, CA 92037, USA
- VA San Diego Healthcare System, La Jolla, CA 92161, USA
| | - Shanglei Liu
- Department of Surgery, University of California San Diego, La Jolla, CA 92037, USA
| | - Thinzar M. Lwin
- Department of Surgical Oncology, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Robert M. Hoffman
- Department of Surgery, University of California San Diego, La Jolla, CA 92037, USA
- VA San Diego Healthcare System, La Jolla, CA 92161, USA
- AntiCancer, Inc., San Diego, CA 92111, USA
| | - Surinder K. Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Michael Bouvet
- Department of Surgery, University of California San Diego, La Jolla, CA 92037, USA
- VA San Diego Healthcare System, La Jolla, CA 92161, USA
- Correspondence: ; Tel.: +1-858-822-6191; Fax: +1-858-249-0483
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247
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Frankel D, Nanni I, Ouafik L, Greillier L, Dutau H, Astoul P, Daniel L, Kaspi E, Roll P. Cytological Samples: An Asset for the Diagnosis and Therapeutic Management of Patients with Lung Cancer. Cells 2023; 12. [PMID: 36899890 DOI: 10.3390/cells12050754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Lung cancer has become the leading cause of cancer death for men and women. Most patients are diagnosed at an advanced stage when surgery is no longer a therapeutic option. At this stage, cytological samples are often the less invasive source for diagnosis and the determination of predictive markers. We assessed the ability of cytological samples to perform diagnosis, and to establish molecular profile and PD-L1 expression, which are essential for the therapeutic management of patients. METHODS We included 259 cytological samples with suspected tumor cells and assessed the ability to confirm the type of malignancy by immunocytochemistry. We summarized results of molecular testing by next generation sequencing (NGS) and PD-L1 expression from these samples. Finally, we analyzed the impact of these results in the patient management. RESULTS Among the 259 cytological samples, 189 concerned lung cancers. Of these, immunocytochemistry confirmed the diagnosis in 95%. Molecular testing by NGS was obtained in 93% of lung adenocarcinomas and non-small cell lung cancer. PD-L1 results were obtained in 75% of patients tested. The results obtained with cytological samples led to a therapeutic decision in 87% of patients. CONCLUSION Cytological samples are obtained by minimally invasive procedures and can provide enough material for the diagnosis and therapeutic management in lung cancer patients.
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248
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Flammia RS, Tufano A, Chierigo F, Würnschimmel C, Hoeh B, Sorce G, Tian Z, Anceschi U, Leonardo C, Del Giudice F, Terrone C, Giordano A, Morrione A, Saad F, Shariat SF, Briganti A, Montorsi F, Chun FKH, Gallucci M, Karakiewicz PI. The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer. J Clin Med 2023; 12:jcm12051776. [PMID: 36902562 PMCID: PMC10003431 DOI: 10.3390/jcm12051776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Female sex in patients treated by radical cystectomy (RC) is associated with more advanced stage and worse survival. However, studies supporting these findings mostly or exclusively relied on urothelial carcinoma of the urinary bladder (UCUB) and did not address non-urothelial variant-histology bladder cancer (VH BCa). We hypothesized that female sex is associated with a more advanced stage and worse survival in VH BCa, similarly to that of UCUB. MATERIALS AND METHODS Within the SEER database (2004-2016), we identified patients aged ≥18 years, with histologically confirmed VH BCa, and treated with comprehensive RC. Logistic regression addressing the non-organ-confined (NOC) stage, as well as cumulative incidence plots and competing risks regression addressing CSM for females vs. males, were fitted. All analyses were repeated in stage-specific and VH-specific subgroups. RESULTS Overall, 1623 VH BCa patients treated with RC were identified. Of those, 38% were female. Adenocarcinoma (n = 331, 33%), neuroendocrine tumor (n = 304, 18%), and other VH (n = 317, 37%) were less frequent in females but not squamous cell carcinoma (n = 671, 51%). Across all VH subgroups, female patients had higher NOC rates than males did (68 vs. 58%, p < 0.001), and female sex was an independent predictor of NOC VH BCa (OR = 1.55, p = 0.0001). Overall, five-year cancer-specific mortality (CSM) were 43% for females vs. 34% for males (HR = 1.25, p = 0.02). CONCLUSION In VH BC patients treated with comprehensive RC, female sex is associated with a more advanced stage. Independently of stage, female sex also predisposes to higher CSM.
