1
|
Wang Q, Li Y, Kan G, Fu X, Wang M, Zhu J. Gastric‑type endocervical adenocarcinoma: A report of two cases. Oncol Lett 2024; 28:344. [PMID: 38872865 PMCID: PMC11170259 DOI: 10.3892/ol.2024.14477] [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: 11/22/2023] [Accepted: 05/09/2024] [Indexed: 06/15/2024] Open
Abstract
Gastric-type endocervical adenocarcinoma (GEA) is an uncommon and highly aggressive malignancy, characterized by non-specific clinical manifestations. The limited number of documented cases poses significant challenges in achieving an early preoperative diagnosis. In the present study, two cases of GEA in female patients, aged 46 and 39 years, who presented with the chief complaint of profuse vaginal discharge are described. Both patients underwent a total hysterectomy and bilateral adnexectomy, leading to the definitive diagnosis of GEA through routine pathological and immunohistochemical examination. Following surgery, case one received conventional chemotherapy with paclitaxel and carboplatin, demonstrating no evidence of recurrence during a follow-up period of >2 years. At present, patient B has been followed up for >1 year without any signs of disease recurrence. Given the rarity and diagnostic challenges associated with GEA, further investigations into its pathogenesis and diagnostic modalities are warranted. Additionally, due to its poor prognosis, close surveillance is essential for monitoring potential recurrences. Reporting such cases is crucial in aiding clinicians to make accurate diagnoses and treatment decisions.
Collapse
Affiliation(s)
- Qian Wang
- Department of Ultrasound Medicine, The First People's Hospital of Linhai City, Linhai, Zhejiang 317000, P.R. China
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Yanyu Li
- Department of Ultrasound Medicine, The First People's Hospital of Linhai City, Linhai, Zhejiang 317000, P.R. China
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Guangjuan Kan
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Xiaofeng Fu
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Minyan Wang
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Jiang Zhu
- Department of Ultrasound Medicine, and State Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| |
Collapse
|
2
|
Zhong D, Gao XQ, Li HX, Wang HB, Liu Y. Analysis of Diagnostic Efficacy of the International Ovarian Tumor Analysis ADNEX Model and the ACR O-RADS US (Ovarian-Adnexal Reporting and Data System) for Benign and Malignant Ovarian Tumors: A Retrospective Study in a Tumor Center in Northeast China. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01170-2. [PMID: 38977614 DOI: 10.1007/s10278-024-01170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 06/12/2024] [Accepted: 06/12/2024] [Indexed: 07/10/2024]
Abstract
This study is to analyze and compare the diagnostic efficacy of the ADNEX model and O-RADS in Northeast China for benign and malignant ovarian-adnexal tumors. From July 2020 to February 2022, ultrasound images of 312 ovarian-adnexal masses included in the study were analyzed retrospectively, and the properties of these masses were identified using the ADNEX model and O-RADS. The diagnostic efficiency of the ADNEX model and O-RADS was analyzed using a ROC curve, and the capacities of the two models in differentiating benign and malignant ovarian masses at the optimum cutoff value were compared, as well as the consistency of their diagnosis results was evaluated. The study included 312 ovarian-adnexal masses, including 145 malignant masses and 167 benign masses from 287 patients with an average age of (46.8 ± 11.3) years. The AUC of the ADNEX model was 0.974, and the optimum cutoff value was the risk value > 24.2%, with the corresponding sensitivity and specificity being 97.93 and 86.83, respectively. The AUC of the O-RADS was 0.956, and the optimum cutoff value was > O-RADS 3, with the corresponding sensitivity and specificity being 97.24 and 85.03, respectively. The AUCs of the two models were 0.924 and 0.911 at the optimum cutoff values, with no statistical differences between them (P = 0.284). Consistency analysis: the kappa values of the two models for the determination and pathological results of masses were 0.840 and 0.815, respectively, and that for the diagnostic outcomes was 0.910. Both the ADNEX model and O-RADS had good diagnostic performance in people from Northeast China. Their diagnostic capabilities were similar, and diagnostic results were highly consistent at the optimum cutoff values.
Collapse
Affiliation(s)
- Di Zhong
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Nan Gang District, No.150 of Ha Ping Road, Harbin, 150000, China
| | - Xiao-Qiang Gao
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Nan Gang District, No.150 of Ha Ping Road, Harbin, 150000, China
| | - Hai-Xia Li
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Nan Gang District, No.150 of Ha Ping Road, Harbin, 150000, China
| | - Hong-Bo Wang
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Nan Gang District, No.150 of Ha Ping Road, Harbin, 150000, China
| | - Ying Liu
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Nan Gang District, No.150 of Ha Ping Road, Harbin, 150000, China.
| |
Collapse
|
3
|
Sulaniya C, Lakhera KK, Babu A, Patel P, Singh S, Mehta D, Singhal PM. Ovarian Germ Cell Tumors in North-Western India: A Comprehensive 3-Year Retrospective Study of 145 Cases at a Tertiary Cancer Hospital. Indian J Surg Oncol 2024; 15:288-295. [PMID: 38741622 PMCID: PMC11088569 DOI: 10.1007/s13193-024-01889-y] [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: 08/14/2023] [Accepted: 01/03/2024] [Indexed: 05/16/2024] Open
Abstract
Germ cell tumors encompass a broad spectrum of neoplasms arising from germ cell lineage, demonstrating varying histological profiles and clinical presentations. These tumors encompass a range of benign and malignant entities. While global trends provide insights into their prevalence, specific regional variations, such as those within North-Western India, remain less explored. This study seeks to bridge this knowledge gap by examining the prevalence and characteristics of germ cell tumors within a tertiary cancer hospital. In this retrospective analysis, all cases of germ cell tumors diagnosed over a 3-year period in the specified tertiary cancer hospital were included. Cases with incomplete records or inadequate pathological data were excluded. Data encompassing histological subtypes, patient age distribution, clinical presentations, and histopathological features were collected and analyzed. The study comprised 145 cases of germ cell tumors. Teratomas were the most prevalent subtype, with mature teratomas accounting for the majority. The highest incidence occurred within the 21-30-year age group with a mean age of 24.77 years. Abdominal mass (56%) and abdominal pain (34%) were the prominent clinical presentations. Benign cases constituted the majority 85.5%. Solid tumors (p < 0.00001) and tumors more than 10 cm (p .029028) were found to have a high propensity to be malignant, which was proven to be statistically significant. This study comprehensively explains germ cell tumors' prevalence, clinical features, and histopathological subtypes in a tertiary cancer hospital in North-Western India. The predominance of teratomas, particularly mature ones, aligns with global trends. The age distribution and clinical presentations reflect common patterns. The diverse histopathological appearances underscore the heterogeneous nature of germ cell tumors. This study offers valuable insights for clinical management and further regional research.
Collapse
Affiliation(s)
- Chandrakanta Sulaniya
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Kamal Kishor Lakhera
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Agil Babu
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Pinakin Patel
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Suresh Singh
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Deeksha Mehta
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| | - Pranav Mohan Singhal
- Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India
| |
Collapse
|
4
|
Wang X, Xu X, Ma Y, Tang Y, Huang Z. Comparative Study of 5-Aminolevulinic Acid-Mediated Photodynamic Therapy and the Loop Electrosurgical Excision Procedure for the Treatment of Cervical High-Grade Squamous Intraepithelial Lesions. Pharmaceutics 2024; 16:686. [PMID: 38794347 PMCID: PMC11125031 DOI: 10.3390/pharmaceutics16050686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
The loop electrosurgical excision procedure (LEEP) is a common treatment for cervical intraepithelial neoplasia (CIN). Photodynamic therapy (PDT) mediated by 5-aminolevulinic acid (ALA) is a non-invasive modality that has been used for treating precancerous diseases and HPV infections. This comparative study evaluated the efficacy and safety of ALA PDT and the LEEP in the treatment of cervical high-grade squamous intraepithelial lesions (HSILs). Patient records were reviewed and HSIL patients with HPV infections (24-51 years old) who underwent PDT or LEEP treatment were selected. Efficacy was analyzed blindly based on HPV-DNA, cytology, and colposcopy-directed biopsy obtained at 6 months after treatment. Treatment-related discomfort and side effects were also analyzed. Cure rates of 88.1% and 70.0% were achieved for the PDT group and LEEP group (p < 0.05), respectively. HPV-negative conversion rates of 81.0% and 62.0% were achieved for the PDT group and LEEP group (p < 0.05), respectively. The overall lesion remission rate of the PDT group was 19% higher than that of the LEEP group. The incidence of side effects was much lower in the PDT group. These results show that ALA PDT is a feasible non-invasive treatment for cervical HSIL.
Collapse
Affiliation(s)
- Xiaoyun Wang
- Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xiaoming Xu
- Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yaxi Ma
- Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yixin Tang
- Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zheng Huang
- MOE Key Laboratory of Medical Optoelectronics Science and Technology, Fujian Normal University, Fuzhou 350117, China
| |
Collapse
|
5
|
Wang X, Wang YF, Wang SJ. Value of Molecular Typing Combined with Integrated Positron Emission Tomography/Magnetic Resonance Imaging in Risk Stratification of Endometrial Cancer. Int J Womens Health 2024; 16:831-842. [PMID: 38769949 PMCID: PMC11104377 DOI: 10.2147/ijwh.s444046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Objective In this study, we investigated the value of molecular typing combined with integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) semi-quantitative indices in endometrial cancer risk stratification. Methods A retrospective study was conducted on 86 patients who were pathologically diagnosed with endometrial cancer and underwent surgical treatment after curettage at the Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University between January 2017 and March 2023. Prior to surgery, each patient underwent integrated PET/MRI examination. The postoperative samples were subjected to pathological diagnosis, immunohistochemistry, and POLE gene sequencing. The differences in clinicopathological features between the four molecular subtypes and the differences in integrated PET/MRI semi-quantitative indexes (SUV max, ADC min) between the four molecular subtypes were analyzed. The cutoff value of molecular typing combined with integrated PET/MRI semi-quantitative indices for endometrial cancer risk stratification was determined. Results There were statistically significant differences in pathological types and tumor grades among the four molecular subtypes of endometrial cancer. The values of the four integrated PET/MRI semi-quantitative indices (SUV max and ADC min) of the molecular subtypes were statistically different. The SUV max was greater in the p53abn mutation group than in the POLE mutation group (P < 0.05). The ADC minimum of the POLE mutation group and the MMR-d group was lower than the NSMP group (P < 0.05). Molecular typing combined with the integrated PET/MRI semi-quantitative SUV max index can predict the low/medium risk group of endometrial cancer and the medium-high/high risk group, and the cut-off value of SUV max for predicting the risk of early endometrial cancer was 14.72 (sensitivity 66.7%, specificity 68.7%). Conclusion Molecular typing combined with integrated PET/MRI semi-quantitative indicators is useful to achieve risk stratification in patients diagnosed with endometrial cancer and guide individualized treatment.
Collapse
Affiliation(s)
- Xuan Wang
- Department of Gynecology, Xuanwu Hospital Capital Medical University, Beijing, 100053, People’s Republic of China
| | - Yi-Fan Wang
- Department of Gynecology, Beijing Youan Hospital Capital Medical University, Beijing, 100069, People’s Republic of China
| | - Shi-Jun Wang
- Department of Gynecology, Xuanwu Hospital Capital Medical University, Beijing, 100053, People’s Republic of China
| |
Collapse
|
6
|
Webb PM, Jordan SJ. Global epidemiology of epithelial ovarian cancer. Nat Rev Clin Oncol 2024; 21:389-400. [PMID: 38548868 DOI: 10.1038/s41571-024-00881-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/26/2024]
Abstract
Globally, ovarian cancer is the eighth most common cancer in women, accounting for an estimated 3.7% of cases and 4.7% of cancer deaths in 2020. Until the early 2000s, age-standardized incidence was highest in northern Europe and North America, but this trend has changed; incidence is now declining in these regions and increasing in parts of eastern Europe and Asia. Ovarian cancer is a very heterogeneous disease and, even among the most common type, namely epithelial ovarian cancer, five major clinically and genetically distinct histotypes exist. Most high-grade serous ovarian carcinomas are now recognized to originate in the fimbrial ends of the fallopian tube. This knowledge has led to more cancers being coded as fallopian tube in origin, which probably explains some of the apparent declines in ovarian cancer incidence, particularly in high-income countries; however, it also suggests that opportunistic salpingectomy offers an important opportunity for prevention. The five histotypes share several reproductive and hormonal risk factors, although differences also exist. In this Review, we summarize the epidemiology of this complex disease, comparing the different histotypes, and consider the potential for prevention. We also discuss how changes in the prevalence of risk and protective factors might have contributed to the observed changes in incidence and what this might mean for incidence in the future.
