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Okumura T, Hotta K, Imai K, Ito S, Kishida Y, Takada K, Kawaguchi D, Mori Y, Tanaka Y, Tsushima T, Kawata N, Maeda Y, Yoshida M, Yamamoto Y, Minamide T, Ishiwatari H, Sato J, Matsubayashi H, Ono H. Efficacy of texture and color enhancement imaging for the visibility and diagnostic accuracy of non-polypoid colorectal lesions. DEN OPEN 2025; 5:e380. [PMID: 38817687 PMCID: PMC11136699 DOI: 10.1002/deo2.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/11/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024]
Abstract
Objective A newly launched endoscopy system (EVIS X1, CV-1500; Olympus) is equipped with texture and color enhancement imaging (TXI). We aimed to investigate the efficacy of TXI for the visibility and diagnostic accuracy of non-polypoid colorectal lesions. Methods We examined 100 non-polypoid lesions in 42 patients from the same position, angle, and distance of the view in three modes: white light imaging (WLI), narrow-band imaging (NBI), and TXI. The primary outcome was to compare polyp visibility in the three modes using subjective polyp visibility score and objective color difference values. The secondary outcome was to compare the diagnostic accuracy without magnification. Results Overall, the visibility score of TXI was significantly higher than that of WLI (3.7 ± 1.1 vs. 3.6 ± 1.1; p = 0.008) and lower than that of NBI (3.7 ± 1.1 vs. 3.8 ± 1.1; p = 0.013). Color difference values of TXI were higher than those of WLI (11.5 ± 6.9 vs. 9.1 ± 5.4; p < 0.001) and lower than those of NBI (11.5 ± 6.9 vs. 13.1 ± 7.7; p = 0.002). No significant differences in TXI and NBI (visibility score: 3.7 ± 1.0 vs. 3.8 ± 1.1; p = 0.833, color difference values: 11.6 ± 7.1 vs. 12.9 ± 8.3; p = 0.099) were observed for neoplastic lesions. Moreover, the diagnostic accuracy of TXI was significantly higher than that of NBI (65.5% vs. 57.6%, p = 0.012) for neoplastic lesions. Conclusions TXI demonstrated higher visibility than that of WLI and lower than that of NBI. Further investigations are warranted to validate the performance of the TXI mode comprehensively.
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Affiliation(s)
- Taishi Okumura
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Kinichi Hotta
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Kenichiro Imai
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Sayo Ito
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | | | | | - Daiki Kawaguchi
- Division of Gastrointestinal OncologyShizuoka Cancer CenterShizuokaJapan
| | - Yukihiro Mori
- Division of Colon and Rectal SurgeryShizuoka Cancer CenterShizuokaJapan
| | - Yusuke Tanaka
- Division of Colon and Rectal SurgeryShizuoka Cancer CenterShizuokaJapan
| | - Takahiro Tsushima
- Division of Gastrointestinal OncologyShizuoka Cancer CenterShizuokaJapan
| | - Noboru Kawata
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Yuki Maeda
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Masao Yoshida
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | | | | | | | - Junya Sato
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | | | - Hiroyuki Ono
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
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Zhang S, Lin Y, Li Z, Wang Z, Luo R, Zhang X. Clinical treatment strategy and follow-up of lymphoepithelioma-like carcinoma: a retrospective study. Future Sci OA 2024; 10:2384878. [PMID: 39215389 PMCID: PMC11385158 DOI: 10.1080/20565623.2024.2384878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024] Open
Abstract
Aim: To investigate the clinical features, diagnosis and treatment of lymphoepithelioma-like carcinoma (LELC).Materials & methods: The clinical data of 114 LELC patients were retrospectively analyzed.Results: Ninety-eight patients (86.0%) were Epstein-Barr virus-encoded small RNA (EBER) positive detected by situ hybridization. A 67.1% (51/76) patients had PD-L1 expression. The 5-year overall survival rate of EBER negative patients was 51.6% while the rate of positive patients was 84.8% (p = 0.015). The 5-year progression free survival rate of EBER negative patients was 40.2% while the rate of positive patients was 70.2% (p = 0.004).Conclusion: The progression of LELC is relatively slow and present a better prognosis. The occurrence of tumor is closely related to Epstein-Barr virus infection and PD-L1 is highly expressed in tumor cells.
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Affiliation(s)
- Shilong Zhang
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yufu Lin
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
- Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, China
| | - Zhiyong Li
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
- Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, China
| | - Zhiming Wang
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rongkui Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiuping Zhang
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
- Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, China
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Makhlouf Y, Singh VK, Craig S, McArdle A, French D, Loughrey MB, Oliver N, Acevedo JB, O’Reilly P, James JA, Maxwell P, Salto-Tellez M. True-T - Improving T-cell response quantification with holistic artificial intelligence based prediction in immunohistochemistry images. Comput Struct Biotechnol J 2024; 23:174-185. [PMID: 38146436 PMCID: PMC10749253 DOI: 10.1016/j.csbj.2023.11.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/27/2023] Open
Abstract
The immune response associated with oncogenesis and potential oncological ther- apeutic interventions has dominated the field of cancer research over the last decade. T-cell lymphocytes in the tumor microenvironment are a crucial aspect of cancer's adaptive immunity, and the quantification of T-cells in specific can- cer types has been suggested as a potential diagnostic aid. However, this is cur- rently not part of routine diagnostics. To address this challenge, we present a new method called True-T, which employs artificial intelligence-based techniques to quantify T-cells in colorectal cancer (CRC) using immunohistochemistry (IHC) images. True-T analyses the chromogenic tissue hybridization signal of three widely recognized T-cell markers (CD3, CD4, and CD8). Our method employs a pipeline consisting of three stages: T-cell segmentation, density estimation from the segmented mask, and prediction of individual five-year survival rates. In the first stage, we utilize the U-Net method, where a pre-trained ResNet-34 is em- ployed as an encoder to extract clinically relevant T-cell features. The segmenta- tion model is trained and evaluated individually, demonstrating its generalization in detecting the CD3, CD4, and CD8 biomarkers in IHC images. In the second stage, the density of T-cells is estimated using the predicted mask, which serves as a crucial indicator for patient survival statistics in the third stage. This ap- proach was developed and tested in 1041 patients from four reference diagnostic institutions, ensuring broad applicability. The clinical effectiveness of True-T is demonstrated in stages II-IV CRC by offering valuable prognostic information that surpasses previous quantitative gold standards, opening possibilities for po- tential clinical applications. Finally, to evaluate the robustness and broader ap- plicability of our approach without additional training, we assessed the universal accuracy of the CD3 component of the True-T algorithm across 13 distinct solid tumors.
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Affiliation(s)
- Yasmine Makhlouf
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Vivek Kumar Singh
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Stephanie Craig
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Aoife McArdle
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Dominique French
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Maurice B. Loughrey
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
- Cellular Pathology, Belfast Health and Social Care Trust, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK
| | - Nicola Oliver
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Juvenal Baena Acevedo
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | | | - Jacqueline A. James
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
- Regional Molecular Diagnostic Service, Belfast Health and Social Care Trust, Belfast BT9 7AE, UK
| | - Perry Maxwell
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Manuel Salto-Tellez
- Precision Medicine Centre of Excellence, Health Sciences Building, The Patrick G Johnston, Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
- Sonrai Analytics, Belfast BT9 7AE, UK
- Regional Molecular Diagnostic Service, Belfast Health and Social Care Trust, Belfast BT9 7AE, UK
- Integrated Pathology Unit, Institute of Cancer Research and Royal Marsden Hospital, London SW7 3RP, UK
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Hoff CO, Manzi J, Ferreira R, Chauhan A, Housein P, Merchant N, Livingstone A, Vianna R, Abreu P. A neuroendocrine biomarker revolution from monoanalyte to multianalyte biomarkers in non-functioning gastro-entero-pancreatic neuroendocrine neoplasms. Crit Rev Oncol Hematol 2024; 203:104460. [PMID: 39153703 DOI: 10.1016/j.critrevonc.2024.104460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/19/2024] Open
Abstract
Neuroendocrine neoplasms (NENs) arise from neuroendocrine cells in a wide variety of organs. One of the most affected disease sites is the gastrointestinal system, which originates the gastro-entero-pancreatic NENs (GEP-NENs), a heterogenous group of malignancies that are rapidly increasing in incidence. These tumors can be functioning, with secretory activity leading to identifiable clinical syndromes, or non-functioning, with no secretory activity but with local symptoms of tumor growth and metastasis. A limitation in biomarkers is a crucial unmet need in non-secretory NEN management, as clinical decision-making is made more difficult by obstacles in tumor classification, prognostic evaluation, assessment of treatment response and surveillance. The objective of this review is to present existing and novel biomarkers for NENs that can function as prognostic factors and monitor disease progression or regression longitudinally, with a special emphasis on innovative research into novel multianalyte biomarkers.
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Affiliation(s)
- Camilla O Hoff
- University of Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil; Miami Transplant Institute, Jackson Memorial Hospital, University of Miami, Miami, USA
| | - Joao Manzi
- University of Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Raphaella Ferreira
- Miami Transplant Institute, Jackson Memorial Hospital, University of Miami, Miami, USA
| | - Aman Chauhan
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, USA
| | - Peter Housein
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, USA
| | - Nipun Merchant
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, USA
| | - Alan Livingstone
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, USA
| | - Rodrigo Vianna
- Miami Transplant Institute, Jackson Memorial Hospital, University of Miami, Miami, USA
| | - Phillipe Abreu
- Division of Transplant Surgery, University of Colorado Anschutz Medical Campus, USA.
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Smits LJH, Siebers AG, Lissenberg-Witte BI, Lansdorp-Vogelaar I, van Kouwen MCA, Tuynman JB, van Grieken NCT, Nagtegaal ID. Risk factors for advanced colorectal neoplasia and colorectal cancer detected at surveillance: a nationwide study in the modern era. Histopathology 2024; 85:627-638. [PMID: 38859766 DOI: 10.1111/his.15235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/10/2024] [Accepted: 05/25/2024] [Indexed: 06/12/2024]
Abstract
AIM Recommendations for surveillance after colonoscopy are based on risk factors for metachronous advanced colorectal neoplasia (AN) and colorectal cancer (CRC). The value of these risk factors remains unclear in populations enriched by individuals with a positive faecal immunochemical test and were investigated in a modern setting. METHODS AND RESULTS This population-based cohort study included all individuals in the Netherlands of ≥55 years old with a first adenoma diagnosis in 2015. A total of 22,471 patients were included. Data were retrieved from the Dutch Nationwide Pathology Databank (Palga). Primary outcomes were metachronous AN and CRC. Patient and polyp characteristics were evaluated by multivariable Cox regression analyses. During follow-up, 2416 (10.8%) patients were diagnosed with AN, of which 557 (2.5% from the total population) were CRC. Adenomas with high-grade dysplasia (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.40-1.83), villous histology (HR 1.91, 95% CI 1.59-2.28), size ≥10 mm (HR 1.12, 95% CI 1.02-1.23), proximal location (HR 1.12, 95% CI 1.02-1.23), two or more adenomas (HR 1.28, 95% CI 1.16-1.41), and serrated polyps ≥10 mm (HR 1.67, 95% CI 1.42-1.97) were independent risk factors for metachronous AN. In contrast, only adenomas with high-grade dysplasia (HR 2.49, 95% CI 1.92-3.24) were an independent risk factor for metachronous CRC. CONCLUSIONS Risk factors for metachronous AN and CRC were identified for populations with access to a faecal immunochemical test (FIT)-based screening programme. If only risk factors for metachronous CRC are considered, a reduction in criteria for surveillance seems reasonable.
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Affiliation(s)
- Lisanne J H Smits
- Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert G Siebers
- Palga: the Dutch Nationwide Pathology Databank, Stichting Palga, Houten, The Netherlands
| | - Birgit I Lissenberg-Witte
- Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Mariette C A van Kouwen
- Department of Gastroenterology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jurriaan B Tuynman
- Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nicole C T van Grieken
- Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
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Kim TH, Woo S, Lee DH, Do RK, Chernyak V. MRI imaging features for predicting macrotrabecular-massive subtype hepatocellular carcinoma: a systematic review and meta-analysis. Eur Radiol 2024; 34:6896-6907. [PMID: 38507054 DOI: 10.1007/s00330-024-10671-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To identify significant MRI features associated with macrotrabecular-massive hepatocellular carcinoma (MTM-HCC), and to assess the distribution of Liver Imaging Radiology and Data System (LI-RADS, LR) category assignments. METHODS PubMed and EMBASE were searched up to March 28, 2023. Random-effects model was constructed to calculate pooled diagnostic odds ratios (DORs) and 95% confidence intervals (CIs) for each MRI feature for differentiating MTM-HCC from NMTM-HCC. The pooled proportions of LI-RADS category assignments in MTM-HCC and NMTM-HCC were compared using z-test. RESULTS Ten studies included 1978 patients with 2031 HCCs (426 (20.9%) MTM-HCC and 1605 (79.1%) NMTM-HCC). Six MRI features showed significant association with MTM-HCC: tumor in vein (TIV) (DOR = 2.4 [95% CI, 1.6-3.5]), rim arterial phase hyperenhancement (DOR =2.6 [95% CI, 1.4-5.0]), corona enhancement (DOR = 2.6 [95% CI, 1.4-4.5]), intratumoral arteries (DOR = 2.6 [95% CI, 1.1-6.3]), peritumoral hypointensity on hepatobiliary phase (DOR = 2.2 [95% CI, 1.5-3.3]), and necrosis (DOR = 4.2 [95% CI, 2.0-8.5]). The pooled proportions of LI-RADS categories in MTM-HCC were LR-3, 0% [95% CI, 0-2%]; LR-4, 11% [95% CI, 6-16%]; LR-5, 63% [95% CI, 55-71%]; LR-M, 12% [95% CI, 6-19%]; and LR-TIV, 13% [95% CI, 6-22%]. In NMTM-HCC, the pooled proportions of LI-RADS categories were LR-3, 1% [95% CI, 0-2%]; LR-4, 8% [95% CI, 3-15%]; LR-5, 77% [95% CI, 71-82%]; LR-M, 5% [95% CI, 3-7%]; and LR-TIV, 6% [95% CI, 2-11%]. MTM-HCC had significantly lower proportion of LR-5 and higher proportion of LR-M and LR-TIV categories. CONCLUSIONS Six MRI features showed significant association with MTM-HCC. Additionally, compared to NMTM-HCC, MTM-HCC are more likely to be categorized LR-M and LR-TIV and less likely to be categorized LR-5. CLINICAL RELEVANCE STATEMENT Several MR imaging features can suggest macrotrabecular-massive hepatocellular carcinoma subtype, which can assist in guiding treatment plans and identifying potential candidates for clinical trials of new treatment strategies. KEY POINTS • Macrotrabecular-massive hepatocellular carcinoma is a subtype of HCC characterized by its aggressive nature and unfavorable prognosis. • Tumor in vein, rim arterial phase hyperenhancement, corona enhancement, intratumoral arteries, peritumoral hypointensity on hepatobiliary phase, and necrosis on MRI are indicative of macrotrabecular-massive hepatocellular carcinoma. • Various MRI characteristics can be utilized for the diagnosis of the macrotrabecular-massive hepatocellular carcinoma subtype. This can prove beneficial in guiding treatment decisions and identifying potential candidates for clinical trials involving novel treatment approaches.
