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Drexler K, Bollmann L, Karrer S, Berneburg M, Haferkamp S, Niebel D. Retrospective Single-Center Case Study of Clinical Variables and the Degree of Actinic Elastosis Associated with Rare Skin Cancers. BIOLOGY 2024; 13:529. [PMID: 39056721 PMCID: PMC11274094 DOI: 10.3390/biology13070529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
(1) Background: Rare skin cancers include epithelial, neuroendocrine, and hematopoietic neoplasias as well as cutaneous sarcomas. Ultraviolet (UV) radiation and sunburns are important drivers for the incidence of certain cutaneous sarcomas; however, the pathogenetic role of UV light is less clear in rare skin cancers compared to keratinocyte cancer and melanoma. In this study, we compared the degree of actinic elastosis (AE) as a surrogate for lifetime UV exposure among selected rare skin cancers (atypical fibroxanthoma [AFX], pleomorphic dermal sarcoma [PDS], dermatofibrosarcoma protuberans [DFSP], Kaposi sarcoma [KS], Merkel cell carcinoma [MCC], and leiomyosarcoma [LMS]) while taking into account relevant clinical variables (age, sex, and body site). (2) Methods: We newly established a semi-quantitative score for the degree of AE ranging from 0 = none to 3 = total loss of elastic fibers (basophilic degeneration) and multiplied it by the perilesional vertical extent (depth), measured histometrically (tumor-associated elastosis grade (TEG)). We matched the TEG of n = 210 rare skin cancers from 210 patients with their clinical variables. (3) Results: TEG values were correlated with age and whether tumors arose on UV-exposed body sites. TEG values were significantly higher in AFX and PDS cases compared to all other analyzed rare skin cancer types. As expected, TEG values were low in DFSP and KS, while MCC cases exhibited intermediate TEG values. (4) Conclusions: High cumulative UV exposure is more strongly associated with AFX/PDS and MCC than with other rare skin cancers. These important results expand the available data associated with rare skin cancers while also offering insight into the value of differentiating among these tumor types based on their relationship with sun exposure, potentially informing preventative, diagnostic and/or therapeutic approaches.
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Affiliation(s)
| | | | | | | | | | - Dennis Niebel
- Department of Dermatology, University Medical Center Regensburg, 93053 Regensburg, Germany; (K.D.)
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2
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Yap M, Harvey NT, Mesbah Ardakani N, Wood BA. Metastatic atypical fibroxanthoma: the importance of structured reporting for cutaneous sarcoma-like tumour. Pathology 2024:S0031-3025(24)00121-1. [PMID: 38834438 DOI: 10.1016/j.pathol.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 06/06/2024]
Affiliation(s)
- Megan Yap
- Department of Dermatology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Nathan T Harvey
- PathWest Dermatopathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia; The University of Western Australia, Perth, WA, Australia
| | - Nima Mesbah Ardakani
- PathWest Dermatopathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia; The University of Western Australia, Perth, WA, Australia
| | - Benjamin A Wood
- PathWest Dermatopathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia; The University of Western Australia, Perth, WA, Australia.
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Kuntz T, Grimm A, Hofmann SC, Michalowitz AL, Schaller J, Hellmich M, Assaf C, Oellig F, Kreuter A. Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma. J Dtsch Dermatol Ges 2024; 22:513-519. [PMID: 38483049 DOI: 10.1111/ddg.15379] [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: 07/28/2023] [Accepted: 01/11/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND OBJECTIVES Previous work has demonstrated that hydrochlorothiazide (HCTZ) is a risk factor for squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) due to pro-photocarcinogenic effects. Atypical fibroxanthoma (AFX) and pleomorphic sarcoma (PDS), both ultraviolet-induced cancers, display a rare but rising cutaneous tumor entity. This study aimed to evaluate if the use of HCTZ is higher in patients with AFX/PDS than in patients with SCC/BCC and subsequently may be a risk factor for AFX/PDS-development. PATIENTS AND METHODS In a retrospective study of four German skin cancer centers, AFX/PDS cases and SCC/BCC controls were sex and age matched (1:3) over a time-period of 7 years (2013-2019) to evaluate the use of HCTZ, immunosuppressive medication, second malignancies, and presence of diabetes mellitus. RESULTS Overall, 146 AFX/PDS and 438 controls (SCC/BCC) were included in the study. The use of HCTZ was significantly higher in patients with AFX/PDS (44.5%) compared to patients with SCC/BCC (25.3%). Additionally, the presence of diabetes mellitus was significantly higher in AFX/PDS patients. CONCLUSIONS This study demonstrates a significantly higher use of HCTZ in patients with AFX/PDS compared to SCC/BCC. This result suggests that HCTZ may be a risk factor for AFX/PDS. Additionally, diabetes mellitus or its comorbidities may be associated with an increased risk for AFX/PDS.
