1
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Song J, Yan XX, Zhang FL, Lei YY, Ke ZY, Li F, Zhang K, He YQ, Li W, Li C, Pan YM. Unveiling the secrets of gastrointestinal mucous adenocarcinoma survival after surgery with artificial intelligence: A population-based study. World J Gastrointest Oncol 2024; 16:2404-2418. [DOI: 10.4251/wjgo.v16.i6.2404] [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] [Received: 12/29/2023] [Revised: 02/27/2024] [Accepted: 04/03/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Research on gastrointestinal mucosal adenocarcinoma (GMA) is limited and controversial, and there is no reference tool for predicting postoperative survival.
AIM To investigate the prognosis of GMA and develop predictive model.
METHODS From the Surveillance, Epidemiology, and End Results database, we collected clinical information on patients with GMA. After random sampling, the patients were divided into the discovery (70% of the total, for model training), validation (20%, for model evaluation), and completely blind test cohorts (10%, for further model evaluation). The main assessment metric was the area under the receiver operating characteristic curve (AUC). All collected clinical features were used for Cox proportional hazard regression analysis to determine factors influencing GMA’s prognosis.
RESULTS This model had an AUC of 0.7433 [95% confidence intervals (95%CI): 0.7424-0.7442] in the discovery cohort, 0.7244 (GMA: 0.7234-0.7254) in the validation cohort, and 0.7388 (95%CI: 0.7378-0.7398) in the test cohort. We packaged it into Windows software for doctors’ use and uploaded it. Mucinous gastric adenocarcinoma had the worst prognosis, and these were protective factors of GMA: Regional nodes examined [hazard ratio (HR): 0.98, 95%CI: 0.97-0.98, P < 0.001)] and chemotherapy (HR: 0.62, 95%CI: 0.58-0.66, P < 0.001).
CONCLUSION The deep learning-based tool developed can accurately predict the overall survival of patients with GMA postoperatively. Combining surgery, chemotherapy, and adequate lymph node dissection during surgery can improve patient outcomes.
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Affiliation(s)
- Jie Song
- Department of Gastroenterology, Dongying People’s Hospital, Dongying Hospital of Shandong Provincial Hospital Group, Dongying 257000, Shandong Province, China
| | - Xiang-Xiu Yan
- Department of Gastroenterology, Dongying People’s Hospital, Dongying Hospital of Shandong Provincial Hospital Group, Dongying 257000, Shandong Province, China
| | - Fang-Liang Zhang
- Gastrointestinal Surgery Department, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Yong-Yi Lei
- Obstetrical Department, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Zi-Yin Ke
- School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Fang Li
- Department of Pathology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
| | - Kai Zhang
- General Department, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Yu-Qi He
- Department of Gastroenterology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Wei Li
- Department of Thoracic Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
| | - Chao Li
- Department of Gastroenterology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
| | - Yuan-Ming Pan
- Cancer Research Center, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
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2
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Song J, Yan XX, Zhang FL, Lei YY, Ke ZY, Li F, Zhang K, He YQ, Li W, Li C, Pan YM. Unveiling the secrets of gastrointestinal mucous adenocarcinoma survival after surgery with artificial intelligence: A population-based study. World J Gastrointest Oncol 2024; 16:2392-2406. [DOI: 10.4251/wjgo.v16.i6.2392] [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] [Received: 12/29/2023] [Revised: 02/27/2024] [Accepted: 04/03/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Research on gastrointestinal mucosal adenocarcinoma (GMA) is limited and controversial, and there is no reference tool for predicting postoperative survival.
AIM To investigate the prognosis of GMA and develop predictive model.
METHODS From the Surveillance, Epidemiology, and End Results database, we collected clinical information on patients with GMA. After random sampling, the patients were divided into the discovery (70% of the total, for model training), validation (20%, for model evaluation), and completely blind test cohorts (10%, for further model evaluation). The main assessment metric was the area under the receiver operating characteristic curve (AUC). All collected clinical features were used for Cox proportional hazard regression analysis to determine factors influencing GMA’s prognosis.
RESULTS This model had an AUC of 0.7433 [95% confidence intervals (95%CI): 0.7424-0.7442] in the discovery cohort, 0.7244 (GMA: 0.7234-0.7254) in the validation cohort, and 0.7388 (95%CI: 0.7378-0.7398) in the test cohort. We packaged it into Windows software for doctors’ use and uploaded it. Mucinous gastric adenocarcinoma had the worst prognosis, and these were protective factors of GMA: Regional nodes examined [hazard ratio (HR): 0.98, 95%CI: 0.97-0.98, P < 0.001)] and chemotherapy (HR: 0.62, 95%CI: 0.58-0.66, P < 0.001).
CONCLUSION The deep learning-based tool developed can accurately predict the overall survival of patients with GMA postoperatively. Combining surgery, chemotherapy, and adequate lymph node dissection during surgery can improve patient outcomes.
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Affiliation(s)
- Jie Song
- Department of Gastroenterology, Dongying People’s Hospital, Dongying Hospital of Shandong Provincial Hospital Group, Dongying 257000, Shandong Province, China
| | - Xiang-Xiu Yan
- Department of Gastroenterology, Dongying People’s Hospital, Dongying Hospital of Shandong Provincial Hospital Group, Dongying 257000, Shandong Province, China
| | - Fang-Liang Zhang
- Gastrointestinal Surgery Department, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Yong-Yi Lei
- Obstetrical Department, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Zi-Yin Ke
- School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Fang Li
- Department of Pathology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
| | - Kai Zhang
- General Department, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Yu-Qi He
- Department of Gastroenterology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Wei Li
- Department of Thoracic Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
| | - Chao Li
- Department of Gastroenterology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
| | - Yuan-Ming Pan
- Cancer Research Center, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
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Liu Y, Feng Z, Wei X, Yao P, Liu X, Jia Y, Zhang S, Yan W. Lymph node and bone metastasis of pulmonary intestinal adenocarcinoma: A case report. Oncol Lett 2023; 26:488. [PMID: 37818133 PMCID: PMC10561161 DOI: 10.3892/ol.2023.14075] [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: 06/21/2023] [Accepted: 09/13/2023] [Indexed: 10/12/2023] Open
Abstract
Pulmonary enteric adenocarcinoma (PEAC) is a rare pathological type of lung adenocarcinoma, accounting for ~0.6% of primary lung adenocarcinoma, which has similar morphological and immunohistochemical characteristics to colorectal adenocarcinoma. Making a certain differential diagnosis of PEAC based on morphological and immunohistochemical results is difficult. It is known that PEAC may metastasize to the pancreas, skin, soleus muscle and intestine, but no bone metastasis has been reported. At our department, a rare case of PEAC with bone and lymph node metastasis was previously diagnosed. The present case study reports on a 58-year-old male patient encountered at our hospital with pain in the lumbar, back and right iliac with no obvious cause. Chest CT indicated a space-occupying lesion in the left upper lung lobe, enlarged lymph nodes in the mediastinum and left lung, and partial vertebral bone destruction. Enhanced CT results indicated multiple foci of active bone metabolism in the body, while rectal colonoscopy showed no obvious abnormalities. Histopathological and immunohistochemical results after right iliac bone puncture suggested stage IV PEAC with secondary malignancies in bones, mediastinal lymph node, hilar lymph node and left supraclavicular lymph node.
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Affiliation(s)
- Yanbin Liu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Zeyao Feng
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xinyu Wei
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Peizhuo Yao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xuanyu Liu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Yiwei Jia
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Shuqun Zhang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Wanjun Yan
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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4
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Wang Y, Liu L, Yu Y. Mucins and mucinous ovarian carcinoma: Development, differential diagnosis, and treatment. Heliyon 2023; 9:e19221. [PMID: 37664708 PMCID: PMC10468386 DOI: 10.1016/j.heliyon.2023.e19221] [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: 07/19/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Mucinous ovarian carcinoma (MOC) is a rare histological type of epithelial ovarian cancer. It has poor response to conventional platinum-based chemotherapy regimens and PARPi-based maintenance treatment, resulting in short survival and poor prognosis in advanced-disease patients. MOC is characterized by mucus that is mainly composed of mucin in the cystic cavity. Our review discusses in detail the role of mucins in MOC. Mucins are correlated with MOC development. Furthermore, they are valuable in the differential diagnosis of primary and secondary ovarian mucinous tumors. Some types of mucins have been studied in the context of chemoresistance and targeted therapy for ovarian cancer. This review may provide a new direction for the diagnosis and treatment of advanced MOC.
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Affiliation(s)
- Yicong Wang
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
| | - Lifeng Liu
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
| | - Yongai Yu
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
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Iman H, Benjamin A, Peyton K, Habbit NL, Ahmed B, Heslin MJ, Mobley JA, Greene MW, Lipke EA. Engineered colorectal cancer tissue recapitulates key attributes of a patient-derived xenograft tumor line. Biofabrication 2022; 14:10.1088/1758-5090/ac73b6. [PMID: 35617932 PMCID: PMC9822569 DOI: 10.1088/1758-5090/ac73b6] [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: 12/10/2021] [Accepted: 05/26/2022] [Indexed: 01/11/2023]
Abstract
The development of physiologically relevantin vitrocolorectal cancer (CRC) models is vital for advancing understanding of tumor biology. Although CRC patient-derived xenografts (PDXs) recapitulate key patient tumor characteristics and demonstrate high concordance with clinical outcomes, the use of thisin vivomodel is costly and low-throughput. Here we report the establishment and in-depth characterization of anin vitrotissue-engineered CRC model using PDX cells. To form the 3D engineered CRC-PDX (3D-eCRC-PDX) tissues, CRC PDX tumors were expandedin vivo, dissociated, and the isolated cells encapsulated within PEG-fibrinogen hydrogels. Following PEG-fibrinogen encapsulation, cells remain viable and proliferate within 3D-eCRC-PDX tissues. Tumor cell subpopulations, including human cancer and mouse stromal cells, are maintained in long-term culture (29 days); cellular subpopulations increase ratiometrically over time. The 3D-eCRC-PDX tissues mimic the mechanical stiffness of originating tumors. Extracellular matrix protein production by cells in the 3D-eCRC-PDX tissues resulted in approximately 57% of proteins observed in the CRC-PDX tumors also being present in the 3D-eCRC-PDX tissues on day 22. Furthermore, we show congruence in enriched gene ontology molecular functions and Hallmark gene sets in 3D-eCRC-PDX tissues and CRC-PDX tumors compared to normal colon tissue, while prognostic Kaplan-Meier plots for overall and relapse free survival did not reveal significant differences between CRC-PDX tumors and 3D-eCRC-PDX tissues. Our results demonstrate high batch-to-batch consistency and strong correlation between ourin vitrotissue-engineered PDX-CRC model and the originatingin vivoPDX tumors, providing a foundation for future studies of disease progression and tumorigenic mechanisms.
