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1.
Int J Gynaecol Obstet ; 148(1): 96-101, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31560127

RESUMO

OBJECTIVE: To probe the influence of metabolic syndrome (MS) on the long-term survival of patients with non-endometrioid adenocarcinoma. METHODS: Between January 2003 and December 2012, 139 Chinese patients with non-endometrial adenocarcinoma were analyzed in a retrospective study. Patients who had received any treatment before surgery were excluded. Survival times were compared between patients with and without MS. RESULTS: Overall, 41 (29.5%) patients had MS; the highest incidence of MS was observed in those with uterine serous carcinoma (19/45, 42.2%). For uterine serous carcinoma or adenosquamous carcinoma, MS was an independent predictive factor of morbidity (P=0.023 and 0.016, respectively). For the overall population, those with MS had a significantly lower survival rate than those without MS (P=0.008), and the median overall survival (mOS) was 15 months versus 55 months (P<0.001, hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.29-0.69). Similarly, a lower survival rate (P=0.020) and shorter mOS (19 months vs 55 months, P=0.007, HR 0.41, 95% CI 0.20-0.83) were also found in the uterine serous carcinoma population with MS. Multivariate Cox regression analyses showed that disease stage (P=0.023) and MS (P=0.008) were independent prognostic factors for uterine serous carcinoma. CONCLUSION: The present study suggests that MS is a prognostic factor for non-endometrioid adenocarcinoma, especially uterine serous carcinoma.


Assuntos
Carcinoma Adenoescamoso/mortalidade , Cistadenocarcinoma Seroso/mortalidade , Síndrome Metabólica/complicações , Neoplasias Uterinas/mortalidade , Adulto , Idoso , Carcinoma Adenoescamoso/complicações , Carcinoma Adenoescamoso/patologia , Estudos de Casos e Controles , Cistadenocarcinoma Seroso/complicações , Cistadenocarcinoma Seroso/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias Uterinas/complicações , Neoplasias Uterinas/patologia
2.
Medicine (Baltimore) ; 98(43): e17688, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651897

RESUMO

RATIONALE: Oral adenosquamous carcinoma (ASC) is rare and its origins are controversial. We here present a patient with oral ASC that developed after surgery for oral squamous cell carcinoma (SCC). PATIENT CONCERNS: A 70-year-old man with SCC on the oral floor underwent surgical resection. However, the enlarged ulcer presented on the oral floor 9 month after surgery. DIAGNOSES: The biopsy of the ulcer revealed a SCC. Imaging examinations detected enhancement of a large lesion expanded to the tongue, but no evidence of regional lymph node or distant metastasis was shown. Based on these results, local recurrence of the cancer was diagnosed (cT4aN0M0). INTERVENTIONS: The surgery for the recurrent tumor was performed. OUTCOMES: The pathological examination of the surgical specimen indicated recurrent tumor was ASC. Thus, histopathological and immunohistochemical analyses of both the initial SCC and the subsequent ASC were performed in an attempt to explore the origin of the ASC. As the results, pathological review of both tumors suggested the subsequent ASC was developed from the tumor cells with adenoid phenotype in the initial SCC. LESSONS: This report suggests that the oral ASC was origin from the oral SCC, which can contribute to new knowledge for pathogenesis of oral cancer.


Assuntos
Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/patologia , Idoso , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/cirurgia , Evolução Fatal , Humanos , Masculino , Neoplasias Bucais/cirurgia , Recidiva Local de Neoplasia/cirurgia
3.
Medicine (Baltimore) ; 98(39): e17043, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574801

