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Objective To investigate the clinicopathological characteristics and treatment effect of patients with non-small cell lung cancer (NSCLC) and uncommon epidermal growth factor receptor (EGFR) gene mutations. Methods Real-time fluorescence quantitative PCR was used to detect the mutation of EGFR in 674 samples of patients with NSCLC.The correlation between uncommon EGFR mutations and clinicopathological characteristics was analyzed. Results The EGFR mutation rate was 47.92%, of which the incidence of uncommon EGFR mutations was 5.19%, showed the presence of ex18 G719 A/S/C (G719X)(1.63%), ex20ins (1.04%), ex21 L861Q (0.74%), and compound mutations (1.78%).Correlation analysis showed that uncommon EGFR mutations were more common in women, non-smokers, patients with high-medium differentiation and adenocarcinoma, and patients were more prone to brain and bone metastasis (all P < 0.05).NSCLC with uncommon EGFR mutations showed no significant differences in clinical and pathological features compared with those with common sensitive mutations (all P > 0.05).Follow-up information was available on 31 patients, with a median follow-up time of 10 months, of which 23 were in advanced stage.Among eight patients with G719X mutation in late stage, seven patients used EGFR tyrosine kinase inhibitor (EGFR TKIs)(five of them used afatinib) in the first line and had a median PFS of 12 months; one patient received chemotherapy with pemetrexed and carboplatin and had PFS of seven months, which was lower than that of the TKI group.Among four patients with L861Q mutation in late stage, one patient was untreated and the three remaining were treated with TKI in the first line and had a median PFS of eight months.The patient who was treated with afatinib and bevacizumab was still stable after 11 months of follow-up.Two patients with EGFR ex20ins in advanced stage were treated with chemotherapy and bevacizumab.Nine patients with compound mutations in advanced stage were treated with TKI; among which, five patients harboring T790M compound mutations were treated with third-generation TKI and had a median PFS of more than 10 months. Conclusion The correlation between specific uncommon EGFR mutation and clinical pathological characteristics varies.For advanced patients with uncommon EGFR mutations (except for ex20ins), TKI is generally chosen as the first-line clinical treatment.Afatinib is recommended for advanced NSCLC patients with G719X and L861Q mutations.Third-generation TKI has significant efficacy in patients with complex mutations containing T790M.
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Objective@#To describe the clinicopathologic features and outcome of a patient with epithelial-myoepithelial carcinoma of the lacrimal gland who underwent modified lateral orbitotomy with en toto removal of the lesion and adjuvant radiotherapy.@*Methods@#This is a case report.@*Results@#A 31-year-old Filipino male seafarer presented with a 2-month history of an enlarging left superotemporal orbital mass and inferonasal displacement of the globe. Magnetic resonance imaging revealed a superotemporal extraconal mass within the lacrimal sac fossa with evidence of osseous infiltration of the superolateral orbital rim. Modified lateral orbitotomy was performed with en toto removal of the lesion and the clinically infiltrated adjacent lateral bony margin. Histopathologic diagnosis of epithelial-myoepithelial carcinoma of the lacrimal gland was made based on the classic and distinct biphasic morphology and was confirmed with immunohistochemistry studies (cytokeratin-7, S-100, and p63). Systemic surveillance using positron emission tomography and computed tomography scan with contrast revealed no evidence of regional or distant metastasis. Adjuvant radiotherapy of the orbital area was performed for increased local control. Twelve months postoperatively, the patient showed no evidence of tumor recurrence.@*Conclusion@#Epithelial-myoepithelial carcinoma of the lacrimal gland is a rare condition, and this is the first documented case from the Philippines. Accurate diagnosis is necessary for appropriate treatment. It should be included in the differential diagnosis of infiltrative lesions in the lacrimal gland fossa.
