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1.
Zhonghua Zhong Liu Za Zhi ; 42(6): 491-494, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575946

RESUMO

Objective: To investigate the clinical characteristics and surgical management based on the clinical manifestation, pathological feature and the medical imaging finding of ciliated muconodular papillary tumor (CMPT). Methods: The data of clinical manifestation, pathological feature and the medical imaging finding of 15 patients with CMPT who received surgical treatment from January 2017 to April 2019 were collected and retrospectively analyzed. Results: CMPT generally occurred in the elderly people. Most of the diameter of the tumor was less than 1 cm, while the diameters of other 3 patient were 1~2 cm. The computed tomography (CT) scan of 9 patients displayed solid nodule, while 4 displayed ground glass opacity (GGO), and other 2 showed no significant abnormal. Thirteen patients received minimally invasive video-assisted thoracoscopic surgery (VATS), the other 2 received open surgery. Eight patients received lobectomy, 3 received thoracoscopic anatomical partial-lobectomy, 4 received wedge resection. The frozen section diagnostic results of 8 patients were adenocarcinoma, including 3 mucinous adenocarcinoma. Other 5 patients were diagnosed as CMPT and 2 were reported as infection nodule. During the perioperative period, 2 patients occurred cardiac arrhythmia, 1 occurred pulmonary infection. None of the patients had local recurrence or distant metastasis during the follow-up. Conclusions: CMPT usually presents as solitary peripheral lung nodules without obvious symptoms. Most CMPTs are incidentally detected by routine CT scan. Some of the cases are accompanied by primary lung cancer probably. Surgical treatment is the major therapy for CMPT. The imaging feature of CT scam usually shows a solid nodule or a GGO locates in peripheral pulmonary. Frozen section diagnosis for CMPTs can be easily confused with adenocarcinoma or mucinous adenocarcinoma.


Assuntos
Adenocarcinoma Mucinoso/cirurgia , Neoplasias Pulmonares/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Adenocarcinoma Mucinoso/patologia , Idoso , Feminino , Humanos , Tempo de Internação , Neoplasias Pulmonares/patologia , Recidiva Local de Neoplasia , Estudos Retrospectivos , Nódulo Pulmonar Solitário/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
2.
Rev Fac Cien Med Univ Nac Cordoba ; 77(2): 113-116, 2020 04 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32558515

RESUMO

Introduction: An appendiceal collision tumor is defined as the presence of histologically distinct types of tumors in the appendix without transition between them. Appendiceal tumors are rare, with epithelial neoplasms and neuroendocrine tumors being the most common. Objective: Report the case of woman with acute appendicitis and diagnosis of an appendiceal collision tumor. Case presentation: A 35 years old woman, who consulted for a 24 hours of continuous epigastric pain with migration to the right iliac fossa; the routine blood test showed leukocytosis with neutrophilia and an ultrasound scan abdomen demonstratedsigns in favor of acute appendicitis; a diagnosis of acute appendicitis and surgical treatment. The anatomopathological study and immunostaining revealed well-differentiated neuroendocrine neoplasia and low-grade mucinous epithelial neoplasia. A follow-up with postsurgical tumor markers was performed with normal results, in addition to computed tomography and postoperative colonoscopy without alterations. Discussion: Appendiceal collision tumor is infrequently. Generally the diagnosis is made with anatomopathological study and supposes great challenges for postoperative control because there are no guidelines to follow up. Conclusion: More research should be done in order to have recommendations for this disease. Conclusion: More research should be done in order to have recommendations for this disease.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico , Neoplasias do Apêndice/diagnóstico , Apendicite/diagnóstico , Tumores Neuroendócrinos/diagnóstico , Doença Aguda , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Adulto , Apendicectomia , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/cirurgia , Apendicite/patologia , Apendicite/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia
3.
Gan To Kagaku Ryoho ; 47(1): 123-125, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-32381879

