Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 727
Filtrar
1.
Medicine (Baltimore) ; 99(1): e18298, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895768

RESUMO

INTRODUCTION: Leptomeningeal dissemination due to HER2-overexpressing breast cancer is a rare and hard to treat complication with short-term dismal prognosis. PATIENT CONCERNS: A 34-year-old female previously treated because of HER2+ breast cancer is admitted to the Neurology Department in December 2016 due to sensory-motor neurological semiology. DIAGNOSIS: A wide set of diagnostic tests is performed and finally cytologic findings after repeated CSF confirm leptomeningeal infiltration by breast carcinoma (panCK+, GATA3+). INTERVENTIONS: Weekly intrathecal triple therapy with methotrexate, cytarabine and hydrocortisone plus trastuzumab is carried out during 4 months. OUTCOMES: Clinical and pathological response that lasts more than 24 months. CONCLUSION: Leptomeningeal carcinomatosis is an oncological situation where conventional therapies have limited activity. In HER2+ advanced breast cancer patients, intrathecal therapy with anti-HER2 therapy (trastuzumab) is feasible and may reach long-term disease control, especially in cases of low-tumor burden.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Carcinomatose Meníngea/tratamento farmacológico , Carcinomatose Meníngea/secundário , Trastuzumab/uso terapêutico , Adulto , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal/tratamento farmacológico , Feminino , Humanos , Carcinomatose Meníngea/patologia , Gravidez , Complicações Neoplásicas na Gravidez/tratamento farmacológico , Complicações Neoplásicas na Gravidez/patologia , Receptor ErbB-2
2.
Malays J Pathol ; 41(2): 207-211, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31427558

RESUMO

INTRODUCTION: Salivary gland intraductal carcinoma (IDC) is rare. We present the second case of IDC originating from an intraparotid lymph node (LN) with a more detailed description of the histogenesis, immunohistochemistry (IHC) and updated molecular information. CASE REPORT: An 87-year-old male had a tumour nodule over the left parotid tail for about 20 years. Physical examinations revealed a 4.5 cm soft, non-tender and fixed mass. After the left parotidectomy, pathology confirmed the diagnosis of IDC arising within an intraparotid lymph node. The cystic component of the tumour was lined by single to multilayered ductal cells with micropapillary growth pattern. The solid part showed intraductal proliferation of neoplastic cells in solid, cribriform, micropapillary and Roman bridge-like structure. By immunohistochemistry (IHC), the tumour cells were positive for S-100, CK (AE1/AE3), mammaglobin, SOX10, and estrogen receptor (ER), with myoepithelial cell rimming highlighted by positive p63 and calponin IHC stains. The prognosis of this patient is excellent after complete excision. DISCUSSION: The mechanism of salivary gland tumour arising in the intra-parotid gland LN was assumed to be related to salivary duct inclusion within the intraparotid gland LN which is a normal occurrence during embryology development. Although the terminology may raise some confusion about the relationship between IDC and conventional salivary duct carcinoma (SDA), they are different in immunophenotype and clinicopathologic features. IDC is characterised by S100 (+) ER (+) with predominant intraductal growth and excellent prognosis; while SDC features S100 (-) androgen receptor (+) with predominant invasive growth and aggressive behavior. Recent discovery of recurrent RET gene rearrangement in IDC but not SDC also supports that IDC is not precursor lesion of the SDC.


Assuntos
Carcinoma Ductal/patologia , Linfonodos/patologia , Neoplasias Parotídeas/patologia , Idoso de 80 Anos ou mais , Humanos , Masculino
3.
Ophthalmic Plast Reconstr Surg ; 35(5): e118-e121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31365510

RESUMO

Ductal carcinoma of the lacrimal gland is a very rare and aggressive neoplasm, with clinical and histopathologic similarities to salivary ductal carcinoma. Of the 25 previously reported cases, 2 patients had metastases to local lymph nodes confirmed on pathologic examination. The authors now report the clinical presentation, histopathologic and immunohistochemical features, and the treatment of a third patient with lacrimal gland ductal carcinoma with spread to local lymph nodes. In contrast to ductal carcinoma, lymph node involvement has not been reported in the largest series of adenoid cystic carcinoma, a much more common lacrimal gland malignancy. This case highlights the need for possible lymph node surveillance in patients with lacrimal gland ductal carcinoma.


