Prognostic differences between type Ⅰ and type Ⅱ renal papillary cell carcinoma / 现代泌尿外科杂志

【Objective】 To analyze the clinical characteristics and prognostic differences between type Ⅰ and type Ⅱ papillary renal cell carcinoma (PRCC), and identify the prognosis-related independent predictors. 【Methods】 A total of 143 PRCC patients treated during Jan.2012 and Dec.2019 were involved, including 91 type Ⅰ patients and 52 type Ⅱ patients. The prognostic factors were analyzed with univariate and multivariate Cox regression analysis. The differences in cancer-specific survival (CSS) between the two groups were analyzed with Kaplan-Meier method and log-rank test. 【Results】 The patients’ age was 53.41±13.50 years. After a mean follow-up of 63.27±26.20 months, 14 patients died, and the overall CSS was 90.2%. The prognosis of type Ⅰ patients was better than type Ⅱ patients (94.5% vs. 82.7%, P=0.020). Cox regression suggested that PRCC subtype and stage were significantly associated with prognosis. There was no difference in prognosis between type Ⅰ and type Ⅱ patients in T1/T2 subgroup (P>0.05). However, in T3/T4 subgroup, type Ⅰ patients had a significant better prognosis than type Ⅱ patients (P=0.023), while the above trends were not observed in G1/G2 and G3/G4 subgroups (P>0.05). 【Conclusion】 PRCC subtype and stage are independent prognostic predictors. The impact of PRCC subtype on prognosis is mainly manifested in the subgroup of patients with T3 or higher stage.

The correlation between metabolic parameters in (18)F-FDG PET-CT and solid and micropapillary histological subtypes in lung adenocarcinoma / 中华肿瘤杂志

Objective: Solid and micropapillary pattern are highly invasive histologic subtypes in lung adenocarcinoma and are associated with poor prognosis while the biopsy sample is not enough for the accurate histological diagnosis. This study aims to assess the correlation and predictive efficacy between metabolic parameters in (18)F-fluorodeoxy glucose positron emission tomography/computed tomography ((18)F-FDG PET-CT), including the maximum SUV (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and solid and micropapillary histological subtypes in lung adenocarcinoma. Methods: A total of 145 resected lung adenocarcinomas were included. The clinical data and preoperative (18)F-FDG PET-CT data were retrospectively analyzed. Mann-Whitney U test was used for the comparison of the metabolic parameters between solid and micropapillary subtype group and other subtypes group. Receiver operating characteristic (ROC) curve and areas under curve (AUC) were used for evaluating the prediction efficacy of metabolic parameters for solid or micropapillary patterns. Univariate and multivariate analyses were conducted to determine the prediction factors of the presence of solid or micropapillary subtypes. Results: Median SUV(max) and TLG in solid and papillary predominant subtypes group (15.07 and 34.98, respectively) were significantly higher than those in other subtypes predominant group (6.03 and 10.16, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for prediction of solid and micropapillary predominant subtypes [AUC=0.811(95% CI: 0.715~0.907) and 0.725(95% CI: 0.610~0.840), P<0.05]. Median SUV(max) and TLG in lung adenocarcinoma with the solid or micropapillary patterns (11.58 and 22.81, respectively) were significantly higher than those in tumors without solid and micropapillary patterns (4.27 and 6.33, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for predicting the presence of solid or micropapillary patterns [AUC=0.757(95% CI: 0.679~0.834) and 0.681(95% CI: 0.595~0.768), P<0.005]. Multivariate logistic analysis showed that the clinical stage (Stage Ⅲ-Ⅳ), SUV(max) ≥10.27 and TLG≥7.12 were the independent predictive factors of the presence of solid or micropapillary patterns (P<0.05). Conclusions: Preoperative SUV(max) and TLG of lung adenocarcinoma have good prediction efficacy for the presence of solid or micropapillary patterns, especially for the solid and micropapillary predominant subtypes and are independent factors of the presence of solid or micropapillary patterns.