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Lacrimal ApparatusABSTRACT
End-stage renal disease(ESRD) patients with malignant renal tumor has its unique clinicopathological characteristics, and there are currently few domestic related studies. A retrospective analysis was performed on the clinical data of 16 ESRD patients with malignant renal tumor in Jiangxi Provincial People's Hospital. Their ages ranged from 20 to 70 yrs (mean 47.6 yrs). Most of the patients were asymptomatic and all underwent radical nephrectomy or radical nephroureterectomy. Clear cell carcinoma occurred in 11 cases, and papillary renal cell carcinoma in 2 cases. The vast majority of 13 cases were low-stage, low-grade tumors. All 13 cases were followed up for an average of 43.7 months and no recurrence or metastasis was found. In addition, the patients of renal sarcomatoid carcinoma, renal pelvis carcinoma and renal sarcoma survived for 2 to 20 months with poor prognosis.
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Lower incidence and mortality rates from prostate cancer (PCa) have been shown in Asian men in general compared to Westerners. This is the first study detailing the clinicopathologic features of resected prostate cancer in Filipino men living in the Philippines (PH). This study investigated the supposed "lower risk" Filipino and "higher risk" American PCa patients from the PH and the United States of America (USA), respectively. We examined 348 (176 from PH, 172 from USA) radical prostatectomy cases. The clinicopathologic features of both groups (age at time of diagnosis, preoperative prostate-specific antigen [pre-op PSA] level, Gleason score [GS], Grade groups [GG], margin involvement, extraprostatic extension [EPE], seminal vesicle invasion [SVI], and regional lymph node [RLN] metastasis) were compared. Six of seven prognosticators examined were more strongly associated with Filipinos than with Americans. Filipinos were older at diagnosis (PH: 64.32 ± 6.56 years vs USA: 58.98 ± 8.08 years) and had higher pre-op PSA levels (PH: 21.39 ± 46.40 ng ml
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Objective@#To investigate clinicopathological features and prognostic factors of gastric neuroendocrine tumors (G-NEN).@*Methods@#Clinical and pathological data of patients with G-NEN diagnosed by pathological examination in Chinese PLA General Hospital from January 2000 to June 2018 were retrospectively analyzed in this case-control study. Patients with complicated visceral lesions, other visceral primary tumors, mental disorders and incomplete clinicopathological data were excluded. Finally, 240 hospitalized patients who met the inclusion criteria were enrolled. Physical examination information, tumor characteristics and pathological characteristics of patients were summarized. The Cox regression models were used to analyze the risk factors affecting G-NEN and the survival conditions were described by Kaplan-Meier survival curves and log-rank test.@*Results@#In 240 patients with G-NEN, the mean age was (60.3±10.1) years; 181 were male (75.4%) and 59 females (24.6%); mean tumor diameter was (4.2±2.8) cm; 51 cases (21.2%) were neuroendocrine tumor (NET), 139 cases (57.9%) neuroendocrine carcinoma (NEC), 50 cases (20.8%) mixed neuroendocrine carcinoma (MANEC); 28 cases (11.7%) were G1 low grades, 34 cases (14.2%) G2 medium grades, and 178 cases (74.2%) G3 high grades; tumor infiltration depth T1 to T4 were 44 cases (18.3%), 27 cases (11.2%), 60 cases (25.0%) and 109 cases (45.4%) respectively; 163 cases (67.9%) developed lymphatic metastasis and 46 patients (19.2%) distant metastasis; tumor stage from stage I to stage IV were 55 cases (22.9%), 42 cases (17.5%), 94 cases (39.2%) and 53 cases (22.1%) respectively. Of the 240 G-NEN patients, 223 cases (92.9%) were followed up. The median survival time of the patients was 39.2 (95% CI: 29.1 to 47.5) months. Univariate survival analysis showed that age ≥ 60 years, tumor diameter ≥ 4.2 cm, tumor grade G3, lymphatic metastasis, distant metastasis, and tumor stage III-IV were risk factors for G-NEN patients. Multivariate survival analysis revealed that lymphatic metastasis (HR=1.783, 95%CI: 1.007-3.155, P=0.047) and distant metastasis (HR=2.288, 95% CI: 1.307-4.008, P=0.004) were independent risk factors of the prognosis. Further analysis of the G3 subgroup of G-NEN showed that the 5-year survival rate of NET-G3 was 76.19%, which was significantly higher than that of NEC-G3 and MANEC-G3 (15.60% and 24.73%, P=0.012).@*Conclusions@#Most G-NEN patients are in advanced stage at diagnosis. Lymphatic metastasis and distant metastasis indicate poor prognosis. The prognosis of high proliferation NET-G3 patients is better as compared to those of NEC-G3 and MANEC-G3. This classification is worth further attention.