Assuntos
Carcinoma Ductal/patologia , Neoplasias Oculares/patologia , Doenças do Aparelho Lacrimal/patologia , Metástase Linfática/patologia , Humanos , Masculino , Pessoa de Meia-Idade
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(6): 416-419, 2019 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-31177683

RESUMO

Objective: To investigate the clinical manifestations and pathological changes of salivary duct carcinoma (SDC) and the relationship between them, so as to provide reference for the diagnosis of SDC. Methods: In this retrospective analysis 40 cases of SDC diagnosed from January 2012 to August 2018 in the Department of Pathology of the First Affiliated Hospital of Zhengzhou University were enrolled and the clinical and pathological characteristics were analyzed, 29 were male and 11 were female, the ratio of male to female was 2.64∶1, the median age was 59.0 years, the average course of disease was 3.5 years. The reported cases of SDC were reviewed and compared with patients of this study. Results: Among the 40 patients, 24 cases occurred in parotid gland, 9 cases in submandibular gland and 7 cases in small salivary glands; 24 cases had cancer cell infiltration and invasion of adjacent tissues, 11 cases had lymph node metastasis and 9 cases had distant metastasis at the time of diagnosis. Pathological results showed that 27 cases belonged to primary salivary duct carcinoma, 13 cases belonged to malignant transformation of pleomorphic adenoma; 10 cases invaded local nerve, 22 cases invaded glandular lobules and ducts. Immunohistochemical results showed that 33 cases were positive for androgen receptor, 27 cases were positive for cytokeratin-7, 22 cases were positive for human epidermal growth factor receptor-2, 8 cases were positive for gross cyst disease fluid protein 15. The proliferation index of nuclear antigen Ki-67 ranged from 10% to 90%. Among them 18 cases were over 50% and 22 cases were below 50%. Conclusions: Salivary duct carcinoma is a rare and highly malignant tumor of the salivary gland. Accurate pathological diagnosis is helpful to inhibit the early local recurrence, distant metastasis and improve survival rate of salivary duct carcinoma.


Assuntos
Adenoma Pleomorfo , Carcinoma Ductal , Neoplasias das Glândulas Salivares , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/patologia , Carcinoma Ductal/diagnóstico , Carcinoma Ductal/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ductos Salivares , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia
5.
APMIS ; 127(8): 554-560, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31127651

RESUMO

This study aimed to investigate the expression of programmed death receptor ligand 1 (PD-L1) and deficient mismatch repair (dMMR) in ductal adenocarcinoma of the prostate. A tissue microarray of 32 ductal and 42 grade-matched acinar adenocarcinomas was used. Slides were stained for PD-L1, PD-L2, MMR proteins, CD4 and CD8. PD-L1 expression in tumor cells was only seen in 3% (1/34) of ductal and 5% (2/42) of acinar adenocarcinomas (p = 1.0), while PD-L1 expression in tumor-infiltrating immune cells was seen in 29% (10/34) of ductal and 14% (6/42) of acinar adenocarcinomas (p = 0.16). dMMR, as defined by loss of one or more of the MMR proteins, was identified in 5% (4/73) of cases, including 1 ductal and 3 acinar adenocarcinomas. There was a suggested association between infiltration of CD8+ lymphocytes and ductal subtype (p = 0.04) but not between CD4+ lymphocytes and tumor type (p = 0.28). The study shows that both dMMR and PD-L1 expression is uncommon in tumor cells of both ductal and acinar adenocarcinoma of the prostate, while PD-L1 expression in tumor-infiltrating immune cells is a more common finding.


