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Butz F, Dukaczewska A, Kunze CA, Krömer JM, Reinhard L, Jann H, Fehrenbach U, Müller-Debus CF, Skachko T, Pratschke J, Goretzki PE, Mogl MT, Dobrindt EM. Influence of Lymphatic, Microvascular and Perineural Invasion on Oncological Outcome in Patients with Neuroendocrine Tumors of the Small Intestine. Cancers (Basel) 2024; 16:305. [PMID: 38254794 PMCID: PMC10813650 DOI: 10.3390/cancers16020305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
For the histopathological work-up of resected neuroendocrine tumors of the small intestine (siNET), the determination of lymphatic (LI), microvascular (VI) and perineural (PnI) invasion is recommended. Their association with poorer prognosis has already been demonstrated in many tumor entities. However, the influence of LI, VI and PnI in siNET has not been sufficiently described yet. A retrospective analysis of all patients treated for siNET at the ENETS Center of Excellence Charité-Universitätsmedizin Berlin, from 2010 to 2020 was performed (n = 510). Patients who did not undergo primary resection or had G3 tumors were excluded. In the entire cohort (n = 161), patients with LI, VI and PnI status had more distant metastases (48.0% vs. 71.4%, p = 0.005; 47.1% vs. 84.4%, p < 0.001; 34.2% vs. 84.7%, p < 0.001) and had lower rates of curative surgery (58.0% vs. 21.0%, p < 0.001; 48.3% vs. 16.7%, p < 0.001; 68.4% vs. 14.3%, p < 0.001). Progression-free survival was significantly reduced in patients with LI, VI or PnI compared to patients without. This was also demonstrated in patients who underwent curative surgery. Lymphatic, vascular and perineural invasion were associated with disease progression and recurrence in patients with siNET, and these should therefore be included in postoperative treatment considerations.
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Affiliation(s)
- Frederike Butz
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Agata Dukaczewska
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Catarina Alisa Kunze
- Department of Pathology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Janina Maren Krömer
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Lisa Reinhard
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Henning Jann
- Department of Hepatology and Gastroenterology, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Charlotte Friederieke Müller-Debus
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Tatiana Skachko
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Johann Pratschke
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Peter E. Goretzki
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Martina T. Mogl
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Eva Maria Dobrindt
- Department of Surgery, Campus Charité Mitte|Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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Lee J, Ahn S, Kim H, An J, Sim J. A robust model training strategy using hard negative mining in a weakly labeled dataset for lymphatic invasion in gastric cancer. J Pathol Clin Res 2024; 10:e355. [PMID: 38116763 PMCID: PMC10766063 DOI: 10.1002/cjp2.355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
Gastric cancer is a significant public health concern, emphasizing the need for accurate evaluation of lymphatic invasion (LI) for determining prognosis and treatment options. However, this task is time-consuming, labor-intensive, and prone to intra- and interobserver variability. Furthermore, the scarcity of annotated data presents a challenge, particularly in the field of digital pathology. Therefore, there is a demand for an accurate and objective method to detect LI using a small dataset, benefiting pathologists. In this study, we trained convolutional neural networks to classify LI using a four-step training process: (1) weak model training, (2) identification of false positives, (3) hard negative mining in a weakly labeled dataset, and (4) strong model training. To overcome the lack of annotated datasets, we applied a hard negative mining approach in a weakly labeled dataset, which contained only final diagnostic information, resembling the typical data found in hospital databases, and improved classification performance. Ablation studies were performed to simulate the lack of datasets and severely unbalanced datasets, further confirming the effectiveness of our proposed approach. Notably, our results demonstrated that, despite the small number of annotated datasets, efficient training was achievable, with the potential to extend to other image classification approaches used in medicine.
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Affiliation(s)
- Jonghyun Lee
- Department of Medical and Digital EngineeringHanyang University College of EngineeringSeoulRepublic of Korea
- Department of PathologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Sangjeong Ahn
- Department of PathologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Hyun‐Soo Kim
- Department of Pathology and Translational GenomicsSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Jungsuk An
- Department of PathologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Jongmin Sim
- Department of PathologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
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Cho SH, Park BS, Son GM, Kim HS, Kim SJ, Park SB, Choi CW, Kim HW, Shin DH, Yun MS. Differences in Factors Predicting Lymph Node Metastasis Between pT1 Rectal Cancer and pT1 Colon Cancer: A Retrospective Study. Am Surg 2023; 89:5829-5836. [PMID: 35766839 DOI: 10.1177/00031348221111517] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies have demonstrated conflicting results regarding factors that predict lymph node metastasis (LNM) in pT1 colorectal cancers. We hypothesized that these discrepancies could be related to different factors predicting LNM between rectal and colon cancer. This study aimed to compare predicting factors for LNM between pT1 rectal and colon cancer. METHODS This retrospective study evaluated a prospectively maintained database that included 380 patients with pT1 colorectal cancer from January 2010 to December 2020. Patients were grouped according to whether they had rectal or colon cancer, with or without LNM, and factors predicting LNM were analyzed. RESULTS In pT1 rectal cancer, LNM was associated with deeper submucosal (SM) invasion (P = .024) and a higher proportion of poorly differentiated tumors (P = .006). In pT1 colon cancer, LNM was associated with a higher proportion of moderately/poorly differentiated tumors (P = .002) and lymphatic invasion (P = .004). In the multivariate analysis for rectal cancer, depth of SM invasion (≥3000 μm) was an independent predictive factor for LNM (95% confidence interval [CI], 1.48-27.94; P = .013), whereas for colon cancer, moderately/poorly differentiated tumors (95% CI, 1.38-8.13; P = .008) and lymphatic invasion (95% CI, 1.44-11.78; P = .008) were independent predictive factors for LNM. DISCUSSION There were distinct differences in the factors predicting LNM between pT1 rectal cancer and colon cancer. These results suggest the necessity in differentiating between rectal and colon cancer when performing studies on LNM in pT1 colorectal cancer.
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Affiliation(s)
- Sung Hwan Cho
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Byung-Soo Park
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Gyung Mo Son
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Hyun Sung Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Su Jin Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Su Bum Park
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Cheol Woong Choi
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Hyung Wook Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Dong Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Mi Sook Yun
- Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Chung DH, Han JH, Jeong SH, Yuk HD, Jeong CW, Ku JH, Kwak C. Role of lymphatic invasion in predicting biochemical recurrence after radical prostatectomy. Front Oncol 2023; 13:1226366. [PMID: 37752996 PMCID: PMC10518614 DOI: 10.3389/fonc.2023.1226366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Objective Lymphatic invasion in prostate cancer is associated with poor prognosis. However, there is no consensus regarding the clinical and prognostic value of lymphatic invasion. This study aimed to investigate the prognostic value of lymphatic invasion in biochemical recurrence (BCR) and compare the recurrence rates between patients with lymphatic invasion and lymph node metastasis. Methods We retrospectively analyzed 2,207 patients who underwent radical prostatectomy (RP) without pelvic lymph node dissection (PLND) and 742 patients who underwent RP with PLND for clinically localized or locally advanced prostate cancer, between 1993 and 2020, at Seoul National University Hospital. Kaplan-Meier analysis was performed to estimate BCR-free survival (BCRFS) using the log-rank test. The Cox proportional hazards model was used to identify the significant factors for BCR. Propensity score matching was performed with a 1:2 ratio to match age, initial PSA level, pathological T stage, and Gleason score to exclude confounding effects. Results Of the 2,207 patients who underwent RP without PLND, lymphatic invasion (L1Nx) was observed in 79 (3.5%) individuals. Among the 742 patients who underwent RP with PLND, lymph node metastases were found in 105 patients (14.2%). In patients with lymph node metastasis, lymphatic invasion was observed in 50 patients (47.6%), whereas lymphatic invasion was observed in 53 patients (8.3%) among those without lymph node metastasis. In patients who underwent RP without PLND, Kaplan-Meier analysis showed significantly poorer BCR-free survival in the L1Nx group than in the L0Nx group (p < 0.001). In patients who underwent RP with PLND, the L1N0, L0N1, and L1N1 groups showed significantly worse prognoses than the L0N0 group (p < 0.001). However, there was no significant difference in BCRFS between the L1N0 and lymph node metastasis groups, including the L0N1 and L1N1 groups. After propensity score matching at a 1:2 ratio, the L1Nx group showed significantly poorer outcomes in terms of BCRFS than the L0Nx group (p = 0.05). In addition, the L1N0 group showed a significantly worse prognosis than the L0N0 group after propensity score matching. Conclusion Lymphatic invasion in radical prostatectomy specimens is an independent prognostic factor, which can complement lymph node status for predicting biochemical recurrence. Considering lymphatic invasion as an adverse pathological finding, similar to lymph node metastasis, adjuvant therapy could be considered in patients with lymphatic invasion.
