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A Case of Serous Tubal intraepithelial Carcinoma Diagnosed by Cytology during the Operation

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Open Journal of Pathology 2018年第3期8卷 69-77页

作者： Kenji Niwa Tsuneo Ishihara Yoko Ueda Motoki Takenaka Tomomi Shiga Sakae Mori Keigo Kuwabara Yoshio Yamaguchi Takuji Tanaka Department of Obstetrics & Gynecology Gujo City Hospital Gujo City Japan Department of Obstetrics & Gynecology Gifu University School of Medicine Gifu City Japan Section of Laboratory Medicine Gujo City Hospital Gujo City Japan Department of Diagnostic Pathology & Research Center of Diagnostic Pathology Gifu Municipal Hospital Gifu City Japan

We experienced a case of serous tubal intraepithelial carcinoma (STIC), which is the earliest morphologically recognizable precursor of pelvic high grade serous carcinoma, diagnosed by cytology during the operation. A 48-year-old Japanese woman visited to our department because of abnormal cytological result and the left adnexal mass on female cancer screening. Pre-operatively, she was diagnosed as cervical intraepithelial neoplasia (CIN) 3, adenomyosis, and the left adnexal cystic lesion with papillary growth. At laparotomy, the left adnexal tumor turned out to be cystic fallopian tube with small papillary growth on the inner surface, but abnormal findings were not present on bilateral ovaries. The cytology of the imprint smears from the papillary projection and ascitic fluid showed positive, suggesting serous adenocarcinoma. Histopathological examination of the lesion revealed the left fallopian tube lesion was STIC with immunohistochemically positive reactivity against p53. No metastases including disseminated lesions were noted. The patient received four courses of systemic chemotherapy, and had no recurrent signs 10 months after the operation.

关键词： Serous Tubal intraepithelial Carcinoma Cytology Immonohistochemistry p53 Ki-67

Biomarkers Expression in Cervical Cancer and High Grade Squamous intraepithelial Lesions

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Journal of Cancer Therapy 2012年第6期3卷 1066-1073页

作者： Ostojich Marcela Gimenez Liliana Gianni Sergio Alvarez Ana Marino Lina De Dios Diana Jasnis Maria Adela Departament of Gynecology Institute of Oncology Angel H Roffo University of Buenos Aires Argentina Department of Clinical Oncology Institute of Oncology Angel H Roffo University of Buenos Aires Argentina Department of Immunobiology Institute of Oncology Angel H Roffo University of Buenos Aires Argentina. Department of Pathology Institute of Oncology Angel H Roffo University of Buenos Aires Argentina

Objectives: The finding of new prognostic factors in human cervix cancer is necessary to improve present conventional treatments. The aim of the present study was to determine the expression and evaluate the prognostic value of hypoxia-inducible factor-1(HIF-1α), vascular endothelial growth factor (VEGF) and eritropoyetin receptor (EpoR) in cervix cancer stages IIA-IIB and in preinvasive high grade squamous intraepithelial lesions (HSIL) Methods: The study included 70 patients with cervix cancer, FIGO stages IIA-IIB, 28 patients with HSIL and normal cervix (n = 28). HIF-1α, VEGF and EpoR expression were analyzed in tissue samples by immunohistochemistry using commercial antibodies. Expression and overexpression of the tumor markers were quantified according to German Immunoreactive Score. Results: HIF-1α, EpoR and VEGF overexpression was detected in 30%, 37% and 51% of cancer patients respectively. Patients with HSIL showed enhanced expression only of EpoR and VEGF (39.2% and 71.4%) while VEGF was overexpressed in 21% of the specimen. No correlation was found between VEGF and EpoR with disease-free overall survival (OS), tumor recurrences or prognostic factors. Only overexpression of HIF-1 was associated with less median survival measured up to 24 months, unless it was not maintained a long time. Conclusion: Although any of the markers could be considered as independent prognostic factor for cervix cancer patients, our data showed a significant increase in their expression from the premalignant lesion up to the invasive stages of tumor progression.

