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Wan G, Leung BW, DeSimone MS, Nguyen N, Rajeh A, Collier MR, Rashdan H, Roster K, Zhou X, Moseley CB, Nirmal AJ, Pelletier RJ, Maliga Z, Marko-Varga G, Németh IB, Tsao H, Asgari MM, Gusev A, Stagner AM, Lian CG, Hurlbert MS, Liu F, Yu KH, Sorger PK, Semenov YR. Development and validation of time-to-event models to predict metastatic recurrence of localized cutaneous melanoma. J Am Acad Dermatol 2024; 90:288-298. [PMID: 37797836 PMCID: PMC10843255 DOI: 10.1016/j.jaad.2023.08.105] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND The recent expansion of immunotherapy for stage IIB/IIC melanoma highlights a growing clinical need to identify patients at high risk of metastatic recurrence and, therefore, most likely to benefit from this therapeutic modality. OBJECTIVE To develop time-to-event risk prediction models for melanoma metastatic recurrence. METHODS Patients diagnosed with stage I/II primary cutaneous melanoma between 2000 and 2020 at Mass General Brigham and Dana-Farber Cancer Institute were included. Melanoma recurrence date and type were determined by chart review. Thirty clinicopathologic factors were extracted from electronic health records. Three types of time-to-event machine-learning models were evaluated internally and externally in the distant versus locoregional/nonrecurrence prediction. RESULTS This study included 954 melanomas (155 distant, 163 locoregional, and 636 1:2 matched nonrecurrences). Distant recurrences were associated with worse survival compared to locoregional/nonrecurrences (HR: 6.21, P < .001) and to locoregional recurrences only (HR: 5.79, P < .001). The Gradient Boosting Survival model achieved the best performance (concordance index: 0.816; time-dependent AUC: 0.842; Brier score: 0.103) in the external validation. LIMITATIONS Retrospective nature and cohort from one geography. CONCLUSIONS These results suggest that time-to-event machine-learning models can reliably predict the metastatic recurrence from localized melanoma and help identify high-risk patients who are most likely to benefit from immunotherapy.
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Affiliation(s)
- Guihong Wan
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Systems Biology, Harvard Medical School, Boston, Massachusetts; Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Bonnie W Leung
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mia S DeSimone
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nga Nguyen
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ahmad Rajeh
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael R Collier
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hannah Rashdan
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katie Roster
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xu Zhou
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey
| | - Cameron B Moseley
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ajit J Nirmal
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts
| | - Roxanne J Pelletier
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts
| | - Zoltan Maliga
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts
| | | | - István Balázs Németh
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maryam M Asgari
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Population Medicine, Harvard Pilgrim Healthcare, Boston, Massachusetts
| | - Alexander Gusev
- Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Anna M Stagner
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christine G Lian
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marc S Hurlbert
- Melanoma Research Alliance, Washington, District of Columbia
| | - Feng Liu
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey
| | - Kun-Hsing Yu
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter K Sorger
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts
| | - Yevgeniy R Semenov
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Systems Biology, Harvard Medical School, Boston, Massachusetts.
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Zhang X, Chen Y, Chen W, Zhang Z. Combining Clinicopathologic and Ultrasonic Features for Predicting Skip Metastasis of Lateral Lymph Nodes in Papillary Thyroid Carcinoma. Cancer Manag Res 2023; 15:1297-1306. [PMID: 38027237 PMCID: PMC10657546 DOI: 10.2147/cmar.s434807] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Skip metastasis, regarded as lateral lymph node metastasis (LLNM) without involving the central lymph node metastasis (CLNM), in papillary thyroid carcinoma (PTC) patients is commonly unpredictable. The purpose of the present research was to investigate the independent risk factors of skip metastasis in patients with PTC. Methods and Materials In the present research, 228 consecutive PTC patients who experienced total thyroidectomy coupled with central and lateral lymph node dissection from May 2020 to September 2022 at the Affiliated hospital of Jiangsu University were included in our research. Univariate and multivariate analysis were then applied to investigate the risk factors of skip metastasis in patients with PTC. Furthermore, a predictive model of skip metastasis was then constructed based on risk factors. Results The skip metastasis rate was 11.8% (27/228) in the current research. After the univariate and multivariate analysis, tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location were determined to be predictive factors of skip metastasis. The risk score of skip metastasis was calculated: risk score = 1.229 × (if tumor nodule ≤ 10mm) + 1.518 × (if unilaterality nodule) + 1.074 × (if microcalcification in nodule) + 2.332 × (if nodule in upper location). Conclusion Tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location can increase the occurrence of skip metastasis in patients with PTC, which is expected to provide useful information to guide the suitable intraoperative window.
