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Feng Y, Duan TJ, Huang Q, Li ZY, Liu YP, Luo MS, Lu GF, Shi W, Zhang ZY, Li HX. The clinicopathological characteristics of gastric cancer and precancerous conditions in gastric DLBCL and MALT lymphoma patients: a multi-center retrospective study. Ann Med 2023; 55:2193423. [PMID: 37183786 DOI: 10.1080/07853890.2023.2193423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE The objective of this study is to explore the clinicopathological characteristics of gastric cancer and precancerous conditions in patients with primary gastric lymphoma. METHODS We analyzed 474 cases of primary gastric lymphoma, mainly DLBCL and MALT, from three clinical centres retrospectively, and compared the clinicopathological parameters of primary gastric lymphoma patients complicated with gastric cancer, precancerous conditions, or with no complications. RESULTS A total of 5.1% of the patients with primary gastric lymphoma were diagnosed with gastric cancer, including metachronous gastric adenocarcinoma (3.2%) and synchronous gastric adenocarcinoma (1.9%). Of the patients with gastric lymphoma, 14.6% had precancerous conditions including atrophy (14.6%), intestinal metaplasia (8.9%), and low-grade intraepithelial neoplasia (1.9%). Primary gastric lymphoma patients with an ulcerative type (p = 0.009) and Lugano classification stage IIE + IV (p < 0.001) lymphoma had a higher risk of complicating with gastric cancers or precancerous conditions. The rate of infection of Helicobacter pylori (Hp) was 68.4% in patients with primary gastric lymphoma, which was higher in patients with MALT lymphoma (p < 0.001), Lugano classification stage I + II (p < 0.001), and patients complicated with precancerous conditions and gastric cancer (p < 0.001), especially gastric cancer of the intestinal type (p = 0.04). Gastric cancer (95.8%) and precancerous conditions (91.3%) occurred mostly in Hp-infected primary gastric lymphoma patients, with a minor subset of Hp-eradicated patients. Primary gastric lymphoma patients had a higher detection rate of early gastric cancer (25.0%) and a five-year survival rate (40.0%) than the general Chinese population. CONCLUSIONS Patients with primary gastric lymphoma have a high risk of developing gastric cancer and precancerous conditions, and this risk may be related to Helicobacter pylori infection. Follow-up of primary gastric lymphoma provides an opportunity for the detection of early gastric cancer.Key messages5.1% of the patients with primary gastric lymphoma were diagnosed with gastric cancer.14.6% of the patients with gastric lymphoma had premalignant lesions including atrophy (14.6%), intestinal metaplasia (8.9%), and low-grade intraepithelial neoplasia (1.9%).Primary gastric lymphoma patients complicating with gastric cancer had a higher infection rate of Helicobacter pylori (100.0%), a detection rate of early gastric cancer (25.0%) and a five-year survival rate (40.0%) than the general Chinese population.
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Affiliation(s)
- Yun Feng
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Tian-Jiao Duan
- Department of Gastroenterology, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Qing Huang
- Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of China
| | - Zhi-Yi Li
- Department of Hematology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Ya-Ping Liu
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Miao-Sha Luo
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Gui-Fang Lu
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Wen Shi
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Zhi-Yong Zhang
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
| | - Hong-Xia Li
- The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, People's Republic of China
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Batiuk E, Bassett M, Hakar M, Lin HC, Hunter AK. A rare case of primary gastric Hodgkin lymphoma in an adolescent with Nijmegen breakage syndrome. BMC Pediatr 2023; 23:189. [PMID: 37085783 PMCID: PMC10120165 DOI: 10.1186/s12887-023-03929-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/21/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Nijmegen Breakage Syndrome (NBS) is a rare autosomal recessive DNA repair disorder that increases risk of hematological malignancy. Primary gastric malignancies are exceedingly rare in pediatric patients and not typically high on the differential of abdominal pain. CASE PRESENTATION A 14-year-old male with NBS presented with persistent abdominal pain and was diagnosed with primary Hodgkin disease of the stomach. CONCLUSIONS In pediatric patients with predisposition to malignancies, such as those with underlying chromosome instability disorders, all symptoms must be carefully considered.