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Affiliation(s)
- Tae-Hyung Kim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sungmin Woo
- Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Richard K Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Victoria Chernyak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Li J, Zou L, Ma H, Zhao J, Wang C, Li J, Hu G, Yang H, Wang B, Xu D, Xia Y, Jiang Y, Jiang X, Li N. Interpretable machine learning based on CT-derived extracellular volume fraction to predict pathological grading of hepatocellular carcinoma. Abdom Radiol (NY) 2024; 49:3383-3396. [PMID: 38703190 DOI: 10.1007/s00261-024-04313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE To develop a non-invasive auxiliary assessment method based on CT-derived extracellular volume (ECV) to predict the pathological grading (PG) of hepatocellular carcinoma (HCC). METHODS The study retrospectively analyzed 238 patients who underwent HCC resection surgery between January 2013 and April 2023. Six machine learning algorithms were employed to construct predictive models for HCC PG: logistic regression, extreme gradient boosting, Light Gradient Boosting Machine (LightGBM), random forest, adaptive boosting, and Gaussian naive Bayes. Model performance was evaluated using receiver operating characteristic curve analysis, including area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F1 score. Calibration plots were used for visual evaluation of model calibration. Clinical decision curve analysis was performed to assess potential clinical utility by calculating net benefit. RESULTS 166 patients from Hospital A were allocated to the training set, while 72 patients from Hospital B (constituting 30.25% of the total sample) were assigned to the test set. The model achieved an AUC of 1.000 (95%CI: 1.000-1.000) in the training set and 0.927 (95%CI: 0.837-0.999) in the validation set, respectively. Ultimately, the model achieved an AUC of 0.909 (95%CI: 0.837-0.980) in the test set, with an accuracy of 0.778, sensitivity of 0.906, specificity of 0.789, negative predictive value of 0.556, and F1 score of 0.908. CONCLUSION This study successfully developed and validated a non-invasive auxiliary assessment method based on CT-derived ECV to predict the HCC PG, providing important supplementary information for clinical decision-making.
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Affiliation(s)
- Jie Li
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China
| | - Linxuan Zou
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, China
| | - Jifu Zhao
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China
| | - Chengyan Wang
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China
| | - Jun Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264000, China
| | - Guangchao Hu
- School of Medical Imaging, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, 264003, China
| | - Haoran Yang
- School of Medical Imaging, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, 264003, China
| | - Beizhong Wang
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China
| | - Donghao Xu
- School of Medical Imaging, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, 264003, China
| | - Yuanhao Xia
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, China
- School of Medical Imaging, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, 264003, China
| | - Yi Jiang
- Department of Vascular Interventional Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264000, China
| | - Xingyue Jiang
- Department of Radiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Bincheng District, Binzhou, 256600, China.
| | - Naixuan Li
- Department of Vascular Interventional Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264000, China.
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Gu JX, Huang K, Zhao WL, Zheng XM, Wu YQ, Yan SR, Huang YG, Hu P. NCAPD2 augments the tumorigenesis and progression of human liver cancer via the PI3K‑Akt‑mTOR signaling pathway. Int J Mol Med 2024; 54:84. [PMID: 39092569 PMCID: PMC11315656 DOI: 10.3892/ijmm.2024.5408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024] Open
Abstract
Non‑SMC condensin I complex subunit D2 (NCAPD2) is a newly identified oncogene; however, the specific biological function and molecular mechanism of NCAPD2 in liver cancer progression remain unknown. In the present study, the aberrant expression of NCAPD2 in liver cancer was investigated using public tumor databases, including TNMplot, The Cancer Genome Atlas and the International Cancer Genome Consortium based on bioinformatics analyses, and it was validated using a clinical cohort. It was revealed that NCAPD2 was significantly upregulated in liver cancer tissues compared with in control liver tissues, and NCAPD2 served as an independent prognostic factor and predicted poor prognosis in liver cancer. In addition, the expression of NCAPD2 was positively correlated with the percentage of Ki67+ cells. Finally, single‑cell sequencing data, gene‑set enrichment analyses and in vitro investigations, including cell proliferation assay, Transwell assay, wound healing assay, cell cycle experiments, cell apoptosis assay and western blotting, were carried out in human liver cancer cell lines to assess the biological mechanisms of NCAPD2 in patients with liver cancer. The results revealed that the upregulation of NCAPD2 enhanced tumor cell proliferation, invasion and cell cycle progression at the G2/M‑phase transition, and inhibited apoptosis in liver cancer cells. Furthermore, NCAPD2 overexpression was closely associated with the phosphatidylinositol 3‑kinase (PI3K)‑Akt‑mammalian target of rapamycin (mTOR)/c‑Myc signaling pathway and epithelial‑mesenchymal transition (EMT) progression in HepG2 and Huh7 cells. In addition, upregulated NCAPD2 was shown to have adverse effects on overall survival and disease‑specific survival in liver cancer. In conclusion, the overexpression of NCAPD2 was shown to lead to cell cycle progression at the G2/M‑phase transition, activation of the PI3K‑Akt‑mTOR/c‑Myc signaling pathway and EMT progression in human liver cancer cells.
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Affiliation(s)
- Jiang-Xue Gu
- Department of Laboratory Medicine and Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Ke Huang
- Department of Laboratory Medicine and Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Wei-Lin Zhao
- Department of Laboratory Medicine and Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Xiao-Ming Zheng
- Central Operating Room, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Yu-Qin Wu
- Central Operating Room, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Shi-Rong Yan
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
- Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Yu-Gang Huang
- Department of Laboratory Medicine and Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Pei Hu
- Department of Laboratory Medicine and Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
- Institute of Biomedical Research, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Hepatocellular Carcinoma, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
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9
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Dos Santos Soares F, de Carvalho JR, de Lima BAM, Felix RCM, Bulzico DA, Pujatti PB. Improvement of Laboratory Hepatic Parameters After Treatment With 177 Lu-DOTATATE : Cohort in an Oncology Reference Center. Clin Nucl Med 2024; 49:917-923. [PMID: 39087646 DOI: 10.1097/rlu.0000000000005375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE Well-differentiated neuroendocrine neoplasms (NETs) overexpress the somatostatin receptor, which is the target for the peptide receptor radionuclide therapy (PRRT). NETs have a slow growth rate and can metastasize to liver, bone, and lungs. In NETs patients, liver metastasis is an important prognostic marker because liver failure is one of the most common causes of death in this population. In this regard, we aimed to describe the changes in laboratorial parameters in patients submitted to PRRT with 177 Lu-DOTATATE, focusing on hepatic parameters. PATIENTS AND METHODS One hundred ten patients treated with 1 to 4 cycles of 7.4 GBq (200 mCi) of 177 Lu-DOTATATE from January 2011 to December 2021 were analyzed in this retrospective observational single-center study. Patients were submitted to blood tests before and after each cycle of PRRT. Laboratory measurements were collected to assess liver function, cholestasis, kidney, and bone marrow function. RESULTS In the general population (n = 110), ALP ( P = 0.013) and GGT ( P < 0.001) showed a statistically significant reduction. Patients with high liver disease volume showed a statistically significant reduction in ALT ( P = 0.016), whereas patients with low liver disease volume showed a statistically significant reduction in GGT ( P = 0.013). All parameters for bone marrow function showed a statistically significant decrease in all population subsets. CONCLUSIONS Patients treated with 177 Lu-DOTATATE showed a significant improvement in liver function and cholestasis parameters, and a consistent decrease in bone marrow function, even in the presence of advanced liver disease.
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Kastinen M, Sirniö P, Elomaa H, Äijälä VK, Karjalainen H, Tapiainen VV, Pohjanen VM, Kemppainen J, Sliashynskaya K, Ahtiainen M, Rintala J, Meriläinen S, Rautio T, Saarnio J, Mattila TT, Lindgren O, Wirta EV, Helminen O, Seppälä TT, Böhm J, Mecklin JP, Tuomisto A, Mäkinen MJ, Väyrynen JP. Establishing Criteria for Tumor Necrosis as Prognostic Indicator in Colorectal Cancer. Am J Surg Pathol 2024; 48:1284-1292. [PMID: 39004843 PMCID: PMC11404753 DOI: 10.1097/pas.0000000000002286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Tumor necrosis has been reported to represent an independent prognostic factor in colorectal cancer, but its evaluation methods have not been described in sufficient detail to introduce tumor necrosis evaluation into clinical use. To study the potential of tumor necrosis as a prognostic indicator in colorectal cancer, criteria for 3 methods for its evaluation were defined: the average percentage method (tumor necrosis percentage of the whole tumor), the hotspot method (tumor necrosis percentage in a single hotspot), and the linear method (the diameter of the single largest necrotic focus). Cox regression models were used to calculate cancer-specific mortality hazard ratios (HRs) for tumor necrosis categories in 2 colorectal cancer cohorts with more than 1800 cases. For reproducibility assessment, 30 cases were evaluated by 9 investigators, and Spearman's rank correlation coefficients and Cohen's kappa coefficients were calculated. We found that all 3 methods predicted colorectal cancer-specific survival independent of other prognostic parameters, including disease stage, lymphovascular invasion, and tumor budding. The greatest multivariable HRs were observed for the average percentage method (cohort 1: HR for ≥ 40% vs. <3% 3.03, 95% CI, 1.93-4.78; cohort 2: HR for ≥ 40% vs. < 3% 2.97; 95% CI, 1.63-5.40). All 3 methods had high reproducibility, with the linear method showing the highest mean Spearman's correlation coefficient (0.91) and Cohen's kappa (0.70). In conclusion, detailed criteria for tumor necrosis evaluation were established. All 3 methods showed good reproducibility and predictive ability. The findings pave the way for the use of tumor necrosis as a prognostic factor in colorectal cancer.
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Affiliation(s)
- Meeri Kastinen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Päivi Sirniö
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Hanna Elomaa
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä
- Department of Education and Research, Central Finland Health Care District, Jyväskylä
| | - Ville K Äijälä
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Henna Karjalainen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Vilja V Tapiainen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Vesa-Matti Pohjanen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Janette Kemppainen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Katja Sliashynskaya
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Maarit Ahtiainen
- Department of Pathology, Central Finland Health Care District, Jyväskylä
| | - Jukka Rintala
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Sanna Meriläinen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Tero Rautio
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Juha Saarnio
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Taneli T Mattila
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Outi Lindgren
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Erkki-Ville Wirta
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere
- Faculty of Medicine and Health Technology, Tampere University and Tays Cancer Centre, Tampere University Hospital, Tampere
| | - Olli Helminen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Toni T Seppälä
- Faculty of Medicine and Health Technology, Tampere University and Tays Cancer Centre, Tampere University Hospital, Tampere
- Department of Gastrointestinal Surgery, Helsinki University Central Hospital, University of Helsinki, Helsinki
- Applied Tumor Genomics, Research Program Unit, University of Helsinki, Helsinki
| | - Jan Böhm
- Department of Pathology, Central Finland Health Care District, Jyväskylä
| | - Jukka-Pekka Mecklin
- Department of Education and Research, Central Finland Health Care District, Jyväskylä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anne Tuomisto
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Markus J Mäkinen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
| | - Juha P Väyrynen
- Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu
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11
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Seager A, Sharp L, Neilson LJ, Brand A, Hampton JS, Lee TJW, Evans R, Vale L, Whelpton J, Bestwick N, Rees CJ. Polyp detection with colonoscopy assisted by the GI Genius artificial intelligence endoscopy module compared with standard colonoscopy in routine colonoscopy practice (COLO-DETECT): a multicentre, open-label, parallel-arm, pragmatic randomised controlled trial. Lancet Gastroenterol Hepatol 2024; 9:911-923. [PMID: 39153491 DOI: 10.1016/s2468-1253(24)00161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Increased polyp detection during colonoscopy is associated with decreased post-colonoscopy colorectal cancer incidence and mortality. The COLO-DETECT trial aimed to assess the clinical effectiveness of the GI Genius intelligent endoscopy module for polyp detection, comparing colonoscopy assisted by GI Genius (computer-aided detection [CADe]-assisted colonoscopy) with standard colonoscopy in routine practice. METHODS We did a multicentre, open-label, parallel-arm, pragmatic randomised controlled trial in 12 National Health Service (NHS) hospitals (ten NHS Trusts) in England, among adults (aged ≥18 years) undergoing planned colonoscopy for gastrointestinal symptoms or for surveillance due to personal or family history (ie, symptomatic indications), or colorectal cancer screening. Randomisation (1:1) to CADe-assisted colonoscopy or standard colonoscopy was done with a web-based dynamic adaptive algorithm, immediately before colonoscopy, with stratification by age group, sex, colonoscopy indication (screening or symptomatic), and NHS Trust. Recruiting staff, participants, and colonoscopists were unmasked to trial allocation; histopathologists, co-chief investigators, and trial statisticians were masked. CADe-assisted colonoscopy consisted of standard colonoscopy plus the GI Genius module active for at least the entire inspection phase of colonoscope withdrawal. The primary outcome was mean adenomas per procedure (total number of adenomas detected divided by total number of procedures); the key secondary outcome was adenoma detection rate (proportion of colonoscopies with at least one adenoma). Analysis was by intention to treat (ITT), with outcomes compared between groups by mixed-effects regression modelling, in which effect estimates were adjusted for randomisation stratification variables. Data were imputed for outcome measures with more than 5% missing values. All participants who underwent colonoscopy were assessed for safety. The trial is registered on ISRCTN (ISRCTN10451355) and ClinicalTrials.gov (NCT04723758), and is complete. FINDINGS Between March 29, 2021, and April 6, 2023, 2032 participants (1132 [55·7%] male, 900 [44·3%] female; mean age 62·4 years [SD 10·8]) were recruited and randomly assigned: 1015 to CADe-assisted colonoscopy and 1017 to standard colonoscopy. 1231 (60·6%) participants were undergoing screening and 801 (39·4%) had symptomatic indications. Mean adenomas per procedure was 1·56 (SD 2·82; n=1001 participants with available data) in the CADe-assisted colonoscopy group versus 1·21 (1·91; n=1009) in the standard colonoscopy group, representing an adjusted mean difference of 0·36 (95% CI 0·14-0·57; adjusted incidence rate ratio 1·30 [95% CI 1·15-1·47], p<0·0001). Adenomas were detected in 555 (56·6%) of 980 participants in the CADe-assisted colonoscopy group versus 477 (48·4%) of 986 in the standard colonoscopy group, representing a proportion difference of 8·3% (95% CI 3·9-12·7; adjusted odds ratio 1·47 [95% CI 1·21-1·78], p<0·0001). Numbers of adverse events were similar between the CADe-assisted colonoscopy and standard colonoscopy groups (adverse events: 25 vs 19; serious adverse events: four vs six), and no adverse events in the CADe-assisted colonoscopy group were deemed to be related to GI Genius use on independent review. INTERPRETATION Results of the COLO-DETECT trial support the use of GI Genius to increase detection of premalignant colorectal polyps in routine colonoscopy practice. FUNDING Medtronic.
