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Tian FY, Wang JX, Huang G, An W, Ai LS, Wang S, Wang PZ, Yu YB, Zuo XL, Li YQ. Clinical and endoscopic features of primary small bowel lymphoma: a single-center experience from mainland China. Front Oncol 2023; 13:1142133. [PMID: 37397371 PMCID: PMC10313208 DOI: 10.3389/fonc.2023.1142133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Objective The worldwide incidence of primary small intestinal lymphoma (PSIL) is increasing. However, little is known about the clinical and endoscopic characteristics of this disease. The aim of this study was to investigate the clinical and endoscopic data of patients with PSIL, with the goal of enhancing our understanding of the disease, improving diagnostic accuracy, and facilitating more accurate prognosis estimation. Methods Ninety-four patients diagnosed with PSIL were retrospectively studied at Qilu Hospital of Shandong University between 2012 and 2021. The clinical data, enteroscopy findings, treatment modalities, and survival times were collected and analyzed. Results Ninety-four patients (52 males) with PSIL were included in this study. The median age of onset was 58.5 years (range: 19-80 years). Diffuse large B-cell lymphoma (n=37) was the most common pathological type. Abdominal pain (n=59) was the most frequent clinical presentation. The ileocecal region (n=32) was the most commonly affected site, and 11.7% of patients had multiple lesions. At the time of diagnosis, the majority of patients (n=68) were in stages I-II. A new endoscopic classification of PSIL was developed, including hypertrophic type, exophytic type, follicular/polypoid type, ulcerative type, and diffusion type. Surgery did not show a significant increase in overall survival; chemotherapy was the most commonly administered treatment. T-cell lymphoma, stages III-IV, "B" symptoms, and ulcerative type were associated with poor prognosis. Conclusion This study provides a comprehensive analysis of the clinical and endoscopic features of PSIL in 94 patients. This highlights the importance of considering clinical and endoscopic characteristics for accurate diagnosis and prognosis estimation during small bowel enteroscopy. Early detection and treatment of PSIL is associated with a favorable prognosis. Our findings also suggest that certain risk factors, such as pathological type, "B" symptoms, and endoscopic type, may affect the survival of PSIL patients. These results underscore the need for careful consideration of these factors in the diagnosis and treatment of PSIL.
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Affiliation(s)
- Feng-Yu Tian
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Jue-Xin Wang
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Gang Huang
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Wen An
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Li-Si Ai
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Sui Wang
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Pei-Zhu Wang
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Yan-Bo Yu
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
| | - Yan-Qing Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China
- Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
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Chen Q, Feng Y, Yang J, Liu R. Development and validation of a population-based prognostic nomogram for primary colorectal lymphoma patients. Front Oncol 2022; 12:991560. [PMID: 36353557 PMCID: PMC9638023 DOI: 10.3389/fonc.2022.991560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background Primary colorectal lymphoma (PCL) is a relatively rare cancer type, constituting 15%–20% of primary gastrointestinal lymphoma and <1% of all colorectal malignancies. Given its low incidence, standard guidelines for case management are not available. This large population-based study aims to construct a nomogram to predict survival outcomes and to help tailor individualised treatment decisions in patients with PCL. Methods A retrospective cohort study of patients with PCL was developed using data registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1990 and 2015. The prognostic nomogram was constructed using R software after univariate and multivariate Cox regression analyses. Cox regression models were assessed using the proportional hazards (PH) assumption. Kaplan−Meier survival analysis was used to analyze survival outcomes. The 1-, 3-, 5-, and 10-year area under the curve (AUC) values of ROC (receiver operating characteristic) curves, the concordance index (C-index), and calibration curves were calculated to verify the predictive performance of the nomogram. Results The final nomogram included age, Ann Arbor stage, histology, location, marital status, and treatment, all of which had an important effect on overall survival (OS). The discrimination of the nomogram revealed good prognostic accuracy and clinical applicability as indicated by C-index values of 0.713 and 0.711 in the training and validation cohorts, respectively. Kaplan−Meier survival curves were significantly different for distinct conditions. Conclusion This study developed and validated a six-factor nomogram for predicting PCL patient prognosis. This nomogram might be useful for risk stratification and making better individualised decisions for PCL patients.
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Affiliation(s)
- Qian Chen
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Feng
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaxin Yang
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Liu
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Rui Liu,
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Kosto A, Gozlan‐Talmor A, Levy E, Nalbandyan K, Fuchs L, Galante O. Unusual presentation of aggressive high‐grade B‐cell lymphoma of colonic origin: A case report and review of the literature. Clin Case Rep 2022; 10:e05929. [PMID: 35734188 PMCID: PMC9192348 DOI: 10.1002/ccr3.5929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/10/2022] [Accepted: 04/27/2022] [Indexed: 11/19/2022] Open
Abstract
Colonic lymphoma is a rare disease. The presented case is unique, being manifested with abrupt onset, including circulatory shock and lactic acidosis as the initial presentation. Although rare, colorectal lymphoma should be included in the DD of patients with abdominal symptoms. Shock and lactic acidosis can be an initial presentation of colonic lymphoma. Diagnosis is mostly based on pathology and the evaluation of ascites.
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Affiliation(s)
- Amit Kosto
- Department of Internal Medicine Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
| | - Aya Gozlan‐Talmor
- Department of Hematology Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
| | - Etai Levy
- Department of Hematology Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
| | - Karen Nalbandyan
- Department of Pathology Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
| | - Lior Fuchs
- Medical Intensive Care Unit Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
| | - Ori Galante
- Medical Intensive Care Unit Soroka University Medical Center; Faculty of Health Sciences Ben Gurion University of the Negev Beer‐Sheva Israel
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Shu Y, Xu X, Yang W, Xu L. Surgery plus chemotherapy versus chemotherapy alone in primary intestinal lymphoma: a meta-analysis. J Int Med Res 2021; 49:3000605211056845. [PMID: 34763562 PMCID: PMC8593296 DOI: 10.1177/03000605211056845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Primary intestinal lymphomas (PILs) are uncommon tumors, but their incidence is increasing. Currently, their management is centered around systemic treatments, such as chemotherapy and radiotherapy, whereas surgery is restricted to selected indications. This meta-analysis aimed to evaluate the role of surgery in PIL treatment. Methods We collected publications comparing surgery plus chemotherapy versus chemotherapy alone in patients with PIL from 2000 to 2021. All trials analyzed the summary odds ratios (ORs) of endpoints, including the 5-year overall survival (OS), 3-year OS, and 3-year progression-free survival rates. Combined pooled ORs were analyzed using fixed- or random-effects models according to heterogeneity. Results Six studies were included. Compared with chemotherapy alone, surgery plus chemotherapy was associated with significantly higher 5-year OS [OR = 4.88, 95%confidence interval (CI) = 1.91–12.44, Z = 3.32], 3-year OS (OR = 3.83, 95%CI = 2.33–6.30, Z = 5.30), and 3-year progression-free survival (OR = 3.51, 95%CI = 2.20–5.58, Z = 5.29). Conclusions Surgery plus chemotherapy was associated with better outcomes than chemotherapy alone, especially in the early stages. Therefore, surgery plus chemotherapy may be the preferred strategy for appropriately selected patients with PIL. The protocol for this systematic review was registered at INPLASY (INPLASY202180102) and is available in full (https: //doi.org/10.37766/inplasy2021.8.0102).