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Affiliation(s)
- Elizabeth Batiuk
- Internal Medicine Residency Program, Olive View-UCLA Medical Center, Sylmar, USA.
| | - Mikelle Bassett
- Department of Pediatrics, Oregon Health & Science University, Portland, USA
| | - Melanie Hakar
- Department of Pathology, Oregon Health & Science University, Portland, USA
| | - Henry C Lin
- Department of Pediatrics, Oregon Health & Science University, Portland, USA
| | - Anna K Hunter
- Department of Pediatrics, Oregon Health & Science University, Portland, USA
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Yang J, Liu T, Zhu Y, Zhang F, Zhai M, Zhang D, Zhao L, Jin M, Lin Z, Zhang T, Zhang L, Yu D. A dynamic predictive nomogram of long-term survival in primary gastric lymphoma: a retrospective study. BMC Gastroenterol 2022; 22:347. [PMID: 35842604 PMCID: PMC9288002 DOI: 10.1186/s12876-022-02419-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma (NHL). Due to the rarity of the disease, it is important to create a predictive model that provides treatment and prognosis for patients with PGL and physicians. Methods A total of 8898 and 127 patients diagnosed with PGL were obtained from the SEER database and from our Cancer Center as training and validation cohorts, respectively. Univariate and multivariate Cox proportional hazards models were used to investigate independent risk factors for the construction of predictive survival nomograms, and a web nomogram was developed for the dynamic prediction of survival of patients with PGL. The concordance index (C-index), calibration plot, and receiver operating characteristics (ROC) curve were used to evaluate and validate the nomogram models. Results There were 8898 PGL patients in the SEER cohort, most of whom were married men over the age of 60, 16.1% of the primary tumors were localized in the antrum and pylori of the stomach, which was similar to the composition of 127 patients in the Chinese cohort, making both groups comparable. The Nomogram of overall survival (OS) was compiled based on eight variables, including age at diagnosis, sex, race, marital status, histology, stage, radiotherapy and chemotherapy. Cancer-specific survival (CSS) nomogram was developed with eight variables, including age at diagnosis, sex, marital status, primary tumor site, histology, stage, radiotherapy and chemotherapy. The C-index of OS prediction nomogram was 0.948 (95% CI: 0.901–0.995) in the validation cohort, the calibration plots showed an optimal match and a high area below the ROC curve (AUC) was observed in both training and validation sets. Also, we established the first web-based PGL survival rate calculator (https://yangjinru.shinyapps.io/DynNomapp/). Conclusion The web dynamic nomogram provided an insightful and applicable tool for evaluating PGL prognosis in OS and CSS, and can effectively guide individual treatment and monitoring. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02419-2.
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Affiliation(s)
- Jinru Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Tao Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Ying Zhu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Fangyuan Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Menglan Zhai
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Dejun Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Lei Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Min Jin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Zhenyu Lin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Liling Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
| | - Dandan Yu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
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Diamantidis MD, Papaioannou M, Hatjiharissi E. Primary gastric non-Hodgkin lymphomas: Recent advances regarding disease pathogenesis and treatment. World J Gastroenterol 2021; 27:5932-5945. [PMID: 34629810 PMCID: PMC8475005 DOI: 10.3748/wjg.v27.i35.5932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/27/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
Primary gastric lymphomas (PGLs) are distinct lymphoproliferative neoplasms described as heterogeneous entities clinically and molecularly. Their main histological types are diffuse large B-cell lymphoma (DLBCL) or mucosa-associated lymphoma tissue. PGL has been one of the main fields of clinical research of our group in recent years. Although gastric DLBCLs are frequent, sufficient data to guide optimal care are scarce. Until today, a multidisciplinary approach has been applied, including chemotherapy, surgery, radiotherapy or a combination of these treatments. In this minireview article, we provide an overview of the clinical manifestations, diagnosis and staging of these diseases, along with their molecular pathogenesis and the most important related clinical published series. We then discuss the scientific gaps, perils and pitfalls that exist regarding the aforementioned studies, in parallel with the unmet need for future research and comment on the proper methodology for such retrospective studies. Aiming to fill this gap, we retrospectively evaluated the trends in clinical presentation, management and outcome among 165 patients with DLBCL PGL who were seen in our institutions in 1980-2014. The study cohort was divided into two subgroups, comparing the main 2 therapeutic options [cyclophosphamide doxorubicin vincristine prednisone (CHOP) vs rituximab-CHOP (R-CHOP)]. A better outcome with immunochemotherapy (R-CHOP) was observed. In the next 2 mo, we will present the update of our study with the same basic conclusion.