RESUMO

RATIONALE: Post-hysterectomy collision tumors of the vulva has rarely been reported. Though long-term HPV infection may induce vulva tumor, but the relationship between HPV infection and collision vulva tumor is not clear. And there are no clear rules of the post-hysterectomy cancer surveillance for human papilloma virus (HPV) long-term infections. So here we first report a case of post-hysterectomy rare collision vulva tumor with long-term HPV infection composed of squamous cell carcinoma of the labia major and adenosquamous carcinoma of bartholin gland and hope to bring new direction to our future research. PATIENT CONCERNS: A 48-year-old woman with long-term HPV infection, 3 years after hysterectomy, gravida 3, para 2, was admitted to our hospital with complaints of a 4-month history of an itching vulva ulceration. An anabrosis was located on the surface of the solid mass of the bartholin gland at the posterior part of the right labium and the right inguinal lymph nodes were palpable. Result of the incisional biopsy of the ulcer area at local hospital was atypical squamous cells couldn't exclude high-grade squamous intraepithelial lesion (ASC-H). Subsequently more authoritative pathological consultation results suggested squamous cell carcinoma of the vulva. DIAGNOSES: Post-hysterectomy collision vulva tumor with long-term HPV infection composed of squamous cell carcinoma of the labia major and adenosquamous carcinoma of bartholin gland. INTERVENTIONS: The extensive excision of the vulva, bilateral inguinal lymph nodes dissection, and local skin flap transposition surgeon was done to this patient. The final certificate diagnosis was: vulvar tumor T1bM0N0 composed of squamous cell carcinoma of the labia major and adenosquamous carcinoma of bartholin gland; HPV infection; post hysterectomy, and bilateral salpingectomy. OUTCOMES: The patient recovered well after surgery, and consequently received 6 courses of TC (paclitaxel + carboplatin) chemotherapy, and 9 months and 13 days followed up. So far patient recorded as complete response (CR). LESSONS: Collision vulva tumor occurred post-hysterectomy is extremely rare. It is most likely related to long-term HPV infection, which suggests us should to modify the manner of the post-hysterectomy cancer surveillance for HPV long-term infections. For patients with high-risk HPV infection, even if the cytology results are negative, we may should perform colposcopy and vulva biopsy more positively to prevent the disease from progressing into cancer. And the pathogenesis of relationship between HPV infection and collision vulva tumor is still need further investigation.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoescamoso/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Histerectomia , Neoplasias Primárias Múltiplas/diagnóstico , Infecções por Papillomavirus/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Neoplasias Vulvares/diagnóstico , Glândulas Vestibulares Maiores/patologia , Biópsia , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/virologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Colposcopia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/virologia , Infecções por Papillomavirus/patologia , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/virologia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/virologia
5.
Anticancer Res ; 39(8): 4575-4580, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366562

RESUMO

BACKGROUND/AIM: The aim of this study was to examine the clinicopathological features of pancreatic adenosquamous carcinoma (PASC). PATIENTS AND METHODS: Our study included seven patients who underwent resection of PASC. RESULTS: PASC is characterized by large tumors and strong infiltration into the major blood vessels and other organs, forcing many patients to undergo extended resections. In addition, all patients experienced liver metastasis recurrence following surgery, with a very poor prognosis. Histopathologically, a poorly differentiated sarcomatous component existed in all patients in addition to an adenocarcinoma component and squamous carcinoma component. Although P40 staining for the sarcomatous component was positive along with squamous carcinoma, E-cadherin expression disappeared while vimentin was expressed. It has been suggested that it is highly likely that these sarcomatous components are derived from squamous carcinoma and have an impact on prognosis. CONCLUSION: The sarcomatous component may be related to the biological malignancy of PASC.