RESUMO

A 79-year-old male presented with right inguinal mass and right leg pain. Laparoscopic right hemicolectomy was performed for transverse colon cancer(type 1, muc, pSS, pN1a, pStage Ⅲa)3 years and 6 months ago. We resected the mass located in the spermatic cord and reconstructed it using the Direct Kugel Patch. Histopathological examination revealed mucinous carcinoma and was diagnosed as a metastatic lesion. Local recurrence was detected in the spermatic cord 1 year after resection, and radical inguinal orchiectomy was performed. Six months after the surgery performed for local recurrence, repeated recurrence was detected in the mesh used for reconstruction. Because this recurrence time was short, the patient opted for chemotherapy; however, this resulted in tumor growth, and surgery had to be scheduled. We performed extended resection of the abdominal wall and reconstruction using the fascia lata tensor muscle flap. Although intestinal obstruction, aspiration pneumonia, and skin flap necrosis were observed, the patient was discharged on the 85th postoperative day and remained alive without recurrence for 17 months. Mucinous carcinoma tends to cause local recurrence and requires adequate surgical margin resection. Extended excision should be considered in such cases of repeated local recurrence without distant metastases.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias Colorretais , Cordão Espermático , Idoso , Humanos , Masculino , Recidiva Local de Neoplasia
4.
Zhonghua Zhong Liu Za Zhi ; 42(4): 331-335, 2020 Apr 23.
Artigo em Chinês | MEDLINE | ID: mdl-32375450

RESUMO

Objective: To investigate the clinicopathological characteristics and outcomes of a series of ovarian metastases of pancreatic ductal adenocarcinoma. Methods: Data of clinical manifestation, pathological characteristic, treatment and follow-up result from ten patients with ovarian metastases of pancreatic ductal adenocarcinoma confirmed by pathology were retrospectively analyzed. Results: The median age of onset was 46 years (38~79 years). The primary tumors were located in the body and tail of the pancreas in 8 cases. Bilateral ovarian metastasis occurred in 8 patients at the time of diagnosis. The median time from patients with clinical symptom to ovarian metastases was 2.5 months (0~12 months). Peritoneal metastasis was found in all of 10 cases. Nine cases were accompanied by CA125 elevation. The major features of metastatic carcinoma in the ovary were cystic-solid appearance (8 cases) and mucinous adenocarcinoma (6 cases) with no obvious immunohistochemical features in pathological observation. All patients underwent palliative ovariectomy at onset, and one patient underwent primary tumor resection simultaneously. Seven patients received chemotherapy. The median survival time of the 10 patients was 10.3 months. Conclusions: Ovarian metastases of pancreatic ductal adenocarcinoma are easily misdiagnosed. The final diagnosis depends on clinical manifestations, imaging and histopathological observation. Ovariectomy may be associated with better outcome.


Assuntos
Adenocarcinoma Mucinoso/patologia , Carcinoma Ductal Pancreático/patologia , Tumor de Krukenberg/patologia , Metástase Neoplásica/patologia , Neoplasias Ovarianas/patologia , Neoplasias Pancreáticas/patologia , Adenocarcinoma Mucinoso/mortalidade , Adulto , Idoso , Antígeno Ca-125/sangue , Carcinoma Ductal Pancreático/mortalidade , China/epidemiologia , Feminino , Humanos , Tumor de Krukenberg/mortalidade , Tumor de Krukenberg/secundário , Proteínas de Membrana/sangue , Pessoa de Meia-Idade , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/secundário , Ovário/patologia , Estudos Retrospectivos
6.
J Surg Oncol ; 122(3): 399-406, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32346885

