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Signet ring colorectal carcinoma:Do we need to improve the treatment algorithm?

World Journal of Gastrointestinal Oncology 2016年第12期8卷 819-825页

作者： Anup Sunil Tamhankar Parag Ingle Reena Engineer Munita Bal Vikas Ostwal Avanish Saklani Department of surgical Oncology Tata Memorial Centre Department of Radiotherapy Tata Memorial Centre Department of surgical pathology Tata Memorial Centre Department of Medical Oncology Tata Memorial Centre Department of Gastro-Intestinal Surgery Tata Memorial Centre

AIMTo elaborate about this peculiar variant from a tertiary cancer center from India. METHODSIt’s a retrospective study (2011-2014) of all patients diagnosed with signet ring colo-rectal cancer (SRCC). Various clinico-pathological variables were studied. RESULTSOne hundred and seventy consecutive patients with SRCC were diagnosed (11.4% of all colorectal cancers). Median Age of the cohort was 41 years. Most common location was recto-sigmoid area (54.7%). Majority patients presented in stage III and IV (91.2%). Most of the stage IV patients had isolated peritoneal metastases (86.5%). Colonic tumors had higher incidence of peritoneal metastases (91.8% vs 83.3%) as well as isolated peritoneal recurrences (37.5% vs 16.7%) than rectal primaries. Thirty-seven point five percent of patients recurred after curative surgery. Amongst them 63.63% patients had isolated peritoneal recurrences. Circumferential resection margin (CRM) was involved in 17.9% patients. Median relapse free survival (RFS) and overall survival (OS) of the cohort were 14.9 and 18.13 mo respectively. CRM involvement, colonic primary were associated with poorer RFS and OS. CONCLUSIONSRCC has predilection for peritoneal dissemination. More aggressive and/or extended chemotherapy schedules as well as prophylactic hyperthermic intra-peritoneal chemotherapy at the time of primary surgery may be attempted in these patients.

关键词： Colorectal cancer Signet ring cell carcinoma Peritoneal metastases Hyperthermic intra-peritoneal chemotherapy

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Companion diagnostics for the targeted therapy of gastric cancer

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World Journal of Gastroenterology 2015年第39期21卷 10948-10955页

作者： Changhoon Yoo Young Soo Park departments of Oncology Asan Medical Center University of Ulsan College of Medicine Department of pathology Asan Medical Center University of Ulsan College of Medicine

Gastric cancer is the fourth most common type ofcancer and represents a major cause of cancer-related deaths worldwide. With recent biomedical advances in our understanding of the molecular characteristics of gastric cancer, many genetic alterations have been identified as potential targets for its treatment. Multiple novel agents are currently under development as the demand for active agents that improve the survival of gastric cancer patients constantly increases. Based on lessons from previous trials of targeted agents, it is now widely accepted that the establishment of an optimal diagnostic test to select molecularly defined patients is of equal importance to the development of active agents against targetable genetic alterations. Herein, we highlight the current status and future perspectives of companion diagnostics in the treatment of gastric cancer.

关键词： Companion diagnostics gastric cancer human epiderm

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Large cell neuroendocrine carcinoma of the ampulla of Vater

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 465-467页

作者： Eswaran Selvakumar Velayutham Vimalraj Shanmugasundaram Rajendran Tirupporur G.Balachandar Devy G.Kannan Satyanesan Jeswanth Palaniappan Ravichandran Arunachalam Sundaram Rajagopal Surendran departments of pathology and surgical Gastroenterology Center for G.I.Bleeding & Division of Hepatobiliary Pancreatic Diseases Government Stanley Medical College Hospitalthe Tamilnadu Dr.M.G.R.Medical UniversityChennaiTamilnaduIndia

BACKGROUND: Neuroendocrine tumors of the ampulla of Vater are extremely rare, and few cases of large cell neuroendocrine carcinoma (LCNEC) of the ampulla have been reported. METHODS: A 48-year-old male with obstructive jaundice was admitted to our hospital. On examination the patient was found to have a periampullary growth and subsequently underwent the Whipple's procedure. RESULTS: Histopathological examination and immunohistochemistry revealed features of LCNEC of the ampulla of Vater. The patient developed multiple liver metastases 6 months after Whipple's procedure. CONCLUSION: LCNEC of the ampulla of Vater is rare and highly aggressive, with a dismal prognosis.