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Affiliation(s)
- Michael D Diamantidis
- Department of Hematology, Thalassemia and Sickle Cell Disease Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
| | - Maria Papaioannou
- Division of Hematology, First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Evdoxia Hatjiharissi
- Division of Hematology, First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
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Lochman P, Páral J. Primary Gastric Lymphoma Invading Spleen, Pancreas, and Transverse Colon. Case Rep Oncol 2021; 14:928-930. [PMID: 34248560 PMCID: PMC8255734 DOI: 10.1159/000516759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022] Open
Abstract
Primary gastric lymphoma is a relatively rare tumour which is not primarily indicated on for surgical treatment. We present a case of locally advanced primary gastric lymphoma with penetration to the surrounding organs that had to be managed surgically. The proximal gastrectomy with splenectomy, distal pancreatectomy, and left colectomy was performed. We reached R0 resection, and patient was recovered well.
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Affiliation(s)
- Petr Lochman
- Department of Field Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czechia.,Department of Surgery, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czechia
| | - Jiří Páral
- Department of Field Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czechia.,Department of Surgery, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czechia
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Ahmed M, Al-Khazraji A, Syed U, Seen T, Walfish A. Aggressive primary gastric lymphoma (PGL) masquerading as hepatocellular cancer (HCC) in alcoholic cirrhosis. BMC Gastroenterol 2021; 21:104. [PMID: 33663398 PMCID: PMC7934532 DOI: 10.1186/s12876-021-01691-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/24/2021] [Indexed: 12/01/2022] Open
Abstract
Background The gastrointestinal tract is sa well-known site for extranodal Non-Hodgkin lymphomas, with the stomach is known to be the most common site on lymphoma, primary gastric lymphoma (PGL). The lymphoproliferative disorder rarely occurs in patients with cirrhosis. We report a unique case of metastatic PGL in a patient with cirrhosis. Case presentation A middle-aged male with decompensated alcoholic cirrhosis presented with two weeks of epigastric abdominal pain, abdominal distension, and jaundice. Abdominal triple-phase CT scan was consistent with cirrhosis, ascites, and multiple new hypodense liver lesions classified as an intermediate probability for HCC based on the LI-RADS classification system (LI RADS 3). Due to the CT findings in the setting of cirrhosis, a provisional diagnosis of HCC was made. Upper endoscopy revealed new multiple umbilicated submucosal nodules in the gastric body. Biopsy and immunostaining consistent with high-grade B-cell lymphoma. Targeted liver biopsy with similar morphology and immunostaining profile consistent with metastatic primary gastric DLBCL. Conclusions The case highlights the importance of recognizing metastatic PGL in patients with underlying cirrhosis to differentiate lymphoma from hepatocellular cancer. Targeted liver biopsies with lymphoma immunostaining are required to make a diagnosis.
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Affiliation(s)
- Moiz Ahmed
- Division of Gastroenterology and Hepatology, Icahn School of Medicine At Mount Sinai (Elmhurst) Hospital, 79-01 Broadway, Elmhurst, NY, 11373, USA
| | - Ahmed Al-Khazraji
- Division of Gastroenterology and Hepatology, Icahn School of Medicine At Mount Sinai (Elmhurst) Hospital, 79-01 Broadway, Elmhurst, NY, 11373, USA.
