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Yan J, Zhang H, Zhang M, Tian M, Nie G, Xie D, Zhu X, Li X. The association between trace metals in both cancerous and non-cancerous tissues with the risk of liver and gastric cancer progression in northwest China. J Pharm Biomed Anal 2024; 242:116011. [PMID: 38359492 DOI: 10.1016/j.jpba.2024.116011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/16/2024] [Accepted: 02/03/2024] [Indexed: 02/17/2024]
Abstract
Liver cancer and gastric cancer have extremely high morbidity and mortality rates worldwide. It is well known that an increase or decrease in trace metals may be associated with the formation and development of a variety of diseases, including cancer. Therefore, this study aimed to evaluate the contents of aluminium (Al), arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), selenium (Se), and zinc (Zn) in cancerous liver and gastric tissues, compared to adjacent healthy tissues, and to investigate the relationship between trace metals and cancer progression. During surgery, multiple samples were taken from the cancerous and adjacent healthy tissues of patients with liver and gastric cancer, and trace metal levels within these samples were analysed using inductively coupled plasma mass spectrometry (ICP-MS). We found that concentrations of As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Se, and Zn in tissues from patients with liver cancer were significantly lower than those in healthy controls (P < 0.05). Similarly, patients with gastric cancer also showed lower levels of Cd, Co, Cr, Mn, Ni, and Zn-but higher levels of Cu and Se-compared to the controls (P < 0.05). In addition, patients with liver and gastric cancers who had poorly differentiated tumours and positive lymph node metastases showed lower levels of trace metals (P < 0.05), although no significant changes in their concentrations were observed to correlate with sex, age, or body mass index (BMI). Logistic regression, principal component analysis (PCA), Bayesian kernel regression (BKMR), weighted quantile sum (WQS) regression, and quantile-based g computing (qgcomp) models were used to analyse the relationships between trace metal concentrations in liver and gastric cancer tissues and the progression of these cancers. We found that single or mixed trace metal levels were negatively associated with poor differentiation and lymph node metastasis in both liver and gastric cancer, and the posterior inclusion probability (PIP) of each metal showed that Cd contributed the most to poor differentiation and lymph node metastasis in both liver and gastric cancer (all PIP = 1.000). These data help to clarify the relationship between changes in trace metal levels in cancerous liver and gastric tissues and the progression of these cancers. Further research is warranted, however, to fully elucidate the mechanisms and causations underlying these findings.
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Affiliation(s)
- Jun Yan
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou 730000, Gansu, People's Republic of China
| | - Honglong Zhang
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China
| | - Mingtong Zhang
- GanSu Provincial Institute of Drug Control, Lanzhou 730000, Gansu, People's Republic of China
| | - Meng Tian
- Deyang People's Hospital, Deyang 618000, Sichuan, People's Republic of China
| | - Guole Nie
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China
| | - Danna Xie
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China
| | - Xingwang Zhu
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China
| | - Xun Li
- The First School of Clinical Medical, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou 730000, Gansu, People's Republic of China.
