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1.
Medicine (Baltimore) ; 98(33): e16834, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415404

RESUMO

RATIONALE: Pembrolizumab, an immune-checkpoint inhibitor (ICI), has been shown to be effective for treatment-naive patients with non-small cell lung cancer (NSCLC) and high expression of programmed death-ligand 1 (PD-L1). Therefore, treatment regimens containing pembrolizumab have become a standard therapy for these patients. However, the use of pembrolizumab is limited owing to the side effects of ICIs. PATIENT CONCERNS AND DIAGNOSES: The patient was a 65-year-old man with a left lung mass surrounded by interstitial shadow. The tumor was diagnosed as adenocarcinoma, cT4N3M0, stage IIIC, and the tumor cells showed high PD-L1 expression. It was unclear whether the interstitial shadow was interstitial lung disease (ILD) or lymphangitis carcinomatosa. INTERVENTIONS AND OUTCOMES: The patient received carboplatin and nab-paclitaxel, a less risky regimen for ILD, as the first-line therapy. Administration of 2 cycles of this regimen markedly improved both the tumor diameter and interstitial shadow. The interstitial shadow was clinically diagnosed as lymphangitis carcinomatosa and not ILD. Subsequently, the patient was treated with pembrolizumab, and the tumor showed much further shrinkage with no deterioration of the interstitial shadow. To date, the patient is alive with no complaints and no disease progression, and has continued pembrolizumab treatment for a total of 12 months. LESSONS: In patients at a high risk of ICI-related side effects, platinum-doublet chemotherapy may be permitted as the first-line therapy for NSCLC with high PD-L1 expression. However, if the risk associated with ICIs is resolved, early switching from chemotherapy to pembrolizumab might be desirable, even if the chemotherapy is effective.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/diagnóstico , Doenças Pulmonares Intersticiais/diagnóstico , Neoplasias Pulmonares/diagnóstico , Linfangite/diagnóstico , Anticorpos Monoclonais Humanizados/uso terapêutico , Carcinoma/tratamento farmacológico , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Linfangite/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Compostos de Platina/uso terapêutico
2.
Medicine (Baltimore) ; 98(28): e15336, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305389

RESUMO

BACKGROUND: Human epididymis protein 4 (HE4) protein has garnered a great degree of interest as a complementary biomarker to carbohydrate antigen 125 (CA125), or even as an independent biomarker for monitoring, diagnosis, and prognostication of ovarian cancer. Its use is currently limited to ovarian cancer. Recent studies have suggested that it could also be used in other types of cancers. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines was used to design this meta-analysis protocol. The final study will also be conducted under the PRISMA guidelines for systematic reviews and meta-analyses. The core bibliographic database search will be carried out by 2 reviewers working individually, with each conducting an initial screening based on titles and abstracts. The shortlisted articles will be selected for review and statistical analysis based on predefined inclusion and exclusion criteria. Study characteristics, relevant clinicopathological characteristics and statistical data required for meta-analysis (hazard ratios [HRs] and 95% confidence interval [CIs) will be extracted and compiled into a MS Excel datasheet. Meta-analysis will be performed, using a random-effects model, and the results (pooled HR and 95% CI) will be presented in the form of a forest plot. Publication bias will also be assessed by use of Egger bias indicator test and funnel plot symmetry. If data are insufficient, a narrative line of review will be pursued. DISCUSSION: HE4 protein has been shown to have great potential for clinical use as a diagnostic and prognostic marker in epithelial ovarian cancer (EOC). However, HE4 is not only limited to expression in ovarian cancer, but is also overexpressed in lung and endometrial cancers. The effectiveness of HE4 as a biomarker in cancers (other than EOC) has not yet been studied in the form of a comprehensive systematic review and meta-analysis. The results of this study should allow for expanded use of HE4 as a multiutility biomarker in multiple cancer types, thereby, elevating HE4's value as a cancer biomarker. PROSPERO REGISTRATION: CRD42019120326.