| | - Umer Syed
- Division of Gastroenterology and Hepatology, Icahn School of Medicine At Mount Sinai (Elmhurst) Hospital, 79-01 Broadway, Elmhurst, NY, 11373, USA
| | - Tasur Seen
- Division of Gastroenterology and Hepatology, Icahn School of Medicine At Mount Sinai (Elmhurst) Hospital, 79-01 Broadway, Elmhurst, NY, 11373, USA
| | - Aaron Walfish
- Division of Gastroenterology and Hepatology, Icahn School of Medicine At Mount Sinai (Elmhurst) Hospital, 79-01 Broadway, Elmhurst, NY, 11373, USA
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Ren Y, Liu J, Wang L, Luo Y, Ding X, Shi A, Liu J. Multiple metabolic parameters and visual assessment of 18F-FDG uptake heterogeneity of PET/CT in advanced gastric cancer and primary gastric lymphoma. Abdom Radiol (NY) 2020; 45:3569-3580. [PMID: 32274551 DOI: 10.1007/s00261-020-02503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Advanced gastric cancer (AGC) and primary gastric lymphoma (PGL) are the two most common malignant tumors of the stomach. Conventional imaging examinations have difficulty distinguishing the two. This study explored the values of multiple parameters and visual assessment of 18F-fluorodeoxyglucose(18F-FDG) uptake heterogeneity of positron emission tomography/computed tomography(PET/CT) for differentiating between AGC and PGL. METHODS This retrospective study included 70 AGC and 26 PGL patients, all of whom had undergone 18F-FDG PET/CT before treatment. We analyzed the differences between AGC and PGL in the distribution of metastatic lesions and multiple metabolic parameters, including the maximum standardized uptake value (SUVmax), SUVmax/maximal thickness(THKmax), metabolic tumor volume and total lesion glycolysis (TLG). In addition, 18F-FDG uptake heterogeneity was visually assessed using a visual scoring method and a method of measuring SUVmax differences (SUVmax-d). RESULTS The most common metastasis of AGC patients were liver, bone, peritoneal and proximal lymph nodes; PGL patients had fewer peritoneal metastases and lymph node metastasis could appeared to be "skip metastasis." The metabolic parameters-SUVmax, SUVmax/THKmax and TLG-were higher in patients who had PGL, especially in diffuse large B-cell lymphoma (DLBCL). In the visual assessment of 18F-FDG uptake heterogeneity, the measurements of SUVmax-d in PGL were significantly higher than in AGC. Receiver operating characteristics curve analysis suggested that SUVmax has the highest comprehensive diagnostic efficiency due to having the highest value of area under the curve and the highest accuracy (77.2%). CONCLUSION 18F-FDG PET/CT had a high diagnostic efficiency for discrimination of AGC and PGL, especially between DLBCL and other pathological subtypes. Visual assessment used to evaluate 18F-FDG uptake heterogeneity could help to distinguish the two types of tumors. In addition, our innovative method of measuring the heterogeneity of 18F-FDG uptake-namely, SUVmax-d-could contribute to identification of the two tumor types and should have its significance clarified by future studies.
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Kilaru S, Panda SS, Das H, Sahoo N, Mohapatra D, Mohapatra SSG, Kolluri S. Primary gastric Hodgkin's lymphoma: A rare coincidence. Cancer Treat Res Commun 2020; 24:100194. [PMID: 32707425 DOI: 10.1016/j.ctarc.2020.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/20/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
Mostly primary gastric lymphomas are of the non-Hodgkin variety. Primary Hodgkin lymphoma (HL) of the stomach is an unusual entity that may be a big challenge in diagnosis. We reporter are case presenting as gastric outlet obstruction, which was later diagnosed as primary Hodgkin's Lymphoma of the stomach. Its rare coincidence makes it worth to be reported to sensitize clinicians as well as pathologists for the uncommon extra nodal site of Hodgkin's Lymphoma.
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Affiliation(s)
- Sindhu Kilaru
- Department of Medical Oncology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
| | - Soumya Surath Panda
- Department of Medical Oncology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
| | - Hemlata Das
- Department of Pathology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India.