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Affiliation(s)
- Thomas Kuntz
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Alexander Grimm
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Silke C Hofmann
- Department of Dermatology, Allergology, und Dermatosurgery, Helios University Hospital Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
| | - Alena-Lioba Michalowitz
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Jörg Schaller
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Klinikum Krefeld, Krefeld, Germany
| | - Frank Oellig
- Institute of Pathology, Mülheim an der Ruhr, Germany
| | - Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
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Kuntz T, Grimm A, Hofmann SC, Michalowitz AL, Schaller J, Hellmich M, Assaf C, Oellig F, Kreuter A. Hydrochlorothiazid: Erhöhtes Risiko für atypisches Fibroxanthom und pleomorphes dermales Sarkom. J Dtsch Dermatol Ges 2024; 22:513-520. [PMID: 38574023 DOI: 10.1111/ddg.15379_g] [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: 07/28/2023] [Accepted: 01/11/2024] [Indexed: 04/06/2024]
Abstract
ZusammenfassungHintergrund und ZieleBisherige Arbeiten haben gezeigt, dass Hydrochlorothiazid (HCT) aufgrund seiner photokarzinogenen Wirkung einen Risikofaktor für Plattenepithelkarzinome (SCC) und Basalzellkarzinome (BCC) darstellt. Atypische Fibroxanthome (AFX) und pleomorphe dermale Sarkome (PDS), beides UV‐induzierte Tumoren, stellen eine seltene, aber zunehmende Tumorentität der Haut dar. In dieser Studie soll untersucht werden, ob die Einnahme von HCT bei Patienten mit AFX/PDS höher ist als bei Patienten mit SCC/BCC und ob dies ein Risikofaktor für die Entwicklung von AFX/PDS sein könnte.Patienten und MethodikIn einer retrospektiven Studie an vier deutschen Hautkrebszentren wurden AFX/PDS‐Fälle und SCC/BCC‐Kontrollen über einen Zeitraum von sieben Jahren (2013‐2019) geschlechts‐ und alters‐gematcht (1:3) auf die Einnahme von HCT und immunsuppressiven Medikamenten sowie auf Zweitmalignome und Diabetes mellitus untersucht.ErgebnisseInsgesamt wurden 146 AFX/PDS und 438 Kontrollen (SCC/BCC) in die Studie eingeschlossen. Die Einnahme von HCT war bei Patienten mit AFX/PDS (44,5%) im Vergleich zu Patienten mit SCC/BCC (25,3%) signifikant häufiger. Außerdem war Diabetes mellitus bei AFX/PDS‐Patienten signifikant häufiger.SchlussfolgerungenDiese Studie zeigt eine signifikant höhere Einnahme von HCT bei Patienten mit AFX/PDS im Vergleich zu SCC/BCC. Dies legt nahe, dass HCT ein Risikofaktor für AFX/PDS sein könnte. Darüber hinaus könnten ein Diabetes mellitus oder dessen Begleiterkrankungen mit einem erhöhten Risiko für AFX/PDS assoziiert sein.
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Affiliation(s)
- Thomas Kuntz
- Klinik für Dermatologie und Venerologie, Universität Köln
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Alexander Grimm
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Silke C Hofmann
- Klinik für Dermatologie, Venerologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal
| | - Alena-Lioba Michalowitz
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Jörg Schaller
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinik Duisburg
| | - Martin Hellmich
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät der Universität Köln
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Helios Klinikum Krefeld
| | | | - Alexander Kreuter
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinik Duisburg
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Mor E, Lonie S, Mitchell C, Henderson M, Webb A, Gyorki DE, Snow H. Pleomorphic dermal sarcoma of the scalp - A single-centre experience. Surg Oncol 2024; 52:102017. [PMID: 38091877 DOI: 10.1016/j.suronc.2023.102017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 02/19/2024]
Abstract
BACKGROUND Pleomorphic dermal sarcoma (PDS) of the scalp is a rare tumour which is usually slow growing, but occasionally displays rapid growth and has a low rate of local recurrence. Surgical resection is the mainstay of treatment, with or without radiotherapy. The aim of this study is to describe the surgical approach and the additional benefit of radiotherapy to the treatment of these patients. METHODS Retrospective, single-centre analysis of patients with PDS of the scalp that underwent surgical resection between 2007 and 2021 (n = 24). Treatment variables including depth of resection (superficial or deep to the galea aponeurotica) and adjuvant radiotherapy were investigated. RESULTS Twenty-four patients were included in this study. Median age was 80 (range, 52-95), with a median ASA score of 3 (2-3). Sixteen (66.6 %) patients underwent surgical resection including the galea, while the rest (n = 8) did not or was not known. Radiotherapy was given in 7 (29 %) patients in which only 3 (12.5 %) were in the galeal resection group. Reasons for radiotherapy administration were concomitant SCC found at the same area of resection and close margins. In a median follow-up of was 26.2 months (range, 13.6-102.5) there was only one recurrence event. CONCLUSIONS PDS of the scalp can be safely managed with a surgical resection if clear surgical margins are achieved without radiotherapy with good oncological outcomes.
