Pancreatic cancer with synchronous liver and colon metastases: A case report.

BACKGROUND: Metastasis of pancreatic cancer to the colon is rare and the features need to be further elucidated. Herein, we report a rare case of pancreatic cancer with simultaneous liver and colon metastases. CASE SUMMARY: A 48-year-old man with intrahepatic space-occupying lesions based on a computed tomography scan was admitted to our hospital for further treatment. Abdominal magnetic resonance imaging revealed a 6.4 cm × 4.2 cm mass in the tail of the pancreas and multiple low-density masses in the liver parenchyma. In addition, a mass of 2.2 cm × 1.6 cm with surface congestive erosions in the sigmoid colon was detected by colonoscopy. Histopathological examination of biopsies from both the liver and colon lesions revealed a moderately to poorly differentiated adenocarcinoma. Immunohistochemical staining of the colon tumor was positive for cytokeratin (CK) 7 and CK, but negative for colorectal adenocarcinoma-related markers CK 20, CDX2, and SATB2, thus indicating that the metastasis originated from the pancreas. Next-generation sequencing for genomic profiling of the liver and colon metastases both found mutations in KRAS (p.G12D) and TP53 (c.376-1delG), with microsatellite stable and low tumor mutational burden without actionable or cancer-predisposing gene mutations detected. The patient was subsequently treated with 12 cycles of FOLFIRINOX which led to a sustainable response, followed by ongoing maintenance treatment with irinotecan plus fluorouracil. CONCLUSION: For this rare case, careful evaluation of histopathological and immunohistochemical staining results are required. The genomic profiling of colon lesions was revealed for the first time, and FOLFIRINOX showed good treatment efficacy in this patient.

Ultrasound-Assisted Extraction Optimization of Proanthocyanidins from Kiwi (Actinidia chinensis) Leaves and Evaluation of Its Antioxidant Activity.

Using ultrasound (US) in proanthocyanidin (PA) extraction has become one of the important emerging technologies. It could be the next generation for studying the US mechnophore impact on the bioactive compound's functionality. The objective of this study was to demonstrate the potential of US treatment on PAs extracted from kiwifruit (Actinidia chinensis) leaves, and to provide a comprehensive chemical composition and bioactivity relationship of the purified kiwifruit leaves PAs (PKLPs). Several methods like single-factor experiments and response surface methodology (RSM) for the four affected factors on US extraction efficiency were constructed. HPLC-QTOF-MS/MS, cytotoxicity analysis, and antioxidant activity were also demonstrated. In the results, the modeling of PA affected factors showed that 40% US-amplitude, 30 mL/g dry weight (DW) solvent to solid ration (S/S), and 70 °C for 15 min were the optimum conditions for the extraction of PAs. Furthermore, PKLPs exhibited significant radical scavenging and cellular antioxidant activity (p < 0.05). In conclusion, this study's novelty comes from the broad prospects of using US in PKLP green extraction that could play an important role in maximizing this phytochemical functionality in drug discovery and food science fields.

The variation and clinical significance of hormone receptors and Her-2 status from primary to metastatic lesions in breast cancer patients.

The objective of this study is to investigate how the change of hormone receptor (HR) and human epidermal growth factor receptor-2 (Her-2) status is related to patients' clinical features. One hundred ninety-three cases of patients treated at general hospital of PLA from 2000 to 2015 with advanced breast cancer were included. All patients developed recurrence that were re-biopsied and had complete pathological profile both at initial diagnosis and at relapse. HR status before and after relapse were available for all patients, while only 143 cases had Her-2 status at the two stages. The changes of ER, PR, and Her-2 status and their association with clincopathological factors and DFS were analyzed. The discordant rates of ER, PR, and Her-2 status between primary breast cancer and recurrent tumor were 34.2, 38.3, and 16.8 %, respectively. At relapse, the rates of gain of ER and PR positivity were 10.9 and 13.5 %, respectively; the rates of loss of ER and PR positivity were 23.3 and 24.9 %. Loss of positivity was more frequent than gain of positivity (p ER < 0.000, p PR = 0.001). Among patients with Her-2 negative primary tumors, 15.4 % acquired Her-2 positivity at relapse; and among Her-2 positive patients at initial diagnosis, 1.4 % turned to Her-2 negative at relapse; gain of positivity was more frequent than loss of positivity (p < 0.000). Patients with tumor larger than 2 cm in diameter were more likely to experience change of Her-2 status (25.0 vs 5.8 %, p = 0.005). Yet, the change of ER/PR was not significantly associated with the size of primary tumor. Patients with ER positive recurrent disease and PR positive primary tumor had a DFS of more than 40 months. Compared to patients who maintained PR negative, patients who gained PR positivity at relapse had significantly longer DFS by 8.5 % (35.2 vs 26.7 months, p = 0.024). Patients losing ER positivity at relapse had shorter DFS by 7.8 months compared to those with stable ER positive tumors; patients gaining ER positivity experienced longer DFS by 8.3 months; but both differences were not statistically significant. Loss of Her-2 positivity was associated with longer DFS by 13.8 months as opposed to stable Her-2 status, without statistical significance. For patients with Her-2 negative primary tumor, the changes of Her-2 status were not associated with DFS. 34.2, 38.3, and 16.8 % of breast cancer patients had their ER, PR, and Her-2 status changed after recurrence, and these changes of receptor status were associated with DFS to some degree. Gain of PR positivity at relapse was significantly correlated with longer DFS.