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Affiliation(s)
- Dae Hyuk Chung
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jang Hee Han
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Hwan Jeong
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeong Dong Yuk
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Nagaro H, Ichikawa H, Takizawa K, Nagahashi M, Abe S, Hirose Y, Moro K, Miura K, Nakano M, Shimada Y, Sakata J, Wakai T. Clinical Significance of Phosphorylated Sphingosine Kinase 1 Expression in Pancreatic Ductal Adenocarcinoma. Anticancer Res 2023; 43:3969-3977. [PMID: 37648331 DOI: 10.21873/anticanres.16584] [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: 06/12/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM Sphingosine-1-phosphate (S1P) is a pleiotropic, bioactive, lipid mediator, produced by sphingosine kinase 1 (SphK1). In this study, we evaluated the expression of phosphorylated SphK1 (pSphK1) in patients with pancreatic ductal adenocarcinoma (PDAC) and investigated its clinical significance. MATERIALS AND METHODS A total of 111 patients who underwent curative-intent resection for PDAC were enrolled. We investigated pSphK1 (Ser-225) expression in surgically resected specimens of PDAC using immunohistochemistry. The patients were divided into two groups according to pSphK1 immunoreactive expression: a pSphK1-high group (n=63) and a pSphK1-low group (n=48). RESULTS Logistic regression analyses revealed that lymphatic invasion (p=0.007) was a significantly independent factor associated with high pSphK1 immunoreactive expression. The pSphK1-high group showed significantly worse disease-specific survival (DSS) than the pSphK1-low group (5-year DSS rate, 19.6% vs. 58.7%; p=0.001). High pSphK1 immunoreactive expression (hazard ratio=2.547; 95% confidence interval= 1.434-4.527; p=0.001) was an independent prognostic factor for DSS. CONCLUSION High pSphK1 expression is independently associated with lymphatic invasion and unfavorable prognosis in PDAC patients. Thus, the SphK1-S1P axis may be important in mechanisms of tumor progression, such as lymphatic invasion, in PDAC patients.
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Affiliation(s)
- Hiroki Nagaro
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;
| | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Nagahashi
- Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Hyogo, Japan
| | - Shun Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuki Moro
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Yamashita S, Muraoka S, Wakamiya T, Kikkawa K, Kohjimoto Y, Hara I. Prognostic Impact of Lymphatic Invasion in Patients with High-Risk Prostate Cancer after Robot-Assisted Radical Prostatectomy and Extended Lymph Node Dissection: A Single-Institution Prospective Cohort Study. Cancers (Basel) 2022; 14:cancers14143466. [PMID: 35884527 PMCID: PMC9323994 DOI: 10.3390/cancers14143466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The prognostic impact of lymphatic invasion in patients with high-risk prostate cancer (PC) remains unclear. The aim of our single-institution prospective cohort study was to examine the impact of lymphatic invasion on biochemical recurrence (BCR) in patients with high-risk PC according to National Comprehensive Cancer Network (NCCN) criteria who underwent robot-assisted radical prostatectomy (RARP) and extended lymph node dissection (eLND). A total of 183 patients were included who underwent RARP and eLND for NCCN high-risk PC between June 2014 and August 2019. Lymphatic invasion in resected specimens was observed in 47 patients (26%), whereas lymph node metastasis was observed in 17 patients (9%). During follow-up, BCR was observed in 48 patients (26%). The BCR rate in patients with lymphatic invasion was significantly higher than that in patients without lymphatic invasion (p < 0.01). According to multivariable Cox proportional hazards regression analyses, lymphatic invasion was a significant independent predictor of BCR in the overall patient group and was independently associated with BCR, even in patients without lymph node metastasis. In conclusion, evaluation of lymphatic invasion could be useful in predicting BCR in patients undergoing RARP and eLND for high-risk PC.
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Toriumi T, Yagi K, Ri M, Yajima S, Okumura Y, Aikou S, Yamashita H, Nomura S, Seto Y. Lymphatic invasion is a prognostic factor of pathological N0 esophageal squamous cell carcinoma. Dis Esophagus 2022; 35:6479782. [PMID: 34937084 DOI: 10.1093/dote/doab087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/27/2021] [Indexed: 12/11/2022]
Abstract
Adjuvant treatment after upfront esophagectomy for esophageal squamous cell carcinoma (ESCC) is indicated only for patients with lymph node metastasis in Japan. However, the recurrence rate after curative resection is high even for node-negative patients; thus, understanding the prognostic factors for patients with node-negative ESCC, which still remains unidentified, is important. Here, we aimed to reveal the prognostic factors for the long-term outcomes of patients with node-negative ESCC. Moreover, we compared the long-term outcomes among high-risk node-negative and node-positive patients. This single-institution retrospective study included 103 patients with pT1b-3N0 ESCC who underwent upfront surgery to identify the population at a high risk of recurrence. To compare overall survival (OS) and recurrence-free survival (RFS) between high-risk node-negative and node-positive patients, 51 node-positive ESCC patients with pStage IIIA or less who had undergone upfront surgery were also included. Univariable and multivariable analyses were performed using the Cox proportional hazard regression model. OS and RFS were compared using the log-rank test. Only lymphatic invasion (Ly+) was associated with worse 3-year OS (hazard ratio, 8.63; 95% confidence interval, 2.09-35.69; P = 0.0029) and RFS (hazard ratio, 4.87; 95% confidence interval, 1.69-14.02; P = 0.0034). The node-negative and Ly+ patients showed significantly worse OS (P = 0.0242) and RFS (P = 0.0114) than the node-positive patients who underwent chemotherapy. Ly+ is the only independent prognostic factor in patients with node-negative ESCC. Patients with node-negative and Ly+ ESCC may benefit from adjuvant treatment.
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Affiliation(s)
- Tetsuro Toriumi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motonari Ri
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shoh Yajima
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Okumura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Surgery, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroharu Yamashita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Mitsui S, Tanaka Y, Doi T, Hokka D, Maniwa Y. Prognostic value of preoperative plasma fibrinogen levels in resected stage I non-small cell lung cancer. Thorac Cancer 2022; 13:1490-1495. [PMID: 35412025 PMCID: PMC9108075 DOI: 10.1111/1759-7714.14419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 12/17/2022] Open
Abstract
Background The number of surgical procedures has increased among patients with early‐stage lung cancer. If the poor prognostic factors for stage I non‐small cell lung cancer (NSCLC) can be simply validated preoperatively, appropriate treatment will be provided. The current study aimed to evaluate the prognostic value of preoperative plasma fibrinogen levels in patients with resected stage I NSCLC. Methods We retrospectively analyzed the clinicopathological information of patients (n = 149) who underwent lobectomy for stage I NSCLC between May 2014 and July 2016. Data about peripheral blood analysis, histopathological finding, and follow‐up assessment results were collected from the databases. Patients were divided into the low and high fibrinogen groups. Univariate and multivariate analyses were performed to evaluate the predictors of recurrence and survival. Results Compared with the low fibrinogen group (<377 mg/dl), the high fibrinogen group (≥377 mg/dl) had a significantly greater number of male participants (p = 0.04), smokers (p < 0.001), and those with elevated cytokeratin antigen levels (p = 0.04), lymphatic invasion (p = 0.007), and squamous cell carcinoma (p < 0.001). Plasma fibrinogen level was considered a significant independent factor for recurrence and overall survival on both the univariate and multivariate analyses (p < 0.001 and p = 0.010) and the multivariate analysis alone (p = 0.020 and p < 0.012). Conclusion Preoperative plasma fibrinogen level might be a useful predictor of recurrence and survival in patients with stage I NSCLC. The treatment strategy for patients with high fibrinogen levels could be cautiously considered preoperatively.
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Affiliation(s)
- Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Straker RJ, Taylor LA, Neuwirth MG, Sinnamon AJ, Shannon AB, Abbott J, Miura JT, Chu EY, Xu X, Karakousis GC. Optimizing Detection of Lymphatic Invasion in Primary Cutaneous Melanoma With the Use of D2-40 and a Paired Melanocytic Marker. Am J Dermatopathol 2022; 44:21-27. [PMID: 34231497 PMCID: PMC8671172 DOI: 10.1097/dad.0000000000002018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT Dual immunohistochemical (IHC) staining with D2-40 and S100 improves detection of lymphatic invasion (LI) in primary cutaneous melanoma. However, limited data exist evaluating this technique using other melanocytic markers, and thus, the optimal marker for detection of LI is unestablished. To address this knowledge gap, a case-control study was performed comparing melanoma specimens from 22 patients with known lymphatic spread (LS) with a control group of 11 patients without LS. Specimens underwent dual IHC staining with D2-40 and MART-1, SOX-10, and S100 to evaluate for LI. Receiver operating characteristic analysis was used to estimate each stain's accuracy for detection of LI. The LS group was more likely to be ≥65 years (P = 0.04), have a tumor thickness of ≥1 mm (P < 0.01), and have ulcerated tumors (P = 0.02). Detection of LI with D2-40/MART-1 significantly correlated with LS (P = 0.03), and the D2-40/MART-1 stain was most accurate for LI based on receiver operating characteristic curve analysis (area under the curve [AUC] 0.705) in comparison with D2-40/SOX-10 (AUC 0.575) and D2-40/S100 (AUC 0.633). These findings suggest that MART-1 may be the optimal melanocytic marker to combine with D2-40 for detection of LI in melanoma. Further studies are needed to determine the utility of routinely performing these stains for histopathologic analysis of melanoma.
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Affiliation(s)
- Richard J. Straker
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Laura A. Taylor
- Department of Dermatology, University of Louisville, Louisville, KY
| | | | | | - Adrienne B. Shannon
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - James Abbott
- Department of Dermatology, University of Utah, Salt Lake City, UT
| | - John T. Miura
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Emily Y. Chu
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Xiaowei Xu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Giorgos C. Karakousis
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
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10
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Chang K, Song B, DO IG, Koo DH, Lee HW, Son BH, Yoo CH, Kim K. Venous Invasion and Perineural Invasion as Upstaging and Poor Prognostic Factors in N0 Gastric Cancers. Anticancer Res 2021; 41:5803-5810. [PMID: 34732454 DOI: 10.21873/anticanres.15397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Lymph node metastasis is an important prognostic factor in gastric cancer patients. In node-negative (N0) gastric cancer patients, additional prognostic factors are needed to reinforce TNM staging. PATIENTS AND METHODS We semi-quantitatively recorded the presence of lymphatic, venous, and perineural invasion and evaluated the possibility that they could be used as upstaging factors in N0 gastric cancer by comparing N0 gastric cancer cases with N1 cases. RESULTS Venous (p<0.001) and perineural (p<0.001) invasion were important factors in the relapse-free survival of N0 patients, but lymphatic invasion was not. N0 cases with venous or perineural invasion had survival curves similar to those of N1 patients. In addition, the number of invasive features (lymphatic, venous, or perineural) was an important factor in predicting poor patient survival. CONCLUSION Venous and perineural invasion were significant prognostic factors in N0 gastric cancer cases. It is necessary to record lymphatic, venous, and perineural invasion separately in the pathology report, especially in cases of N0 gastric cancer.