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Affiliation(s)
- Yefei Shu
- Department of Medical Oncology, 499809Hangzhou Cancer Hospital, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaofeng Xu
- Department of Oncology and Hematology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, China
| | - Wei Yang
- Department of Oncology and Hematology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, China
| | - Ling Xu
- Department of Oncology and Hematology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, China
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Primary diffuse large B-cell lymphoma of the sigmoid colon. Int J Surg Case Rep 2021; 87:106454. [PMID: 34600235 PMCID: PMC8488484 DOI: 10.1016/j.ijscr.2021.106454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Extranodal lymphomas are commonly encountered in the gastrointestinal tract but lymphomas of colon and rectum are rare. Non-Hodgkin lymphoma is the most common type of colonic lymphoma and represents less than 0.5% of colorectal neoplasms. Chemotherapeutical agents are gateway to disease remission and sometimes cure in most patients but surgery may be necessary in emergent situations. Case presentation A 77-year-old male patient presented with abdominal discomfort, constipation, and obstructive defecation symptoms. Radiological imaging revealed a mass in the sigmoid colon extending towards the rectum. Colonoscopy was performed and biopsy of a nearly 10 cm ulcerovegetative lesion was obtained. Histological examination following biopsy revealed it to be a diffuse large B-cell lymphoma of the sigmoid colon. There was no indication for surgery and the patient was referred to medical oncology clinic for chemotherapy treatment. Discussion Non-Hodgkin lymphoma is a lymphoproliferative disorder with the diffuse large B cell lymphoma (DLBCL) being the most common subtype. The DLBCL subtype is rarely observed in the colon and rectum. Chromosomal abnormalities are involved in the pathophysiology and gene rearrangements lead to adjustments in lymphocyte function and differentiation. Conclusion In this case report, we present a rare presentation of a Non-Hodgkin lymphoma presenting in the sigmoid colon. The disease can present with nonspecific symptoms and various imaging modalities along with histopathological evaluation is necessary for the correct subtyping of lymphoma. Chemoradiotherapy is key for treatment, and surgery is usually reserved for cases of obstruction, perforation, or bleeding. Non-Hodgkin lymphoma is the most common type of colonic lymphoma. Extranodal lymphomas of the colon and rectum are rare. Histopathological evaluation is important for subtyping of lymphoma. Chemotherapy is the main form of treatment but sometimes surgery is required.
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Nakrani R, Yeung HM, Arnon M, Selby A, Burgert-Lon C, Kamat B. An unusual presentation of non-IBD related colorectal primary extranodal diffuse large B cell lymphoma with a colo-colonic fistula. J Community Hosp Intern Med Perspect 2021; 11:662-666. [PMID: 34567459 PMCID: PMC8462868 DOI: 10.1080/20009666.2021.1951946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diffuse large B cell lymphoma of the sigmoid colon and rectum is relatively uncommon and aggressive. Due to its nonspecific symptomatology, patients are often diagnosed late into the disease and present with life-threatening complications, such as hemorrhage, obstruction, or perforation, requiring emergent surgical intervention. Patients with colorectal lymphoma typically have inflammatory bowel disease or immunosuppression. We present a case of a 79-year-old male with no known inflammatory bowel disease or immunosuppression, who had significant weight loss, diarrhea, and abdominal fullness, found by CT to have irregular wall thickening of the recto-sigmoid colon along with a colo-colonic fistula, concerning for bowel perforation. Endoscopic evaluation and biopsy confirmed the diagnosis of recto-sigmoid Diffuse large B cell lymphoma, with a PET/CT scan revealing stage IV disease. He had a partial response to six cycles of palliative reduced dose R-CHOP and is currently receiving palliative radiation to the sigmoid colon and rectum. Surgery and/or chemoradiation remain the mainstay therapy for this condition. Clinicians, however, must consider patient’s functional, nutritional, and clinical status prior to choosing an optimal therapeutic regimen. This case illustrates a unique clinical presentation of this condition and the associated diagnostic and therapeutic challenges that arise in order to prevent life-threatening complications.
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Affiliation(s)
- Rima Nakrani
- Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | - Ho-Man Yeung
- Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | - Matan Arnon
- Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | - Alexandra Selby
- Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | | | - Bhishak Kamat
- Department of Radiology, Temple University Hospital, Philadelphia, PA, USA
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Takeuchi H, Kamada T, Ohdaira H, Takahashi J, Nakashima K, Nakaseko Y, Yoshida M, Okada S, Yamanouchi E, Suzuki Y. Double percutaneous transesophageal gastrotubing precluded high risk surgery for intestinal malignant lymphoma. Ann Med Surg (Lond) 2021; 64:102198. [PMID: 33747497 PMCID: PMC7966977 DOI: 10.1016/j.amsu.2021.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
Primary gastrointestinal lymphoma is relatively rare and typically treated by chemotherapy. In some cases, surgery for obstruction in the proximal small intestine is challenging and has a high risk for anastomotic leakage. An 80-year-old woman presented to our hospital with vomiting and abdominal distension. Enteroscopy showed a type 2 circumferential tumor in the proximal jejunum 6 cm on the anal side from Treitz ligament. Biopsy showed solid and diffuse proliferation of large atypical cells with round and irregular nuclei. On immunohistochemistry, these cells were positive for CD20, CD79a, and CD138. Diffuse large B-cell lymphoma (DLBCL) was diagnosed and classified as Ann Arbor stage IIE and Lugano classification stage II 2 and scored 1 point on the International Prognostic Index (i.e., low risk). Given the risk of anastomotic leakage due to lesions and residual obstructive enteritis, surgery was not performed. The patient received double percutaneous transesophageal gastrotubing (dPTEG) to facilitate decompression and enteral nutrition. Enteral nutrition and chemotherapy were initiated immediately after dPTEG insertion. After one course of rituximab plus cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R–CHOP), the tumor showed a partial response, and the obstruction was improved. Oral ingestion was started, and the dPTEG tube was removed. After six courses of R–CHOP, enhanced CT, positron emission tomography-CT, and serum interleukin-2 levels indicated complete treatment response. During treatment, gastrointestinal perforation did not occur, oral intake was good, and careful follow-up will be continued. dPTEG for obstructive small intestinal DLBCL could help avoid high-risk surgery, and a complete response to chemotherapy was achieved. ・Surgery for obstruction in the proximal small intestine is challenging and has a high risk for anastomotic leakage. ・Double percutaneous transesophageal gastrotubing is a novel treatment that can achieve both intestinal decompression and enteral nutrition. ・Performing dPTEG for obstructive small intestinal DLBCL precluded the use of high-risk surgery and facilitated a complete response to chemotherapy.