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Affiliation(s)
- Hassani Iman
- Department of Chemical Engineering, Auburn University, Auburn, AL 36849, USA
| | - Anbiah Benjamin
- Department of Chemical Engineering, Auburn University, Auburn, AL 36849, USA
| | - Kuhlers Peyton
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA
| | - Nicole L. Habbit
- Department of Chemical Engineering, Auburn University, Auburn, AL 36849, USA
| | - Bulbul Ahmed
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA
| | - Martin J. Heslin
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - James A. Mobley
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205-3703, USA,Division of Molecular and Translational Biomedicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205-3703, USA
| | - Michael W. Greene
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA,Co-corresponding authors Elizabeth A. Lipke, , Michael W. Greene,
| | - Elizabeth A. Lipke
- Department of Chemical Engineering, Auburn University, Auburn, AL 36849, USA,Co-corresponding authors Elizabeth A. Lipke, , Michael W. Greene,
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6
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Yun BS, Won S, Kim JH, Lee N, Kim M, Kim MK, Kim ML, Jung YW, Kim JY, Seong SJ, Shin E. PAX2, PAX8, and PR are correlated with ovarian seromucinous borderline tumor with endometriosis. J Ovarian Res 2022; 15:41. [PMID: 35387670 PMCID: PMC8985320 DOI: 10.1186/s13048-022-00975-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian "seromucinous carcinoma" has been recently removed in 2020 5th Edition of WHO classification of Female Genital Tumors and is considered as a subtype of endometrioid carcinoma with mucinous differentiation, while "seromucinous borderline tumor" remains and exists as a distinct entity. Both diseases may be considered as no more same lineage. However, ovarian seromucinous borderline tumor (SMBT) is also one of the endometriosis-related neoplasm of ovary similar to endometrioid tumor, featuring that about 50% of ovarian SMBTs combine endometriosis. The present study was aimed to investigate whether the ovarian SMBTs are different in clinical features and molecular patterns, according to the presence of combined endometriosis. RESULTS There were no statistical differences in clinical findings between two groups. There was also no significant difference in pregnancy outcomes and recurrence between two groups. In immunohistochemical patterns, there was a statistically significant difference in PAX2 and PAX8 expression between in ovarian SMBT with or without endometriosis (P = 0.016, P < 0.001). Only a few cases of ovarian SMBT with endometriosis showed expression of PAX2 and conversely, most of the cases showed expression of PAX8. PR positivity was more prominent in ovarian SMBT with endometriosis than without endometriosis (P = 0.018), although there was no difference in positive ER expression. There were no statistical differences in WT1, CK20 and CDX2 expressions between two groups. CONCLUSIONS Ovarian SMBT with endometriosis did not clinically differ from that without endometriosis. However, the molecular patterns were different between two groups and ovarian SMBT with endometriosis is close to endometrioid tumor types unlike SMBT without endometriosis. Further, a direct comparison study between seromucinous borderline tumor and endometrioid borderline tumor is needed with a gene profiling study to prove their relationship.
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Affiliation(s)
- Bo Seong Yun
- Department of Obstetrics and Gynecology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, Korea
| | - Seyeon Won
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ju-Hyun Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Nara Lee
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Miseon Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Mi Kyoung Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Mi-La Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Yong Wook Jung
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Pathology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Seok Ju Seong
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Eunah Shin
- Department of Pathology, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, 16995, Gyeonggi-do, Korea.
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7
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Dum D, Menz A, Völkel C, De Wispelaere N, Hinsch A, Gorbokon N, Lennartz M, Luebke AM, Hube-Magg C, Kluth M, Fraune C, Möller K, Bernreuther C, Lebok P, Clauditz TS, Jacobsen F, Sauter G, Uhlig R, Wilczak W, Steurer S, Minner S, Marx AH, Simon R, Burandt E, Krech T. Cytokeratin 7 and cytokeratin 20 expression in cancer: A tissue microarray study on 15,424 cancers. Exp Mol Pathol 2022; 126:104762. [PMID: 35390310 DOI: 10.1016/j.yexmp.2022.104762] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/23/2022] [Accepted: 03/30/2022] [Indexed: 01/15/2023]
Abstract
Combined analysis of cytokeratin 7 (CK7) and cytokeratin 20 (CK20) is often used for assessing the origin of metastatic cancer. To evaluate the diagnostic utility of CK7 and CK20, tissue microarrays containing 15,424 samples from 120 different tumor types and subtypes and 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. CK7 positivity was seen in 52% (8.7% weak, 5.9% moderate, 37% strong) and CK20 positivity in 23% (5.1% weak, 3.4% moderate, 15% strong) of interpretable tumors. Of 8390 positive tumors, 1181 (14%) showed positivity for CK7 and CK20, 5380 (64%) showed positivity for CK7 alone, and 1829 (22%) showed positivity for CK20 alone. CK20 predominated in gastrointestinal tract, urothelial and Merkel cell carcinomas. CK7 was usually negative in prostate cancer and colorectal cancer. Combined evaluation of CK7/CK20 revealed the best diagnostic utility in CK20 positive tumors, where CK7 negativity is often linked to colorectal origin while CK7 positivity argues for urothelial origin or mucinous ovarian cancer. Associations with unfavorable tumor features were found for cytokeratin 7 loss in breast cancer of no special type, urothelial and renal cell carcinomas, for CK7 overexpression in high-grade serous ovarian and gastric cancer, and for CK20 overexpression in urothelial carcinoma. CK20 loss was linked to MSI in gastric (p = 0.0291) and colorectal adenocarcinoma (p < 0.0001). These analyses provide comprehensive data on the frequency of CK7 and CK20 immunostaining - alone or in combination - in human cancers. These data facilitate interpretation of CK7/CK20 immunostaining in cancers.
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Affiliation(s)
- David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Cosima Völkel
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Noémi De Wispelaere
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ria Uhlig
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas H Marx
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
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8
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Choi HB, Pyo JS, Son S, Kim K, Kang G. Diagnostic and Prognostic Roles of CDX2 Immunohistochemical Expression in Colorectal Cancers. Diagnostics (Basel) 2022; 12:diagnostics12030757. [PMID: 35328309 PMCID: PMC8947721 DOI: 10.3390/diagnostics12030757] [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: 03/08/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 02/05/2023] Open
Abstract
The study is aimed to evaluate the diagnostic and prognostic role of the immunohistochemical expression of the Caudal-type homeobox transcription factor 2 (CDX2) in colorectal cancers (CRCs) through a meta-analysis. By searching relevant databases, 38 articles were eligible to be included in this study. We extracted the information for CDX2 expression rates and the correlation between CDX2 expression and clinicopathological characteristics. The estimated rates of CDX2 expression were 0.882 [95% confidence interval (CI) 0.774−0.861] and 0.893 (95% CI 0.820−0.938) in primary and metastatic CRCs, respectively. Furthermore, based on their histologic subtype, CDX2 expression rates of adenocarcinoma and medullary carcinoma were 0.886 (95% CI 0.837−0.923) and 0.436 (95% CI 0.269−0.618), respectively. There was a significant difference in CDX2 expression rates between adenocarcinoma and medullary carcinoma in the meta-regression test (p < 0.001). In addition, CDX2 expression was significantly lower in CRCs with the BRAFV600E mutation than in CRCs without mutation. Patients with CDX2 expression had better overall and cancer-specific survival rates than those without CDX2 expression. Thus, CDX2 is a useful diagnostic and prognostic marker CRCs.
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Affiliation(s)
- Hong Bae Choi
- Department of Surgery, Daehang Hospital, Seoul 06699, Korea
| | - Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Korea
| | - Soomin Son
- Division of Molecular Life and Chemical Sciences, College of Natural Sciences, Ewha Woman's University, Seoul 03760, Korea
| | | | - Guhyun Kang
- Department of Pathology, Daehang Hospital, Seoul 06699, Korea
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9
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Novel Diagnostic Biomarkers in Colorectal Cancer. Int J Mol Sci 2022; 23:ijms23020852. [PMID: 35055034 PMCID: PMC8776048 DOI: 10.3390/ijms23020852] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/27/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is still a leading cause of cancer death worldwide. Less than half of cases are diagnosed when the cancer is locally advanced. CRC is a heterogenous disease associated with a number of genetic or somatic mutations. Diagnostic markers are used for risk stratification and early detection, which might prolong overall survival. Nowadays, the widespread use of semi-invasive endoscopic methods and feacal blood tests characterised by suboptimal accuracy of diagnostic results has led to the detection of cases at later stages. New molecular noninvasive tests based on the detection of CRC alterations seem to be more sensitive and specific then the current methods. Therefore, research aiming at identifying molecular markers, such as DNA, RNA and proteins, would improve survival rates and contribute to the development of personalized medicine. The identification of “ideal” diagnostic biomarkers, having high sensitivity and specificity, being safe, cheap and easy to measure, remains a challenge. The purpose of this review is to discuss recent advances in novel diagnostic biomarkers for tumor tissue, blood and stool samples in CRC patients.
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10
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Shoji T, Tatsuki S, Abe M, Tomabechi H, Takatori E, Kaido Y, Nagasawa T, Kagabu M, Baba T, Itamochi H. Novel Therapeutic Strategies for Refractory Ovarian Cancers: Clear Cell and Mucinous Carcinomas. Cancers (Basel) 2021; 13:6120. [PMID: 34885229 PMCID: PMC8656608 DOI: 10.3390/cancers13236120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/13/2022] Open
Abstract
Ovarian cancer has the worst prognosis among gynecological cancers. In particular, clear cell and mucinous carcinomas are less sensitive to chemotherapy. The establishment of new therapies is necessary to improve the treatment outcomes for these carcinomas. In previous clinical studies, chemotherapy with cytotoxic anticancer drugs has failed to demonstrate better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers. The issues that need to be addressed include the most appropriate combination of therapies, identifying patients who may benefit from each therapy, and how results should be incorporated into the standard of care for ovarian clear cell and mucinous carcinomas. In this article, we have reviewed the most promising therapies for ovarian clear cell and mucinous carcinomas, which are regarded as intractable, with an emphasis on therapies currently being investigated in clinical studies.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Shunsuke Tatsuki
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Marina Abe
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hidetoshi Tomabechi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hiroaki Itamochi
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan;
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11
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Qureshi S, Patel NA, Patel N, Ghassibi MP, Tse DT, Dubovy SR. Metastatic Uterine Carcinosarcoma to the Orbit. Ophthalmic Plast Reconstr Surg 2021; 37:e198-e202. [PMID: 34284421 PMCID: PMC8597944 DOI: 10.1097/iop.0000000000002006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Metastases of solid tumors to the eye and ocular adnexa are rare. Herein, the authors describe the clinical, histologic, and immunohistochemical findings of a patient with a history of adenocarcinoma of the colon and a uterine carcinosarcoma (malignant mixed Müllerian tumor) who presented with proptosis and decreased vision. Positive staining with PAX-8, p16 and negative reaction for CK20 and CDX2 helped to establish the uterine origin of the metastasis. This rare case demonstrates the utility of immunohistochemical probes, especially in patients with a complex oncological history, where multiple primary sources of the metastasis are in the differential diagnosis.