关键词： Prognostic Marker Cervical Cancer intraepithelial Lesion HIF-1α VEGF EpoR

Incidental Serous Tubal intraepithelial Carcinoma Detected by a Surgery for Ectopic Pregnancy

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Open Journal of Obstetrics and Gynecology 2020年第5期10卷 738-743页

作者： Takuro Yamamoto Koki Shimura Takuya Sugahara Nozomi Ogiso Tomoharu Okubo Department of Obstetrics and Gynecology Japanese Red Cross Kyoto Daiichi Hospital Honmachi Higashiyama-Ku Kyoto Japan

Serous tubal intraepithelial carcinoma is a putative precursor of high-grade serous carcinoma, which is the most common histological type of ovarian or pelvic peritoneal cancer. Serous tubal intraepithelial carcinoma is commonly found in patients with breast cancer susceptibility gene mutations who undergo risk-reducing salpingo-oophorectomy. Incidental serous tubal intraepithelial carcinoma found by a non-prophylactic surgery is rare. A 33-year-old woman referred to our hospital for a diagnosis of ectopic pregnancy. She underwent a laparoscopic right salpingectomy. Pathologically, ectopic pregnancy in the ampulla of the right fallopian tube was confirmed and serous tubal intraepithelial carcinoma was observed in the fallopian tube. Subsequently, she underwent a laparoscopic hysterectomy, bilateral oophorectomy, and left salpingectomy as additional treatment. She has experienced no recurrence thus far for 37 months since the surgery.

关键词： Serous Tubal intraepithelial Carcinoma Ectopic Pregnancy Laparoscopic Surgery

Management of cervical intraepithelial neoplasia in Japanese pregnant women

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Open Journal of Obstetrics and Gynecology 2013年第3期3卷 337-340页

作者： Yuko Matsubara Toru Fujioka Hisashi Hashimoto Katsuyuki Hamada Keiichi Matsubara Akihiro Nawa Department of Obstetrics and Gynecology School of Medicine Ehime University Toon Japan

Objective: In this study, we evaluated the management of cervical intraepithelial neoplasia (CIN) in pregnant women and evaluated the postpartum prognosis. Methods: Twenty-four pregnant women, who were diagnosed with CIN at Ehime University Hospital between January 2008 and October 2012, were recruited. The mode of delivery and pathophysiological examination results in the postpartum period were evaluated. Results: Four patients were antenatally diagnosed with either CIN1 or CIN2. Of these patients, CIN regressed or remained stable during pregnancy, and there was no disease progression in the postpartum period. Nine patients were diagnosed with severe dysplasia (CIN3) and eleven patients had carcinoma in situ (CIS). Of these patients, 5/9 (55%) and 4/11 (36%), respectively, had disease regression postnatally. No CIN lesion progressed to invasive carcinoma after delivery. Conclusions: We determined that many cases diagnosed antenatally with CIN regressed during the postpartum period, regardless of the grade of CIN. We recommend a conservative management strategy with careful ante- and postpartum examinations for pregnant women with CIN.

关键词： Cervical intraepithelial Neoplasia Prenancy

Missed diagnosis of early gastric cancer or high-grade intraepithelial neoplasia

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World Journal of Gastroenterology 2013年第13期19卷 2092-2096页

作者： Wei Ren Jin Yu Zhi-Mei Zhang Yuan-Kun Song Yi-Hui Li Lei Wang Department of Gastroenterology Xin Qiao HospitalThe Third Military Medical University

AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions inc

关键词： Missed diagnosis Early gastric cancer High-grade intraepithelial neoplasia Endoscopic diagnosis Biopsies

Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy

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World Journal of Gastrointestinal Pathophysiology 2011年第6期2卷 93-99页

作者： Tsutomu Nishida Shusaku Tsutsui Motohiko Kato Takuya Inoue Shunsuke Yamamoto Yoshito Hayashi Tomofumi Akasaka Takuya Yamada Shinichiro Shinzaki Hideki Iijima Masahiko Tsujii Tetsuo Takehara Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine2-2 YamadaokaSuitaOsaka 565-0871Japan

Treatment strategies,whether as follow-up or"total incisional biopsy"for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen,are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic *** on the histological findings of the biopsy specimen,it is difficult to differentiate between reactive or regenerative changes,inflammation and neoplastic changes,intraepithelial and invasive ***,gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during *** advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and highfrequency generators,may make endoscopic treatment,such as endoscopic submucosal dissection(ESD),a therapeutic option for gastric intraepithelial neoplasia,including low-grade *** studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness.