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Affiliation(s)
- Xin Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Ying Chen
- Department of Medical Pharmacy, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Wanyin Chen
- Department of Medical Gynecology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Zheng Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
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Wu CL, Chang SW, Lee JYY, Chen TY, Chen CC, Chu CB, Medeiros LJ, Chang KC. Distribution and clinical features of lymphomas involving skin in Taiwan. Kaohsiung J Med Sci 2023; 39:522-532. [PMID: 36794661 DOI: 10.1002/kjm2.12659] [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: 10/25/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/17/2023] Open
Abstract
A wide variety of primary and secondary lymphoma types involves the skin. However, reports with comparisons between both groups are limited in Taiwan. We retrospectively enrolled all cutaneous lymphomas and evaluated their clinicopathologic features. There were 221 cases of lymphoma: 182 (82.3%) primary and 39 (17.7%) secondary. Mycosis fungoides was the most common primary T-cell lymphoma, 92 (41.7%) cases, followed by CD30-positive T-cell lymphoproliferative disorders including lymphomatoid papulosis (n = 33, 14.9%) and cutaneous anaplastic large cell lymphoma (n = 12, 5.4%). The most frequent primary B-cell lymphomas were marginal zone lymphoma (n = 8, 3.6%) and diffuse large B-cell lymphoma (DLBCL), leg type (n = 8, 3.6%). DLBCL including variants was the most common secondary lymphoma involving skin. Most primary lymphomas presented at low-stage (T-cell, 86%; B-cell, 75%), whereas the majority of secondary lymphomas presented at high-stage (T-cell, 94%; B-cell, 100%). Patients with secondary lymphomas had an older mean age, more frequent B symptoms, lower serum albumin and hemoglobin, and a higher frequency of atypical lymphocytes in blood than those with primary lymphomas. In primary lymphomas, older age, lymphoma types, decreased lymphocyte counts and atypical lymphocytes in blood were poorer prognostic factors. In secondary lymphoma patients, lymphoma types, high serum lactate dehydrogenase and low hemoglobin levels predicted poorer survival. We found that the distribution of primary cutaneous lymphomas in Taiwan mirrors that of other Asian countries but shows some differences as compared with Western countries. Primary cutaneous lymphomas have a better prognosis than secondary lymphomas. Histologic classification of lymphomas highly correlated with disease presentation and prognosis.
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Affiliation(s)
- Cheng-Lin Wu
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Julia Yu-Yun Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsai-Yun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chia-Bao Chu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kung-Chao Chang
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pathology, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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Kim HS, Kim CG, Hong JY, Kim IH, Kang B, Jung S, Kim C, Shin SJ, Choi HJ, Cheon J, Chon HJ, Lim HY. The presence and size of intrahepatic tumors determine the therapeutic efficacy of nivolumab in advanced hepatocellular carcinoma. Ther Adv Med Oncol 2022; 14:17588359221113266. [PMID: 35860833 PMCID: PMC9290164 DOI: 10.1177/17588359221113266] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 12/13/2021] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: Inter-tumoral heterogeneity at the differential lesion level raises the possibility of distinct organ-specific responses to immune checkpoint inhibitors (ICIs). We aimed to comprehensively examine the clinicopathological factors to predict and assess the efficacy of nivolumab, programmed cell death protein 1 (PD-1) blockade at an individual tumor site-specific level in patients with advanced hepatocellular carcinoma (aHCC). Patients and Methods: We enrolled 261 aHCC patients treated with nivolumab between 2012 and 2018. Eighty-one clinicopathological factors were comprehensively collected and analyzed. The association between all variables and survival outcomes was evaluated. According to tumor site, the organ-specific responses were assessed based on the Response Evaluation Criteria in Solid Tumors, version 1.1. Results: The liver was the most commonly involved organ (75.1%), followed by the lungs (37.5%) and lymph nodes (LNs, 11.5%). The liver of nonresponders was more frequently the