Collapse
Affiliation(s)
- Penelope M Webb
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
- School of Public Health, The University of Queensland, Herston, Queensland, Australia.
| | - Susan J Jordan
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| |
Collapse
|
7
|
Yin X, Wei X, Al Shamsi R, Ali FS, Al Kindi F, Zhang X, Liang J, Pan X, Al Masqari M, Zheng L, Zhou Q, Agaimy A, Chen N. Benign metastasizing fumarate hydratase (FH)-deficient uterine leiomyomas: clinicopathological and molecular study with first documentation of multi-organ metastases. Virchows Arch 2024:10.1007/s00428-024-03806-8. [PMID: 38642139 DOI: 10.1007/s00428-024-03806-8] [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: 02/04/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
Leiomyoma is the most prevalent benign tumor of the female reproductive system. Benign metastasizing leiomyoma (BML) is a rare phenomenon that presents at distant sites, typically the lungs, exhibiting histopathological features similar to the primary uterine tumor in the absence of malignancy features in both. Fumarate hydratase-deficient uterine leiomyoma (FH-d UL) is an uncommon subtype among uterine smooth muscle tumors (0.5-2%), showing distinctive histomorphology and FH inactivation. The majority of FH-d ULs are sporadic, caused by somatic FH inactivation, while a minority of cases occur in the context of the hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome caused by germline FH inactivation. Metastasizing FH-d UL has not been well documented and might be under-reported. Here, we present two cases (21- and 34-year-old females) who presented with metastasizing FH-d UL after myomectomy/hysterectomy with histologically proven multiple lung metastases in both, in addition to multi-organ involvement in one case (cervical-thoracic lymph nodes, left kidney, perihepatic region, left zygomatic bone, and soft tissues). Pathological examination confirmed FH-d leiomyomas in the primary/recurrent uterine tumors, multiple lung lesions, and a renal mass. The minimal criteria for diagnosis of leiomyosarcoma were not fulfilled. Genetic testing revealed germline pathogenic FH variants in both cases (c.1256C > T; p.Ser419Leu in Case 1 and c.425A > G; p.Gln142Arg in Case 2). These novel cases highlight a rare but possibly under-recognized presentation of FH-d BML. Our study suggests that FH-d BML cases might be enriched for the HLRCC syndrome.
Collapse
Affiliation(s)
- Xiaoxue Yin
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxia Wei
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ruqaiya Al Shamsi
- Department of Pathology, The Royal Hospital, Muscat, Sultanate of Oman
| | - Fatima S Ali
- Department of Pathology, The Royal Hospital, Muscat, Sultanate of Oman
| | - Faiza Al Kindi
- Department of Radiology, The Royal Hospital, Muscat, Sultanate of Oman
| | - Xingming Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Liang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuyi Pan
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Linmao Zheng
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiao Zhou
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Abbas Agaimy
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Ni Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
8
|
Liu S, Li F, Cao Q, Li N, Gao Q. A Case Study of Gastric Adenocarcinoma and Squamous Cell Carcinoma of the Cervix. Onco Targets Ther 2024; 17:339-344. [PMID: 38644954 PMCID: PMC11027916 DOI: 10.2147/ott.s435811] [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: 11/20/2023] [Accepted: 03/28/2024] [Indexed: 04/23/2024] Open
Abstract
Gastric adenocarcinoma (GAS) is a rare subtype of mucinous adenocarcinoma characterized by gastric differentiation and is unrelated to human papillomavirus (HPV) infection. This report discusses a 40-year-old female who presented with abdominal distension accompanied by increased abdominal circumference. CT of the abdomen and pelvis showed a large 21.0*12.7*26.0 cm mass later diagnosed as GAS combined with squamous cell carcinoma on surgical pathology. Immunohistological staining of GAS was positive for CK7, MUC6, PAX-8 CEA, and P53 (wild type) and negative for CDX2, CK20, ER, PR, P16, and WT1. The proliferative index (Ki-67) was 20%. Immunohistochemical staining of squamous cell carcinoma was positive for P16 and P53 (wild type), and the proliferative index (Ki-67) was 90%. However, the pathogenesis and molecular mechanisms of GAS have not been fully elucidated. As more cases are identified and reported, additional targeted therapies can be developed and tested in these patients.
Collapse
Affiliation(s)
- Suqing Liu
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Fengling Li
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Qinghua Cao
- Department of Pathology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Ning Li
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| | - Qian Gao
- Department of Gynaecology and Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People’s Republic of China
| |
Collapse
|
9
|
Wu Z, Zhang Q, Jin Y, Zhang X, Chen Y, Yang C, Tang X, Jiang H, Wang X, Zhou X, Yu F, Wang B, Guan M. Population-based BRCA germline mutation screening in the Han Chinese identifies individuals at risk of BRCA mutation-related cancer: experience from a clinical diagnostic center from greater Shanghai area. BMC Cancer 2024; 24:411. [PMID: 38566028 PMCID: PMC10988807 DOI: 10.1186/s12885-024-12089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Deleterious BRCA1/2 (BRCA) mutation raises the risk for BRCA mutation-related malignancies, including breast, ovarian, prostate, and pancreatic cancer. Germline variation of BRCA exhibits substantial ethnical diversity. However, there is limited research on the Chinese Han population, constraining the development of strategies for BRCA mutation screening in this large ethnic group. METHODS We profile the BRCA mutational spectrum, including single nucleotide variation, insertion/deletion, and large genomic rearrangements in 2,080 apparently healthy Chinese Han individuals and 522 patients with BRCA mutation-related cancer, to determine the BRCA genetic background of the Chinese Han population, especially of the East Han. Incident cancer events were monitored in 1,005 participants from the healthy group, comprising 11 BRCA pathogenic/likely pathogenic (PLP) variant carriers and 994 PLP-free individuals, including 3 LGR carriers. RESULTS Healthy Chinese Han individuals demonstrated a distinct BRCA mutational spectrum compared to cancer patients, with a 0.53% (1 in 189) prevalence of pathogenic/likely pathogenic (PLP) variant, alongside a 3 in 2,080 occurrence of LGR. BRCA1 c. 5470_5477del demonstrated high prevalence (0.44%) in the North Han Chinese and penetrance for breast cancer. None of the 3 LGR carriers developed cancer during the follow-up. We calculated a relative risk of 135.55 (95% CI 25.07 to 732.88) for the development of BRCA mutation-related cancers in the BRCA PLP variant carriers (mean age 42.91 years, median follow-up 10 months) compared to PLP-free individuals (mean age 48.47 years, median follow-up 16 months). CONCLUSION The unique BRCA mutational profile in the Chinese Han highlights the potential for standardized population-based BRCA variant screening to enhance BRCA mutation-related cancer prevention and treatment.
Collapse
Affiliation(s)
- Zhiyuan Wu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Qingyun Zhang
- Central Laboratory, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Yiting Jin
- Department of General Surgery, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Xinju Zhang
- Central Laboratory, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Yanli Chen
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Can Yang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Xuemei Tang
- Central Laboratory, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Haowen Jiang
- Department of Urology, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Xiaoyi Wang
- Department of Pancreatic Surgery, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Xinli Zhou
- Department of Oncology, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Feng Yu
- Health Management Center, Huashan Hospital, Fudan University, 200040, Shanghai, China
| | - Bing Wang
- Health Management Center, Huashan Hospital, Fudan University, 200040, Shanghai, China.
| | - Ming Guan
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, 200040, Shanghai, China.
- Central Laboratory, Huashan Hospital, Fudan University, 200040, Shanghai, China.
| |
Collapse
|
10
|
Lin J, Liu L, Wang L, Ma N, Zhang K, Xie N, Yu H, Deng S, Sun Y. The management of uterine tumor resembling an ovarian sex cord tumor (UTROSCT): case series and literature review. World J Surg Oncol 2024; 22:42. [PMID: 38310233 PMCID: PMC10837875 DOI: 10.1186/s12957-024-03319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
AIMS To present a case series of 11 rare uterine tumors resembling ovarian sex cord tumors (UTROSCTs), and review the literature on this topic to offer up-to-date treatment management for UTROSCTs. METHOD Eight cases from Fujian Cancer Hospital between January 2017 and May 2023 and three patients from Fujian Union Hospital between October 2012 and October 2020 were retrospectively reviewed. All cases were pathologically confirmed as UTROSCTs by two senior and experienced pathologists. Clinical behaviors, medical data, histopathological features, therapy approaches, and survival outcomes were discussed. RESULTS The median age at initial diagnosis was 53 years (29-70 years). 3 (27.3%) patients were under 40. Seven cases presented with abnormal vaginal bleeding, one with menstrual disorder, one with abnormal vaginal secretion, and two patients were accidentally found by physical examination without any symptoms. Three patients were initially misdiagnosed with endometrial cancer by MRI. Curettage was performed in all cases. Nine of them were well diagnosed by routine curettage, except for two samples, which were identified after surgery. Immunohistochemical biomarkers, such as CD99, Desmin, WT-1, CK, Vimentin, SMA, α-Inhibin, Ki67, CD56, ER, PR, and CR, tend to be positive in UTRO SCs patients. Six patients underwent hysterectomy with bilateral salpingo-oophorectomy. Two cases received a radical hysterectomy with bilateral salpingo-oophorectomy, retroperitoneal lymph node dissection, and omentum dissection. Three UTROSCTs were under observation after mass resection. The median PFS was 24 months (range 1-125 months). CONCLUSION UTROSCT is a rare mesenchymal tumor with low malignant potential. Treatment modalities should be carefully considered to balance the therapy outcomes and patient needs. Surgery conservative management might be suitable for young women with fertility desires.
Collapse
Affiliation(s)
- Jie Lin
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Linying Liu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Linghua Wang
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Ning Ma
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Kailin Zhang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ning Xie
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Haijuan Yu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Sufang Deng
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yang Sun
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
| |
Collapse
|
11
|
Li X, Li Y, Shi X, Cheng S, Meng T, Gao H, Shi J. Atypical Placental Site Nodules within the Diverticulum of the Uterine Incision, a Rare Gestational Trophoblastic Disease Misdiagnosed as Intrauterine Residue: A Case Report. Reprod Sci 2024; 31:555-559. [PMID: 37783889 PMCID: PMC10827965 DOI: 10.1007/s43032-023-01361-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023]
Abstract
Atypical placental site nodule (APSN) is a rare benign gestational trophoblastic disease (GTD). It is a tumor-like transformation that has a certain probability of developing into a placental site trophoblastic tumor (PSTT) or epithelioid trophoblastic tumor (ETT). Because of its atypical clinical presentation, it is difficult to diagnose and susceptible to misdiagnosis highly, thus delaying the patient's condition. We report a scarce case of atypical nodules at the placental site of the uterine incision diverticulum in a 35-year-old female, who was irregular vaginal bleeding after a cesarean Sect. 2 years. She was diagnosed by several local hospitals with intrauterine residue and was given a variety of Traditional Chinese Medicine (TCM) orally, but the symptoms of irregular vaginal bleeding have not been alleviated. After being transferred to several hospitals, she went to Hubei Maternal and Child Health Hospital for treatment. Under the condition of excluding the second pregnancy, she underwent hysteroscopic resection of lesions and laparoscopic repair of uterine incision diverticulum. The pathological diagnosis after the operation suggested that the focus at the uterine incision was an atypical placental nodule that invaded the myometrium of the uterus. The operation completely removed the focus, and then the patient was followed up every 3 months in the first postoperative year, then every 6 months up to 3 years, and then annually thereafter up to 5 years, and then maybe every 2 years thereafter. The patient's condition was quickly controlled, and the prognosis was good.