| | - Nibedita Sahoo
- Department of Pathology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
| | - Debahuti Mohapatra
- Department of Pathology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
| | | | - Spoorthy Kolluri
- Department of Medical Oncology, IMS & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
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Gu S, Wang X, Feng L, Xie Y, Ping L, Liu W, Li J, Liu Y, Ding N, Song Y, Zhu J. Prognostic role of serum miRNA-16 in primary gastric lymphoma. Int J Clin Exp Pathol 2018; 11:5430-5435. [PMID: 31949626 PMCID: PMC6963034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/19/2018] [Indexed: 06/10/2023]
Abstract
Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma. However, uniform criteria for treatment and outcome evaluation are lacking. MicroRNA-16 (miRNA-16) has been shown to exhibit tumor-suppressive properties in many cancers and is a good biomarker of prognosis. We detected the expression level of miRNA-16 in 91 patients with PGL by qPCR and analyzed the prognostic significance. The proportion of patients with high expression of miRNA-16 was greater in patients with disease onset at age ≤ 60 years (P = 0.027), early-stage disease (P = 0.06), and marginal zone B-cell lymphoma (P = 0.0031). Furthermore, the proportion of patients with high expression of miRNA-16 was greater in those with a complete response than in those without a complete response (P = 0.054). However, miRNA-16 expression was not a statistically significant predictor of survival. These results suggest that miRNA-16 is a useful biomarker of disease prognosis in patients with PGL.
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Affiliation(s)
- Shanshan Gu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
- Myasthenia Gravis Treatment Center of Hebei Province, First Hospital of ShijiazhuangHebei, China
| | - Xiaogan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Lixia Feng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Yan Xie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Lingyan Ping
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Weiping Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Jiao Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Yalu Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Ning Ding
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and InstituteBeijing, China
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Ma Z, Fang M, Huang Y, He L, Chen X, Liang C, Huang X, Cheng Z, Dong D, Liang C, Xie J, Tian J, Liu Z. CT-based radiomics signature for differentiating Borrmann type IV gastric cancer from primary gastric lymphoma. Eur J Radiol 2017. [PMID: 28629560 DOI: 10.1016/j.ejrad.2017.04.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate the value of CT-based radiomics signature for differentiating Borrmann type IV gastric cancer (GC) from primary gastric lymphoma (PGL). MATERIALS AND METHODS 40 patients with Borrmann type IV GC and 30 patients with PGL were retrospectively recruited. 485 radiomics features were extracted and selected from the portal venous CT images to build a radiomics signature. Subjective CT findings, including gastric wall peristalsis, perigastric fat infiltration, lymphadenopathy below the renal hila and enhancement pattern, were assessed to construct a subjective findings model. The radiomics signature, subjective CT findings, age and gender were integrated into a combined model by multivariate analysis. The diagnostic performance of these three models was assessed with receiver operating characteristics curves (ROC) and were compared using DeLong test. RESULTS The subjective findings model, the radiomics signature and the combined model showed a diagnostic accuracy of 81.43% (AUC [area under the curve], 0.806; 95% CI [confidence interval]: 0.696-0.917; sensitivity, 63.33%; specificity, 95.00%), 84.29% (AUC, 0.886 [95% CI: 0.809-0.963]; sensitivity, 86.67%; specificity, 82.50%), 87.14% (AUC, 0.903 [95%CI: 0.831-0.975]; sensitivity, 70.00%; specificity, 100%), respectively. There were no significant differences in AUC among these three models (P=0.051-0.422). CONCLUSION Radiomics analysis has the potential to accurately differentiate Borrmann type IV GC from PGL.
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Affiliation(s)
- Zelan Ma
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Mengjie Fang
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100190, China.
| | - Yanqi Huang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Lan He
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
| | - Xin Chen
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China.
| | - Cuishan Liang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Xiaomei Huang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Zixuan Cheng
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
| | - Di Dong
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100190, China.
| | - Changhong Liang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Jiajun Xie
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China.
| | - Jie Tian
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
| | - Zaiyi Liu
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Jo HH, Kang SM, Kim SH, Ra M, Park BK, Kwon JG, Kim EY, Jung JT, Kim HG, Ryoo HM, Kang UR. [A Case of Gastro-Gastric Intussusception Secondary to Primary Gastric Lymphoma]. Korean J Gastroenterol 2017; 68:40-4. [PMID: 27443623 DOI: 10.4166/kjg.2016.68.1.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In adults, most intussusceptions develop from a lesion, usually a benign or malignant neoplasm, and can occur at any site in the gastrointestinal tract. Intussusception in the proximal gastrointestinal tract is uncommon, and gastro-gastric intussusception is extremely rare. We present a case of gastro-gastric intussusception secondary to a primary gastric lymphoma. An 82-year-old female patient presented with acute onset chest pain and vomiting. Abdominal CT revealed a gastro-gastric intussusception. We performed upper gastrointestinal endoscopy, revealing a large gastric mass invaginated into the gastric lumen and distorting the distal stomach. Uncomplicated gastric reposition was achieved with endoscopy of the distal stomach. Histological evaluation of the gastric mass revealed a diffuse large B cell lymphoma that was treated with chemotherapy.