organ of progression, while the lungs of responders were more frequently the organs of response. Among the 455 individual lesions (liver, n = 248; lung, n = 124; LN, n = 35; others including bone or soft tissues, n = 48), intrahepatic tumors showed the least response (10.1%), followed by lung (24.2%) and LN tumors (37.1%), indicating the presence of distinct organ-specific responses to nivolumab. In intrahepatic tumors, the organ-specific response rate decreased as the size increased (13% for ⩽50 mm, 8.1% for 50–100 mm, and 5.5% for >100 mm). In the subgroup analysis according to tumor location, patients with lung only metastasis (⩾30 mm) showed the best progression-free survival (PFS) and overall survival (OS). In contrast, primary HCC (⩾100 mm) without lung metastasis had the worst PFS and OS. Comprehensive analyses also revealed that liver function and systemic inflammatory indices, such as neutrophil-to-lymphocyte ratio (NLR), were significantly associated with PFS and OS. Conclusion: The presence and size of liver tumors, liver function, and NLR are key factors determining the response to nivolumab in aHCC. These clinical factors should be considered when treating patients with advanced HCC with PD-1 blockade.
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Affiliation(s)
- Han Sang Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Gon Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Yong Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Il-Hwan Kim
- Department of Oncology, Haeundae Paik Hospital, Cancer Center, Inje University College of Medicine, Busan, Korea
| | - Beodeul Kang
- Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Sanghoon Jung
- Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Chan Kim
- Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Sang Joon Shin
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jin Choi
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jaekyung Cheon
- Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Gyeonggi-do, Korea
| | - Hong Jae Chon
- Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Gyeonggi-do, Korea
| | - Ho Yeong Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06171, Republic of Korea
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Zhu X, Dent S, Paquet L, Zhang T, Tesolin D, Graham N, Aseyev O, Song X. How Canadian Oncologists Use Oncotype DX for Treatment of Breast Cancer Patients. ACTA ACUST UNITED AC 2021; 28:800-812. [PMID: 33557029 PMCID: PMC7985759 DOI: 10.3390/curroncol28010077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/20/2022]
Abstract
Background: The literature suggests that medical oncologists differ on how they use the Oncotype DX (ODX) genomic assay for making decisions about systemic therapy in breast cancer patients. Given the emergence of data supporting the use of genomic profiling for the prognosis and predicting benefit of chemotherapy, we surveyed medical oncologists in Canada to assess their usage and perception of the ODX assay. Methods: A 34-item survey was distributed to Canadian medical oncologists via the Canadian Association of Medical Oncologists. Data was collected on physician demographics, ODX usage patterns, and physicians’ perception of the impact clinical and pathologic characteristics make on ODX utilization. Results: Response rate was 20.6% with 47 responses received from 228 survey sent. Forty-five responses were eligible for analysis. Sixty-two percent (28/45) of respondents treated predominantly breast cancer, and 60% (27/45) have been in practice for at least 10 years. The most cited reason for using ODX was to avoid giving patients unnecessary chemotherapy (64%; 29/45). Sixty-seven percent (30/45) deferred making treatment decisions until ODX testing was completed. Factors most strongly impacting ODX utilization included: patient request, medical comorbidities and tumor grade. In clinical scenarios, ODX was more frequently selected for patients aged 40–65 (vs. <40 or >65), grade 2 tumors (vs. grade 1 or 3), and Ki-67 index of 10–20% (vs. <10% or >20%). Conclusions: This survey demonstrated that Canadian medical oncologists are preferentially using ODX to avoid giving patients unnecessary chemotherapy. The utilization of ODX is mainly in patients with intermediate clinical and pathologic features.
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Affiliation(s)
- Xiaofu Zhu
- The Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (X.Z.); (S.D.); (N.G.); (X.S.)
| | - Susan Dent
- The Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (X.Z.); (S.D.); (N.G.); (X.S.)