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Affiliation(s)
| | - Nimesh A. Patel
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL 33136
| | - Nish Patel
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL 33136
| | - Mark P. Ghassibi
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL 33136
| | - David T. Tse
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL 33136
| | - Sander R. Dubovy
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL 33136
- Florida Lions Ocular Pathology Laboratory, Miami, FL, 33136
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12
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Rico SD, Schmalfeldt B, Müller V, Wölber L, Witzel I, Paluchowski P, von Leffern I, Heilenkötter U, Jacobsen F, Bernreuther C, Clauditz T, Simon R, Steurer S, Burandt E, Marx AH, Krech T. MUC5AC expression is linked to mucinous/endometroid subtype, absence of nodal metastasis and mismatch repair deficiency in ovarian cancer. Pathol Res Pract 2021; 224:153533. [PMID: 34171599 DOI: 10.1016/j.prp.2021.153533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 02/07/2023]
Abstract
Mucin 5AC (MUC5AC) is a secreted gel-forming mucin which is expressed by mucus producing cells of several organs but can also be found in cancer cells of the ovary, pancreas, and gastrointestinal tract. This study aimed to characterize the expression of MUC5AC and its potential prognostic implications in different ovarian cancer subtypes. MUC5AC expression was analyzed by immunohistochemistry on a tissue microarray containing 603 ovarian cancers. MUC5AC was commonly expressed in mucinous (27/36; 75%) and endometrioid (12/39; 31%) carcinomas, whereas malignant mixed Mullerian tumors (2/27; 7%), high-grade serous (20/373; 5%) and clear cell carcinomas (1/28; 4%) were only rarely MUC5AC positive and also showed lower expression levels. MUC5AC positive endometroid carcinomas and high-grade serous carcinomas lacked lymph node metastases (p = 0.0495 and p = 0.0216) suggesting a more favorable prognosis. Deficient mismatch repair (dMMR), associated with a favorable prognosis in different cancer types, was found in 4/39 (10%) MUC5AC positive cancers but in only 5/375 (1%) of MUC5AC negative cancers (p = 0.0052). In subgroup analyses MUC5AC positive endometroid carcinomas more frequently showed dMMR (4/10; 40%) as opposed to MUC5AC negative endometroid carcinomas (3/23; 13%; p = 0.0932). In summary, the results of our study show that MUC5AC expression is associated with mucinous and endometrioid ovarian carcinomas, lack of nodal metastases and dMMR. MUC5AC expressing ovarian cancers should be evaluated for dMMR.
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Affiliation(s)
| | - Barbara Schmalfeldt
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Germany
| | - Volkmar Müller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Germany
| | - Linn Wölber
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Germany
| | - Isabell Witzel
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Germany
| | - Peter Paluchowski
- Department of Gynecology, Regio Clinic Pinneberg, Pinneberg, Germany
| | | | - Uwe Heilenkötter
- Department of Gynecology, Regio Clinic Itzehoe, Itzehoe, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas H Marx
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
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13
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Rekhi B, Karmarkar S, Gupta C, Deodhar KK, Menon S, Pathuthara S, Maheshwari A, Shylasree TS, Gupta S. Evaluation of cell blocks from effusion specimens in Gynecologic Oncopathology: An experience of 220 cases, diagnosed at a Tertiary Cancer Referral Center. INDIAN J PATHOL MICR 2021; 63:427-434. [PMID: 32769333 DOI: 10.4103/ijpm.ijpm_858_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
One of the common indications of ascitic fluid examination in gynecological oncopathology is the detection and classification of malignant cells, especially in cases of clinically suspicious tubo-ovarian masses. The present study was undertaken to assess and validate the diagnostic utility of cell blocks (CBs) and compare its results with the corresponding conventional smears, prepared from effusion samples. CBs were prepared by thromboplastin technique in 220 cases. In 208 cases, diagnostic concordance between results obtained from smears and corresponding CBs was evaluated. Various antibody markers were tested, as per individual case. The average age of patients was 52.2 years. Positive immunohistochemical (IHC) staining for various markers was observed in 182 cases (82.7%) The most frequently positive antibody marker was PAX8 (101/134), followed by p53 (85/92) [mutation type (either diffusely positive or completely negative)], WT1 (tumor cells) (80/112), calretinin (2/87) (diffuse), BerEP4 (21/49), CA125 (21/24), CK7 (31/39) and CK20 and CDX2, together (5/16). Various other IHC markers utilized, including their positive expression, were TTF1 (1/10), p40 (3/3), p63 (2/4), ER (21/29), HBME1 (1/7), GATA3 (1/4), and MIC2 (1/1). Complete diagnostic concordance between CBs and smears was observed in 170/208 cases (81.7%). There were 20 major discordances, 10 minor and 8 cases with sampling errors. IHC was useful in classifying 158/182 (86.8%) cases, including serous or Müllerian adenocarcinoma (n = 123), mostly high-grade (121); metastatic squamous carcinoma (3); gastrointestinal-type adenocarcinoma (8); pulmonary adenocarcinoma (1); breast adenocarcinoma (1); Ewing sarcoma (1); and mesothelioma (2). CBs are complementary to smears in the detection of gynecological malignancies, mostly high-grade serous adenocarcinomas. These provide an opportunity for testing several IHC markers, for a precise diagnosis, including in various uncommon case scenarios, associated with significant therapeutic implications.
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Affiliation(s)
- Bharat Rekhi
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Srushti Karmarkar
- Department of Surgical Pathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Chhavi Gupta
- Department of Surgical Pathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Kedar K Deodhar
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Saleem Pathuthara
- Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - T S Shylasree
- Department of Surgical Oncology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Gynecology Disease Management Group, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
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14
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Dundr P, Singh N, Nožičková B, Němejcová K, Bártů M, Stružinská I. Primary mucinous ovarian tumors vs. ovarian metastases from gastrointestinal tract, pancreas and biliary tree: a review of current problematics. Diagn Pathol 2021; 16:20. [PMID: 33706757 PMCID: PMC7953678 DOI: 10.1186/s13000-021-01079-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background Making the distinction between primary mucinous and metastatic ovarian tumors is often difficult, especially in tumors with a primary source from the gastrointestinal tract, pancreas and biliary tree. The aim of the following paper is to provide an overview of the problematics, with a focus on the possibilities of the differential diagnosis at the macroscopic, microscopic and immunohistochemical level. Main body The three main aspects of mucinous ovarian tumors are described in detail, including the comparison of the available diagnostic algorithms based on the evaluation of mostly macroscopic features, characterization of the spectrum of microscopic features, and a detailed analysis of the immunophenotype comparing 20 antibodies with the assessment of their statistical significance for differential diagnosis purposes. Specific features, including Krukenberg tumor and pseudomyxoma peritonei, are also discussed. Conclusion Despite the growing knowledge of the macroscopic and microscopic features of ovarian mucinous tumors and the availability of a wide range of immunohistochemical antibodies useful in this setting, there still remains a group of tumors which cannot be precisely classified without close clinical-pathological cooperation.
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Affiliation(s)
- Pavel Dundr
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic.
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, Queen Mary University of London, London, UK.,Blizard Institute of Core Pathology, Queen Mary University of London, London, UK
| | - Barbora Nožičková
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Kristýna Němejcová
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Michaela Bártů
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Ivana Stružinská
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
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15
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Mikaeel RR, Young JP, Tapia Rico G, Hewett PJ, Hardingham JE, Uylaki W, Horsnell M, Price TJ. Immunohistochemistry features and molecular pathology of appendiceal neoplasms. Crit Rev Clin Lab Sci 2021; 58:369-384. [PMID: 33569997 DOI: 10.1080/10408363.2021.1881756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Primary appendiceal neoplasms (ANs) comprise a heterogeneous group of tumors. The pathology and classification of ANs have been controversial, and thus, a new classification of these neoplasms was published in the World Health Organization (WHO) classification of tumors (5th edition, 2019). However, immunohistochemistry (IHC) features of epithelial ANs are not explained in this edition and the limited data on the molecular pathology of these tumors shows inconsistent findings in various studies. It would be useful to identify biomarkers appropriate for each subtype to better aid in treatment selection. Therefore, we reviewed the literature to investigate what is known of the molecular pathology and IHC features of the most frequently diagnosed pathological subtypes of epithelial ANs based on the recent classification. The inconsistencies in research findings regarding the IHC features and molecular pathology of ANs could be due to differences in the number of samples and their collection and preparation as well as to the lack of a universally accepted classification system for these neoplasms. However, the literature shows that epithelial ANs typically stain positive for MUC2, CK20, and CDX2 and that the expression of SATB2 protein could be used as a biomarker for appendix tumor origin. Low-grade appendiceal mucinous neoplasms tend to have mutations in KRAS and GNAS but are usually wild-type for BRAF, APC, and P53. Conversely, appendiceal adenocarcinomas are frequently found with mutations in KRAS, GNAS, P53, PIK3CA, and APC, and have significant nuclear expression of β-catenin, loss of nuclear or nuclear and cytoplasmic expression of SMAD4, and loss of cytoplasmic membranous expression of E-cadherin. Goblet cell carcinomas (GCCs) typically stain positive for keratin and mucin markers and are frequently mutated in P53 and chromatin-modifier genes, but they tend to be wild-type for KRAS, GNAS, APC, and PIK3CA. The expression of CK7 and SATB2 proteins is usually negative in appendiceal neuroendocrine neoplasms and they lack the mutations in common cancer-associated genes including APC, BRAF, SMAD4, and PIK3C. The available data suggest that GCCs have distinct molecular and immunohistochemical features and that they have characteristics more in common with adenocarcinoma than classical neuroendocrine tumors. In addition, MSI does not seem to have a role in the pathogenesis of epithelial ANs because they are rarely detected in these tumors. Finally, hereditary predisposition may have a role in the development of ANs because heterozygous CTNNβ1, NOTCH1, and NOTCH4 germline mutations have recently been identified in low and high grades ANs.
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Affiliation(s)
- Reger R Mikaeel
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.,Department of Biology, College of Science, University of Duhok, Duhok, Kurdistan
| | - Joanne P Young
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gonzalo Tapia Rico
- Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Peter J Hewett
- University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Jennifer E Hardingham
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Wendy Uylaki
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Mehgan Horsnell
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Timothy J Price
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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16
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Abouelkhair MB, Mabrouk SH, Zaki SSA, Nada OH, Hakim SA. The Diagnostic Value of Cadherin 17 and CDX2 Expression as Immunohistochemical Markers in Colorectal Adenocarcinoma. J Gastrointest Cancer 2020; 52:960-969. [PMID: 32929682 DOI: 10.1007/s12029-020-00513-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Colorectal cancer is a major cause of morbidity and mortality throughout the world. Although the diagnosis of colorectal cancer is straightforward in primary site, yet it may represent a diagnostic problem in metastatic tumor of unknown primary origin. Hence, immunohistochemical analysis in combination with morphologic assessment and correlation with clinical data becomes crucial, because it is important to specify the primary site of metastasis since some specific tumor types may respond well to targeted molecular therapies. Therefore, establishment of reliable diagnostic markers that confirm or rule out colorectal origin is mandatory. AIM To study the expression of cadherin 17 and CDX2 in colorectal carcinoma and to evaluate their diagnostic roles in identifying metastatic colonic from non-colonic adenocarcinomas in cancer of unknown primary site. DESIGN AND METHODS This retrospective study included 65 cases of adenocarcinomas: 35 cases of colorectal adenocarcinoma (primary or metastatic) and 30 cases of non-colorectal adenocarcinoma. They were retrieved from the archives of Pathology Department of Ain Shams University and Ain Shams University Specialized Hospitals during the period from 2010 to 2015. Immunohistochemical study was performed using cadherin 17 and CDX2 antibodies. RESULTS The sensitivity and specificity of CDX2 and cadherin 17 are 97.1% and 53.3% and 100% and 50% in detecting colonic adenocarcinoma respectively. The PPV, NPV, and overall accuracy of CDX2 versus cadherin 17 were 70.8%, 94.1%, and 76.9% versus 70%, 100%, and 76.9% respectively. CONCLUSION Cadherin 17 is a more sensitive marker than CDX2 in diagnosis of carcinoma of unknown primary site especially when colorectal carcinoma is suspected.