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Affiliation(s)
- Alexander Seager
- Department of Research and Innovation, South Tyneside and Sunderland NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK; Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Laura J Neilson
- Department of Gastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK; Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Andrew Brand
- North Wales Organisation for Randomised Trials in Health, Clinical Trials Unit, Bangor University, Bangor, UK
| | - James S Hampton
- Department of Research and Innovation, South Tyneside and Sunderland NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK; Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Tom J W Lee
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Department of Gastroenterology, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Rachel Evans
- North Wales Organisation for Randomised Trials in Health, Clinical Trials Unit, Bangor University, Bangor, UK
| | - Luke Vale
- Newcastle University-Health Economics Group, Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Nathania Bestwick
- Department of Research and Innovation, South Tyneside and Sunderland NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK; Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Bowel Cancer UK, London, UK
| | - Colin J Rees
- Department of Gastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK; Population Health Sciences Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
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12
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Oppat KM, Bennett FJ, Maithel SK. A Review of the Indications, Outcomes, and Postoperative Management After Total and Completion Pancreatectomy for Pancreatic Cancer: More Is Not Necessarily Better. Surg Clin North Am 2024; 104:1049-1064. [PMID: 39237163 DOI: 10.1016/j.suc.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
With improvements in surgical technique and advances in pancreatic endocrine and exocrine replacement therapy, the indications for, and threshold to perform, total or completion pancreatectomy in the modern surgical era are ever evolving. The following review will evaluate such indications for pancreatic cancer including pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasms. The authors also review the literature on oncologic outcomes of total and completion pancreatectomy for pancreatic cancer. Finally, they discuss the quality of life and postoperative management of the a-pancreatic state.
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Affiliation(s)
- Kailey M Oppat
- Emory University, 1365B Clifton Road, NE Building B, Suite 4100, Office 4202, Atlanta, GA 30302, USA
| | - Frances J Bennett
- Emory University, 1365B Clifton Road, NE Building B, Suite 4100, Office 4202, Atlanta, GA 30302, USA
| | - Shishir K Maithel
- Emory University, 1365B Clifton Road, NE Building B, Suite 4100, Office 4202, Atlanta, GA 30302, USA.
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13
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Ma Y, Yang Y, Zhang H, Mugaanyi J, Hu Y, Wu S, Lu C, Mao S, Wang K. Sarcomatoid carcinoma of the pancreas (Review). Oncol Lett 2024; 28:477. [PMID: 39161336 PMCID: PMC11332573 DOI: 10.3892/ol.2024.14610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/20/2024] [Indexed: 08/21/2024] Open
Abstract
Sarcomatoid carcinoma of the pancreas (SCP) is a rare and aggressive subtype of undifferentiated pancreatic ductal adenocarcinoma, with a generally poor prognosis and only sporadic cases reported worldwide. Histologically, the most notable feature of SCP is the presence of abundant of mesenchymatoid spindle tumor cells in the tumor, which lack glandular differentiation. Immunohistochemically, SCP is characterized by the expression of both mesenchymal and epithelial markers. With only a few reported cases, there is limited knowledge about its molecular and clinicopathological characteristics. Therefore, the present study performed a literature search to identify all relevant published studies. The present review provides an overview of the histogenesis, diagnosis, genetic features, prognosis and treatment of SCP, specifically focusing on the molecular alterations. Furthermore, a single-center experience is reported, which adds to the limited evidence available in the literature.
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Affiliation(s)
- Yijie Ma
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Yiwen Yang
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Huizhi Zhang
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Joseph Mugaanyi
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Yangke Hu
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Shengdong Wu
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Caide Lu
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Shuqi Mao
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
| | - Ke Wang
- Department of Hepatobiliary Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang 315048, P.R. China
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14
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Fang D, Wu L, Gan BL, Guo CL, Chen ZH, Zhou SA, Wu F, QunXu L, Chen ZR, Shi N, Jin HS. Impact of prior SARS-CoV-2 infection on postoperative recovery in patients with hepatocellular carcinoma resection. BMC Gastroenterol 2024; 24:317. [PMID: 39289600 DOI: 10.1186/s12876-024-03412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND The impact of prior SARS-CoV-2 infection on postoperative recovery of patients who underwent liver resection for hepatocellular carcinoma (HCC) remains uncertain given the lack of sufficient evidence. AIM To investigate the impact of prior SARS-CoV-2 infection on postoperative recovery of patients who underwent liver resection for hepatocellular carcinoma (HCC). METHODS Patients who were pathologically diagnosed with HCC and underwent elective partial hepatectomy in Guangdong Provincial People's Hospital between January 2022 and April 2023 were enrolled in this retrospective cohort study. The patients were divided into two groups based on their history of SARS-CoV-2 infection. Rehabilitation parameters, including postoperative liver function, incidence of complications, and hospitalization expenses, were compared between the two groups. Propensity score matching (PSM) was performed to reduce confounding bias. RESULTS We included 172 patients (58 with and 114 without prior SARS-CoV-2 infection) who underwent liver resection for HCC. No significant differences in the rehabilitation parameters were observed between the two groups. After PSM, 58 patients were selected from each group to form the new comparative groups. Similar results were obtained within the population after PSM. CONCLUSION Prior SARS-CoV-2 infection does not appear to affect postoperative rehabilitation, including liver function, postoperative complications, or hospitalization expenses among patients with HCC after elective partial hepatectomy.
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Affiliation(s)
- Dan Fang
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Lei Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Bi-Ling Gan
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Chu-Lin Guo
- Huankui Academy, Nanchang University, Nanchang, China
| | | | - Shun-An Zhou
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Fan Wu
- Peking Union Medical College, Beijing, China
| | - Lian- QunXu
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Zhen-Rong Chen
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Ning Shi
- Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangzhou, China.
| | - Hao-Sheng Jin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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15
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Zhang S, Cheng G, Zhu S, Lin D, Wu C. Protocol for the generation, characterization, and functional assays of organoid cultures from normal and cancer-prone human esophageal tissues. STAR Protoc 2024; 5:103316. [PMID: 39277865 DOI: 10.1016/j.xpro.2024.103316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/29/2024] [Accepted: 08/22/2024] [Indexed: 09/17/2024] Open
Abstract
Multiple sampling strategies to cover different or dynamic stages of malignant continuum with organoid cultures provide a valuable platform for epithelium homeostasis, transformation, and cancer progression. Here, we present a protocol to initiate, culture, passage, and characterize organoids from normal and cancer-prone human esophageal tissues. We describe steps for multiple sampling of malignant continuum and the initiation and maintenance of multi-stage organoids. We then detail procedures for the histological characterization of organoids and co-culture systems based on organoids and stromal cells. For complete details on the use and execution of this protocol, please refer to Chen et al.1.
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Affiliation(s)
- Shaosen Zhang
- Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China.
| | - Guoyu Cheng
- Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China
| | - Shihao Zhu
- Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China
| | - Dongxin Lin
- Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China; Key Laboratory of Cancer Genomic Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Changping Laboratory, Beijing 102206, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing 211166, China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Chen Wu
- Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China; Key Laboratory of Cancer Genomic Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Changping Laboratory, Beijing 102206, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing 211166, China; CAMS Oxford Institute, Chinese Academy of Medical Sciences, Beijing 100006, China
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16
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Lopez-Ramirez F, Soleimani S, Azadi JR, Sheth S, Kawamoto S, Javed AA, Tixier F, Hruban RH, Fishman EK, Chu LC. Radiomics machine learning algorithm facilitates detection of small pancreatic neuroendocrine tumors on CT. Diagn Interv Imaging 2024:S2211-5684(24)00172-4. [PMID: 39278763 DOI: 10.1016/j.diii.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/15/2024] [Accepted: 08/22/2024] [Indexed: 09/18/2024]
Abstract
PURPOSE The purpose of this study was to develop a radiomics-based algorithm to identify small pancreatic neuroendocrine tumors (PanNETs) on CT and evaluate its robustness across manual and automated segmentations, exploring the feasibility of automated screening. MATERIALS AND METHODS Patients with pathologically confirmed T1 stage PanNETs and healthy controls undergoing dual-phase CT imaging were retrospectively identified. Manual segmentation of pancreas and tumors was performed, then automated pancreatic segmentations were generated using a pretrained neural network. A total of 1223 radiomics features were independently extracted from both segmentation volumes, in the arterial and venous phases separately. Ten final features were selected to train classifiers to identify PanNETs and controls. The cohort was divided into training and testing sets, and performance of classifiers was assessed using area under the receiver operator characteristic curve (AUC), specificity and sensitivity, and compared against two radiologists blinded to the diagnoses. RESULTS A total of 135 patients with 142 PanNETs, and 135 healthy controls were included. There were 168 women and 102 men, with a mean age of 55.4 ± 11.6 (standard deviation) years (range: 20-85 years). Median PanNET size was 1.3 cm (Q1, 1.0; Q3, 1.5; range: 0.5-1.9). The arterial phase LightGBM model achieved the best performance in the test set, with 90 % sensitivity (95 % confidence interval [CI]: 80-98), 76 % specificity (95 % CI: 62-88) and an AUC of 0.87 (95 % CI: 0.79-0.94). Using features from the automated segmentations, this model achieved an AUC of 0.86 (95 % CI: 0.79-0.93). In comparison, the two radiologists achieved a mean 50 % sensitivity and 100 % specificity using arterial phase CT images. CONCLUSION Radiomics features identify small PanNETs, with stable performance when extracted using automated segmentations. These models demonstrate high sensitivity, complementing the high specificity of radiologists, and could serve as opportunistic screeners.
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Affiliation(s)
- Felipe Lopez-Ramirez
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sahar Soleimani
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Javad R Azadi
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sheila Sheth
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Satomi Kawamoto
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Ammar A Javed
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Florent Tixier
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Ralph H Hruban
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Elliot K Fishman
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Linda C Chu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Liu Y, Esnakula AK, Jain S, Lin J, Panarelli N, Pyatibrat S, Karamchandani DM. Spectra of well-differentiated neuroendocrine lesions in the extrahepatic biliary system: a case series. Histopathology 2024. [PMID: 39267205 DOI: 10.1111/his.15316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/14/2024]
Abstract
AIMS Neuroendocrine tumours (NETs) occurring in the extrahepatic biliary system are exceedingly rare. While NETs typically manifest as mass lesions, the occurrence of microscopic neuroendocrine cell proliferation without a distinct mass remains undocumented at this location. This study aims to characterise the clinicopathological features of a series of well-differentiated neuroendocrine lesions involving the extrahepatic biliary tree, including mass forming NETs and microscopic non-mass-forming neuroendocrine cell proliferation, designated neuroendocrine cell micronests (NCMs). METHODS AND RESULTS Surgical resections of NETs/NCMs involving the extrahepatic bile ducts and gallbladder were identified from electronic pathology databases among seven institutions spanning from January 2011 to September 2023. Clinical and histological findings were recorded. Ten patients (four female, six male: age range = 34-75 years) were included in the study. Histopathological examination revealed visible mass-forming lesions in four cases (1.6-14.0 cm in size), identified in the gallbladder (n = two) or extrahepatic bile duct (n = two), all diagnosed as well-differentiated NETs. The remaining six cases revealed incidental non-mass-forming NCMs in either the cystic duct (n = two), common bile duct (n = three) or gallbladder (n = one), ranging from < 0.1 to 0.4 cm; four were associated with biliary lithiasis. No evidence of metastasis or recurrence was seen in the follow-up period (range = 0.1-11.2 years). CONCLUSIONS This study highlights the spectrum of extrahepatic biliary well-differentiated neuroendocrine lesions, ranging from incidental microscopic NCMs to grossly apparent mass-forming NETs, potentially requiring different clinical management. Noteworthy is the frequent association of incidental microscopic neuroendocrine cell proliferations with biliary lithiasis, indicating a potential neuroendocrine metaplastic pathogenesis that merits further exploration.
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Affiliation(s)
- Yongjun Liu
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Ashwini K Esnakula
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Shilpa Jain
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | - Jingmei Lin
- Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Nicole Panarelli
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY, USA
| | - Sergey Pyatibrat
- Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
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18
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Ecker BL, Seier K, Eckhoff AM, Tortorello GN, Allen PJ, Balachandran VP, Blackburn N, D'Angelica MI, DeMatteo RP, Blazer DG, Drebin JA, Fisher WE, Fortuna D, Gill AJ, Gingras MC, Kingham TP, Lee MK, Lidsky ME, Nussbaum DP, Overman MJ, Samra JS, Shen R, Sigel CS, Soares KC, Vollmer CM, Wei AC, Zani S, Roses RE, Gonen M, Jarnagin WR. Genome-Derived Ampullary Adenocarcinoma Classifier and Postresection Prognostication. JAMA Surg 2024:2823529. [PMID: 39259526 PMCID: PMC11391358 DOI: 10.1001/jamasurg.2024.3588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Importance Ampullary adenocarcinoma (AA) is characterized by clinical and genomic heterogeneity. A previously developed genomic classifier defined biologically distinct phenotypes with greater accuracy than standard histologic classification. External validation is needed before routine clinical use. Objective To test external validity of the prognostic value of the hidden genome classifier of AA. Design, Setting, and Participants This retrospective cohort study took place at 6 international academic institutions. Consecutive patients (n = 192) who underwent curative-intent resection of histologically confirmed AA were included. The data were analyzed from January 2005 through July 2020. Exposures The multilevel meta-feature regression model previously trained on a prospectively sequenced cohort of 3411 patients (1001 pancreatic adenocarcinoma, 165 distal bile duct adenocarcinoma, and 2245 colorectal adenocarcinoma) was applied to AA sequencing data to quantify the relative proportions of parental cell of origin. Main Outcome and Measures Genomic classification was correlated with immunohistologic subtype (intestinal [INT] or pancreatobiliary [PB]) and with overall survival (OS), using the log-rank test and Cox proportional hazard models. Results Among 192 patients with AA (median age, 69.0 [IQR, 60.0-74.0] years and 134 were male [64%]), concordance between immunohistologic and genomic subtypes was 55%. Most INT subtype tumors were categorized into the colorectal genomic subtype (43 of 57 [72.9%]). Of the 114 PB subtype tumors, 29 had a pancreatic genomic profile (25.4%) and 24 had a distal bile duct genomic profile (21.1%). Whereas the standard immunohistologic subtypes were not associated with survival (log rank P = .26), predicted genomic probabilities were correlated with survival probability. Genomic scores with higher colorectal probability were associated with higher survival probability; higher pancreatic and distal bile duct probabilities were associated with lower survival probability. Conclusions and Relevance The AA genomic classifier is reproducible with available molecular testing in a diverse international cohort of patients and improves stratification of the divergent clinical outcomes beyond standard immunohistologic classification. These data provide a molecular classification that may be incorporated into clinical trials for prospective validation.