Assuntos
Antígeno B7-H1/imunologia , Carcinoma Ductal/genética , Reparo de Erro de Pareamento de DNA , Neoplasias da Próstata/genética , Antígeno B7-H1/genética , Biomarcadores Tumorais/genética , Carcinoma Ductal/patologia , Humanos , Linfócitos do Interstício Tumoral/imunologia , Masculino , Instabilidade de Microssatélites , Neoplasias da Próstata/patologia , Análise Serial de Tecidos , Microambiente Tumoral
6.
Medicine (Baltimore) ; 98(18): e15449, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045815

RESUMO

TP53 gene is mutated in approximately 80% of triple-negative breast cancer (TNBC). However, the prognostic significance of immunohistochemical (IHC)-detected p53 protein expression remains controversial in TNBC. In this study, we retrospectively analyzed the association between IHC-detected p53 expression and the prognosis in a cohort of 278 patients with stage I-III triple-negative breast invasive ductal carcinoma (IDC), who received surgery at the department of breast surgery in the Fourth Hospital of Hebei Medical University from 2010-01 to 2012-12. We found a positive expression ratio of IHC-detected p53 in triple-negative breast IDC of 58.6% (163/278). Furthermore, levels of expression were significantly associated with vessel tumor emboli and higher histologic grade (P = .038, P = .043, respectively), with the highest expression level observed in G3 breast cancer (64.7%). Additionally, Kaplan-Meier analysis showed that p53 expression indicated worse overall survival (OS) in the whole cohort (79.6% vs 89.6%, Log-rank test P = .025) as well as in stratified prognostic stage II patients (90.8% vs 100%, Log-rank test P = .027). The mortality risk of p53 expression patients was 2.22 times higher than that of p53 negative patients (HR: 2.222; 95%CI: 1.147-4.308). In addition, p53 expression was also associated with poor disease-free survival (DFS) (76.7% vs 86.8%, P = .020). Cox proportional hazard ratio model showed p53 expression was an independent risk factor for OS (P = .018) and DFS (P = .018) after controlling for tumor size, lymph node status, and vessel tumor emboli. Altogether, our data showed that IHC-detected p53 expression is a promising prognostic candidate for poor survival in triple-negative breast IDC patients. However, more studies are needed to determine if p53 may be applied to clinical practice as a biomarker and/or novel therapeutic target for TNBC.


Assuntos
Carcinoma Ductal/mortalidade , Carcinoma Ductal/patologia , Genes p53/fisiologia , Neoplasias de Mama Triplo Negativas/mortalidade , Neoplasias de Mama Triplo Negativas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Proteína Supressora de Tumor p53/genética
7.
Strahlenther Onkol ; 195(7): 648-658, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30997540

RESUMO

BACKGROUND: We examined the expression of nonhomologous end-joining (NHEJ) proteins by breast cancer cells in patients with or without ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy. We also investigated whether there was a difference of NHEJ-related protein expression by tumor cells between two types of IBTR, i.e., true recurrence (TR) with regrowth from the tumor bed or development of a new primary tumor (NP). PATIENTS AND METHODS: The original cohort comprised 560 breast cancer patients who received breast-conserving therapy between February 1995 and March 2006, including 520 patients without IBTR and 40 patients with IBTR. Propensity score matching was employed to select 40 trios (120 patients) consisting of 1 patient with IBTR and 2 patients without IBTR. Immunohistochemical examination of proteins related to NHEJ was performed in surgical specimens. RESULTS: The 40 patients with IBTR included 22 patients who developed TR and 18 who had NP. The 15-year overall survival rate was 85.9% for patients with NP and 95.5% for those with TR, while it was 96.5% for patients without IBTR. Patients with high XRCC4 expression in tumor cells had significantly higher IBTR rates than those with low XRCC4 expression (P < 0.001). The frequency of TR was significantly higher in patients with high expression of XRCC4 than in those with low XRCC4 expression (p < 0.001). XRCC4 expression by tumor cells was not significantly related to development of NP. CONCLUSION: IBTR due to TR may be related to low radiosensitivity of tumor cells, possibly related to high XRCC4 expression.