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Affiliation(s)
- Mariam B Abouelkhair
- Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt
| | - Shadia H Mabrouk
- Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt
| | - Sahar S A Zaki
- Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt
| | - Ola H Nada
- Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt
| | - Sarah A Hakim
- Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt.
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17
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Aldaoud N, Erashdi M, AlKhatib S, Abdo N, Al-Mohtaseb A, Graboski-Bauer A. The utility of PAX8 and SATB2 immunohistochemical stains in distinguishing ovarian mucinous neoplasms from colonic and appendiceal mucinous neoplasm. BMC Res Notes 2019; 12:770. [PMID: 31771640 PMCID: PMC6880435 DOI: 10.1186/s13104-019-4816-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/16/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives It is challenging to distinguish between primary ovarian mucinous tumors and metastatic mucinous neoplasms from the lower gastrointestinal tract, including appendiceal tumors. A combination of PAX8 and SATB2 immunohistochemical stains can be used as a diagnostic tool to distinguish between these cases. Results Immunostaining for SATB2, PAX8, CK7, CK20 and CDX2 was performed on 50 ovarian mucinous neoplasms (OMN) (39 cystadenomas, 4 borderline and 7 adenocarcinomas), 63 mucinous colorectal carcinoma (CRC), and 9 appendiceal mucinous neoplasms (AMN) [8 low grade appendiceal mucinous neoplasms (LAMN) and 1 adenocarcinoma]. PAX8 was positive in 32% of OMN and negative in all CRC and AMN cases. SATB2 was expressed in 2.0% of OMN, 77.8% of AMN, and 49.2% of CRC cases. CK7 was positive in 78.0% of OMN, 33.3% of AMN, and 9.5% of CRC cases. CK20 was expressed in 24.0% of OMN, 88.9% of OMN, and 87.3% of CRC cases. CDX2 was positive in 14.0% of OMN, 100% of AMN, and 90.5% of CRC cases. PAX8 can differentiate between OMN and AMN with high specificity but low sensitivity. CDX2 is the most sensitive marker for CRC and AMN, whereas SATB2 has better specificity.
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Affiliation(s)
- Najla Aldaoud
- Department of Pathology and Laboratory Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan.
| | - Madiha Erashdi
- Department of Pathology and Laboratory Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan
| | - Sohaib AlKhatib
- Department of Pathology and Laboratory Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan
| | - Nour Abdo
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Alia Al-Mohtaseb
- Department of Pathology and Laboratory Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan
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18
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Naem A, Dlewati A, Alhimyar M, Ousta MA, Alsaid B. A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report. Int J Surg Case Rep 2019; 65:301-304. [PMID: 31760217 PMCID: PMC6883337 DOI: 10.1016/j.ijscr.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022] Open
Abstract
The Müllerian cyst incidence in males is rare but quiet possible. The pathological and immunohistochemical examination is essential for the diagnosis. The immunopositivity for WT1 plays a great role in explaining the cyst’s behavior. Applying the total surgical resection is mandatory in preventing the recurrence. Chemotherapy can minimize the recurrence and improve the patient’s life quality.
Introduction The retroperitoneal Müllerian cysts are extremely rare lesions seen mostly in female patients but their occurrence in males is quite possible. Their exact etiology stills unknown, its histological and immunohistochemical characteristics may serve as an evidence that reflects its origin. Case presentation We present a case of a resected retroperitoneal Müllerian cyst that reoccurred severely after 3 months of the first laparotomy in a male patient with a significant history of testicular teratocarcinoma. Due to the cyst’s localization and its proximity to vital retroperitoneal structures, total surgical resection couldn’t be made and the recurrence was minimized by post-operative oral chemotherapy. Discussion The retroperitoneal Müllerian cyst is a benign cystadenoma that could be confused with other retroperitoneal lesions, which makes the pathological examination with the immunohistochemical study of the cyst’s wall essential to make the diagnosis. The immunopositivity to Cytokeratin 7 and the immunonegativity to Cytokeratin 20 is a key feature that confirm the diagnosis whenever the retroperitoneal Müllerian cyst is suspected. Due to its high vascularity, we highly recommend the administration of chemotherapy which targets the proliferative cyst’s cells. Conclusion The RMCs are rare benign lesions that tend to reoccur if total surgical resection isn’t made, when the total resection couldn’t be achieved, the-unspecific anti-mitotic drugs may help in minimizing the recurrence and improve the life quality of the patient.
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Affiliation(s)
- Antoine Naem
- Faculty of Medicine of Damascus University, Syria.
| | | | | | - Mohamad Ali Ousta
- Faculty of Medicine of Damascus University, Syria; Department of General Surgery of Al-Assad University Hospital, Syria.
| | - Bayan Alsaid
- Faculty of Medicine of Damascus University, Syria; Department of General Surgery of Al-Assad University Hospital, Syria.
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19
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Parker NA, McBride C, Forge J, Lalich D. Bowel obstruction caused by colonic metastasis of lung adenocarcinoma: a case report and literature review. World J Surg Oncol 2019; 17:63. [PMID: 30961608 PMCID: PMC6454752 DOI: 10.1186/s12957-019-1611-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/29/2019] [Indexed: 01/07/2023] Open
Abstract
Introduction Lung cancer is the most common cause of cancer-related deaths globally. Metastatic disease is often found at the time of initial diagnosis in the majority of lung cancer patients. However, colonic metastases are rare. This report describes an uncommon case of colonic metastasis from lung adenocarcinoma. Case presentation A 64-year-old female presented to her gastroenterologist for progressively worsening abdominal pain and constipation. Exploratory colonoscopy revealed a large rectosigmoid mass resulting in near total rectal occlusion. Her specialist recommended she immediately go to her regional hospital for further workup. On admission, she complained of continued abdominal pain and constipation. Notably, she had a past medical history of non-small cell lung cancer (T1bN3M0 stage IIIB), diagnosed 1 year prior. She was thought to be in remission following radiation and immunotherapy with pembrolizumab. Upon hospital admission, she underwent an urgent colostomy, ileocecectomy and anastomosis, and rectosigmoid mass resection with tissue sampling. Pathology confirmed the diagnosis of colonic metastasis from primary lung adenocarcinoma. Treatment was with systemic chemotherapy followed by localized radiation to the pelvic region was started. She did not respond well to these therapies. Subsequent imaging showed refractory tumor growth in the pelvic region. Treatment could not be completed due to the patient experiencing a debilitating stroke, and she was transitioned to hospice care. Conclusions Clinicians should have a low threshold for intestinal investigation and considerations for colonic metastasis when patients with a history of primary lung cancer have abdominal symptoms.
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Affiliation(s)
- N A Parker
- Department of Internal Medicine, University of Kansas School of Medicine, 2817 N Tallgrass St, Wichita, KS, 67226, USA.
| | - C McBride
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - J Forge
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - D Lalich
- Department of Anatomical and Clinical Pathology, Wesley Medical Center, 550 N. Hillside St, Wichita, KS, 67214, USA
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Naem A, Dlewati A, Alhimyar M, Ousta MA, Alsaid B. A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report. Int J Surg Case Rep 2019; 65:301-304. [DOI: https:/doi.org/10.1016/j.ijscr.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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21
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Metastatic Cecal Adenocarcinoma to the Gallbladder Presenting with Acute Cholecystitis. Case Rep Oncol Med 2018; 2018:5308585. [PMID: 30420930 PMCID: PMC6215578 DOI: 10.1155/2018/5308585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers and the second highest cause of cancer-related deaths (Jemal et al., 2011). Common presentations of CRC include alterations in bowel habit, weight loss, and lower gastrointestinal bleeding. We report a case of a 74-year-old male who presented with fever and right upper quadrant pain, with positive Murphy's sign on examination. The case was initially managed with a routine cholecystectomy. Histological examination revealed a moderately differentiated adenocarcinoma with a superimposed histologically proven acute acalculous cholecystitis. CT scan done postsurgery showed a cecal mass with retroperitoneal lymphadenopathy. Biopsy result of cecal mass was remarkable for colon adenocarcinoma. We are not aware of any similar prior cases reported in English literature.
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22
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Missaoui N, Salhi S, Bdioui A, Mestiri S, Abdessayed N, Mokni M, Yacoubi MT. Immunohistochemical Characterization Improves the Reproducibility of the Histological Diagnosis of Ovarian Carcinoma. Asian Pac J Cancer Prev 2018; 19:2545-2551. [PMID: 30256049 PMCID: PMC6249481 DOI: 10.22034/apjcp.2018.19.9.2545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Ovarian cancer is the leading cause of gynecologic cancer-related death. Histological
assessment remains the standard clue for the diagnosis of ovarian carcinoma. Misinterpretation and inconsistent
application of histological criteria may lead to significant interobserver variability and poor reproducibility of
the diagnosis. In this study, we investigated the discrepancy in histological diagnosis and the significance of a designed
panel of immunohistochemical markers for the improvement of the diagnostic reproducibility of ovarian carcinomas.
Methods: We performed a retrospective study on 74 ovarian carcinomas. All tumor slides were independently
reviewed by two pathologists. The results for seven available immunomarkers as p53, WT-1, p16INK4A, CK7,
CK20, and estrogen and progesterone receptors were determined for all cases by immunohistochemistry. Results:
The histological diagnosis review performed using standard histology showed a concordance of diagnoses in 86% of
cases with Cohen’s kappa of 0.80. Immunohistochemical results increased significantly the diagnosis reproducibility
with a concordance of 91% and a Cohen’s kappa of 0.86 (P = 0.001). Conclusion: Although the histological diagnosis
remains reliable, the use of a designed panel of immunohistochemical markers improves significantly the interobserver
concordance and the classification accuracy of ovarian carcinomas.
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Affiliation(s)
- Nabiha Missaoui
- Research Unit UR14ES17, Cancer Epidemiology and Cytopathology in Tunisian Center, Medicine Faculty of Sousse, University of Sousse, Tunisia.,Faculty of Sciences and Techniques, Sidi Bouzid, Kairouan University, Tunisia.,Pathology Department, Farhat Hached Hospital, Sousse, Tunisia.
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Mirza-Aghazadeh-Attari M, Darband SG, Kaviani M, Mihanfar A, Aghazadeh Attari J, Yousefi B, Majidinia M. DNA damage response and repair in colorectal cancer: Defects, regulation and therapeutic implications. DNA Repair (Amst) 2018; 69:34-52. [PMID: 30055507 DOI: 10.1016/j.dnarep.2018.07.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/15/2018] [Accepted: 07/15/2018] [Indexed: 12/11/2022]
Abstract
DNA damage response, a key factor involved in maintaining genome integrity and stability, consists of several kinase-dependent signaling pathways, which sense and transduce DNA damage signal. The severity of damage appears to determine DNA damage responses, which can include cell cycle arrest, damage repair and apoptosis. A number of recent studies have demonstrated that defection in signaling through this network is thought to be an underlying mechanism behind the development and progression of various types of human malignancies, including colorectal cancer. In this review, colorectal cancer and its molecular pathology as well as DNA damage response is briefly introduced. Finally, the involvement of key components of this network in the initiation/progression, prognosis, response to treatment and development of drug resistance is comprehensively discussed.