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Affiliation(s)
- Kyungseek Chang
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Boram Song
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;
| | - In-Gu DO
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Hoe Koo
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyoun Wook Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Byung Ho Son
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chang Hak Yoo
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungeun Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;
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11
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Abstract
Tumor-associated lymphatic vessels play an important role in tumor progression, mediating lymphatic dissemination of malignant cells to tumor-draining lymph nodes and regulating tumor immunity. An early, necessary step in the lymphatic metastasis cascade is the invasion of lymphatic vessels by tumor cell clusters or single tumor cells. In this review, we discuss our current understanding of the underlying cellular and molecular mechanisms, which include tumor-specific as well as normal, developmental and immunological processes “hijacked” by tumor cells to gain access to the lymphatic system. Furthermore, we summarize the prognostic value of lymphatic invasion, discuss its relationship with local recurrence, lymph node and distant metastasis, and highlight potential therapeutic options and challenges.
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Affiliation(s)
- Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu 520-2192, Japan;
| | - Lothar C. Dieterich
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zurich, Switzerland
- Correspondence:
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12
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Okubo Y, Sato S, Osaka K, Yamamoto Y, Suzuki T, Ida A, Yoshioka E, Suzuki M, Washimi K, Yokose T, Kishida T, Miyagi Y. Clinicopathological Analysis of the ISUP Grade Group And Other Parameters in Prostate Cancer: Elucidation of Mutual Impact of the Various Parameters. Front Oncol 2021; 11:695251. [PMID: 34395260 PMCID: PMC8356042 DOI: 10.3389/fonc.2021.695251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/13/2021] [Indexed: 01/29/2023] Open
Abstract
Background Prostate cancer has become increasingly common worldwide. Although Grade group (GG) is widely accepted as an indicator of prostate cancer grade, there are malignancies that cannot be defined by GG alone. Moreover, the relationship between GG and other parameters remains unclear. Herein, we aimed to explore the biological characteristics of prostate cancer. Methods This study included 299 radical prostatectomy cases. The Chi-square test and analysis of variance were used to analyze the association of GG with binary and continuous variables. We then conducted morphological analyses. Multivariate analyses were performed to extract the data on risk factors for biochemical recurrence (BCR) and lymph node metastasis. Results The lymphatic, venous, perineural, and seminal vesicle invasion rates were 37/299 (12.4%), 25/299 (8.4%), 280/299 (93.6%), and 23/299 (7.7%), respectively. The extraprostatic extension (EPE), positive surgical margin, tertiary Gleason pattern 5, intraductal carcinoma of the prostate gland, and lymph node metastasis rates were 89/299 (29.8%), 106/299 (35.5%), 33/260 (12.7%), 56/299 (18.7%), and 23/299 (7.7%), respectively. As GG increased, various parameters became easier to visualize; however, there were differences between the parameters. Postoperative BCR was observed in 31/242 (12.8%) cases without preoperative hormone therapy; GG2, GG3, GG4, and GG5 accounted for 4, 7, 7, and 13 cases, respectively. Multivariate analyses revealed that GG and tumor diameter were significant risk factors for early BCR, whereas lymphatic invasion, EPE, and seminal vesicle invasion were significant risk factors for lymph node metastasis. For BCR, the odds ratios (ORs) for GG and tumor diameter were 2.253 (95% confidence interval (CI]): 1.297–3.912; P=0.004) and 1.074 (95% CI: 1.011–1.142; P=0.022), respectively. For lymph node metastasis, ORs for the presence of lymphatic invasion, EPE, and seminal vesicle invasion were 7.425 (95% CI: 1.688–22.583; P=0.004), 4.391 (95% CI: 1.037–18.589; P=0.044), and 5.755 (95% CI: 1.308–25.316; P=0.021), respectively. Conclusions We summarized various parameters correlating with each GG. Through multivariate analyses, we established the independent risk factors for early BCR and lymph node metastasis. In addition to GG, other important indices of malignancy were determined and weighted to provide a basis for future investigations.
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Affiliation(s)
- Yoichiro Okubo
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Shinya Sato
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan
| | - Kimito Osaka
- Department of Urology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yayoi Yamamoto
- Department of Radiology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Takahisa Suzuki
- Department of Urology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Arika Ida
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Emi Yoshioka
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Masaki Suzuki
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan.,Department of Pathology, University of Tokyo Hospital, Tokyo, Japan
| | - Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Takeshi Kishida
- Department of Urology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan
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13
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Talabnin K, Talabnin C, Khiaowichit J, Sutatum N, Asavaritikrai P, Suksaweang S, Tongtawee T, Ishihara M, Azadi P, Sripa B. High expression of tissue O-linked glycans is associated with a malignant phenotype of cholangiocarcinoma. J Int Med Res 2021; 49:300060520976864. [PMID: 33535865 PMCID: PMC7869157 DOI: 10.1177/0300060520976864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective This study aimed to investigate the expression of O-linked
glycoprotein glycans in tissue of patients with cholangiocarcinoma compared
with adjacent normal tissue. Methods Sixty patients with cholangiocarcinoma were included in the study.
Permethylated O-linked glycans from intrahepatic
cholangiocarcinoma tissue and adjacent normal tissue were analyzed using
nano-spray ionization-linear ion trap mass spectrometry. Histochemistry of
peanut agglutinin lectin was used for detection and localization of
galactose (Gal) 1, N-acetyl-galactosamine (GalNAc) 1. Results O-linked glycans from patients with cholangiocarcinoma were
composed of di- to hexa-saccharides with a terminal galactose and sialic
acids (N-acetylneuraminic acid [NeuAc]). A total of eight
O-linked glycan structures were detected. Gal1GalNAc1 and
Gal2 N-acetyl-glucosamine 1 GalNAc1 expression was significantly higher in
tissue from patients with cholangiocarcinoma compared with adjacent normal
tissue, while NeuAc1Gal1GalNAc1 expression was significantly lower. High
Gal1GalNAc1 expression was significantly associated with the late stage of
cholangiocarcinoma (stages II–IV), lymphatic invasion, and vascular
invasion. Conclusion Our study shows expression of O-linked glycans in
progression of cholangiocarcinoma and highlights the association of
Gal1GalNAc1 with lymphatic and vascular invasion of cholangiocarcinoma.
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Affiliation(s)
- Krajang Talabnin
- School of Pathology, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand.,Liver Fluke and Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Chutima Talabnin
- Liver Fluke and Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,School of Chemistry, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Juthamas Khiaowichit
- School of Translational Medicine, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Nuchanard Sutatum
- School of Translational Medicine, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Pundit Asavaritikrai
- School of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Sanong Suksaweang
- School of Pathology, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Taweesak Tongtawee
- School of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Mayumi Ishihara
- Complex Carbohydrate Research Center, The University of Georgia, Athens, Georgia, USA
| | - Parastoo Azadi
- Complex Carbohydrate Research Center, The University of Georgia, Athens, Georgia, USA
| | - Banchob Sripa
- Liver Fluke and Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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14
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Zhang Y, Liu Y, Shen D, Zhang H, Huang H, Li S, Ren J. Detection and prognostic value of intratumoral and peritumoral lymphangiogenesis in colorectal cancer. Transl Cancer Res 2020; 9:6189-6197. [PMID: 35117229 PMCID: PMC8798527 DOI: 10.21037/tcr-20-1038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/12/2020] [Indexed: 12/18/2022]
Abstract
Background Colorectal cancer (CRC) with lymphatic invasion is one of the critical prognostic factors in lymph node metastasis. Lymphangiogenesis has a significant effect on lymphatic metastasis and tumor progression. However, the significance of intratumoral and peritumoral lymphangiogenesis has been controversial in CRC. The aim of this study is to investigate the different role of introtumoral and peritumoral lymphangiogenesis in CRC progression and prognosis. Methods Lymphangiogenesis of 120 CRC specimens, as measured by lymphatic vessel density (LVD), was examined by immunostaining for podoplanin, a lymphatic vessel-specific marker. The mean number of lymphatic vessels of three hotspots was measured in intratumoral and peritumoral areas as intratumoral LVD (LVDit) and peritumoral LVD (LVDpt), respectively. The association of LVDit and LVDpt with the clinicopathological findings and prognosis was investigated. Results Compared to the peritumoral lymphatics, the intratumoral lymphatics were small, collapsed and irregular. The mean LVDpt was higher than the mean LVDit (P<0.001). LVDit was positively correlated with tumor size (P=0.009), tumor histologic grade (P=0.023), and overall survival (P=0.036). LVDpt was correlated with lymph node metastasis (P<0.001), tumor stage (P=0.004), and overall survival (P=0.016). Conclusions LVDpt plays a prominent role in lymph node metastasis, whereas LVDit is more closely correlated with tumor growth and histopathological differentiation. Both LVDpt and LVDit contribute to CRC progression and prognosis.