Assuntos
Neoplasias da Mama/genética , Neoplasias da Mama/cirurgia , Carcinoma Ductal/genética , Carcinoma Lobular/genética , Proteínas de Ligação a DNA/genética , Mastectomia Segmentar , Recidiva Local de Neoplasia/genética , Adulto , Idoso , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Carcinoma Ductal/mortalidade , Carcinoma Ductal/patologia , Carcinoma Lobular/mortalidade , Carcinoma Lobular/patologia , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Segunda Neoplasia Primária/genética , Segunda Neoplasia Primária/mortalidade , Segunda Neoplasia Primária/patologia , Prognóstico , Pontuação de Propensão , Taxa de Sobrevida
8.
Ann Otol Rhinol Laryngol ; 128(7): 647-653, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30894024

RESUMO

OBJECTIVE: To identify and evaluate patients with parotid bed malignancy demonstrating radiographic findings of auriculotemporal (AT) nerve involvement. METHODS: A retrospective review of patients with parotid bed malignancy was performed to identify patients with imaging findings of AT nerve involvement and record associated clinical findings, symptoms, and pathology information. Independent, blinded review of radiographic images by a senior neuroradiologist was performed to identify imaging characteristics and categorize patients into highly likely or possible involvement groups. RESULTS: Of 547 patients identified with parotid bed malignancy, 23 patients exhibited radiographic findings suggestive of AT nerve involvement. Thirteen patients met criteria for highly likely involvement, and 10 patients met criteria for possible involvement. Cutaneous malignancy with metastasis to the parotid bed accounted for 11 of 23 patients, and the most common histology was squamous cell carcinoma (9 patients). Primary parotid malignancy accounted for 12 of 23 patients, and the most common histology was salivary ductal carcinoma (3 patients). All 13 highly likely patients reported periauricular pain, and 11 of 13 demonstrated facial weakness. Features suggesting advanced disease included radiographic findings of intracranial involvement (10/23 patients), nonsurgical primary treatment (13/23 patients), and positive margins on pathology report (7/10 patients). CONCLUSION: AT nerve involvement is an uncommon but important phenomenon that often occurs in the setting of advanced disease and is commonly associated with periauricular pain and coexisting facial weakness. Awareness of the associated clinical features and imaging patterns can allow for appropriate identification of this pattern of spread and help to optimize treatment planning.


Assuntos
Carcinoma Ductal/diagnóstico por imagem , Nervo Mandibular/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Carcinoma Ductal/patologia , Carcinoma Ductal/fisiopatologia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/fisiopatologia , Neoplasias de Cabeça e Pescoço/secundário , Humanos , Imagem por Ressonância Magnética , Nervo Mandibular/fisiopatologia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/fisiopatologia , Neoplasias Parotídeas/secundário , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/fisiopatologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/secundário
9.
Clin Nucl Med ; 44(7): 585-586, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30829873

RESUMO

A 34-year-old woman with history of bilateral saline implants, invasive ductal carcinoma of the right breast, and suspicious left breast calcifications was referred for left breast lymphoscintigraphy before bilateral mastectomy. A total of 3.2 mCi of Tc-filtered sulfur colloid was administered with 3 subdermal injections in the superior, lateral, and inferior periareolar left breast in the late afternoon preceding the day of surgery. Imaging identified radiotracer uptake within a dense, circular area deep to the injection sites within the left breast, compatible with implant puncture and radiotracer administration within the indwelling breast implant.