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Affiliation(s)
- Mohammad Mirza-Aghazadeh-Attari
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Ghazizadeh Darband
- Danesh Pey Hadi Co., Health Technology Development Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mojtaba Kaviani
- School of Nutrition and Dietetics, Acadia University, Wolfville, Nova Scotia, Canada
| | - Ainaz Mihanfar
- Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Bahman Yousefi
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Maryam Majidinia
- Solid Tumor Research Center, Urmia University of Medical Sciences, Urmia, Iran.
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24
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Park JH, Jung DH, Baek JH. Metastatic colon cancer of an ovarian cancer origin mimicking primary colon cancer: A case report. ACTA ACUST UNITED AC 2018. [DOI: 10.14216/kjco.18009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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25
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Wang Y, Li H. Identification of proteins associated with paclitaxel resistance of epithelial ovarian cancer using iTRAQ-based proteomics. Oncol Lett 2018; 15:9793-9801. [PMID: 29928353 PMCID: PMC6004651 DOI: 10.3892/ol.2018.8600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/26/2017] [Indexed: 01/01/2023] Open
Abstract
Chemotherapy is an important adjuvant therapy for epithelial ovarian cancer (EOC). The main cause of chemotherapy failure in EOC is paclitaxel resistance. The present study aimed to identify novel biomarkers to predict chemosensitivity to paclitaxel and improve our understanding of the molecular mechanisms underlying paclitaxel resistance in EOC. In the present study, the heterogeneity of EOC was evaluated by adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in vitro. Fresh samples were collected from 54 EOC cases during cytoreductive surgery. Tumor cells were isolated, cultured, and tested for sensitivity to paclitaxel. Proteins that were differentially expressed between paclitaxel-resistant tissues and paclitaxel-sensitive tissues were identified via isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomic analysis. Two upregulated proteins, plexin domain containing 2 (Plxdc2) and cytokeratin 7 (CK7), were selected to verify the iTRAQ method using western blot analysis in EOC tissues with different chemosensitivities (sensitive, weakly sensitive and resistant). There was notable heterogeneity of chemosensitivity in the EOC specimens. Highly to mildly-differentiated or early-stage (I/II) EOC specimens had decreased sensitivity to paclitaxel compared with specimens with low differentiation (P<0.05) or an advanced stage (III; P<0.05), respectively. A total of 496 significantly differentially expressed proteins, including 263 that were downregulated (P<0.05) and 233 that were upregulated (P<0.05) in paclitaxel-resistant tissues compared with paclitaxel-sensitive tissues, were identified using iTRAQ in combination with LC-MS/MS. The expression levels of two proteins associated with paclitaxel resistance, Plxdc2 and CK7, were further validated by western blotting, which revealed that they were upregulated in the paclitaxel-resistant tissues. The present study determined candidate proteins associated with paclitaxel resistance in EOC. Plxdc2 and CK7 may be potential makers for distinguishing patients with paclitaxel-resistant EOC from those with paclitaxel-sensitive EOC.
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Affiliation(s)
- Yuanjing Wang
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
| | - Hongxia Li
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
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26
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Inamura K. Clinicopathological Characteristics and Mutations Driving Development of Early Lung Adenocarcinoma: Tumor Initiation and Progression. Int J Mol Sci 2018; 19:ijms19041259. [PMID: 29690599 PMCID: PMC5979290 DOI: 10.3390/ijms19041259] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 01/01/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide, with lung adenocarcinoma representing the most common lung cancer subtype. Among all lung adenocarcinomas, the most prevalent subset develops via tumorigenesis and progression from atypical adenomatous hyperplasia (AAH) to adenocarcinoma in situ (AIS), to minimally invasive adenocarcinoma (MIA), to overt invasive adenocarcinoma with a lepidic pattern. This stepwise development is supported by the clinicopathological and molecular characteristics of these tumors. In the 2015 World Health Organization classification, AAH and AIS are both defined as preinvasive lesions, whereas MIA is identified as an early invasive adenocarcinoma that is not expected to recur if removed completely. Recent studies have examined the molecular features of lung adenocarcinoma tumorigenesis and progression. EGFR-mutated adenocarcinoma frequently develops via the multistep progression. Oncogene-induced senescence appears to decrease the frequency of the multistep progression in KRAS- or BRAF-mutated adenocarcinoma, whose tumor evolution may be associated with epigenetic alterations and kinase-inactive mutations. This review summarizes the current knowledge of tumorigenesis and tumor progression in early lung adenocarcinoma, with special focus on its clinicopathological characteristics and their associations with driver mutations (EGFR, KRAS, and BRAF) as well as on its molecular pathogenesis and progression.
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Affiliation(s)
- Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
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27
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Zhang YJ, Chen JW, He XS, Zhang HZ, Ling YH, Wen JH, Deng WH, Li P, Yun JP, Xie D, Cai MY. SATB2 is a Promising Biomarker for Identifying a Colorectal Origin for Liver Metastatic Adenocarcinomas. EBioMedicine 2018; 28:62-69. [PMID: 29396302 PMCID: PMC5898029 DOI: 10.1016/j.ebiom.2018.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/02/2018] [Accepted: 01/02/2018] [Indexed: 02/07/2023] Open
Abstract
SATB2 (Special AT-rich sequence-binding protein 2) has recently been shown to be a specific biomarker of colorectal cancer (CRC). The aim of this study was to investigate the diagnostic potential of SATB2 as a means of detecting a CRC origin for liver metastases. SATB2 expression was examined in a resection cohort of 101 CRC and 273 non-CRC adenocarcinoma samples using immunohistochemistry (IHC). The diagnostic accuracy of CRC origins of liver metastases based on SATB2 and a three marker panel of SATB2, CK20 and CDX2 was evaluated using an independent cohort of 192 liver biopsies. IHC showed 97 of the 101 (96.0%) primary CRC samples were SATB2 positive, compared to only 6 of the 273 (2.1%) samples of other cancer types. The sensitivity, specificity and AUC values of SATB2 expression in resection samples were 97%, 97.1% and 0.977, respectively. Meanwhile, for the liver biopsy samples, the sensitivity, specificity and AUC values of a CRC liver metastases was 92.2%, 97.8% and 0.948 for SATB2, 95.1%, 91.0% and 0.959 for CK20, and 100%, 85.4% and 0.976 for CDX2, respectively. Further analysis demonstrated that all three-marker positivity was detected in 92/103 (89.3%) CRC and 2/89 (2.2%) non-CRC liver metastases sampled by biopsy. Our findings suggest that SATB2, as measured by IHC, could serve as a promising diagnostic biomarker of CRC metastases. Combining evaluation of SATB2 with CK20 and CDX2 to form a three marker panel further improved the detection of metastatic CRCs in liver biopsy tissues.
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Affiliation(s)
- Yi-Jun Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jie-Wei Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Sheng He
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui-Zhong Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yi-Hong Ling
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jia-Huai Wen
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Hao Deng
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Peng Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jing-Ping Yun
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Dan Xie
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Mu-Yan Cai
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China.
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Al-Maghrabi J, Emam E, Gomaa W. Immunohistochemical staining of cytokeratin 20 and cytokeratin 7 in colorectal carcinomas: Four different immunostaining profiles. Saudi J Gastroenterol 2018; 24:129-134. [PMID: 29637921 PMCID: PMC5900473 DOI: 10.4103/sjg.sjg_465_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/AIM Aberrant expression of CK20/CK7 is reported in a percentage of colorectal carcinomas (CRC); however, its relation to clinicopathological variables and survival data is still unclear. The objective of this study is to explore patterns of CK20/CK7 immunostaining in CRC and to analyse the diagnostic, prognostic, and predictive role of patterns of CK20/CK7 immunostaining. MATERIALS AND METHODS A total of 144 CRC cases were retrieved from the archives at the Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia. Immunohistochemistry was performed using antibody to CK7 and CK20. Immunostaining was defined as low and high by using the extent of staining. The association of CK7 and CK20 with clinicopathological characteristics and survival. RESULTS CK20 was expressed in a higher percentage of CRC and nodal metastasis than CK7. No difference in CK7 and CK20 immunostaining in primary and metastasis carcinomas was found. Four patterns of CK20/CK7 were identified; CK20+/CK7- (60.4%), CK20+/CK7+ (2.1%), CK20-/CK7- (35.4%), and CK20-/CK7+ (2.1%). There was no statistically significant correlation between CK20/CK7 immunohistochemical profile and clinicopathological characteristics, prognosis, and survival was determined. CONCLUSIONS Our results may support the heterogeneity of CRC. CRC showed four different subclasses following patterns of relative CK20/CK7 immunostaining. A considerable number of CRC expressed aberrant immune profile of CK20/CK7, which should be considered during diagnosing CRC in metastatic regions. Further studies on larger cohorts correlating different immunohistochemical cytokeratin profiles to molecular subtypes of CRC are recommended for better understanding of pathogenesis and behaviour of CRC.
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Affiliation(s)
- Jaudah Al-Maghrabi
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Address for correspondence: Dr. Jaudah Al-Maghrabi, Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. E-mail:
| | - Eman Emam
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Wafaey Gomaa
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Department of Pathology, Faculty of Medicine, Minia University, Al-Minia, Egypt
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A Comprehensive Evaluation of Special AT-rich Sequence-binding Protein 2 (SATB2) Immunohistochemical Staining in Mucinous Tumors From Gastrointestinal and Nongastrointestinal Sites. Appl Immunohistochem Mol Morphol 2017; 27:378-385. [PMID: 29271791 DOI: 10.1097/pai.0000000000000627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Special AT-rich sequence-binding protein 2 (SATB2) is an accurate marker for conventional colorectal carcinoma (CRC), although its sensitivity and specificity in mucinous tumors from the colon and other sites remains unknown. The objective of this study is to evaluate the accuracy of SATB2 expression detected by immunohistochemical assay, as a marker of primary CRC in mucinous adenocarcinomas. SATB2 immunohistochemical stains were performed on whole sections from 63 conventional CRCs (controls), 47 mucinous CRCs (mCRC), and 182 noncolorectal mucinous tumors. SATB2 intensity was scored as 1 to 3 based on the estrogen receptor/progesterone receptor grading system, and the percent positive cells was scored in broad categories as follows: 0 (negative)≤5%, 1=5% to 49%, 2≥50%. An optimal sensitivity/specificity pairing (83% and 95%, respectively) was achieved in the mCRCs when the additive intensity and percent score was ≥3 (ie, intensity score+percent score=total score). Defining this total score (histologic score/"H score") as a "positive" result, the sensitivity of SATB2 for conventional CRC was 98% (62/63) versus 83% (39/47) for mCRCs (P=0.02); whereas 5% (9/182) of all noncolorectal mucinous tumors were considered positive. SATB2 especially demonstrated reduced specificity when applied to mucinous gastroesophageal and breast carcinomas, which showed significant expression in 27% and 9% of cases, respectively. In summary, SATB2 is a less sensitive marker of colorectal origin in mCRC compared with conventional CRC and shows significantly reduced specificity in mucinous gastroesophageal and breast primaries.
