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Background: Endoscopy plays an important role in the early detection of gastric neoplastic lesions, but different techniques lead to different diagnostic accuracy. Aims: To explore and compare the diagnostic value of conventional endoscopy with white light imaging (WLI) and magnifying endoscopy with narrow-band imaging (ME-NBI) for early gastric neoplastic lesions. Methods: Patients suspected of having early gastric neoplastic lesions by WLI were collected consecutively from Jan. 2016 to Jun. 2018 at Shanghai Renji Hospital, and received ME-NBI within 2 weeks. The diagnosis based on WLI and ME-NBI was recorded, respectively. Targeted biopsy was re-performed in patients with suspected neoplastic lesion yet having no abnormalities in first biopsy. Patients with neoplastic lesions proved by pathology were treated with endoscopic resection or surgical operation and enrolled in the analysis. Using pathological diagnosis as gold standard, the diagnostic performance of WLI and ME-NBI for distinguishing intestinal-type gastric adenoma and early gastric cancer (EGC) was evaluated. Results: A total of 301 patients (301 lesions) were included, including 171 adenoma and 130 EGC. The interobserver agreement between two endoscopists was optimal for both WLI and ME-NBI observation (WLI: κ=0.70; ME-NBI: κ=0.81). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ME-NBI for distinguishing intestinal-type gastric adenoma from EGC were higher than those of WLI (89.2% vs. 76.9%, 90.6% vs. 71.9%, 87.9% vs. 67.6%, 91.7% vs. 80.4%, and 90.0% vs. 74.1%, respectively, all P<0.05). Conclusions: ME-NBI is superior to WLI in distinguishing intestinal-type gastric adenoma from EGC.
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Objective To assess the potential risk factors of canceration for intestinal?type gastric adenoma. Methods A retrospective study were performed on the data of 142 intestinal?type gastric adenoma patients who underwent endoscopic resection and was confirmed by postoperative histopathology at Digestive Endoscopy Centre, Shanghai Renji Hospital from May 2012 to December 2016. Potential risk factors for canceration of intestinal?type gastric adenoma were analyzed using univariate and multivariate Logistic analysis. Results A total of 142 intestinal?type gastric adenomas from 142 patients were collected in the study,comprised of 124 noncancerous lesions(low grade intraepithelial neoplasia)and 18 cancerous lesions (high grade intraepithelial neoplasia or carcinoma). Age 65 and older(P=0.03, OR=3.37, 95%CI:1.10?10.29),size equal or greater than 2 cm(P= 0.04, OR= 3.93, 95%CI: 1.07?14.49), and Helicobacter Pylori infection(P=0.04,OR=3.60,95%CI:1.07?12.14)were significantly associated with canceration in the univariate Logistic regression analysis. In the multivariate regression analysis,age 65 and older(P=0.03,OR=4.36,95%CI:1.17?16.24),size equal or greater than 2 cm(P=0.02,OR=5.79, 95%CI:1.28?26.12),and Helicobacter Pylori infection(P=0.03,OR=3.89,95%CI:1.15?13.59)were independent risk factors of canceration. Conclusion Intestinal?type gastric adenoma has varying degrees of intraepithelial neoplasia. Patient who is 65 years or older, or with Helicobacter Pylori infection, and lesion diameter of more than 2 cm are the potential risk factors of carceration.
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Background: Gastric carcinomas have various pathological features. Based on patterns of growth and invasiveness, however, they fall into two types: diffuse type and intestinal type. These two types of carcinoma appear to be different in their histogenetic origins. Objectives: To analyse various types of gastric cancer reported in last five years. To compare the features of intestinal and diffuse type gastric carcinoma including gross appearance, staging, grading of tumor. Materials and Methods: This was a retrospective study of 324 gastric cancer which were surgically resected and received over 5 years. The tumors were divided into groups according to their gross and microscopic patterns. Gross appearance was classified based on Borrmann classification. Microscopic features evaluated include tumor cell type, extent of invasion, degree of maturation, formation of glandular structures, nodal metastasis. Results: Totally 320 cases of gastric cancer were received of which 218(68%) were male, 102(32%) were female. Gastric cancers are rare below the age of 30 years. Comparing the type of gastric cancer intestinal type were 269(84%), diffuse type were 24(7.5%) and other type of gastric cancer including GIST, lymphoma, mucinous adenocarcinoma were 27(8.5%). Younger patients have higher stage of lymph node metastasis in diffuse type, but not for the intestinal type. Conclusion: Gastric cancer more common in male (M:F= 2:1) and most frequently seen in 5th decade. Intestinal type constitutes the most common type of gastric tumor. Gross appearance of diffuse type was predominantly infiltrative (79%).