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Key Words
- Bowel obstruction
- CHOP, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone
- DLBCL, diffuse large B-cell lymphoma
- Diffuse large B-Cell lymphoma
- Malignant lymphoma
- PEG, percutaneous endoscopic gastrostomy
- PGINHL, primary gastrointestinal non-Hodgkin's lymphoma
- PTEG, percutaneous trans-esophageal gastro-tubing
- Percutaneous transesophageal gastrotubing
- R–CHOP, rituximab plus cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone
- Small intestine
- dPTEG, double percutaneous transesophageal gastrotubing
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Affiliation(s)
- Hideyuki Takeuchi
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Teppei Kamada
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Hironori Ohdaira
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Junji Takahashi
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Keigo Nakashima
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Yuichi Nakaseko
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Masashi Yoshida
- Department of Surgery, International University of Health and Welfare Hospital, Japan
| | - Shinya Okada
- Department of Pathology, International University of Health and Welfare Hospital, Japan
| | - Eigoro Yamanouchi
- Department of Radiology, International University of Health and Welfare Hospital, Japan
| | - Yutaka Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, Japan
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Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas. Dig Dis Sci 2020; 65:3570-3582. [PMID: 31993894 DOI: 10.1007/s10620-020-06078-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The objective of this study was to construct and authenticate nomograms to project overall survival (OS) and cancer-specific survival (CSS) in primary gastrointestinal non-Hodgkin lymphomas (PGINHL). METHODS Suitable patients were chosen from the Surveillance, Epidemiology and End Results database and Wannan Medical College Yijishan Hospital. The Cox regression model was used to acquire independent predictive factors to develop nomograms for projecting OS and CSS. The performance of the nomograms was validated using the Harrell's concordance index (C-index), calibration curves, and decision curve analysis (DCA) and was compared with that of the AJCC 7th staging system. Survival curves were obtained using the Kaplan-Meier method, while the log-rank test was used to compare the difference among the groups. RESULTS The C-index of the nomograms for OS and CSS was 0.735 (95% CI = 0.719-0.751) and 0.761 (95% CI = 0.739-0.783), respectively, signifying substantial predictive accuracy. These outcomes were reproducible when the nomograms were used for the internal and external validation cohorts. Moreover, assessments of the C-index, AUC, and DCA between the nomogram results and the AJCC 7th staging system showed that the former was better for evaluation and was more clinically useful. CONCLUSIONS We constructed the nomogram which could predict 1-, 3-, and 5-year OS and CSS of patients with PGINHL. Our nomogram showed good performance, suggesting that it can be used as an efficacious instrument for predictive assessment of patients with PGINHL.
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Fernandez Turizo MJ, Kharfan‐Dabaja MA, Alhaj Moustafa M, Ayala E, Jiang L, Parrondo R. Primary diffuse large B-cell lymphoma presenting as acute appendicitis: A report of 2 cases and a literature review. Clin Case Rep 2020; 8:293-298. [PMID: 32128176 PMCID: PMC7044370 DOI: 10.1002/ccr3.2653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 12/19/2022] Open
Abstract
Primary appendiceal lymphomas (PAL) are a type of primary gastrointestinal non-Hodgkin lymphoma (PGINHL) with an incidence of <1%. There is considerable discordance with regard to the optimal management of PGINHL. We describe two cases of PAL, perform a literature review, and discuss the available evidence for optimal treatment.
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Affiliation(s)
| | | | | | - Ernesto Ayala
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFLUSA
| | - Liuyan Jiang
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFLUSA
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Hori Y, Yamamoto H, Nozaki Y, Torisu T, Fujiwara M, Taguchi K, Nishiyama K, Nakamura S, Kitazono T, Oda Y. Colorectal diffuse large B-cell lymphoma: molecular subclassification and prognostic significance of immunoglobulin gene translocation. Hum Pathol 2019; 96:67-78. [PMID: 31734190 DOI: 10.1016/j.humpath.2019.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/24/2022]
Abstract
Primary colorectal diffuse large B-cell lymphoma (DLBCL) is rare, and its clinicopathological and genetic features are poorly understood. The aim of our study was to elucidate the frequency and prognostic significance of molecular subgroups in colorectal DLBCL. We examined 25 cases of colorectal lymphoma with DLBCL-like morphology and classified them into germinal center B-cell like (GCB)/non-GCB subgroups by immunohistochemistry (IHC) for CD10, bcl-6 and MUM1, or into double-expressor (DE)/non-DE subgroups by IHC for bcl-2 and c-myc. Translocations involving BCL2, BCL6, MYC, IGH, IGK, IGL, and MALT1 were also investigated using break-apart fluorescence in situ hybridization (FISH). The 25 cases were classified into two entities-DLBCL, not otherwise specified (NOS) (n = 23; 92%) and high grade B-cell lymphoma, double hit (n = 2; 8%)-according to the recent WHO classification. None of them showed histological evidence of Epstein-Barr virus infection or high-grade transformation from low grade B-cell lymphoma. Ten cases were GCB-type and four cases were DE-type, but these subtypes did not contribute to clinicopathological differences. Translocations involving BCL2, BCL6, MYC, IGH, IGK, IGL, and MALT1 were detected in 3 (12%), 3 (12%), 10 (40%), 14 (56%), 3 (12%), 3 (12%), and 0 (0%) of 25 cases, respectively. Of note, the presence of IGH translocation was significantly associated with better overall survival (P = .0053) and progression free survival (P = .0259). Similarly, the translocation involving at least one of the IGs (IGH, IGK, and/or IGL) was associated with more favorable prognosis in DLBCLs or even in DLBCL, NOS. This is the first report to reveal that a small subset of colorectal DLBCL corresponds to double-hit lymphoma. In addition, translocations involving at least one of the IGs may be a favorable prognostic factor in colorectal DLBCL. Testing the translocation involving rearrangement of IGs as well as MYC and BCL2/BCL6 may thus be useful for diagnosis and prognosis.
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Affiliation(s)
- Yoshifumi Hori
- Department of Anatomic Pathology, Kyushu University, Japan
| | | | - Yui Nozaki
- Department of Anatomic Pathology, Kyushu University, Japan
| | - Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | | | - Kenichi Taguchi
- Department of Pathology, National Kyushu Cancer Center, Fukuoka, Japan
| | | | - Shotaro Nakamura
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Kyushu University, Japan.