- Duke Cancer Institute, Duke University, Durham, NC 27710, USA
| | - Lise Paquet
- Department of Psychology, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - Tinghua Zhang
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada;
| | - Daniel Tesolin
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P3E 2C6, Canada;
| | - Nadine Graham
- The Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (X.Z.); (S.D.); (N.G.); (X.S.)
| | - Olexiy Aseyev
- Regional Cancer Care Northwest, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON P7B 6V4, Canada
- Correspondence:
| | - Xinni Song
- The Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (X.Z.); (S.D.); (N.G.); (X.S.)
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Li H, Yan S, Liu Y, Ma L, Liu X, Liu Y, Cheng Y. Analysis of NTRK mutation and clinicopathologic factors in lung cancer patients in northeast China. Int J Biol Markers 2020; 35:36-40. [PMID: 32921229 DOI: 10.1177/1724600820949883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/15/2022]
Abstract
OBJECTIVE NTRK mutations and clinicopathological factors in patients with lung cancer in northeast China were analyzed by next-generation sequencing (NGS), and references were provided for patients with NTRK mutations undergoing targeted therapy in northeast China. METHODS A total of 224 specimens in 173 patients with lung cancer were collected. This included 51 patients with matched tissue and whole blood samples,133 tissue samples, 84 whole blood samples, and 7 pleural effusion samples. NGS (520 genes) was used to detected NTRK mutations and clinicopathologic factors. RESULTS NTRK mutation was detected in eight patients (8/173, 4.6%), including four NTRK missense mutations (4/173, 2.3%), two NTRK fusion gene mutations (2/173, 1.2%), and two NTRK copy number deletions (2/173, 1.2%). Among the eight patients with NTRK mutations, four were associated with lung cancer driver gene mutations (3/4 EGFR, 1/4ALK); NTRK in two patients was inconsistent in tissue and paired whole blood testing; NTRK missense mutation was detected in one patient, and NTRK copy number deletion was detected in the other; and NTRK wild type was detected in two patients. There was no correlation between NTRK mutation and clinicopathologic factors (including gender, age, pathological type, smoking status, metastasis site). CONCLUSION NTRK mutation was only 4.6%, effective fusion gene mutation was 1.2%, and common driver gene mutation in lung cancer was evident in 50% of patients. The results of NTRK were inconsistent with matched tissues and whole blood. Therefore, patients with NTRK mutation should use a variety of specimen types and large target area sequencing (panel) analysis method to provide individualized treatment.
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Affiliation(s)
- Hui Li
- Translational Medical Research Lab, Jilin Cancer Hospital, Changchun, China
| | - Shi Yan
- Translational Medical Research Lab, Jilin Cancer Hospital, Changchun, China
| | - Ying Liu
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China
| | - Lixia Ma
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China
| | - Xianhong Liu
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China
| | - Yan Liu
- Translational Medical Research Lab, Jilin Cancer Hospital, Changchun, China
| | - Ying Cheng
- Translational Medical Research Lab, Jilin Cancer Hospital, Changchun, China.,Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China
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Zhang Y, Wang LF, Gao JH, Li L, Jiang P, Lv X, Yu LX, Yang J, Li RT, Liu BR. Clinical significance of epithelial-mesenchymal transition-related molecules in lung adenocarcinoma. ACTA ACUST UNITED AC 2019; 26:e121-e127. [PMID: 31043817 DOI: 10.3747/co.26.4471] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Epithelial-mesenchymal transition (emt) refers to the biologic process in which epithelial cells are transformed into interstitial phenotypes by specific pathways. This transition plays an important biologic role in the process by which epithelium-derived malignant tumour cells acquire the ability to migrate and invade. We explored the relationship between emt-associated molecules and patient-related clinical factors to determine whether any clinical characteristics could be used as biomarkers for emt-related protein alterations in lung cancer-especially lung adenocarcinoma. Methods Tumour specimens were collected from 80 patients with lung adenocarcinoma who underwent surgery or lung biopsy, with 4 patients being evaluated a 2nd time after re-biopsy. Expression of emt-related proteins, including E-cadherin and vimentin, was evaluated by immunohistochemistry. We analyzed the relationship between clinicopathologic characteristics and expression level of the emt markers. Results Positive expression of E-cadherin was observed in 63 patients (79%), and vimentin, in 46 patients (57.5%). No significant relationships between E-cadherin or vimentin expression and smoking history, sex, age, driving gene mutations, or cell differentiation were identified. A significant correlation was observed between vimentin expression and pathologic stage. Of the 4 patients who were evaluated a 2nd time after re-biopsy, 3 showed the same emt-related protein expression status as in the first analysis. In the remaining patient, E-cadherin had changed completely. Conclusions Clinicopathologic factors in cancer patients did not help to diagnose emt status in lung adenocarcinoma; however, TNM stage might be associated with vimentin expression.