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Affiliation(s)
- Brett L Ecker
- Division of Surgical Oncology, Rutgers Cancer Institute, New Brunswick, New Jersey
| | - Kenneth Seier
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Austin M Eckhoff
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Gabriella N Tortorello
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Peter J Allen
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Vinod P Balachandran
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nicola Blackburn
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, 370 Victoria Street, Darlinghurst, Sydney, New South Wales, Australia
| | - Michael I D'Angelica
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ronald P DeMatteo
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Daniel G Blazer
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Jeffrey A Drebin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William E Fisher
- Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Danielle Fortuna
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anthony J Gill
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, 370 Victoria Street, Darlinghurst, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Westbourne Street, St Leonards, New South Wales, Australia
| | - Marie-Claude Gingras
- Department of Molecular and Human Genetics, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - T Peter Kingham
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Major K Lee
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Michael E Lidsky
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Daniel P Nussbaum
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Michael J Overman
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jaswinder S Samra
- Royal North Shore Hospital, Westbourne Street, St Leonards, New South Wales, Australia
| | - Ronglai Shen
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Carlie S Sigel
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kevin C Soares
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles M Vollmer
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alice C Wei
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sabino Zani
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Robert E Roses
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mithat Gonen
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William R Jarnagin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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19
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Wang Y, Zang F, Shao B, Gao Y, Yang H, Guo Y, Ding T, Sun B. From bioinformatics to clinical applications: a novel prognostic model of cuproptosis-related genes based on single-cell RNA sequencing data in hepatocellular carcinoma. BMC Immunol 2024; 25:59. [PMID: 39251909 PMCID: PMC11382408 DOI: 10.1186/s12865-024-00649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024] Open
Abstract
OBJECTIVE AND METHODS To ascertain the connection between cuproptosis-related genes (CRGs) and the prognosis of hepatocellular carcinoma (HCC) via single-cell RNA sequencing (scRNA-seq) and RNA sequencing (RNA-seq) data, relevant data were downloaded from the GEO and TCGA databases. The differentially expressed CRGs (DE-CRGs) were filtered by the overlaps in differentially expressed genes (DEGs) between HCC patients and normal controls (NCs) in the scRNA-seq database, DE-CRGs between high- and low-CRG-activity cells, and DEGs between HCC patients and NCs in the TCGA database. RESULTS Thirty-three DE-CRGs in HCC were identified. A prognostic model (PM) was created employing six survival-related genes (SRGs) (NDRG2, CYB5A, SOX4, MYC, TM4SF1, and IFI27) via univariate Cox regression analysis and LASSO. The predictive ability of the model was validated via a nomogram and receiver operating characteristic curves. Research has employed tumor immune dysfunction and exclusion as a means to examine the influence of PM on immunological heterogeneity. Macrophage M0 levels were significantly different between the high-risk group (HRG) and the low-risk group (LRG), and a greater macrophage level was linked to a more unfavorable prognosis. The drug sensitivity data indicated a substantial difference in the half-maximal drug-suppressive concentrations of idarubicin and rapamycin between the HRG and the LRG. The model was verified by employing public datasets and our cohort at both the protein and mRNA levels. CONCLUSION A PM using 6 SRGs (NDRG2, CYB5A, SOX4, MYC, TM4SF1, and IFI27) was developed via bioinformatics research. This model might provide a fresh perspective for assessing and managing HCC.
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Affiliation(s)
- Yong Wang
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China.
| | - Fenglin Zang
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Bing Shao
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Yanan Gao
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Haicui Yang
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Yuhong Guo
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Tingting Ding
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
| | - Baocun Sun
- Department of Pathology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, Tianjin, 300060, China
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20
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Niedra H, Peculis R, Saksis R, Mandrika I, Vilisova S, Nazarovs J, Breiksa A, Gerina A, Earl J, Ruz-Caracuel I, Rosas MG, Pukitis A, Senterjakova N, Rovite V. Tumor and α-SMA-expressing stromal cells in pancreatic neuroendocrine tumors have a distinct RNA profile depending on tumor grade. Mol Oncol 2024. [PMID: 39245631 DOI: 10.1002/1878-0261.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 07/12/2024] [Accepted: 08/22/2024] [Indexed: 09/10/2024] Open
Abstract
Alpha-smooth muscle actin (α-SMA) expression in the stroma is linked to the presence of cancer-associated fibroblasts and is known to correlate with worse outcomes in various tumors. In this study, using a GeoMx digital spatial profiling approach, we characterized the gene expression of the tumor and α-SMA-expressing stromal cell compartments in pancreatic neuroendocrine tumors (PanNETs). The profiling was performed on tissues from eight retrospective cases (three grade 1, four grade 2, and one grade 3). Selected regions of interest were segmented geometrically based on tissue morphology and fluorescent signals from synaptophysin and α-SMA markers. The α-SMA-expressing stromal-cell-associated genes were involved in pathways of extracellular matrix modification, whereas, in tumor cells, the gene expression profiles were associated with pathways involved in cell proliferation. The comparison of gene expression profiles across all three PanNET grades revealed that the differences between grades are not only present at the level of the tumor but also in the α-SMA-expressing stromal cells. Furthermore, the tumor cells from regions with a rich presence of adjacent α-SMA-expressing stromal cells revealed an upregulation of matrix metalloproteinase-9 (MMP9) expression in grade 3 tumors. This study provides an in-depth characterization of gene expression profiles in α-SMA-expressing stromal and tumor cells, and outlines potential crosstalk mechanisms.
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Affiliation(s)
- Helvijs Niedra
- Department of Molecular and Functional Genomics, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Raitis Peculis
- Department of Molecular and Functional Genomics, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Rihards Saksis
- Department of Molecular and Functional Genomics, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Ilona Mandrika
- Department of Molecular and Functional Genomics, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Sofija Vilisova
- Oncology clinic, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Jurijs Nazarovs
- Institute of Pathology, Pauls Stradins Clinical University Hospital, Riga, Latvia
- Department of Pathology, Riga Stradins University, Latvia
| | - Austra Breiksa
- Institute of Pathology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Aija Gerina
- Oncology clinic, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Julie Earl
- Ramón y Cajal Health Research Institute (IRYCIS), Ramón y Cajal University Hospital. Ctra. Colmenar Viejo, CIBERONC, Madrid, Spain
| | - Ignacio Ruz-Caracuel
- Ramón y Cajal Health Research Institute (IRYCIS), Ramón y Cajal University Hospital. Ctra. Colmenar Viejo, CIBERONC, Madrid, Spain
- Department of Pathology, Ramón y Cajal University Hospital. Ctra, Colmenar Viejo, Madrid, Spain
| | - Marta Gabriela Rosas
- Department of Pathology, Ramón y Cajal University Hospital. Ctra, Colmenar Viejo, Madrid, Spain
| | - Aldis Pukitis
- Centre of Gastroenterology, Hepatology and Nutrition Therapy, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Natalja Senterjakova
- Centre of Gastroenterology, Hepatology and Nutrition Therapy, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Vita Rovite
- Department of Molecular and Functional Genomics, Latvian Biomedical Research and Study Centre, Riga, Latvia
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21
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Sorbye H, Kong G, Grozinsky-Glasberg S, Strosberg J. PRRT in high-grade digestive neuroendocrine neoplasms (NET G3 and NEC). J Neuroendocrinol 2024:e13443. [PMID: 39243213 DOI: 10.1111/jne.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/16/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024]
Abstract
Peptide receptor radionuclide therapy (PRRT) has been primarily studied in low and intermediate-grade digestive neuroendocrine tumors (NET G1-G2). The documentation of a similar benefit for high-grade digestive neuroendocrine neoplasms (NEN) has been limited. This review evaluates the use of PRRT for high-grade digestive NEN (well-differentiated NET G3 and poorly differentiated neuroendocrine carcinomas [NEC]). We identified one phase III trial and seven retrospective studies reporting specifically on PRRT outcome of >10 digestive high-grade NEN patients. The retrospective single-arm studies indicate a benefit for PRRT in NET G3. The randomized phase III NETTER-2 trial demonstrates major PFS superiority of PRRT versus somatostatin analog therapy as the first-line treatment for the NET G3 subgroup. PRRT can now be considered a potential first-line treatment for somatostatin receptor-positive NET G3 patients, but whether it should be the first-line standard of care for all NET G3 patients is still not clarified. For NEC, scarce data are available, and pathologic distinction between NEC and NET G3 can be difficult when Ki-67 is below 55%. PRRT could be considered as a treatment for refractory NEC in very selected cases when there is a high uptake on somatostatin receptor imaging, Ki-67 is below 55%, and there is no rapid tumor progression.
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Affiliation(s)
- Halfdan Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Grace Kong
- Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Simona Grozinsky-Glasberg
- Neuroendocrine Tumor Unit, ENETS Center of Excellence, Division of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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22
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Gonda TA, Cahen DL, Farrell JJ. Pancreatic Cysts. N Engl J Med 2024; 391:832-843. [PMID: 39231345 DOI: 10.1056/nejmra2309041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Affiliation(s)
- Tamas A Gonda
- From the Division of Gastroenterology and Hepatology, Department of Medicine, New York University (NYU) Grossman School of Medicine and NYU Langone Health, New York (T.A.G.); the Division of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands (D.L.C); and the Division of Digestive Diseases, Department of Medicine, Yale University School of Medicine and Yale New Haven Health, New Haven, CT (J.J.F.)
| | - Djuna L Cahen
- From the Division of Gastroenterology and Hepatology, Department of Medicine, New York University (NYU) Grossman School of Medicine and NYU Langone Health, New York (T.A.G.); the Division of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands (D.L.C); and the Division of Digestive Diseases, Department of Medicine, Yale University School of Medicine and Yale New Haven Health, New Haven, CT (J.J.F.)
| | - James J Farrell
- From the Division of Gastroenterology and Hepatology, Department of Medicine, New York University (NYU) Grossman School of Medicine and NYU Langone Health, New York (T.A.G.); the Division of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands (D.L.C); and the Division of Digestive Diseases, Department of Medicine, Yale University School of Medicine and Yale New Haven Health, New Haven, CT (J.J.F.)
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23
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Li J, Yao H, Lu Y, Zhang S, Zhang Z. Chinese national clinical practice guidelines on prevention, diagnosis and treatment of early colorectal cancer. Chin Med J (Engl) 2024; 137:2017-2039. [PMID: 39104005 PMCID: PMC11374253 DOI: 10.1097/cm9.0000000000003253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The incidence and mortality of colorectal cancer (CRC) in China are increasing in recent years. The clarified pathogenesis and detectable precancerous lesions of CRC make it possible to prevent, screen, and diagnose CRC at an early stage. With the development of endoscopic and surgical techniques, the choice of treatment for early CRC is also worth further discussion, and accordingly, a standard follow-up program after treatment needs to be established. METHODS This clinical practice guideline (CPG) was developed following the recommended process of the World Health Organization, adopting Grading of Recommendations Assessment, Development and Evaluation (GRADE) in assessing evidence quality, and using the Evidence to Decision framework to formulate clinical recommendations, thereby minimizing bias and increasing transparency of the CPG development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline's completeness and transparency. RESULTS This CPG comprises 46 recommendations concerning prevention, screening, diagnosis, treatment, and surveillance of CRC. In these recommendations, we have indicated protective and risk factors for CRC and made recommendations for chemoprevention. We proposed a suitable screening program for CRC based on the Chinese context. We also provided normative statements for the diagnosis, treatment, and surveillance of CRC based on existing clinical evidence and guidelines. CONCLUSIONS The 46 recommendations in this CPG are formed with consideration for stakeholders' values and preferences, feasibility, and acceptability. Recommendations are generalizable to resource-limited settings with similar CRC epidemiology pattern as China.
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Affiliation(s)
- Jingnan Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Hongwei Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Yun Lu
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266555, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing 100050, China
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China
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24
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Regmi SM, Regmi P, Paudyal A, Upadhyay D, Lamichhane S, Dahal A, Thatal S, Tiwari A. Tumor budding is associated with poor prognosis and clinicopathologic factors in esophageal carcinoma: A meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108668. [PMID: 39265415 DOI: 10.1016/j.ejso.2024.108668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/24/2024] [Accepted: 09/03/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Tumor budding is associated with the prognosis of several solid cancers, but further evidence is needed to identify its relation with esophageal cancer. Our study aims to assess the relationship between tumor budding and overall survival, disease-free survival, and clinicopathologic variables in EC. METHODS Multiple electronic databases were searched and 20 relevant studies containing 3370 patients were identified. The fixed effects and a random-effects model were used to perform a meta-analysis. RESULT Tumor budding was associated with poor overall survival in EC in both univariate analyses (HR:2.63; 95 % CI 2.06-3.38; p < 0.001) and multivariate analysis (HR: 2.00; 95 % CI 1.68 to 2.39; P < 0.001). Tumor budding was also associated with poor overall survival in subtypes of EC in subgroup analyses i.e. ESCC (HR:3.26; 95 % CI 2.48 to 4.29; P < 0.001), and EAC (HR:2.00; 95 % CI 1.36 to 2.95; P < 0.001) in univariate analysis and ESCC (HR: 2.95; 95 % CI 2.18 to 3.99; P < 0.001) and EAC (HR: 1.65; 95 % CI 1.33 to 2.04; P < 0.001) in multivariate analyses. In addition, tumor budding was also associated with poor DFS (HR: 3.39; 95 % CI 2.1 to 5.48; P < 0.001). Furthermore, tumor budding was associated with poor clinicopathologic factors like advanced T-stage, lymph node metastasis, lymphatic invasion, and venous invasion. CONCLUSION The findings of our study suggest that tumor budding is a promising independent prognostic factor and is correlated with poor clinicopathologic variables of esophageal carcinoma. The inclusion of tumor budding in future grading systems may help in improving currently available staging systems of esophageal carcinoma.