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Abstract
BACKGROUND Primary colorectal lymphoma is rare, representing 0.2% to 0.6% of all colorectal cancers. Because of its low incidence and histologic variety, no treatment guidelines exist. OBJECTIVE The purpose was to report the experience of primary colorectal lymphoma in an institutional and a national cohort. DESIGN This was a retrospective cohort study. SETTINGS The study was conducted with institutional data composed of 3 tertiary referral centers and national data. PATIENTS Patients with primary colorectal lymphoma were identified within the Mayo Clinic (1990-2016) and the Surveillance, Epidemiology, and End Results database (1990-2014). MAIN OUTCOME MEASURES Primary outcomes were overall and 5-year survival. RESULTS For the institutional cohort (N = 82), 5-year survival was 79.9%. Five-year survival was higher for rectal (88.4%) than for colon tumors (77.2%; p = 0.004). On multivariable analysis, age <50 years was associated with higher overall survival (p = 0.04). Left-sided colon masses and aggressive histological subtypes were associated with worse survival (0.04 and 0.03). No effect of treatment modality on survival was noted. For the national cohort (N = 2942), 5-year survival was 58.4%. Five-year survival for rectal tumors was 61.0% and 57.8% for colon tumors. On multivariable analysis, factors associated with improved survival were age <70 y, (p < 0.0001), female sex (p = 0.005), right-sided masses (p = 0.02), and diagnoses after 2000 compared with 1990-1999 (p < 0.0001). Aggressive pathology (p < 0.0001) and stage III or stage IV presentation compared with stage I (p = 0.02 and p < 0.0001) were associated with worse survival. LIMITATIONS The institutional cohort was limited by sample size to describe treatment effect on survival. A major limitation of the national cohort was the ability to describe treatment modalities other than surgery, including chemotherapy and/or no additional treatment. CONCLUSIONS Poorer survival was noted in elderly patients and in those with aggressive pathology. An overall survival advantage was seen in women in the national cohort. Currently, optimal strategies should follow a patient-centered multidisciplinary approach. See Video Abstract at http://links.lww.com/DCR/A807. LINFOMA COLORECTAL PRIMARIO EXPERIENCIA INSTITUCIONAL Y REVISIÓN DE UNA BASE DE DATOS NACIONAL: El linfoma colorectal primario es poco frecuente, representando del 0.2% al 0.6% de todos los cánceres colorectales. Debido a su baja incidencia y variedad histológica, no existen guías de tratamiento. OBJETIVO El propósito fue reportar la experiencia en linfoma colorectal primario en una cohorte institucional y una nacional. DISEÑO:: Este fue un estudio de cohorte retrospectivo. ESCENARIO El estudio se realizó con datos institucionales provenientes de 3 centros de referencia terciarios y datos nacionales. PACIENTES Se identificaron pacientes con linfoma colorectal primario en la base de datos de la Clínica Mayo (1990-2016) y en la base de datos de vigilancia, epidemiología y resultados finales [Surveillance, Epidemiology, and End Results database (1990-2014)]. PRINCIPALES MEDIDAS DE RESULTADO Los resultados primarios fueron la sobrevida general y a 5 años. RESULTADOS Para la cohorte institucional (N = 82), la sobrevida a 5 años fue de 79.9%. La sobrevida a cinco años fue mayor en tumores rectales (88.4%) que en los de colon (77.2%; p = 0.004). En el análisis multivariable, la edad <50 años se asoció con una mayor sobrevida general (p = 0,04). Las masas de colon izquierdo y los subtipos histológicos agresivos se asociaron con una peor sobrevida (0.04 y 0.03). No se observó ningún efecto según la modalidad de tratamiento en la sobrevida. Para la cohorte nacional (N = 2942), la sobrevida a 5 años fue del 58.4%. La sobrevida a cinco años fue de 61.0% para los tumores rectales y 57.8% para los tumores de colon. En el análisis multivariable, los factores asociados con una mayor sobrevida fueron edad <70 años, (p <0.0001), sexo femenino (p = 0.005), masas derechas (p = 0.02) y los casos diagnósticados después del año 2000 comparados con los de 1990-1999 (p <0.0001). Histopatología agresiva (p <0.0001) y presentación en estadio III o estadio IV en comparación con estadio I (p = 0.02 y p <0.0001) se asociaron con una peor sobrevida. LIMITACIONES La cohorte institucional estuvo limitada por el tamaño de la muestra para describir el efecto del tratamiento en la sobrevida. Una limitación mayor en la cohorte nacional fue la habilidad para describir modalidades de tratamiento distintas a la cirugía, incluyendo quimioterapia y/o ningún tratamiento adicional. CONCLUSIONES Una menor sobrevida fue documentada en pacientes de edad avanzada y en aquellos con histopatología agresiva. Se observó ventaja en cuanto a sobrevida general en las mujeres de la cohorte nacional. Actualmente, las estrategias óptimas deben de seguir un abordaje multidisciplinario centrado en cada paciente. Vea el abstract en video en http://links.lww.com/DCR/A807.
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Maguire LH, Hawkins AT. Surgical Resection for Primary Rectal Lymphoma: Support for Local Excision? J Surg Res 2019; 244:189-195. [PMID: 31299435 DOI: 10.1016/j.jss.2019.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/11/2019] [Accepted: 06/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Primary rectal lymphoma is an uncommon and heterogeneous malignancy. Because of its rarity, few data exist to guide treatment or counsel patients. We present the largest series to date of patients undergoing nonpalliative surgery for rectal lymphoma. We hypothesize that there will be no difference in overall survival between patients undergoing local resection (LR) or radical resection (RR). MATERIALS AND METHODS The National Cancer Data Base was queried for all cases of resected primary rectal lymphoma between years 2004 and 2014. Exclusion criteria included patients with stage IV disease and those operated on for palliation. Patients were categorized by resection approach-LR or RR. Approach along with demographic, histologic, and hospital-level factors were analyzed with a Cox proportional hazard analysis. RESULTS A total of 233 patients were identified. Mean age was 63 y (interquartile range 53-73), and 57% of the population was female. The most common histologic subtypes were marginal (44%), diffuse large B-cell (20%), and follicular lymphoma (17%). Eighty-seven percent underwent LR. There was no significant difference in R0 resection (LR: 38% versus RR: 58%; P = 0.07), adjuvant chemotherapy (LR: 18% versus RR: 29%; P = 0.22), or adjuvant radiation (LR: 21% versus RR: 16%; P = 0.63) between the groups. Five-year overall survival was 79%, and there was no significant difference in approach (LR: 81% versus RR: 56%, P = 0.06). Multivariable analysis did not identify an association between approach and overall survival. CONCLUSIONS Surgical resection of rectal lymphoma is rare. Our data support consideration of LR when possible, given the lack of convincing survival benefit of radical surgery or R0 resection.
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Affiliation(s)
- Lillias H Maguire
- Division of Colorectal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alexander T Hawkins
- Division of General Surgery, Section of Colon & Rectal Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
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Maguire LH, Geiger TM, Hardiman KM, Regenbogen SE, Hopkins MB, Muldoon RL, Ford MM, Hawkins AT. Surgical management of primary colonic lymphoma: Big data for a rare problem. J Surg Oncol 2019; 120:431-437. [PMID: 31187517 DOI: 10.1002/jso.25582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/11/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Primary colonic lymphoma (PCL) is rare, heterogeneous, and presents a therapeutic challenge for surgeons. Optimal treatment strategies are difficult to standardize, leading to variation in therapy. Our objective was to describe the patient characteristics, short-term outcomes, and five-year survival of patients undergoing nonpalliative surgery for PCL. METHODS We performed a retrospective cohort analysis in the National Cancer Database. Included patients underwent surgery for PCL between 2004 to 2014. Patients with metastases and palliative operations were excluded. Univariate predictors of overall survival were analyzed using multivariable Cox proportional hazard analysis. RESULTS We identified 2153 patients. Median patient age was 68. Diffuse large B-cell lymphoma accounted for 57% of tumors. 30- and 90-Day mortality were high (5.6% and 11.1%, respectively). Thirty-nine percent of patients received adjuvant chemotherapy. For patients surviving 90 days, 5-year survival was 71.8%. Chemotherapy improved survival (surgery+chemo, 75.4% vs surgery, 68.6%; P = .01). Adjuvant chemotherapy was associated with overall survival after controlling for age, comorbidity, and lymphoma subtype (HR 1.27; 95% CI, 1.07-1.51; P = .01). CONCLUSIONS Patients undergoing surgery for PCL have high rates of margin positivity and high short-term mortality. Chemotherapy improves survival, but <50% receive it. These data suggest the opportunity for improvement of care in patients with PCL.