Assuntos
Carcinoma/diagnóstico , Carcinoma/metabolismo , Metanálise como Assunto , Proteínas/metabolismo , Revisão Sistemática como Assunto , Biomarcadores Tumorais/metabolismo , Humanos , Prognóstico , Projetos de Pesquisa
3.
Rev Assoc Med Bras (1992) ; 65(6): 893-901, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340322

RESUMO

Breast cancer (BC) is one of the primary health problems worldwide. As the most common cancer in women in the world and in Brasil, behind only non-melanoma skin cancer, this neoplasm corresponds to approximately 28% of new cases per year in the country. BC also affects men, although the incidence corresponds to only 1% of total cases. Currently, most of the chemotherapeutic agents used in BC treatment are extremely toxic and cause long-term side effects. There is also a need to obtain earlier diagnoses, more accurate prognoses and make new therapies available that are more selective and effective in order to improve the current scenario. Therefore, this work sought to evaluate the importance of the biomarker survivin (Sur) in relation to BC, through the detailing of the role of Sur as a biomarker, the correlation between this protein and the prognosis of BC patients, and a summary of therapeutic strategies that target Sur for the development of new anticancer therapies.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma/diagnóstico , Carcinoma/patologia , Survivina/análise , Apoptose , Biomarcadores Tumorais/análise , Feminino , Humanos , Prognóstico
4.
J Cancer Res Clin Oncol ; 145(8): 1977-1986, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31309300

RESUMO

CONTEXT: Parathyroid carcinoma (PC) is a rare endocrine malignancy with no approved systemic therapies for unresectable locally invasive or distant metastatic disease. Understanding the molecular changes in advanced PC can provide better understanding of this disease and potentially help directing targeted therapy. OBJECTIVE: To evaluate tumor-specific genetic changes using next-generation sequencing (NGS) panels. DESIGN: All patients with advanced PC were tested for hot-spot panels using NGS panels including a 50-gene panel, a 409-gene panel if the standard 50-gene panel (Ion Torrent, Life Technology) was negative or a FoundationOne panel. SETTING: The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. PATIENTS OR OTHER PARTICIPANTS: 11 patients with advanced PC were selected to undergo molecular testing. MAIN OUTCOME MEASURE(S): Genetic profiles of advanced PC. RESULTS: Among the 11 patients, 4 patients had the 50-gene panel only, 6 had 409-gene panel after a negative 50-gene panel and 1 had FoundationOne. One patient who had 50-gene panel only also had his metastatic site (esophagus) of his tumor tested with FoundationOne. The most common mutations identified were in the PI3 K (PIK3CA, TSC1 and ATM) (4/11 patients) and TP53 (3/11) pathways. Genes not previously reported to be mutated in PC included: SDHA, TERT promoter and DICER1. Actionable mutations were found in 54% (6/11) of the patients. CONCLUSIONS: Mutational profiling using NGS panels in advanced PC has yielded important potentially targetable genetic alterations. Larger studies are needed to identify commonly mutated genes in advanced PC patients. Development of novel therapies targeting these cellular pathways should be considered.


Assuntos
Carcinoma/genética , Perfilação da Expressão Gênica , Técnicas de Diagnóstico Molecular/métodos , Monitorização Fisiológica/métodos , Neoplasias das Paratireoides/genética , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/diagnóstico , Carcinoma/patologia , Carcinoma/terapia , Análise Mutacional de DNA/métodos , Progressão da Doença , Feminino , Seguimentos , Perfilação da Expressão Gênica/métodos , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/tendências , Terapia de Alvo Molecular/métodos , Terapia de Alvo Molecular/tendências , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/terapia
6.
Br J Radiol ; 92(1100): 20190163, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31112412

RESUMO

OBJECTIVE: To evaluate the agreement between multiple detector CT (MDCT) and laparoscopy in the preoperative categorization of peritoneal carcinomatosis, and to determine the impact of this categorization on the prediction of cytoreduction status. METHODS: This prospective study included 80 consecutive females with primary ovarian cancer eligible for cytoreductive surgery (CRS). MDCT and diagnostic laparoscopy were performed prior to surgery for assessment of peritoneal carcinomatosis extent. Based on PCI (peritoneal cancer index) score, carcinomatosis was categorized into three groups. Categorization agreement between CT and laparoscopy was assessed and compared with the intraoperative-histopathologically proven PCI. Impact of PCI categorization on cytoreduction status was also evaluated. RESULTS: The overall agreement between CT and laparoscopy in preoperative peritoneal carcinomatosis categorization was good (K =0.71-0.79) in low category group and excellent in both moderate and large group (interclass correlation coeeficient = 0.89-0.91). (p<0.01) Optimal cytoreduction was achieved in 62/80 (77.5%) patients, PCI < 20 was detected in 48/62 (77.4%), pre-operative PCI < 20 correctly predicted optimal cytoreductive surgery (OCS) in 40/48 (83.3%) cases. Suboptimal cytoreduction was performed in 18/80 (22.5%) patients. PCI > 20 was detected in (10/18) 55.6%, preoperative CT and laparoscopy PCI > 20 correctly predicted SCS in 8/10 (80%) cases. The area under receiver operating characteristic curve showed that PCI cut-off <20 was the best predictor of OCS with an accuracy 85%, sensitivity 97%, specificity 40%, negative predictive value 76%, and positive predictive value 93%. CONCLUSION: Both laparoscopy and CT are equally effective in pre-operative peritoneal carcinomatosis categorization. PCI < 20 is accurate in the prediction of optimal cytoreduction. More than half of patients with suboptimal cytoreduction had PCI > 20 and interval debulking surgery can be recommended. ADVANCES IN KNOWLEDGE: Both laparoscopy and CT are equally effective in pre-operative peritoneal carcinomatosis categorization. PCI < 20 is accurate in the prediction of optimal cytoreduction. More than half of patients with suboptimal cytoreduction had PCI > 20 and interval debulking surgery can be recommended.