Collapse
Affiliation(s)
- Xin Li
- Medical College, Wuhan University of Science and Technology, Wuhan, 430065, People's Republic of China
| | - Yanli Li
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China
| | - Xiuting Shi
- Medical College, Wuhan University of Science and Technology, Wuhan, 430065, People's Republic of China
| | - Shiyu Cheng
- Medical College, Wuhan University of Science and Technology, Wuhan, 430065, People's Republic of China
| | - Tingzhu Meng
- Medical College, Wuhan University of Science and Technology, Wuhan, 430065, People's Republic of China
| | - Han Gao
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
| | - Jie Shi
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
| |
Collapse
|
12
|
Yadav G, Srinivasan G, Jain A. Cervical cancer: Novel treatment strategies offer renewed optimism. Pathol Res Pract 2024; 254:155136. [PMID: 38271784 DOI: 10.1016/j.prp.2024.155136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Cervical cancer poses a significant global public health issue, primarily affecting women, and stands as one of the four most prevalent cancers affecting woman globally, which includes breast cancer, colorectal cancer, lung cancer and cervical cancer. Almost every instance of cervical cancer is associated with infections caused by the human papillomavirus (HPV). Prevention of this disease hinges on screening and immunization of the patients, yet disparities in cervical cancer occurrence exist between developed and developing nations. Multiple factors contribute to cervical cancer, including sexually transmitted diseases (STDs), reproductive and hormonal influences, genetics, and host-related factors. Preventive programs, lifestyle improvements, smoking cessation, and prompt precancerous lesion treatment can reduce the occurrence of cervical cancer. The persistency and recurrence of the cases are inherited even after the innovative treatments available for cervical cancer. For patient's ineligible for curative surgery or radiotherapy, palliative chemotherapy remains the standard treatment. Novel treatment strategies are emerging to combat the limited effectiveness of chemotherapy. Nanocarriers offer the promise of concurrent chemotherapeutic drug delivery as a beacon of hope in cervical cancer research. The primary aim of this review study is to contribute to a thorough understanding of cervical cancer, fostering awareness and informed decision-making and exploring novel treatment methods such as nanocarriers for the treatment of cervical cancer. This manuscript delves into cutting-edge approaches, exploring the potential of nanocarriers and other innovative treatments. Our study underscores the critical need for global awareness, early intervention, and enhanced treatment options. Novel strategies, such as nanocarriers, offer renewed optimism in the battle against cervical cancer. This research provides compelling evidence for the investigation of these novel therapeutic approaches within the medical field. Cervical cancer remains a formidable adversary, but with ongoing advancements and unwavering commitment, we move closer to a future where it is a preventable and treatable disease, even in the most underserved regions.
Collapse
Affiliation(s)
- Gangotri Yadav
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India.
| | - Ganga Srinivasan
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India
| | - Ashish Jain
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India
| |
Collapse
|
13
|
Bae BK, Bae H, Cho WK, Kim BG, Choi CH, Kim TJ, Lee YY, Lee JW, Kim HS, Park W. Risk Factors Affecting Clinical Outcomes of Low-risk Early-stage Human Papillomavirus-Associated Endocervical Adenocarcinoma Treated by Surgery Alone: Application of Silva Pattern. Int J Gynecol Pathol 2024:00004347-990000000-00134. [PMID: 38294049 DOI: 10.1097/pgp.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
This study aimed to report the clinical outcomes and risk factors for survival of patients with low-risk early-stage human papillomavirus-associated (HPVA) endocervical adenocarcinoma (EAC) treated with surgery alone. This retrospective study obtained the clinicopathological data of patients with early-stage HPVA EAC who underwent surgery between 2012 and 2018. The Silva pattern of invasion was determined by reviewing pathology slides. Locoregional recurrence-free survival (RFS), RFS, and overall survival were calculated, and the risk factors for survival were analyzed. One hundred seventeen patients with a median follow-up of 5.2 years (0.5-9.7 yr) were included. The most common histologic type was usual (94/117, 80.3%). The Silva pattern was A in 79 patients (67.5%), B in 30 (25.6%), and C in 8 (6.8%). The 5-year locoregional RFS, RFS, and overall survival rates were 92.4%, 87.8%, and 97.2%, respectively. The presence of intermediate-risk factors and Silva pattern C were significantly associated with worse survival. Based on these findings, patients were categorized into 2 groups: Group 1 (Silva pattern A or Silva pattern B without intermediate-risk factors) and Group 2 (Silva pattern B with intermediate-risk factors or Silva pattern C). Group 2 showed significantly worse outcomes than Group 1, including the 5-year locoregional RFS (98.6% vs 68.0%), RFS (96.4% vs 54.6%), and overall survival (100.0% vs 86.5%). In conclusion, surgery alone for early-stage HPVA EAC resulted in favorable outcomes. Consideration of the Silva pattern, in addition to well-known risk factors, could help in precise risk group stratification of low-risk, early-stage HPVA EAC.
Collapse
|
14
|
O'Keefe CL, Watts LYA, Allbritton JI. A Case of Basaloid Differentiated Vulvar Intraepithelial Neoplasia. J Low Genit Tract Dis 2024; 28:110-112. [PMID: 37922473 DOI: 10.1097/lgt.0000000000000781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
|
15
|
Dagher C, Liu YL, Mueller JJ, Weigelt B. Moving into the modern era of molecular classification for endometrial cancer. J Surg Oncol 2024; 129:120-125. [PMID: 38100711 DOI: 10.1002/jso.27552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
The molecular subtypes of endometrial carcinoma (EC) were first described by The Cancer Genome Atlas (TCGA) a decade ago. Using surrogate approaches, the molecular classification has been demonstrated to be prognostic across EC patients and to have predictive implications. Starting in 2020, the molecular classification has been incorporated into multiple guidelines as part of the risk assessment and most recently into the International Federation of Gynecology and Obstetrics (FIGO) staging. This review article discusses the implementation of the EC molecular classification into clinical practice, the therapeutic implications, and the molecular and clinical heterogeneity of the EC molecular subtypes.
Collapse
Affiliation(s)
- Christian Dagher
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ying L Liu
- Gynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jennifer J Mueller
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Britta Weigelt
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
16
|
Cavalluzzi MM, Viale M, Rotondo NP, Ferraro V, Lentini G. Drug Repositioning for Ovarian Cancer Treatment: An Update. Anticancer Agents Med Chem 2024; 24:637-647. [PMID: 38367265 DOI: 10.2174/0118715206282904240122063914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/28/2023] [Accepted: 01/06/2024] [Indexed: 02/19/2024]
Abstract
Ovarian cancer (OC) is one of the most prevalent malignancies in female reproductive organs, and its 5-year survival is below 45%. Despite the advances in surgical and chemotherapeutic options, OC treatment is still a challenge, and new anticancer agents are urgently needed. Drug repositioning has gained significant attention in drug discovery, representing a smart way to identify new clinical applications for drugs whose human safety and pharmacokinetics have already been established, with great time and cost savings in pharmaceutical development endeavors. This review offers an update on the most promising drugs repurposable for OC treatment and/or prevention.
Collapse
Affiliation(s)
| | - Maurizio Viale
- U.O.C. Bioterapie, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Valeria Ferraro
- Department of Pharmacy - Drug Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Giovanni Lentini
- Department of Pharmacy - Drug Sciences, University of Bari Aldo Moro, Bari, Italy
| |
Collapse
|
17
|
Leo E, Stanzione A, Miele M, Cuocolo R, Sica G, Scaglione M, Camera L, Maurea S, Mainenti PP. Artificial Intelligence and Radiomics for Endometrial Cancer MRI: Exploring the Whats, Whys and Hows. J Clin Med 2023; 13:226. [PMID: 38202233 PMCID: PMC10779496 DOI: 10.3390/jcm13010226] [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: 12/02/2023] [Revised: 12/23/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Endometrial cancer (EC) is intricately linked to obesity and diabetes, which are widespread risk factors. Medical imaging, especially magnetic resonance imaging (MRI), plays a major role in EC assessment, particularly for disease staging. However, the diagnostic performance of MRI exhibits variability in the detection of clinically relevant prognostic factors (e.g., deep myometrial invasion and metastatic lymph nodes assessment). To address these challenges and enhance the value of MRI, radiomics and artificial intelligence (AI) algorithms emerge as promising tools with a potential to impact EC risk assessment, treatment planning, and prognosis prediction. These advanced post-processing techniques allow us to quantitatively analyse medical images, providing novel insights into cancer characteristics beyond conventional qualitative image evaluation. However, despite the growing interest and research efforts, the integration of radiomics and AI to EC management is still far from clinical practice and represents a possible perspective rather than an actual reality. This review focuses on the state of radiomics and AI in EC MRI, emphasizing risk stratification and prognostic factor prediction, aiming to illuminate potential advancements and address existing challenges in the field.
Collapse
Affiliation(s)
- Elisabetta Leo
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Mariaelena Miele
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Giacomo Sica
- Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Luigi Camera
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Pier Paolo Mainenti
- Institute of Biostructures and Bioimaging of the National Council of Research (CNR), 80131 Naples, Italy
| |
Collapse
|
18
|
Albertí-Valls M, Megino-Luque C, Macià A, Gatius S, Matias-Guiu X, Eritja N. Metabolomic-Based Approaches for Endometrial Cancer Diagnosis and Prognosis: A Review. Cancers (Basel) 2023; 16:185. [PMID: 38201612 PMCID: PMC10778161 DOI: 10.3390/cancers16010185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Endometrial cancer, the most prevalent gynecological malignancy in developed countries, is experiencing a sustained rise in both its incidence and mortality rates, primarily attributed to extended life expectancy and lifestyle factors. Currently, the absence of precise diagnostic tools hampers the effective management of the expanding population of women at risk of developing this disease. Furthermore, patients diagnosed with endometrial cancer require precise risk stratification to align with optimal treatment planning. Metabolomics technology offers a unique insight into the molecular landscape of endometrial cancer, providing a promising approach to address these unmet needs. This comprehensive literature review initiates with an overview of metabolomic technologies and their intrinsic workflow components, aiming to establish a fundamental understanding for the readers. Subsequently, a detailed exploration of the existing body of research is undertaken with the objective of identifying metabolite biomarkers capable of enhancing current strategies for endometrial cancer diagnosis, prognosis, and recurrence monitoring. Metabolomics holds vast potential to revolutionize the management of endometrial cancer by providing accuracy and valuable insights into crucial aspects.
Collapse
Affiliation(s)
- Manel Albertí-Valls
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
| | - Cristina Megino-Luque
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
- Department of Medicine, Division of Hematology and Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Anna Macià
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
| | - Sònia Gatius
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC)
| | - Xavier Matias-Guiu
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC)
- Laboratory of Precision Medicine, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Department of Pathology, Hospital de Bellvitge, Gran via de l’Hospitalet 199, 08908 Barcelona, Spain
| | - Núria Eritja
- Oncologic Pathology Group, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; (C.M.-L.); (A.M.); (S.G.); (X.M.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC)
| |
Collapse
|
19
|
Song DH, Yang J, Kim CH, Kim MH, Jo JY, Baek JC. FcRn Expression in Endometrial Cancer and Its Association with Clinicopathologic Features. Diagnostics (Basel) 2023; 13:3660. [PMID: 38132243 PMCID: PMC10742809 DOI: 10.3390/diagnostics13243660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Endometrial cancer (EC) has robust molecular diagnostic evidence that correlates well with prognosis. In various types of cancers, FcRn has been identified as an early marker for prognosis. This study aims to assess FcRn expression and its association with clinicopathological features in endometrial cancer. MATERIALS AND METHODS We employed a tissue microarray (TMA) from a retrospective cohort of 41 patients diagnosed with endometrioid endometrial cancer post hysterectomy between January 2002 and December 2009 at Gyeongsang National University Hospital. Relevant clinical data collection for the cohort involved reviewing patients' electronic medical charts. FcRn expression in microarrays of patient EC tissue was examined in conjunction with clinicopathologic data. Experiments, including siRNA knock-down, PCR mRNA semiquantification, Western blot, and confluence change tests, were conducted on the Ishikawa cell line. RESULTS The overall FcRn expression rate in EC patients was 41.8%. FIGO stage showed a statistically significant relationship with FcRn expression, while age, lymphovascular invasion, myometrial invasion, and tumor size had no effect. In endometrioid cancer cells of FIGO stage IA, FcRn was less frequently expressed than in other high-staged EC patients (p = 0.021). In experiments on the Ishikawa cell line, the siRNA knock-down group exhibited quantitatively lower FCGRT mRNA expression and lower FcRn protein signal compared to the scrambled RNA control group. The change in confluence over time measured at three hotspots did not show a significant difference between groups. CONCLUSIONS To the best of our knowledge, this study represents the initial assessment of FcRn expression in endometrioid EC samples. FcRn expression was significantly associated with the FIGO stage. Ishikawa cell line proliferation did not significantly change in response to decreased FcRn expression. Further studies are needed to elucidate FcRn expression in EC as a potential molecular parameter.
Collapse
Affiliation(s)
- Dae Hyun Song
- Department of Pathology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea; (D.H.S.); (M.H.K.)
- Department of Pathology, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
| | - Juseok Yang
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
- Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea
| | - Cho Hee Kim
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
| | - Min Hye Kim
- Department of Pathology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea; (D.H.S.); (M.H.K.)
- Department of Pathology, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
| | - Jae Yoon Jo
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
- Department of Obstetrics and Gynecology, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
| | - Jong Chul Baek
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.Y.); (C.H.K.); (J.Y.J.)
- Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea
| |
Collapse
|
20
|
Bizzarri N, Imterat M, Fruscio R, Giannarelli D, Perrone AM, Mancari R, Traut A, Rosati A, du Bois A, Ferrari D, De Iaco P, Ergasti R, Ataseven B, Bianchi T, Di Stanislao M, Perri MT, Heitz F, Concin N, Fanfani F, Vizza E, Scambia G, Harter P, Fagotti A. Lymph node staging in grade 1-2 endometrioid ovarian carcinoma apparently confined to the ovary: Is it worth? Eur J Cancer 2023; 195:113398. [PMID: 37890354 DOI: 10.1016/j.ejca.2023.113398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE The aim of this study was to assess the disease-free survival (DFS) and overall survival (OS) of patients with grade 1-2 endometrioid ovarian carcinoma apparently confined to the ovary, according to surgical staging. METHODS Multicenter, retrospective, observational cohort study. Patients with endometrioid ovarian carcinoma, surgical procedure performed between May 1985 and December 2019, stage pT1 N0/N1/Nx, grade 1-2 were included. Patients were stratified according to lymphadenectomy (defined as removal of any lymph node versus no lymph node assessment), and subgroup analyses according to tumor grade were performed. Kaplan-Meier curves and cox regression analyses were used to perform survival analyses. RESULTS 298 patients were included. 199 (66.8 %) patients underwent lymph node assessment. Of these, 166 (83.4 %) had unilateral/bilateral pelvic and para-aortic/caval lymphadenectomy. Eleven (5.5 %) patients of those who underwent lymph node assessment showed pathologic metastatic lymph nodes (FIGO stage IIIA1). Twenty-seven patients (9.1 %) had synchronous endometrioid endometrial cancer. After a median follow up of 45 months (95 %CI:37.5-52.5), 5-year DFS and OS of the entire cohort were 89.8 % and 96.2 %, respectively. Age ≤ 51 years (HR=0.24, 95 %CI:0.06-0.91; p = 0.036) and performance of lymphadenectomy (HR=0.25, 95 %CI: 0.07-0.82; p = 0.022) represented independent protective factors toward risk of death. Patients undergoing lymphadenectomy had better 5-year DFS and OS compared to those not receiving lymphadenectomy, 92.0 % versus 85.6 % (p = 0.016) and 97.7 % versus 92.8 % (p = 0.013), respectively. This result was confirmed after exclusion of node-positive patients. When stratifying according to tumor grade (node-positive excluded), patients with grade 2 who underwent lymphadenectomy had better 5-year DFS and OS than those without lymphadenectomy (93.0 % versus 83.1 %, p = 0.040 % and 96.5 % versus 90.6 %, p = 0.037, respectively). CONCLUSION Staging lymphadenectomy in grade 2 endometrioid ovarian carcinoma patients was associated with improved DFS and OS. Grade 1 and grade 2 might be considered as two different entities, which could benefit from different approach in terms of surgical staging. Prospective studies, including molecular profiles are needed to confirm the survival drivers in this rare setting.
Collapse
Affiliation(s)
- Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Majdi Imterat
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany; Department of Gynaecologic Oncology, Hadassah Medical Centers, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Robert Fruscio
- Fondazione IRCCS San Gerardo dei Tintori, UOC Ginecologia, Università di Milano-Bicocca, Milano, Italy
| | - Diana Giannarelli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Facility of Epidemiology and Biostatistics, Rome, Italy
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rosanna Mancari
- Gynecologic Oncology Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Alexander Traut
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - Andrea Rosati
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - Debora Ferrari
- Fondazione IRCCS San Gerardo dei Tintori, UOC Ginecologia, Università di Milano-Bicocca, Milano, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Raffaella Ergasti
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Beyhan Ataseven
- Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Klinikum Lippe, Academic Department of Gynecology, Gynecologic Oncology and Obstetrics, Detmold, Germany
| | - Tommaso Bianchi
- Fondazione IRCCS San Gerardo dei Tintori, UOC Ginecologia, Università di Milano-Bicocca, Milano, Italy
| | - Marco Di Stanislao
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Teresa Perri
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany; Department for Gynecology with the Center for Oncologic Surgery Charité Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nicole Concin
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - Anna Fagotti
- UOC Ginecologia Oncologica, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| |
Collapse
|
21
|
Ismail A, Choi S, Boussios S. Frontiers of Ovarian Carcinosarcoma. Curr Treat Options Oncol 2023; 24:1667-1682. [PMID: 37938504 PMCID: PMC10781844 DOI: 10.1007/s11864-023-01138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 11/09/2023]
Abstract
OPINION STATEMENT Ovarian carcinosarcoma (OCS), also known as a malignant mixed Müllerian tumour (MMMT), is a rare and aggressive form of cancer that accounts for less than 5% of ovarian cancers. It is characterized by high morbidity and mortality rates, with a median overall survival (OS) of less than 2 years. Several factors, including advancing age, nulliparity, reduced lactation rates, decreased use of oral contraceptive pills, genetic mutations in BRCA (breast cancer) genes, and the use of assisted reproductive technology, may increase the risk of OCS. Poor prognostic factors include an advanced stage at diagnosis, older age, lymph node metastasis, suboptimal surgical cytoreduction, the presence of heterologous features on histopathology, and increased expression of vascular endothelial growth factor (VEGF), tumour protein p53, and p53 alongside Wilms tumour 1 (WT1). The main treatment approach for OCS is cytoreductive surgery followed by platinum-based chemotherapy, although immunotherapy is showing promise. Homologous recombination deficiency (HRD) testing may enhance outcomes by enabling personalized immunotherapy and targeted therapies for specific patient groups, thereby reducing unnecessary side effects and healthcare costs. However, there is currently a lack of standardised treatment regimens for OCS patients, with most studies consisting of case reports and a shortage of suitable comparator groups. This article aims to provide clinicians with information on the epidemiology, risk factors, prognostic factors, and latest therapeutic advancements in OCS.
Collapse
Affiliation(s)
- Ayden Ismail
- GKT School of Medicine, King's College London, London, SE1 9RT, UK
| | - Sunyoung Choi
- GKT School of Medicine, King's College London, London, SE1 9RT, UK
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Kent, Gillingham, ME7 5NY, UK.
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King's College London, London, SE1 9RT, UK.
- Kent Medway Medical School, University of Kent, Kent, Canterbury, CT2 7LX, UK.
- AELIA Organization, 9Th Km Thessaloniki-Thermi, 57001, Thessaloniki, Greece.
| |
Collapse
|
22
|
Liu S, Yan Y, Cui Z, Feng H, Zhong F, Liu Z, Li Y, Ou X, Li W. Relationship between PIWIL1 gene polymorphisms and epithelial ovarian cancer susceptibility among southern Chinese woman: a three-center case-control study. BMC Cancer 2023; 23:1149. [PMID: 38012622 PMCID: PMC10680212 DOI: 10.1186/s12885-023-11651-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/17/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE To investigate the potential correlation between piwi-like RNA-mediated gene silencing 1 (PIWIL1) polymorphisms and susceptibility to epithelial ovarian cancer (EOC). METHODS A case-control study was conducted to evaluate the susceptibility of EOC using multinomial logistic regression analysis. The study analyzed the relationship between five functional single nucleotide polymorphisms (SNPs) in the PIWIL1 gene and EOC risk. Genotyping of 288 cases and 361 healthy samples from South China was identified using a TaqMan assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the relationship between the five selected SNPs and EOC susceptibility. RESULTS Among the five SNPs analyzed, the rs10848087 G > A and rs7957349 G > C variants significantly increased the susceptibility of EOC, rs10773771 C > T was associated with a decreased risk of EOC, while the rs35997018 and rs1106042 variants were not in Hardy-Weinberg equilibrium (p < 0.05). The rs10848087 G > A was significantly associated with increased risk of EOC in individuals with metastasis, FIGO stage I and III, low and high pathological grade, tumor numbers ≤ 3 and > 3, tumor size > 3 cm and ≤ 3 cm, pregnant more than 3 times, pre-menopausal status, and strong positive expression of ER (estrogen receptor), PR (progesterone receptor), PAX8 (paired-box 8), wild-type p53 (tumor protein 53), WT1 (Wilm's tumor gene), P16 (cyclin-dependent kinase inhibitor 2A). In addition, rs10848087 G > A enhanced the EOC risk of cases with negative/mild positive expression of wild p53 and Ki67, and with or without mutant p53 expression. The rs7957349 G > C variant was linked to an increased risk of EOC in subgroups with certain characteristics, including age equal or less than 53 years, metastasis, clinical stage I, low pathological grade, tumor number, tumor size, pregnant times, post-menopause, pre-menopause, and strong positive expression of wild p53 and Ki67 (Antigen identified by monoclonal antibody Ki-67), as well as without mutant p53 expression. The rs10773771 CT/TT alleles were identified to have a protective effect on EOC in women aged 53 years or older, as well as in cases with metastasis, advanced clinical stage, high pathological grade, multiple tumors, tumor size equal to or less than 3 cm, history of pregnancy, post-menopausal status, and strong positive expression of ER, PR, wild-type p53, PAX8, WT1, P16, and Ki67. Furthermore, rs10773771 CT/TT also showed a protective effect in patients with negative or mildly positive expression of PR, PAX8, wild-type p53, WT1, and P16, as well as positive expression of mutant p53. Compared to the reference haplotype GCG, individuals harboring haplotypes GTG were found to have a significantly decreased susceptibility to EOC. PIWIL1 was significantly expressed in the thyroid, pituitary, and adrenal glands with rs7957349 CC alleles. CONCLUSIONS PIWIL1 rs10848087 and rs7957349 were associated with increased risk of EOC, while rs10773771 may have a protective effect against EOC. These genetic variants may serve as potential biomarkers for EOC susceptibility in the South China population.
Collapse
Affiliation(s)
- Shanshan Liu
- Department of Hematology and Oncology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China
| | - Yaping Yan
- Department of Hematology and Oncology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China
| | - Zhizhong Cui
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, China
| | - Haipeng Feng
- Department of Pathology, Shunde Hospital, Southern Medical University, Foshan, 528000, Guangdong, China
| | - Fengmei Zhong
- Department of Pathology, Shunde Hospital, Southern Medical University, Foshan, 528000, Guangdong, China
| | - Ziguang Liu
- Department of Pathology, Shunde Hospital, Southern Medical University, Foshan, 528000, Guangdong, China
| | - Yan Li
- Medical Research Center, Shunde Hospital, Southern Medical University, Foshan, 528000, Guangdong, China
| | - Xiang Ou
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
| | - Wenjuan Li
- Medical Research Center, Shunde Hospital, Southern Medical University, Foshan, 528000, Guangdong, China.
| |
Collapse
|
23
|
Wang W, Zhang F, Li Y, Chen B, Gu Y, Shan Y, Li Y, Chen W, Jin Y, Pan L. Whole exome sequencing identifies common mutational landscape of cervix and endometrium small cell neuroendocrine carcinoma. Front Oncol 2023; 13:1182029. [PMID: 37920164 PMCID: PMC10618670 DOI: 10.3389/fonc.2023.1182029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023] Open
Abstract
Background Primary small cell neuroendocrine carcinomas of the cervix and endometrium are rare gynecological malignancies with limited treatment options. This study aimed to improve the understanding of the carcinogenesis process and identify potential therapeutic targets for these two tumor types by constructing the mutational landscape at the whole exome level. Methods Primary tumor tissues and their matched blood samples were obtained from 10 patients with small cell cervical neuroendocrine carcinoma (NECC) and five patients with small cell endometrial neuroendocrine carcinoma (NECE). Whole exome sequencing was performed to construct the somatic mutation profiles. Mutational signature and recurrent mutated gene analysis were used to identify tumor subtypes and common carcinogenesis processes. Results Based on the burden of different mutational signatures, the NECCs in this work can be divided into two subtypes, including the mismatch repair deficiency like (dMMR-like) type (4/10) and the high spontaneous deamination type (6/10). Components of the PI3K/AKT signaling and RAS signaling were exclusively mutated in these two subtypes, respectively. The integration of human papillomavirus made a limited contribution to tumorigenesis in NECC (20%). The dysfunction of the mismatch repair system and microsatellite instability are the major features of NECE. PI3K/AKT, JAK/STAT signaling, and chromatin remodeling activity were the common mutated pathways in NECE. PIK3CA, WNK2, and KMT2B underwent mutations in both the dMMR-like subtype of NECC (50% - 75%) and in NECE (60% - 80%) specimens, while exhibiting infrequent mutational occurrences in publicly available data pertaining to neuroendocrine carcinomas of the lung or bladder (< 10%). Conclusion We identified the two subtypes of NECC with distinct mutated pathways and potential therapy targets. The dMMR-like type NECC and NECE may share a similar carcinogenesis process that include dysfunction of PI3K/AKT signaling, cell cycle, antiapoptotic processes, and chromatin remodeling activity.