RESUMO

BACKGROUND: Lymph node metastasis (LN+) is a prognostic factor in appendiceal cancers, but predictors and outcomes for LN+ in mucinous appendiceal adenocarcinoma (MAC) remain poorly defined. METHODS: Patients were identified from the 2010 to 2016 NCDB who underwent surgical resection as first-line management for Stage I-III mucinous appendiceal cancer. A LN+ risk-score model was developed using multivariable regression on a training data set and internally validated using a testing data set. Three-year overall survival (OS) was analyzed by Cox proportional hazards regression. RESULTS: Of 1158 patients, LN+ (N = 244, 21.1%) patients were more likely to have higher pT group and grade of disease, lymphovascular invasion (LVI), and positive margins on univariate analyses. Predictive factors associated with LN+ on multivariable analysis included positive surgical margins (odds ratio [OR] 3.00, P <.0001), higher grade (moderately differentiated: OR, 2.16, P < .0001; poorly or undifferentiated: OR, 3.07, P < .0001), and LVI (OR, 7.28, P < .0001). A validated risk-score model using these factors was developed with good performance (AUC 0.749). LN+ patients had a worse 3-year OS compared with LN- patients (17.4% vs 82.6%, hazard ratio 1.96, P = .001). CONCLUSIONS: LN+ is associated with worse survival in patients with MAC. A risk-score model using margin status, LVI, and grade can accurately risk stratify patients for LN+.


Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias do Apêndice/patologia , Linfonodos/patologia , Adenocarcinoma Mucinoso/mortalidade , Adenocarcinoma Mucinoso/cirurgia , Neoplasias do Apêndice/mortalidade , Neoplasias do Apêndice/cirurgia , Bases de Dados Factuais , Feminino , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Análise de Regressão , Estudos Retrospectivos
7.
Virchows Arch ; 477(1): 21-31, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32291497

RESUMO

Intestinal-type intraductal papillary mucinous neoplasm (IPMN) of the pancreas is clinicopathologically distinctive. Our research aimed to elucidate the molecular mechanism of the development and progression of the intestinal-type IPMN. In 60 intestinal-type IPMN specimens, histological transitions from gastric-type epithelia to intestinal-type epithelia were observed in 48 cases (80%). CDX2/MUC2/alcian blue triple staining indicated that CDX2 appeared to precede MUC2 expression and subsequent alcian blue-positive mucin production. Expression of p21 and Ki-67 seemed to be accelerated by CDX2 expression (p = 6.02e-13 and p = 3.1e-09, respectively). p21/Ki-67 double staining revealed that p21 was mostly expressed in differentiated cells in the apex of papillae, while Ki-67 was expressed in proliferative cells in the base of papillae. This clear cellular arrangement seemed to break down with the progression of atypical grade and development of invasion (p = 0.00197). Intestinal-type IPMNs harbored frequent GNAS mutations (100%, 25/25) and RNF43 mutations (57%, 8/14) and shared identical GNAS and KRAS mutations with concurrent gastric-type IPMNs or incipient gastric-type neoplasia (100%, 25/25). RNF43 mutations showed emerging or being selected in intestinal-type neoplasms along with ß-catenin aberration. Activation of protein kinase A and extracellular-regulated kinase was observed in CDX2-positive intestinal-type neoplasm. These results suggest that gastric-type epithelia that acquire GNAS mutations together with induction of intrinsic CDX2 expression may evolve with clonal selection and additional molecular aberrations including RNF43 and ß-catenin into intestinal-type IPMNs, which may further progress with complex villous growth due to disoriented cell cycle regulation, acceleration of atypical grade, and advance to show an invasive phenotype.


Assuntos
Fator de Transcrição CDX2/metabolismo , Carcinoma Ductal Pancreático/patologia , Neoplasias Intestinais/patologia , Neoplasias Pancreáticas/patologia , Adenocarcinoma Mucinoso/patologia , Biomarcadores Tumorais/genética , Carcinoma Papilar/patologia , Diferenciação Celular/fisiologia , Cromograninas/genética , Humanos
9.
Medicine (Baltimore) ; 99(11): e19251, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176049