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ObjectiveAs the pathogenesis of gastric cancer remains unclear, this paper aims to investigate the expression of FAM83C in gastric cancer tissues, to analyze the relationship between the expression difference and clinicopathological features and prognosis, and to further explore the mutation sites and methylation of FAM83C in gastric cancer.MethodsData mining of FAM83C was conducted by TCGA database and Oncomine database to analyze the expression of FAM83C in gastric cancer and other multiple types of cancer. The relationship between the expression of FAM83C and the clinicopathological characteristics of gastric cancer was analyzed by LinkedOmics database. The effect of FAM83C expression on the prognosis of patients with gastric cancer was analyzed by Kaplan Meier Plotter database. The mutation sites and methylation of FAM83C in gastric cancer was analyzed by cBioportal database and MethHC database. The protein network interacting with FAM83C was analyzed by String database.ResultsThere were 56 studies on FAM83C expression differences in the Oncomine database with statistical significance (P<0.05), among which 46 studies suggested that FAM83C was highly expressed in a variety of cancer tissues, and its high expression in gastric cancer was statistically significant (P=0.000733). Meanwhile, the analysis of 637 gastric cancer samples in the TCGA database showed that FAM83C was highly expressed in all kinds of gastric cancer tissues (P<0.05). The differences between FAM83C expression level and patients' age (P=0.0344) and T stage (P=0.034) were statistically significant (P<0.05). The group with high FAM83C expression had shorter survival time and worse prognosis, and the difference was statistically significant (P=0.0071). FAM83C mutations in gastric cancer include missense mutation, frame-shift mutation and splicing mutation. The methylation level of FAM83C gene promoter region in gastric cancer was significantly higher than that in normal gastric tissue (P<0.005). The proteins interacting with FAM83C include SLCO5A1, AKR7A3, MMP24, EIF6 and ARL11, etc., and may participate in the cellular function process together.ConclusionFAM83C is highly expressed in gastric cancer. In addition, its expression level has a certain correlation with the degree of malignancy and poor prognosis of gastric cancer, which is manifested in the characteristics of proto-oncogenes to a certain extent, and is expected to become a new target for clinical diagnosis and treatment of gastric cancer.
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Objective To discuss the correlation between family history of malignant neoplasms (MN-FH) and the clinicopathological features of patients with non-small cell lung cancer (NSCLC). Methods The clinicopathological data of 326 patients with NSCLC in Yangzhou University Affiliated Hospital from June 2016 to June 2018 were analyzed retrospectively. The patients were divided into two groups based on with or without MN-FH, and the clinicopathological features of the two groups were analyzed by χ 2 test. Results Of the 326 patients with NSCLC, 41 (12.6％) were in the MN-FH group and 285 (87.4％) in the MN-FH group. There were no significant differences in sex, age, smoking, location of tumors and histological classification between patients with or without MN-FH (χ 2 values were 0.031, 0.769, 0.546, 0.117, and 0.945, all P > 0.05), but in patients with MN-FH, the proportion of tumor diameter < 5 cm [65.9％ (27/41) vs. 42.5％(121/285), χ 2 = 14.173, P < 0.05], undifferentiation and low differentiation [70.7％ (29/41) vs. 53.7％(153/285), χ 2 = 4.224, P < 0.05], TNM stage Ⅲ+Ⅳ [65.9％ (27/41) vs. 46.7％ (133/285), χ 2 = 5.280, P <0.05], lymph node metastasis [78.0％ (32/41) vs. 60.0％ (171/285), χ 2 = 4.970, P < 0.05], distant metastasis [75.6％ (31/41) vs. 53.3％ (152/285), χ 2 = 7.224, P < 0.05], high degree of malignancy [70.7％ (29/41) vs. 51.6％ (147/285), χ 2 = 5.293, P < 0.05] and combination of other tumors [29.3％ (12/41) vs. 7.7％ (22/285),χ 2 = 17.817, P < 0.05] were significantly higher than those in patients without MN-FH. Conclusions NSCLC patients with MN-FH have a higher degree of malignancy. For people with MN-FH, physical examination is very important.