Collapse
Affiliation(s)
- Wei Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
- Department of Obstetrics and Gynecology, The Fifth People’s Hospital of Ningxia, Shizuishan, China
| | - Fan Zhang
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Engineering Medicine, Beihang University, Beijing, China
| | - Yan Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Gu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Ying Shan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Yaping Li
- Department of Obstetrics and Gynecology, The Fifth People’s Hospital of Ningxia, Shizuishan, China
| | - Wei Chen
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Engineering Medicine, Beihang University, Beijing, China
| | - Ying Jin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Lingya Pan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| |
Collapse
|
24
|
Nakano C, Fukuda T, Tanaka S, Noda T, Uchikura E, Awazu Y, Tasaka R, Imai K, Yamauchi M, Ichimura T, Yasui T, Sumi T. Intestinal‑type mucinous carcinoma of the endometrium showing a polypoidal exophytic form: A case report. Oncol Lett 2023; 26:444. [PMID: 37720664 PMCID: PMC10502935 DOI: 10.3892/ol.2023.14031] [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: 07/14/2023] [Accepted: 08/08/2023] [Indexed: 09/19/2023] Open
Abstract
Although endometrial cancer is a common malignancy in women, rare histological subtypes can pose diagnostic challenges. Primary endometrial intestinal-type mucinous carcinoma is a newly recognized subtype of endometrial cancer that differs from Müllerian-type endometrial mucinous carcinoma. The present case report documents a rare case of intestinal-type mucinous carcinoma of the endometrium showing a polypoidal exophytic form. The patient, an 80-year-old female, was incidentally diagnosed with a uterine tumor during a follow-up for vulvar Paget's disease. Clinical and imaging examinations revealed a localized mass within the uterine cavity. Hysteroscopy and subsequent histological examination confirmed the presence of intestinal-type mucinous carcinoma of the endometrium. Microscopically, the tumor displayed adenocarcinoma containing an intestinal-type glandular epithelium with mild nuclear atypia. It stained positive for the gastrointestinal markers mucin 2 and caudal type homeobox 2, and stained negatively for estrogen receptor α. The patient underwent surgery and adjuvant chemotherapy, with no evidence of recurrence at the latest follow-up 6 months after surgery. Endometrial intestinal-type mucinous carcinoma is a rare histological subtype of endometrial cancer. Differential diagnoses include Müllerian-type endometrial mucinous carcinoma, endocervical adenocarcinoma, metastasis from gastrointestinal tract adenocarcinoma and non-neoplastic gastric/intestinal metaplasia. However, the prognosis of endometrial intestinal-type mucinous carcinoma remains unclear due to limited reported cases. Existing evidence suggests a poorer prognosis compared with classical mucinous carcinomas of the endometrium. The present case, which is characterized by a polypoidal exophytic tumor without myometrial invasion, showed a favorable outcome. Further documentation and characterization of the aforementioned rare malignancy are necessary to enhance the understanding of its clinical physiology and outcomes. The present case report highlights the diagnostic challenges associated with intestinal-type mucinous endometrial carcinoma. The inclusion of this type of malignancy in the latest World Health Organization classification emphasizes the need for further comprehensive studies and case reports to expand the current knowledge on this rare histological subtype.
Collapse
Affiliation(s)
- Chiharu Nakano
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Takeshi Fukuda
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Sayaka Tanaka
- Department of Diagnostic Pathology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Takuya Noda
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Eijiro Uchikura
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Yuichiro Awazu
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Reiko Tasaka
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Makoto Yamauchi
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tomoyuki Ichimura
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tomoyo Yasui
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Toshiyuki Sumi
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| |
Collapse
|
25
|
Zhou Y, Wang A, Sun X, Zhang R, Zhao L. Survival prognosis model for elderly women with epithelial ovarian cancer based on the SEER database. Front Oncol 2023; 13:1257615. [PMID: 37841445 PMCID: PMC10570503 DOI: 10.3389/fonc.2023.1257615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives We aimed to analyze the risk factors of elderly women with epithelial ovarian cancer (EOC) using data on the SEER database, and to generate a nomogram model their 1-, 3-, and 5-year prognoses. The resulting nomogram model should be useful for clinical diagnoses and treatment. Methods We collected clinical data of women older than 70 years with epithelial ovarian cancer (diagnosed on the basis of surgical pathology) from the SEER database including datasets between 2010 and 2019. We randomly grouped the data into two groups (7:3 ratio) using the R language software. We divided the independent prognostic factors obtained by univariate and multi-factor Cox regression analyses into training and validation sets, and we plotted the same independent prognostic factors in a nomogram model of overall survival (OS) at 1, 3, and 5 years. We used the C-index, calibration curve, and area under the curve to validate the nomograms. We further evaluated the model and its clinical applicability using decision curve analyses. Results We identified age, race, marital status, histological type, AJCC staging, differentiation degree, unilateral and bilateral tumor involvement, number of positive lymph nodes, chemotherapy, surgery, sequence of systemic treatment versus surgery, and time from diagnosis to treatment as independent prognostic factors for elderly women with EOC (P < 0.5). The C-indexes were 0.749 and 0.735 in the training and validation sets, respectively; the ROC curves showed that the AUC of each prognostic factor was greater than 0.7; and, the AUC values predicted by the line plot were similar in the training and validation sets. The decision curves suggest that this line plot model has a high clinical value for predicting overall survivals at 1, 3, and 5 years in elderly women with EOC. Conclusion The nomogram model in this study can provide an accurate assessment of the overall survival of women older than 70 years with EOC at the time of the first treatment, and it provides a basis for individualized clinical treatment.
Collapse
Affiliation(s)
- Yingping Zhou
- The First Department of Gynecology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Aifen Wang
- The First Department of Gynecology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Xin Sun
- The First Department of Gynecology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Rong Zhang
- The First Department of General Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Luwen Zhao
- The First Department of Gynecology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| |
Collapse
|
26
|
Wang Y, Zhao L, Zhang K, Liu Y, Guo L, Jing W, Hou H, Shi G, Bin Y, Zhang S, Zhang G, Li Q. Micro-histology combined with cytology improves the diagnostic accuracy of endometrial lesions. Cancer Med 2023; 12:17028-17036. [PMID: 37458126 PMCID: PMC10501300 DOI: 10.1002/cam4.6338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND In the study, we aimed to evaluate the ability of micro-histology combined with cytology to improve the quality of slides and diagnose endometrial lesions. METHODS Endometrial specimens were collected from Li Brushes. Every specimen was prepared for micro-histological and cytological slides, using cell block (CB) and liquid-based cytology (LBC) technologies. Semi-quantitative scoring system was used to evaluate the qualities of slides. CB slides were assessed by 5-category scoring system. Diagnostic accuracy was calculated in LBC, CB, and LBC + CB groups based on the histological gold standard. Endometrial atypical hyperplasia, and endometrial cancer were considered positive, whereas others were considered negative. RESULTS A total of 167 patients were enrolled. CB slides were inferior to LBC slides only in cellularity (p < 0.001), but superior in the other six parameters (all p < 0.001). The satisfaction rate of micro-histology accounted for 92.3%. The accuracy index in the CB group was higher than in the LBC group in terms of sensitivity (85.5% vs. 82.7%) and specificity (98.9% vs. 95.7%). The sensitivity and specificity in the LBC + CB group were increased to 94.2% and 99.0%, respectively. CONCLUSIONS The quality of micro-histological slides was higher than that of cytological slides. By combining micro-histology with cytology, higher accuracy was achieved for endometrial lesions diagnosis.
Collapse
Affiliation(s)
- Yiran Wang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Lanbo Zhao
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Kailu Zhang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Yu Liu
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Lin Guo
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Wei Jing
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Huilian Hou
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Guizhi Shi
- Aviation General Hospital of BeijingMedical University and Beijing Institute of Translational Medicine, University of Chinese Academy of SciencesBeijingChina
| | - Yadi Bin
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Siyi Zhang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Guanjun Zhang
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Qiling Li
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| |
Collapse
|
27
|
Bühler MM, Honcharova-Biletska H, Pauli C, Chronas D, Bolten K. Conservative surgical treatment with fertility preservation in a young adult with NTRK rearranged spindle cell neoplasm of the uterine cervix. Gynecol Oncol Rep 2023; 48:101233. [PMID: 37415959 PMCID: PMC10319898 DOI: 10.1016/j.gore.2023.101233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
In depth molecular studies are constantly expanding our understanding and refining the classification of gynecological neoplasms. NTRK rearranged spindle cell neoplasms of the lower genital tract are an emerging entity, of particular interest due to possible targeted treatment with selective kinase inhibitors. Nonetheless, surgery remains the initial treatment of choice. We present the case of a 24-year-old patient suffering from a NTRK rearranged spindle cell neoplasm of the uterine cervix which was treated with a fertility preserving conservative surgical approach.
Collapse
Affiliation(s)
- Marco M. Bühler
- Department of Pathology and Molecular Pathology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Chantal Pauli
- Department of Pathology and Molecular Pathology, University Hospital of Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Dimitrios Chronas
- Gynecology and Gynecological Oncology, Department of Women’s Health, Zollikerberg Hospital, Zollikerberg, Switzerland
| | - Kristina Bolten
- Gynecology and Gynecological Oncology, Department of Women’s Health, Zollikerberg Hospital, Zollikerberg, Switzerland
| |
Collapse
|
28
|
Jain V, Munro MG, Critchley HOD. Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2. Int J Gynaecol Obstet 2023; 162 Suppl 2:29-42. [PMID: 37538019 PMCID: PMC10952771 DOI: 10.1002/ijgo.14946] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Abnormal uterine bleeding (AUB) is common, often debilitating, and may affect over 50% of reproductive-aged women and girls. Whereas AUB is a collection of symptoms that include intermenstrual bleeding and abnormalities in period duration, cycle length, and regularity, it is heavy menstrual bleeding (HMB) that is most contributory to iron deficiency and related anemia. It is apparent that AUB, in general, and HMB, in particular, remain underrecognized and underreported. FIGO created two systems for assessing and classifying AUB. FIGO System 1 defines the bleeding pattern using four primary descriptors: frequency, duration, regularity, and flow volume. FIGO System 2 provides a structured classification system of possible causes of AUB, using the acronym PALM-COEIN. "PALM" refers to structural causes of AUB (Polyp, Adenomyosis, Leiomyoma, Malignancy), and "COEI" refers to nonstructural causes (Coagulopathy, Ovulatory dysfunction, Endometrial, and Iatrogenic). The "N" is reserved for those entities that are currently not otherwise classified. Using FIGO System 1 as a gateway to FIGO System 2 streamlines the investigation of reproductive-aged women and girls with AUB. Understanding the pathogenesis of the FIGO System 2 "PALM-COEIN" causes helps interpret investigations and the onward management of AUB. Numerous evidence gaps exist concerning AUB; however, if researchers and trialists universally adopt FIGO Systems 1 and 2 for the assessment and diagnosis of AUB, clear translatable research findings can be applied globally.
Collapse
Affiliation(s)
- Varsha Jain
- Centre for Reproductive HealthUniversity of EdinburghEdinburgh, ScotlandUK
| | - Malcolm G. Munro
- Department of Obstetrics and GynecologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | | |
Collapse
|
29
|
Runnebaum IB, Kather A, Vorwergk J, Cruz JJ, Mothes AR, Beteta CR, Boer J, Keller M, Pölcher M, Mustea A, Sehouli J. Ovarian cancer prevention by opportunistic salpingectomy is a new de facto standard in Germany. J Cancer Res Clin Oncol 2023; 149:6953-6966. [PMID: 36847838 PMCID: PMC10374707 DOI: 10.1007/s00432-023-04578-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE The most prevalent and aggressive subtype of epithelial ovarian carcinoma (EOC), high-grade serous carcinoma (HGSC), originates in many cases from the fallopian tubes. Because of poor prognosis and lack of effective screening for early detection, opportunistic salpingectomy (OS) for prevention of EOC is being implemented into clinical routine in several countries worldwide. Taking the opportunity of a gynecological surgery in women at average cancer risk, extramural fallopian tubes are completely resected preserving the ovaries with their infundibulopelvic blood supply. Until recently, only 13 of the 130 national partner societies of the International Federation of Obstetrics and Gynecology (FIGO) have published a statement on OS. This study aimed to analyze the acceptance of OS in Germany. METHODS (1) Survey of German gynecologists in 2015 and 2022 by the Department of Gynecology of the Jena University Hospital in co-operation with the Department of Gynecology at Charité-University Medicine Berlin with support of NOGGO e. V. and AGO e. V. (2) Salpingectomy numbers in Germany for years 2005-2020 as retrieved from the Federal Statistical Office of Germany (Destatis). RESULTS (1) Survey: Number of participants was 203 in 2015 and 166 in 2022, respectively. Nearly all respondents (2015: 92%, 2022: 98%) have already performed bilateral salpingectomy without oophorectomy in combination with benign hysterectomy with the intention to reduce the risk for malignant (2015: 96%, 2022: 97%) and benign (2015: 47%, 2022: 38%) disorders. Compared to 2015 (56.6%), considerably more survey participants performed OS in > 50% or in all cases in 2022 (89.0%). Recommendation of OS for all women with completed family planning at benign pelvic surgery was approved by 68% in 2015 and 74% in 2022. (2) Case number analysis: In 2020, four times more cases of salpingectomy were reported by German public hospitals compared to 2005 (n = 50,398 vs. n = 12,286). Of all inpatient hysterectomies in German hospitals in 2020, 45% were combined with salpingectomy, and more than 65% in women at the age of 35 to 49 years. CONCLUSION Mounting scientific plausibility regarding involvement of fallopian tubes in the pathogenesis of EOC led to change of clinical acceptance of OS in many countries including in Germany. Case number data and widespread expert judgment demonstrate that OS has become a routine procedure in Germany and a de facto standard for primary prevention of EOC.