RESUMO

Lymph nodes (LN) metastasis differentiation from computed tomography (CT) images is a challenging problem. This study aims to investigate the association between radiomics image parameters and LN metastasis in colorectal mucinous adenocarcinoma (MAC).Clinical records and CT images of 15 patients were included in this study. Among them, 1 patient was confirmed with all metastatic LNs, the other 14 were confirmed with all non-metastatic LNs. The regions of the LNs were manually labeled on each slice by experienced radiologists. A total of 1054 LN regions were obtained. Among them, 164 were from metastatic LNs. One hundred nine image parameters were computed and analyzed using 2-sample t test method and logistic regression classifier.Based on 2 sample t test, image parameters between the metastatic group and the non-metastatic group were compared. A total of 73 parameters were found to be significant (P < .01). The selected shape parameters demonstrate that non-metastatic LNs tend to have smaller sizes and more circle-like shapes than metastatic LNs, which validates the common agreement of LN diagnosis using computational method. Besides, several high order parameters were selected as well, which indicates that the textures vary between non-metastatic LNs and metastatic LNs. The selected parameters of significance were further used to train logistic regression classifier with L1 penalty. Based on receiver operating characteristic (ROC) analysis, large area under curve (AUC) values were achieved over 5-fold cross validation (0.88 ±â€Š0.06). Moreover, high accuracy, specificity, and sensitivity values were observed as well.The results of the study demonstrate that some quantitative image parameters are of significance in differentiating LN metastasis. Logistic regression classifiers showed that the parameters are with predictive values in LN metastasis, which may be used to assist preoperative diagnosis.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/patologia , Neoplasias Colorretais/patologia , Linfonodos/patologia , Metástase Linfática/patologia , Tomografia Computadorizada por Raios X/métodos , Absorciometria de Fóton/métodos , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Estudos de Coortes , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Modelos Logísticos , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Cuidados Pré-Operatórios , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
12.
Arch Gynecol Obstet ; 301(4): 1047-1054, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32185553

RESUMO

OBJECTIVE: To evaluate factors associated with survival of patients with advanced stage mucinous ovarian carcinoma (MOC) using a large multi-institutional database. METHODS: Patients diagnosed between 2004 and 2014 with advanced stage (III-IV) MOC were identified within the National Cancer Database. Those without a personal history of another primary tumor who received cancer-directed surgery with a curative intent were selected for further analysis. Overall survival (OS) was evaluated with Kaplan-Meier curves, and compared with the log-rank test. Multivariate Cox analysis was performed to identify independent predictors of survival. RESULTS: A total of 1509 patients with a median age of 59 years (IQR 20) met the inclusion criteria: stage III (n = 1045, 69.3%) and stage IV disease (n = 464, 30.7%). Patients who received chemotherapy (n = 1065, 70.6%) had better OS compared to those who did not (n = 385, 25.5%), (median OS 15.44 vs 5.06 months, p < 0.001). The type of reporting facility (p = 0.65) and the year of diagnosis (p = 0.27) were not associated with OS. Presence of residual disease was strongly associated with OS (p < 0.001). After controlling for confounders, the administration of chemotherapy (HR 0.63, 95% CI 0.55, 0.72) was associated with better survival. CONCLUSION: Advanced stage MOC has an extremely poor prognosis. Patients who received chemotherapy had a small improvement in survival. Every effort to achieve complete gross resection should be performed. Given no improvement in survival outcomes over time, there is an eminent need for novel treatment options.


Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias Ovarianas/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico
13.
AJR Am J Roentgenol ; 214(5): 1092-1100, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32130045