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Affiliation(s)
- Yanbin Zhang
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Department of Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, the Capital Medical University, Beijing, China
| | - Yue Liu
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Danhua Shen
- Department of Pathology, Peking University People's Hospital, Peking University, Beijing, China
| | - Hui Zhang
- Department of Pathology, Peking University People's Hospital, Peking University, Beijing, China
| | - Hongyan Huang
- Department of Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, the Capital Medical University, Beijing, China
| | - Sha Li
- Department of Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, the Capital Medical University, Beijing, China
| | - Jun Ren
- Department of Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, the Capital Medical University, Beijing, China
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15
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Sugita S, Kuwata T, Tokunaga M, Kaito A, Watanabe M, Tonouchi A, Kinoshita T, Nagino M. Clinical significance of lymphatic invasion in the esophageal region in patients with adenocarcinoma of the esophagogastric junction. J Surg Oncol 2020; 122:433-441. [PMID: 32359219 DOI: 10.1002/jso.25964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/01/2019] [Revised: 04/05/2020] [Accepted: 04/21/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES The lymphatic flow around the esophagogastric junction is complicated. Therefore, it is unclear whether lymphatic invasion in the esophageal region (eLI) and in the gastric region (gLI) in patients with adenocarcinoma of the esophagogastric junction (AEG) equally affect the incidence of lymph node metastases (LNM), and consequently, survival. METHODS We retrospectively reviewed clinicopathological data of 175 patients with AEG between January 2008 and July 2017. Risk factors for LNM and impacts of eLI or gLI on survival outcomes were investigated. RESULTS eLI was identified in 34% of the patients (59/175). By multivariate analysis, eLI was associated with an increased risk of both mediastinal LNM (odds ratio [OR] = 2.98, 95% confidence interval [CI]: 1.26-7.05) and abdominal LNM (OR = 5.44, 95% CI: 1.95-15.20). The 5-year overall survival for patients with eLI (53%) was significantly worse than for patients without eLI (76%) (hazard ratio = 2.45, 95% CI: 1.37-10.01). gLI was not selected in either of these analyses. CONCLUSIONS Positive eLI was strongly associated with mediastinal and abdominal LNM and worse survival in patients with AEG compared with gLI. In the histopathological examination, it seems to make sense to assess eLI and gLI separately.
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Affiliation(s)
- Shizuki Sugita
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan.,Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Kuwata
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan.,Department of Pathology, Exploratory Oncology Research & Clinical Trial Center (EPOC), National Cancer Center, Kashiwa, Japan
| | - Masanori Tokunaga
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akio Kaito
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masahiro Watanabe
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan.,Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Tonouchi
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takahiro Kinoshita
- Department of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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16
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Caruana M, Morand M, Belisle A, Nantel-Battista M. Basal cell carcinoma stroma as a mimicker of lymphatic invasion: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20919602. [PMID: 32477557 PMCID: PMC7234329 DOI: 10.1177/2050313x20919602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Basal cell carcinoma metastases are rare. We report a case of an 83 year-old male with recurrent cutaneous infiltrative basal cell carcinoma on the right vertex with tumor aggregates of infiltrative basal cell carcinoma in the lymphatic vessels of the superficial dermis strongly suspected on pathology slide evaluation during Mohs micrographic surgery. D2-40 immunohistochemical stain allows the detection of lymphatic invasion by highlighting endothelial cells. Further histologic review and D2-40 stains performed on the paraffin-embedded sections did not reveal an endothelial cell lining in favor of lymphatic invasion. What was identified as lymphatic invasion was the result of a peculiar basal cell carcinoma stroma. Correct identification of basal cell carcinoma stroma as a mimicker of lymphatic invasion would prevent potentially invasive investigation as well as associated costs. This is of great importance as the prognostic and therapeutic implications can be of significant value for the patient.
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Affiliation(s)
- Marco Caruana
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Meggie Morand
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Annie Belisle
- Department of Pathology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Mélissa Nantel-Battista
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
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17
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Choi WH, Kim MJ, Park JH, Kang JG, Seo SI, Kim HY, Shin WG. Lymphatic Invasion Might Be Considered as an Upstaging Factor in N0 and N1 Gastric Cancer. J Clin Med 2020; 9:E1275. [PMID: 32354156 DOI: 10.3390/jcm9051275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/14/2020] [Accepted: 04/26/2020] [Indexed: 02/06/2023] Open
Abstract
(Background) The aim of this study was to investigate the prognostic impact of lymphatic invasion in gastric cancer, focusing on survival differences between N stage groups. (Methods) A total of 398 consecutive patients who underwent curative gastrectomy for primary gastric adenocarcinoma from January 2006 to December 2015 were analyzed retrospectively using data from a prospectively collected registry database. We compared various clinicopathological features and survival differences between lymphatic invasion-positive and -negative groups. (Results) Of the 398 patients, 141 (35.4%) showed lymphatic invasion. The lymphatic invasion-positive subgroup had poorer prognosis than the lymphatic invasion-negative subgroup in N0 (five-year survival rate: 87.8% vs. 73.6%, p = 0.048) and N1 (87.2% vs. 50%, p = 0.007) stage patients. The odds ratio (OR) of lymphatic invasion to five-year survival rate was 2.078 (95% confidence interval (CI), 1.103-3.916; p = 0.024). The presence of lymphatic invasion had worse effect on survival than age (OR, 1.807; 95% CI, 1.024-2.242; p = 0.029) or tumor depth (OR, 1.286; 95% CI, 1.078-1.897; p = 0.013) in N0 and N1 stage patients. The overall survival of patients with lymphatic invasion was not different from that of patients at a one-higher N stage without lymphatic invasion at any N stage. (Conclusions) The presence of lymphatic invasion may be the most important independent prognostic factor in N0 and N1 gastric cancer and might be an upstaging factor of N stage at any N stage. Therefore, in addition to the number of metastasized lymph nodes, the presence of lymphatic invasion should be included in N stage determination.
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18
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Roesel C, Welter S, Kambartel KO, Weinreich G, Krbek T, Serke M, Ibrahim M, Alnajdawi Y, Plönes T, Aigner C. Prognostic markers in resected large cell neuroendocrine carcinoma: a multicentre retrospective analysis. J Thorac Dis 2020; 12:466-476. [PMID: 32274113 PMCID: PMC7139022 DOI: 10.21037/jtd.2020.01.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Large cell neuroendocrine carcinomas (LCNEC) are rare pulmonary malignancies. Reported survival rates are heterogeneous and the optimal therapeutic strategy is still debated. The prognosis of LCNEC is generally inferior compared to other non-small lung cancers. In early stages, surgery is recommended but might not be sufficient alone. Methods We retrospectively analyzed all consecutive LCNEC patients operated at three institutions with curative intent between May 2005 and January 2017. Data retrieved from individual clinical databases were analyzed with the aim to identify prognostic parameters. Results A total of 251 patients with LCNEC underwent curative intent surgery during the observation period. The median age was 64 years, 156 patients (62.2%) were male and 88.4% were smokers. The pathologic AJCC stage was I in 136 patients, II in 77, III in 33, and IV in 5 patients. Median follow-up was 26 months. Lymphatic vessel invasion (P=0.031) was identified as significant prognostic factor by multivariable analysis. There was a trend towards decreased survival in patients with blood vessel invasion (P=0.067). Even in earlier tumor stages, adjuvant chemotherapy had a positive effect on survival. The overall 1-, 3- and 5-year survival rates were 79.2%, 48.6% and 38.8% respectively. Conclusions Lymphatic invasion (L1) is an independent prognostic factor. Surgery in LCNEC is beneficial in early tumor stages and platinum-based adjuvant chemotherapy may help in achieving better long-term outcomes resulting in most obvious survival differences in stage Ib.
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Affiliation(s)
- Christian Roesel
- Department of Thoracic Surgery, Bethanien Hospital, Moers, Germany
| | - Stefan Welter
- Department of Thoracic Surgery, Lung Hospital, Hemer, Germany
| | - Karl-Otto Kambartel
- Department of Pneumology and Allergology, Bethanien Hospital, Moers, Germany
| | - Gerhard Weinreich
- Department of Pneumology, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Thomas Krbek
- Department of Thoracic Surgery, Bethanien Hospital, Moers, Germany
| | - Monika Serke
- Department of Pneumology, Lung Hospital, Hemer, Germany
| | | | - Yazan Alnajdawi
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, University of Duisburg-Essen, Essen Germany
| | - Till Plönes
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, University of Duisburg-Essen, Essen Germany
| | - Clemens Aigner
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, University of Duisburg-Essen, Essen Germany
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19
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Dieterich LC, Kapaklikaya K, Cetintas T, Proulx ST, Commerford CD, Ikenberg K, Bachmann SB, Scholl J, Detmar M. Transcriptional profiling of breast cancer-associated lymphatic vessels reveals VCAM-1 as regulator of lymphatic invasion and permeability. Int J Cancer 2019; 145:2804-2815. [PMID: 31344266 PMCID: PMC6771758 DOI: 10.1002/ijc.32594] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 12/16/2022]
Abstract
Tumor‐associated lymphangiogenesis and lymphatic invasion of tumor cells correlate with poor outcome in many tumor types, including breast cancer. Various explanations for this correlation have been suggested in the past, including the promotion of lymphatic metastasis and an immune‐inhibitory function of lymphatic endothelial cells (LECs). However, the molecular features of tumor‐associated lymphatic vessels and their implications for tumor progression have been poorly characterized. Here, we report the first transcriptional analysis of tumor‐associated LECs directly isolated from the primary tumor in an orthotopic mouse model of triple negative breast cancer (4T1). Gene expression analysis showed a strong upregulation of inflammation‐associated genes, including endothelial adhesion molecules such as VCAM‐1, in comparison to LECs derived from control tissue. In vitro experiments demonstrated that VCAM‐1 is not involved in the adhesion of tumor cells to LECs but unexpectedly promoted lymphatic permeability by weakening of lymphatic junctions, most likely through a mechanism triggered by interactions with integrin α4 which was also induced in tumor‐associated LECs. In line with this, in vivo blockade of VCAM‐1 reduced lymphatic invasion of 4T1 cells. Taken together, our findings suggest that disruption of lymphatic junctions and increased permeability via tumor‐induced lymphatic VCAM‐1 expression may represent a new target to block lymphatic invasion and metastasis. What's new? Tumor‐associated lymphatic vessels serve important roles in tumor progression and metastasis. Nonetheless, little is known about the molecular changes in these vessels that give rise to a tumor‐promoting phenotype. In this study, transcriptional analysis was performed on lymphatic endothelial cells (LECs) isolated from a mouse model of triple‐negative breast cancer. Endothelial adhesion molecules, including tumor‐induced VCAM‐1, were strongly upregulated in tumor‐associated LECs. Additional experiments showed that VCAM‐1 upregulation influences lymphatic permeability and that its inhibition attenuates lymphatic breast cancer cell invasion. The findings identify VCAM‐1 as a potential target for the blockade of lymphatic invasion of tumor cells.