Assuntos
Carcinoma Adenoescamoso/cirurgia , Neoplasias Pancreáticas/cirurgia , Prognóstico , Idoso , Caderinas/genética , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/patologia , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia
6.
Biomed Res Int ; 2019: 8745828, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31341909

RESUMO

Objective: The aim of this study was to compare the finding of pelvic MRI with clinical staging using cystoscopy and sigmoidoscopy for cervical cancer patients. Method: We reviewed all patients with cervical cancer between January 2001 and December 2015. We correlate the clinical examination, cystoscopy, and sigmoidoscopy with MRI findings. Result: A total of 152 patients were enrolled. 114 (74.9%) were with locally advanced cervix cancer. The true positives for MRI in the detection of parametrium were in 94 patients, with sensitivity, specificity, positive, PPV, and NPV of 72%, 82%, 96%, and 33%, respectively. The false negative of the MRI to detect the bladder invasion was 2. Nineteen patients reported having bladder invasion on MRI not confirmed by cystoscopy. None of the patients who had a negative rectal invasion by MRI were found to have rectal involvement by sigmoidoscopy with a specificity of 91%. Conclusion: The combined MRI and clinical staging for parametrial evaluation should still be carried out for the staging of cervical cancer. However, in the absence of the bladder and the rectal invasion in the MRI, it will be safe to avoid the need for a cystoscopy and/or sigmoidoscopy for complete staging in the majority of patients with cervical cancer.


Assuntos
Neoplasias da Bexiga Urinária/secundário , Neoplasias do Colo do Útero/diagnóstico , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/patologia , Cistoscopia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Arábia Saudita , Sigmoidoscopia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia , Adulto Jovem
7.
Ophthalmic Plast Reconstr Surg ; 35(5): e109-e110, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356465

RESUMO

Adenosquamous carcinoma is a highly aggressive tumor, which can rarely arise from the ocular surface. The authors herein report a patient who presented with a 5 mm mass on the temporal conjunctiva that was clinically diagnosed as squamous cell carcinoma. The lesion was surgically resected with cryopexy to the conjunctival wound edges. Histopathology and immunoractivity confirmed the diagnosis of adenosquamous carcinoma. Following topical interferon alpha 2b for 3 months, there has been no recurrence or distant metastsis during a follow-up of 12 months.


Assuntos
Carcinoma Adenoescamoso/patologia , Neoplasias da Túnica Conjuntiva/patologia , Idoso , Carcinoma Adenoescamoso/terapia , Neoplasias da Túnica Conjuntiva/terapia , Crioterapia , Humanos , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Resultado do Tratamento
9.
Cells ; 8(5)2019 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-31137590

RESUMO

Patient-derived tumor organoids (PDOs) represent a promising preclinical cancer model that better replicates disease, compared with traditional cell culture models. We have established PDOs from various human tumors to accurately and efficiently recapitulate the tissue architecture and function. Molecular targeted therapies with remarkable efficacy are currently in use against various tumors. Thus, there is a need for in vitro functional-potency assays that can be used to test the efficacy of molecular targeted drugs and model complex interactions between immune cells and tumor cells to evaluate the potential for cancer immunotherapy. This study represents an in vitro evaluation of different classes of molecular targeted drugs, including small-molecule inhibitors, monoclonal antibodies, and an antibody-drug conjugate, using lung PDOs. We evaluated epidermal growth factor receptor and human epidermal growth factor receptor 2 (HER2) inhibitors using a suitable high-throughput assay system. Next, the antibody-dependent cellular cytotoxicity (ADCC) activity of an anti-HER2 monoclonal antibody was evaluated to visualize the interactions of immune cells with PDOs during ADCC responses. Moreover, an evaluation system was developed for the immune checkpoint inhibitors, nivolumab and pembrolizumab, using PDOs. Our results demonstrate that the in vitro assay systems using PDOs were suitable for evaluating molecular targeted drugs under conditions that better reflect pathological conditions.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma Adenoescamoso/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Avaliação de Medicamentos/métodos , Neoplasias Pulmonares/tratamento farmacológico , Terapia de Alvo Molecular , Organoides/efeitos dos fármacos , Anticorpos Monoclonais Humanizados/farmacologia , Antineoplásicos/farmacologia , Biópsia , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Receptores ErbB/antagonistas & inibidores , Humanos , L-Lactato Desidrogenase/análise , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Receptor ErbB-2/antagonistas & inibidores
10.
Tumori ; 105(4): 353-358, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30967031