RESUMO

OBJECTIVE. The purpose of this study is to compare the CT features of colloid carcinoma and tubular adenocarcinoma of the pancreas arising in association with intraductal papillary mucinous neoplasms (IPMNs). MATERIALS AND METHODS. The preoperative CT images of 85 patients with histopathologically proven IPMNs and associated invasive adenocarcinoma located next to each other were retrospectively reviewed. Twenty-nine patients (34.1%; 19 men and 10 women; mean [± SD] age, 68.0 ± 9.5 years) had invasive colloid carcinoma, and 56 patients (65.9%; 31 men and 25 women; mean age, 70.8 ± 10.6 years) had invasive tubular adenocarcinoma. We compared the following CT features between the two groups: IPMN type, main pancreatic duct (MPD) and common bile duct diameters, diameter and characteristics of the largest cystic lesion for branch duct and mixed-type IPMNs, presence of an extracystic or extraductal solid mass next to the cystic lesion or MPD, morphologic features of the upstream MPD in relation to the cystic lesion or solid mass, and presence of a fistula to the adjacent organs. RESULTS. An MPD size of 9.5 mm or greater, a largest cystic lesion diameter of 28 mm or greater, location in the head or neck, septation, calcification, presence of a mural nodule(s) within a cystic lesion or MPD, and presence of a fistula were all more commonly associated with colloid carcinoma. In contrast, presence of an extracystic or extraductal solid mass and an abrupt change in the caliber of the dilated MPD were associated with tubular adenocarcinoma. The best CT feature for differentiating between the two groups was the morphologic features of the upstream MPD in relation to the cystic lesion or solid mass (sensitivity, 81.3%; specificity, 92.3%). CONCLUSION. Preoperative CT is helpful in differentiating two types of invasive carcinoma arising in association with IPMNs. These findings are clinically important because prognosis is better for colloid carcinoma than for tubular adenocarcinoma.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Carcinoma Ductal Pancreático/diagnóstico por imagem , Carcinoma Papilar/diagnóstico por imagem , Invasividade Neoplásica/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma/patologia , Adenocarcinoma Mucinoso/patologia , Idoso , Carcinoma Ductal Pancreático/patologia , Carcinoma Papilar/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Invasividade Neoplásica/patologia , Neoplasias Pancreáticas/patologia , Prognóstico
14.
Bull Cancer ; 107(3): 385-390, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115180

RESUMO

The group of rare malignant ovarian tumors includes the group of germ cell tumors, sex cords stromal ovarian tumors, small cell carcinoma, malignant Brenner tumors, rare epithelial tumors such as mucinous carcinoma, clear cell carcinoma, or low-grade serous carcinoma, as well as ovarian carcinosarcoma. Together they comprise about 10% of all ovarian tumors. Due to their low prevalence and their heterogeneity, data and treatment recommendations are limited. Even though all ovarian tumors are staged according to the FIGO staging of epithelial ovarian tumors, treatment differs especially in germ cell tumors and sex cords stromal ovarian tumors. Non-epithelial ovarian tumors can arise from a variety of ovarian precursor cells such as germ cells, granulosa cells, theca cells, or stromal fibroblasts. As can be expected already due to their divergent precursor lesions, these malignancies are substantially different but united by their rarity. This overview article gives a comprehensive summary on the pathology and clinical presentation, as well as therapy recommendations of a selection of those rare ovarian tumors, based on the latest national guidelines and related important publications.


Assuntos
Neoplasias Ovarianas , Doenças Raras , Adenocarcinoma de Células Claras/patologia , Adenocarcinoma de Células Claras/terapia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/terapia , Tumor de Brenner/patologia , Tumor de Brenner/terapia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/terapia , Carcinossarcoma/patologia , Carcinossarcoma/terapia , Cistadenocarcinoma Seroso/patologia , Cistadenocarcinoma Seroso/terapia , Feminino , Humanos , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Doenças Raras/patologia , Doenças Raras/terapia , Tumores do Estroma Gonadal e dos Cordões Sexuais/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/terapia
15.
Anticancer Res ; 40(3): 1651-1659, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132070