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Affiliation(s)
- Lothar C. Dieterich
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Kübra Kapaklikaya
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Timur Cetintas
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Steven T. Proulx
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Catharina D. Commerford
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Kristian Ikenberg
- Department of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Samia B. Bachmann
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Jeannette Scholl
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
| | - Michael Detmar
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
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Suzuki S, Shimoda M, Shimazaki J, Maruyama T, Oshiro Y, Nishida K, Kuroda J, Miyoshi K, Koike N, Harada N. Number of positive lymph nodes and lymphatic invasion are significant prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma. Clin Exp Gastroenterol 2019; 12:255-262. [PMID: 31239748 PMCID: PMC6559140 DOI: 10.2147/ceg.s207333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 05/02/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Early recurrence of distal cholangiocarcinoma (DCC) may result in a poorer prognosis. This study aimed to evaluate the clinicopathological factors that predict survival and recurrence in patients with DCC. Methods: Fifty-five patients with DCC who underwent pancreaticoduodenectomy between 2005 and 2015 were studied retrospectively. The following clinicopathological parameters were analyzed as predictors of disease-free survival (DFS) and overall survival (OS): sex, age, body mass index, presence of biliary tract decompression, macroscopic type, histological type, tumor size, TNM classification, lymph node metastasis ratio, number of positive lymph nodes (PLNs), lymphatic invasion, venous invasion, perineural invasion, proximal bile duct margin, dissected margin, portal system invasion, arterial system invasion, stage, and residual tumor. Results: Univariate analysis showed that contiguous extension of the primary tumor, PLN, lymphatic invasion, venous invasion, perineural invasion, and stage were significant prognostic factors for DFS and OS. Multivariate analysis revealed that PLN and lymphatic invasion were prognostic for DFS and OS (P<0.001). Significant differences in OS and DFS were found in analyses stratified by PLN (0, 1, 2 vs ≥3) and lymphatic invasion (0 vs 1, 2, 3). Conclusion: Among the clinicopathological parameters analyzed, PLN and lymphatic invasion were confirmed as prognostic factors for DCC.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Tsunehiko Maruyama
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Jun Kuroda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Kenta Miyoshi
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Nobusada Koike
- Department of Surgery, Hachioji Digestive Disease Hospital, Tokyo 192-0903, Japan
| | - Nobuhiko Harada
- Department of Surgery, Hachioji Digestive Disease Hospital, Tokyo 192-0903, Japan
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Zhang MJ, Chen DS, Li H, Liu WW, Han GY, Han YF. Clinical significance of USP7 and EZH2 in predicting prognosis of laryngeal squamous cell carcinoma and their possible functional mechanism. Int J Clin Exp Pathol 2019; 12:2184-2194. [PMID: 31934041 PMCID: PMC6949638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Laryngeal squamous cell carcinoma (LSCC) is one of the most prevalent cancer types in the world. The ubiquitin specific protease 7 (USP7), a kind of deubiquitylating enzyme, has been reported to play multifaceted roles in different tumor types. EZH2 has been found to be highly expressed in various malignantcells and high expression of EZH2 is closely related to tumor growth infiltration, lymph node involvement, clinical stage, and poor prognosis. The aim of this study was to investigate the expression and function of USP7 and EZH2 in LSCC. CASE PRESENTATION Immunohistochemical staining and histochemical staining were performed to explore the expression of USP7 and EZH2 in both LSCC tissues and adjacent normal laryngeal tissues. Chi-square test, univariate analysis, and multivariate analysis were conducted to statistically evaluate the clinical significance of USP7 and EZH2. CONCLUSIONS USP7and EZH2 affects LSCC evolution; USP7 and EZH2 were upregulated in LSCC tissues, which can serve as independent prognostic predictors, and potential therapeutic targets for LSCC.
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Affiliation(s)
- Ming-Jie Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
| | - De-Shang Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
| | - Hui Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
| | - Wei-Wei Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
| | - Guo-Ying Han
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
| | - Yue-Feng Han
- Department of Otorhinolaryngology, The First Affiliated Hospital of Bengbu Medical University Bengbu, Anhui, China
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22
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Chen TH, Lin WR, Lee C, Chiu CT, Hsu JT, Yeh TS, Lin KH, Le PH, Yeh CT. Prognostic Stratification of Advanced Gastric Signet Ring Cell Carcinoma by Clinicopathological Factors and GALNT14 Genotype. J Cancer 2018; 9:3540-3547. [PMID: 30310511 PMCID: PMC6171017 DOI: 10.7150/jca.26293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/27/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Gastric signet ring cell carcinoma (SRCC) is a histologic variant characterized by abundant intracytoplasmic mucin. Although it has been recognized that gastric adenocarcinoma harboring this feature has poorer prognosis, prognostic stratification within gastric SRCCs themselves has not been clearly defined. N-acetylgalactosaminyltransferase14 (GALNT14) genotype has been associated to poorer treatment outcome in mucinous type colorectal cancer. Here we incorporated clinicopathological factors and GALNT14 genotype to stratify prognosis of advanced gastric SRCC. Methods: Totally 347 gastric SRCC patients were retrospectively enrolled for GALNT14 genotyping. Clinicopathological factors were included for prognosis stratification. Results: Of the 347 patients, 341 underwent radical-intent gastrectomy and 6 received palliative gastrectomy. Kaplan-Meier analysis for overall survival indicated that Tumor-Node-Metastasis staging could only stratify the patients into three prognosis-distinguishable groups: group-1 (stage IA); group-2 (stage IB/IIA) and group-3 (the remaining Tumor-Node-Metastasis stages combined). Multivariate Cox-proportional hazard models for group-3 patients revealed GALNT14 "TT" genotype (P = 0.0482). Tumor size (P = 0.0009), node status (P <0.0001), metastasis status (P = 0.0096), and perineural invasion (P = 0.037) independently associated with unfavorable OS. Exploratory subgroup analysis showed that GALNT14"TT" genotype was associated with unfavorable OS in SRCCs with more aggressive phenotypes: node status >0 (P = 0.0013), lymphatic invasion (P = 0.021), vascular invasion (P = 0.0076) and perineural invasion (P = 0.0161). Accordingly, a scoring system was established capable of stratifying advanced gastric SRCC patients into three distinguishable prognostic subgroups. Conclusions: Gastric SRCC could be stratified into different prognostic subgroups by combining clinicopathological factors and GALNT14 genotype.
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Affiliation(s)
- Tsung-Hsing Chen
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Wey-Ran Lin
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chieh Lee
- Department of Industrial Engineering & Management, Yuan Ze University College of Engineering, Chung-Li City, Taiwan
| | - Cheng-Tang Chiu
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jun-Te Hsu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ta-Sen Yeh
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kwang-Huei Lin
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan.,Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology Taoyuan, Taiwan
| | - Puo-Hsien Le
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chau-Ting Yeh
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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23
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Moy AP, Mochel MC, Muzikansky A, Duncan LM, Kraft S. Lymphatic invasion predicts sentinel lymph node metastasis and adverse outcome in primary cutaneous melanoma. J Cutan Pathol 2017; 44:734-739. [PMID: 28555886 DOI: 10.1111/cup.12969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 02/16/2017] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sentinel lymph node (SLN) metastasis is a powerful predictor of survival in primary cutaneous melanoma. Lymphatic invasion (LI) may correlate with increased risk of SLN metastasis. Intralymphatic metastases, often difficult to detect on hematoxylin and eosin (H&E) stained sections, are readily identified with dual immunohistochemistry for melanocytic and lymphatic markers. METHODS We used dual S100/D240 immunohistochemistry to detect LI in 125 melanomas from patients who underwent SLN biopsy and correlated LI with melanoma staging parameters and disease status. RESULTS Dual immunohistochemistry allowed for the identification of LI in 33 cases (26%), compared to only 2% on H&E stained sections. Melanomas with LI showed greater thickness, higher mitotic rate and more frequent ulceration. Eleven of 33 cases with LI (33%) and 10 of 92 cases without LI (11%) were associated with a positive SLN (P = .006). More patients without LI were disease-free at last follow-up (80%) than patients with LI (50%; P = .002); LI was significantly associated with decreased progression-free survival. CONCLUSION The detection of LI is improved by dual immunohistochemistry and predicts SLN metastasis. The presence of LI may impact therapeutic planning in melanoma, such as the decision to perform a SLN biopsy.