Assuntos
Implantes de Mama/efeitos adversos , Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal/diagnóstico por imagem , Linfocintigrafia , Adulto , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Feminino , Humanos , Compostos Radiofarmacêuticos/farmacocinética , Coloide de Enxofre Marcado com Tecnécio Tc 99m/farmacocinética
10.
Ann Diagn Pathol ; 39: 59-62, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30772651

RESUMO

Prostatic ductal adenocarcinoma (PDA) is a rare histologic subtype of prostate cancer characterized by large glands lined with tall columnar pseudostratified epithelium. PDA has several architectural patterns, with papillary and cribriform being the most common. The cribriform pattern of acinar carcinoma has shown to be associated with a worse prognosis in terms of disease progression and disease-specific mortality. However, the significance of cribriform pattern in PDA is unknown. In this study, we sought to compare the adverse pathologic features between cribriform-type and non-cribriform-type PDA, and between PDA and acinar carcinoma with Gleason scores 8-10. We identified PDA cases diagnosed between 2008 and 2018 and 428 radical prostatectomy (RP) specimens containing Gleason 8-10 acinar carcinoma. The slides of all PDA cases were reviewed, and pathologic features were recorded. We found that the vast majority of PDA contained admixed acinar carcinoma, with a median percentage of the ductal component of 50% (range 5-100). 29% of PDA was graded as Grade Group 4 and 35.5% as Grade Group 5. At the time of RP, 45.2% of cases presented as pathologic stage T3a and 29% as T3b. Cribriform-type PDA demonstrated a significantly higher likelihood of extraprostatic extension (84% vs 33.3%, p = 0.01), seminal vesical invasion (36% vs 0%, p = 0.04), lymphovascular invasion (40% vs 0%, p = 0.03) and advanced pathologic stage (84% vs 33.3%, p = 0.01) compared to PDA without cribriform architecture. The proportion of stage ≥pT3 tumors in PDA was similar compared to that in Gleason 8-10 acinar carcinoma (74.2% vs 70.8%, p = 0.68).


Assuntos
Carcinoma de Células Acinares/patologia , Carcinoma Ductal/patologia , Neoplasias da Próstata/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Acinares/cirurgia , Carcinoma Ductal/cirurgia , Progressão da Doença , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Prostatectomia , Neoplasias da Próstata/cirurgia , Análise de Sobrevida
12.
Future Oncol ; 15(8): 885-895, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30667284

RESUMO

AIM: To analyze the prognostic factors and the impact of postoperative radiotherapy (PORT) in parotid gland infiltrating ductal carcinoma (IDC). MATERIALS & METHODS: 252 patients diagnosed with parotid gland IDC were identified from the SEER database. Kaplan-Meier and Cox regression analysis was performed to evaluate the prognostic factors. Propensity score matching was applied then. RESULTS: Multivariate analysis showed old age and chemotherapy were independent risk factors in parotid gland IDC. Subgroup analysis demonstrated that overall survival (OS) rate of the PORT group was significantly superior to that of the no radiotherapy group in the T3-4 subgroup (p = 0.049), N1 subgroup (p = 0.019) and Tumor, Node, Metastasis (TNM) III subgroup (p = 0.025). CONCLUSION: PORT improved survival of parotid gland IDC patients within T3-4, N1 and TNM III subgroups.


Assuntos
Carcinoma Ductal/terapia , Neoplasias Parotídeas/terapia , Programa de SEER/estatística & dados numéricos , Fatores Etários , Carcinoma Ductal/mortalidade , Carcinoma Ductal/patologia , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/estatística & dados numéricos , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Glândula Parótida/patologia , Glândula Parótida/efeitos da radiação , Glândula Parótida/cirurgia , Neoplasias Parotídeas/mortalidade , Neoplasias Parotídeas/patologia , Prognóstico , Radioterapia Adjuvante/métodos , Radioterapia Adjuvante/estatística & dados numéricos , Taxa de Sobrevida
13.
Histol Histopathol ; 34(4): 381-390, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30246858