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Background: Gastric carcinomas have various pathological features. Based on patterns of growth and invasiveness, however, they fall into two types: diffuse type and intestinal type. These two types of carcinoma appear to be different in their histogenetic origins. Objectives: To analyse various types of gastric cancer reported in last five years. To compare the features of intestinal and diffuse type gastric carcinoma including gross appearance, staging, grading of tumor. Materials and Methods: This was a retrospective study of 324 gastric cancer which were surgically resected and received over 5 years. The tumors were divided into groups according to their gross and microscopic patterns. Gross appearance was classified based on Borrmann classification. Microscopic features evaluated include tumor cell type, extent of invasion, degree of maturation, formation of glandular structures, nodal metastasis. Results: Totally 320 cases of gastric cancer were received of which 218(68%) were male, 102(32%) were female. Gastric cancers are rare below the age of 30 years. Comparing the type of gastric cancer intestinal type were 269(84%), diffuse type were 24(7.5%) and other type of gastric cancer including GIST, lymphoma, mucinous adenocarcinoma were 27(8.5%). Younger patients have higher stage of lymph node metastasis in diffuse type, but not for the intestinal type. Conclusion: Gastric cancer more common in male (M:F= 2:1) and most frequently seen in 5th decade. Intestinal type constitutes the most common type of gastric tumor. Gross appearance of diffuse type was predominantly infiltrative (79%).
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The multiracial population in Malaysia has lived together for almost a century, however, the risk ofgastric cancer among them varies. This study aimed to determine the distribution of different gastricadenocarcinoma subtypes and Helicobacter pylori infection status among gastric adenocarcinomapatients. Patients with gastric adenocarcinoma were enrolled from November 2013 to June 2015.Blood samples were collected for detection of H. pylori using ELISA method. Gastric adenocarcinomacases were more prevalent in the Chinese (52.8%), followed by the Malays (41.7%) and leastprevalent in the Indians (5.6%). Gastric adenocarcinoma located in the cardia was significantly moreprevalent in the Malays (66.7%) compared to the Chinese (26.3%), whereas non-cardia cancer wasdiagnosed more in the Chinese (73.7%) compared to the Malays (33.3%) [P = 0.019; OR = 5.6, 95CI: 1.27 to 24.64]. The Malays also had significantly higher prevalence of gastric tumour locatedat the cardia or fundus than other gastric sites compared to the Chinese (P = 0.002; OR: 11.2, 95%CI: 2.2 to 56.9). Among the cardia gastric cancer patients, 55.6% of the Malays showed intestinalhistological subtype, whereas all the Chinese had the diffuse subtype. More than half of the patients(55.3%) with gastric adenocarcinoma were positive for H. pylori infection and among them, 66.7%were Chinese patients. The risk of gastric adenocarcinoma in our population is different amongethnicities. Further studies on host factors are needed as it might play an important role in gastriccancer susceptibility in our population.
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Primary vulva malignancy is a rare gynecologic malignancy. Most of them are squamous cell carcinomas and adenocarcinomas are much less common. Intestinal type is a rare variant of primary adenocarcinoma of the vulva. It histologically resembles mucinous colonic carcinomas. Origin from cloacal remnants has been suggested but remains speculative. A 64-year-old woman was referred to our clinic with a 1-month history of an itching vulva mass. An incisional biopsy was performed at other hospital and disclosed adenocarcinoma of intestinal type. Extensive workups were performed to detect other underlying carcinomas but revealed nothing abnormal. She underwent wide local excision without lymph node dissection for a primary vulva carcinoma. She received no adjuvant therapy and has been free from recurrent disease for 12 months after surgery. The authors report a rare case and review the relevant literature.
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Female , Humans , Middle Aged , Adenocarcinoma , Adenocarcinoma, Mucinous , Biopsy , Carcinoma, Squamous Cell , Colon , Lymph Node Excision , Mucins , Pruritus , Vulva , Vulvar NeoplasmsABSTRACT
OBJECTIVE To investigate the expression and clinical significance of epidermal growth factor receptor (EGFR), the mutations of gene EGFR, KRAS and BRAF in sinonasal intestinal-type adenocarcinomas. METHODS We investigated the EGFR protein expression by immunohistochemistry method with antibodies targeting the extracellular domain, the intracellular domain, and the phosphorylated isoform in a series of 11sinonasal intestinal-type adenocarcinomas tissues. EGFR, KRAS, and BRAF mutational status were detected by DNA direct sequencing and Melt curve method.RESULTS The findings were analyzed with respect to clinical data, histological typing, and outcome of the patients. EGFR was expressed in 72.7% tumors with a focal distribution with both extracellular domain and intracellular domain, which showed a significantly correlation. p-EGFR was expressed in 9.1% tumors. 9.1% tumors had the mutation of EGFR gene in exon 19, 9.1% tumors had the mutation in exon 2 and exon 15 of gene KRAS and BRAF respectively. There was no association between these molecular features and the survival period of the patients. CONCLUSION The current study revealed various EGFR expression patterns in sinonasal intestinal-type adenocarcinomas, that indicated the tumor heterogeneity. Sinonasal intestinal-type adenocarcinomas share common alterations of the EGFR pathway as the mutation of EGFR, KRAS and BRAF genes, but with a lower frequency.