RESUMO

INTRODUCTION: Exocrine pancreatic cancers include common type pancreatic ductal adenocarcinoma and cystic neoplasms, which account for 85% and 10% of cases, respectively. The remaining 5% are rare histotypes, comprising adenosquamous carcinoma, acinar cell carcinoma, signet ring cell carcinoma, medullary carcinoma, pancreatoblastoma, hepatoid carcinoma, undifferentiated carcinoma and its variant with osteoclast-like giant cells, solid pseudopapillary carcinoma, and carcinosarcoma. Due to their low incidence, little knowledge is available on their clinical and molecular features as well as on treatment choices. The national initiative presented here aims at the molecular characterization of series of rare histotypes for which therapeutic and follow-up data are available. METHODS: A nationwide Italian Rare Pancreatic Cancer (IRaPaCa) task force whose first initiative is a multicentric retrospective study involving 21 Italian cancer centers to retrieve histologic material and clinical and treatment data of at least 100 patients with rare exocrine pancreatic cancers has been created. After histologic revision by a panel of expert pathologists, DNA and RNA from paraffin tissues will be investigated by next-generation sequencing using molecular pathway-oriented and immune-oriented mutational and expression profiling panels constructed availing of the information from the International Cancer Genome Consortium. Bioinformatic analysis of data will drive validation studies by immunohistochemistry and in situ hybridization, as well as nanostring assays. CONCLUSIONS: We expect to gather novel data on rare pancreatic cancer types that will be useful to inform the design of therapeutic choices.


Assuntos
Neoplasias Pancreáticas/patologia , Carcinoma de Células Acinares/patologia , Carcinoma Adenoescamoso/patologia , Carcinoma Ductal Pancreático/patologia , Feminino , Humanos , Imuno-Histoquímica/métodos , Itália , Masculino , Estudos Retrospectivos
11.
Zhonghua Bing Li Xue Za Zhi ; 48(4): 270-275, 2019 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-30955261

RESUMO

Objective: The diagnostic criteria of lung biopsy specimens by 2015 WHO lung tumor classification were used to evaluate lung biopsy specimens along with detection of genetic alterations of major tumor driving genes including epidermal growth factor receptor (EGFR). Methods: The clinical data, histological slides, immunohistochemical stains and special stains of 806 lung biopsy specimens at Beijing Hospital from July 2015 to July 2018 were retrospectively analyzed. Diagnosis of lung cancer was reclassified according to the 2015 WHO lung tumor classification and related gene mutation data were analyzed. Results: During a three-year period, the total number of lung cancer diagnosis was 483 cases, including 221 female and 262 male patients with age ranging from 37 to 85 years (median age of 65 years). There were 40 cases(8.28%) of small cell carcinoma,11 cases (2.28%) of large cell neuroendocrine carcinoma, 3 cases (0.62%) of combined neuroendocrine carcinoma, 2 cases(0.41%) of atypical carcinoid, 208 cases (43.06%) of adenocarcinoma, 92 cases(19.05%) of non-small cell carcinoma, favor adenocarcinoma, 66 cases (13.66%) of squamous cell carcinoma, 42 cases(8.70%) of non-small cell carcinoma, favor squamous cell carcinoma, 16 cases(3.31%) of non-small cell carcinoma, not otherwise specified, and 3 cases (0.62%) of non-small cell carcinoma, possible adenosquamous carcinoma. Among 202 cases tested, 107 cases (52.97%) showed EGFR mutations, including 86 of 133 cases (64.66%) of adenocarcinoma and 18 of 52 cases (34.62%) of non-small cell carcinoma, favor adenocarcinoma. Twenty two cases were found to have T790M mutation among 27 patients after EGFR TKI targeted drug therapy. Immunohistochemical staining of ALK (D5F3) was positive in 3 of 354 cases of non-small cell lung cancer, confirmed by EML4-ALK fusion gene fluorescence PCR. ROS1 gene fusion was found in 1 of 38 cases. Splicing mutations in exon 14 of MET gene were seen in one case of non-small cell carcinoma with spindle cell differentiation. Conclusion: The new diagnostic criteria by the 2015 WHO lung tumor classification is better suited for diagnosing lung biopsy specimens and providing accurate treatment guidance and improving the patient outcome.