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Lu SH, Tsai WS, Chang YH, Chou TY, Pang ST, Lin PH, Tsai CM, Chang YC. Identifying cancer origin using circulating tumor cells. Cancer Biol Ther 2017; 17:430-8. [PMID: 26828696 PMCID: PMC4910938 DOI: 10.1080/15384047.2016.1141839] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Circulating tumor cells (CTCs) have become an established clinical evaluation biomarker. CTC count provides a good correlation with the prognosis of cancer patients, but has only been used with known cancer patients, and has been unable to predict the origin of the CTCs. This study demonstrates the analysis of CTCs for the identification of their primary cancer source. Twelve mL blood samples were equally dispensed on 6 CMx chips, microfluidic chips coated with an anti-EpCAM-conjugated supported lipid bilayer, for CTC capture and isolation. Captured CTCs were eluted to an immunofluorescence (IF) staining panel consisting of 6 groups of antibodies: anti-panCK, anti-CK18, anti-CK7, anti-TTF-1, anti-CK20/anti-CDX2, and anti-PSA/anti-PSMA. Cancer cell lines of lung (H1975), colorectal (DLD-1, HCT-116), and prostate (PC3, DU145, LNCaP) were selected to establish the sensitivity and specificity for distinguishing CTCs from lung, colorectal, and prostate cancer. Spiking experiments performed in 2mL of culture medium or whole blood proved the CMx platform can enumerate cancer cells of lung, colorectal, and prostate. The IF panel was tested on blood samples from lung cancer patients (n = 3), colorectal cancer patients (n = 5), prostate cancer patients (n = 5), and healthy individuals (n = 12). Peripheral blood samples found panCK+ and CK18+ CTCs in lung, colorectal, and prostate cancers. CTCs expressing CK7+ or TTF-1+, (CK20/ CDX2)+, or (PSA/ PSMA)+ corresponded to lung, colorectal, or prostate cancer, respectively. In conclusion, we have designed an immunofluorescence staining panel to identify CTCs in peripheral blood to correctly identify cancer cell origin.
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Affiliation(s)
- Si-Hong Lu
- a Graduate Institute of Life Sciences, National Defense Medical Center , Taiwan.,b Genomics Research Center, Academia Sinica , Taiwan
| | - Wen-Sy Tsai
- c Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University , Taiwan
| | - Ying-Hsu Chang
- d Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University , Taiwan
| | - Teh-Ying Chou
- e Pathology and Laboratory Medicine Department, Taipei Veterans General Hospital , Taiwan
| | - See-Tong Pang
- d Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University , Taiwan
| | - Po-Hung Lin
- d Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University , Taiwan
| | - Chun-Ming Tsai
- f Chest Department , Taipei Veterans General Hospital , Taiwan
| | - Ying-Chih Chang
- a Graduate Institute of Life Sciences, National Defense Medical Center , Taiwan.,b Genomics Research Center, Academia Sinica , Taiwan
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31
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Haraldsson S, Klarskov L, Nilbert M, Bernstein I, Bonde J, Holck S. Differential expression of CK20, β-catenin, and MUC2/5AC/6 in Lynch syndrome and familial colorectal cancer type X. BMC Clin Pathol 2017; 17:11. [PMID: 28824332 PMCID: PMC5559789 DOI: 10.1186/s12907-017-0052-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 08/11/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hereditary non-polyposis colorectal cancer comprises Lynch syndrome and familial colorectal cancer type X (FCCTX). Differences in genetics, demographics and histopathology have been extensively studied. The purpose of this study is to characterize their immunoprofile of markers other than MMR proteins. METHODS We compared the expression patterns of cytokeratins (CK7 and CK20), mucins (MUC2/5 AC/6), CDX2 and β-catenin in Lynch syndrome and FCCTX. RESULTS Differences were identified for CK20 and nuclear β-catenin, which were significantly more often expressed in FCCTX than in Lynch syndrome (p < 0.001), whereas MUC2, MUC5AC and MUC6 were overexpressed in Lynch syndrome tumors compared with FCCTX tumors (p = 0.001, < 0.01, and < 0.001, respectively). We observed no differences in the expression patterns of CK7 and CDX2. CONCLUSIONS In summary, we identified significant differences in the immunoprofiles of colorectal cancers linked to FCCTX and Lynch syndrome with a more sporadic-like profile in the former group and a more distinct profile with frequent MUC6 positivity in the latter group.
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Affiliation(s)
- Stefan Haraldsson
- Department of Gastroenterology, Copenhagen University Hospital, Kettegaard Alle 29, DK-2650 Hvidovre, Denmark
| | - Louise Klarskov
- Department of Pathology, Herlev-Gentofte Hospital, Herlev, Denmark
| | - Mef Nilbert
- Clinical Research Centre, HNPCC register, Copenhagen University Hospital, Hvidovre, Denmark.,Institute of Clinical Sciences, Division of Oncology, Lund University, Lund, Sweden
| | - Inge Bernstein
- HNPCC register, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Surgical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Jesper Bonde
- Department of Pathology and Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark
| | - Susanne Holck
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
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32
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Altree-Tacha D, Tyrrell J, Haas T. CDH17 Is a More Sensitive Marker for Gastric Adenocarcinoma Than CK20 and CDX2. Arch Pathol Lab Med 2017; 141:144-150. [PMID: 28029907 DOI: 10.5858/arpa.2015-0404-oa] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -CDH17, which is expressed in the intestinal epithelium, is a novel oncogene involved in tumor invasion and metastasis. A panel consisting of cytokeratin (CK) 7, CD20, and CDX2 antibodies is typically used to diagnose gastrointestinal adenocarcinomas. However, studies have shown that CDH17 is a highly specific marker for gastrointestinal adenocarcinoma and may be important in clinical diagnosis. OBJECTIVE -To evaluate the sensitivity and specificity of CDH17, CK20, and CDX2 antibodies in neoplastic tissues, with emphasis on colon, stomach, and esophageal gastrointestinal lineage. DESIGN -Immunohistochemistry was performed with CDH17, CK20, and CDX2 antibodies on formalin-fixed, paraffin-embedded tissue microarrays from normal (n = 26) and neoplastic (n = 884) tissues. RESULTS -CDH17 immunostaining was positive in 97.3% (145 of 149) of colon adenocarcinomas, whereas CK20 and CDX2 stained positively in 88.6% (132 of 149) and 93.3% (139 of 149), respectively. In metastatic colon cancers, CDH17, CK20, and CDX2 positive staining was observed in 90.6% (29 of 32), 59.4% (19 of 32), and 81.3% (26 of 32) of cases, respectively. In stomach adenocarcinomas, CDH17 positively stained 64.0% (112 of 175) of tissues, compared to CK20 and CDX2, where staining was observed in only 24.6% (43 of 175) and 46.9% (82 of 175), respectively. In esophageal adenocarcinomas, CDH17, CK20, and CDX2 stained 38.7% (12 of 31), 25.8% (8 of 31), and 29% (9 of 31) of specimens, respectively. Low or no expression was observed in other neoplastic tissues, except pancreatic cancers, where CDH17 displayed higher expression than CK20 and CDX2. CONCLUSIONS -CDH17 is a specific and more sensitive marker in the gastrointestinal tract than CK20 and CDX2. CDH17 may be especially valuable when gastrointestinal tumors are suspected in cancers of unknown primary.
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Affiliation(s)
| | | | - Thomas Haas
- From Chief Scientific Officer (Dr Altree-Tacha) and the Department of Research and Development (Dr Tyrrell), Biocare Medical, Concord, California; and the Department of Pathology, Mercy Health System, Janesville, Wisconsin (Dr Haas)
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Chen CT, Lai HY, Jung SM, Lee CY, Wu CT, Lee ST. Neurenteric Cyst or Neuroendodermal Cyst? Immunohistochemical Study and Pathogenesis. World Neurosurg 2016; 96:85-90. [PMID: 27586176 DOI: 10.1016/j.wneu.2016.08.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Neurenteric cysts are rare central nervous system lesions derived from an endodermal origin. There is no consensus concerning pathogenesis because of the paucity of occurrences. We report an immunohistochemical study of 10 cases with neurenteric cysts and postulate its pathogenesis. METHODS Ten patients underwent surgical treatment for neurenteric cysts from 1995 to 2015. We retrospectively reviewed clinical, radiologic, operative, and pathologic findings for these patients. Immunohistochemical stains were completed in all cases to distinguish cell type and origin. RESULTS Three cell types were identified: pseudostratified-ciliated, goblet-columnar, and simple cuboidal cells. All cases were positive for cytokeratin 7, and negative for cytokeratin 20, caudal-type homeobox 2, mucin 2, thyroid transcription factor 1, human chorionic gonadotropin, placental alkaline phosphatase, and cluster of differentiation 31. Four of them had positive staining for mucin 5AC, with expression only in goblet-columnar cells. According to the immunohistochemical results, the cells resembled the respiratory tract (pseudostratified-ciliated), stomach (goblet-columnar), and respiratory bronchioles (simple cuboidal). Seventy-five percent of cases with recurrence had a goblet-columnar component, emphasizing the importance of total resection of the cyst and complete pathologic examination. CONCLUSIONS We postulate that the cystic tumor was derived from multipotent endodermal cells that migrated and traveled along the neuroectoderm, with incomplete differentiation into various cell types as a result of an unsuitable microenvironment. Because the neurenteric canal was only the channel of migration rather than a component of the cysts, the term neuroendodermal cysts is more precise in presenting the embryopathogenesis.
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Affiliation(s)
- Chun-Ting Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China
| | - Hung-Yi Lai
- Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China
| | - Shih-Ming Jung
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China
| | - Ching-Yi Lee
- Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China.
| | - Chieh-Tsai Wu
- Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China
| | - Shih-Tseng Lee
- Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taiwan, Republic of China
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Strickland S, Parra-Herran C. Immunohistochemical characterization of appendiceal mucinous neoplasms and the value of special AT-rich sequence-binding protein 2 in their distinction from primary ovarian mucinous tumours. Histopathology 2016; 68:977-87. [DOI: 10.1111/his.12899] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/31/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Sarah Strickland
- Department of Pathology and Laboratory Medicine; University of Ottawa; Ottawa Ontario Canada
- The Ottawa Hospital and Eastern Ontario Regional Laboratory Association; Ottawa Ontario Canada
| | - Carlos Parra-Herran
- Department of Laboratory Medicine and Pathobiology; University of Toronto; Toronto Ontario Canada
- Sunnybrook Health Science Centre; Toronto Ontario Canada
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Saraiva AL, Payan-Carreira R, Gärtner F, Fortuna da Cunha MR, Rêma A, Faria F, Lourenço LM, Pires MDA. An immunohistochemical study on the expression of sex steroid receptors, Ki-67 and cytokeratins 7 and 20 in feline endometrial adenocarcinomas. BMC Vet Res 2015; 11:204. [PMID: 26268561 PMCID: PMC4535787 DOI: 10.1186/s12917-015-0530-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 08/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometrial adenocarcinomas are a rare type of tumour in cats. Though different morphologies have been reported, the most frequent histological type of feline endometrial adenocarcinoma (FEA) is the papillary serous. Characterization of molecular markers expression in FEA may contribute to clarify the pathogenesis of these tumours and to assess the differences between normal endometrium and FEA regarding the expression pattern of several proteins. Therefore, this study aimed to evaluate the immunohistochemical profile of a wide panel of antibodies (specific for ER-α, PR, Ki-67, CK7 and CK20) in twenty-four cases of FEA. Comparisons were made between FEA and feline normal cyclic endometrium in follicular (n = 13) and luteal (n = 10) stages. Except for Ki-67, all other molecular markers were assessed independently for the intensity of immunolabeling and for the percentage of cells expressing the protein. RESULTS This study showed that in FEA a loss of expression occurs for ER-α (P ≤ 0.0001) and less markedly also for PR. The lost in sex steroid receptors concerns a decrease in both the proportion of labelled cells and the intensity of immunolabelling (P = 0.002 and P = 0.024, respectively). Proliferative activity, estimated via Ki-67 immunoreaction, significantly increased in FEA as compared to normal endometrium (P ≤ 0.0001). Feline endometrial adenocarcinomas maintained the CK7+/CK20+ status of normal endometrium. However, FEA showed decreased CK7 intensity of labelling compared to normal endometria (P ≤ 0.0001) and loss of CK20 expression, both in intensity (P ≤ 0.0001) and in percentage of positive cells (P = 0.01), compared to normal tissues. CONCLUSIONS Data gathered in this study suggest that proliferation in FEA accompanies ER-α down-regulation, possibly following activation of pathways mediated by local growth factors. Moreover, FEA retains combined expression of CK7 and CK20, as evidenced in normal endometrial epithelia, although a decrease in CK7 expression was observed.