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Roccuzzo G, Orlando G, Rumore MR, Morrone A, Fruttero E, Caliendo V, Picciotto F, Sciarrillo A, Quaglino P, Cassoni P, Ribero S, Senetta R. Predictors of Recurrence and Progression in Poorly Differentiated Cutaneous Squamous Cell Carcinomas: Insights from a Real-Life Experience. Dermatology 2023; 240:329-336. [PMID: 38008073 DOI: 10.1159/000535040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023] Open
Abstract
INTRODUCTION Surgery represents the primary treatment option for cutaneous squamous cell carcinoma (cSCC) aiming for complete tumor resection (R0). Recurrence and metastasis significantly affect survival and outcomes, and poorly differentiated (G3) cSCC is associated with a higher risk of recurrence. However, the specific clinical and histopathological features that predict recurrence and progression in G3-cSCC remain unclear. METHODS A retrospective analysis was conducted on a series of patients with primary G3-cSCC diagnosed at the Turin University Hospital between January 2016 and January 2021. After independent histological revision, logistic regression models were used to identify clinico-pathological predictors of cutaneous recurrence, lymphnode/metastatic progression, and both types of progression. RESULTS Among the 161 G3-cSCC patients, 80.1% (129/161) showed no signs of local recurrence or metastatic progression, while 19.9% (32 patients) had progressed. In the univariate logistic regression, tumor clinical diameter, depth of infiltration (DOI), and lymphovascular invasion (LVI) were identified as significant predictors across the various types of progression (p < 0.05). In the context of multivariate logistic regression, distinct models proved to be significant. For skin recurrence, a 3-variable model incorporating DOI (OR 1.16, 95% CI, 1.01-1.35, p = 0.050), LVI (OR 3.61, 95% CI, 1.11-11.8, p = 0.034), and desmoplasia (OR 3.45, 95% CI, 1.25-9.5, p = 0.017) was selected. Regarding lymphnode/metastatic progression, a 3-variable model combining pT2 (OR 6.10, 95% CI, 1.15-32.35, p = 0.034), pT3 (OR 14.33, 95% CI, 2.79-73.63, p = 0.001), and LVI (OR 3.86, 95% CI, 1.10-13.62, p = 0.036) was identified. Lastly, a 2-variable model for both types of progression consisted of vertical tumor thickness (OR 5.45, 95% CI, 1.11-27.32, p = 0.039) and LVI (OR 1.15, 95% CI, 1.04-1.26, p = 0.006). CONCLUSION Tumor size, DOI, and LVI were significant predictors of recurrence and metastatic progression. Notably, the size of histologically defined tumor-free margins did not affect the risk of recurrence, whilst LVI emerged as a key predictor of all forms of progression. These findings provide insights into risk stratification and suggest that close monitoring and potential adjuvant therapies, such as radiation therapy, may be necessary especially for patients with lymphovascular involvement.
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Affiliation(s)
- Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Giulia Orlando
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Maria Rebecca Rumore
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonio Morrone
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Enrico Fruttero
- Department of Surgery, Dermatologic Surgery Section, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, Turin, Italy
| | - Virginia Caliendo
- Department of Surgery, Dermatologic Surgery Section, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, Turin, Italy
| | - Franco Picciotto
- Department of Surgery, Dermatologic Surgery Section, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, Turin, Italy
| | - Alberto Sciarrillo
- Department of Surgical Sciences, Structure of Reconstructive and Aesthetic Plastic Surgery, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Rebecca Senetta
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
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Mathur R, Malik A, Mishra A, Mair M, Singh AG, Singhavi HR, Mahuvakar AD, Qayuumi B, Shetty KSR, Bal M, Nair SV, Nair D, Chaturvedi P. Prognostic Impact of Poor Differentiation of Squamous Cell Carcinoma in Treatment Naïve Node-Negative Early Oral Cancers. Indian J Surg Oncol 2023; 14:524-530. [PMID: 37324289 PMCID: PMC10267037 DOI: 10.1007/s13193-023-01712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
We have conducted this study to understand the impact of poor differentiation (PD), as a sole poor prognostic factor, in early oral cancers. This was a retrospective analysis of a prospectively maintained database of clinically node-negative early T stage OSCC patients operated between 2012 and 2014. Impact of PD on the survival and role of adjuvant therapy in these patients was noted. Out of 1172 patients screened, 280 patients were found to be eligible for the study. 11.4% patients had PDSCC. It was found to be associated with tongue cancers and peri-neural invasion. It had a significant impact on OS and DFS (48.7 months vs 81.4 months, p < 0.00 and 44.6 months vs 73.5 months, p < 0.00 respectively. Hazard ratio for DFS: 4.08. Although patients with PDSCC had better survival with radiotherapy, but this was not statistically significant. Poor differentiation as a stand-alone factor impacts survival in patients with early oral cancer. It may be seen more often in patients with tongue cancer and may have associated PNI. The role of adjuvant therapy in such patients is not clear.