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Affiliation(s)
- Lillias H Maguire
- Division of Colorectal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Timothy M Geiger
- Section of Colon & Rectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Karin M Hardiman
- Division of Colorectal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Scott E Regenbogen
- Division of Colorectal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Michael Benjamin Hopkins
- Section of Colon & Rectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Roberta L Muldoon
- Section of Colon & Rectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Molly M Ford
- Section of Colon & Rectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alexander T Hawkins
- Section of Colon & Rectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Abstract
BACKGROUND Colon and rectal lymphomas are rare and can occur in the context of posttransplant lymphoproliferative disorder. Evidence-based management guidelines are lacking. OBJECTIVE The purpose of this study was to characterize the presentation, diagnosis, and management of colorectal lymphoma and to identify differences within the transplant population. DESIGN This was a retrospective review of patients evaluated for colorectal lymphoma between 2000 and 2017. Patients were identified through clinical note queries. SETTINGS Four hospitals within a single health system were included. PATIENTS Fifty-two patients (64% men; mean age = 64 y; range, 26-91 y) were identified. No patient had <3 months of follow-up. Eight patients (15%) had posttransplant lymphoproliferative disorder. MAIN OUTCOME MEASURES Overall survival, recurrence, and complications in treatment pathway were measured. RESULTS Most common presentations were rectal bleeding (27%), abdominal pain (23%), and diarrhea (23%). The most common location was the cecum (62%). Most frequent histologies were diffuse large B-cell lymphoma (48%) and mantle cell lymphoma (25%). Posttransplant lymphoproliferative disorder occurred in the cecum (n = 4) and rectum (n = 4). Twenty patients (38%) were managed with chemotherapy; 25 patients (48%) underwent primary resection. Mass lesions had a higher risk of urgent surgical resection (35% vs 8%; p = 0.017). Three patients (15%) treated with chemotherapy presented with perforation requiring emergency surgery. Overall survival was 77 months (range, 25-180 mo). Patients with cecal involvement had longer overall survival (96 vs 26 mo; p = 0.038); immunosuppressed patients had shorter survival (16 vs 96 mo; p = 0.006). Survival in patients treated with surgical management versus chemotherapy was similar (67 vs 105 mo; p = 0.62). LIMITATIONS This was a retrospective chart review, with data limited by the contents of the medical chart. This was a small sample size. CONCLUSIONS Colorectal lymphoma is rare, with variable treatment approaches. Patients with noncecal involvement and chronic immunosuppression had worse overall survival. Patients with mass lesions, particularly cecal masses, are at higher risk to require urgent intervention, and primary resection should be considered. See Video Abstract at http://links.lww.com/DCR/A929.
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Cai YB, Chen HY, He JJ, Hu YT, Yang Q, Chen LB, Xiao Q, Ding KF. The role of surgical intervention in primary colorectal lymphoma: A SEER population-based analysis. Oncotarget 2018; 7:72263-72275. [PMID: 27708217 PMCID: PMC5342160 DOI: 10.18632/oncotarget.12344] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 08/08/2016] [Indexed: 12/26/2022] Open
Abstract
Background Primary colorectal lymphoma (PCL) is a rare colorectal malignancy. The standard treatment and prognostic factors of PCL remain unexplored. Therefore, a large population-based study should be conducted to provide a detailed review of this disease. Methods We extracted the data of eligible patients with PCL registered in the SEER database from 1973 to 2011. All statistical analyses were performed using SPSS 19.0. Results A total of 2050 (61.3%) of the 3342 patients with PCL underwent surgical intervention, and 1292 (38.7%) patients received no surgical treatment. The median overall survival was 95 months, and patients receiving surgery exhibited significantly prolonged survival (adjusted HR =0.69, P <0.001). Young age, early tumor stage, and indolent lymphoma were independent predictors of improved survival. Further survival analyses demonstrated the potential benefit of surgery in patients with early tumor stage, right-sided lesions, or diffuse large B-cell PCL. Conversely, surgical intervention did not improve the survival of patients with advanced-stage, left-sided, or indolent PCL. Conclusion PCL is a rare tumor that can be effectively treated. Surgical intervention may play an important role in the treatment of PCL. Early tumor stage, a right-sided lesion, and diffuse large B-cell histological PCL seem to be the clinical characteristics of optimal surgical candidates.
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Affiliation(s)
- Yi-Bo Cai
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hai-Yan Chen
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jin-Jie He
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ye-Ting Hu
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qi Yang
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Liu-Bo Chen
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qian Xiao
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ke-Feng Ding
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Genipin suppresses colorectal cancer cells by inhibiting the Sonic Hedgehog pathway. Oncotarget 2017; 8:101952-101964. [PMID: 29254217 PMCID: PMC5731927 DOI: 10.18632/oncotarget.21882] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/04/2017] [Indexed: 01/12/2023] Open
Abstract
Genipin, a major component of Gardenia jasminoides Ellis fruit, has been shown to inhibit the growth of gastric, prostate, and breast cancers. However, the anti-proliferative activity of genipin in colorectal cancer (CRC) has not been characterized. Herein, we demonstrated that genipin inhibits the proliferation of CRC cells and that genipin suppressed the Hedgehog pathway. Further investigation showed that p53 and NOXA protein levels were increased during inhibition of Hedgehog pathway-mediated apoptosis in CRC cells. We also showed that p53 modulated the expression of NOXA during genipin-induced apoptosis, and suppression via SMO also played a role in this process. Subsequently, GLI1 was ubiquitinated by the E3 ligase PCAF. In a xenograft tumor model, genipin suppressed tumor growth, which was also associated with Hedgehog inactivation. Taken together, these results suggest that genipin induces apoptosis through the Hedgehog signaling pathway by suppressing p53. These findings reveal a novel regulatory mechanism involving Hedgehog/p53/NOXA signaling in the modulation of CRC cell apoptosis and tumor-forming defects.
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Yoon DH, Sohn BS, Oh SY, Lee WS, Lee SM, Yang DH, Huh J, Suh C. Feasibility of abbreviated cycles of immunochemotherapy for completely resected limited-stage CD20+ diffuse large B-cell lymphoma (CISL 12-09). Oncotarget 2017; 8:13367-13374. [PMID: 28076329 PMCID: PMC5355104 DOI: 10.18632/oncotarget.14531] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/28/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The appropriate number of chemotherapy cycles for limited stage diffuse large B-cell lymphoma (DLBCL) patients without gross residual lesions after complete resection, has not been specifically questioned. We performed a multicenter, single-arm, phase 2 study to investigate the feasibility of 3 cycles of abbreviated R-CHOP chemotherapy in low-risk patients with completely resected localized CD20+ DLBCL. RESULTS Between December 2010 and May 2013, we recruited 23 patients. One was excluded due to ineligibility, and hence, 22 were included in the final analysis. The primary sites comprised the intestine (n = 15), cervical lymph nodes (n = 4), stomach (n = 1), tonsil (n = 1), and spleen (n = 1). All patients successfully completed the 3 cycles of planned R-CHOP chemotherapy. Over a median follow-up of 39.5 months (95% confidence interval, 29.9-47.1 months), both the estimated 2-year disease-free survival and overall survival rates was 95% confidence interval, 85.9-104.1%. Only one patient with an international prognostic index of 2 experienced relapse and died. The most common grade 3 or 4 toxicity condition included neutropenia (n = 8, 36.4%). Three patients experienced grade 3 febrile neutropenia, but no grade 3 or 4 non-hematologic toxicity was observed. MATERIALS AND METHODS DLBCL patients without residual lesions after resection were enrolled and R-CHOP chemotherapy was repeated at 3-week-intervals over 3 cycles. The primary endpoint was 2-year disease-free survival. CONCLUSIONS Three cycles of abbreviated R-CHOP immunochemotherapy is feasible for completely resected low risk localized DLBCL.