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Affiliation(s)
| | | | - Aliza Paudyal
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Diksha Upadhyay
- Nobel Medical College Teaching Hospital (P) Ltd, Biratnagar, Nepal
| | | | - Alok Dahal
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sunil Thatal
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Apil Tiwari
- BP Koirala Institute of Health Sciences, Dharan, Nepal
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25
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Sahin N, Ozyalvac FT, Donmez T, Surek A, Sahin EA, Calis G, Bulut S, Aydin H, Kabuli HA, Gumusoglu AY. The incidence of incidental neoplasia in pathology samples of patient who underwent appendectomy due to acute appendicitis. A single center experience: 6446 cases. Ir J Med Sci 2024:10.1007/s11845-024-03793-4. [PMID: 39230650 DOI: 10.1007/s11845-024-03793-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/18/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE Appendectomy is the standard treatment of acute appendicitis. However, recent advancements have introduced medical treatment as a potential alternative. Within this context, it's important to recognize the rare occurrence of appendiceal tumors, often incidentally discovered during histopathological examination following appendectomy. Consequently, there's a concern about the possibility of overlooking appendiceal neoplasms, particularly in cases where conservative treatment for acute appendicitis is considered. METHODS The files of patients who underwent surgery for acute appendicitis between January 2015 and December 2023 and were diagnosed with neoplasia in their pathology reports were retrospectively registered. Demographic characteristics of the patients, laboratory and imaging features, details of the surgery performed, preoperative and intraoperative suspicion of neoplasm and data from pathology reports were collected and analyzed. RESULTS A total of 6446 patients were operated for acute appendicitis. Neoplasia was detected in the histopathological examination of 93 patients (1.44%). Acute appendicitis was diagnosed in 51.6% of the patients by computed tomography. Neoplasm suspicion was present in 9.7% of patients in preoperative imaging methods and in 6.5% of patients intraoperatively. Only appendectomy was performed in 94.5% of patients. The most common appendiceal neoplasm is neuroendocrine tumors (40.9%), followed by appendiceal mucinous neoplasm (29%), sessile serrated adenoma (15%), and adenocarcinoma (6.5%). CONCLUSION Although appendiceal neoplasms are relatively rare in proportion, they represent a significant numerical value due to the density of cases. Therefore, this information should be taken into consideration when evaluating treatment options for acute appendicitis.
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Affiliation(s)
- Nurettin Sahin
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey.
| | - Ferman Tevfik Ozyalvac
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Turgut Donmez
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Ahmet Surek
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Emine Ayca Sahin
- Department of Emergency, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Goker Calis
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Sezer Bulut
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Husnu Aydin
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Hamit Ahmet Kabuli
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Alpen Yahya Gumusoglu
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
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26
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Mallak N, Yilmaz B, Meyer C, Winters C, Mench A, Jha A, Prasad V, Mittra E. Theranostics in Neuroendocrine Tumors: Updates and Emerging Technologies. Curr Probl Cancer 2024; 52:101129. [PMID: 39232443 DOI: 10.1016/j.currproblcancer.2024.101129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 05/22/2024] [Indexed: 09/06/2024]
Abstract
Advancements in somatostatin receptor (SSTR) targeted imaging and treatment of well-differentiated neuroendocrine tumors (NETs) have revolutionized the management of these tumors. This comprehensive review delves into the current practice, discussing the use of the various FDA-approved SSTR-agonist PET tracers and the predictive imaging biomarkers, and elaborating on Lu177-DOTATATE peptide receptor radionuclide therapy (PRRT) including the evolving areas of post-therapy imaging practices, PRRT retreatment, and the potential role of dosimetry in optimizing patient treatments. The future directions sections highlight ongoing research on investigational PET imaging radiotracers, future prospects in alpha particle therapy, and combination therapy strategies.
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Affiliation(s)
- Nadine Mallak
- Department of Diagnostic Radiology, Molecular Imaging and Therapy Section, Oregon Health & Sciences University, Portland, OR, USA
| | - Burcak Yilmaz
- Department of Diagnostic Radiology, Molecular Imaging and Therapy Section, Oregon Health & Sciences University, Portland, OR, USA
| | - Catherine Meyer
- Department of Diagnostic Radiology, Medical Physics Section, Oregon Health & Sciences University, Portland, OR, USA
| | - Celeste Winters
- Department of Diagnostic Radiology, Medical Physics Section, Oregon Health & Sciences University, Portland, OR, USA
| | - Anna Mench
- Department of Diagnostic Radiology, Medical Physics Section, Oregon Health & Sciences University, Portland, OR, USA
| | - Abhinav Jha
- Department of Biomedical Engineering, Washington University, St. Louis, MO, USA
| | - Vikas Prasad
- Department of Biomedical Engineering, Washington University, St. Louis, MO, USA; Department of Radiology, Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, US
| | - Erik Mittra
- Department of Diagnostic Radiology, Molecular Imaging and Therapy Section, Oregon Health & Sciences University, Portland, OR, USA.
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27
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Delgado-Coka LA, Roa-Peña L, Babu S, Horowitz M, Petricoin EF, Matrisian LM, Blais EM, Marchenko N, Allard FD, Akalin A, Jiang W, Larson BK, Hendifar AE, Picozzi VJ, Choi M, Shroyer KR, Escobar-Hoyos LF. Keratin 17 is a prognostic and predictive biomarker in pancreatic ductal adenocarcinoma. Am J Clin Pathol 2024; 162:314-326. [PMID: 38642081 PMCID: PMC11369068 DOI: 10.1093/ajcp/aqae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/05/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES To determine the role of keratin 17 (K17) as a predictive biomarker for response to chemotherapy by defining thresholds of K17 expression based on immunohistochemical tests that could be used to optimize therapeutic intervention for patients with pancreatic ductal adenocarcinoma (PDAC). METHODS We profiled K17 expression, a hallmark of the basal molecular subtype of PDAC, by immunohistochemistry in 2 cohorts of formalin-fixed, paraffin-embedded PDACs (n = 305). We determined a K17 threshold of expression to optimize prognostic stratification according to the lowest Akaike information criterion and explored the potential relationship between K17 and chemoresistance by multivariate predictive analyses. RESULTS Patients with advanced-stage, low K17 PDACs treated using 5-fluorouracil (5-FU)-based chemotherapeutic regimens had 3-fold longer survival than corresponding cases treated with gemcitabine-based chemotherapy. By contrast, PDACs with high K17 did not respond to either regimen. The predictive value of K17 was independent of tumor mutation status and other clinicopathologic variables. CONCLUSIONS The detection of K17 in 10% or greater of PDAC cells identified patients with shortest survival. Among patients with low K17 PDACs, 5-FU-based treatment was more likely than gemcitabine-based therapies to extend survival.
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Affiliation(s)
- Lyanne A Delgado-Coka
- Departments of Pathology
- Departments of Preventative Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, US
| | - Lucia Roa-Peña
- Departments of Pathology
- Department of Pathology, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | | | - Emanuel F Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Fairfax, VA, US
- Perthera, McLean, VA, US
| | - Lynn M Matrisian
- Scientific and Medical Affairs, Pancreatic Cancer Action Network, Manhattan Beach, CA, US
| | | | | | - Felicia D Allard
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, US
| | - Ali Akalin
- Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester, MA, US
| | - Wei Jiang
- Department of Pathology, Anatomy and Cell Biology, Sidney Kimmel Cancer Center Thomas Jefferson University Hospital, Philadelphia, PA, US
| | - Brent K Larson
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, US
| | - Andrew E Hendifar
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, US
| | | | | | | | - Luisa F Escobar-Hoyos
- Departments of Pathology
- Departments of Therapeutic Radiology
- Departments of Molecular Biophysics and Biochemistry
- Department of Medicine, Division of Oncology, Yale University, New Haven, CT, US
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28
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Casey M, Brown A, Romero-Hernandez F, Wang JJ, Ganjouei AA, Tozzi F, Rashidian N, Kirkwood K, Corvera C, Nakakura E, Alseidi A, Adam M. National practice patterns in the use of endoscopic ultrasound biopsy for resectable Pancreatic Neuroendocrine Tumors: Insights into the role of DOTATATE PET/CT in diagnosis. Am J Surg 2024; 235:115779. [PMID: 38811243 DOI: 10.1016/j.amjsurg.2024.115779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Pancreatic neuroendocrine tumors (PNETs) are typically diagnosed using endoscopic ultrasound-guided (EUS) biopsy, which can be associated with complications. Since 2016, DOTATATE PET/CT has emerged as an effective tool to localize and stage PNETs. METHODS Patients with PNETs who underwent R0 resections were identified from the 2004-2019 National Cancer Database PUF. Joinpoint regression and multivariable logistic regression were used to analyze trends in the use of biopsy. RESULTS Of 16,746 R0 resected PNET patients, 44 % underwent diagnostic biopsy. Joinpoint regression showed a significant increase in the use of biopsy from 2004 to 2019 (APC 1.80, p < 0.001). A higher percentage of patients diagnosed after DOTATATE approval underwent biopsy compared to those diagnosed before (48 % vs. 42 %, p < 0.001). Adjusted analysis showed diagnosis after 2016 was associated with increased odds of biopsy (OR = 1.67, p < 0.001). CONCLUSIONS Despite technologic advancement with DOTATATE PET/CT, there has been a significant increase in the proportion of resectable PNETs undergoing preoperative biopsy.
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Affiliation(s)
- Megan Casey
- School of Medicine, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Audrey Brown
- Department of Surgery, University of California, San Francisco, San Francisco, CA, 94143, USA
| | | | - Jaeyun Jane Wang
- Department of Surgery, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Amir Ashraf Ganjouei
- Department of Surgery, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Francesca Tozzi
- Department of General, HPB Surgery and Liver Transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Nikdokht Rashidian
- Department of General, HPB Surgery and Liver Transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Kimberly Kirkwood
- Division of Surgical Oncology, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Carlos Corvera
- Division of Surgical Oncology, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Eric Nakakura
- Division of Surgical Oncology, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Adnan Alseidi
- Division of Surgical Oncology, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Mohamed Adam
- Division of Surgical Oncology, University of California, San Francisco, San Francisco, CA, 94143, USA.
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29
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An HR, Kim HD, Ryu MH, Park YS. SMARCA4-deficient undifferentiated gastric carcinoma: a case series and literature review. Gastric Cancer 2024; 27:1147-1152. [PMID: 38772975 DOI: 10.1007/s10120-024-01510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/14/2024] [Indexed: 05/23/2024]
Abstract
Undifferentiated gastric carcinoma, characterized by anaplastic cells lacking distinct features of cytological or architectural differentiation, poses diagnostic and therapeutic challenges. Recent studies have suggested an association between this carcinoma and deficiencies in the SWI/SNF complex, particularly mutations in subunits such as SMARCA4. We herein report six cases of SMARCA4-deficient undifferentiated gastric carcinoma with molecular findings, highlighting the rarity and diagnostic pitfalls of this malignancy. Predominantly occurring in males over 50 years, these cases presented with nonspecific symptoms and were often diagnosed at an advanced stage. Histologically, the tumors exhibited a sheet-like growth pattern, reduced or absent epithelial markers, and loss of BRG-1 expression, with molecular analysis confirming SMARCA4 gene mutations. The response to conventional chemotherapy was poor, underscoring the importance of complete surgical resection and the development of alternative treatment modalities.
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Affiliation(s)
- Hyeong Rok An
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Hyung-Don Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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30
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Laffi A, Bertuzzi AF, Carrara S, Zerbi A, Lania A, Lavezzi E, Ferrillo G, Jandric J, Carnaghi C, Rossi RE, Grimaudo MS, Spaggiari P, Uccella S. Co-existing Neuroendocrine Tumors in the Ileum and Pancreas: A Clinico-Pathological Challenge. Endocr Pathol 2024; 35:256-266. [PMID: 38848012 DOI: 10.1007/s12022-024-09814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/18/2024]
Abstract
Ileal (I) and pancreatic (Pan) neuroendocrine tumors (NETs) are among the most common digestive neuroendocrine neoplasms (NENs). Coexisting NETs at both sites are rare, and establishing the primary or metastatic nature of the two lesions may be crucial for the appropriate treatment. We reviewed all the clinical reports of patients with INETs or PanNETs, diagnosed and treated in our ENETS Center of Excellence between 2012 and 2022. We selected patients with a history of synchronous or metachronous neuroendocrine (NE) lesions at the ileum and pancreas. For those with available histological samples from both sites, an immunohistochemistry (IHC) analysis for CDX2, Islet1, and serotonin has been performed. We found seven patients with NET in both the ileum and pancreas. F to M ratio was 4:3, and the median age at first diagnosis was 54 years (42-79). Five cases had synchronous lesions; in 2 cases, PanNETs were diagnosed respectively 8 and 56 months, after INETs. In four patients, with available histological samples from both the sites, a pathologic review and the IHC analysis have been performed, identifying three different scenarios: (i) primary INET metastatic to the pancreas, (ii) primary PanNET metastatic to the ileum, and (iii) synchronous primary PanNET and INET. In our experience, coexisting ileal and pancreatic NENs are rare occurrences. A multidisciplinary evaluation case-by-case and, whenever feasible, a comprehensive histopathological examination are needed to distinguish between metastatic and primary disease, in order to properly treat the patient.
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Affiliation(s)
- Alice Laffi
- Department of Oncology & Hematology, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Silvia Carrara
- Gastroenterology Department, Endoscopic Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandro Zerbi
- Pancreatic Surgery Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Andrea Lania
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Elisabetta Lavezzi
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuseppe Ferrillo
- Radiology Department, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Jelena Jandric
- Nuclear Medicine Department, IRCCS, Humanitas Research Hospital, Rozzano Milan, Italy
| | | | - Roberta Elisa Rossi
- Gastroenterology Department, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Maria Susanna Grimaudo
- Department of Oncology & Hematology, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paola Spaggiari
- Pathology Department, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
- Pathology Department, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy.
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31
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Ma Y, Jiang Z, Pan L, Zhou Y, Xia R, Liu Z, Yuan L. Current development of molecular classifications of gastric cancer based on omics (Review). Int J Oncol 2024; 65:89. [PMID: 39092559 DOI: 10.3892/ijo.2024.5677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
Gastric cancer (GC) is a complex and heterogeneous disease with significant phenotypic and genetic variation. Traditional classification systems rely mainly on the evaluation of clinical pathological features and conventional biomarkers and might not capture the diverse clinical processes of individual GCs. The latest discoveries in omics technologies such as next‑generation sequencing, proteomics and metabolomics have provided crucial insights into potential genetic alterations and biological events in GC. Clustering strategies for identifying subtypes of GC might offer new tools for improving GC treatment and clinical trial outcomes by enabling the development of therapies tailored to specific subtypes. However, the feasibility and therapeutic significance of implementing molecular classifications of GC in clinical practice need to addressed. The present review examines the current molecular classifications, delineates the prevailing landscape of clinically relevant molecular features, analyzes their correlations with traditional GC classifications, and discusses potential clinical applications.