RESUMO

BACKGROUND: Although ERG and SPINK1 molecular alterations have been studied in acinar and ductal adenocarcinoma of the prostate, EZH2 expression has not been previously evaluated in ductal adenocarcinoma. METHODS: We collected cases of pure and mixed ductal adenocarcinoma of the prostate and evaluated clinical significance and EZH2, ERG, and SPINK1 protein expression. RESULTS: We investigated 61 ductal adenocarcinomas, 22 pure and 39 mixed ductal/acinar. Except for tumor growth pattern, none of the clinical parameters studied significantly differed between pure and mixed tumors. Thirty-five percent of ductal adenocarcinomas were organ confined, 15% displayed seminal vesicle invasion. Lymph node and distal metastasis occurred in 13% and 24% of cases, respectively; 34% of patients experienced biochemical failure, 7% died of disease. Ninety-eight percent of tumors expressed EZH2; in 80% of cases >50% of tumor cells were positive. ERG and SPINK1 were expressed in 20% and 36% of cases, respectively. There was no difference in protein expression between pure and mixed ductal adenocarcinomas. ERG expression tended to be lower, and SPINK1 higher than reported for acinar tumors. Biochemical failure, metastasis and death did not differ between EZH2, ERG, and SPINK1 positive and negative patients, nor between <50% versus >50% expression of SPINK1 and EZH2, respectively. CONCLUSIONS: Pure and mixed ductal adenocarcinomas have similar clinical behavior and molecular alterations. Higher EZH2 and SPINK1 protein expression, compared to acinar prostatic adenocarcinoma, might account for the more aggressive clinical course of ductal adenocarcinoma.


Assuntos
Carcinoma Ductal/patologia , Proteína Potenciadora do Homólogo 2 de Zeste/biossíntese , Neoplasias da Próstata/patologia , Inibidor da Tripsina Pancreática de Kazal/biossíntese , Adulto , Idoso , Biomarcadores Tumorais/análise , Carcinoma Ductal/metabolismo , Proteína Potenciadora do Homólogo 2 de Zeste/análise , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/metabolismo , Regulador Transcricional ERG/análise , Regulador Transcricional ERG/biossíntese , Inibidor da Tripsina Pancreática de Kazal/análise
14.
Hum Pathol ; 84: 173-182, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30267779

RESUMO

Androgen-deprivation therapy has been used to treat salivary duct carcinoma (SDC). The androgen receptor splice variant-7 (AR-V7) has been detected in castration-resistant prostate cancer and implicated in resistance to androgen receptor (AR)-targeted therapies. Given the potential role of AR/AR-V7 in SDC treatment, this study focuses on AR/AR-V7 expression in SDC specimens collected before androgen-deprivation therapy. RNA in situ hybridization (ISH) and immunohistochemistry (IHC) to detect total AR and AR-V7 were performed on formalin-fixed, paraffin-embedded SDC specimens from 23 patients. Full-length AR and AR-V7 transcripts were quantified in a subset of tumors by reverse-transcription polymerase chain reaction. Twenty SDCs were positive for total AR by ISH and IHC. Among AR-positive SDCs, 70% (14/20) were positive for AR-V7 messenger RNA by ISH, whereas 15% (3/20) were positive for AR-V7 protein by IHC. The 3 SDCs that expressed the highest levels of AR-V7 were all from female patients; one of them expressed a significant amount of AR-V7 and barely detectable full-length AR transcripts by reverse-transcription polymerase chain reaction. IHC expression of Forkhead box protein A1, prostate-specific antigen, prostatic acid phosphatase, and NKX3.1 was observed in some SDCs regardless of patient sex. Five SDCs demonstrated strong human epidermal growth factor receptor 2 expression. We conclude that treatment-naïve SDCs may express AR-V7 at levels comparable to or even exceeding the levels detected in castration-resistant prostate cancer. Our data support the feasibility to incorporate AR-V7 assessment via ISH and/or IHC in the ongoing clinical trials evaluating the therapeutic benefit of AR-targeted therapies in SDC patients.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma Ductal/metabolismo , Receptores Androgênicos/biossíntese , Neoplasias das Glândulas Salivares/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Ductal/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isoformas de Proteínas/biossíntese , Receptores Androgênicos/genética , Ductos Salivares/patologia , Neoplasias das Glândulas Salivares/patologia
15.
Am J Dermatopathol ; 41(2): 140-143, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29979196