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Affiliation(s)
- Rocco Simone Flammia
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
- Correspondence:
| | - Antonio Tufano
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
| | - Francesco Chierigo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16146 Genova, Italy
| | - Christoph Würnschimmel
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Benedikt Hoeh
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60596 Frankfurt am Main, Germany
| | - Gabriele Sorce
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Zhen Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
| | - Umberto Anceschi
- Department of Urology, Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Costantino Leonardo
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Carlo Terrone
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16146 Genova, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
- Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | - Andrea Morrione
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
| | - Shahrokh F. Shariat
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Urology, Second Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 11942, Jordan
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Felix K. H. Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60596 Frankfurt am Main, Germany
| | - Michele Gallucci
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
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Cierpiał-Wolan M, Wójcik S, Gawełko J, Czarnota M. Does the Level of Air Pollution Affect the Incidence of Lung Adenocarcinoma in South-Eastern Poland? Int J Environ Res Public Health 2023; 20:3177. [PMID: 36833873 PMCID: PMC9961870 DOI: 10.3390/ijerph20043177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to assess the association of long-term exposure to particulate matter with aerodynamic diameter, PM2.5, PM10, NO2 and SO2 as well as CO, with lung adenocarcinoma (AD) in south-east Poland for the years from 2004 to 2014. The study group consisted of 4296 patients with lung adenocarcinoma and the level of selected pollutants. To analyse the data, a standard statistics for cohort data, that is a risk ratio (RR), was used. The dependencies occurring in the distribution of pollutants and cancer incidence were examined using Moran's I correlation coefficient. The current study suggests that PM10, NO2 and SO2 exposure as an air pollutant may increase female lung adenocarcinoma incidence. In men, the increased risk of adenocarcinoma lung cancer is affected by SO2 and PM10. A high morbidity rate in urban areas and suburbs may be connected with commuting from moderately polluted living areas to highly polluted working areas.
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Affiliation(s)
- Marek Cierpiał-Wolan
- Institute of Economics and Finance, College of Social Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Department, Statistical Office in Rzeszów, 35-959 Rzeszów, Poland
| | - Sebastian Wójcik
- Department, Statistical Office in Rzeszów, 35-959 Rzeszów, Poland
- Institute of Mathematics, College of Natural Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Jan Gawełko
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Michalina Czarnota
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
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250
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Mathiesen M, Holm J, Thorsteinsson M. Radio frequency ablation of dysplastic Barrett's esophagus: Outcomes of a single-center registry. Scand J Surg 2023:14574969231151378. [PMID: 36756673 DOI: 10.1177/14574969231151378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Barrett's esophagus (BE) is associated with an increased risk of esophageal adenocarcinoma. The use of radio frequency ablation (RFA) for complete eradication of BE with confirmed low-grade dysplasia (LGD) or high-grade dysplasia (HGD) has been promising in multicenter trials. Our aim was to evaluate the safety and efficacy outcomes associated with RFA for patients with BE and LGD/HGD in a single-center setting. METHODS This was a retrospective single-center study conducted at Department of Surgery and Transplantation, Rigshospitalet, Denmark. Data were collected from all patients who had undergone RFA for LGD or HGD from January 2014 to December 2018. Effectiveness outcomes were based on histology: complete eradication of dysplasia (CE-D), defined as all esophageal biopsies being negative for dysplasia at the last biopsy session, and complete eradication of intestinal metaplasia (CE-IM) defined as esophageal biopsies being without intestinal metaplasia. Safety outcomes were based on the proportion of complications to the RFA treatment. RESULTS A total of 107 patients were identified during the follow-up period (75% men, median age = 65 years); 83% had LGD and 17% had HGD. The median follow-up was 25 months. After the last RFA treatment, CE-D was achieved in 89%. CE-D and CE-IM were achieved in 60%. Complications occurred in 6.5% of the patients. CONCLUSIONS In patients with BE and confirmed LGD or HGD, RFA was associated with a high rate of CE-D and a low risk of complications. The observed safety and efficacy outcomes were comparable with those previously reported in multicenter trials, showing that the Danish treatment of BE with LGD and HGD is comparable with those of larger European expert centers.
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Affiliation(s)
- Molly Mathiesen
- Department of Surgery and TransplantationRigshospitaletCopenhagen University Hospital, Copenhagen ØDenmark
| | - Jakob Holm
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten Thorsteinsson
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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