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Affiliation(s)
- Andrea P Moy
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark C Mochel
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia
| | - Alona Muzikansky
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lyn M Duncan
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Stefan Kraft
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
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24
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Saito Y, Omura G, Yasuhara K, Rikitake R, Akashi K, Fukuoka O, Yoshida M, Ando M, Asakage T, Yamasoba T. Prognostic value of lymphovascular invasion of the primary tumor in hypopharyngeal carcinoma after total laryngopharyngectomy. Head Neck 2017; 39:1535-1543. [PMID: 28580699 DOI: 10.1002/hed.24705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 11/28/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to determinate the prognostic value of lymphovascular invasion in the specimens resected during total laryngopharyngectomy for hypopharyngeal carcinoma. METHODS Patients who underwent total laryngopharyngectomy at our institution between 2004 and 2014 were included in this study and retrospectively analyzed. We then discriminated for vascular invasion and lymphatic invasion of the primary tumor in all cases. RESULTS We reviewed 135 records (120 men and 15 women; age range, 36-84 years). Tumors with lymphatic invasion tended to be associated with more metastatic lymph nodes and extracapsular spread (ECS) of metastatic lymph nodes. Tumors with vascular invasion tended to be associated with nonpyriform sinus locations. In a multivariate analysis, nonpyriform sinus locations, >3 metastatic lymph nodes, and vascular invasion remained significant prognostic factors for overall survival (OS); in recursive partitioning analysis, ECS and vascular invasion remained important categorical variables for OS. CONCLUSION Vascular invasion is a strong prognostic biomarker for advanced hypopharyngeal carcinoma. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1535-1543, 2017.
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Affiliation(s)
- Yuki Saito
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Go Omura
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kazuo Yasuhara
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Rikitake
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ken Akashi
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Osamu Fukuoka
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masafumi Yoshida
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mizuo Ando
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahiro Asakage
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan
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25
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Muppa P, Gupta S, Frank I, Boorjian SA, Karnes RJ, Thompson RH, Thapa P, Tarrell RF, Herrera Hernandez LP, Jimenez RE, Cheville JC. Prognostic significance of lymphatic, vascular and perineural invasion for bladder cancer patients treated by radical cystectomy. Pathology 2017; 49:259-266. [PMID: 28259358 DOI: 10.1016/j.pathol.2016.12.347] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/01/2016] [Accepted: 12/07/2016] [Indexed: 12/15/2022]
Abstract
In radical cystectomy specimens with bladder cancer, lymphatic and vascular invasion are often reported as 'angiolymphatic' or 'lymphovascular' invasion, terms that combine the findings of tumour within simple endothelial-lined lymphatic spaces and tumour within muscle-lined blood vessels. It is unclear if these patterns of invasion have different prognostic significance. In addition, there are conflicting data regarding the significance of lymphatic, vascular and perineural invasion in patients with bladder cancer. Herein, we studied 1504 patients treated by radical cystectomy for bladder cancer at our institution and followed for a mean of 10.6 years. Cases were re-reviewed by a urological pathologist for lymphatic invasion defined as tumour within a non-muscle-lined endothelial-lined lymphatic space, vascular invasion defined as tumour in a muscle-lined blood vessel, and perineural invasion defined as tumour within the perineural sheath. Associations of clinical and pathological features with bladder cancer death were evaluated using Cox proportional hazards regression models and summarised with hazard ratios and 95% confidence intervals. Survival was estimated by the Kaplan-Meier method. Multivariate analysis showed that lymphatic and vascular invasion but not perineural invasion were significantly associated with cancer specific survival (p<0.0001 and p=0.02, respectively). There was a significant association of lymphatic and vascular invasion but not perineural invasion with involved regional lymph nodes (p<0.0001 and p=0.004, respectively). In patients with metastasis to regional lymph nodes, lymphatic invasion remained significantly associated with outcome (p=0.02). The frequency of lymphatic and vascular invasion varied amongst histological subtypes of bladder cancer. Vascular and lymphatic invasion should be clearly defined and reported for radical cystectomy specimens containing bladder cancer.
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Affiliation(s)
- Prasuna Muppa
- Departments of Laboratory Medicine and Pathology, United States
| | - Sounak Gupta
- Departments of Laboratory Medicine and Pathology, United States
| | | | | | | | | | - Prabin Thapa
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Robert F Tarrell
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | | | | | - John C Cheville
- Departments of Laboratory Medicine and Pathology, United States.
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Haraguchi N, Ohara N, Koseki J, Takahashi H, Nishimura J, Hata T, Mizushima T, Yamamoto H, Ishii H, Doki Y, Mori M. High expression of ADAMTS5 is a potent marker for lymphatic invasion and lymph node metastasis in colorectal cancer. Mol Clin Oncol 2016; 6:130-134. [PMID: 28123746 DOI: 10.3892/mco.2016.1088] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 09/29/2016] [Indexed: 12/19/2022] Open
Abstract
Members of the ADAMTS family contain propeptide, metalloproteinase and disintegrin domains and serve key roles for cancer cell proliferation, progression and metastasis. Although overexpression of ADAMTS5 has been reported in glioblastoma, and head and neck cancer, little has been demonstrated in colorectal cancer types. The present study aimed to clarify the significance of ADAMTS5 for clinicopathological factors and prognosis in colorectal cancer. The mRNA expression of ADAMTS5 was measured in 143 colorectal cancer specimens. ADAMTS5 expression was increased as the pathological stage increased. The expression of ADAMTS5 in stage III-IV colorectal cancer was significantly greater compared with that of stage 0-II colorectal cancer (P=0.0003). The median expression of ADAMTS5 was used to divide the ADAMTS5 higher expressing group and the ADAMTS5 lower expressing group to assess the correlation of ADAMTS5 expression with clinicopathological factors and prognosis. The proportions of lymphatic invasion and lymph node metastasis were significantly greater in the ADAMTS5 higher expressing group (P=0.0214 and P=0.0289 respectively). Overall survival and disease-free survival were assessed by the Kaplan-Meier curve with calculation of significance by the log-rank test; however, no significant difference was observed between the ADAMTS5 higher expressing group and the ADAMTS5 lower expressing group (P=0.7490 and P=0.9455, respectively). The present study confirmed high expression of ADAMTS5 as a potent marker for lymphatic invasion and lymphnode metastasis in colorectal cancer. To clarify the function of ADAMTS5 in colorectal cancer, further molecular investigations are required.
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Affiliation(s)
- Naotsugu Haraguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Nobuyoshi Ohara
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Jun Koseki
- Department of Cancer Profiling Discovery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Taishi Hata
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hideshi Ishii
- Department of Cancer Profiling Discovery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
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Donizy P, Kaczorowski M, Halon A, Leskiewicz M, Matkowski R. Lymphangioinvasion in routine H&E staining is strongly associated with poor clinical outcome in lymph node-negative cutaneous melanoma patients. Folia Histochem Cytobiol 2016; 54:126-133. [PMID: 27654015 DOI: 10.5603/fhc.a2016.0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/16/2016] [Revised: 08/01/2016] [Accepted: 08/02/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Lymphatic invasion (LYI) and lymphangiogenesis in the primary tumor are important processes related to the dissemination of neoplasms. The aim of the study was to examine the relationship of LYI status in cutaneous melanoma with patient survival and clinicopathological data. MATERIAL AND METHODS LYI status was assessed in 104 hematoxylin-eosin (H&E) stained melanoma primary tumor samples and analyzed in relation to patient survival and other clinicopathological and histopathological characteristics. RESULTS LYI was found in 30 (28.8%) patients. It was observed more frequently in ulcerated, proliferating, and thicker tumors. It correlated with the presence of sentinel lymph node, regional and distant metastases. The presence of LYI significantly correlated with shorter overall survival, cancer specific overall survival and disease-free survival in Kaplan-Meier analysis (all P < 0.001). Positive LYI status was a factor of unfavorable prognosis also in patients without regional lymph node metastases. CONCLUSIONS Our results support earlier observations that LYI is a powerful prognostic factor. We recommend an assessment of LYI status during routine review of cutaneous melanoma slides stained with H&E as a standard, potentially informative, yet economically beneficial procedure.
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Affiliation(s)
- Piotr Donizy
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland.
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Abstract
OBJECTIVE pTNM stage IIA colorectal cancer (CRC) is not currently submitted to any adjuvant treatment due to its good prognosis. Nevertheless, a percentage of cases unexpectedly recur. The aim of this study was to assess and compare the prognostic value and inter-observer agreement of a novel histological grading system based on the counting of poorly differentiated clusters (PDC) of cancer cells and that of conventional histological grade, lymphatic, venous and perineural invasion (LVI, VI, PNI), tumour budding (TB) and tumor border configuration in stage IIA CRC. MATERIALS AND METHODS the afore mentioned histological parameters were assessed in 82 stage IIA CRCs. Inter-observer agreement and correlation with tumour relapse were analyzed by using Fleiss-Cohen's weighted K statistics, Fisher exact test and Chi-squared test. The Mantel-Cox log-rank test was applied to assess the strength of association with disease-free interval (DFI). RESULTS inter-observer agreement was very good/good in the assessment of PDC presence and grade, while it was moderate at best in the evaluation of the other parameters. The presence of PDC, high PDC grade, LVI and TB were significantly associated with disease progression (p < 0.0001; p = 0.0012; p = 0.0308; p = 0.0002) and shorter DFI (p = 0.0001; p < 0.0001; p = 0.0129; p = 0.0008). PDC presence (p < 0.0001) and TB (p = 0.012) were independent prognostic factors in multivariate analysis. CONCLUSIONS our findings suggest that the assessment of PDC may be useful to stratify patients with stage IIA CRC for recurrence risk, and to identify high risk patients who could benefit from adjuvant chemotherapy.