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Affiliation(s)
- Eyal Mor
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
| | - Sarah Lonie
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine Mitchell
- Department of Anatomical Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael Henderson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Angela Webb
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David E Gyorki
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Hayden Snow
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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McClelland K, Brady A, Reid P, Houghton J. Keloidal atypical fibroxanthoma of the scalp. BMJ Case Rep 2023; 16:e258025. [PMID: 37973539 PMCID: PMC10660152 DOI: 10.1136/bcr-2023-258025] [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] [Indexed: 11/19/2023] Open
Abstract
Atypical fibroxanthoma (AFX) is a rare low-grade sarcoma that occurs mainly in the elderly and may recur locally. There are multiple variants including keloidal AFX (KAF). KAF is characterised by a proliferation of atypical spindled and epithelioid cells admixed with bizarre pleomorphic cells. These cells intersect among broad bands of keloidal collagen. AFX is a diagnosis of exclusion so a broad panel of immunohistochemical staining should be applied to rule out other differentials (squamous cell carcinoma (SCC), melanoma, leiomyosarcoma, etc). There is added difficulty with the diagnosis of KAF as it may mimic multiple keloidal lesions, including exuberant scarring, as in this case. p53 immunohistochemistry staining can be useful in highlighting the presence of tumour cells. Additionally, next generation sequencing can detect genetic mutations identified in clonal proliferations consistent with tumour formation. KAF is easily overlooked and it should be included in the differential diagnosis for keloidal lesions showing even mild atypia.
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Affiliation(s)
- Kathryn McClelland
- Department of Cellular Pathology, Southern Health and Social Care Trust, Portadown, UK
| | - Aidan Brady
- Department of Cellular Pathology, Southern Health and Social Care Trust, Portadown, UK
| | - Paula Reid
- Department of Cellular Pathology, Southern Health and Social Care Trust, Portadown, UK
| | - Joe Houghton
- Institute of Pathology, Belfast Trust, Belfast, UK
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Agaimy A. The many faces of Atypical fibroxanthoma. Semin Diagn Pathol 2023; 40:S0740-2570(23)00071-0. [PMID: 37438163 DOI: 10.1053/j.semdp.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/14/2023]
Abstract
Atypical fibroxanthoma (AFX) is an uncommon, primary dermal neoplasm of uncertain histogenesis, typically originating in the sun-damage skin of the head and neck of the elderly. Since first description in 1958, ∼3000 cases have been reported in the literature. However, the disease is underreported as the neoplasm is considered a standard diagnosis in the last decades. On the other hand, many earlier reports likely have included non-AFX mimics or aggressive pleomorphic dermal sarcomas. In contrast to its alarming high-grade histology, AFX behaves indolently with rare recurrences/ metastatic rate of <2%. The overall 10- and 20-year disease-specific survival rates are ∼ 100% and 98%, respectively. Histologically, AFX displays undifferentiated pleomorphic spindle cell morphology akin to undifferentiated pleomorphic sarcoma (UPS), a feature that was the basis of the abandoned historical terminology "MFH of skin". However, in contrast to other undifferentiated sarcomatoid neoplasms, AFX is notorious for its highly variable histology with a plethora of patterns, underlining a wide differential diagnosis. Notably, spindle cell, keloid-like, pleomorphic, epithelioid, rhabdoid, clear cell, foamy cell, granular cell, bizarre cell, pseudoangiomatous, inflammatory, osteoclast-rich, and many others have been recognized with varying frequencies. Immunohistochemically, AFX is characterized by nonspecific profile with block-type expression of CD10 and aberrant p53 pattern and lack of pankeratin and other lineage-specific epithelial, mesenchymal, melanocytic and hematolymphoid markers. Sarcomatoid melanoma, spindle cell carcinoma and cutaneous anaplastic large cell lymphoma are major considerations. Distinction of AFX from pleomorphic dermal sarcoma (PDS) is arbitrary and is based on presence of ≥ 1 of four unfavorable histological features: more than minimal subcutaneous involvement, coagulative necrosis, lymphovascular invasion and perineurial invasion.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
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Coelho-Lima J, Bruty J, Watkins J, Liu H, Price R, Stefanos N. Clear cell variant of atypical fibroxanthoma and pleomorphic dermal sarcoma: molecular characterization and review of the literature. J Cutan Pathol 2022; 49:1031-1034. [PMID: 35922373 DOI: 10.1111/cup.14307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are unusual cutaneous tumors that typically arise in sun-damaged skin of elderly individuals. Several histopathologic variants have been described, but the clear cell variant is particularly rare with only 18 cases of AFX and 1 case of PDS reported. Here, we present two cases of clear cell AFX and PDS highlighting key histopathologic findings and molecular alterations assessed by next generation sequencing (NGS).