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Objective To investigate the expression of programmed death ligand 1 (PD-L1) in lung adenocarcinoma tissues and its correlation with clinicopathological features of patients. Methods A total of 141 paraffin-embedded specimens of patients with newly diagnosed lung adenocarcinoma by pathology from January to August 2018 in the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School were collected. The expression of PD-L1 in the tumor cells (TC) and tumor-infiltrating immune cells (IC) were detected by immunohistochemistry EnVision staining. Based on the percentage of expression, PD-L1 in TC and IC were divided into TC3 (≥50％), TC2 (≥5％ and <50％), TC1 (≥1％ and <5％), and TC0 (<1％); IC3 (≥10％), IC2 (≥5％ and <10％), IC1 (≥1％ and <5％), and IC0 (<1％). Results PD-L1 expression was positive in 90 cases, and the positive rate was 63.8％ (90/141) at a TC1 or IC1 threshold. When a TC3 or IC3 threshold was applied, PD-L1 expression was positive in 17 cases, and the positive rate was 12.1％ (17/141). In the TC1 or IC1 threshold group, PD-L1 expressions were different in patients with different sex, nerve invasion and pleural invasion, and the differences were statistically significant (all P < 0.05). While in the TC3 or IC3 threshold group, PD-L1 expressions were different in patients with different cell differentiation, clinical stage, lymphocyte infiltration, vascular invasion and nerve invasion, and the differences were statistically significant (all P < 0.05). In both TC1 or IC1 threshold group and TC3 or IC3 threshold group, PD-L1 expression was associated with nerve invasion (both P < 0.05). Conclusions PD-L1 expression is associated with nerve invasion. PD-L1 inhibitors expect to be used as a potential treatment strategy for recurrent and progressive lung adenocarcinoma patients with high level expression of PD-L1.
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Objective: To explore the expression of PTK7 in pancreatic ductal adenocarcinoma and its clinical significance. Methods: The clinical and follow-up data of 85 patients with pancreatic ductal adenocarcinoma who underwent radical surgery at Tianjin Medical University Cancer Institute and Hospital from May 2011 to January 2016 were analyzed. The expression of PTK7 in 85 pancreatic cancer tissues and the corresponding para-cancer tissues was detected by immunohistochemistry, and the relationship between PTK7 expression level and the clinical pathological features and prognosis was analyzed. Results: Positive expression of PTK7 was observed mainly in the cytoplasm, presenting as brownish yellow granules. It was noted that expression of PTK7 in pancreatic ductal adenocarcinoma tissues and para-carcinoma tissues was 70.6% (60/85) and 52.9% (45/85), respectively, and the positive rate in pancreatic ductal adenocarcinoma tissues was significantly higher than that in para-carcinoma tissues; the difference was statistically significant (P<0.05). The abnormal expression of PTK7 was correlated with the tumor stage, lymph node metastasis, and the vascular tumor embolus (P<0.05). The survival analysis suggested that the survival time or recurrence-free time of patients with PTK7 high expression in pancreatic duct adenocarcinoma was significantly shorter than in those with low expression (P<0.05, respectively). ShRNA interference of PTK7 was successfully established in the cell stabilizing system, verified by MTT and clone formation. Results indicated that cell survival was significantly lower in the shRNA experimental group compared to the control group (P<0.05), the number of colonies formed was significantly smaller in the shRNA experimental group compared to the control group (P<0.05), and the expression of proliferation-related proteins Ki-67 and PCNA was significantly lower in the shRNA experimental group compared to the control group (P<0.05, respectively). Conclusions: The up-regulation of PTK7 expression in pancreatic ductal ad-enocarcinoma tissues was associated with the tumor stage, lymph node metastasis, and the vascular tumor thrombus, suggesting poor prognosis. It was also found that in pancreatic cancer cell lines, PTK7 could promote the proliferation of pancreatic cancer cells by regulating the levels of proliferative factors Ki-67 and PCNA.