关键词： Gastric intraepithelial neoplasia Adenoma Dysplasia Endoscopic submucosal dissection Endoscopic mucosal resection Endoscopic resection Adenocarcinoma

Recent advances in the study of HPV-associated carcinogenesis

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Virologica Sinica 2015年第2期30卷 101-106页

作者： Liyan Jin Zhi-Xiang Xu Division of Hematology and Oncology Comprehensive Cancer Center University of Alabama at Birmingham Birmingham 35205 USA

Human papillomaviruses(HPVs) cause virtually all cervical cancers, the second leading cause of death by cancer among women, as well as other anogenital cancers and a subset of head and neck cancers. Approximately half of women, who develop cervical cancer die from it. Despite the optimism that has accompanied the introduction of prophylactic vaccines to prevent some HPV infections, the relatively modest uptake of the vaccine, especially in the developing world, and the very high fraction of men and women who are already infected, means that HPV-associated disease will remain as a significant public health problem for decades. In this review, we summarize some recent findings on HPV-associated carcinogenesis, such as mi RNAs in HPV-associated cancers, implication of stem cells in the biology and therapy of HPV-positive cancers, HPV vaccines, targeted therapy of cervical cancer, and drug treatment for HPV-induced intraepithelial neoplasias.

关键词： human papillomavirus(HPV) carcinogenesis vaccine mi RNA cancer stem cell(CSC) cervical intraepithelial neoplasias(CIN) targeted therapy

MicroRNA in pancreatic ductal adenocarcinoma and its precursor lesions

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World Journal of Gastrointestinal Oncology 2016年第1期8卷 18-29页

作者： yasmin g hernandez aimee l lucas department of internal medicine icahn school of medicine at mount sinaiNew YorkNY 10029United States henry janowitz division of gastroenterology icahn school of medicine at mount sinaiNew YorkNY 10029United States

Pancreatic ductal adenocarcinoma(PDAC) is the 4^(th) deadliest cancer in the United States, due to its aggressive nature, late detection, and resistance to chemotherapy. The majority of PDAC develops from 3 precursor lesions, pancreatic intraepithelial lesions(PanIN), intraductual papillary mucinous neoplasm(IPMN), and mucinous cystic neoplasm. Early detection and surgical resection can increase PDAC 5-year survival rate from 6% for Stage Ⅳ to 50% for Stage Ⅰ. To date, there are no reliable biomarkers that can detect PDAC. MicroRNAs(miRNA) are small noncoding RNAs(18-25 nucleotides) that regulate gene expression by affecting translation of messenger RNA(mRNA). A large body of evidence suggests that miRNAs are dysregulated in various types of cancers. MiRNA has been profiled as a potential biomarker in pancreatic tumor tissue, blood, cyst fluid, stool, and saliva. Four mi RNA biomarkers(miR-21, miR-155, miR-196, and miR-210) have been consistently dysregulated in PDAC. MiR-21, miR-155, and miR-196 have also been dysregulated in IPMN and PanIN lesions suggesting their use as early biomarkers of this disease. In this review, we explore current knowledge of miRNA sampling, miR NA dysregulation in PDAC and its precursor lesions, and advances that have been made in using miRNA as a biomarker for PDAC and its precursor lesions.

关键词： Pancreatic cancer MicroRNA Biomarkers Pancreatic intraepithelial lesions Intraductal papillarymucinous neoplasm

Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer

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World Journal of Gastroenterology 2019年第34期25卷 5082-5096页

作者： Diane Lorenzo Vinciane Rebours Frédérique Maire Maxime Palazzo Jean-Michel Gonzalez Marie-Pierre Vullierme Alain Aubert Pascal Hammel Philippe Lévy Louis de Mestier Pancreatology Department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 75013France INSERM UMR1149Paris 92110France Departement of Gastroenterology Aix Marseille university-APHM-Hopital NordMarseille 13000France Radiology Department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France Oncology Department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France

Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and ***-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo *** appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic *** can also be used to obtain tissue ***,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to *** cost-effectiveness of screening is also *** new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.

关键词： Endoscopic ultrasound Familial pancreatic cancer Fine-needle aspiration Intraductal papillary mucinous neoplasm Pancreatic cancer Pancreatic intraepithelial neoplasia Pancreatic cancer screening guidelines