Assuntos
Carcinoma/diagnóstico , Laparoscopia/métodos , Tomografia Computadorizada Multidetectores/métodos , Neoplasias Peritoneais/diagnóstico , Adulto , Idoso , Carcinoma/diagnóstico por imagem , Carcinoma/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/cirurgia , Peritônio/diagnóstico por imagem , Peritônio/cirurgia , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Adulto Jovem
7.
APMIS ; 127(7): 491-502, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30942913

RESUMO

Secretory carcinoma (SC) of salivary glands is a newly described low-grade malignancy characterized by the presence of ETV6 rearrangement. Only a few cases and very small series with cytomorphology were reported so far. Six cases of fine-needle aspirations (FNAs) from afterward histologically, immunohistochemically and genetically confirmed SCs were retrieved from the archives of the authors. Ancillary immunocytochemistry (ICC) and translocation detection were performed on cell blocks (CBs). All aspirates were sufficiently cellular and cells were arranged in more or less cohesive groups with only mild nuclear polymorphism. The cytoplasm was eosinophilic, granulated and vacuolated, especially in CBs. Secretory material within the microcystic spaces was periodic acid-Schiff (PAS) positive. Triple positivity of immunomarkers S-100 protein, mammaglobin and vimentin was present. The proliferation index was low. Ancillary techniques suggested the possibility of SC in a few cytology cases; nevertheless, the final diagnosis was based on histomorphology, immunohistochemistry and genetics. The SC of salivary glands is detectable pre-operatively using ICC and genetics. The presence of the diagnostic ETV6 rearrangement increases the accuracy of FNA to the maximum. According to the Milan system, cases genetically not confirmed should be categorized as Suspicious for Malignancy or Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP), both requiring surgery.


Assuntos
Carcinoma/diagnóstico , Carcinoma/patologia , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha Fina/métodos , Carcinoma/metabolismo , Citodiagnóstico/métodos , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-ets/metabolismo , Proteínas Repressoras/metabolismo , Proteínas S100/metabolismo , Neoplasias das Glândulas Salivares/metabolismo , Glândulas Salivares/metabolismo , Vimentina/metabolismo , Adulto Jovem
8.
Indian J Pathol Microbiol ; 62(2): 313-318, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971565

RESUMO

Brooke-Spiegler syndrome (BSS) is a rare autosomal dominant disease characterized by the development of multiple cutaneous adnexal neoplasms namely cylindroma, trichoepithelioma and spiradenoma. The neoplasms associated with this syndrome are generally benign, but rarely they may undergo malignant transformation. A 63-year-old male presented with an ulcerated nodular lesion over glabella and multiple asymptomatic nodular lesions over face, scalp, chest and limbs. His father, grandfather and paternal cousins had history of similar lesions. Histopathological examination revealed trichoblastic carcinoma arising from trichoepithelioma over glabella and cylindroma on the chest. With these findings we arrived at a diagnosis of BSS with malignant transformation of trichoepithelioma. Trichoblastic carcinoma arising in trichoepithelioma in a patient with BSS is extremely rare with only a single case reported in literature.