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Affiliation(s)
- Hyeong Ho Jo
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sun Mi Kang
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Si Hye Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Moni Ra
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Byeong Kyu Park
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Joong Goo Kwon
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Eun Young Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jin Tae Jung
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hun Mo Ryoo
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Ung Rae Kang
- Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Korea
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Kakinoki Y, Hashiguchi J, Ishio T, Chiba K, Niino D, Ohshima K. CD20-positive primary gastric T-cell lymphoma poorly responding to initial treatment with rituximab plus CHOP, and a literature review. Int J Hematol 2015; 102:702-8. [PMID: 26251099 DOI: 10.1007/s12185-015-1841-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/30/2015] [Accepted: 07/07/2015] [Indexed: 01/01/2023]
Abstract
There have been rare reported cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) that co-expressed CD20. A 44-year-old Japanese male was initially misdiagnosed as CD20-positive diffuse large B-cell lymphoma with a background of reactive CD3-positive T-cells in the stomach. After four cycles of R-CHOP [rituximab plus cyclophosphamide (CY), doxorubicin, vincristine, and prednisolone (PSL)], total gastrectomy with regional lymph node dissection was performed due to the poor response to R-CHOP. A final diagnosis of CD20-positive primary gastric PTCL-NOS was made based on the immunohistochemical, flow cytometric, and molecular genetic findings. In the present case, CD20 immunostaining for T-cell lymphoma cells in tumor tissue varied; in a large part, these were strong to weak-positive, and in some parts, absent. We additionally reviewed the literature focusing on CD20-positive PTCL-NOS treated with rituximab. The administration of rituximab has been performed as an initial treatment in 11 cases, including the case reported here. The response was good in cases with high expression of CD20, while it was poor in cases with variable intensity in CD20 staining, which is consistent with our experience in the present case. The efficacy of rituximab may be associated with intensity of CD20 expression in T cells and its homogeneity in the tumor tissue.
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Tang WJ, Lv WF, Wang SC, Pan B, Xu GL. Clinical value of 18F-FDG PET/CT in diagnosis and follow-up of primary gastric lymphoma. Shijie Huaren Xiaohua Zazhi 2014; 22:5144-5148. [DOI: 10.11569/wcjd.v22.i33.5144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the clinical value of 18F-fluorodeoxygiucose positron emission computed tomography (18F-FDG PET/CT) in the diagnosis and follow-up of primary gastric lymphoma (PGL).
METHODS: Thirty-five patients with endoscopically or pathologically confirmed PGL were enrolled into this study. Among them, 12 patients underwent pre-treatment 18F-FDG PET/CT scans, and the other 23 patients (32 episodes) underwent a total of 32 post-treatment 18F-FDG PET/CT scans, with 8 scanned 2-3 times. The lesions on the images of 18F-FDG PET/CT were observed and analyzed, and the SUVmax was measured.
RESULTS: Among the 12 patients who underwent pre-treatment 18F-FDG PET/CT scans, 5 had infiltration type PGLs and showed gastric wall thickening [SUVmax = 22.5 ± 7.6 (7.2-30.9), average thickness = 3.4 cm ± 1.3 cm (1.2-4.8 cm)], 6 had nodule type [SUVmax = 24.2 ± 13.0 (5.8-39.4), average diameter = 2.8 cm ± 1.5 cm (1.0-4.6 cm), and 1 had mass type (SUVmax = 21.0, size = 19.5 cm × 1.4 cm). Among the 23 patients who underwent after-treatment 18F-FDG PET/CT scans, using endoscopic pathology or clinical follow-up beyond six months as standard, 11 had negative images, and the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG PET/CT were 83.3% (10/12), 1.7% (11/12), 87.5% (21/24), 84.6% (11/13) and 84.6% (11/13), respectively.