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Affiliation(s)
- Yubo Ma
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Zhengchen Jiang
- Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, P.R. China
| | - Libin Pan
- Department of Pharmacy, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310005, P.R. China
| | - Ying Zhou
- Department of Pharmacy, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310005, P.R. China
| | - Ruihong Xia
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Zhuo Liu
- Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, P.R. China
| | - Li Yuan
- Zhejiang Key Lab of Prevention, Diagnosis and Therapy of Upper Gastrointestinal Cancer, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
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32
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Gustafson A, Sadowski SM. Invited Editorial: Long-Term Survival Outcomes After Minimally Invasive Surgery for Ileal Neuroendocrine Tumors. Ann Surg Oncol 2024; 31:5487-5488. [PMID: 38839670 DOI: 10.1245/s10434-024-15563-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Alexandra Gustafson
- Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Samira M Sadowski
- Neuroendocrine Cancer Therapy Section, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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33
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Zhou M, Bao D, Huang H, Chen M, Jiang W. Utilization of diffusion-weighted derived mathematical models to predict prognostic factors of resectable rectal cancer. Abdom Radiol (NY) 2024; 49:3282-3293. [PMID: 38744701 DOI: 10.1007/s00261-024-04239-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE This study explored models of monoexponential diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), stretched exponential (SEM), fractional-order calculus (FROC), and continuous-time random-walk (CTRW) as diagnostic tools for assessing pathological prognostic factors in patients with resectable rectal cancer (RRC). METHODS RRC patients who underwent radical surgery were included. The apparent diffusion coefficient (ADC), the mean kurtosis (MK) and mean diffusion (MD) from the DKI model, the distributed diffusion coefficient (DDC) and α from the SEM model, D, β and u from the FROC model, and D, α and β from the CTRW model were assessed. RESULTS There were a total of 181 patients. The area under the receiver operating characteristic (ROC) curve (AUC) of CTRW-α for predicting histology type was significantly higher than that of FROC-u (0.780 vs. 0.671, p = 0.043). The AUC of CTRW-α for predicting pT stage was significantly higher than that of FROC-u and ADC (0.786 vs.0.683, p = 0.043; 0.786 vs. 0.682, p = 0.030), the difference in predictive efficacy of FROC-u between ADC and MK was not statistically significant [0.683 vs. 0.682, p = 0.981; 0.683 vs. 0.703, p = 0.720]; the difference between the predictive efficacy of MK and ADC was not statistically significant (p = 0.696). The AUC of CTRW (α + β) (0.781) was significantly higher than that of FROC-u (0.781 vs. 0.625, p = 0.003) in predicting pN stage but not significantly different from that of MK (p = 0.108). CONCLUSION The CTRW and DKI models may serve as imaging biomarkers to predict pathological prognostic factors in RRC patients before surgery.
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Affiliation(s)
- Mi Zhou
- Department of Radiology, Sichuan Provincial Orthopedic Hospital, Chengdu, China.
| | - Deying Bao
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Hongyun Huang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Meining Chen
- Department of MR Scientific Marketing, Siemens Healthineers, Shanghai, 200135, China
| | - Wenli Jiang
- Department of Radiology, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing, 400010, China
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Nakazawa N, Sohda M, Ide M, Shimoda Y, Sano A, Sakai M, Oyama T, Shirabe K, Saeki H. Poorly cohesive gastric cancer with increased epithelial‑mesenchymal transition is associated with a poor prognosis. Oncol Lett 2024; 28:420. [PMID: 39006950 PMCID: PMC11240270 DOI: 10.3892/ol.2024.14554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/10/2024] [Indexed: 07/16/2024] Open
Abstract
The present study examined the surgical outcome and prognosis of patients with poorly cohesive carcinoma (PCC), and characterized the molecular pathological factors, epithelial-mesenchymal transition (EMT) and interstitial signals of the disease. A total of 281 patients who underwent gastric cancer (GC) surgery between April 2015 and August 2020 were included. Furthermore, tissue samples from another 197 patients with GC who underwent surgery between 1999 and 2003 were assessed using a tissue microarray. Preoperatively treated cases and endoscopic submucosal dissection cases were excluded, and multiple blocks containing the invasion region were collected for tissue microarray. For tissue microarray analysis, the clinicopathological factors of protein wnt3a (wnt3a), leucine-rich repeat-containing G-protein coupled receptor 5, transforming growth factor-β-induced, phosphorylated serine/threonine-protein kinase mTOR and E-cadherin expression were collected as EMT markers. The results of the surgical case evaluation and tissue microarray indicated that PCC was more common in younger patients and women, as the ratio of women to men was higher in the PCC group compared with that in the non-PCC group. However, none of the results revealed that the prognosis was worse in all patients with PCC compared with the non-PCC group. Furthermore, in the tissue microarray study, PCC samples exhibited significantly decreased expression of the cell adhesion molecule E-cadherin, suggesting enhanced EMT, which activates wnt3a signaling. PCC with increased EMT was significantly associated with a poor prognosis.
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Affiliation(s)
- Nobuhiro Nakazawa
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Munenori Ide
- Department of Diagnostic Pathology, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Yuki Shimoda
- Department of Diagnostic Pathology, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Akihiko Sano
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Tetsunari Oyama
- Department of Diagnostic Pathology, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
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35
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Liu B, Yuan X, Dong K, Zhang J, Fu T, Du C. Exploration of the role of EMC3‑AS1 as a potential diagnostic and prognostic indicator in liver cancer. Oncol Lett 2024; 28:412. [PMID: 38988441 PMCID: PMC11234810 DOI: 10.3892/ol.2024.14545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/31/2024] [Indexed: 07/12/2024] Open
Abstract
The aim of the present study was to evaluate the diagnostic and prognostic significance of the long non-coding RNA (lncRNA) endoplasmic reticulum membrane protein complex subunit 3 antisense RNA 1 (EMC3-AS1) in liver cancer, and its impact on the proliferative and invasive capabilities of liver cancer cells. EMC3-AS1 expression in liver cancer was assessed using data from The Cancer Genome Atlas and three Gene Expression Omnibus datasets, and validated in clinical liver cancer samples using reverse transcription-quantitative PCR. The prognostic and diagnostic potentials of this lncRNA were evaluated using Kaplan-Meier and receiver operating characteristic analyses, respectively. The infiltration of immune cells and differential expression of immune checkpoints (ICs) between high- and low-EMC3-AS1 expression groups were investigated. Therapeutic correlation analyses were also undertaken to assess the impact of EMC3-AS1 in the treatment of liver cancer. In addition, in vitro experiments were conducted using small interfering RNA to knock down the expression of EMC3-AS1 in HepG2, Sk-Hep-1 and Huh-7 cells, and evaluate the effect on cell proliferation, colony formation and migration. The results revealed a significant upregulation of EMC3-AS1 expression in liver cancer tissues compared with that in adjacent normal tissues, which was associated with an unfavorable prognosis and demonstrated diagnostic effectiveness for patients with liver cancer. Furthermore, patients with high EMC3-AS1 expression exhibited increased levels of IC markers in comparison with those with low EMC3-AS1 expression. In addition, EMC3-AS1 was indicated to have clinical significance in the prediction of the response to immunotherapy and chemotherapy. Notably, the in vitro experiments demonstrated that the knockdown of EMC3-AS1 significantly hindered cell proliferation, colony formation and migration. Consequently, it was concluded that EMC3-AS1 is upregulated in liver cancer and serves as a prognostic indicator for unfavorable outcomes in patients with liver cancer. Additionally, targeting EMC3-AS1 through knockdown interventions showed potential in mitigating the ability of liver cancer cells to proliferate and migrate, which highlights its dual role as a biomarker and therapeutic target for liver cancer.
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Affiliation(s)
- Bo Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
- Department of Hepatobiliary Surgery, Pidu District People's Hospital of Chengdu, Chengdu, Sichuan 611730, P.R. China
| | - Xia Yuan
- School of Bioscience and Technology, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Ke Dong
- Department of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Jie Zhang
- Department of Hepatobiliary Surgery, Pidu District People's Hospital of Chengdu, Chengdu, Sichuan 611730, P.R. China
| | - Tingting Fu
- Department of Nosocomial Infection Control, Pidu District People's Hospital of Chengdu, Chengdu, Sichuan 611730, P.R. China
| | - Chengyou Du
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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Tan CK, Suzuki S, Ang TL, Koh XH, Wang LM, Aniwan S, Chiu HM, Laohavichitra K, Chirapongsathorn S, Yamamura T, Kuo CY, Yoshida N, Takezawa T, Rerknimitr R, Ishikawa H, Gotoda T. Sessile serrated lesion prevalence and factors associated with their detection: a post-hoc analysis of a multinational randomized controlled trial from Asia. Endoscopy 2024; 56:684-693. [PMID: 38857619 DOI: 10.1055/a-2324-6262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
BACKGROUND Sessile serrated lesions (SSLs) are associated with an increased risk of colorectal cancer. Data on the prevalence of SSLs in Asia are limited. We performed this study to estimate the prevalence of SSLs in Asia and to explore endoscopic factors that are associated with SSL detection. METHODS This is a post-hoc analysis of a multicenter randomized controlled trial from four Asian countries/regions that compared adenoma detection rates using linked-color imaging (LCI) and white-light imaging. Colonoscopies were performed in an average-risk population for screening, diagnostic examination, or polyp surveillance. Patients with SSLs were compared against those without SSLs to evaluate for possible predictors of SSL detection using Firth's logistic regression. RESULTS 2898 participants (mean age 64.5 years) were included in the analysis. The estimated prevalence of SSLs was 4.0% (95%CI 3.4%-4.8%), with no sex or age group differences. On multivariable analysis, use of LCI (adjusted odds ratio [aOR] 1.63, 95%CI 1.10-2.41), experienced endoscopists (aOR 1.94, 95%CI 1.25-3.00), use of transparent cap (aOR 1.75, 95%CI 1.09-2.81), and longer withdrawal time (aOR 1.06, 95%CI 1.03-1.10) were independently associated with SSL detection. Synchronous adenoma detection (aOR 1.89, 95%CI 1.20-2.99) was also predictive of SSL detection. CONCLUSION The prevalence of SSLs in Asia is 4.0%. Use of LCI or a transparent cap, greater endoscopist experience, and longer withdrawal time were all associated with increased SSL detection.
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Affiliation(s)
- Chin Kimg Tan
- Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore
- Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Sho Suzuki
- Gastroenterology and Hepatology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Tiing Leong Ang
- Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore
- Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Xuan Han Koh
- Health Services Research, Changi General Hospital, Singapore, Singapore
| | - Lai Mun Wang
- Laboratory Medicine, Changi General Hospital, Singapore, Singapore
- Pathology Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Satimai Aniwan
- Center of Excellence in Endoscopy for Gastrointestinal Oncology, Chulalongkorn University Department of Internal Medicine, Bangkok, Thailand
| | - Han-Mo Chiu
- Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Sakkarin Chirapongsathorn
- Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Takeshi Yamamura
- Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chen Ya Kuo
- Gastroenterology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Naohisa Yoshida
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takahito Takezawa
- Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Rungsun Rerknimitr
- Center of Excellence in Endoscopy for Gastrointestinal Oncology, Chulalongkorn University Department of Internal Medicine, Bangkok, Thailand
| | - Hideki Ishikawa
- Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takuji Gotoda
- Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
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Foersch S, Schmitt M, Litmeyer A, Tschurtschenthaler M, Gress T, Bartsch DK, Pfarr N, Steiger K, Denkert C, Jesinghaus M. TROP2 in colorectal carcinoma: associations with histopathology, molecular phenotype, and patient prognosis. J Pathol Clin Res 2024; 10:e12394. [PMID: 39177576 PMCID: PMC11342791 DOI: 10.1002/2056-4538.12394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/11/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024]
Abstract
Antibody-drug conjugates (ADCs) directed to trophoblast cell surface antigen 2 (TROP2) have gained approval as a therapeutic option for advanced triple-negative breast cancer, and TROP2 expression has been linked to unfavourable outcomes in various malignancies. In colorectal carcinoma (CRC), there is still a lack of comprehensive studies on its expression frequency and its prognostic implications in relation to the main clinicopathological parameters. We examined the expression of TROP2 in a large cohort of 1,052 CRC cases and correlated our findings with histopathological and molecular parameters, tumour stage, and patient outcomes. TROP2 was heterogeneously expressed in 214/1,052 CRCs (20.3%), with only a fraction of strongly positive tumours. TROP2 expression significantly correlated with an invasive histological phenotype (e.g. increased tumour budding/aggressive histopathological subtypes), advanced tumour stage, microsatellite stable tumours, and p53 alterations. While TROP2 expression was prognostic in univariable analyses of the overall cohort (e.g. for disease-free survival, p < 0.001), it exhibited distinct variations among important clinicopathological subgroups (e.g. right- versus left-sided CRC, microsatellite stable versus unstable CRC, Union for International Cancer Control [UICC] stages) and lost its significance in multivariable analyses that included stage and CRC histopathology. In summary, TROP2 is quite frequently expressed in CRC and associated with an aggressive histopathological phenotype and microsatellite stable tumours. Future clinical trials investigating anti-TROP2 ADCs should acknowledge the observed intratumoural heterogeneity, given that only a subset of TROP2-expressing CRC show strong positivity. The prognostic implications of TROP2 are complex and show substantial variations across crucial clinicopathological subgroups, thus indicating that TROP2 is a suboptimal parameter to predict patient prognosis.
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Affiliation(s)
| | - Maxime Schmitt
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Anne‐Sophie Litmeyer
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Markus Tschurtschenthaler
- Internal Medicine II, Klinikum rechts der IsarTechnical University MunichMunichGermany
- Institute for Translational Cancer Research, German Cancer Consortium (DKTK), Partner Site MunichMunichGermany
| | - Thomas Gress
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhilipps‐University Marburg and University Hospital MarburgMarburgGermany
| | - Detlef K Bartsch
- Department of SurgeryPhilipps‐University Marburg and University Hospital MarburgMarburgGermany
| | - Nicole Pfarr
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Katja Steiger
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Carsten Denkert
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Moritz Jesinghaus
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
- Institute of PathologyTechnical University of MunichMunichGermany
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38
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Lucocq J, Joseph N, Hawkyard J, Haugk B, White S, Lye J, Parkinson D, Mownah O, Menon K, Furukawa T, Hirose Y, Sasahira N, Inoue Y, Mittal A, Samra J, Sheen A, Feretis M, Balakrishnan A, Ceresa C, Davidson B, Pande R, Dasari B, Roberts K, Tanno L, Karavias D, Helliwell J, Young A, Marks K, Nunes Q, Urbonas T, Silva M, Gordon-Weeks A, Barrie J, Gomez D, van Laarhoven S, Nawara H, Doyle J, Bhogal R, Harrison E, Roalso M, Ciprani D, Aroori S, Ratnayake B, Koea J, Capurso G, Stättner S, Bellotti R, Alsaoudi T, Bhardwaj N, Rajesh S, Jeffery F, Connor S, Cameron A, Jamieson N, Gill A, Soreide K, Pandanaboyana S. Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasm and derivation of a prognostic model: An international multicenter study (ADENO-IPMN study). Surgery 2024; 176:890-898. [PMID: 38918108 DOI: 10.1016/j.surg.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/23/2024] [Accepted: 05/06/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasms are unknown. This study determines predictors of long-term (>5 years) disease-free survival and recurrence in adenocarcinoma arising from intraductal papillary mucinous neoplasms and derives a prognostic model for disease-free survival. METHODS Consecutive patients who underwent pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms in 18 academic pancreatic centers in Europe and Asia between 2010 to 2017 with at least 5-year follow-up were identified. Factors associated with disease-free survival were determined using Cox proportional hazards model. Internal validation was performed, and discrimination and calibration indices were assessed. RESULTS In the study, 288 patients (median age, 70 years; 52% male) were identified; 140 (48%) patients developed recurrence after a median follow-up of 98 months (interquartile range, 78.4-123), 57 patients (19.8%) developed locoregional recurrence, and 109 patients (37.8%) systemic recurrence. At 5 years after resection, the overall and disease-free survival was 46.5% (134/288) and 35.0% (101/288), respectively. On Cox proportional hazards model analysis, multivisceral resection (hazard ratio, 2.20; 95% confidence interval, 1.06-4.60), pancreatic tail location (hazard ratio, 2.34; 95% confidence interval, 1.22-4.50), poor tumor differentiation (hazard ratio, 2.48; 95% confidence interval, 1.10-5.30), lymphovascular invasion (hazard ratio, 1.74; 95% confidence interval, 1.06-2.88), and perineural invasion (hazard ratio, 1.83; 95% confidence interval, 1.09-3.10) were negatively associated with long-term disease-free survival. The final predictive model incorporated 8 predictors and demonstrated good predictive ability for disease-free survival (C-index, 0.74; calibration, slope 1.00). CONCLUSION A third of patients achieve long-term disease-free survival (>5 years) after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms. The predictive model developed in the current study can be used to estimate the probability of long-term disease-free survival.
