ABSTRACT
Early breast cancer patients often experience relapse due to residual disease after treatment. Liquid biopsy is a methodology capable of detecting tumor components in blood, but low concentrations at early stages pose challenges. To detect them, next-generation sequencing has promise but entails complex processes. Exploring larger blood volumes could overcome detection limitations. Herein, a total of 282 high-volume plasma and blood-cell samples were collected for dual ctDNA/CTCs detection using a single droplet-digital PCR assay per patient. ctDNA and/or CTCs were detected in 100% of pre-treatment samples. On the other hand, post-treatment positive samples exhibited a minimum variant allele frequency of 0.003% for ctDNA and minimum cell number of 0.069 CTCs/mL of blood, surpassing previous investigations. Accurate prediction of residual disease before surgery was achieved in patients without a complete pathological response. A model utilizing ctDNA dynamics achieved an area under the ROC curve of 0.92 for predicting response. We detected disease recurrence in blood in the three patients who experienced a relapse, anticipating clinical relapse by 34.61, 9.10, and 7.59 months. This methodology provides an easily implemented alternative for ultrasensitive residual disease detection in early breast cancer patients.
ABSTRACT
A 39-year-old woman was referred to the neurology department due to headache, instability and difficulty walking for 5 months. Several ancillary tests were performed. The blood test showed leucocytosis and the cerebrospinal fluid revealed an increased total protein and glucose consumption. Other infections or autoimmune causes were excluded. The MRI showed non-specific brain and spinal cord lesions. Given the findings described, a differential diagnosis between granulomatous meningoencephalitis and primary tumour or metastasis was proposed. Empirical treatment with tuberculostatic agents and corticosteroids was started. The neurological state of the patient worsened, she fell into a non-responsive coma and died in few days. The clinical autopsy performed revealed an adenoid cystic carcinoma with involvement of the central nervous system that developed leptomeningeal dissemination along the spinal cord in a fluid 'wash' pattern.
Subject(s)
Carcinoma, Adenoid Cystic , Adult , Brain , Carcinoma, Adenoid Cystic/diagnosis , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , MeningesABSTRACT
Estas recomendaciones del grupo de trabajo de Uropatología de la Sociedad Española de Anatomía Patológica (SEAP) suponen un resumen del Libro blanco 2017. Se basan en recomendaciones del Colegio Americano de Patólogos, ISUP 2015, Clasificación OMS 2016 y TNM (AJCC) 2017. Incluyen recomendaciones de tallado, examen macroscópico y microscópico, así como de uso de inmunohistoquímica. Se detalla que el patrón Gleason 3 incluye glándulas hiperplásicas, atróficas y microquísticas, y el patrón 4 todas las glándulas cribiformes y glomeruloides. El Gleason en pieza de prostatectomía se modifica, y si existe un patrón terciario mayor que el primario y el secundario que comprende más del 5% del tumor, se incorpora como secundario. Tanto para biopsias como para prostatectomías, si el Gleason es 7, se recomienda informar el porcentaje de patrón 4. Se especifica el Gleason en variantes tumorales y situaciones especiales. Estas recomendaciones deben ser adaptadas según la práctica individual e institucional de acuerdo con los medios disponibles
These guidelines from the uropathology working group of the Spanish Society of Pathology (SEAP) are based on the European and ISUP 2015 recommendations and those of the College of American Pathologists, as well as the latest WHO 2016, TNM (AJCC) 2017 classifications. They include recommendations for specimen sampling, macro- and microscopic examination and immunohistochemistry. Gleason patterns are specified: Gleason pattern 3 includes hyperplastic, atrophic and microcystic glands, while pattern 4 includes all cribriform or glomeruloid glands. The Gleason score in prostatectomy specimens may change; if a tertiary pattern occurs in more than 5% of the tumour, it becomes a secondary pattern. In both biopsies and prostatectomy specimens, if the Gleason score is 7, the percentage of pattern 4 should be stated. Gleason scoring in tumor variants and special situations should also be specified. These recommendations should be adapted according to the resources available
Subject(s)
Humans , Pathology/methods , Immunohistochemistry/methods , Microscopy/methods , Prostatic Neoplasms/pathology , Histocytological Preparation Techniques/methods , Biopsy/methods , Transurethral Resection of Prostate/methods , Organ Sparing Treatments/methodsABSTRACT
These guidelines from the uropathology working group of the Spanish Society of Pathology (SEAP) are based on the European and ISUP 2015 recommendations and those of the College of American Pathologists, as well as the latest WHO 2016, TNM (AJCC) 2017 classifications. They include recommendations for specimen sampling, macro- and microscopic examination and immunohistochemistry. Gleason patterns are specified: Gleason pattern 3 includes hyperplastic, atrophic and microcystic glands, while pattern 4 includes all cribriform or glomeruloid glands. The Gleason score in prostatectomy specimens may change; if a tertiary pattern occurs in more than 5% of the tumour, it becomes a secondary pattern. In both biopsies and prostatectomy specimens, if the Gleason score is 7, the percentage of pattern 4 should be stated. Gleason scoring in tumor variants and special situations should also be specified. These recommendations should be adapted according to the resources available.