RESUMO

BACKGROUND/AIM: The purpose of this study was to investigate the clinical, pathological, and prognostic differences between adenocarcinoma (ADC) and mucinous adenocarcinoma (MUC) in colorectal cancer (CRC). PATIENTS AND METHODS: This was a retrospective study of a Japanese high-volume cancer Center over a 10-year period. From April 2007 to December 2016, a total of 3,296 patients with primary CRC were included in the study. The clinical characteristics of MUC and ADC were compared. Then, propensity score matching was performed according to a 1:2 ratio. Multivariate analysis was used for independent risk factors related to prognosis. The overall survival (OS) and disease-free survival (DFS) of 126 cases of MUC and 256 cases of ADC were studied, as well as the survival rate of each stage. RESULTS: MUC accounts for 3.82% of the total CRC. Compared to ADC, MUC is more common in female patients (47.62% vs. 38.77%; p=0.045), with higher carcinoembryonic antigen levels (56.35% vs. 34.95%; p<0.001), more ulcerative and infiltrative types (82.54% vs. 72.93%; p=0.016), higher incidence of perineural infiltration (51.59% vs. 41.04%; p=0.018), deeper infiltration (T3-T4: 90.48% vs. 65.84%; p<0.001), and more advanced cancer (stage III-IV: 59.52% vs. 44.79%; p=0.001). MUC is also more likely to recur (24.6% vs. 14.32%; p=0.001). Regarding the long-term survival rate, the OS (p<0.001) and DFS (p=0.05) is consequently worse. After propensity score matching, multivariate analysis showed that MUC was a common independent risk factor for DFS [odds ratio (OR)=4.277; 95% confidence interval (CI), 0.327-0.97; p=0.039], and also for OS (OR= 6.836; 95% CI, 0.274-0.831; p=0.009). In MUC, OS and DFS were still relatively worse (OS: p=0.017; DFS: p=0.038). However, only significant statistical differences were shown in stage II (OS: p=0.003; DFS: p=0.007). No significant differences were noted in the stages I, III, or IV. CONCLUSION: MUC is a high-risk factor for stage II CRC. Adjuvant chemotherapy should be routinely recommended for patients with MUC stage II, and special attention should be paid during their follow-up.


Assuntos
Adenocarcinoma Mucinoso/complicações , Neoplasias Colorretais/diagnóstico , Adenocarcinoma Mucinoso/patologia , Idoso , Estudos de Coortes , Neoplasias Colorretais/patologia , Feminino , Humanos , Japão , Masculino , Estadiamento de Neoplasias , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco
16.
Jpn J Clin Oncol ; 50(6): 701-711, 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32083303

RESUMO

OBJECTIVE: The clinicopathological significance of Mucin5AC (MUC5AC) in lung adenocarcinoma with mucin production is still unclear. This study aimed to explore MUC5AC expression in lung adenocarcinoma with mucin production and its correlation with histological subtypes, common driver mutations and its impact on prognosis. METHODS: MUC5AC and thyroid transcription factor 1 immunohistochemistry was performed on surgical samples from 90 patients with lung adenocarcinoma with mucin production. Common driver mutations including EGFR and KRAS mutations and ALK rearrangement were detected by established methods. RESULTS: MUC5AC was significantly associated with lymphovascular invasion (P = 0.023) and tumors with intra-cytoplasmic mucin (P < 0.001). Moreover, MUC5AC was more significant in invasive mucinous adenocarcinoma (P < 0.001), as well as in tumors with KRAS mutations (P = 0.005) and a lack of thyroid transcription factor 1 expression (P < 0.001). Conversely, MUC5AC was less significantly detected in acinar predominant adenocarcinoma (P = 0.036) and tumors with EGFR mutations (P = 0.001). Notably, MUC5AC in non-pure mucinous subtype of lung adenocarcinoma with mucin production showed more aggressive behavior, distinct expression pattern and a lack of significant correlation with thyroid transcription factor 1 (P = 0.113) when compared with pure mucinous subtype. MUC5AC-positive tumors were significantly associated with a worse prognosis compared to MUC5AC-negative tumors (P < 0.001). A multivariate survival analysis showed that MUC5AC was an independent prognosis factor for poor prognosis (P = 0.006). CONCLUSIONS: The clinicopathological features of non-pure mucinous subtype of lung adenocarcinoma with mucin production were distinct and should be distinguished from pure mucinous subtype. MUC5AC was associated with poor prognosis and could be a potential therapeutic target for this distinct type of lung adenocarcinoma that has few effective treatments.