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Objective:This study was conducted to detect circulating miR-6861-5p and evaluate its diagnositic value in the diagnosis and treatment of breast cancer.Methods:MiR-6861-5p expression was detected by RT-qPCR in 112 patients with breast cancer en-rolled in the Second People Hospital of Dezhou from January 2012 to June 2015,with 37 patients diagnosed with benign breast le-sions,and 53 healthy people.The relationship between circulating miR-6861-5p and clinicopathologic features and the postoperative recurrence of breast cancer was analyzed to explore the diagnostic value of circulating miR-6861-5p in patients with breast cancer.Re-sults:Circulating miR-6861-5p expression was significantly higher in patients with breast cancer(7.99±1.63)than in patients with be-nign breast lesions(6.45±1.06)and healthy people(6.43±1.28)(P<0.05).There was a significant correlation between circulating miR-6861-5p and lymph node metastasis,estrogen receptor,progesterone receptor,HER-2 expression,TNM staging,molecular typing,and histological staging in patients with breast cancer(P<0.05).Circulating miR-6861-5p significantly decreased after tumor resection(P<0.05)and was significantly correlated with the recurrence rates after treatment.The sensitivity and specificity of diagnosis in breast cancer by detecting circulating miR-6861-5p were 69.6% and 77.8%,respectively.Conclusions:There is high expression of circulating miR-6861-5p in breast cancer,which may serve as useful diagnostic,staging,cancer cell metastasis,and postoperative recurrence bio-marker in patients with breast cancer.
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Objective@#To explore the association between plasma leptin (LEP) levels, soluble leptin receptor(SLR), free leptin index and breast cancer.@*Methods@#245 new female cases of primary breast cancer confirmed by histopathology examination were sequentially recruited into the study. A total of 245 age-matched healthy women were enrolled as controls during the same period. A standardized questionnaire was used to collect the demographic information of the subjects. Blood samples were collected and the levels of LEP and SLR in plasma were measured by enzyme linked immunosorbent assay. The differences of LEP, SLR and FLI expression between control and cases group, as well as different breast cancer subtypes and TNM stages were compared using t-test and ANOVA after stratification by menopause status. Multivariate logistic regression was used to explore the contributions of the three indexes to the risk of breast cancer.@*Results@#Females in both cases and control group were (50.7 ± 9.4) years old. The level of SLR and FLI (P50(P25,P75)) in premenopausal women were 18.4 (11.2, 28.7), 0.5 (0.4, 0.6) μg/L in case group and 27.7 (19.2, 43.4), 0.3 (0.3, 0.4) μg/L in control group (P<0.001). While the level of postmenopausal women in case group were 20.3 (12.8, 31.8), 0.5 (0.4, 0.6) μ g/L (P<0.001), and 30.1 (18.8, 40.5), 0.3 (0.3, 0.5) μg/L in control group (P<0.001), respectively. After adjustment for confounding factors and BMI, the relationship between FLI and breast cancer remained significant for both pre- and postmenopausal women while the association between SLR and breast cancer was significant only in premenopausal women. Compared with the lowest level of SLR, higer levels of SLR is associated with a reduced risk of breast cancer (premenopausal women, OR=0.10, 95% CI: 0.04-0.29, Ptrend<0.001). Compared with the lowest level of FLI, FLI at higher levels is associated with an increased risk of breast cancer (premenopausal women, OR=7.14, 95% CI: 2.86-17.83, Ptrend<0.001; postmenopausal women, OR=8.10, 95% CI: 2.85-22.98, Ptrend<0.001). No significant association between LEP and breast cancer or association between the three indexes and breast cancer subtypes and TNM stages was found (P>0.05).@*Conclusion@#SLR may be a protective factor for breast cancer while FLI may increase the risk of breast cancer.