RESUMO

Squamoid eccrine ductal carcinoma (SEDC) is an uncommon cutaneous adnexal malignancy that has the potential for an aggressive clinical course. The authors present a case of SEDC that resulted in widespread metastases and death. The clinical, histological, and immunohistochemical features of SEDC and several entities on the differential diagnosis are reviewed.


Assuntos
Carcinoma Ductal/patologia , Carcinoma de Apêndice Cutâneo/patologia , Glândulas Écrinas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Idoso de 80 Anos ou mais , Carcinoma Ductal/diagnóstico , Carcinoma de Apêndice Cutâneo/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Primárias Múltiplas/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico
16.
Asian J Surg ; 42(1): 93-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29249392

RESUMO

BACKGROUND/OBJECTIVE: The definition of R0 resection for invasive pancreatic ductal carcinoma (IPDC) is important. However, there are different definitions among several countries in the world. METHODS: From 2001 to 2015, 100 consecutive patients with IPDC who underwent pancreatic resection in our hospital were enrolled. We compared survival and recurrence patterns between the R0 group and R1 group based on the UICC (Union for International Cancer Control) classification (current-R0 vs. current-R1) and based on our revised classification, which defines R0 as a surgical margin of >1 mm (revised-R0 vs. revised-R1). RESULTS: The 100 patients comprised 58 males and 42 females, and their median age was 70 [32-87]. There were 84 patients in the current-R0 group and 43 in the revised-R0 group. There was no difference in overall survival (OS) or recurrence-free survival (RFS) between the current-R0 group and current-R1 group. However, there was a tendency toward a higher OS rate in the revised-R0 than revised-R1 group (log-rank p = 0.065), and RFS was significantly better in the revised-R0 than revised-R1 group (log-rank p = 0.002). There was no significant difference in the recurrence patterns between the current-R0 and current-R1 groups. In contrast, the local recurrence rate was significantly lower in the revised-R0 than revised-R1 group (21% vs. 42%, respectively; p = 0.026). CONCLUSION: The revised classification of surgical resection may be more useful than the current UICC classification for prediction of prognosis and local recurrence of IPDC.


Assuntos
Carcinoma Ductal/mortalidade , Carcinoma Ductal/cirurgia , Pancreatectomia , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Ductal/classificação , Carcinoma Ductal/patologia , Feminino , Previsões , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/epidemiologia , Pancreatectomia/classificação , Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/patologia , Prognóstico , Taxa de Sobrevida
17.
Histopathology ; 74(3): 474-482, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30160779

RESUMO

AIMS: Intraductal and cribriform carcinoma of the prostate are increasingly recognised as independent prognosticators of poor outcome, both in prostate biopsies and surgical specimens. We studied the concordance of biopsy and prostatectomy diagnosis for these two subpathologies in relationship with pathological stage. METHODS AND RESULTS: Mandatory synoptic reporting of intraductal and cribriform carcinoma in prostate biopsies and prostatectomy specimens was adopted by two academic institutions in November 2015. Synoptic reports of 245 biopsy and corresponding prostatectomy specimens were interrogated to determine the prevalence of intraductal and cribriform carcinoma. Sensitivity and specificity were determined, with prostatectomy diagnosis as the gold standard. Associations with pathological stage as primary outcome parameter were determined using univariable and multivariable logistic regression analysis. Prevalence of the combination of intraductal and cribriform carcinoma was 26.9% in biopsies and 51.8% in prostatectomy specimens. Sensitivity and specificity at biopsy were 47.2% and 94.9%, respectively. Intraductal and cribriform carcinoma at biopsy were associated with advanced pathological stage independent of grade (P = 0.013). Among patients with grade group 2 prostate cancer at biopsy, the more advanced pathological stage distribution was similar for those with a false negative and a true positive biopsy diagnosis of intraductal and cribriform carcinoma (P = 0.29). CONCLUSION: In spite of low sensitivity, intraductal and cribriform carcinoma at biopsy was associated strongly with advanced stage at radical prostatectomy. As a false negative biopsy diagnosis was equally associated with advanced pathological stage, efforts should be undertaken to improve the sensitivity of biopsy diagnosis for intraductal and cribriform carcinoma.