Collapse
Affiliation(s)
- I B Runnebaum
- Department of Gynecology and Reproductive Medicine, Jena University Hospital, Friedrich Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - A Kather
- Department of Gynecology and Reproductive Medicine, Jena University Hospital, Friedrich Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - J Vorwergk
- Department of Gynecology and Reproductive Medicine, Jena University Hospital, Friedrich Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - J J Cruz
- Department of Gynecology and Reproductive Medicine, Jena University Hospital, Friedrich Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany
- Department of Obstetrics and Perinatal Medicine, Bonn University Hospital, Sigmund Freud Street 25, 53127, Bonn, Germany
| | - A R Mothes
- Department of Gynecology and Reproductive Medicine, Jena University Hospital, Friedrich Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany
- Department of Gynecology, St. Georg Hospital Eisenach, Academic Teaching Hospital of University of Jena, Muehlhaeuser Str. 94, 99817, Eisenach, Germany
| | - C R Beteta
- Department of Gynecology with Center for Oncological Surgery, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Boer
- Nord-Ostdeutsche Gesellschaft für Gynaekologische Onkologie (NOGGO e.V.), Schwedenstraße 9, 13359, Berlin, Germany
| | - M Keller
- Nord-Ostdeutsche Gesellschaft für Gynaekologische Onkologie (NOGGO e.V.), Schwedenstraße 9, 13359, Berlin, Germany
| | - M Pölcher
- Department of Gynecologic Oncology and Minimal Invasive Surgery, Rotkreuzklinikum München Frauenklinik, Taxisstraße 3, 80637, München, Germany
| | - A Mustea
- Gynecology and Gynecologic Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - J Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Nord-Ostdeutsche Gesellschaft für Gynaekologische Onkologie (NOGGO e.V.), Schwedenstraße 9, 13359, Berlin, Germany
| |
Collapse
|
30
|
Bhai P, Turowec J, Santos S, Kerkhof J, Pickard L, Foroutan A, Breadner D, Cecchini M, Levy MA, Stuart A, Welch S, Howlett C, Lin H, Sadikovic B. Molecular profiling of solid tumors by next-generation sequencing: an experience from a clinical laboratory. Front Oncol 2023; 13:1208244. [PMID: 37483495 PMCID: PMC10359709 DOI: 10.3389/fonc.2023.1208244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Background Personalized targeted therapies have transformed management of several solid tumors. Timely and accurate detection of clinically relevant genetic variants in tumor is central to the implementation of molecular targeted therapies. To facilitate precise molecular testing in solid tumors, targeted next-generation sequencing (NGS) assays have emerged as a valuable tool. In this study, we provide an overview of the technical validation, diagnostic yields, and spectrum of variants observed in 3,164 solid tumor samples that were tested as part of the standard clinical diagnostic assessment in an academic healthcare institution over a period of 2 years. Methods The Ion Ampliseq™ Cancer Hotspot Panel v2 assay (ThermoFisher) that targets ~2,800 COSMIC mutations from 50 oncogenes and tumor suppressor genes was validated, and a total of 3,164 tumor DNA samples were tested in 2 years. A total of 500 tumor samples were tested by the comprehensive panel containing all the 50 genes. Other samples, including 1,375 lung cancer, 692 colon cancer, 462 melanoma, and 135 brain cancer, were tested by tumor-specific targeted subpanels including a few clinically actionable genes. Results Of 3,164 patient samples, 2,016 (63.7%) tested positive for at least one clinically relevant variant. Of 500 samples tested by a comprehensive panel, 290 had a clinically relevant variant with TP53, KRAS, and PIK3CA being the most frequently mutated genes. The diagnostic yields in major tumor types were as follows: breast (58.4%), colorectal (77.6%), lung (60.4%), pancreatic (84.6%), endometrial (72.4%), ovary (57.1%), and thyroid (73.9%). Tumor-specific targeted subpanels also demonstrated high diagnostic yields: lung (69%), colon (61.2%), melanoma (69.7%), and brain (20.7%). Co-occurrence of mutations in more than one gene was frequently observed. Conclusions The findings of our study demonstrate the feasibility of integrating an NGS-based gene panel screen as part of a standard diagnostic protocol for solid tumor assessment. High diagnostic rates enable significant clinical impact including improved diagnosis, prognosis, and clinical management in patients with solid tumors.
Collapse
Affiliation(s)
- Pratibha Bhai
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Jacob Turowec
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Stephanie Santos
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jennifer Kerkhof
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - LeeAnne Pickard
- Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Aidin Foroutan
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Daniel Breadner
- Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Matthew Cecchini
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Michael A. Levy
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Alan Stuart
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Stephen Welch
- Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Christopher Howlett
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Hanxin Lin
- Molecular Genetics Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - Bekim Sadikovic
- Molecular Genetics Laboratory, London Health Sciences Centre, London, ON, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| |
Collapse
|
31
|
Pelayo M, Sancho-Sauco J, Sanchez-Zurdo J, Abarca-Martinez L, Borrero-Gonzalez C, Sainz-Bueno JA, Alcazar JL, Pelayo-Delgado I. Ultrasound Features and Ultrasound Scores in the Differentiation between Benign and Malignant Adnexal Masses. Diagnostics (Basel) 2023; 13:2152. [PMID: 37443546 DOI: 10.3390/diagnostics13132152] [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: 04/19/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Several ultrasound (US) features help ultrasound experts in the classification of benign vs. malignant adnexal masses. US scores serve in this differentiation, but they all have misdiagnoses. The main objective of this study is to evaluate what ultrasound characteristics are associated with malignancy influencing ultrasound scores. METHODS This is a retrospective analysis of ultrasound features of adnexal lesions of women managed surgically. Ultrasound characteristics were analyzed, and masses were classified by subjective assessment of the ultrasonographer (SA) and other ultrasound scores (IOTA Simple Rules Risk Assessment SRRA, ADNEX model, and O-RADS). RESULTS Of a total of 187 adnexal masses studied, 134 were benign (71.7%) and 53 were malignant (28.3%). SA, IOTA SRRA, ADNEX model with or without CA125 and O-RADS had high levels of sensitivity (93.9%, 81.1%, 94.3%, 88.7%, 98.1%) but lower specificity (80.2%, 82.1%, 82.8%, 77.6%, 73.1%) with similar AUC (0.87, 0.87, 0.92, 0.90, 0.86). Ultrasound features significantly related with malignancy were the presence of irregular contour, absence of acoustic shadowing, vascularized solid areas, ≥1 papillae, vascularized septum, and moderate-severe ascites. CONCLUSION IOTA SRRA, ADNEX model, and O-RADS can help in the classification of benign and malignant masses. Certain ultrasound characteristics studied in ultrasound scores are associated with malignancy.
Collapse
Affiliation(s)
- Mar Pelayo
- HM Puerta del Sur, HM Rivas Hospital, 3428521 Madrid, Spain
| | - Javier Sancho-Sauco
- Department of Obstetrics and Gynecology, Universitary Hospital Ramón y Cajal, Alcalá de Henares University, 3428034 Madrid, Spain
| | | | - Leopoldo Abarca-Martinez
- Department of Obstetrics and Gynecology, Universitary Hospital Ramón y Cajal, Alcalá de Henares University, 3428034 Madrid, Spain
| | | | | | - Juan Luis Alcazar
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, 3431008 Pamplona, Spain
| | - Irene Pelayo-Delgado
- Department of Obstetrics and Gynecology, Universitary Hospital Ramón y Cajal, Alcalá de Henares University, 3428034 Madrid, Spain
| |
Collapse
|
32
|
Liu J, Wei J, Yang Y, Wei J. Pathological discrimination between luteinized thecoma associated with sclerosing peritonitis and thecoma. Medicine (Baltimore) 2023; 102:e33911. [PMID: 37335673 DOI: 10.1097/md.0000000000033911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Similarities between luteinized thecoma associated with sclerosing peritonitis (LTSP) and thecoma, cause difficulty in clinical differential diagnoses. To improve the situation, we selected 10 specified molecular pathological markers that are frequently used in clinical pathology of ovarian sex cord-stromal tumors to determine whether they exert a discriminatory effect. METHODS Applying immunohistochemistry, we analyzed the expression of alpha-1,6-mannosylglycoprotein 6-beta-n-acetylglucosaminyltransferase B (MGAT5B), nuclear receptor coactivator 3 (NCOA3), proliferation marker protein Ki-67 (MKI67), estrogen receptor, progesterone receptor, Vimentin, receptor tyrosine-protein kinase erbB-2, Catenin beta-1 (β-Catenin), CD99 antigen (CD99) and Wilms tumor protein (WT1) in 102 cases of diseases containing 11 LTSP and 91 thecoma. Whole-exome sequencing and fluorescence in situ hybridization were used to examine the MGAT5B-NCOA3 fusion gene in LTSP. Statistical analysis was performed using t test, one-way analysis of variance test, and post hoc test. RESULTS Six significant markers were verified for the discrimination between LTSP and thecoma, containing 4 upregulating indicators MGAT5B, NCOA3, MKI67, β-Catenin, and 2 downregulating markers CD99 and WT1 in luteinized cells. In addition, the MGAT5B-NCOA3 fusion gene was identified in LTSP for the first time with significantly rich expression compared to thecoma. CONCLUSIONS We verified 6 significant molecular pathological markers containing MGAT5B, NCOA3, MKI67, β-Catenin, CD99, and WT1 and identified MGAT5B-NCOA3 fusion gene in LTSP; this work will help clinicians to discriminate between medical conditions and treat patients accurately.
Collapse
Affiliation(s)
- Jia Liu
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Hubei Province, China
| | | | | | | |
Collapse
|
33
|
Zheng T, Pan J, Du D, Liang X, Yi H, Du J, Wu S, Liu L, Shi G. Preoperative assessment of high-grade endometrial cancer using a radiomic signature and clinical indicators. Future Oncol 2023; 19:587-601. [PMID: 37097730 DOI: 10.2217/fon-2022-0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Aim: To develop and validate a radiomics-based combined model (ModelRC) to predict the pathological grade of endometrial cancer. Methods: A total of 403 endometrial cancer patients from two independent centers were enrolled as training, internal validation and external validation sets. Radiomic features were extracted from T2-weighted images, apparent diffusion coefficient map and contrast-enhanced 3D volumetric interpolated breath-hold examination images. Results: Compared with the clinical model and radiomics model, ModelRC showed superior performance; the areas under the receiver operating characteristic curves were 0.920 (95% CI: 0.864-0.962), 0.882 (95% CI: 0.779-0.955) and 0.881 (95% CI: 0.815-0.939) for the training, internal validation and external validation sets, respectively. Conclusion: ModelRC, which incorporated clinical and radiomic features, exhibited excellent performance in the prediction of high-grade endometrial cancer.