Assuntos
Adenocarcinoma de Pulmão/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/genética , Mucina-5AC/genética , Fator Nuclear 1 de Tireoide/genética , Adenocarcinoma de Pulmão/metabolismo , Adenocarcinoma de Pulmão/cirurgia , Adenocarcinoma Mucinoso/genética , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Receptores ErbB/genética , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Mucina-5AC/análise , Mutação , Prognóstico , Proteínas Proto-Oncogênicas p21(ras)/genética , Fator Nuclear 1 de Tireoide/análise
18.
J Cancer Res Clin Oncol ; 146(5): 1291-1298, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32088782

RESUMO

PURPOSE: The purpose of this study was to determine the optimal method for measuring pathological invasive size that predicts prognosis in invasive mucinous adenocarcinoma (IMA). METHODS: We analyzed patients who underwent complete surgical resection for lung IMA. The invasive size of IMA was measured using two methods: (1) excluding lepidic method (ELM), that is, lepidic component was excluded from the invasive area regardless of alveolar mucin and (2) including lepidic method (ILM), that is, lepidic component was included as invasive area if alveolar space was filled with mucin. The prognostic predictability of ELM and ILM on survival was assessed using univariable and multivariable Cox regression models. The discriminative power was assessed using concordance probability estimate (CPE) and Akaike's information criteria (AIC), and the prognostic impact of the newly redefined pathological stage according to ELM or ILM was also assessed. RESULTS: A total of 101 patients were included. The median invasive size via ELM and ILM was 1.4 cm (range, 0.0-7.7 cm) and 2.1 cm (range, 0.0-14.2 cm), respectively. ELM had better discriminative power than ILM (ELM, HR = 1.38, AIC = 110.19, CPE = 0.671; ILM, HR = 1.19, AIC = 111.52, CPE = 0.655). Although the survival curves based on ILM crossed between T3 and T4, the overall survival (OS) curves based on ELM were sufficiently distinct from one another. CONCLUSIONS: ELM has higher discriminative power for OS, and thus the optimal method for measuring the pathological invasive size of IMA should exclude the lepidic component regardless of alveolar mucin.


Assuntos
Adenocarcinoma de Pulmão/patologia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma de Pulmão/mortalidade , Adenocarcinoma Mucinoso/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Modelos de Riscos Proporcionais , Taxa de Sobrevida
19.
Gynecol Oncol ; 156(3): 552-560, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31902686

RESUMO

OBJECTIVE: Mucinous ovarian carcinoma (MOC) is an uncommon ovarian cancer histotype that responds poorly to conventional chemotherapy regimens. Although long overall survival outcomes can occur with early detection and optimal surgical resection, recurrent and advanced disease are associated with extremely poor survival. There are no current guidelines specifically for the systemic management of recurrent MOC. We analyzed data from a large cohort of women with MOC to evaluate the potential for clinical utility from a range of systemic agents. METHODS: We analyzed gene copy number (n = 191) and DNA sequencing data (n = 184) from primary MOC to evaluate signatures of mismatch repair deficiency and homologous recombination deficiency, and other genetic events. Immunohistochemistry data were collated for ER, CK7, CK20, CDX2, HER2, PAX8 and p16 (n = 117-166). RESULTS: Molecular aberrations noted in MOC that suggest a match with current targeted therapies include amplification of ERBB2 (26.7%) and BRAF mutation (9%). Observed genetic events that suggest potential efficacy for agents currently in clinical trials include: KRAS/NRAS mutations (66%), TP53 missense mutation (49%), RNF43 mutation (11%), ARID1A mutation (10%), and PIK3CA/PTEN mutation (9%). Therapies exploiting homologous recombination deficiency (HRD) may not be effective in MOC, as only 1/191 had a high HRD score. Mismatch repair deficiency was similarly rare (1/184). CONCLUSIONS: Although genetically diverse, MOC has several potential therapeutic targets. Importantly, the lack of response to platinum-based therapy observed clinically corresponds to the lack of a genomic signature associated with HRD, and MOC are thus also unlikely to respond to PARP inhibition.


Assuntos
Adenocarcinoma Mucinoso/genética , Adenocarcinoma Mucinoso/terapia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/terapia , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/patologia , Idoso , Estudos de Coortes , Reparo de Erro de Pareamento de DNA , Feminino , Recombinação Homóloga , Humanos , Imuno-Histoquímica , Mutação , Estadiamento de Neoplasias , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Receptor ErbB-2/genética , Receptor ErbB-3/genética
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