Assuntos
Adenocarcinoma/diagnóstico , Carcinoma Ductal/diagnóstico , Neoplasias da Próstata/diagnóstico , Adenocarcinoma/patologia , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Carcinoma Ductal/patologia , Conjuntos de Dados como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia , Neoplasias da Próstata/patologia , Sensibilidade e Especificidade
18.
Medicine (Baltimore) ; 97(48): e13410, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30508942

RESUMO

RATIONALE: Triple-negative breast cancer (TNBC) is associated with unfavorable prognosis due to lack of targeted agents. Bevacizumab, an anti-angiogenic monoclonal antibody against vascular endothelial growth factor A, has shown clinical effects in patients with TNBC. PATIENT CONCERNS: We reported a 49-year-old woman presenting with a giant breast tumor. DIAGNOSES: Stage IV TNBC with chest wall metastasis. INTERVENTIONS: The patient underwent long-term use of bevacizumab combined with chemotherapy. OUTCOMES: The patient was on follow-up for 46 months, a remarkable improvement of the chest wall cutaneous lesion was observed. LESSONS: Bevacizumab may provide benefits for TNBC patients with chest wall metastasis.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Bevacizumab/administração & dosagem , Carcinoma Ductal/tratamento farmacológico , Carcinoma Ductal/secundário , Neoplasias Torácicas/tratamento farmacológico , Neoplasias Torácicas/secundário , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Ductal/patologia , Cisplatino/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Torácicas/patologia , Parede Torácica/efeitos dos fármacos , Parede Torácica/patologia , Resultado do Tratamento , Neoplasias de Mama Triplo Negativas/patologia , Fator A de Crescimento do Endotélio Vascular/efeitos dos fármacos
19.
Theranostics ; 8(18): 5072-5087, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30429887

RESUMO

Pancreatic ductal adenocarcinoma (PDAC) constitutes one of the most challenging lethal tumors and has a very poor prognosis. In addition to cancer cells, the tumor microenvironment created by a repertoire of resident and recruited cells and the extracellular matrix also contribute to the acquisition of hallmarks of cancer. Among these factors, cancer-associated fibroblasts (CAFs) are critical components of the tumor microenvironment. CAFs originate from the activation of resident fibroblasts and pancreatic stellate cells, the differentiation of bone marrow-derived mesenchymal stem cells and epithelial-to-mesenchymal transition. CAFs acquire an activated phenotype via various cytokines and promote tumor proliferation and growth, accelerate invasion and metastasis, induce angiogenesis, promote inflammation and immune destruction, regulate tumor metabolism, and induce chemoresistance; these factors contribute to the acquisition of major hallmarks of PDAC. Therefore, an improved understanding of the impact of CAFs on the major hallmarks of PDAC will highlight the diagnostic and therapeutic values of these targeted cells.


Assuntos
Adenocarcinoma/patologia , Fibroblastos Associados a Câncer/patologia , Carcinoma Ductal/patologia , Neoplasias Pancreáticas/patologia , Microambiente Tumoral , Adenocarcinoma/fisiopatologia , Animais , Carcinoma Ductal/fisiopatologia , Modelos Animais de Doenças , Transição Epitelial-Mesenquimal , Humanos , Células-Tronco Mesenquimais/fisiologia , Neoplasias Pancreáticas/fisiopatologia , Células Estreladas do Pâncreas/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA