The oncogenic properties of the EWSR1::CREM fusion gene are associated with polyamine metabolism

[High expression of CREM is associated with poor prognosis in gastric cancer patients]

OBJECTIVE

To analyze the expression of CREM in gastric cancer (GC) and its correlation with prognosis of the patients.

METHODS

TCGA and GEO databases were used to analyze the expression levels of CREM mRNA in GC and adjacent tissues. Immunohistochemistry was used to examine the expression of CREM protein in 43 pairs of GC and adjacent tissues, and the correlation of CREM expression with clinicopathological features of the patients was analyzed. Kaplan-Meier survival analysis was used to explore the relationship between CREM expression and survival of GC patients. LinkedOmics database was used to annotate the GO function and KEGG pathway enrichment of CREM-related genes.

RESULTS

Database analysis showed that CREM was highly expressed in GC tissues (P < 0.05) and positively correlated with poor prognosis in GC patients (P=0.01). Immunohistochemistry results showed significantly higher CREM expression in GC tissues than in paired adjacent tissues (P < 0.0001), and its expression level was correlated with T-stage and N-stage of the tumor (P < 0.05). The overall survival of GC patients with high expression of CREM was shorter (RR=4.02, P=0.0046). Gene enrichment analysis showed that high CREM expression promotes occurrence and progression of GC very likely through the cell adhesion signaling pathway.

CONCLUSION

CREM is highly expressed in GC, and its high expression is associated with a poor prognosis of GC patients, suggesting the potential of CREM to serve as a prognostic indicator for GC.

Angiomatoid Fibrous Histiocytoma of the Chest Wall Protruding into the Thoracic Cavity Mimicking Metastasis in a Patient with Breast Cancer

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor of intermediate malignancy and uncertain differentiation. To date, only four patients diagnosed with AFH located in the chest wall have been described. Herein, we describe a 44-year-old woman diagnosed with breast infiltrating lobular carcinoma. During the imaging study with positron emission tomography-computerized tomography scan, a 4 cm solid lesion located in the chest wall was identified. Fine-needle aspiration followed by surgical excision with intraoperative frozen section study was performed. The combined histomorphologic, immunohistochemical, and molecular findings confirmed the diagnosis of AFH. In this report, we describe, to the best of our knowledge, the first patient with synchronous AFH and breast cancer.