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Affiliation(s)
- Y Zhang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - L F Wang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - J H Gao
- The Comprehensive Cancer Center, Suzhou Yongding Hospital, Suzhou, P.R.C
| | - L Li
- Department of Pathology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, P.R.C
| | - P Jiang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - X Lv
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - L X Yu
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - J Yang
- Department of Pathology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, P.R.C
| | - R T Li
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
| | - B R Liu
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, and Clinical Cancer Institute of Nanjing University, Nanjing, P.R.C
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Hu XY, Zhang W, Hu Y, Zhang Y, Gong R, Liang JY, Liu L. A meta-analysis reveals prognostic role of programmed death ligand-1 in Asian patients with non-small cell lung cancer. ACTA ACUST UNITED AC 2016; 36:313-20. [PMID: 27376797 DOI: 10.1007/s11596-016-1585-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/12/2016] [Indexed: 12/25/2022]
Abstract
Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1 (PD-L1) in non-small cell lung cancer (NSCLC), but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from PubMed, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS), and odd ratios (ORs) with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients (HR=1.60, 95% CI: 0.88-2.89, P=0.123). Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients (HR=2.00, 95% CI: 1.55-2.57, P<0.001). Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation (HR=1.84, 95% CI: 1.49-2.28, P<0.001), late stage (HR=1.21, 95% CI: 1.02-1.43, P=0.026) and anaplastic lymphoma kinase (ALK) translocation (HR=2.63, 95% CI: 1.08-6.40, P=0.034), but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.
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Doepker MP, Thompson ZJ, Centeno BA, Kim RD, Wong J, Hodul PJ. Clinicopathologic and survival analysis of resected ampullary adenocarcinoma. J Surg Oncol 2016; 114:170-5. [PMID: 27158031 DOI: 10.1002/jso.24281] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/20/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Ampullary adenocarcinoma (AAC) is a rare neoplasm. We sought to determine the clinicopathologic factors contributing to the overall survival (OS) and recurrence-free (RFS) survival. METHODS Patients (pts) with resected AAC were identified from 1996 to 2015 and reviewed for clinicopathologic factors and correlated with outcome. RESULTS We identified and evaluated 106 pts diagnosed with AAC. The median age was 70.2 years (range 41-86) and 60 (56.6%) were male. Overall, 105 pts (99.1%) had a pancreaticoduodenectomy. An R0 resection was achieved in 101 (95%) pts. Median follow-up was 19 months with a median OS of 49.3 months. Lymph node metastasis and poorly differentiated tumors adversely affected OS on multivariate analysis (MVA). Twenty patients (18.9%) developed recurrence. The median RFS was 27 months. RFS was adversely affected by lymph node count and metastasis, tumor differentiation, and histological subtype on MVA. Survival was not affected by the addition of adjuvant therapy. Retrieval of ≤12 lymph nodes and lymph node ratio ≥0.10 resulted in worse OS on Kaplan-Meier analysis. CONCLUSIONS Our data show retrieval of ≤12 nodes, involvement of nodes with AAC, moderately or poorly differentiated tumors, and pancreaticobiliary subtype adversely affected survival, while the use of adjuvant therapy demonstrated no significant benefit. J. Surg. Oncol. 2016;114:170-175. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Matthew P Doepker
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
| | | | | | - Richard D Kim
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Joyce Wong
- Department of Surgical Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Pamela J Hodul
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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10