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Affiliation(s)
| | - Nejo Joseph
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jake Hawkyard
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Beate Haugk
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Steve White
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jonathan Lye
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Daniel Parkinson
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Omar Mownah
- Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK
| | - Krishna Menon
- Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK
| | - Takaki Furukawa
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Yuki Hirose
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Naoki Sasahira
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Yosuke Inoue
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | | | - Jas Samra
- Royal North Shore Hospital, Sydney, NSW, Australia
| | - Amy Sheen
- New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Michael Feretis
- Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Anita Balakrishnan
- Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Carlo Ceresa
- Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK
| | - Brian Davidson
- Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK
| | - Rupaly Pande
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Bobby Dasari
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Keith Roberts
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Lulu Tanno
- Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK
| | - Dimitrios Karavias
- Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK
| | - Jack Helliwell
- Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alistair Young
- Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kate Marks
- Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Quentin Nunes
- Department of Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, UK
| | - Tomas Urbonas
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Michael Silva
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Alex Gordon-Weeks
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Jenifer Barrie
- Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK
| | - Dhanny Gomez
- Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK
| | - Stijn van Laarhoven
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation trust, UK
| | - Hossam Nawara
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation trust, UK
| | - Joseph Doyle
- Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ricky Bhogal
- Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ewen Harrison
- Department of Clinical Surgery, University of Edinburgh, UK
| | - Marcus Roalso
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway
| | - Debora Ciprani
- Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Somaiah Aroori
- Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Bathiya Ratnayake
- Hepato-Pancreatico-Biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, NZ
| | - Jonathan Koea
- Hepato-Pancreatico-Biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, NZ
| | - Gabriele Capurso
- Digestive and Disease Unit, S. Andrea Hospital, Rome, Italy; Pancreas Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan, Italy
| | - Stefan Stättner
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Austria
| | - Ruben Bellotti
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Tareq Alsaoudi
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Neil Bhardwaj
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Srujan Rajesh
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Fraser Jeffery
- Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, NZ
| | - Saxon Connor
- Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, NZ
| | - Andrew Cameron
- Wolfson Wohl Cancer Research Center, Research Institute of Cancer Sciences, University of Glasgow, UK
| | - Nigel Jamieson
- Wolfson Wohl Cancer Research Center, Research Institute of Cancer Sciences, University of Glasgow, UK
| | - Anthony Gill
- Royal North Shore Hospital, Sydney, NSW, Australia; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia
| | - Kjetil Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway
| | - Sanjay Pandanaboyana
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
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El-Deek HEDM, El-Naggar MS, Morsy AMM, Sedik MF, Osman HA, Ahmed AM. P4HA2 involved in SLUG-associated EMT predicts poor prognosis of patients with KRAS-positive colorectal cancer. Med Mol Morphol 2024; 57:167-176. [PMID: 38522060 PMCID: PMC11343967 DOI: 10.1007/s00795-024-00385-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/18/2024] [Indexed: 03/25/2024]
Abstract
This study aimed to examine the immunohistochemical expression of epithelial-mesenchymal transition biomarkers: P4HA2 and SLUG in colorectal carcinoma (CRC) specimens, then to assess their relation to clinicopathological features including KRAS mutations and patients' survival, and finally to study the correlation between them in CRC. The result of this study showed that SLUG and P4HA2 were significantly higher in association with adverse prognostic factors: presence of lympho-vascular invasion, perineural invasion, higher tumor budding, tumor stage, presence of lymph node metastasis, and presence of distant metastasis. CRC specimens with KRAS mutation were associated with significant higher SLUG and P4HA2 expression. High expression of both SLUG and P4HA2 was significantly unfavorable prognostic indicator as regards overall survival (OS) and disease-free survival (DFS). In KRAS mutated cases, high P4HA2 expression was the only significant poor prognostic indicator as regarding DFS. In conclusions, our data highlight that both SLUG and P4HA2 expression may serve as potentially important poor prognostic biomarkers in CRC and targeting these molecules may be providing a novel therapeutic strategy. In KRAS mutation group, high P4HA2 expression is the only independent prognostic factor for tumor recurrence, so it can be suggested to be a novel target for therapy.
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Affiliation(s)
| | - Maha Salah El-Naggar
- Department of Clinical Oncology, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | | | - Mayada Fawzy Sedik
- Department of Medical Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Heba Ahmed Osman
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Asmaa M Ahmed
- Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
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40
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Wang Y, Ye Z, Lou X, Xu J, Jing D, Zhou C, Qin Y, Chen J, Xu X, Yu X, Ji S. Comparison among different preclinical models derived from the same patient with a non-functional pancreatic neuroendocrine tumor. Hum Cell 2024; 37:1522-1534. [PMID: 39078546 DOI: 10.1007/s13577-024-01107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/17/2024] [Indexed: 07/31/2024]
Abstract
Pancreatic neuroendocrine tumors are the second most common tumors of the pancreas, and approximately half of patients are diagnosed with liver metastases. Currently, the improvement in the efficacy of relevant treatment methods is still limited. Therefore, there is an urgent need for in-depth research on the molecular biological mechanism of pancreatic neuroendocrine tumors. However, due to their relatively inert biology, preclinical models are extremely scarce. Here, the patient-derived organoid, and patient-derived xenograft were successfully constructed. These two models and the previously constructed cell line named SPNE1 all derived from the same patient with a grade 3 non-functional pancreatic neuroendocrine tumor, providing new tumor modeling platforms, and characterized using immunohistochemistry, whole-exome sequencing, and single-cell transcriptome sequencing. Combined with a tumor formation experiment in immunodeficient mice, we selected the model that most closely recapitulated the parental tumor. Overall, the patient-derived xenograft model most closely resembled human tumor tissue.
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Affiliation(s)
- Yan Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Zeng Ye
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Xin Lou
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Junfeng Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Desheng Jing
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Chenjie Zhou
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Yi Qin
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China
| | - Jie Chen
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Head and Neck and Neuroendocrine Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xiaowu Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China.
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
| | - Xianjun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China.
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
| | - Shunrong Ji
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China.
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
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41
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Tie SJ, Fan ML, Zhang JY, Yu J, Wu N, Su GQ, Xu Z, Huang WF. Clinical outcomes after endoscopic resection and the risk of lymph node metastasis in rectal neuroendocrine tumors: a single-center retrospective study. Surg Endosc 2024; 38:5178-5186. [PMID: 39043886 DOI: 10.1007/s00464-024-11088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/14/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND AND AIM The incidence of rectal neuroendocrine tumors (R-NETs) has increased in recent years. However, the predictors of lymph node (LN) metastasis and clinical outcomes, particularly following endoscopic treatment, remain unclear. Our study aims to elucidate the potential risk factors for LN metastasis and the clinical outcomes of patients undergoing endoscopic resection in R-NETs. METHODS A total of 128 patients with R-NETs were retrospectively identified from a single center between June 2012 and December 2021. Risk factors for LN metastasis in R-NETs were analyzed using multivariate analysis. Additionally, the clinical outcomes of endoscopic resections in patients with R-NETs were assessed. RESULTS In our study, 128 patients with R-NETs were retrospectively analyzed. The risk factors for LN metastasis determined by multivariate analysis were tumor size and patient age at diagnosis. Among the 111 patients treated with endoscopic resection and with tumor margin records available, 92 underwent endoscopic submucosal dissection (ESD) and 19 underwent conventional endoscopic mucosal resection (EMR). There was no significant difference between the two groups regarding the positive rates of basal tumor margin and lateral tumor margin. Furthermore, 64 patients who underwent endoscopic resection for R-NETs were successfully followed up (range, 1.64-76.71 months), during which only one patient developed local recurrence. CONCLUSION Tumor size and age at diagnosis were predictors for LN metastasis of R-NETs. Both ESD and EMR are alternative techniques with a favorable prognosis for R-NETs, even in cases with positive resection margins. However, due to the relatively small number of patients undergoing EMR and missing data in follow-up protocols, definitive conclusions require further large-scale studies.
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Affiliation(s)
- Sheng-Jiao Tie
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Mei-Ling Fan
- Department of Gastroenterology, The Third Hospital of Xiamen, Xiamen, China
| | - Jin-Yan Zhang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Juan Yu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Na Wu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Guo-Qiang Su
- Department of Colorectal Cancer Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhong Xu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
| | - Wei-Feng Huang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
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42
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Tsoli M, Wilson H, Armonis P, Kamieniarz L, Thuringer J, Mirnezami R, Caplin M, Kaltsas G, Toumpanakis C. Peritoneal metastases in patients with neuroendocrine neoplasms: a challenging site of metastases with clinical and prognostic implications. J Endocrinol Invest 2024; 47:2295-2303. [PMID: 38451399 DOI: 10.1007/s40618-024-02330-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/03/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Peritoneal metastases (PM) of neuroendocrine neoplasm (NEN) origin are identified with increasing frequency and exert a significant effect on quality of life and clinical status of the patients. The aim of this study was to identify the characteristics and the prognostic significance of PM in patients with NENs. METHODS A retrospective analysis of the data of patients from two tertiary referral centers was performed. We defined a control group of age- and gender-matched NEN patients with comparable stage IV disease but no PM. RESULTS We analysed 70 patients (41 females) with PM. Small intestine was the most common primary NEN site (87.1%). PM prevalence was 10.3%. Forty-four patients presented with synchronous PM, whereas 26 developed metachronous PM. The majority of patients had other concomitant metastases (50 hepatic, 6 lung and 12 bone metastases). Twelve patients developed intestinal obstruction. After PM diagnosis, 76% of patients received treatment with somatostatin analogues while six patients (8.6%) were treated with peptide receptor radionuclide therapy (PRRT). The median progression-free survival (PFS) in the PRRT-treated group was 15 months (95% CI 2-28). Median overall survival (OS) in the PM group was 142 months [95% CI 71-213] while it was not reached in the control group. CONCLUSION Peritoneal metastases show low prevalence among NEN patients and are most likely to develop in patients with small intestinal NENs and advanced metastatic disease. The presence of PM does seem to be associated with a negative prognostic impact on OS of NEN patients and their identification and prompt treatment is of major importance.
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Affiliation(s)
- M Tsoli
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, 1st Department of Propaedeutic and Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Agiou Thoma 17, 11527, Athens, Greece.
| | - H Wilson
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - P Armonis
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - L Kamieniarz
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - J Thuringer
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - R Mirnezami
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - M Caplin
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
| | - G Kaltsas
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, 1st Department of Propaedeutic and Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Agiou Thoma 17, 11527, Athens, Greece
| | - C Toumpanakis
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK
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43
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Giordano PG, Díaz Zelaya AG, Aguilera Molina YY, Taboada Mostajo NO, Ajete Ramos Y, Ortega García R, Peralta de Michelis E, Meneu Díaz JC. [Clinico-pathological evaluation of tumor budding in the oncological progression of colorectal cancer]. Med Clin (Barc) 2024; 163:159-166. [PMID: 38697893 DOI: 10.1016/j.medcli.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Tumor budding (TB), defined as the presence of individual neoplastic cells or isolated groups of up to 4 cells at the front of tumor invasion, has become an adverse prognostic marker in colorectal cancer (CRC) in recent decades. The prognostic impact of TB in CRC remains not clearly defined and histological methods for its evaluation vary depending on the center. The objective of this study is to investigate the association between TB and CRC, in terms of oncological evolution and pathological stage. METHODS A retrospective observational study was conducted, including patients undergoing curative oncological surgery for CRC between January 2017 and December 2022. The effects of TB on disease-free survival (DFS) and overall survival (OS) were evaluated according to the Kaplan-Meier curves. RESULTS In 78 cases TB was described in the pathology report. TB was present in 56 patients (71.8%), divided into the following categories: low grade in 22 (39.3%), intermediate grade in 17 (30.4%) and high grade in 17 (30.4%). The proportion of patients who presented lymph node metastases, lympho-vascular and perineural invasion was significantly higher in patients with TB (26.8% vs 0%, P=.008; 41.1% vs 4.5%, P=.002; 16.1% vs 0% P=.054; respectively). DFS was 86.3% in low-grade TB, 75.3% in intermediate-grade TB, and 70.3% in high-grade TB. Cases with intermediate and high grade were associated with a shorter OS compared to the low grade group (93.7% and 75.4% vs 100% P=.012, respectively). CONCLUSION These results suggest that TB expression may be a useful risk factor as a prognostic factor for the detection of lymph node metastasis, local recurrence, and distant metastasis in CRC.
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Affiliation(s)
- Pietro Giovanni Giordano
- Servicio de Cirugía General, Visceral y Robótica, Hospital Universitario Ruber Juan Bravo, Madrid, España; Servicio de Patología, Hospital Universitario Ruber Juan Bravo, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Alcobendas, Madrid, España.
| | | | - Yari Yuritzi Aguilera Molina
- Servicio de Cirugía General, Visceral y Robótica, Hospital Universitario Ruber Juan Bravo, Madrid, España; Servicio de Patología, Hospital Universitario Ruber Juan Bravo, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Alcobendas, Madrid, España
| | | | - Yelene Ajete Ramos
- Servicio de Cirugía General, Visceral y Robótica, Hospital Universitario Ruber Juan Bravo, Madrid, España
| | - Ricardo Ortega García
- Servicio de Cirugía General, Visceral y Robótica, Hospital Universitario Ruber Juan Bravo, Madrid, España
| | | | - Juan Carlos Meneu Díaz
- Servicio de Cirugía General, Visceral y Robótica, Hospital Universitario Ruber Juan Bravo, Madrid, España; Servicio de Patología, Hospital Universitario Ruber Juan Bravo, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Alcobendas, Madrid, España
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44
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Pastier C, De Hingh IHJT, Goéré D. New insights in the management of pseudomyxoma peritonei. J Surg Oncol 2024. [PMID: 39206531 DOI: 10.1002/jso.27842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
While a rare entity, peritoneal pseudomyxoma treatment evolves. Decision-making criteria improve with imaging development and exploratory laparoscopy. Surgery remains at the core of the therapeutic strategy whatever disease progression. Complete cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) is standard of care. Iterative cytoreduction or debulking is sometimes justified. Intraperitoneal chemotherapy modalities change with early postoperative HIPEC or pressurized intraperitoneal aerosol chemotherapy. Systemic or local treatment such as new chemo/immuno-therapies or BromAc should improve outcomes. Expertise and multicentric cooperation are more than ever needed.