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Affiliation(s)
- Ana Laura Saraiva
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal. .,Escola Universitária Vasco da Gama (EUVG), Avenida José R. Sousa Fernandes, Campus Universitário, Bloco B, Lordemão, 3020-210, Coimbra, Portugal.
| | - Rita Payan-Carreira
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Fátima Gärtner
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal. .,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal.
| | - Marta R Fortuna da Cunha
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Alexandra Rêma
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal.
| | - Fátima Faria
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal.
| | - Lígia M Lourenço
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Maria Dos Anjos Pires
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
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Barbeiro S, Martins CA, Gonçalves C. Duodenal and Colonic Metastases of Ovarian Neoplasm. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2015; 22:175-177. [PMID: 28868401 PMCID: PMC5580010 DOI: 10.1016/j.jpge.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra Barbeiro
- Gastroenterology Department, Centro Hospitalar de Leiria, Leiria, Portugal
| | | | - Cláudia Gonçalves
- Gastroenterology Department, Centro Hospitalar de Leiria, Leiria, Portugal
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Ueda T, Nakagawa H, Hachisuga T. Ovarian mucinous epithelial neoplasm showing immunohistochemical pattern of lower gastrointestinal origin with stromal minor sex-cord elements: A case report. Gynecol Oncol Rep 2015; 10:13-5. [PMID: 26075993 PMCID: PMC4434153 DOI: 10.1016/j.gore.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 08/15/2014] [Indexed: 11/19/2022] Open
Abstract
•We report a case of an ovarian mucinous cystadenoma that exhibited extensive sex-cord differentiation.•The ovarian tumor coincided with a uterine endometrial carcinoma.•The immunohistochemical pattern of mucinous epithelium of the ovarian tumor was suggestive of lower gastrointestinal origin.
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Affiliation(s)
- Taeko Ueda
- Corresponding author. Tel.: + 81 93 603 1611; fax: + 81 93 691 9337.
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Lino-Silva LS, Salcedo-Hernández RA, Herrera-Gómez A, Padilla-Rosciano A, Ramírez-Jaramillo M, Herrera-Goepfert RE, Meneses-García A. Colonic Cribriform Carcinoma, a Morphologic Pattern Associated With Low Survival. Int J Surg Pathol 2015; 23:13-19. [DOI: 10.1177/1066896914542125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Colorectal carcinoma is one of the most common cancers in the human body. Colorectal carcinoma is a heterogeneous disease with variegated morphological patterns; some have shown themselves to have prognostic value. The World Health Organization classification recognizes many histological variants associated with adverse prognostic factors, one is the cribriform colonic carcinoma (CCC). In this work, we analyzed 18 cases of CCC compared with 228 conventional adenocarcinomas of colon, with the hypotheses that CCC compared with non-CCC have worse prognosis and decreased overall survival. CCC represent 7.3% of all colonic adenocarcinomas in this series, it presents in a median age of 56.3 years, all cases are in clinical stage III and IV, all invade subserosal adipose tissues or serosa, 90% have >5 positive lymph nodes and 89% have lymphovascular invasion. These known adverse prognostic factors reflect a lower 5-year survival, stage by stage, than conventional intestinal-type adenocarcinoma (56.8% vs 83.3%, P = .035). Cribriform carcinoma is a morphologic pattern that is underrecognized; in this work, we demonstrate its association with low survival, extensive lymphovascular invasion, and extensive lymph node metastasis, strong indicators of aggressive disease. Their proper recognition is mandatory to increase the number of cases and series to support our findings and include it in the current classifications.
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Takayama Y, Nobusawa S, Ochiai I, Watanabe H, Ishigame H, Ikota H, Hirato J, Nakayama J, Yokoo H. Malignant meningioma with adenocarcinoma-like metaplasia: demonstration of intestinal phenotype. Neuropathology 2014; 35:158-64. [PMID: 25377638 DOI: 10.1111/neup.12155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/13/2014] [Indexed: 11/27/2022]
Abstract
Meningiomas show a diverse histopathologic appearance, often referred to as metaplastic changes; however, adenocarcinoma-like metaplasia is an extremely rare condition. Here, we present a novel case. A dura-based bulky mass located in the right frontotemporal region was identified radiologically in an 83-year-old woman. The tumor, yellow to ash-gray in color, was subtotally removed. Histopathological examination revealed robust adenocarcinoma-like structures within a conventional meningothelial neoplasm. Meningioma elements showed a WHO grade I to III histology. Morphological and immunophenotypic transition between meningothelial and columnar epithelial cells was confirmed on detailed observation. It was of note that the adenocarcinomatous components shared an immunophenotype with intestinal epithelium, expressing CDX2, MUC2 and cytokeratin 20. The present case could be differentiated from secretory meningioma based on distinct cellular atypia, lack of intracytoplasmic lumina and pseudosammoma bodies, and the intact status of the KLF4 gene. In addition, the morphological and immunophenotypic transition excluded the possibility of metastatic carcinoma within meningioma. This is the first reported case of meningioma with adenocarcinoma-like metaplasia harboring an intestinal immunophenotype.
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Affiliation(s)
- Yoshiyasu Takayama
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan; Department of Pathology, Gunma University Hospital, Maebashi, Japan
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He YF, Zhang MY, Wu X, Sun XJ, Xu T, He QZ, Di W. High MUC2 expression in ovarian cancer is inversely associated with the M1/M2 ratio of tumor-associated macrophages and patient survival time. PLoS One 2013; 8:e79769. [PMID: 24324582 PMCID: PMC3855613 DOI: 10.1371/journal.pone.0079769] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/26/2013] [Indexed: 11/21/2022] Open
Abstract
Mucin 2 (MUC2) is a mucin molecule aberrantly expressed by ovarian cancer cells. Previous in vitro studies have indicated that MUC2 promotes cancer growth and metastasis through a tumor-associated macrophage (TAM)-dependent mechanism. However, this mechanism has never been linked to clinical oncology, and its prognostic significance needed to be clarified. Here, we collected 102 consecutive ovarian cancer specimens and used the multiple immuno-histo-chemical/-fluorescent technique to determine the correlations between the MUC2 expression status, the ratio of M1/M2 TAMs and the densities of cyclooxygenase-2 (COX-2)+ TAMs and COX-2+ cancer cells. The Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to evaluate the prognostic influences of these parameters. As a result, we found that the MUC2 overexpression (immunostaining ++/+++) was significantly correlated with a reduced ratio of M1/M2 TAMs (p<0.001), an increased density of COX-2+ TAMs (p<0.001) and an increased density of COX-2+ cancer cells (p=0.017). Moreover, most of the M2 TAMs (93%-100%) and COX-2+ TAMs (63%-89%) overlapped; and the COX-2+ cancer cells were frequently observed near the COX-2+ TAMs. In the Cox regression analysis, MUC2 overexpression was found to be an independent prognostic factor for ovarian cancer patients, of which the hazard ratio (HR) was 2.354 (95% confidence interval (CI): 1.031-10.707, p=0.005). Also, the reduced ratio of M1/M2 TAMs and the increased densities of COX-2+ TAMs and COX-2+ cancer cells were demonstrated to be the predictors of poor prognosis, among which the reduced M1/M2 ratio possessed the highest HR (1.767, 95% CI: 1.061-6.957, p=0.019). All these findings revealed that MUC2 can concurrently exert M2-polarizing and COX-2-inducing effects on TAMs, by which it causes an imbalanced TAM M1-/M2-polarization pattern and induces local PGE2 synthesis (in both TAMs and cancer cells). The positive feedback between local PGE2 synthesis and TAM M2-polarization accelerates ovarian cancer progression.
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MESH Headings
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/metabolism
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/pathology
- Aged
- Cyclooxygenase 2/genetics
- Cyclooxygenase 2/metabolism
- Cystadenocarcinoma, Serous/genetics
- Cystadenocarcinoma, Serous/metabolism
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- Dinoprostone/metabolism
- Feedback, Physiological
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Macrophages/classification
- Macrophages/metabolism
- Macrophages/pathology
- Middle Aged
- Mucin-2/genetics
- Mucin-2/metabolism
- Neoplasm Staging
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Proportional Hazards Models
- Signal Transduction
- Survival Analysis
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Affiliation(s)
- Yi-feng He
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Mei-ying Zhang
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xin Wu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiang-jun Sun
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ting Xu
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Qi-zhi He
- Department of Pathology, First Maternity and Infant Health Hospital, Tongji University, Shanghai, China
| | - Wen Di
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- * E-mail:
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Ou J, Deng J, Wei X, Xie G, Zhou R, Yu L, Liang H. Fibronectin extra domain A (EDA) sustains CD133(+)/CD44(+) subpopulation of colorectal cancer cells. Stem Cell Res 2013; 11:820-33. [PMID: 23811539 DOI: 10.1016/j.scr.2013.05.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 04/24/2013] [Accepted: 05/19/2013] [Indexed: 12/21/2022] Open
Abstract
Fibronectin is a major extracellular matrix glycoprotein with several alternatively spliced variants, including extra domain A (EDA), which was demonstrated to promote tumorigenesis via stimulating angiogenesis and lymphangiogenesis. Given that CD133(+)/CD44(+) cancer cells are critical in tumorigenesis of colorectal cancer (CRC), we hypothesize that fibronectin EDA may promote tumorigenesis by sustaining the properties of CD133(+)/CD44(+) colon cancer cells. We found that tumor tissue and serum EDA levels are substantially higher in advanced versus early stage human CRC. Additionally we showed that tumor tissue EDA levels are positively correlated with differentiation status and chemoresistance, and correlated with a poor prognosis of CRC patients. We also showed that in colon cancer cells SW480, CD133(+)/CD44(+) versus CD133(-)/CD44(-) cells express significantly elevated EDA receptor integrin α9β1. Silencing EDA in SW480 cells reduces spheroid formation and cells positive for CD133 or CD44, which is associated with reduced expressions of embryonic stem cell markers and increased expressions of differentiation markers. Blocking integrin α9β1 function strongly reversed the effect of EDA overexpression. We also provided evidence suggesting that EDA sustains Wnt/β-catenin signaling activity via activating integrin/FAK/ERK pathway. In xenograft models, EDA-silenced SW480 cells exhibit reduced tumorigenic and metastatic capacity. In conclusion, EDA is essential for the maintenance of the properties of CD133(+)/CD44(+) colon cancer cells.