Assuntos
Carcinoma Adenoide Cístico/patologia , Carcinoma/diagnóstico , Síndromes Neoplásicas Hereditárias/complicações , Neoplasias Cutâneas/complicações , Neoplasias das Glândulas Sudoríparas/diagnóstico , Transformação Celular Neoplásica , Diagnóstico Diferencial , Face/patologia , Doenças do Cabelo/diagnóstico , Doenças do Cabelo/patologia , Folículo Piloso/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Couro Cabeludo/patologia , Neoplasias das Glândulas Sudoríparas/patologia
9.
Arkh Patol ; 81(2): 51-58, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31006781

RESUMO

Carcinoma with unknown primary site (CUPs) is a group of malignant tumors, the first manifestation of which is metastatic dissemination. A primary tumor cannot be usually identified by a physical examination of patients with CUPs; a postmortem study plays a significant role in the diagnosis of the origin of metastasis. The paper gives the data available in the literature data on the postmortem diagnosis of CUPs and considers the morphological characteristics of metastases and the possibilities of immunohistochemical diagnosis and a molecular genetic method in the search for a primary focus.


Assuntos
Carcinoma , Neoplasias Primárias Desconhecidas , Carcinoma/diagnóstico , Humanos , Neoplasias Primárias Desconhecidas/diagnóstico
11.
Biosci Trends ; 13(1): 1-9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30867371

RESUMO

Since the American Joint Committee on Cancer (AJCC) subdivided the T2 stage of gallbladder carcinoma (GBC) into T2a and T2b, the diagnosis and treatment of those stages have been a subject of heated discussion and controversy. T2 is a stage of GBC that might be treatable. Based on the extent of lymph node metastasis and distant metastasis, T2 GBC can be classified into various pathological stages such as IIA, IIB, IIIB, and IVB, leading to controversy in clinical settings. This review aims to discuss the effectiveness of and controversies concerning S4b+5 resection, the acceptable extent of lymph node dissection, the timing for treatment of incidental gallbladder cancer, and adjuvant therapy. This review also aims to suggest directions for and recommendations regarding clinical research in the future.


Assuntos
Carcinoma/cirurgia , Neoplasias da Vesícula Biliar/cirurgia , Carcinoma/diagnóstico , Terapia Combinada , Neoplasias da Vesícula Biliar/diagnóstico , Hepatectomia , Humanos , Achados Incidentais , Excisão de Linfonodo , Prognóstico
12.
Clin Lab ; 65(3)2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30868864

RESUMO

BACKGROUND: Circular RNAs (circRNAs) are potential, novel biomarkers for the early diagnosis of gastric carcinoma. Herein, a meta-analysis was conducted to assess the diagnostic potential for circRNAs in gastric carcinoma. METHODS: Online databases were searched for eligible studies. Study quality was judged using the Quality Assessment for Studies of Diagnostic Accuracy (QUADAS) checklist-II tool. STATA 12.0 and Meta-Disc 1.4 software were used for statistical analysis. RESULTS: Twelve studies consisting of 1,278 patients and 1,250 paired controls were considered for meta-analysis. The pooled sensitivity and specificity of circRNAs for gastric carcinoma were compared to normal controls and found to be 0.68 (95% CI: 0.66 - 0.71) and 0.70 (95% CI: 0.68 - 0.73), respectively. A corresponding area under the receiver operating characteristic curve of 0.78 was identified. Moreover, stratified analysis demonstrated an improved diagnostic value for circRNAs when tissue and plasma specimens were combined. CONCLUSIONS: This meta-analysis demonstrates that circRNAs are promising biomarkers for gastric carcinoma.


Assuntos
Carcinoma/diagnóstico , RNA/metabolismo , Neoplasias Gástricas/diagnóstico , Carcinoma/metabolismo , Humanos , Neoplasias Gástricas/metabolismo
13.
Postgrad Med ; 131(5): 309-318, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30900501