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Affiliation(s)
- Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byeong Seok Sohn
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Won-Sik Lee
- Department of Hemato-Oncology, Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Min Lee
- Department of Hemato-Oncology, Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jeong JH, Kim S, Kim JE, Yoon DH, Lee SW, Huh J, Suh C. Clinical characteristics, treatment, and outcome of primary rectal lymphoma: a single center experience of 16 patients. Blood Res 2017; 52:125-129. [PMID: 28698849 PMCID: PMC5503890 DOI: 10.5045/br.2017.52.2.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/09/2017] [Accepted: 04/18/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort. METHODS We retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014. RESULTS These 16 patients with PRL constituted 0.8% of all non-Hodgkin's lymphoma patients (N=1,984). B-cell lymphomas (N=14) made up the majority of the series, and half of these were extranodal marginal zone lymphomas (ENMZL, N=7). Ten patients received systemic chemotherapy with (N=3) or without rituximab (N=7), and 4 of these received additional local therapy. The others received radiotherapy (N=3) or endoscopic mucosal resection (N=3). Twelve patients (75%) achieved complete response (CR) after first-line treatment. Event-free survival (EFS) and overall survival (OS) in stages IE and IIE were significantly longer compared with stages IVE (P=0.001 and P=0.001, respectively). All patients with ENMZL (N=7) achieved CR during or after initial treatment. CONCLUSION PRL is very rare and seems to present mostly as B-cell type. Stage is the most important prognostic factor, with significantly better survival associated with localized diseases. ENMZL may be one of the most common types of PRL with favorable treatment outcomes.
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Affiliation(s)
- Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Shin Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Ayub A, Santana-Rodríguez N, Raad W, Bhora FY. Primary appendiceal lymphoma: clinical characteristics and outcomes of 116 patients. J Surg Res 2017; 207:174-180. [DOI: 10.1016/j.jss.2016.08.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/10/2016] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
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Management of Primary Gastrointestinal Non-Hodgkin Lymphomas: a Population-Based Survival Analysis. J Gastrointest Surg 2016; 20:1141-9. [PMID: 26992397 DOI: 10.1007/s11605-016-3129-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/08/2016] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Primary gastrointestinal non-Hodgkin lymphomas (PGINHL) are a heterogeneous group of rare GI malignancies with limited data to guide management. This study describes management of PGINHL in a population-based registry and aims to determine the association between receipt of surgery and long-term survival. METHODS All adults diagnosed with PGINHL over 27 years in the Surveillance, Epidemiology, and End Results were identified (excluding mucosa-associated lymphoid tissue lymphomas). Demographic and clinical characteristics were assessed. Survival was compared using the log-rank method. Cox hazard modeling was used to determine independent prognostic factors. RESULTS We identified 16,129 patients. The majority were of gastric origin and had diffuse large B cell histology. Surgery was performed in 46.9 % of patients, not recommended in 41.8 % and recommended but not performed in 10.1 %. Overall 1-year and 5-year survival rates were 65.6 and 35.6 %, respectively. Patients undergoing surgery had a 5-year survival of 43.6 % compared to 34.8 % for whom surgery was recommended but not performed (p < .0001), (receipt of chemotherapy not available). Female gender, gastric location, follicular or mantle cell histology, and radiation therapy were associated with improved survival. CONCLUSIONS Nearly 50 % of PGINHL patients underwent surgery. Surgery was not associated with improved survival. More prospective, case-matched studies are needed to guide management.
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Lightner AL, Shannon E, Gibbons MM, Russell MM. Primary Gastrointestinal Non-Hodgkin's Lymphoma of the Small and Large Intestines: a Systematic Review. J Gastrointest Surg 2016; 20:827-39. [PMID: 26676930 DOI: 10.1007/s11605-015-3052-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/30/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Primary gastrointestinal non-Hodgkin's lymphoma (PGINHL) of small and large intestines is a group of heterogeneous, rare malignancies. Optimal treatment practices remain undefined. METHODS A systematic review (2003-2015) was performed to assess tumor characteristics, treatment practices, and treatment outcomes of PGINHL of small and large intestines. RESULTS Twenty-eight studies (1658 patients) were included; five focused on follicular lymphoma subtype. Of the non-follicular patients, 59.3% presented with abdominal pain, 37.2% were located in ileocecum, and 53.6% were diffuse large B cell lymphoma subtype. The majority of patients (60.7%) were treated with a combination of surgery and chemotherapy. Forty-three percent of studies concluded an overall survival benefit with surgery; none reported increased postoperative morbidity or mortality. Survival outcomes were not typically stratified by emergent versus elective surgery. Multivariate analysis within individual studies associated B cell lymphoma and ileocecum location with higher survival, while advanced stage and B symptoms were associated with poorer survival. Patients with asymptomatic follicular lymphoma had no progression with a watchful waiting approach. CONCLUSIONS The majority of patients with non-follicular small and large intestinal PGINHLs are treated with both chemotherapy and surgery. Although surgery appears to be an important part of the treatment algorithm, definitive statements regarding its survival benefit remain limited due to lack of patient stratification based on timing and indication for surgery.
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Affiliation(s)
- Amy L Lightner
- Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, 200 1st St. SW Rochester, MN 55905, Los Angeles, CA, USA.
| | - Evan Shannon
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Melinda Maggard Gibbons
- Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, 200 1st St. SW Rochester, MN 55905, Los Angeles, CA, USA
| | - Marcia M Russell
- Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, 200 1st St. SW Rochester, MN 55905, Los Angeles, CA, USA.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Desmas I, Burton JH, Post G, Kristal O, Gauthier M, Borrego JF, Di Bella A, Lara-Garcia A. Clinical presentation, treatment and outcome in 31 dogs with presumed primary colorectal lymphoma (2001-2013). Vet Comp Oncol 2016; 15:504-517. [DOI: 10.1111/vco.12194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 09/28/2015] [Accepted: 10/13/2015] [Indexed: 12/16/2022]
Affiliation(s)
- I. Desmas
- Royal veterinary College; Hatfield UK
| | - J. H. Burton
- Flint Animal Cancer Center; Department of Clinical Sciences, Colorado State University; Fort Collins CO USA
| | - G. Post
- The Veterinary Cancer Center; Norwalk CT USA
| | - O. Kristal
- Chavat Daat Veterinary Speciality Center; Beit Berl Israel
| | - M. Gauthier
- Mississauga Oakville Veterinary Emergency Hospital and Referral Services; Oakville ON Canada
| | - J. F. Borrego
- School of Veterinary Medicine; University of Madison-Wisconsin; Madison WI USA
| | - A. Di Bella
- Vets Now Referrals; Medicine Service; Glasgow UK
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Chen Y, Chen Y, Chen S, Wu L, Xu L, Lian G, Yang K, Li Y, Zeng L, Huang K. Primary Gastrointestinal Lymphoma: A Retrospective Multicenter Clinical Study of 415 Cases in Chinese Province of Guangdong and a Systematic Review Containing 5075 Chinese Patients. Medicine (Baltimore) 2015; 94:e2119. [PMID: 26632732 PMCID: PMC5059001 DOI: 10.1097/md.0000000000002119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/10/2015] [Accepted: 10/27/2015] [Indexed: 12/27/2022] Open
Abstract
Primary gastrointestinal lymphoma (PGIL) is a rare malignant tumor without standard diagnosis and treatment methods. This study is aimed to systematically analyze its clinical characteristics and draw out an appropriate flow chart of diagnosis and treatment process for PGIL in China.This study retrospectively analyzed the clinicopathological characteristics, diagnostic approaches, prognostic factors, and therapeutic modalities in 415 cases of PGIL in Chinese province of Guangdong. A systematic review was conducted in 118 studies containing 5075 patients to further identify clinical manifestations and mortalities of therapeutic modalities.The most common clinical presentations were abdominal pain and bloody stools. Endoscopic biopsy was an important diagnostic means, and usually more than once to make a definite diagnosis. Retrospective multicenter clinical study showed that younger onset age (<60 years), female, one region involved, one lesion, early stage, International Prognostic Index (IPI ≤1), normal lactate dehydrogenase (LDH), normal albumin, and nonemergency operation were significant prognostic factors for B-cell lymphoma; non-B symptom, tumor restricted to gastric or ileocecal region, one lesion, performance status (PS ≤1), normal LDH, and nonsurgery alone were significant prognostic factors for T-cell lymphoma. Site of origin and IPI were independent prognostic factors for B-cell lymphoma; PS was the independent prognostic factor for T-cell lymphoma. And T-cell lymphoma had worse overall survival (OS) and progression-free survival (PFS) than B-cell lymphoma. Among different therapeutic modalities, chemotherapy alone or combined with surgery showed better OS and PFS than surgery alone for diffuse large B-cell lymphoma (DLBCL) of stage I/II E and T-cell lymphoma. For DLBCL of stage III E/IV and mucosa-associated lymphoid tissue lymphoma, OS and PFS did not differ among different therapeutic groups. In meta-analysis, surgery plus chemotherapy showed lowest mortality.Chemotherapy alone or combined with surgery may be the first-line treatment for DLBCL of stage I/II E and T-cell lymphoma. A flow chart of diagnosis and treatment process for PGIL was approximately drew out.