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Affiliation(s)
- Clément Pastier
- Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, Université Paris Cité, Paris, France
| | - I H J T De Hingh
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Diane Goéré
- Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, Université Paris Cité, Paris, France
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45
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Shigematsu Y, Saito R, Kanda H, Takahashi Y, Takeuchi K, Takahashi S, Inamura K. Inverse Correlation between pks-Carrying Escherichia coli Abundance in Colorectal Cancer Liver Metastases and the Number of Organs Involved in Recurrence. Cancers (Basel) 2024; 16:3003. [PMID: 39272861 PMCID: PMC11394077 DOI: 10.3390/cancers16173003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Colibactin, a genotoxin produced by Escherichia coli strains harboring the polyketide synthetase (pks) gene cluster, causes DNA damage and somatic mutations. pks+E. coli is enriched in primary colorectal cancer (CRC) and is associated with clonal driver mutations, but its role in CRC liver metastasis is unclear. We assessed the association of pks+ E. coli in CRC liver metastasis tissues with systemic and local immune responses and the number of organs involved in recurrence using specimens and clinicopathological data from 239 patients with CRC liver metastasis who underwent metastasectomy. The levels of pks+E. coli in fresh-frozen specimens were quantified as "very low" (<50th percentile), "low" (50th to 75th percentiles), and "high" (>75th percentile) using a digital PCR. Immunohistochemical analysis of tumor-infiltrating immune cells was performed using tissue microarrays. Systemic inflammation was evaluated using serum C-reactive protein (CRP) levels. pks+E. coli was detected in 66.7% (157 of 239) liver metastasis tissues. Higher levels of pks+E. coli were associated with decreased serum CRP levels and reduced densities of CD4+ cells and CD163+ cells in the tumor-immune microenvironment. The "high" pks+ E. coli group had fewer metastatic organs involved than the "very low" pks+ E. coli group (mean number of organs: 1.00 vs. 1.23). These findings suggest that pks+E. coli play a modulating role in CRC metastasis.
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Affiliation(s)
- Yasuyuki Shigematsu
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Division of Pathology, Cancer Institute, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Rumiko Saito
- Department of Medical Oncology, Cancer Institute Hospital, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Department of Clinical Chemotherapy, Cancer Chemotherapy Center, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Graduate School of Engineering, Chiba Institute of Technology, 2-17-1 Tsudanuma, Narashino, Chiba 275-0016, Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, 780 Komuro, Ina, Kita-adachi-gun, Saitama 362-0806, Japan
| | - Yu Takahashi
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Kengo Takeuchi
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Division of Pathology, Cancer Institute, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Pathology Project for Molecular Targets, Cancer Institute, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Department of Clinical Chemotherapy, Cancer Chemotherapy Center, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Kentaro Inamura
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Division of Pathology, Cancer Institute, JFCR, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Division of Tumor Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0431, Japan
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Cavalcoli F, Rausa E, Ferrari D, Rosa R, Maccauro M, Pusceddu S, Sabella G, Cantù P, Vitellaro M, Coppa J, Mazzaferro V. Pathological Characteristics, Management, and Prognosis of Rectal Neuroendocrine Tumors: A Retrospective Study from a Tertiary Hospital. Diagnostics (Basel) 2024; 14:1881. [PMID: 39272666 PMCID: PMC11394532 DOI: 10.3390/diagnostics14171881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/22/2024] [Accepted: 08/24/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Rectal neuroendocrine tumors (rNENs) are rare, constituting 1-2% of rectal tumors, and are often asymptomatic, leading to challenges in early diagnosis. Current management guidelines recommend endoscopic resection for small lesions and surgical intervention for larger or high-risk tumors. This study aims to retrospectively analyze the pathological characteristics, management, and prognosis of rNEN patients. METHODS Data from the Neuroendocrine Tumor Registry at a tertiary hospital in Milan, Italy from 2005 to 2023 were retrospectively analyzed. Patient demographics, disease characteristics, pathology findings, treatment details, and surveillance data were collected. Statistical analyses included descriptive statistics, multivariable binary logistic regression, and Kaplan-Meier survival analysis. RESULTS Forty-five patients were included, 53.3% male with a mean age of 57.5 years. Most patients were asymptomatic, with incidental diagnosis during colonoscopy. Endoscopic excision was the primary treatment modality (77.8%), with surgical resection reserved for incomplete or inappropriate endoscopic resections. Disease progression occurred in 13 patients (28.9%), with tumor-related mortality of 22.2%. Kaplan-Meier analysis showed 5- and 10-year survival rates of 68.8% and 59.1%, respectively, with corresponding progression-free survival rates of 72.8% and 54.0%. Tumor stage was significantly associated with disease progression on multivariable analysis (OR = 7.230, p = 0.039). CONCLUSIONS This study highlights the heterogeneous presentation and prognosis of rNENs, with a substantial proportion diagnosed incidentally. Endoscopic management was predominantly utilized, aligning with current guidelines for localized tumors. Tumor stage emerged as a significant predictor of disease progression, emphasizing the importance of accurate staging for optimal management. Further research is warranted to refine management protocols and validate these findings.
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Affiliation(s)
- Federica Cavalcoli
- Gastroenterology and Gastrointestinal Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Emanuele Rausa
- Unit of Hereditary Digestive Tract Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
- Colorectal Surgery Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Davide Ferrari
- Colorectal Surgery Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Roberto Rosa
- Gastroenterology and Gastrointestinal Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Marco Maccauro
- Departement of Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Sara Pusceddu
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Giovanna Sabella
- Department of the Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Paolo Cantù
- Gastroenterology and Gastrointestinal Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
- Colorectal Surgery Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Jorgelina Coppa
- HPB Surgery, Hepatology and Liver Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Vincenzo Mazzaferro
- HPB Surgery, Hepatology and Liver Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
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Tamada H, Uehara T, Yoshizawa T, Iwaya M, Asaka S, Nakajima T, Kamakura M, Ota H. Exploring LGR5 as a prognostic marker of extrahepatic cholangiocarcinoma: insights from expression analysis and clinical correlations. Diagn Pathol 2024; 19:116. [PMID: 39198902 PMCID: PMC11350935 DOI: 10.1186/s13000-024-01537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 08/15/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) is a cancer stem cell (CSC) marker of colorectal cancer and may be a CSC marker of other cancer types. Few studies have been conducted on LGR5 expression in extrahepatic cholangiocarcinoma (ECC). METHODS We analyzed LGR5 expression using RNAscope, a highly sensitive RNA in situ hybridization technique. Fifty-three ECCs were selected from the medical archives at Shinshu University Hospital and analyzed using a tissue microarray. LGR5 expression levels were divided into expression and no expression groups. LGR5 expression and clinicopathological characteristics were analyzed. RESULTS Among 25 cases, no LGR5-positive dots were identified. Among 28 cases, some LGR5-positive dots were observed in carcinoma cells, together with a wide range of LGR5-positive cells. LGR5 expression was conspicuous in glandular duct formations. Well- to moderately differentiated types showed significantly higher LGR5 expression than the poorly differentiated type (p = 0.0268). LGR5 expression was associated with good overall survival (p = 0.0219) and good disease-free survival (DFS) (p = 0.0228). High LGR5 expression was associated with well- to moderately-differentiated types, indicating a favorable prognosis. In terms of DFS, multivariate analysis showed that high LGR5 expression was an independent favorable prognostic factor (p = 0.0397). CONCLUSIONS These findings suggest that LGR5 is a promising, novel prognostic marker.
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Affiliation(s)
- Hisashi Tamada
- Department of Pathology, Nagano Red Cross Hospital, Nagano, Japan
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
| | - Takahiro Yoshizawa
- Department of Gastroenterological, Pediatric and Transplant Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Mai Iwaya
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Shiho Asaka
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Tomoyuki Nakajima
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Masato Kamakura
- Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan
| | - Hiroyoshi Ota
- Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
- Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
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Ravizza D, Giunta M, Sala I, Bagnardi V, Tamayo D, de Roberto G, Trovato C, Bravi I, Soru P, Maregatti M, Pisa E, Bertani E, Bonomo G, Spada F, Nicola F. Gastric neuroendocrine tumors: 20-Year experience in a reference center. J Neuroendocrinol 2024:e13440. [PMID: 39191460 DOI: 10.1111/jne.13440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/17/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024]
Abstract
Few studies have been published on the long-term outcomes of patients with gastric neuroendocrine tumors (gNETs). We analyzed their management over a two-decade period, focusing on endoscopic and clinical outcomes. Clinical, laboratory, endoscopic, surgical, and histopathological data from Types 1 and 3 gNETs histologically diagnosed between March 2000 and December 2021 at the European Institute of Oncology (IEO, Milan) were retrospectively collected. Sixty-nine patients were included (60 Type 1, 9 Type 3): 53 (77%) were treated endoscopically, 6 (9%) surgically, and 10 (14%) did not receive any treatment. Overall, 293 lesions were removed endoscopically: 74% by forceps, 20% by endoscopic mucosal resection (EMR), and 5% by endoscopic submucosal dissection (ESD). No differences were observed between EMR and ESD in terms of complete resection rate (p value = .50) and complications rate (p value = .084). The median follow-up period was 5.8 years (range: 0.3-20.5), during which no gNET-related deaths were observed. Metachronous gNETs developed in 60% of patients with Type 1 gNET. Six patients with lymph node metastases (LNM) were younger (p value = .006) and had larger lesions (p value <.001) than patients without LNM. Most Type 1 gNETs were successfully excised using forceps, with EMR and ESD being equally effective. The presence of incomplete resection was not associated with a worse prognosis, which remains excellent in this highly recurrent disease. Younger age and a size ≥10 mm were associated with an increased risk of LNM. CLINICAL TRIAL REGISTRATION: Project code UID 2854.
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Affiliation(s)
- Davide Ravizza
- Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Mariangela Giunta
- Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Isabella Sala
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Darina Tamayo
- Data Management-Clinical Trial Office, Scientific Direction, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Cristina Trovato
- Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Ivana Bravi
- Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Pietro Soru
- Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Eleonora Pisa
- Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Emilio Bertani
- Digestive Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Guido Bonomo
- Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Francesca Spada
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fazio Nicola
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
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Fei S, Wu WD, Zhang HS, Liu SJ, Li D, Jin B. Primary coexisting adenocarcinoma of the colon and neuroendocrine tumor of the duodenum: A case report and review of the literature. World J Gastrointest Surg 2024; 16:2724-2734. [PMID: 39220064 PMCID: PMC11362920 DOI: 10.4240/wjgs.v16.i8.2724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Neuroendocrine tumors (NETs) arise from the body's diffuse endocrine system. Coexisting primary adenocarcinoma of the colon and NETs of the duodenum (D-NETs) is a rare occurrence in clinical practice. The classification and treatment criteria for D-NETs combined with a second primary cancer have not yet been determined. CASE SUMMARY We report the details of a case involving female patient with coexisting primary adenocarcinoma of the colon and a D-NET diagnosed by imaging and surgical specimens. The tumors were treated by surgery and four courses of chemotherapy. The patient achieved a favorable clinical prognosis. CONCLUSION Coexisting primary adenocarcinoma of the colon and D-NET were diagnosed by imaging, laboratory indicators, and surgical specimens. Surgical resection combined with chemotherapy was a safe, clinically effective, and cost-effective treatment.
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Affiliation(s)
- Song Fei
- Department of Thoracic and Cardiovascular Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Wei-Dong Wu
- Department of Thoracic and Cardiovascular Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Han-Shuo Zhang
- Department of Gastrointestinal Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Shao-Jie Liu
- Department of Gastrointestinal Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Dan Li
- Department of Thoracic and Cardiovascular Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Bo Jin
- Department of Thoracic and Cardiovascular Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China
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50
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Yasinzai AQK, Lee KT, Khan I, Tareen B, Sohail AH, Iqbal A, Khan I, Waheed A, Ramamoorthy BU, Ullah A, Blakely AM. Colorectal Leiomyosarcoma: Demographics Patterns, Treatment Characteristics, and Survival Analysis in the U.S. Population. J Gastrointest Cancer 2024:10.1007/s12029-024-01110-x. [PMID: 39190114 DOI: 10.1007/s12029-024-01110-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Colorectal leiomyosarcoma (CR-LMS) is a rare neoplasm arising from smooth muscle cells. It accounts for less than 0.1% of all colorectal malignancies. In this population-based study, we aim to understand the demographics, treatment characteristics, and pathologic factors associated with survival in CR-LMS. METHODS Data from the SEER Program (2000-2018) were analyzed using SEER*Stat and SPSS. Statistical methods included descriptive analysis, Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards regression to assess the impact of various factors on disease-specific and overall survival. RESULTS A total of 191 cases of CR-LMS were identified. Most patients were 60-69 years of age (median: 64 years) and Caucasian (78%). There was nearly the same distribution in sex (M:F ratio; 1:1.2). The overall 5-year observed survival was 50.3% (95% C.I., 46.3-54.2). The 5-year disease-specific survival (DSS) was 66.1% (95% C.I., 62.0-70.1). The 5-year overall survival after resection was 60.8% (95% C.I., 56.3-65.3). Multivariable analysis identified grades III and IV (p = 0.028) as negative predictors of overall survival. Regional spread and distant stage are negative predictors of overall survival (p < 0.01). CONCLUSION Our data reveals that colorectal leiomyosarcoma (CR-LMS) often presents in patients around 64 years old with advanced stages and poor differentiation. Key adverse prognostic factors include older age, high tumor grade, large tumor size, and distant metastases, with surgical resection showing the best survival outcomes. To improve outcomes, further research and consolidation of data are essential for developing targeted therapies and comprehensive guidelines.
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Affiliation(s)
| | | | - Imran Khan
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Bisma Tareen
- Department of Medicine, Bolan Medical College, Quetta, 83700, Pakistan
| | - Amir Humza Sohail
- Department of Surgical Oncology, University of New Mexico, Albuquerque, NM, USA
| | - Asif Iqbal
- Department of Medicine, Northeastern Health System, Tahlequah, OK, USA
| | - Israr Khan
- Insight Hospital and Medical Center, Chicago, USA
| | - Abdul Waheed
- Department of Surgery, Baycare Health System, Clearwater, Fl, USA
| | | | - Asad Ullah
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - Andrew M Blakely
- Surgical Oncology Program, National Cancer Institute, Bethesda, MD, 20892, USA.
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