Assuntos
Adenocarcinoma/patologia , Carcinoma Adenoescamoso/patologia , Carcinoma Neuroendócrino/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Pequenas/patologia , Neoplasias Pulmonares/patologia , Adenocarcinoma/classificação , Adenocarcinoma/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma Adenoescamoso/classificação , Carcinoma Adenoescamoso/genética , Carcinoma Neuroendócrino/classificação , Carcinoma Neuroendócrino/genética , Carcinoma Pulmonar de Células não Pequenas/classificação , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma de Células Pequenas/classificação , Carcinoma de Células Pequenas/genética , Feminino , Genes erbB , Humanos , Neoplasias Pulmonares/classificação , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Mutação , Proteínas Tirosina Quinases/genética , Proteínas Proto-Oncogênicas/genética , Estudos Retrospectivos , Organização Mundial da Saúde
12.
J Med Case Rep ; 13(1): 118, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31030664

RESUMO

BACKGROUND: Anaplastic lymphoma kinase-positive lung cancer is a form of lung cancer that accounts for approximately 5% of non-small cell lung cancers. Recently, anaplastic lymphoma kinase inhibitors have been used for treatment of anaplastic lymphoma kinase-positive lung cancer, and their high clinical effect has also been demonstrated in cases of advanced stage lung cancer. Alectinib is an anaplastic lymphoma kinase inhibitor that it is recognized as a standard drug for primary therapy because of its superiority to crizotinib. CASE PRESENTATION: A 37-year-old Japanese man was admitted to our hospital due to multiple brain metastases. An autopsy report revealed that the cause of death was anaplastic lymphoma kinase-positive lung cancer, exacerbated in a short period despite treatment with alectinib. Necropsy revealed anaplastic lymphoma kinase-positive adenosquamous carcinoma of the lung, suggesting that it was involved in the prognosis of this patient. Based on the autopsy results, we reviewed the pathological tissue from transbronchial lung biopsy at the time of clinical diagnosis. The tissue specimen for clinical diagnosis in this case was a papillary adenocarcinoma. However, when this tissue was immunostained, thyroid transcription factor 1-negative and cytokeratin 5/6-positive parts were recognized. This result indicates that we could diagnose this patient as having had adenosquamous carcinoma of the lung. CONCLUSION: In cases of anaplastic lymphoma kinase-positive lung cancer poorly responsive to anaplastic lymphoma kinase inhibitors, re-examination of the tissue should be considered because there is a possibility of anaplastic lymphoma kinase-positive adenosquamous carcinoma.


Assuntos
Neoplasias Encefálicas/secundário , Carcinoma Adenoescamoso/patologia , Neoplasias Pulmonares/patologia , Adulto , Quinase do Linfoma Anaplásico/genética , Autopsia , Neoplasias Encefálicas/diagnóstico por imagem , Carcinoma Adenoescamoso/diagnóstico , Evolução Fatal , Humanos , Neoplasias Pulmonares/diagnóstico
13.
BMJ ; 365: l1207, 2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30944091