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Affiliation(s)
- Yinting Chen
- From the Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation (YiC, SC, GL, KY, YL, KH); Department of Gastroenterology (YiC, SC, GL, KY, YL, KH), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Intensive Care Unit of Internal Medicine (YaC), The First Affiliated Hospital of Sun Yat-Sen University; Department of Ultrasound (LW), The Third Affiliated Hospital of Sun Yat-Sen University; Department of Gastroenterology (LX), Guangdong General Hospital, Guangzhou; and Department of Oncology (LZ), The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
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MacQueen IT, Shannon EM, Dawes AJ, Ostrzega N, Russell MM, Maggard-Gibbons M. The Role of Surgery in the Clinical Management of Primary Gastrointestinal Non-Hodgkin's Lymphoma. Am Surg 2015. [DOI: 10.1177/000313481508101016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Primary gastrointestinal non-Hodgkin's lymphoma (PGINHL) is a heterogeneous family of tumors, with treatment modalities including chemotherapy, surgery, and radiotherapy. Because the role of surgery in PGINHL remains disputed, this study aims to assess the impact of operative resection on survival. We used a pathology database to identify all cases of PGINHL diagnosed at a single academic-affiliated medical center from 1988 to 2013. Demographic and clinical data were abstracted from the medical record. We summarized the clinical courses of patients with PGINHL and then performed a survival analysis to compare overall and disease-free survival, stratified by demographic and clinical variables. We identified 33 patients diagnosed with PGINHL during the study period. Of 29 who subsequently received treatment at the institution, 15 initially underwent chemotherapy, 10 underwent surgical resection, and 4 underwent surgery for other reasons such as diagnosis without resection or management of disease complications. Three patients suffered surgical complications and two of these patients died. We found no difference in overall survival between patients receiving surgical resection and patients managed initially with chemotherapy. This case series supports a continued role for surgical resection in the management of patients with PGINHL, though anticipated benefits should be weighed against the risk of complications.
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Affiliation(s)
- Ian T. MacQueen
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Evan M. Shannon
- University of California San Francisco, San Francisco, California
| | - Aaron J. Dawes
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, California
- VA/Robert Wood Johnson Foundation Clinical Scholars Program, Los Angeles, California
| | - Nora Ostrzega
- Department of Pathology, Olive View-UCLA Medical Center, Sylmar, California; and
| | - Marcia M. Russell
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Melinda Maggard-Gibbons
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Surgery, Olive View-UCLA Medical Center, Sylmar, California
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Kim BR, Oh SC, Lee DH, Kim JL, Lee SY, Kang MH, Lee SI, Kang S, Joung SY, Min BW. BMP-2 induces motility and invasiveness by promoting colon cancer stemness through STAT3 activation. Tumour Biol 2015; 36:9475-86. [PMID: 26124007 DOI: 10.1007/s13277-015-3681-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/16/2015] [Indexed: 12/11/2022] Open
Abstract
Bone morphogenetic proteins (BMPs) have been involved in metastatic progression and tumorigenesis of many cancer types. However, it remains unclear how BMP-2 contributes to the initiation and development of these cancers. Here, we investigated the role of BMP-2 in colon cancer stem cell (CSC) development from colon cancer cells. We also determined the effects of BMP-2 on CSC development and epithelial-mesenchymal transition (EMT) in human colon cancer cell lines HCT-116 and SW620. We found that BMP-2 enhanced sphere formation of colon cancer cells without serum. Also, BMP-2-induced spheres displayed up-regulation of stemness markers (CD133+ and EpCAM+) and increased drug resistance, hallmarks of CSCs. Importantly, expression of EMT activators p-Smad1/5 and Snail and N-cadherin was increased in the spheres' cells, indicating that BMP-2 signaling might result in CSC self-renewal and EMT. Furthermore, siRNA-mediated knockdown of signal transducer and activator of transcription 3 (STAT3) in HCT-116 cells reversed BMP-2-induced EMT and stem cell formation. Taken together, our results suggest that the BMP-2 induced STAT3-mediated induction of colon cancer cell metastasis requires an EMT and/or changes in CSC markers.
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Affiliation(s)
- Bo Ram Kim
- Graduate School of Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sang Cheul Oh
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dae-Hee Lee
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung Lim Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Suk Young Lee
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Myoung Hee Kang
- University of Ulsan College of Medicine, Asan Institute for Life Science, Seoul, Republic of Korea
| | - Sun Il Lee
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-gil, Guro-gu, Seoul, 152-703, Republic of Korea
| | - Sanghee Kang
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-gil, Guro-gu, Seoul, 152-703, Republic of Korea
| | - Sung Yup Joung
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-gil, Guro-gu, Seoul, 152-703, Republic of Korea
| | - Byung Wook Min
- Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-gil, Guro-gu, Seoul, 152-703, Republic of Korea.
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Lu CS, Chen JH, Huang TC, Wu YY, Chang PY, Dai MS, Chen YC, Ho CL. Diffuse large B-cell lymphoma: sites of extranodal involvement are a stronger prognostic indicator than number of extranodal sites in the rituximab era. Leuk Lymphoma 2015; 56:2047-55. [PMID: 25382616 DOI: 10.3109/10428194.2014.982636] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) is an enhanced prognostic tool that has identified some specific extranodal sites as a poor prognostic factor. We retrospectively analyzed 148 Taiwanese patients with newly diagnosed diffuse large B-cell lymphoma receiving rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like regimens from January 2001 to December 2010 at the Tri-Service General Hospital. In univarate analysis, ≥ 2 extranodal involved sites had no significant prognostic relevance (p = 0.108), although extranodal involvement of the lung/pleura, liver, lower urinary tract or bone marrow was a statistically significant poor prognostic factor (p < 0.001). In multivariate analysis, specific extranodal sites had a stronger predictive value for poor prognosis (relative risk 3.654, 95% confidence interval 1.514-8.815, p = 0.004) compared with the number of extranodal sites involved. This finding suggests that specific extranodal involved sites have prognostic value in the R era.