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Affiliation(s)
- Rachit Mathur
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Akshat Malik
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
- Department of Surgical Oncology, Max Institute of Cancer Care, Saket, New Delhi, 110017 India
| | - Aseem Mishra
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Manish Mair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Arjun G. Singh
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Hitesh R. Singhavi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Ankit D. Mahuvakar
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Burhanuddin Qayuumi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - K. S. Rathan Shetty
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Munita Bal
- Department of Pathology, Tata Memorial Centre, Parel, Homi Bhabha National Institute, Mumbai, 400012 India
| | - Sudhir V. Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Deepa Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
| | - Pankaj Chaturvedi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai, 400012 India
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Margalit O, Shacham-Shmueli E, Yang YX, Lawerence YR, Levy I, Reiss KA, Golan T, Halpern N, Aderka D, Giantonio B, Mamtani R, Boursi B. Prognostic Implications of Tumor Differentiation in Clinical T1N0 Gastric Adenocarcinoma. Oncologist 2020; 26:e111-e114. [PMID: 32969129 PMCID: PMC7794188 DOI: 10.1002/onco.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Background Current guidelines recommend neoadjuvant chemotherapy in patients with locoregional gastric adenocarcinoma. Patients diagnosed with early stage gastric adenocarcinoma are usually managed with upfront surgical intervention. However, pathologic staging in a subset of these clinically staged patients identifies more advanced locoregional disease requiring adjuvant treatment. Therefore, identifying these patients prior to surgical intervention is critical to ensure employment of the appropriate treatment paradigm. The aim of the current study was to define patient characteristics associated with clinical understaging in early gastric cancer. Methods Using the National Cancer Database (2004–2014) we identified 3,892 individuals with clinical T1N0 gastric adenocarcinoma who underwent upfront definitive surgery, had negative surgical margins, and did not receive preoperative chemotherapy or radiotherapy. Patient characteristics were compared between those with pathologic stage T1N0 disease and those who were upstaged upon surgery. Results Twenty‐seven percent of clinical T1N0 gastric adenocarcinomas had a change in stage because of pathologically defined ≥T2 disease or positive lymph nodes. Individuals who were upstaged had a higher tumor grade compared with those with pathologic stage T1N0 disease. Specifically, 41.9% (530/1,264) of individuals with a poorly differentiated tumor were upstaged, compared with only 10.7% (70/656) with a well‐differentiated tumor. Approximately 75% of cases involved upstaging because of T misclassification. The highest percentage of upstaging was shown for tumors located at the fundus and body of the stomach. Conclusion Upstaging of clinical T1N0 gastric adenocarcinoma is characterized by higher tumor grade and is mostly a result of a change in T stage. These findings mandate thorough workup in order to identify patients with clinically staged T1N0 disease requiring preoperative chemotherapy. Implications for Practice Upstaging of clinical T1N0 gastric adenocarcinoma is characterized by higher tumor grade and is mostly a result of a change in T stage. These findings mandate thorough workup in order to identify patients with clinically staged T1N0 disease requiring preoperative chemotherapy. This article evaluates the frequency of upstaging following surgery among cT1N0 gastric cancer and defines the corresponding patient characteristics, with the goal of better identifying those patients who require preoperative chemotherapy.