RESUMO

Pulmonary lymphangitis carcinomatosis (PLC) is a life-threating complication in patients suffering from malignancies. Misleading and nonspecific symptoms often result in a delayed diagnosis. This review was aimed at evaluating epidemiology, clinical manifestations, and survival of patients with PLC reported in the literature. According to our knowledge, this study is the first such extensive analysis of PLC. We searched for the literature in the PubMed database for articles published from 1970 to 2018 using keywords: lung, pulmonary, lymphangitic, carcinoma, carcinomatosis. Pulmonary lymphangitis carcinomatosis rarely occurs, thus all data were extracted from case reports and case series consisted of a method for identifying individual-level patient data. In the final analysis, 108 articles (139 individual patient cases) were included. The mean age of PLC occurrence is 49.21 years. There is no difference in the prevalence between men and women. The most common underlying primary tumors coexisting with PLC are breast (17.3%), lung (10.8%), and gastric cancers (10.8%). Dyspnea and dry cough were the most common symptoms occurring in 59.0% and 33.8% of patients, respectively. In half the patients, PLC developed in fewer than ten months after first diagnosis of cancer. Pulmonary lymphangitis carcinomatosis diagnosis is associated with a poor prognosis: approximately half of patients die within two months of their first respiratory symptoms and three weeks from admission to hospital. Regarding survival time, we observed better results achieved in patients described between 2000 and 2018 compared to 1970 through 1999. In the presence of progressive dyspnea, cough, and lesions comparable to interstitial lung disease, diagnosis of PLC should be considered. Pulmonary lymphangitis carcinomatosis can be the first manifestation of primary occult neoplasm and may occur at any age. Adenocarcinoma, especially primary lung, breast, and gastric cancers is the most common cancer coexisting with PLC.


Assuntos
Carcinoma/diagnóstico , Carcinoma/secundário , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Linfangite/diagnóstico , Linfangite/patologia , Adulto , Neoplasias da Mama/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias Gástricas/patologia
14.
Vet Pathol ; 56(4): 526-535, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30857503

RESUMO

Canine spindle cell mammary tumor (CSCMT) is an infrequent canine mammary tumor (CMT) composed of spindle or fusiform cells, which represents a challenge for pathologists and clinicians. Mammary tumors submitted for histopathology from 1998 to 2013 and compatible with CSCMTs were retrospectively selected. The tumors were diagnosed based on the hematoxylin and eosin (HE)-stained section; malignant tumors were graded using a canine soft tissue sarcoma grading scheme and a canine mammary tumor grading scheme, and they were further assigned a diagnosis based on immunohistochemistry (IHC) for pancytokeratin, cytokeratin 14, p63, calponin, vimentin, Ki-67, CD31, desmin, myosin, smooth muscle actin, glial fibrillary acidic protein, and S-100. The origin of the tumors was assessed as mammary, skin, or unknown. The prevalence of CSCMT was 1% of all CMTs. CSCMTs included 3 benign tumors (1 angioma and 2 benign myoepitheliomas) and 67 malignant tumors that after IHC were diagnosed as malignant myoepithelioma (64%), carcinoma and malignant myoepithelioma (19%), hemangiosarcoma (8%), undifferentiated sarcoma (5%), peripheral nerve sheath tumor (3%), and fibrosarcoma (2%). The diagnosis based on the HE-stained section differed from the diagnosis after IHC in 75% of the malignant cases. The majority of malignant CSCMTs were solitary (57%) large tumors (6.42 ± 3.92 cm) with low metastatic potential and high survival rate (8% tumor-related mortality). Higher sarcoma grade was associated with older age (P = .034) and greater tumor size (P = .037). Malignant CSCMTs need to be evaluated by IHC to ensure the histotype and the relatively benign clinical behavior, despite their large size.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma/veterinária , Doenças do Cão/diagnóstico , Neoplasias Mamárias Animais/diagnóstico , Mioepitelioma/veterinária , Neoplasias da Bainha Neural/veterinária , Sarcoma/veterinária , Animais , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/patologia , Doenças do Cão/epidemiologia , Doenças do Cão/patologia , Cães , Feminino , Imuno-Histoquímica/veterinária , Imunofenotipagem/veterinária , Neoplasias Mamárias Animais/epidemiologia , Neoplasias Mamárias Animais/patologia , Mioepitelioma/diagnóstico , Mioepitelioma/epidemiologia , Mioepitelioma/patologia , Gradação de Tumores , Neoplasias da Bainha Neural/diagnóstico , Neoplasias da Bainha Neural/epidemiologia , Neoplasias da Bainha Neural/patologia , Prognóstico , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/epidemiologia , Sarcoma/patologia
15.
J Med Case Rep ; 13(1): 57, 2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-30853030