Collapse
Affiliation(s)
- Tao Zheng
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| | - Jiangyang Pan
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| | - Dan Du
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Xin Liang
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Huiling Yi
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Juan Du
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Shuo Wu
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Lanxiang Liu
- Department of Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, PR China
| | - Gaofeng Shi
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| |
Collapse
|
34
|
Czegle I, Huang C, Soria PG, Purkiss DW, Shields A, Wappler-Guzzetta EA. The Role of Genetic Mutations in Mitochondrial-Driven Cancer Growth in Selected Tumors: Breast and Gynecological Malignancies. Life (Basel) 2023; 13:life13040996. [PMID: 37109525 PMCID: PMC10145875 DOI: 10.3390/life13040996] [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: 12/28/2022] [Revised: 03/15/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
There is an increasing understanding of the molecular and cytogenetic background of various tumors that helps us better conceptualize the pathogenesis of specific diseases. Additionally, in many cases, these molecular and cytogenetic alterations have diagnostic, prognostic, and/or therapeutic applications that are heavily used in clinical practice. Given that there is always room for improvement in cancer treatments and in cancer patient management, it is important to discover new therapeutic targets for affected individuals. In this review, we discuss mitochondrial changes in breast and gynecological (endometrial and ovarian) cancers. In addition, we review how the frequently altered genes in these diseases (BRCA1/2, HER2, PTEN, PIK3CA, CTNNB1, RAS, CTNNB1, FGFR, TP53, ARID1A, and TERT) affect the mitochondria, highlighting the possible associated individual therapeutic targets. With this approach, drugs targeting mitochondrial glucose or fatty acid metabolism, reactive oxygen species production, mitochondrial biogenesis, mtDNA transcription, mitophagy, or cell death pathways could provide further tailored treatment.
Collapse
Affiliation(s)
- Ibolya Czegle
- Department of Internal Medicine and Haematology, Semmelweis University, H-1085 Budapest, Hungary
| | - Chelsea Huang
- Department of Pathology and Laboratory Medicine, Loma Linda University Health, Loma Linda, CA 92354, USA
| | - Priscilla Geraldine Soria
- Department of Pathology and Laboratory Medicine, Loma Linda University Health, Loma Linda, CA 92354, USA
| | - Dylan Wesley Purkiss
- Department of Pathology and Laboratory Medicine, Loma Linda University Health, Loma Linda, CA 92354, USA
| | - Andrea Shields
- Department of Pathology and Laboratory Medicine, Loma Linda University Health, Loma Linda, CA 92354, USA
| | | |
Collapse
|
35
|
Mehra P, Aditi S, Prasad KM, Bariar NK. Histomorphological Analysis of Ovarian Neoplasms According to the 2020 WHO Classification of Ovarian Tumors: A Distribution Pattern in a Tertiary Care Center. Cureus 2023; 15:e38273. [PMID: 37255899 PMCID: PMC10225821 DOI: 10.7759/cureus.38273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND In 2018, ovarian carcinoma ranked as the eighth most common cancer diagnosed and the leading cause of cancer death in women. High-grade serous carcinoma is the most common histological type seen among malignant cases. A diverse group of neoplasms is seen in the ovary with variable clinical, morphological, and histological features, so assessing the nature of ovarian neoplasms further assists in the treatment of the disease. AIM This study was conducted to assess the different histopathological variants of ovarian neoplasms according to the latest 2020 World Health Organization (WHO) classification of ovarian tumors. Further analysis of the frequency, age, clinical features in patients, and distribution of various ovarian tumors is assessed. MATERIALS AND METHODS A retrospective study was conducted in the Department of Pathology at Patna Medical College and Hospital (PMCH), Patna. The data of the patients from the past three years, from February 2020 to February 2023, were retrieved and assessed. Gross and microscopic findings, including clinical details of patients with ovarian masses, were analyzed from the previous records. RESULT A total of 110 cases of ovarian neoplasms on histopathology were analyzed. The age range was 11-70 years. The types of specimens received were those of total abdominal hysterectomy, salphingoopherectomy, and unilateral or bilateral ovarian cystectomy. The most common presentation was an abdominal mass, followed by pain in the abdomen. The majority of the tumors were benign (69%), malignancy was observed in 24.5% of cases, and borderline tumors were seen in 5.4% of cases. Epithelial tumors were the commonest tumors, accounting for 70%, followed by germ cell tumors (21%). Serous cystadenoma was the commonest benign tumor, followed by mature teratoma and serous cystadenocarcinoma. High-grade serous cystadenocarcinoma was the commonest malignant ovarian tumor (9%), followed by low-grade serous cystadenocarcinoma (4.5%) and metastatic carcinoma of the ovary. Krukenberg tumor was seen in two cases, and a very rare case of sclerosing stromal tumor was seen in one of the cases. CONCLUSION Ovarian neoplasms usually present with a variety of clinicomorphological and histological features. The most common neoplasm observed in the ovary is surface epithelial tumors, which are benign lesions that commonly affect reproductive age groups. Newer advancements like immunohistochemistry (IHC) and genetic studies have made the diagnosis easier and more precise. However, in institutes with limited resources, a histopathological study is still the gold standard in the diagnosis and prognostic evaluation of these tumors.
Collapse
Affiliation(s)
- Pallavi Mehra
- Pathology and Laboratory Medicine, Patna Medical College, Patna, IND
| | - Sneha Aditi
- Pathology and Laboratory Medicine, Patna Medical College, Patna, IND
| | - Krishna M Prasad
- Pathology and Laboratory Medicine, Patna Medical College, Patna, IND
| | - Navin K Bariar
- Pathology and Laboratory Medicine, Patna Medical College, Patna, IND
| |
Collapse
|
36
|
Jung D, Almstedt K, Battista MJ, Seeger A, Jäkel J, Brenner W, Hasenburg A. Immunohistochemical markers of prognosis in adult granulosa cell tumors of the ovary - a review. J Ovarian Res 2023; 16:50. [PMID: 36869369 PMCID: PMC9983179 DOI: 10.1186/s13048-023-01125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Granulosa cell tumors (GCT) are rare malignant ovarian tumors. The two subtypes, adult and juvenile granulosa cell tumors, differ in clinical and molecular characteristics. GCT are low-malignant tumors and are generally associated with favorable prognosis. However, relapses are common even years and decades after diagnosis. Prognostic and predictive factors are difficult to assess in this rare tumor entity. The purpose of this review is to provide a comprehensive overview of the current state of knowledge on prognostic markers of GCT to identify patients with a high risk of recurrence. METHODS Systematic research for adult ovarian granulosa cell tumors and prognosis revealed n = 409 English full text results from 1965 to 2021. Of these articles, n = 35 were considered for this review after title and abstract screening and topic-specific matching. A specific search for pathologic markers with prognostic relevance for GCT identified n = 19 articles that were added to this review. RESULTS FOXL2 mutation and FOXL2 mRNA were inverse and immunohistochemical (IHC) expression of CD56, GATA-4 and SMAD3 was associated with reduced prognosis. IHC analysis of estrogen receptor, Anti-Mullerian hormone (AMH) and inhibin was not associated with prognosis for GCT. Analyses of mitotic rate, Ki-67, p53, β-catenin and HER2 revealed inconsistent results.
Collapse
Affiliation(s)
- Dennis Jung
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany.
| | - Katrin Almstedt
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Marco J Battista
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Alexander Seeger
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Jörg Jäkel
- Department of Pathology, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Walburgis Brenner
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Annette Hasenburg
- Department of Gynecology and Obstetrics, University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| |
Collapse
|
37
|
Hollis RL. Molecular characteristics and clinical behaviour of epithelial ovarian cancers. Cancer Lett 2023; 555:216057. [PMID: 36627048 DOI: 10.1016/j.canlet.2023.216057] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
Ovarian carcinoma (OC) is an umbrella term for multiple distinct diseases (histotypes), each with their own developmental origins, clinical behaviour and molecular profile. Accordingly, OC management is progressing away from a one-size-fits all approach, toward more molecularly-driven, histotype-specific management strategies. Our knowledge of driver events in high grade serous OC, the most common histotype, has led to major advances in treatments, including PARP inhibitor use. However, these agents are not suitable for all patients, most notably for many of those with rare OC histotypes. Identification of additional targeted therapeutic strategies will require a detailed understanding of the molecular landscape in each OC histotype. Until recently, tumour profiling studies in rare histotypes were sparse; however, significant advances have been made over the last decade. In particular, reports of genomic characterisation in endometrioid, clear cell, mucinous and low grade serous OC have significantly expanded our understanding of mutational events in these tumour types. Nonetheless, substantial knowledge gaps remain. This review summarises our current understanding of each histotype, highlighting recent advances in these unique diseases and outlining immediate research priorities for accelerating progress toward improving patient outcomes.
Collapse
Affiliation(s)
- Robert L Hollis
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh, UK.
| |
Collapse
|
38
|
Mori T, Kato H, Kawaguchi M, Kanayama T, Furui T, Noda Y, Hyodo F, Matsuo M. MRI characteristics for predicting histological subtypes in patients with uterine cervical adenocarcinoma. Eur J Radiol 2023; 158:110612. [PMID: 36542931 DOI: 10.1016/j.ejrad.2022.110612] [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: 06/12/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the magnetic resonance imaging (MRI) findings of uterine cervical adenocarcinoma for predicting different histological subtypes. MATERIALS AND METHODS We retrospectively analyzed MRI findings of 76 consecutive patients with histopathologically-confirmed uterine cervical adenocarcinoma undergoing preoperative MRI examination. An experienced pathologist classified the histological subtypes based on World Health Organization's 2020 classification and into human papillomavirus (HPV)-associated adenocarcinomas (HPVAs, n = 54) (usual type and variants) and HPV-independent adenocarcinomas (HPVIs, n = 22) (gastric type adenocarcinoma (GAS), clear cell type, and other types). Different MRI variables were compared quantitatively and qualitatively between HPVA and HPVI and between GAS and non-GAS tumor types. RESULTS The maximum tumor diameter was significantly greater in HPVIs than HPVAs (41.9 ± 18.6 vs 32.7 ± 15.6 mm; p < 0.05). Heterogeneous enhancement on fat-suppressed gadolinium-enhanced T1-weighted images was more frequently seen in HPVIs than HPVAs (62 % vs 15 %; p < 0.01) and in GASs than non-GASs (78 % vs 16 %; p < 0.01). Also, infiltrative growth pattern (58 % vs 20 %; p < 0.05) and intratumoral cyst formation (83 % vs 47 %) (p < 0.05) were more frequent in GASs than non-GASs. CONCLUSIONS Compared with HPVAs, HPVIs tend to have a larger tumor size with heterogeneous enhancement, of which GASs frequently show infiltrative growth patterns with intratumoral cyst formation and heterogeneous enhancement.
Collapse
Affiliation(s)
- Takayuki Mori
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | | | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University, Gifu, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Institute for Advanced Study, Gifu University, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| |
Collapse
|
39
|
Highly Differentiated Follicular Carcinoma of Ovarian Origin: A Systematic Review of the Literature. Curr Oncol 2022; 29:9105-9116. [PMID: 36547126 PMCID: PMC9776615 DOI: 10.3390/curroncol29120712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
(1) Background: Highly differentiated follicular carcinoma of ovarian origin (HDFCO) is an extremely uncommon neoplasm, associated with struma ovarii. There are scarce cases reported in the literature and, subsequently, no reliable conclusions on its pathophysiology, treatment, and prognosis can be drawn. The goal of this study is to enrich the literature on the topic by adding our own experience with a case, and simultaneously accumulate all cases published up to date. (2) Methods: The present review was performed in accordance with the guidelines for systematic reviews and meta-analyses (PRISMA). PubMed (1966-2022), Scopus (2004-2022), and Clinicaltrials.gov databases were screened for relevant articles published up to July 2022. (3) Results: Twenty patients with HDFCO were identified. The included patients were aged 47.15 years (range 24-74). The predominant origin was ovarian (60%) and extraperitoneal spread was confirmed in 15% of the cases. Surgical treatment varied from conservative to radical (35.3% vs. 41.2%, respectively) and the administration of supplementary therapy and thyroidectomy was not universal. Combined thyroidectomy/radioactive iodine therapy was applied in just 62.5% of the reported cases. There was one patient who demonstrated disease recurrence and lives with the disease. No disease related morbidity was reported. (4) Conclusions: HDFCO represents a low-grade malignant tumor, whose rarity does not allow for reliable conclusions. Standard treatment including complete surgical excision and supplementary treatment seems to offer a favorable prognosis in selected cases.
Collapse
|
40
|
Liu R, He X, Li Z. Positive clinical outcomes following therapy with programmed cell death protein 1/programmed cell death ligand 1 inhibitors in neuroendocrine carcinoma of the cervix. Front Pharmacol 2022; 13:1029598. [DOI: 10.3389/fphar.2022.1029598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Neuroendocrine carcinoma of the cervix (NECC) is a highly aggressive and rare gynecological malignancy with a poor prognosis. Despite aggressive local and systemic treatments, there are high rates of locoregional recurrence and distant metastases. Therefore, more potent treatments are required to manage NECC. In recent years, emerging immune checkpoint inhibitors, such as programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors, have been used in treating various solid tumors and provide a new direction for immune-targeted therapy for NECC. In this review, we summarize the biomarkers useful for the evaluation of the therapy with PD-1/PD-L1 inhibitors in patients with NECC and the clinical applications and prospects of monotherapy with PD-1/PD-L1 inhibitors and combinations with other therapies in patients with NECC. In some individual case reports, therapeutic strategies with PD-1/PD-L1 inhibitors showed good efficacy. Further studies are needed to confirm the possibility of using PD-1/PD-L1 inhibitors as a standard treatment strategy in NECC.