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Objective:To discuss the diagnostic value of miR-26a/b and relationship of this microRNA with clinicopathological features in patients with gastric cancer. Methods:The expression of serum miR-26a/b was detected in 121 patients with gastric cancer and 116 healthy controls using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The relationship of miR-26a/b and clinicopathological parameters of patients were analyzed. The receiver operating curve (ROC) was constructed to in vestigate the value of miR-26a/b in the diagnosis of gastric cancer. Results:The relative expression levels of serum miR-26a and miR-26b in patients with gastric cancer were lower than those in the control group (1.60±1.02 vs. 5.35±0.44;1.44±0.71 vs. 5.35±0.71;P<0.05). The relative expression level of miR-26a/b correlated with TNM stage, and the relative expression level of miR-26a also correlated with invasion depth and lymph node metastasis (P<0.05), but not with sex, age, tumor size, or histological type (P>0.05). The area under the ROC curve of miR-26a was 0.828 (95％CI:0.776～0.881), with sensitivity of 73.3％and specificity of 81.0％, while the area under the ROC curve of miR-26b was 0.853 (95％CI:0. 801～0.906), with sensitivity of 68.1％and specificity of 99.2％. Conclusion:The expression of miR-26a/b significantly reduced in patients with gastric cancer, and its expression level correlated with the clinical stage, invasion depth, and lymph node metastasis. MiR-26a/b has potential diagnostic value for gastric cancer.
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Purpose The aim was to examine c-MET,ALK,ROS1 variants in advanced non-small cell lung cancer (NSCLC) patients,and to analysis the association of c-MET,ALK,ROS1 variants with the clinical and pathological features.Methods The c-MET,ALK,ROS1 were detected by fluorescence in situ hybridization (FISH) in the 91 cases of NSCLC specimens.The correlation of c-MET gene amplification with clinicopathological features and the ALK,ROS1 fusions was analyzed.Results The positive rate of c-MET gene amplification was 8.79％ (8/91),the positive rates on male and female were 1.82％ and 19.4％,respectively.In ＜ 60-years-old and ≥60-years-old NSCLC patients,the positive rates were 7.5％ and 8.89％,resepectively.The positive rate was higher in stage Ⅲ than stage Ⅳ (9.62％ vs 7.69％),the c-MET gene amplification was detected in 9.2％ adenocarcinoma patients but none in squamous carcinoma patients.The detection rates of ALK fusions and ROS1 fusions were 10％ and 13.3％,respectively.One patient was detected the coexistence of MET with ROS1 fusion.Conclusion The c-MET gene amplification is correlated with gender,but not with age,histological types and clinical stages.C-MET amplification,ALK fusions and ROS1 fusions are almost no coexistence,but not completely mutually exclusive.To they knowledge,this is the first case report the coexistence of MET amplification with ROS1 fusion in NSCLC.