RESUMO

BACKGROUND: Nuclear protein in testis midline carcinoma is a rare, highly metastatic undifferentiated carcinoma that typically arises in midline structures and is characterized by having a fusion involving the nuclear protein in testis, NUT, gene. Nuclear protein in testis midline carcinoma has been identified in patients of all ages and is often initially misdiagnosed due to the rapid timeline of symptom onset. CASE PRESENTATION: Here we report the case of a 47-year-old Caucasian woman with a nuclear protein in testis midline carcinoma that was initially mistaken for a sinus infection. After symptom progression while on an aggressive antibiotic regimen, the source of her symptoms was correctly identified as a sella mass. Comprehensive analysis of the tumor was performed, and standard cytogenetic analysis identified a translocation of 15q and 19p. Further testing identified a NUT-BRD4 fusion and confirmed the diagnosis of nuclear protein in testis midline carcinoma. Despite definitive diagnosis and surgical, radiation, and, ultimately, systemic therapy, she progressed rapidly, developing widespread metastases, and ultimately died from the disease 5 months after diagnosis. CONCLUSIONS: Based on this and other previous reports, aggressive therapy should be initiated once nuclear protein in testis midline carcinoma is diagnosed and close surveillance employed in an attempt to prevent and/or recognize metastases as early as possible. Aggressive therapy has shown little efficacy such that the average overall survival for patients with nuclear protein in testis midline carcinoma is very short, often less than 6 months. Thus, early enrollment into clinical trials testing novel therapies for the treatment of nuclear protein in testis midline carcinoma should be considered. Finally, additional reports of nuclear protein in testis midline carcinoma are needed to fully characterize this rare and highly aggressive cancer.


Assuntos
Carcinoma/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Proteínas Nucleares/genética , Proteínas de Fusão Oncogênica/genética , Proteínas Oncogênicas/genética , Biomarcadores Tumorais/genética , Carcinoma/genética , Carcinoma/terapia , Quimiorradioterapia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Pessoa de Meia-Idade , Mutação/genética , Sinusite
16.
Indian J Pathol Microbiol ; 62(1): 125-128, 2019 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30706876

RESUMO

Lymphoepithelioma is a rare clinical entity, first was described in nasopharynx, and have been reported in another organs. Lymphoepithelioma-like carcinoma (LEC) of the breast is an undifferentiated carcinoma. Approximately 32 cases have been described, and differential diagnoses include primary breast lymphoma and medullary carcinoma. We present a 57-year-old woman, diagnosed with LEC of the breast, treated with mastectomy, followed by adjuvant chemotherapy, radiotherapy, and hormone therapy, with a disease-free interval of 2 years. There is scarce evidence related to the best treatment choice in this histological type.


Assuntos
Neoplasias da Mama/diagnóstico , Carcinoma/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Carcinoma/tratamento farmacológico , Carcinoma/radioterapia , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Tratamento Farmacológico , Feminino , Herpesvirus Humano 4/isolamento & purificação , Hormônios/uso terapêutico , Humanos , Hibridização In Situ , Linfoma/diagnóstico , Linfoma/patologia , Mastectomia , Pessoa de Meia-Idade , Nasofaringe/virologia
17.
APMIS ; 127(4): 170-180, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30803053

RESUMO

The objective of this study was to examine the expression level of cytochrome P450 4B1 (CYP4B1) protein and its clinical significance in specimens from patients with urothelial carcinomas (UC) including upper tract urothelial carcinoma (UTUC, n = 340) and urinary bladder urothelial carcinoma (UBUC, n = 295). Data mining on public domains identified five potential candidate transcripts which were downregulated in advanced UBUCs, indicating that it might implicate in UC progression. Immunohistochemistry was performed to analyze the CYP4B1 protein levels on 635 tissues from UC patients retrospectively. Immunoexpression of CYP4B1 was further estimated using the H-score method. Correlations between CYP4B1 H-score and important clinicopathological factors, as well as the significance of CYP4B1 expression level for disease-specific and metastasis-free survivals were evaluated. In UTUCs and UBUCs, 118 (34.7%) and 92 (31.2%) patients, respectively, were identified to be of CYP4B1 downregulation. The CYP4B1 expression level was found to be associated with several clinicopathological factors and patient survivals. Downregulation of CYP4B1 protein was correlated to advanced primary tumor (p < 0.001), nodal metastasis (p < 0.001), high histological grade (p = 0.001), vascular invasion (p < 0.001), perineural invasion (p = 0.017) and mitotic rate (p = 0.036) in UTUCs and/or UBUCs. Low CYP4B1 protein level independently predicted inferior disease-specific (p = 0.009; p < 0.001) and metastasis-free (p = 0.035; p < 0.001) survivals in UTUC and UBUC patients. Our findings showed that downregulation of CYP4B1 protein level is an independent unfavorable prognosticator. Loss of the CYP4B1 gene expression may play an important role in UC progression.