CONCLUSION: 18F-FDG PET/CT plays an important role in the pre-treatment diagnosis of PGL as well as post-treatment surveillance of PGL from a clinical perspective.
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Shan GD, Hu FL, Yang M, Chen HT, Chen WG, Wang YG, Chen LH, Li YM, Xu GQ. Clonal immunoglobulin heavy chain and T-cell receptor γ gene rearrangements in primary gastric lymphoma. World J Gastroenterol 2013; 19:5727-5731. [PMID: 24039368 PMCID: PMC3769912 DOI: 10.3748/wjg.v19.i34.5727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 07/24/2013] [Accepted: 08/06/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the diagnostic value of immunoglobulin heavy chain (IgH) and T-cell receptor γ (TCR-γ) gene monoclonal rearrangements in primary gastric lymphoma (PGL).
METHODS: A total of 48 patients with suspected PGL at our hospital were prospectively enrolled in this study from January 2009 to December 2011. The patients were divided into three groups (a PGL group, a gastric linitis plastica group, and a benign gastric ulcer group) based on the pathological results (gastric mucosal specimens obtained by endoscopy or surgery) and follow-up. Endoscopic ultrasonography (EUS) and EUS-guided biopsy were performed in all the patients. The tissue specimens were used for histopathological examination and for IgH and TCR-γ gene rearrangement polymerase chain reaction analyses.
RESULTS: EUS and EUS-guided biopsy were successfully performed in all 48 patients. In the PGL group (n = 21), monoclonal IgH gene rearrangements were detected in 14 (66.7%) patients. A positive result for each set of primers was found in 12 (57.1%), 8 (38.1%), and 4 (19.0%) cases using FR1/JH, FR2/JH, and FR3/JH primers, respectively. Overall, 12 (75%) patients with mucosal-associated lymphoid tissue lymphoma (n = 16) and 2 (40%) patients with diffuse large B-cell lymphoma (n = 5) were positive for monoclonal IgH gene rearrangements. No patients in the gastric linitis plastica group (n = 17) and only one (10%) patient in the benign gastric ulcer group (n = 10) were positive for a monoclonal IgH gene rearrangement. No TCR-γ gene monoclonal rearrangements were detected. The sensitivity of monoclonal IgH gene rearrangements was 66.7% for a PGL diagnosis, and the specificity was 96.4%. In the PGL group, 8 (100%) patients with stage IIE PGL (n = 8) and 6 (46.1%) patients with stage IE PGL (n = 13) were positive for monoclonal IgH gene rearrangements.
CONCLUSION: IgH gene rearrangements may be associated with PGL staging and may be useful for the diagnosis of PGL and for differentiating between PGL and gastric linitis plastica.
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Yan J, Ou-Yang Q, Huang LB, Yang JL. Endoscopic patterns and misdiagnosis of primary gastric lymphoma. Shijie Huaren Xiaohua Zazhi 2007; 15:1658-1661. [DOI: 10.11569/wcjd.v15.i14.1658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To improve the diagnosis level of primary gastric lymphoma by observing the endoscopic patterns and analyzing the reasons of misdiagnosis.
METHODS: A total of 51 primary gastric lymphoma diagnosed by endoscopic biopsy and 27 pseudo-diagnosed "lymphoma" by endoscopy were included in this study. The endoscopic patterns of the two groups were compared and analyzed with Mann-Whitney U rank-sum test.
RESULTS: Primary gastric lymphomas were mainly ulcer type (33/51, 65%) and nodus type (12/51, 23.5%). The 27 suspected gastric lymphomas were mainly nodus type (13/27, 48%) and bulky mucosa type (10/27, 37%). There was significant difference between two groups in endoscopic patterns (P < 0.001). However, there was no significance in movements and texture (P > 0.05).
CONCLUSION: Endoscopic patterns of primary gastric lymphoma present polytypism. It is important for the avoidance of misdiagnosis to acquaint its endoscopic presentation and combine with deep and multi-spot biopsy.
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