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Aim: In this study, it was aimed to investigate the prognostic importance of Tumor budding (TB) in Pancreatic ductal adenocarcinomas(PDAC) and its correlation with histopathological findings according to the International Tumor Budding Consensus Conference(ITBCC) grading. Material and Methods: A total of 75 patients diagnosed with PDAC were included in this study. The demographic features of the cases (age, sex) and the macroscopic features of the tumors (localization,size) were obtained from the electronic archive system. All Hematoxylin-Eosin-stained sections were re-evaluated in terms of differentiation, presence of lymphovascular (LVI) and perineural invasion(PNI), surgical margin positivity, primary tumor(pT), lymph node metastasis(LNM) and tumor budding. Statistically, Chi-square test, cox-regression and Kaplan-Meier test were performed. Results:Thirty four of the cases were female and 41 were male. The mean age was 64.21±9.71years. The degree of TB was TB-few in 17 cases, TB-moderate in 25cases, and TB-high in 33cases. LVI, PNI, LNM and TB-high were poor prognostic factors. Moreover, TB-high was related with poor differantiation,LVI,PNI,LNM and short survival time. Tumor budding was independent negative prognostic factor in multivariable model analyzes. Conclusion: ITBCC scoring can also be used in PDACs. In addition, high tumor budding was a poor prognostic feature and might be a target for tumor-specific treatments as it could be a predictive finding for the locally invasive character of the tumor. Evaluation and grading of TB thought to represent EMT may be a histological feature that can be used in tumor selection for advanced molecular methods to identify subtypes that may be associated with poor prognosis and drug resistance.
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O Carcinoma de Células Acinares (CCA) é uma neoplasia epitelial maligna, composta por células com semelhança morfológica com células acinares e com evidências de produção de enzimas exócrinas pelas células neoplásicas. CCA é um tumor extremamente raro e agressivo: representa cerca de 1% de todas as neoplasias pancreáticas, e a taxa de sobrevida global de 5 anos encontra-se inferior a 10%. Esse relato justifica-se não só pela rara ocorrência da doença, mas também pela escassa literatura acerca dos conhecimentos da patologia estudada. Além disso, o CCA é um tumor com difícil diagnóstico e extremamente agressivo; o tratamento dessa doença continua sendo aprofundado, uma vez que novos estudos sugerem a presença de micrometástases indetectáveis em exames de imagem em pacientes submetidos à ressecção cirúrgica total com margens negativas. Dessa forma, há a necessidade de incrementar relatos de caso à bibliografia existente. O presente trabalho trata-se de um relato de caso de Carcinoma de Células Acinares no pâncreas de paciente do sexo masculino de 9 anos diagnosticado no Hospital da Criança Santo Antônio do Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre.
Acinar Cell Carcinoma (ACC) is an epithelial malignant neoplasm composed of cells with morphological similarity to acinar cells and with evidence of exocrine enzyme production by the neoplastic cells. ACC is extremely rare and an aggressive tumor: it represents about 1% of all pancreatic neoplasms, and the overall 5-year survival rate is less than 10%. This report justifies itself by the rare occurrence of the disease and by the scarce literature concerning the pathology studied. Moreover, ACC is a tumor that is difficult to diagnose and extremely aggressive; the treatment of this disease continues under investigation since new studies suggest the presence of micrometastases - undetectable in imaging studies - in patients undergoing total surgical resection with negative margins. Thus, there is a need to add case reports to the existing bibliography. The present study is a case report of Acinar Cell Carcinoma of the pancreas in a 9-year-old male patient diagnosed at Santo Antônio Children's Hospital, Hospital Complex Santa Casa in Porto Alegre (Hospital da Criança Santo Antônio do Complexo Hospitalar Santa Casa de Misericórdia).
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Carcinoma de Células AcinaresRESUMO
Aims: Blood levels of pro- and anti-inflammatory cytokines were measured in 40 patients with chronic pancreatitis (CP), and pancreatic cancer (PC) as compared to healthy controls. Methods: With respect to the blood levels of pro- and anti-inflammatory cytokines in the 40 patients with chronic pancreatitis (CP), and pancreatic cancer (PC), there was a significant increase of interleukin-2 receptor (IL-2R) and interleukin-6 (IL-6) as compared to healthy controls. Result. Clinical and laboratory analyses revealed an enlargement of the pancreas in 32 (80%), and of the spleen in 3 (7%) patients, respectively. Elevated bilirubin was present in 17 patients (41%), significantly elevated lipase, gamma-glutamyl trans peptidase and alkaline phosphatase activities were found in 24 (62%) patients. ALT and AST activities were significantly elevated in 20 (50%), moderately elevated (3-5 xULN) in 6(15%) patients and slightly elevated (1.5-3 x ULN) in 14 (35%) patients. Serum albumin levels were reduced in 21 (51%) patients. The tumor markers CA 19-9 was elevated in 15 (38%) patients with a tumor in the head of the pancreas that was confirmed by computer tomography. Conclusion. The results indicate that cytokines are activated in patients with CP and PC respectively. This activation is accompanied by an increased levels of pro-inflammatory cytokines IL-2R, IL-6, TNF-αand INF-y, which closely correlate with the major pathological clinical and laboratory parameters in these patients.
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Objectives:To evaluate the clinical value of multi-slice spiral CT angiography(MSCTA)in the preoperative assessment ofvascular involvement and resectability of pancreatic carcinoma.Methods:Forty-eight cases of pancreatic carcinoma confirmedby surgical pathology were retrospectively analyzed.The state of peripancreatic vessels encroached by pancreatic carcinoma and the resectability were compared between MSCTA and routine axial images;16-slice spiral CT and dual Source CT.Results:For the assessment of resectability and peripancreatic vessel invaded by pancreatic carcinoma,dual source CT was better than 16-slice spiral CT;MSCT angiography was better than routine axial images.Conclusion:MSCT angiography technique can well display the delicate relation between tumor and vessels from different directions,and can delineate the vascular involvement of pancreatic carcinoma with high accuracy.It provides valuable information in the preoperative assessment of pancreatic carcinoma.
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Mixed ductal-endocrine carcinoma of the pancreas is composed of ductal and endocrine carcinoma components and each component makes up a significant proportion in the primary tumor as well as in the tumor of metastatic sites. Mixed ductal-endocrine pancreatic carcinoma is exceptionally rare and, to our knowledge, only five cases have been reported in the literature. Recently we experienced a case of mixed ductal-endocrine pancreatic carcinoma with regional lymph node and hepatic metastases in a 63-year-old woman. Here, we report a case of mixed ductal-endocrine pancreatic carcinoma with a review of the literature.