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Affiliation(s)
- Chieh-Sheng Lu
- Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan
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Gigli S, Buonocore V, Barchetti F, Glorioso M, Di Brino M, Guerrisi P, Buonocore C, Giovagnorio F, Giraldi G. Primary colonic lymphoma: An incidental finding in a patient with a gallstone attack. World J Clin Cases 2014; 2:146-150. [PMID: 24868515 PMCID: PMC4023309 DOI: 10.12998/wjcc.v2.i5.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 01/15/2014] [Accepted: 04/11/2014] [Indexed: 02/05/2023] Open
Abstract
We report a case of primary colonic lymphoma incidentally diagnosed in a patient presenting a gallbladder attack making particular attention on the diagnostic findings at ultrasound (US) and total body computed tomography (CT) exams that allowed us to make the correct final diagnosis. A 85-year-old Caucasian male patient was referred to our department due to acute pain at the upper right quadrant, spreaded to the right shoulder blade. Patient had nausea and mild fever and Murphy’s maneuver was positive. At physical examination a large bulky mass was found in the right flank. Patient underwent to US exam that detected a big stone in the lumen of the gallbladder and in correspondence of the palpable mass, an extended concentric thickening of the colic wall. CT scan was performed and confirmed a widespread and concentric thickening of the wall of the ascending colon and cecum. In addition, revealed signs of microperforation of the colic wall. Numerous large lymphadenopathies were found in the abdominal, pelvic and thoracic cavity and there was a condition of splenomegaly, with some ischemic outcomes in the context of the spleen. No metastasis in the parenchimatous organs were found. These imaging findings suggest us the diagnosis of lymphoma. Patient underwent to surgery, and right hemicolectomy and cholecystectomy was performed. Histological examination confirmed our diagnosis, revealing a diffuse large B-cell lymphoma. The patient underwent to Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone chemotherapy showing only a partial regression of the lymphadenopathies, being in advanced stage at the time of diagnosis.
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Huang K, Yuan R, Wang K, Hu J, Huang Z, Yan C, Shen W, Shao J. Overexpression of HOXB9 promotes metastasis and indicates poor prognosis in colon cancer. Chin J Cancer Res 2014; 26:72-80. [PMID: 24653628 DOI: 10.3978/j.issn.1000-9604.2014.01.11] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/26/2014] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Homeobox B9 (HOXB9) is proposed to be involved in tumor angiogenesis and metastasis. We investigated the role of HOXB9 in the progression of colon cancer. METHODS HOXB9 expression was investigated by immunohistochemically and Western blotting in 128 colon cancer patients and the results were analyzed statistically associated with clinicopathological data and survival of the patients. The effect of HOXB9 on cell invasion and metastases abilities were analyzed in vitro and in vivo. RESULTS HOXB9 is overexpressed in colon cancer tissues and significantly correlated with metastasis and poor survival of patients (P<0.05, respectively). Additionally, high levels of expression of HOXB9 were observed in metastatic lymph nodes. The down-regulation of HOXB9 expression can inhibit the migration and invasive ability of colon cancer cells, while exogenous expression of HOXB9 in colon cancer cells enhanced cell migration and invasiveness. Moreover, stable knockdown of HOXB9 reduced the liver and lung metastasis of colon cancer in vivo. CONCLUSIONS HOXB9 may play an important role in the invasion and metastasis of colon cancer cells and may be a useful biomarker for metastasis and prognostic of colon cancer.
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Affiliation(s)
- Kai Huang
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Rongfa Yuan
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Kai Wang
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Junwen Hu
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Zixi Huang
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Chen Yan
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Wei Shen
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
| | - Jianghua Shao
- 1 Department of General Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 2 Department of Gastrointestinal Surgery, Jiangxi Provincial Cancer Hospital, Nanchang 330029, China ; 3 Jiangxi Province Key Laboratory of Molecular Medicine, Nanchang 330006, China
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29
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Chang SC. Clinical features and management of primary colonic lymphoma. FORMOSAN JOURNAL OF SURGERY 2012. [DOI: 10.1016/j.fjs.2012.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Liu Y, Zhang F, Zhang XF, Qi LS, Yang L, Guo H, Zhang N. Expression of nucleophosmin/NPM1 correlates with migration and invasiveness of colon cancer cells. J Biomed Sci 2012; 19:53. [PMID: 22631075 PMCID: PMC3404909 DOI: 10.1186/1423-0127-19-53] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 05/25/2012] [Indexed: 12/23/2022] Open
Abstract
Background We aimed to examine the expression level of Nucleophosmin (NPM1) protein in colon cancer tissues and to investigate the potential role of NPM1 in the regulation of cell migration and invasiveness. Methods Immunohistochemical assay was performed to examine the expression pattern of NPM1 in 31 groups of colonic carcinoma samples, including colon tumors, adjacent normal tissues, and matched metastatic lymph nodes from the same patients. Small interfering RNA technique and exogenous expression of wild type NPM1 methods were used to further verify the function of NPM1. Results High-expression of NPM1 correlates with lymph node metastasis (P = 0.0003) and poor survival rate of human colon cancer patients (P = 0.017). SiRNA-mediated reduction of NPM1 was also shown to inhibit the migration and invasiveness of metastatic colon cancer HCT116 cell line. In addition, the exogenous expression of NPM1 in HT29 cells, a NPM1 low expression and low invasive colon cancer cell line, enhanced cell migration and invasiveness along with increased cell proliferation. Conclusions The current study uncovered the critical role of NPM1 in the regulation of colon cancer cells migration and invasion, and NPM1 may serve as a potential marker for the prognosis of colon cancer patients.
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Affiliation(s)
- Yan Liu
- Tianjin Medical University, Cancer Institute and Hospital, Research Center of Basic Medical Sciences, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin 300060, China
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Konstantinidis IT, Probstfeld MR. Lymphoma presenting as a necrotic colonic mass. World J Gastrointest Surg 2012; 4:102-3. [PMID: 22590664 PMCID: PMC3351491 DOI: 10.4240/wjgs.v4.i4.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 11/27/2011] [Accepted: 12/10/2011] [Indexed: 02/06/2023] Open
Abstract
Primary colonic lymphomas represent a rare minority among the colonic neoplasms. Their correct pre-operative identification is crucial for the design of treatment. We herein describe a case of a colonic lymphoma presenting as a necrotic colonic mass and we discuss the current evidence about the presentation, diagnosis and treatment of lymphomas isolated to the colon.
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Affiliation(s)
- Ioannis T Konstantinidis
- Ioannis T Konstantinidis, Department of Surgery, The University of Arizona College of Medicine, Tucson, AZ 85724-5058, United States
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Huang XM, Gao Q. Clinicopathological features and treatment of primary small intestinal lymphoma: recent advances. Shijie Huaren Xiaohua Zazhi 2011; 19:2947-2952. [DOI: 10.11569/wcjd.v19.i28.2947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Primary small intestinal lymphoma (PSIL) is an extra-nodal lymphoma whose clinical and histological presentations are usually heterogeneous depending on the site of the lesion. Proper staging criteria are important for clinicopathological diagnosis. Although there is no consensus regarding the role of surgery and chemotherapy in the treatment of PSIL, surgery followed by chemotherapy and radiotherapy is still the main treatment. This review summarizes the clinicopathological features, diagnosis, therapy and prognosis of PSIL.
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