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Doepker MP, Hanna KH, Thompson ZJ, Binitie OT, Letson DG, Gonzalez RJ. Recurrence and survival analysis of resected soft tissue sarcomas of pelvic retroperitoneal structures. J Surg Oncol 2016; 113:103-7. [PMID: 26744131 DOI: 10.1002/jso.24090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/08/2015] [Accepted: 10/28/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The purpose is to determine the clinicopathologic factors related to survival and recurrence of primary resected pelvic soft tissue sarcomas (STS). METHODS Demographic/clinical variables were recorded. RESULTS Thirty-five pts were identified. Median follow-up was 24.2 months. There were 23 (65.7%) high/intermediate-grade and 12 (34.3%) low-grade tumors included in the final analysis. Eight patients (22.9%) received neoadjuvant therapy. Margins were grossly negative in 27 (77.1%, 17-R0, 10-R1) and grossly positive (R2) in 8 (22.9%). Adjuvant therapy was used in 13 patients (37.1%). The 2- and 3-year RFS was 56.5% and 51.3%, with 14 patients recurring at a median time of 16 months (6-local, 8-distant). All distant recurrences were in high-grade tumors. There were no differences in RFS for margins (R0 vs. R1), neoadjuvant/adjuvant therapy, size (≥10 vs. <10 cm) or gender. High/intermediate-grade tumors had worse RFS (P < 0.008). The 2- and 3-year OS was 80.9%. OS was improved for R0/R1 resection (P < 0.001). Resection to R0/R1 margin was a significant predictor of improved OS (P = 0.001). CONCLUSIONS High/intermediate-grade lesions were associated with worse OS and RFS. Resection to gross negative margins was the only independent predictor of OS. Adjuvant therapy may be reserved for high-grade lesions due to increased metastatic potential. J
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Affiliation(s)
| | - Karim H Hanna
- University of South Florida Medical School, Tampa, Florida
| | | | - Odion T Binitie
- Department of Sarcoma, Moffitt Cancer Center, Tampa, Florida
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Liu D, Zhou K, Li Q, Deng F, Ma Y. Expression of Wnt11 and Rock2 protein with clinical characteristics of esophageal squamous cell carcinoma in Kazakh and Han patients. Int J Clin Exp Pathol 2015; 8:7122-7130. [PMID: 26261605 PMCID: PMC4525939] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/17/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Esophageal squamous cell carcinoma (ESCC) is one of the most malignancies with a very poor outcome in China. Wnt11 and Rock2, new identified proteins highly associated with metastasis of many cancers, which were never reported in esophageal squamous cell carcinoma (ESCC). Here we measured the expression levels of Wnt11 and Rock2 in tissues from 265 patients with ESCC. Immunohistochemical staining was employed to detect the correlation of Wnt11 and Rock2 expression with clinicopathological features. METHODS The expression of Wnt11 and Rock2 was detected by immunohistochemistry in esophageal squamous cell carcinomas and normal esophageal tissues. A chi-square test was used to assess the statistical significance of the correlations between Wnt11, Rock2 expression and different clinicopathological parameters, respectively. RESULTS The high-expression of Wnt11 and Rock2 was observed in ESCCs. Seventy-five cases of ESCC (51.7%) showed a positive expression of Wnt11, which indicated a significant association with the AJCC stage (P=0.007). Ninety-eight cases of ESCC (65.5%) showed a positive expression of Rock2, which indicated a significant association with ethnic background. There were no close correlations between Rock2 expression and gender, tumor location, AJCC stage, lymph node metastasis. Specifically, the expression of Rock2 was significantly different between Hans and Kazaks ethnicities (P=0.000). In Kaplan-Meier curve analysis, no significant correlation was observed between the expression of Wnt11, Rock-2 and the poor prognosis of ESCCs. CONCLUSION Our finding suggests that the over-expression of Rock2 may play an important role in the carcinogenesis and progression, and may become a new underlying molecular marker in the diagnosis and treatment in ESCC.
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Affiliation(s)
- Dong Liu
- Department of Pathology, First Affiliated Hospital, Xinjiang Medical UniversityUrumqi 830054, China
| | - Keming Zhou
- Hypertension Center of the People’s Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang Uygur Autonomous RegionUrumqi 830001, China
| | - Qiaoxin Li
- Department of Pathology, First Affiliated Hospital, Xinjiang Medical UniversityUrumqi 830054, China
| | - Feiyan Deng
- Department of Pathology, First Affiliated Hospital, Xinjiang Medical UniversityUrumqi 830054, China
| | - Yuqing Ma
- Department of Pathology, First Affiliated Hospital, Xinjiang Medical UniversityUrumqi 830054, China
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