RESUMO

OBJECTIVES: To examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and to assess tumour human papillomavirus status of ASC and RICC. DESIGN: Nationwide, population based, nested case-control study. SETTING: Sweden. PARTICIPANTS: All cases of invasive cervical carcinoma in Sweden during 2002-11 (4254 confirmed cases after clinical and histopathological review). 338 cases were neither squamous cell carcinoma nor adenocarcinoma, including 164 cases of ASC and 174 cases of RICC (glassy cell carcinoma, clear cell carcinoma, small cell carcinoma, neuroendocrine cell carcinoma, large cell carcinoma, and undifferentiated carcinoma). 30 birth year matched controls from the general Swedish population were matched to each case by applying incidence density sampling. MAIN OUTCOME MEASURES: Conditional logistic regression was used to calculate odds ratios, interpreted as incidence rate ratios, for risk of ASC and RICC in relation to screening status and screening history, adjusted for education. Human papillomavirus distribution of ASC and RICC was based on available archival tumour tissues from most Swedish pathology biobanks. RESULTS: Women with two screening tests in the previous two recommended screening intervals had a lower risk of ASC (incidence rate ratio 0.22, 95% confidence interval 0.14 to 0.34) and RICC (0.34, 0.21 to 0.55), compared with women without any test. High risk human papillomavirus was detected in 148/211 (70%) cases with valid human papillomavirus results from tumour tissues. The risk reduction among women with tumours that were positive (incidence rate ratio 0.28, 0.18 to 0.46) and negative (0.27, 0.13 to 0.59) for high risk human papillomavirus was similar, compared with women who did not attend any test. CONCLUSIONS: Cervical screening is associated with reduced risk of ASC and RICC, and most ASC and RICC are positive for high risk human papillomavirus. This evidence provides a benchmark for evaluating future cervical screening strategies.


Assuntos
Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/epidemiologia , Detecção Precoce de Câncer , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adulto , Idoso , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Estudos de Casos e Controles , Colo do Útero/patologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Sistema de Registros , Risco , Comportamento de Redução do Risco , Neoplasias do Colo do Útero/patologia , Adulto Jovem
14.
Int J Radiat Oncol Biol Phys ; 104(4): 895-902, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-30940530

RESUMO

PURPOSE: Image guided adaptive brachytherapy (IGABT) for cervical cancer improves pelvic control and survival across all stages. Improvement in pelvic control is larger in advanced stages, but improvement in survival is similar across stages. This paper analyzes the patterns of failure in the RetroEMBRACE cohort to investigate this discrepancy. METHODS AND MATERIALS: 731 patients from 12 institutions treated with chemoradiation therapy and magnetic resonance imaging or computed tomography-based IGABT were evaluated. The pattern of failure at time of first relapse was analyzed. RESULTS: Three hundred twenty-five failures (single and synchronous) occurred in 222 of 731 patients (30%). Among the 325 failures, 9% were local and 6% regional. Pelvic (local or regional) failures made up 13%, paraaortic node (PAN) 9%, systemic 21%, and distant (systemic + PAN) 24%. Of the 222 patients with treatment failure, 21% had pelvic failure alone, 57% had distant failure alone, and 23% had both pelvic and distant failure. Of all failures that occurred, 40% to 50% occurred in the first year, with a further 20% to 30% occurring in the second year. Although local, regional, and PAN failure tended to plateau after year 3, systemic failure continued to occur up to year 10. CONCLUSIONS: Implementation of IGABT has changed the patterns of relapse after chemoradiation therapy for cervical cancer. The predominant failure after IGABT is systemic, whereas the predominant failure with conventional brachytherapy is pelvic. Effective treatments to eradicate micrometastases in PAN and distant organs are needed in addition to IGABT and chemoradiation therapy to maximize local, regional, PAN, and systemic control and improve survival.


Assuntos
Braquiterapia/métodos , Quimiorradioterapia/métodos , Recidiva Local de Neoplasia , Radioterapia Guiada por Imagem/métodos , Neoplasias do Colo do Útero/terapia , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/terapia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Falha de Tratamento , Neoplasias do Colo do Útero/patologia , Adulto Jovem
15.
Asian J Surg ; 42(6): 711-714, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30871770