Assuntos
Hidrocarboneto de Aril Hidroxilases/análise , Carcinoma/diagnóstico , Carcinoma/patologia , Regulação para Baixo , Sistema Urinário/patologia , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
18.
Anticancer Res ; 39(2): 585-590, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711933

RESUMO

BACKGROUND/AIM: Oxidative stress is involved in several carcinogenic pathways. Nuclear factor erythroid 2-related factor (Nrf2), Kelch-like ECH-associated protein 1 (Keap1) and Park7 (DJ-1) are the main regulators of antioxidant enzymes eliminating reactive oxidative species (ROS). The roles of these proteins were studied as potential prognostic factors in endometrial cancer. MATERIALS AND METHODS: Nrf2, Keap1 and DJ-1 expression in endometrial carcinomas was analyzed immunohistochemically. Correlations between staining patterns and clinical prognostic variables were evaluated. RESULTS: Extensive cytoplasmic Keap1 staining correlated to several factors associated with poor prognosis of endometrial cancer including advanced stage, poor histological differentiation, lymphovascular invasion, pelvic lymph node metastasis and deep myometrial invasion. In multivariate analysis, cytoplasmic Keap1 was a stronger predictor of poor progression-free survival than grade. Nuclear Nrf2 staining was seen in all patients with lymph node metastasis while DJ-1 staining was associated with clinically favourable disease types. CONCLUSION: Cytoplasmic Keap1 expression indicates poor prognosis in endometrial cancer.


Assuntos
Citoplasma/metabolismo , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/metabolismo , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Idoso , Idoso de 80 Anos ou mais , Antioxidantes/metabolismo , Carcinoma/diagnóstico , Carcinoma/metabolismo , Carcinoma/mortalidade , Diferenciação Celular , Núcleo Celular/metabolismo , Tomada de Decisões , Intervalo Livre de Doença , Neoplasias do Endométrio/mortalidade , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Análise Multivariada , Miométrio/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo , Prognóstico , Proteína Desglicase DJ-1/metabolismo , Espécies Reativas de Oxigênio/metabolismo
19.
BMJ Case Rep ; 12(2)2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30709891

RESUMO

Chronic non-puerperal uterine inversion is a rare event, with only a handful of cases reported in literature. We report a case of a 64-year-old postmenopausal woman who presented with complaints of mass per vaginam and postmenopausal bleeding. On examination, she appeared to have third-degree cervical descent with an irregular growth seen over what appeared to be the cervix, biopsy of which showed keratinising squamous cell carcinoma. Subsequently, an inverted uterus was diagnosed at laparotomy with an irregular growth seen over the inverted portion of the uterine fundus, histopathology of which revealed squamous cell carcinoma of endometrium.


Assuntos
Carcinoma/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Inversão Uterina/diagnóstico , Neoplasias Uterinas/diagnóstico , Doença Crônica , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade
20.
Mol Genet Genomic Med ; 7(3): e506, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30636379

RESUMO

BACKGROUND: Paired-box gene 1 (PAX1), a member of the PAX family, plays a role in pattern formation during embryogenesis, and might be essential for development of the vertebral column. METHODS: PAX1 is silenced by methylation in several cancers and is considered a tumor suppressor gene. Our previous studies reported PAX1 as hypermethylated in cervical cancer tissues, thereby suggesting it as a potential screening marker. Recently, an increasing number of studies have confirmed PAX1 methylation as a promising biomarker in cervical cancer based on its excellent discriminatory ability between high-grade cervical lesions and normal tissues, resulting in a reduced necessity for referral for colposcopy and biopsy. Additionally, PAX1 is also hypermethylated in other tumors, including those associated with epithelial ovarian cancer, esophageal squamous cell carcinoma, head and neck squamous cell carcinoma, and endometrial carcinoma, and shows relatively good sensitivity and specificity for the detection of these tumors. RESULTS: This review summarizes reports of PAX1 methylation and its promising role in cancer screening, especially that associated with cervical cancer. CONCLUSION: According to current evidence, combined testing for human papillomavirus and PAX1 methylation analysis represents an efficacious cervical cancer-screening protocol.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma/genética , Metilação de DNA , Fatores de Transcrição Box Pareados/genética , Carcinoma/diagnóstico , Detecção Precoce de Câncer/métodos , Testes Genéticos/métodos , Humanos
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