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Affiliation(s)
- Ofer Margalit
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel
| | - Einat Shacham-Shmueli
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel
| | - Yu-Xiao Yang
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yaacov R Lawerence
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel.,Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Idan Levy
- Department of Gastroenterology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Kim A Reiss
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Talia Golan
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel
| | - Naama Halpern
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel
| | - Dan Aderka
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel
| | - Bruce Giantonio
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ronac Mamtani
- Department of Gastroenterology, Sheba Medical Center, Tel-Hashomer, Israel.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ben Boursi
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Tel-Aviv University, Tel-Aviv, Israel.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Feng Z, Xu QS, Wang C, Li B, Li JZ, Mao MH, Li H, Qin LZ, Han Z. Clinicopathological features, management and outcome of patients with poorly-differentiated oral and oropharyngeal squamous cell carcinoma. J Craniomaxillofac Surg 2017; 45:1478-1485. [PMID: 28743604 DOI: 10.1016/j.jcms.2017.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/20/2017] [Accepted: 06/27/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore the clinicopathological features, risk factors, and management of poorly differentiated oral and oropharyngeal squamous cell carcinoma (OOSCC) patients in the northern Chinese population. METHOD A total of 118 poorly differentiated OOSCC patients from 2236 consecutive cases were retrospectively enrolled in this study. RESULTS Cox regression analysis showed that site (hazard ratio (HR): 2.561, 95% confidence interval (CI): 1.064-6.164, p = 0.036) and lymph node ratio (LNR) (HR: 3.915, 95% CI: 1.797-8.530, p = 0.001) were independent predictive factors for 5-year disease-specific survival (DSS). LNR >0.036, oropharynx site, and advanced clinical stage formulate a model of risk stratification. The patients with a risk score of ≥2 were identified as the high-risk population, and patients with a risk score of 0 or 1 were identified as the low-risk population. Patients in the high-risk population who underwent surgery plus concurrent chemoradiotherapy (CCRT) had markedly better 5-year DSS than those who only underwent surgery (60.0% vs. 20.0%, p = 0.016). However, patients in the low-risk population who underwent surgery alone exhibited a similar 5-year DSS (68.2%) compared with those who received surgery plus radiotherapy (RT) (68.2%) or surgery plus CCRT (50.0%) (p = 0.907). CONCLUSIONS High LNR, oropharynx site and advanced clinical stage constitute a model of risk stratification for patients with poorly differentiated OOSCC. If two or more risk factors are present, surgery and adjuvant chemoradiotherapy can give the best prognosis.
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Affiliation(s)
- Zhien Feng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Qiao Shi Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Chong Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Bo Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Jin Zhong Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Ming Hui Mao
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hua Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Li Zheng Qin
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Zhengxue Han
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China.
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Guo T, Ng KK, Chiang HW, Ma MF, Lin Y, Qian JM. Duodenal Neuroendocrine Carcinoma Presenting with Disseminated Liver and Bone Metastases as the Primary Manifestation: Case Report and Literature Review. Cell Biochem Biophys 2016; 72:305-9. [PMID: 25564359 DOI: 10.1007/s12013-014-0430-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Neuroendocrine tumors are composed by a heterogeneous group of tumors with a wide range of morphologic, functional, and behavioral characteristics. These tumors are generally slow growing and behave in an indolent fashion. However, they have the potential to spread, especially for poorly differentiated neuroendocrine carcinomas, and when they do, they can be very aggressive, with high propensity for distant metastases, and difficult to treat with current modalities. As poorly differentiated neuroendocrine carcinomas rarely occur in extrapulmonary sites, to the best of our knowledge, this is the first case report of a poorly differentiated duodenal neuroendocrine carcinoma with diffuse liver and bone metastases as the primary manifestation. Despite receiving a trial of chemotherapeutic regimen, the patient had progressive intrahepatic cholestasis and died of subacute hepatic failure.
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Affiliation(s)
- Tao Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Ka Kei Ng
- Department of Gastroenterology, Centro Hospitalar Conde de S. Januario (CHCSJ), Macao, China
| | - Hoi Wan Chiang
- Department of Gastroenterology, Centro Hospitalar Conde de S. Januario (CHCSJ), Macao, China
| | - Man Fei Ma
- Department of Gastroenterology, Centro Hospitalar Conde de S. Januario (CHCSJ), Macao, China
| | - Yi Lin
- Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jia Ming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
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