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Affiliation(s)
- Valeria Barresi
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Luca Reggiani Bonetti
- b Department of Laboratory Integrated Activities , Anatomic Pathology and Legal Medicine, University of Modena and Reggio Emilia , Modena , Italy
| | - Antonio Ieni
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Giovanni Branca
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Giovanni Tuccari
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
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Van Wyk HC, Foulis AK, Roxburgh CS, Orange C, Horgan PG, McMillan DC. Comparison of Methods to Identify Lymphatic and Blood Vessel Invasion and their Prognostic Value in Patients with Primary Operable Colorectal Cancer. Anticancer Res 2015; 35:6457-6463. [PMID: 26637856] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIM Lymphatic and blood vessel invasion are important independent prognostic factors in colorectal cancer, but identification of the separate components remains difficult. The aim of the present study was to compare routine hematoxylin and eosin (H&E) and elastica staining with immunohistochemistry using D2-40 and CD31. MATERIALS AND METHODS A total of 75 surgical specimens of colorectal cancer were examined for blood and lymphatic vessel invasion, by comparing stains. RESULTS The minimum clinical follow-up of survivors was 5 years. During that time, 45 patients died, 34 from their cancer. Lymphatic invasion by H&E was found in 19% compared to 40% detected with D2-40 (p<0.001). Lymphatic invasion was not associated with T-stage (H&E, p=0.923; D2-40, p=0.724) but was significantly associated with N-stage, (H&E, p=0.001; D2-40, p<0.001). No significant association between lymphatic invasion (H&E or D2-40) and cancer-specific survival was found on univariate analysis. Blood vessel invasion by elastic detection was detected in 53% compared to 32% detected with CD31 (p=0.090). Blood vessel invasion was associated with T-stage, (elastica, p=0.028; CD31, p=0.839) but was not associated with N-stage (elastica, p=0.377; CD31, p=0.519). On univariate analysis of blood vessel invasion was associated with cancer-specific survival (elastica, p=0.009) when detected by elastica, but not when detected by CD31, (p=0.611). Lymphatic invasion (D2-40) was associated with blood vessel invasion (elastic) (p=0.019). On multivariate analysis, blood vessel invasion with elastica had independent prognostic value (hazard ratio=2.55, 95% confidence interval=1.23-5.28; p=0.012). CONCLUSION The results of the present study indicate that immunohistochemistry using D2-40 improves the identification of lymphatic invasion compared to use of H&E staining only; however, its prognostic value was limited. Elastica staining improves the detection rate of blood vessel invasion (compared to CD31) and venous invasion detected with elastica had independent prognostic value in patients undergoing curative resection for colorectal cancer.
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Affiliation(s)
- Hester Catharina Van Wyk
- Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Royal Infirmary, Glasgow, U.K.
| | - Alan K Foulis
- University Unit of Pathology, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Southern General Hospital, Glasgow, U.K
| | - Campbell S Roxburgh
- Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Royal Infirmary, Glasgow, U.K
| | - Clare Orange
- University Unit of Pathology, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Southern General Hospital, Glasgow, U.K
| | - Paul G Horgan
- Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Royal Infirmary, Glasgow, U.K
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences-University of Glasgow, Royal Infirmary, Glasgow, U.K
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Wu M, Cao M, He Y, Liu Y, Yang C, Du Y, Wang W, Gao F. A novel role of low molecular weight hyaluronan in breast cancer metastasis. FASEB J 2014; 29:1290-8. [PMID: 25550464 DOI: 10.1096/fj.14-259978] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [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: 07/14/2014] [Accepted: 11/17/2014] [Indexed: 12/22/2022]
Abstract
Low molecular weight hyaluronan (LMW-HA), a degradation fragment of the extracellular matrix component hyaluronan (HA), has been proven to play a crucial role in cancer progression. However, no systematic clinical study of breast cancer has been performed to correlate LMW-HA levels with metastasis. In the present study, we analyzed 176 serum specimens and found for the first time that the serum LMW-HA (but not total HA) level significantly correlated with lymph node metastasis, suggesting that serum LMW-HA represents a better prognostic indicator of breast cancer progression than HA. Similarly, we found that breast cancer cell lines displaying higher invasive potential had a higher LMW-HA concentration than less-invasive cell lines. This higher LMW-HA level was accompanied by the overexpression of hyaluronan synthase (HAS2) and hyaluronidase (both HYAL1 and HYAL2). Of great importance, decreasing LMW-HA production significantly inhibited breast cancer cell migration and invasion. Overall, our results suggest that during cancer progression, cancer cells may actively remodel their microenvironment via an autocrine/paracrine-like process, resulting in elevated LMW-HA levels, which in turn may facilitate cancer progression by promoting the migration and invasion of cancer cells. Therefore, cancer-associated LMW-HA may be a more promising molecular biomarker than total HA for detecting metastasis and may have further applications in breast cancer treatment.
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Affiliation(s)
- Man Wu
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Manlin Cao
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yiqing He
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yiwen Liu
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Cuixia Yang
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yan Du
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Wenjuan Wang
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Feng Gao
- *Department of Molecular Biology, Department of Rehabilitation Medicine, and Department of Molecular Biology and Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
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Imamura T, Komatsu S, Ichikawa D, Kubota T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Morimura R, Murayama Y, Kuriu Y, Ikoma H, Nakanishi M, Sakakura C, Otsuji E. Poor prognostic subgroup in T3N0 stage IIA gastric cancer, suggesting an indication for adjuvant chemotherapy. J Surg Oncol 2014; 111:221-5. [PMID: 25327711 DOI: 10.1002/jso.23796] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/29/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adjuvant chemotherapy following curative gastrectomy is recommended for patients with pStage II or III, except pT3 (ss), N0 gastric cancer in Japan. This study aimed to detect the poor prognostic subgroup of T3N0 gastric cancer, suggesting an indication for adjuvant chemotherapy. METHODS Between 1999 and 2011, 116 patients with pStage IIA gastric cancer underwent curative gastrectomy. We reviewed their hospital records retrospectively. RESULTS The 5-year overall survival (OS) rates of patients with T1N2+T2N1 and T3N0 gastric cancer were 79% and 77%, respectively. Univariate and multivariate analyses revealed lymphatic invasion (LY+) to be an independent poor prognostic factor in T3N0 gastric cancer [P=0.004, HR 12.3 (95% CI: 2.07-112)]. The prognosis of patients with T3N0LY+ gastric cancer was significantly poorer than those with other pStage IIA gastric cancer (5-year OS; T3N0LY+ vs. other Stage IIA: 68% vs. 83%, P=0.043). The incidence of peritoneal recurrence was higher in patients with T3N0LY+ gastric cancer than in those with other Stage IIA gastric cancer (T3N0LY+ vs. other stage IIA: 9.0% vs. 2.8%, P=0.134). CONCLUSIONS Lymphatic invasion was an independent poor prognostic factor in T3N0 gastric cancer. Adjuvant chemotherapy should be recommended to patients with T3N0LY+ gastric cancer.
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Affiliation(s)
- Taisuke Imamura
- Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, Kawaramachihirokoji, Kamigyo-ku, Kyoto, Japan
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32
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Abstract
Tumor staging according to the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, metastasis (TNM) system is currently regarded as the standard for staging of patients with colorectal cancer. This system provides the strongest prognostic information for patients with early stage disease and those with advanced disease. For patients with intermediate levels of disease, it is less able to predict disease outcome. Therefore, additional prognostic markers are needed to improve the management of affected patients. Ideal markers are readily assessable on hematoxylin and eosin-stained tumor slides, and in this way are easily applicable worldwide. This review summarizes the histological features of colorectal cancer that can be used for prognostic stratification. Specifically, we refer to the different histological variants of colorectal cancer that have been identified, each of these variants carrying distinct prognostic significance. Established markers of adverse outcomes are lymphatic and venous invasion, as well as perineural invasion, but underreporting still occurs in the routine setting. Tumor budding and tumor necrosis are recent advances that may help to identify patients at high risk for recurrence. The prognostic significance of the antitumor inflammatory response has been known for quite a long time, but a lack of standardization prevented its application in routine pathology. However, scales to assess intra- and peritumoral inflammation have recently emerged, and can be expected to strengthen the prognostic significance of the pathology report.