[Effect of FCGR3A Polymorphisms on Antibody-dependent Cetuximab-mediated Cytotoxicity in A549 Cells].

OBJECTIVE: To investigate the effect of FCGR3A polymorphisms on the antibody-dependent cell-mediated cytotoxicity (ADCC) activity induced by cetuximab against A549 cells. METHODS: A549 cell line was used as target cells and NKTm cells as effector cells. FCGR3A polymorphisms were detected by direct sequencing. The ADCC activity mediated by cetuximab was assessed by CCK-8 assay. RESULTS: Three genotypes of FCGR3A were detected:V/V,V/F,and F/F. The ADCC activity of NKTm cells with these three different genotypes mediated by cetuximab were significantly different (P=0.0015). NKTm cells with FCGR3A-158V/V genotypes had significantly higher ADCC activity than FCGR3A-V/F or F/F genotypes (P<0.01),whereas the ADCC activity between V/F and F/F genotype showed no statistical significance(P>0.05). CONCLUSION: FCGR3A polymorphisms have an impact on ADCC activity mediated by cetuximab in NKTm cells.

[Clinical paired study of comparing docetaxel plus capecitabine versus docetaxel plus epirubicin as first-line treatment in women with HER-2 negative advanced breast cancer].

OBJECTIVE: To assess the efficacy of docetaxel plus capecitabine versus docetaxel plus epirubicin as first-line treatment in women with HER-2 negative advanced breast cancer. METHODS: A paired study was conducted for 92 cases with HER-2 negative advanced breast cancer. They received 3 weekly cycles of either TX (docetaxel 75 mg/m(2), day 1; capecitabine 1000 mg/m(2) orally twice daily, days 1-14) or TE (docetaxel 75 mg/m(2), day 1; epirubicin 75 mg/m(2), day 1). The objective was to compare 6-month non-progression rate, time to progression (TTP) , overall response rate (ORR) and toxicities. RESULTS: The 6-month non-progression rates were 78% with TX versus 70% with TE (P = 0.477). Medium TTP was 10.2 versus 8.7 months (P = 0.128) and ORR was 72% and 63% respectively (P = 0.505) . Severe toxicities included hand-foot syndrome (37% vs 4%, P < 0.001), grade 3-4 neutropenia (30% vs 70%, P < 0.001) and febrile neutropenia (2% vs 11%, P = 0.004) respectively. No relevant differences in other toxicities were observed in two arms. CONCLUSION: Both regimens of TX and TE have similar efficacy and are well-tolerated as the first-line therapy for HER-2 negative advanced breast cancer.

Risk effects of GST gene polymorphisms in patients with acute myeloid leukemia: a prospective study.

Glutathione S-transferase (GST) enzyme levels are associated with risk of many cancers, including hematologic tumours. We here aimed to investigate the relationships between GSTM1, GSTT1 and GSTP1 polymorphisms and the risk of AML. Genotyping of GSTs was based upon duplex polymerase-chain-reactions with the confronting- two-pair primer (PCR-CTPP) method in 163 cases and 204 controls. Individuals carrying null GSTT1 genotype had a 1.64 fold risk of acute leukemia relative to a non-null genotype (P<0.05). A heavy risk was observed in those carrying combination of null genotypes of GSTM1 and GSTT1 and GSTP1 Val allele genotypes when compared with those carrying wild genotypes, with an OR (95% CI) of 3.39 (1.26-9.26) (P<0.05). These findings indicate that genetic variants of GST and especially the GSTT1 gene have a critical function in the development of AML. Our study offers important insights into the molecular etiology of AML.

Relationship between soy food intake and breast cancer in China.

AIMS: Soy food intake may be associated with reduced risk of breast cancer, by far the most frequent cancer among women, but the results are inconsistent. We aimed to investigate the relationship further in Chinese population and to assess the importance of hormone receptor status. METHODS: A case-control study was conducted with totals of 183 cases and 192 controls recruited from January 2008 to January 2011 among patients admitted to the General Hospital of PLA and the Second Affiliated Hospital of Guangzhou Medical University, China. Trained interviewers conducted face-to-face interviews using a structured questionnaire to collect information on dietary habits and potential confounding factors. RESULTS: The highest relative to lowest soy isoflavone intake was associated with a 58% decrease risk of breast cancer (OR=0.42, 95% CI=0.22-0.80). Higher consumption of soy protein also decreased breast cancer risk, and the highest consumption reduced 54% cancer risk compared with the lowest (OR=0.46, 95%CI=0.24-0.88). The inverse association between highest intake of soy isoflavone and soy protein with the risk of breast cancer was statistically in postmenopausal women (OR=0.57, 95%CI=0.29-0.83; OR=0.50, 95%CI=0.38-0.95). In the ER/PR status stratified analysis, a significantly reduced risk was observed for ER+/PR+ breast cancer among highest intake of soy isoflavone and soy protein, with ORs of 0.47 and 0.63, respectively. CONCLUSION: Our study suggested that a high intake of soy food is inversely associated with breast cancer risk, the effect depending to some extent on the hormone receptor status.