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Affiliation(s)
- Jose Coelho-Lima
- Histopathology Registrar, Addenbrooke's Hospital, Cambridge, UK.,NIHR Academic Clinical Fellow, University of Cambridge, Cambridge, UK
| | - Jonathan Bruty
- Clinical Scientist, East of England Genomic Laboratory Hub, Cambridge, UK
| | - James Watkins
- Consultant Histopathologist, Addenbrooke's Hospital, Cambridge, UK
| | - Hongxiang Liu
- Consultant Clinical Scientist, East of England Genomic Laboratory Hub, Cambridge, UK
| | - Richard Price
- Consultant Plastic Surgeon, Addenbrooke's Hospital, Cambridge, UK
| | - Niki Stefanos
- Consultant Histopathologist, Addenbrooke's Hospital, Cambridge, UK
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Tan P, Li M, Liu Z, Li T, Zhao L, Fu W. Glycolysis-Related LINC02432/Hsa-miR-98–5p/HK2 Axis Inhibits Ferroptosis and Predicts Immune Infiltration, Tumor Mutation Burden, and Drug Sensitivity in Pancreatic Adenocarcinoma. Front Pharmacol 2022; 13:937413. [PMID: 35795552 PMCID: PMC9251347 DOI: 10.3389/fphar.2022.937413] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
Pancreatic adenocarcinoma (PAAD) is a malignant cancer with high incidence and mortality. Glycometabolic rearrangements (aerobic glycolysis) is a hallmark of PAAD and contributes to tumorigenesis and progression through numerous mechanisms. This study aimed to identify a novel glycolysis-related lncRNA-miRNA-mRNA ceRNA signature in PAAD and explore its potential molecular function. We first calculated the glycolysis score for each PAAD patient by the ssGSEA algorithm and found that patients with higher hallmark glycolysis scores had poorer prognosis. Subsequently, we obtained a novel glycolysis-related LINC02432/hsa-miR-98–5p/HK2 axis from the TCGA and GEO databases using comprehensive bioinformatics analysis and developed a nomogram to predict overall survival. Furthermore, functional characterization analysis revealed that LINC02432/hsa-miR-98–5p/HK2 axis risk score was negatively correlated with ferroptosis. The tumor immune infiltration analysis suggested positive correlations between ceRNA risk score and infiltrated M0 macrophage levels in PAAD. Correlation analysis found that ceRNA risk scores were positively correlated with four chemokines (CXCL3, CXCL5, CXCL8 and CCL20) and one immune checkpoint gene (SIGLEC15). Meanwhile, tumor mutation burden (TMB), an indicator for predicting response to immunotherapy, was positively correlated with ceRNA risk score. Finally, the drug sensitivity analysis showed that the high-risk score patients might be more sensitive to EGFR, MEK and ERK inhibitors than low-risk score patients. In conclusion, our study suggested that LINC02432/hsa-miR-98–5p/HK2 axis may serve as a novel diagnostic, prognostic, and therapeutic target in PAAD treatment.
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Affiliation(s)
- Peng Tan
- Department of Cell Biology and Genetics / Institute of Genetics and Developmental Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mo Li
- Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhuoran Liu
- Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tongxi Li
- Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lingyu Zhao
- Department of Cell Biology and Genetics / Institute of Genetics and Developmental Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, China
- *Correspondence: Lingyu Zhao, ; Wenguang Fu,
| | - Wenguang Fu
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Lingyu Zhao, ; Wenguang Fu,
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10
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Atypical fibroxanthoma and pleomorphic dermal sarcoma: Is superficial infiltration in subcutaneous tissue acceptable in AFX? Ann Diagn Pathol 2022; 58:151915. [DOI: 10.1016/j.anndiagpath.2022.151915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 11/23/2022]
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