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Affiliation(s)
- Nora I Schneider
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Cord Langner
- Institute of Pathology, Medical University of Graz, Graz, Austria
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Fujii T, Sutoh T, Morita H, Yajima R, Yamaguchi S, Tsutsumi S, Asao T, Kuwano H. Vascular invasion, but not lymphatic invasion, of the primary tumor is a strong prognostic factor in patients with colorectal cancer. Anticancer Res 2014; 34:3147-3151. [PMID: 24922686] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND We previously showed that the presence of vascular invasion, but not lymphatic invasion, was a strong prognostic factor for breast cancer. Lymphatic invasion may represent mainly the selective affinity of cancer cells for lymph nodes. The present study was undertaken to evaluate the presence of vascular invasion that may reflect systemic disease as a predictor of disease recurrence in colorectal cancer, separate from lymphatic invasion of the primary tumor. PATIENTS AND METHODS We retrospectively evaluated the cases of 177 consecutive patients with primary colorectal cancer who underwent colorectal resection. We examined the relationship between recurrence and the prognostic significance of clinicopathological factors, particularly lymphatic and vascular invasion. RESULTS The presence of vascular invasion (v) was significant, while that of lymphatic invasion (ly) was not significant in univariate analysis. The presence of vascular invasion was an independent prognostic factor in multivariate analysis. Among the 60 patients in the ly-/v- group, one (1.7%) had disease recurrence, and among the 33 patients in the ly+/v- group, one (3.0%) had disease recurrence. On the other hand, among the 71 patients in the ly+/v+ group, 16 patients (22.5%) suffered recurrence, and among the 13 patients in the ly-/v+ group, four (30.8%) suffered recurrence. It is interesting to note that despite the presence of lymphatic invasion, the group without vascular invasion (ly+/v-) had a few patients with distant metastases, a result which is similar to that of the ly-/v- group. CONCLUSION The presence of vascular invasion, but not lymphatic invasion, could be an indicator of high biological aggressiveness and may be a strong prognostic factor for colorectal cancer.
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Affiliation(s)
- Takaaki Fujii
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Toshinaga Sutoh
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Hiroki Morita
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Reina Yajima
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Satoru Yamaguchi
- Department of Surgical Oncology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Soichi Tsutsumi
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Takayuki Asao
- Oncology Clinical Development, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan
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Okamura K, Takayama K, Kawahara K, Harada T, Nishio M, Otsubo K, Ijichi K, Kohno M, Iwama E, Fujii A, Ota K, Koga T, Okamoto T, Suzuki A, Nakanishi Y. PICT1 expression is a poor prognostic factor in non-small cell lung cancer. Oncoscience 2014; 1:375-82. [PMID: 25594032 PMCID: PMC4278310 DOI: 10.18632/oncoscience.43] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/25/2014] [Indexed: 02/07/2023] Open
Abstract
PICT1 is a key regulator of the MDM2–TP53 pathway. High mRNA expression levels of PICT1 are associated with poor prognosis in several cancers with wild-type TP53. In this study, we identified the PICT1 protein expression profile in non-small cell lung cancer (NSCLC) with wild-type TP53 in the nucleolus and cytoplasm, and revealed the relationship between PICT1 expression and patient clinicopathological factors. PICT1 expression in the tumor cells of 96 NSCLC patients with wild-type TP53 was evaluated by immunohistochemistry. Forty-three of 96 (44.8%) NSCLC samples were positive for nucleolar PICT1, while 40/96 (41.7%) NSCLC samples were positive for cytoplasmic PICT1. There was no correlation between nucleolar PICT1 expression and clinicopathological factors. However, cytoplasmic PICT1 expression was significantly correlated with sex, smoking history, differentiation, lymphatic invasion and pathological stage. In multivariate analysis, lymphatic invasion was significantly associated with cytoplasmic PICT1 expression (hazard ratio: 5.02, P = 0.026). We scrutinized PICT1 expression in samples of NSCLC with wild-type TP53, and showed a correlation between cytoplasmic PICT1 expression and several clinicopathological factors in these patients. Our results indicate that cytoplasmic PICT1 expression is a poor prognostic factor and is associated with tumor progression via lymphatic invasion in these patients.
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Affiliation(s)
- Kyoko Okamura
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Kohichi Kawahara
- Department of Molecular Oncology, Graduate School of Medical and Dental Science, Kagoshima University, Japan. ; Division of Cancer Genetics, Medical Institute of Bioregulation, Kyushu University, Japan
| | - Taishi Harada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Miki Nishio
- Division of Cancer Genetics, Medical Institute of Bioregulation, Kyushu University, Japan
| | - Kohei Otsubo
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan. ; Division of Cancer Genetics, Medical Institute of Bioregulation, Kyushu University, Japan
| | - Kayo Ijichi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan. ; Division of Pathophysiological and Experimental Pathology, Department of Pathology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Mikihiro Kohno
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan. ; Faculty of Medical Sciences, Department of Comprehensive Clinical Oncology, Kyushu University, Japan
| | - Akiko Fujii
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Keiichi Ota
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Takaomi Koga
- Division of Pathophysiological and Experimental Pathology, Department of Pathology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Tatsuro Okamoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akira Suzuki
- Division of Cancer Genetics, Medical Institute of Bioregulation, Kyushu University, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
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Fujii T, Yajima R, Hirakata T, Miyamoto T, Fujisawa T, Tsutsumi S, Ynagita Y, Iijima M, Kuwano H. Impact of the prognostic value of vascular invasion, but not lymphatic invasion, of the primary tumor in patients with breast cancer. Anticancer Res 2014; 34:1255-1259. [PMID: 24596369] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The prognostic value of lymphovascular invasion (LVI) in patients with breast cancer is unclear. Lymphatic invasion may mainly represent the selective affinity of breast cancer cells for lymph nodes. This study was undertaken to evaluate the presence of vascular invasion that may reflect systemic disease as a predictor of disease recurrence in breast cancer, separate from lymphatic invasion of the primary tumor. PATIENTS AND METHODS We retrospectively evaluated the cases of 263 consecutive female patients with primary breast cancer who underwent a radical breast operation. We examined the relationship between recurrence and the prognostic significance of clinico-pathological factors, particularly lymphatic (Iy) and vascular invasion (v). RESULTS The presence of lymphatic invasion and that of vascular invasion were significant in univariate analysis. The presence of vascular invasion was an independent prognostic factor, but lymphatic invasion lost its prognostic significance in multivariate analysis. Among the 91 patients in the ly-/v- group, 5 (5.5%) had disease recurrence, and among the 73 patients in the ly+/v- group, 5 (6.8%) had disease recurrence. On the other hand, among the 95 patients in the ly+/v+ group, 19 (20.0%) had a recurrence, and among the 3 patients in the ly-/v+ group, one had a recurrence. It is interesting to note that despite the presence of lymphatic invasion, the group without vascular invasion (ly+/v-) had a few patients with distant metastases, a result which is similar to that of the ly-/v- group. CONCLUSION The presence of vascular invasion, but not lymphatic invasion, could be an indicator of high biological aggressiveness and may be a valid prognostic factor for breast cancer.
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Affiliation(s)
- Takaaki Fujii
- FACS, Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
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Abstract
Melanoma has a propensity for lymph node metastasis. However, the incidence of lymphatic invasion detected by histology alone in primary melanoma is disproportionately low in comparison to the incidence of positive sentinel lymph nodes (SLN). With the discovery of lymphatic endothelial cell markers, such as podoplanin and LYVE-1, lymphatic vessels can be reliably detected in formalin-fixed paraffin-embedded (FFPE) tissues. There is a now consensus that lymphatic invasion detected by immunohistochemical stains in primary melanoma is much more common than previously reported by histological examination alone. Immunohistochemical stains show that lymphangiogenesis and lymphatic invasion in primary melanoma may occur intratumorally or peritumorally, and lymphatic invasion is common across the range of tumor thicknesses in primary vertical growth phase (VGP) melanomas. A number of studies have shown that lymphatic invasion in primary melanoma is associated with a positive sentinel lymph node biopsy and a worse clinical outcome. Although not currently a part of the standard of care for staging of melanoma, the detection of lymphatic invasion in primary melanoma using immunohistochemical markers may be helpful in planning of therapy in some cases and may find a routine role in primary melanoma microscopic attributes in future.
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Affiliation(s)
- Xiaowei Xu
- Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA
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Ueda Y, Yasuda K, Inomata M, Shiraishi N, Yokoyama S, Kitano S. Biological predictors of survival in stage II colorectal cancer. Mol Clin Oncol 2013; 1:643-648. [PMID: 24649222 PMCID: PMC3915554 DOI: 10.3892/mco.2013.126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 04/23/2013] [Indexed: 01/28/2023] Open
Abstract
The routine use of postoperative adjuvant chemotherapy in patients with stage II colorectal cancer is not recommended. However, the incidence of tumor recurrence or distant metastasis in these patients is reported to be 25–35%. The identification of high-risk patients with stage II colorectal cancer remains difficult. Therefore, the aim of this study was to determine the risk factors that may help identify stage II colorectal cancer patients with unfavorable prognosis. Paraffin-embedded tissue samples from 109 patients with stage II colorectal cancer following curative operation were analyzed. Thirteen clinicopathological variables and 5 biological markers were assessed using immunohistochemistry, including p53 (tumor suppressor gene), CD10 (tumor invasion marker), CD34 (angiogenic marker), Ki-67 (cell proliferation index) and CAM 5.2 (marker of lymph node micrometastasis) and investigated for associations with disease-specific survival. Univariate analysis revealed bowel obstruction, lymph node micrometastasis and lymphatic invasion (P<0.01) to be highly significant factors for determining the 5-year disease-specific survival. By contrast, the multivariate analysis revealed lymph node micrometastasis and lymphatic invasion to be independent prognostic factors. Stage II colorectal cancer patients with lymph node micrometastasis and lymphatic invasion may therefore be suitable candidates for adjuvant chemotherapy to improve prognosis.
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Affiliation(s)
- Yoshitake Ueda
- Departments of Gastroenterological Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Kazuhiro Yasuda
- Departments of Gastroenterological Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Masafumi Inomata
- Departments of Gastroenterological Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Norio Shiraishi
- Departments of Gastroenterological Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Shigeo Yokoyama
- Pathology, Faculty of Medicine, Oita University, Yufu, Oita 879-5593, Japan
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