Collapse
|
41
|
High-Grade Endometrioid Stromal Sarcoma of the Ovary: Malignant Transformation of Ovarian Mature Cystic Teratoma. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101501. [PMID: 36295661 PMCID: PMC9610105 DOI: 10.3390/medicina58101501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022]
Abstract
We report an extremely rare case of ovarian high-grade endometrioid stromal sarcoma arising from a mature cystic teratoma with clinicopathologic features, and then we briefly review the pertinent literature. A 62-year-old nulliparous woman presented with lower abdominal pain that had begun 6 months earlier. Magnetic resonance imaging showed two adnexal masses with fat components, which suggested that they were mature cystic teratomas. The eccentric thick rim of the left mass showed irregular invasion of the uterus, which was suggestive of malignancy. Positron emission tomography/computed tomography demonstrated high fluorodeoxyglucose uptake in the corresponding area. The patient underwent debulking cytoreductive surgery. The diagnosis was of an International Federation of Obstetrics and Gynecology stage IIIC high-grade endometrioid stromal sarcoma arising from a mature cystic teratoma. After surgery, the patient received adjuvant chemotherapy with three courses of doxorubicin regimen. The cancer recurred 3 months after surgery, and the patient died of progressive disease. It might be helpful for clinicians to be aware of this rare disease and the poor prognosis when it is at an advanced stage.
Collapse
|
42
|
Lymphadenectomy Benefits Small Cell Carcinoma of Ovary: A Population-Based Analysis. Curr Oncol 2022; 29:7802-7815. [PMID: 36290894 PMCID: PMC9600050 DOI: 10.3390/curroncol29100617] [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: 08/20/2022] [Revised: 09/29/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Small cell carcinoma of the ovary (SCCO) is a rare type of ovarian cancer with high aggressiveness. The optimal treatment modality remains elusive. This study aims to comprehensively investigate the survival impact of clinical characteristics and treatments including lymphadenectomy in SCCO. A retrospective cohort study was performed and included patients from the Surveillance, Epidemiology, and End Results (SEER) database. Data collected included demographics, therapeutic details, and pathologic characteristics. Propensity-score matching analysis (PSM) was carried out to balance baseline variables between SCCO and non-SCCO. Cox regression, Kaplan-Meier, and stratified analyses were conducted before and after PSM. After filtering, 80 records on SCCO and 39,662 records on non-SSCO were obtained. Patients with SCCO were more prone to present unilateral tumor (57.6% and 85.0%, p < 0.001), larger tumor size (>15 cm: 9.5% and 32.5%; 10-15 cm: 13.2% vs. 22.5%, p < 0.001), younger age (59.1 ± 14.91 vs. 37.2 ± 19.05; p < 0.001), single status (17.0% vs. 45.0%; p < 0.001), single malignant tumor in a lifetime (76.1% vs. 87.5%; p = 0.0244), and pathologic grade IV diseases (14.5% vs. 40.0%; p < 0.001) compared with non-SCCO. After balancing the baseline clinical characteristics with a 1:4 ratio PSM, a total of matched 72 patients with SCCO and 254 patients with non-SCCO were identified. The survival rate of SCCO was distinctly inferior to non-SCCO, particularly in FIGO I, II, and III stages. Lymphadenectomy was performed in 37 (51.39%) SCCO patients, of whom 12 (32.43%) were found to have pathologically positive lymph nodes. Lymphadenectomy was linked to favorable overall survival in SCCO, particularly in the advanced stage, and was also an independent prognostic factor, whereas lymphadenectomy did not reveal an edge in matched non-SCCO. There was a pronounced survival benefit for SCCO when at least 10 or more nodes were resected. Lymphadenectomy in a non-stage-dependent way should be considered and deserves further clinical validation to promote the overall survival in SCCO.
Collapse
|
43
|
Carballo EV, Pham TV, Turashvili G, Hanley K, Starbuck KD, Meisel JL. Recurrent uterine inflammatory myofibroblastic tumor previously managed as leiomyosarcoma has sustained response to alectinib. Gynecol Oncol Rep 2022; 43:101062. [PMID: 36032811 PMCID: PMC9403501 DOI: 10.1016/j.gore.2022.101062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
Inflammatory myofibroblastic tumors can mimic leiomyosarcoma histologically. Highlights the role of molecular testing in the diagnosis and management of uterine mesenchymal tumors Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase involved in cellular growth. Alectinib is one of several ALK inhibitors FDA-approved for patients with ALK-fusion positive lung cancers Supports the paradigm shift toward developing molecularly targeted therapies rather than disease site-specific treatments
Soft tissue sarcomas encompass a wide range of histologic subtypes with varied clinical implications. The incorporation of comprehensive genetic profiling into clinical practice is refining our ability to make these distinctions in diagnosis to better reflect prognosis and clinical behavior of a tumor. In this report, we describe a case of recurrent inflammatory myofibroblastic tumor (IMT) of the uterus, initially diagnosed and managed as leiomyosarcoma. At the time of recurrence, the patient was found to have a TNS1-ALK rearrangement and was treated successfully with alectinib, a second-generation anaplastic lymphoma kinase (ALK)-inhibitor. She had a complete response by imaging six months after initiation of alectinib and remains without evidence of disease at 36 months follow-up. Pathology review in the setting of her known ALK fusion and the 2020 update to the World Health Organization Classification of Female Genital Tumors led to a change in diagnosis from leiomyosarcoma to IMT. Our case highlights the role of molecular testing in the diagnosis and management of uterine mesenchymal tumors and the efficacy of alectinib in this ALK-rearranged recurrent IMT of the uterus. Care must be taken to differentiate between IMT and other uterine mesenchymal tumors as this distinction can impact prognosis and management. Furthermore, this case adds to the growing body of evidence supporting the paradigm shift toward developing molecularly targeted therapies rather than disease site-specific treatments, especially in cases of recurrence as recommended by the National Comprehensive Cancer Network.
Collapse
Affiliation(s)
- Erica V. Carballo
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Emory University School of Medicine, United States
- Corresponding author at: Department of Gynecology & Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr Drive, Glenn Building, Room 410, Atlanta, GA 30303.
| | - Tra V. Pham
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Emory University School of Medicine, United States
| | - Gulisa Turashvili
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, United States
| | - Krisztina Hanley
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, United States
| | - Kristen D. Starbuck
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Emory University School of Medicine, United States
| | - Jane L. Meisel
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Emory University School of Medicine, United States
- Division of Medical Oncology, Department of Hematology and Medical Oncology, Emory University School of Medicine, United States
| |
Collapse
|
44
|
Li Y, Wu Y, Zhang Y, Li X. Case report: Strategies for improving outcomes in patients with primary ovarian small-cell neuroendocrine carcinoma. Front Oncol 2022; 12:954289. [PMID: 36212497 PMCID: PMC9537455 DOI: 10.3389/fonc.2022.954289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
Small-cell neuroendocrine carcinoma (SCNEC) of the ovary is a gynecological malignancy characterized by rapid progression and poor prognosis. SCNEC is divided into primary and metastatic tumor. Primary ovarian neuroendocrine cancer is extremely rare and has a low 5-year survival rate. This paper reports the clinical manifestations of a 58-year-old patient with primary ovarian Small-cell neuroendocrine carcinoma and the prognosis after surgical adjuvant chemotherapy. The prevailing literature on this carcinoma is also reviewed and summarized. Our analysis reveals that histopathological examination is the standard diagnostic tool for ovarian SCNEC. We also highlight the importance of comprehensive imaging evaluation, early pathological diagnosis and comprehensive aggressive treatment to the prognosis of patients.
Collapse
|
45
|
Prieto-Potin I, Idrovo F, Suárez-Gauthier A, Díaz-Blázquez M, Astilleros-Blanco de Córdova L, Chamizo C, Zazo S, Carvajal N, López-Sánchez A, Pérez-Buira S, Aúz-Alexandre CL, Manso R, Plaza-Sánchez J, de Lucas-López V, Pérez-González N, Martín-Valle S, Cristóbal I, Casado V, García-Foncillas J, Rojo F. Comprehensive Approach to Genomic and Immune Profiling: Insights of a Real-World Experience in Gynecological Tumors. Diagnostics (Basel) 2022; 12:diagnostics12081903. [PMID: 36010253 PMCID: PMC9406465 DOI: 10.3390/diagnostics12081903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/22/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
Gynecological cancer accounts for an elevated incidence worldwide requiring responsiveness regarding its care. The comprehensive genomic approach agrees with the classification of certain tumor types. We evaluated 49 patients with gynecological tumors undergoing high-throughput sequencing to explore whether identifying alterations in cancer-associated genes could characterize concrete histological subtypes. We performed immune examination and analyzed subsequent clinical impact. We found 220 genomic aberrations mostly distributed as single nucleotide variants (SNV, 77%). Only 3% were classified as variants of strong clinical significance in BRCA1 and BRCA2 of ovarian high-grade serous (HGSC) and uterine endometrioid carcinoma. TP53 and BRCA1 occurred in 72% and 28% of HGSC. Cervical squamous cell carcinoma was entirely HPV-associated and mutations occurred in PIK3CA (60%), as well as in uterine serous carcinoma (80%). Alterations were seen in PTEN (71%) and PIK3CA (60%) of uterine endometrioid carcinoma. Elevated programmed death-ligand 1 (PD-L1) was associated with high TILs. Either PD-L1 augmented in deficient mis-matched repair (MMR) proteins or POLE mutated cases when compared to a proficient MMR state. An 18% received genotype-guided therapy and a 4% immunotherapy. The description of tumor subtypes is plausible through high-throughput sequencing by recognizing clinically relevant alterations. Additional concomitant assessment of immune biomarkers identifies candidates for immunotherapy.
Collapse
Affiliation(s)
- Iván Prieto-Potin
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Franklin Idrovo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Ana Suárez-Gauthier
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - María Díaz-Blázquez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | | | - Cristina Chamizo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sandra Zazo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Nerea Carvajal
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Almudena López-Sánchez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sandra Pérez-Buira
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Carmen Laura Aúz-Alexandre
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Rebeca Manso
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Jenifer Plaza-Sánchez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Virginia de Lucas-López
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Nuria Pérez-González
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sara Martín-Valle
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Ion Cristóbal
- Cancer Unit for Research on Novel Therapeutic Targets, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Victoria Casado
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Jesús García-Foncillas
- Cancer Unit for Research on Novel Therapeutic Targets, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Federico Rojo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Correspondence:
| |
Collapse
|
46
|
Horn LC, Hiller GGR, Mayr D, Schmoeckel E, Höhn AK. [Practical diagnostic aspects of uterine leiomyosarcoma in the context of the 2020 WHO classification]. DER PATHOLOGE 2022; 43:196-201. [PMID: 35412039 DOI: 10.1007/s00292-022-01064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
The 2020 WHO Classification defines the spindle cell, epithelioid, and myxoid variants as subtypes of uterine leiomyosarcomas (LMS). Presence of cellular atypia (size variation of polymorphic nuclei > 2-3:1), tumor cell necroses, and mitotic count (usually ≥ 10 MF/10 HPF) are still the key features for diagnostic separation from uterine leiomyomas. Preanalytic variables, staining quality, as well as intralesional geographic distribution may affect the mitotic count. Smooth muscle tumors of uncertain malignant potential (STUMP) still exist as a not yet well-characterized diagnostic entity. Immunohistochemical stains against p16, p53, Ki-67, and WT‑1 may aid differential diagnosis in selected cases. Diagnostic molecular pathology is not yet relevant for diagnosis.
Collapse
Affiliation(s)
- Lars-Christian Horn
- Arbeitsgruppe Mamma‑, Gynäko- & Perinatalpathologie, Institut für Pathologie, Universitätsklinikum Leipzig AöR, Liebigstr. 26, 04103, Leipzig, Deutschland.
| | | | - Doris Mayr
- Pathologisches Institut, der Ludwig-Maximilians-Universität München, München, Deutschland
| | - Elisa Schmoeckel
- Pathologisches Institut, der Ludwig-Maximilians-Universität München, München, Deutschland
| | - Anne Kathrin Höhn
- Arbeitsgruppe Mamma‑, Gynäko- & Perinatalpathologie, Institut für Pathologie, Universitätsklinikum Leipzig AöR, Liebigstr. 26, 04103, Leipzig, Deutschland
| |
Collapse
|