RESUMO

Intracystic carcinoma is not common seen in breast malignancy, here we showed a case of intracystic tumor presented in adenosquamoid differentiation. Negative in ER, PR, and HER2 makes treatment out of hormone and target therapy. After simple mastectomy with sentinel lymph node biopsy, we found isolated tumor cell over lymph node. Although AJCC takes ITCs as N0 category, the presence of ITCs is considered as a prognostic factor influencing both the overall and breast cancer-specific survival, thus we gave the patient with adjuvant chemotherapy as locally advanced breast cancer in the NCCN guideline.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , Idoso , Densidade da Mama , Neoplasias da Mama/genética , Neoplasias da Mama/cirurgia , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/cirurgia , Feminino , Humanos , Mamografia , Mastectomia Segmentar , Ultrassonografia Mamária
16.
Bull Cancer ; 106(4): 395-403, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30878134

RESUMO

Among the 20,000 new cases of head and neck neoplasms in France each year, squamous cell carcinomas (HNSCC) represent about 90 % of the cases. Among these, variants of conventional squamous cell carcinomas represent between 5% and 10% of cases. Patient history and risk factors are often similar from those of conventional HSNCC. Variants may, however, be misdiagnosed, which can lead to therapeutic mismanagement due to confusion with sarcomas, glandular tumors or even benign tumors. Diagnostic workup needs to be more cautionary or to include additional exams not to omit their most aggressive component in the case of composite tumors or to under stage the tumor. Immunohistochemistry and specific molecular analyses may be required for proper diagnosis. Central pathological review may also be essential for some of these variants. In addition, some variants are radioresistant and, conversely, others are radiosensitive. An update of the REFCOR 2008 standards was carried out in the light of the international literature and the 2017 WHO/IARC classification for the seven main variants of HNSCC, verrucous, acantholytic (to be named adenoid carcinomas), basaloid, papillary, spindle cell (incorrectly named sarcomatoid), adenosquamous and lymphoepithelial carcinomas.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Doenças Raras , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/terapia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patologia , Carcinoma Papilar/terapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Carcinoma Verrucoso/diagnóstico , Carcinoma Verrucoso/patologia , Carcinoma Verrucoso/terapia , Diagnóstico Diferencial , Erros de Diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/terapia , Doenças Raras/diagnóstico , Doenças Raras/patologia , Doenças Raras/terapia
17.
Korean J Radiol ; 20(3): 364-377, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30799567

RESUMO

Adenocarcinoma currently accounts for 10-25% of all uterine cervical carcinomas and has a variety of histopathological subtypes. Among them, mucinous carcinoma gastric type is not associated with high-risk human papillomavirus (HPV) infection and a poor prognosis, while villoglandular carcinoma has an association with high-risk HPV infection and a good prognosis. They show relatively characteristic imaging findings which can be suggested by magnetic resonance imaging (MRI), though the former is sometimes difficult to be distinguished from lobular endocervical glandular hyperplasia. Various kinds of other tumors including squamous cell carcinoma should be also differentiated on MRI, while it is currently difficult to distinguish them on MRI, and HPV screening and pathological confirmation are usually necessary for definite diagnosis and further patient management.


Assuntos
Adenocarcinoma/diagnóstico , Imagem por Ressonância Magnética , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma de Células Claras/diagnóstico , Adenocarcinoma de Células Claras/diagnóstico por imagem , Adenocarcinoma de Células Claras/patologia , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/diagnóstico por imagem , Carcinoma Adenoescamoso/patologia , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/diagnóstico por imagem , Carcinoma Endometrioide/patologia , Diagnóstico Diferencial , Feminino , Humanos , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia
18.
Rev Col Bras Cir ; 46(1): e2077, 2019 Feb 18.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30785571

RESUMO

OBJECTIVE: to analyze the expression of Vascular Endothelial Growth Factor (VEGF), its receptor (VEGFR-2), age and histological type of advanced cervical carcinomas with respect to the clinical response to neoadjuvant chemotherapy. METHODS: we studied 40 patients with cervical carcinoma (IB2 and IVA) diagnosed by biopsies prior to treatment. All patients underwent neoadjuvant chemotherapy and evaluation for clinical response and expression of VEGF. We considered a tumor regression greater than 50% as a good clinical response. RESULTS: eighteen patients (45%) had good response to chemotherapy, and 22 (55%), poor response. VEGF expression was positive in 16 patients and negative in 24. When analyzed separately for response to chemotherapy, only the positive expression of VEGF was associated with good clinical response (p=0.0157). CONCLUSION: VEGF expression alone was an important marker of good response to neoadjuvant chemotherapy in patients with advanced carcinoma of the cervix.


Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Adenoescamoso/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias do Colo do Útero/tratamento farmacológico , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Adenocarcinoma/cirurgia , Adulto , Idoso , Biópsia , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Colo do Útero , Cisplatino , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
19.
Zhonghua Zhong Liu Za Zhi ; 41(1): 50-55, 2019 Jan 23.
Artigo em Chinês | MEDLINE | ID: mdl-30678417

RESUMO

Objective: Adenosquamous carcinoma of lung is an uncommon subtype with more aggressive behavior and poor prognosis than adenocarcinoma and squamous cell carcinoma. This study was aimed to investigate the clinicopathological characteristics and prognostic factors of lung adenosquamous carcinoma. Methods: The pathological features and follow-up data of 133 patients were collected and the prognostic factors of these patients were retrospectively analyzed. Results: Among the 133 patients, 81 cases (60.9%) smoked. Among the 62 patients whose percentage of histological components were identified, 45 cases had >50% adenocarcinoma components, and 17 cases had >50% squamous cell carcinoma components. 55 patients had lymph node metastasis at the first visit. All patients accepted at least one test of tumor driven gene mutation, and the results showed that the mutation rate of EGFR was 50.8% (67/132), the mutation rate of K-ras was 8.6% (11/128), the ALK-positive rate was 4.2% (2/48). The gender, smoking status, and the proportion of pathological components were the main influence factors of EGFR mutation status. The median overall survival was 28 months, the rates of 1-year, 3-year, and 5-year survival were 72.9%, 23.3%, and 9.0%, respectively. EGFR tyrosine kinase inhibitors (TKIs) treatment was an independent risk factor for prognose of these patients (P=0.024). Conclusions: Lung adenosquamous carcinoma is a rare subtype with high malignancy and poor prognosis. Early diagnosis and driven-mutation-based individualized therapy may improve the survival of patients with lung adenosquamous carcinoma.


Assuntos
Adenocarcinoma , Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Adenocarcinoma/genética , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Biomarcadores Tumorais , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Mutação , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
20.
BJOG ; 126(9): 1169-1174, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30663205

RESUMO

OBJECTIVE: To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART). DESIGN: Retrospective study. SETTING: A university-based cancer hospital. POPULATION: Three hundred and thirty-three patients. METHODS: We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017. MAIN OUTCOME MEASURES: Survival rate, clinicopathological factors related to recurrences. RESULTS: Two hundred and seventy-one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty-two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6-169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5-year recurrence-free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours ≥2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type. CONCLUSIONS: This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well-selected patients with stage IB1 cervical cancers ≥2 cm. However, if patients with tumours ≥2 cm have AS histology, they should be advised with great caution when contemplating ART. TWEETABLE ABSTRACT: Abdominal radical trachelectomy could be a safe, fertility-sparing option for strictly selected patients with stage IA1-IB1 cervical cancers ≤4 cm.


Assuntos
Carcinoma/cirurgia , Recidiva Local de Neoplasia/mortalidade , Traquelectomia/mortalidade , Neoplasias do Colo do Útero/cirurgia , Abdome/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Carcinoma/mortalidade , Carcinoma/patologia , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Colo do Útero/patologia , Colo do Útero/cirurgia , Bases de Dados Factuais , Feminino , Preservação da Fertilidade , Humanos , Recidiva Local de Neoplasia/etiologia , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Traquelectomia/métodos , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia , Adulto Jovem
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