Adenocarcinoma endocervical em Porto Alegre e região metropolitana: morfologia e prevalência / Endocervical adenocarcinoma in Porto Alegre and metropolitan region: morphology and prevalence

Objetivos: determinar a prevalência das neoplasias malignas epiteliais do colo uterino. Investigar a prevalência dos subtipos histológicos, o quadro clínico e a presença do papilomavírus humano em pacientes com adenocarcinoma endocervical. Método: foram analisados, por meio de microscopia óptica, todos os carcinomas do colo uterino do Grupo Hospitalar Conceição ­ Porto Alegre, entre 1995 e 2003, determinando a prevalência dos tipos histológicos. Os casos de adenocarcinoma foram classificados quanto ao subtipo histológico (estabelecido pela Organização Mundial da Saúde), determinando, ainda, o número de lesões intra-epiteliais escamosas associadas e aferindo dados clínicos relevantes. Amostras dos casos de adenocarcinoma foram avaliadas por meio da Reação em Cadeia da Polimerase, a fim de investigar a presença do Papilomavírus Humano nessa neoplasia. Resultados: avaliaram-se 908 casos de carcinoma epidermóide (79,7%) e 229 (20,1%) de adenocarcinoma. Os subtipos mais freqüentes de adenocarcinoma compreenderam o mucinoso (190 casos ­ 82,9%) e o endometrióide (12 casos ­ 5,3%), havendo 72 lesões intra-epiteliais (31,5%) associadas. A idade média das pacientes correspondeu a 53,2 anos, sendo 93 assintomáticas (40,6%) e 139 multíparas (60,6%). A técnica de PCR permitiu a detecção do HPV em 182 (79,48%) dentre os 229 casos de adenocarcinoma do colo uterino, sendo o HPV 18 o tipo predominante (51,09%). Conclusão: é sugerido um aumento relativo da prevalência de adenocarcinoma endocervical, assim como seu provável vínculo com o HPV. Comprovou-se o subtipo mucinoso como o mais prevalente dentre o grupo de adenocarcinomas, sendo uma neoplasia que acomete, freqüentemente, pacientes assintomáticas, multíparas e em com idade média de 50 anos (AU)

Objectives: To determine the prevalence of neoplasias of the cervix. To investigate the prevalence of histological subtypes, the clinical picture, and the presence of the human papillomavirus (HPV) in patients with endocervical adenocarcinoma. Methods: We analyzed all cases of carcinoma of the uterine cervix, which has occurred in the Grupo Hospitalar Conceição, Porto Alegre, between 1995 and 2003, determining their prevalence. The cases of adenocarcinoma were classified according to histological subtype (as established by the World Health Organization), determining, too, the number of associated squamous intraepithelial lesions and appraising relevant clinical data. Samples of cases of adenocarcinoma were assessed by means of Polymerase Chain Reaction (PCR) to investigate the presence of the HPV in this neoplasia. Results: A total of 908 cases of epidermoid carcinoma (79.7%) and 229 (20.1%) cases of adenocarcinoma were evaluated. The most frequent subtypes of adenocarcinoma were the mucinous (190 cases ­ 82.9%) and endometrioid (12 cases ­ 5.3%) types, with 72 associated intraepithelial lesions (31.5%). The mean age of patients was 53.2 years, 93 patients were asymptomatic (40.6%), and 139 were multiparas (60.6%). The PCR technique allowed the detection of HPV in 182 (79.48%) of the 229 cases of adenocarcinoma, HPV 18 being the prevailing type (51.09%). Conclusion: A concerning increase in the prevalence of endocervical adenocarcinoma is suggested, as well as its likely connection with the HPV. The mucinous subtype was confirmed as the most prevalent one among the group of adenocarcinomas, being a neoplasia that often affects asymptomatic, multiparous patients with mean age of 50 years (AU)