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Affiliation(s)
- Juanjuan Ou
- Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, China
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Xu HT, Liu Y, Liu SL, Miao Y, Li QC, Wang EH. TC-1 (C8orf4) expression is correlated with differentiation in ovarian carcinomas and might distinguish metastatic ovarian from metastatic colorectal carcinomas. Virchows Arch 2013; 462:281-7. [PMID: 23377761 DOI: 10.1007/s00428-013-1375-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/04/2013] [Accepted: 01/23/2013] [Indexed: 10/27/2022]
Abstract
Thyroid cancer 1 (TC-1, C8orf4) is involved in the development of many cancers. In this study, we investigated the correlation between the expression of TC-1 and the clinicopathological characteristics of ovarian and colorectal adenocarcinomas. We also explored the possible use of TC-1 as a marker to distinguish between metastatic tumors of the ovary and colorectum. We used immunohistochemistry to examine the expression level of TC-1 in 100 ovarian and 100 colorectal adenocarcinomas and 25 metastatic carcinomas with the ovary or colorectum as primary site. TC-1 was expressed in all ovarian carcinoma samples. The high expression rate of TC-1 was 84 % in ovarian carcinomas, which was much higher than that observed in colorectal adenocarcinomas (35 %, P < 0.001). High expression of TC-1 significantly correlated with poor differentiation of ovarian carcinomas (P = 0.013). To explore the value of TC-1 in distinguishing metastatic ovarian cancers from colorectal cancers, we found the area under the receiver operator characteristic curve of TC-1 to be 0.819 (95 % confidence interval, 0.760-0.878; P < 0.001). Furthermore, TC-1 was highly expressed in 100 % of nine metastatic ovarian cancers, but only in 31 % of 16 metastatic colorectal cancers. The higher expression of TC-1 in ovarian compared to colorectal adenocarcinomas suggests its potential use as a marker, to distinguish between metastatic ovarian and colorectal adenocarcinomas.
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Affiliation(s)
- Hong-Tao Xu
- Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, Shenyang 110001, China.
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Sakai H, Egi H, Hinoi T, Tokunaga M, Kawaguchi Y, Shinomura M, Adachi T, Arihiro K, Ohdan H. Primary lung cancer presenting with metastasis to the colon: a case report. World J Surg Oncol 2012; 10:127. [PMID: 22741562 PMCID: PMC3433337 DOI: 10.1186/1477-7819-10-127] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 06/28/2012] [Indexed: 01/06/2023] Open
Abstract
Although about 50% of lung cancers have distant metastasis at the time of initial diagnosis, colonic metastases are extremely rare. This report presents a rare clinical case of colonic metastasis from primary squamous cell carcinoma of the lung. A 60-year-old female with anorexia and fatigue was referred to the department of pulmonary surgery in our hospital. The patient was diagnosed with primary squamous cell carcinoma of the lung, T2b N3 M1b Stage IV, and chemoradiotherapy was initiated. This treatment led to a good partial response in the primary lung lesion without any new metastatic lesions. The patient developed left abdominal pain due to a bulky sigmoid colon tumor 6 months later, and was preoperatively diagnosed with primary colon cancer. She underwent colonic resection, and the pathology specimen demonstrated poorly differentiated squamous cell carcinoma that was suspected to be colonic metastasis from the primary lung cancer. The postoperative course was uneventful, and she was discharged. Chemotherapy for the lung cancer was scheduled in the department of pulmonary surgery. This report presented a rare case of colonic metastasis from lung cancer. When patients with advanced primary lung cancer complain of abdominal symptoms, we should consider gastrointestinal tract metastasis from lung cancer.
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Affiliation(s)
- Hiroshi Sakai
- Department of Gastroenterological Surgery, Hiroshima University Hospital, Hiroshima, Japan
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Higashiura Y, Kajihara H, Shigetomi H, Kobayashi H. Identification of multiple pathways involved in the malignant transformation of endometriosis (Review). Oncol Lett 2012; 4:3-9. [PMID: 22807950 DOI: 10.3892/ol.2012.690] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/18/2012] [Indexed: 12/14/2022] Open
Abstract
The association between endometriosis and malignant transformation has often been described in the medical literature. A search was conducted between 1966 and 2010 through the English language literature (online Medline PubMed database) using the keywords endometriosis combined with malignant transformation. The search revealed an increase in reports describing endometriosis and malignancy. Approximately 1.0% of women with endometriosis have lesions that undergo malignant transformation. The malignant processes that are associated with endometriosis may be classified into three groups: i) epithelial ovarian cancers (endometrioid adenocarcinoma and clear cell carcinoma), ii) other Müllerian-type tumors, including Müllerian-type mucinous borderline tumor and serous borderline tumor and iii) sarcomas such as adenosarcoma and endometrial stromal sarcoma in the female pelvic cavity. Persistent oxidative stress induced by endometriosis-dependent hemorrhage may be associated with carcinogenesis. In conclusion, the malignant transformation of endometriosis has multiple pathways of development and may share a common pathogenic mechanism; iron-induced oxidative stress derived from repeated hemorrhage.
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Affiliation(s)
- Yumi Higashiura
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
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Guo AT, Song X, Wei LX, Zhao P. Histological origin of pseudomyxoma peritonei in Chinese women: Clinicopathology and immunohistochemistry. World J Gastroenterol 2011; 17:3531-7. [PMID: 21941421 PMCID: PMC3163252 DOI: 10.3748/wjg.v17.i30.3531] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/01/2011] [Accepted: 03/08/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the histological origin of pseudomyxoma peritonei (PMP) in Chinese women.
METHODS: The clinical and pathological data were reviewed for 35 women with PMP, and specimens of the peritoneal, appendiceal and ovarian lesions of each patient were examined using the PV-6000 immunohistochemistry method. Antibodies included cytokeratin (CK)7, CK20, mucin (MUC)-1, MUC-2, carbohydrate antigen (CA)-125, estrogen receptor (ER), and progesterone receptor (PR).
RESULTS: Abundant colloidal mucinous tumors were observed in the peritoneum in all 35 cases. Thirty-one patients had a history of appendectomy, 28 of whom had mucinous lesions. There was one patient with appendicitis, one whose appendix showed no apparent pathological changes, and one with unknown surgical pathology. Ovarian mucinous tumors were found in 24 patients. The tumors were bilateral in 13 patients, on the right-side in nine, and on the left side in two. Twenty patients had combined appendiceal and ovarian lesions; 16 of whom had undergone initial surgery for appendiceal lesions. Four patients had undergone initial surgery for ovarian lesions, and relapse occurred in these patients at 1, 11, 32 and 85 mo after initial surgery. Appendiceal mucinous tumors were found in each of these four patients. Thirty-three of the 35 patients showed peritoneal lesions that were positive for CK20 and MUC-2, but negative for CK7, MUC-1, CA125, ER and PR. The expression patterns in the appendix and the ovary were similar to those of the peritoneal lesions. In one of the remaining two cases, CK20, CK7 and MUC-2 were positive, and MUC-1, CA125, ER and PR were negative. The ovaries were not resected. The appendix of one patient was removed at another hospital, and no specimen was evaluated. In the other case, the appendix appeared to be normal during surgery, and was not resected. Peritoneal and ovarian lesions were negative for CK20, MUC-2, CK7, MUC-1, CA125, ER and PR.
CONCLUSION: Most PMP originated from the appendix. Among women with PMP, the ovarian tumors were implanted rather than primary. For patients with PMP, appendectomy should be performed routinely. The ovaries, especially the right ovaries should be explored.
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Chen Y, Cui T, Yang L, Mireskandari M, Knoesel T, Zhang Q, Pacyna-Gengelbach M, Petersen I. The Diagnostic Value of Cytokeratin 5/6, 14, 17, and 18 Expression in Human Non-Small Cell Lung Cancer. Oncology 2011; 80:333-40. [PMID: 21791943 DOI: 10.1159/000329098] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 05/04/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Yuan Chen
- Institute of Pathology, University Hospital Jena, Friedrich Schiller University Jena, Ziegelmühlenweg 1, Jena, Germany
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Maeda H, Okabayashi T, Hanazaki K, Kobayashi M. Clinical experience of Pseudo-Meigs’ Syndrome due to colon cancer. World J Gastroenterol 2011; 17:3263-6. [PMID: 21912477 PMCID: PMC3158404 DOI: 10.3748/wjg.v17.i27.3263] [Citation(s) in RCA: 4] [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: 01/04/2011] [Revised: 03/01/2011] [Accepted: 03/08/2011] [Indexed: 02/06/2023] Open
Abstract
We report a rare case of Pseudo-Meigs’ Syndrome caused by ovarian metastasis from sigmoid colon cancer, which was accompanied by peritoneal dissemination. A 58-year-old female patient presented with massive right pleural effusion, ascites and a huge pelvic mass. Under the diagnosis of an advanced ovarian tumor, bilateral oophorectomy was performed and sigmoidectomy was also carried out after intraoperative diagnosis of peritoneal dissemination involving the sigmoid colon. However, immunohistochemical staining revealed that the ovarian lesions were metastasis from the primary advanced colon cancer. Postoperatively, ascites and pleural effusion subsided, and the diagnosis of Pseudo-Meigs’ Syndrome due to a metastatic ovarian tumor from colon cancer was determined. The patient is now undergoing a regimen of chemotherapy for colon cancer without recurrence of ascites or hydrothorax 10 mo after the surgery. Pseudo-Meigs’ Syndrome due to a metastatic ovarian tumor from colon cancer is rare but clinically important because long-term alleviation of symptoms can be achieved by surgical resection. This case report suggests that selected patients, even with peritoneal dissemination, may obtain palliation from surgical resection of metastatic ovarian tumors.
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Abstract
Mucinous carcinomas are uncommon histological types that affect several organ sites. Primary mucinous carcinomas of the ovary are distinct from other ovarian carcinoma types, but they can pose a particular challenge for correct diagnosis from metastases, which most usually originate from the colorectum. Correct diagnosis is the mainstay of treatment, because standard practice states that protocols are tailored to the primary organ site. Little is known of mutational alterations in primary and metastatic mucinous carcinomas of the ovary, and few markers exist that can discriminate between them. We reviewed commonalities between ovarian and colorectal mucinous carcinomas with respect to aetiology, molecular alterations, differential diagnosis, and implications for treatment. Although primary mucinous carcinomas of the ovary and colorectum share similar mutational patterns and unfavourable outcomes at advanced stage, compared with their non-mucinous counterparts, important differences exist with respect to mucin localisation and specific molecular alterations. Technologies--eg, next-generation sequencing--could aid identification of additional driver molecular changes that will help clarify the relation between mucinous carcinomas from different organ sites. Perhaps, then, we can consider moving towards testing and adoption of therapeutic approaches tailored to molecular characteristics of mucinous carcinomas, irrespective of organ site, so patients' survival can be optimised.
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Affiliation(s)
- Linda E Kelemen
- Department of Population Health Research, Alberta Health Services-Cancer Care, Calgary, AB, Canada.
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