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Purpose To detect the expression of Cathepsin D(CTSD),heat shock protein 90α (HSP90α) and epidermal growth factor receptor (EGFR) in gastric cancer (GC) tissues and to analyze the association of their expression levels and clinical pathological features of GC,the role of CTSD,HSP90α,EGFR in the carcinogenesis,progression,invasion and metastasis of GC.Methods The expression of CTSD,HSP90α and EGFR in normal gastric mucosa,dysplasia adjacent to carcinoma,GC tissues and lymph node metastasis was measured by immunohistochemistry (IHC) and in situ hybridization (ISH).Results In 110 cases of normal gastric mucosa,83 cases of dysplasia adjacent to carcinoma,110 cases of GC and 78 cases of the lymph node metastasis,the positive rate of CTSD,HSP90α,EGFR protein was 0,18.7％,80.91％ and 92.31％,0.9％,15.66％,75.45％ and 89.74％,0,12.05％,69.09％ and 84.62％,respectively.Correlation analysis showed that the expression CTSD,HSP90α and EGFR in GC tissues was positively correlated (rs =0.853,P ＜ 0.05,rs =0.639,P＜0.05,rs =0.734,P＜0.05).Expression of CTSD,HSP90α and EGFR in GC was correlated with the degree of tumor differentiation,invasive depth,number of lymph node metastasis and TNM stages (P ＜ 0.05).There was no significant correlation with the patient's age,sex,tumor size (P ＞0.05).Conclusion CTSD,HSP90α and EGFR may be associated with malignant behavior,development and invasion and metastasis of GC.
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Objective To explore the expression plasma heat shock protein HSP90αand its clinical signifi-cance for lung cancer patients . Methods Plasma levels of HSP90α protein of 60 patients with lung cancer and 24 healthy individuals are detected by ELISA analysis . Results The average plasma levels of HSP90αprotein [(190.338 ± 105.861) ng/mL] in patients with lung cancer were significantly higher than in healthy con-trols [(41.020 ± 19.736) ng/mL, t = 10.480, P < 0.001]. The sensitivity of HSP90α is higher than CEA, NSE, CYFRA21-1. The sensitivity of HSP90α, CEA, NSE, CYFRA21-1 and STK1 is 100%. HSP90α is correlated with STK1 and metastasis (χ2 = 4.656, P = 0.031). Conclusions This study demonstrates that the plasma level of HSP90αprotein is a useful diagnostic biomarker in lung cancer. The sensitivity is much higher when HSP90αcom-bined with CEA, NSE, CYFRA21-1 and STK1.
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PURPOSE: Although minimally invasive follicular thyroid carcinoma (MIFTC) is considered a thyroid tumor with low malignant potential, some MIFTC can spread, metastasize, and eventually lead to death. This study investigates the risk factors for distant metastasis in MIFTC patients. METHODS: Between 1981 and 2014, the records of 365 consecutive patients who underwent thyroidectomy for MIFTC at Seoul National University Hospital were reviewed. Univariate and multivariate analyses were performed to identify risk factors associated with distant metastasis. RESULTS: Of 351 patients, 10 (2.9%) presented with distant metastasis. Of these, two (0.6%) were found at the time of thyroidectomy, while eight (2.3%) were detected at later exams, over a median of 7.3 years (range, 0.2~30.8). In univariate analysis, lymph node metastasis (P<0.001) was significantly associated with distant metastasis. In multivariate analysis, lymph node metastasis (P<0.001) and locoregional recurrence (P=0.008) were significantly associated with distant metastasis. CONCLUSION: Distant metastasis in MIFTC patients were associated with high-risk clinicopathologic features and more aggressive clinical courses. Further study will be needed to ascertain these results with long-term surveillance.
Subject(s)
Humans , Adenocarcinoma, Follicular , Lymph Nodes , Multivariate Analysis , Neoplasm Metastasis , Recurrence , Risk Factors , Seoul , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .
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Purpose To study the clinicopathologic features and immunophenotype of the basal cell adenoma ( BCA) with a focal crib-riform pattern in salivary gland. Methods Four cases of BCA with a focal cribriform pattern were retrospectively analyzed with their clinical findings, histopathology and immunohistochemical staining for CK, CK14, CK8/18, CK19, EMA, CD10, CD117, BCL-2, CDX-2, SMA, S-100, p63, p53, EGFR and Ki-67. Results Four cases of BCA with a focal cribriform structure all appeared as slow-growing neoplasms with good circumscription and lack of infiltrative properties, with capsular invasion but without capsular break-through. There are have at least a 50% area of cribriform structure in tumors under microscope. Immunohistochemical profiles exhibi-ted weak positivity for CK, EMA, CD10, CD117, BCL-2, CDX-2, p53 and EGFR, moderate for CK14, CK8/18, SMA and S-100, and strong for CK19, p63 and Ki-67 index<1%. Conclusions Cribriform type of salivary bacal cell adenoma is relatively rare and has difficulty in distinction from adenoid cystic carcinoma ( ACC) . Clinicopathologic features and immunophenotype are the most relia-ble points for differential diagnosis of BCA from ACC.
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Purpose To study the clinicopathological characteristics in 22 cases of ovarian mature teratoma with malignant transforma-tion. Methods Clinical and pathologic features were collected and analyzed in 22 out of 1 826 cases of ovarian mature teratoma by retrospective studies, together with immunohistochemical staining. Results In our study, 22 cases (1. 2%) of ovarian mature terato-ma with malignant transformation were identified. The median age was 56. 5 (range, 31~79) years. The main clinical manifestations were pelvic masses, including 13 cases in the left ovary, 8 cases in the right, 1 case was bilateral. Gross cystic teratoma were saw in 19 cases, 3 cases of cystic and solid, the bilateral one was solid in the left which the right was cystic. The teratomas size were 5. 0~30 cm with average 12. 4 cm in diameter. The malignant components’ maximum diameter was about 1. 0~10. 0 cm with average 3. 7 cm. Microscopicically, there were poorly differentiated squamous cell carcinoma in 14 cases, carcinoid carcinoma in 4 cases, adeno-carcinoma in 2 cases, papillary thyroid carcinoma in 2 cases, and the last one was sarcomatoid carcinoma. The FIGO stage distribution was as follows:16 were stage IA, 1 was stage IB, 1 was stage IIA, 4 were stage IIB. Follow up showed 6 cases recurrened, 2 patients died, the rest are survival. Conclusions A low incidence of ovarian mature teratoma in somatic cells with malignant transformation, which are common in postmenopausal women and present with pelvic mass. The main malignant components is squamous cell carcino-ma, patients of stage I have better prognosis. Both clinic and pathology should take more attention to the comprehensive examination and diagnosis of teratoma for prevent misdiagnosis.
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Background and purpose: Breast cancer is a group of heterogeneous diseases which has racial disparities. Our study was to elucidate the clinicopathologic features of breast carcinoma in Shanghai Han and Xinjiang Uygur women and to analyze the racial differences. Methods: In this study, 125 cases of breast invasive ductal carcinoma of Shanghai Han women and 85 cases of Xinjiang Uygur women were collected. The clinical stage was analyzed. Histological grading was observed. Immunohistochemical staining of ER, PR, HER-2, CK5/6, CK14, EGFR, Ki-67 was performed. Molecular subtypes were studied. Results:The average age of onset of breast cancer in Xinjiang Uygur women was younger than in Shanghai Han women (P<0.05), and Xinjiang Uygur women were more likely to be diagnosed at less than 35 years old (P<0.01). The proportion of stageⅠwas higher in Shanghai Han women (20.0%vs 8.2%), while the proportion of stageⅢwas higher in Xinjiang Uygur women (50.6%vs 27.2%) (P<0.01). The proportion of grade 2 was higher in Shanghai Han women (67.2% vs 43.5%), while the proportion of grade 3 was higher in Xinjiang Uygur women (47.1%vs 31.2%) (P<0.01). The proportion of luminal A subtype was higher in Shanghai Han women (36.8%vs 18.3%), while the proportion of basal-like subtype was higher in Xinjiang Uygur women (29.6%vs 12.0%) (P<0.01). The molecular subtype was associated with race and histological grade (P<0.05).Conclusion:There are racial differences in clinicopathologic features of breast carcinoma between Shanghai Han and Xinjiang Uygur women.