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BACKGROUND/AIMS: Epithelial-mesenchymal transition (EMT)-related proteins may exhibit differential expression in intestinal type or pancreatobiliary type ampulla of Vater carcinomas (AVCs). We evaluated the expression of E-cadherin, beta-catenin, and S100A4 in intestinal and nonintestinal type AVCs and analyzed their relationships with clinicopathological variables and survival. METHODS: A clinicopathological review of 105 patients with AVCs and immunohistochemical staining for E-cadherin, beta-catenin, and S100A4 were performed. The association between clinicopathological parameters, histological type, and expression of EMT proteins and their effects on survival were analyzed. RESULTS: Sixty-five intestinal type, 35 pancreatobiliary type, and five other types of AVCs were identified. The severity of EMT changes differed between the AVC types; membranous loss of E-cadherin and beta-catenin was observed in nonintestinal type tumors, whereas aberrant nonmembranous beta-catenin expression was observed in intestinal type tumors. EMT-related changes were more pronounced in the invasive tumor margin than in the tumor center, and these EMT-related changes were related to tumor aggressiveness. Among the clinicopathological parameters, a desmoplastic reaction was related to overall survival, and the reaction was more severe in nonintestinal type than in intestinal type AVCs. CONCLUSIONS: Dysregulation of E-cadherin, beta-cadherin, and S100A4 expression may play a role in the carcinogenesis and tumor progression of AVCs.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Ampulla of Vater/metabolism , Cadherins/metabolism , Common Bile Duct Neoplasms/classification , Disease-Free Survival , Prognosis , Retrospective Studies , S100 Proteins/metabolism , Biomarkers, Tumor/metabolism , beta Catenin/metabolismABSTRACT
Anthrax in man is usually cutaneous, resulting from contact with materials derived from infected livestock. Internal organs are infrequently involved,. This report concerns a case of primary anthrax of intestine. The first case of primary anthrax of intestine is to our knowledge in Korea. The patient was a 14-year-old male who has complained of nausea, vomiting and acute abdominal pain. History was otherwise noncontributory except for ingestion raw meat of the dead cattle, one day before the onset of the disease. The cattle presumably died due to Bacillus anthracis in a village Bae-Ban Dong in the city of Kyung ju, Kyung Pook. Among 15 sufferers, 2 cases died 3 days later. Bacillus anthracis isolated from the raw beef, blood samples of two patients and throat culture of one patient. At laparotomy, the peritoneal cavity was full of serosanginous fluid. Right hemicolectomy including partial resection of ileum was done. The bowel was segmentally dilated, hemorrhagic and necrotic, especially at terminal ileum. The mucosa was edematous and largely ulcerated covered with greenish yellow exudate. The intense vascular congestion with hemorrhage and numerous colonization of bacteria were present through the entire wall. The organisms were large, gram-positive and PAS-negative bacilli in long chain. Bacterial emboli were scattered in lymphatics. The other feature was band like lymphoid cell infiltration in ulcer base and submucosal layer. Payer's patches were prominent and the germinal centers were necrotic. Interfollicular spaces exhibited aggregates of numerous atypical lymphoid cells. The cells were five times larger than resting lymphocytes and had several prominent nucleoli and abundant amphophilic cytoplasm. On immunohistochemical staining, most of atypical cells were positive for T-cell marker and Ki-I Ag. The mesenteric lymph nodes were enlarged, showing reactive feature, and the atypical cells were also demonstrated. The patient recovered completely.
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Male , HumansABSTRACT
One hundred and forty mice, weighing 30-35 grams, were divided into irradiation group (12 Gy total body irradiation from a 60Co source), combined radiation-burn group (12 Gy total body irradiation and 15% TBSA third degree burns), and normal control group.The dynamic changes of the intestinal epithelium were observed with light and electron microscopes and autoradiography within 96 hours after injuries, and attention was paid to the formation and conversion of the misshapen cells. It was Jound that the proliferative cycle of the young cells in the intestinal crypts which were severely injuried by irradiation was significantly retarded, and their G1-phase to G2-phase were prolonged. These cells gradually changed into misshapen cells. Some of the misshapen cells could not divide and finally they wer.e desquamated; abortive proliferation was found in some of them; some others showed pathological karyokinesis. Thus polymorphic cells were formed. It was difficult to show that the misshapen cells could take part in the repair of the intestinal epithelium. It is speculated that the misshapen cells might to some extent have the function of absorption, secretion and barrier.