关键词： large cell neuroendocrine carcinoma ampulla of Vater Whipple's procedure periampullary growth

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Recent advances in the study of testicular nuclear receptor 4

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 171-177页

作者： Xian-fan DING Shi-cheng YU Bi-de CHEN Shin-jen LIN Chawnshang CHANG Gong-hui LI Department of Urology Sir Run Run Shaw HospitalSchool of MedicineZhejiang University George Whipple Lab for Cancer Research Departments of Pathology and UrologyUniversity of Rochester

Testicular nuclear receptor 4(TR4),also known as NR2C2(nuclear receptor subfamily 2,group C,member 2),is a transcriptional factor and a member of the nuclear receptor ***4 was initially cloned from human and rat hypothalamus,prostate,and testes *** almost two decades,its specific tissue distribution,genomic organization,and chromosomal assignment have been well investigated in humans and ***,it has been very difficult to study TR4's physiological functions due to a lack of specific *** knock-out animal techniques provide an alternative approach for defining the biological functions of *** vivo studies of TR4 gene knockout mice(TR4-/-) found that they display severe spinal curvature,subfertility,premature aging,and prostate prostatic intraepithelial neoplasia(PIN) *** modulators,downstream target gene regulation,feedback mechanisms,and differential modulation mediated by the recruitment of other nuclear receptors and coregulators have been identified in studies using the TR4-/-*** the establishment of a tissue-specific TR4-/-mouse model,research on TR4 will be more convenient in the future.

关键词：核受体睾丸前列腺癌组织分布动物技术基因敲除小鼠模型染色体分配

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Primary sclerosing cholangitis associated colitis: Characterization of clinical, histologic features, and their associations with liver transplantation

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World Journal of Gastroenterology 2020年第28期26卷 4126-4139页

作者： John Aranake-Chrisinger Themistocles Dassopoulos Yan Yan ILKe Nalbantoglu Department of pathology and Immunology Lauren V.Ackerman Laboratory of Surgical PathologyWashington University in St.LouisSchool of MedicineMO 63110United States Baylor Center for IBD Baylor University Medical CenterDallasTX 75246United States departments of Surgery and Biostatistics Washington University in St.LouisSchool of MedicineMO 63110United States Department of Anatomic pathology Yale University School of MedicineNew HavenCT 06525United States

BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each *** To study the histologic and clinical features of PSC patients with and without *** We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years ***-IBD patients were matched to IBD patients without PSC by age and colitis *** data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were *** PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to *** required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC *** PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and *** PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of *** different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.

关键词： Primary sclerosing cholangitis Inflammatory bowel disease Liver transplantation Inflammation Pathologic features Clinical associations

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Multiple von Meyenburg complexes mimicking diffuse liver metastases from esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2006年第26期12卷 4250-4252页

作者： Stefan Fritz Thilo Hackert Hendrik Blaker Werner Hartwig Lutz Schneider Markus W Buchler Jens Werner departments of General and Visceral Surgery University of Heidelberg Germany departments of pathology University of Heidelberg Germany

Von Meyenburg complexes are benign liver lesions consisting of adenomatous bile duct proliferates. We present two patients suffering from esophageal cancer accompanied by the occurrence of yon Meyenburg complexes. Preoperative computerized tomography （CT） of the liver had not shown these lesions. In one of the patients, diffuse nodular manifestation was found in both liver lobes, mimicking diffuse hepatic metastases. Intraoperative frozen section revealed the benign nature of the lesions in both cases. The patients underwent esophageal resection without complications. To the best of our knowledge, the coincidence of von Meyenburg complexes and esophageal cancer has never been reported before. This uncommon entity should be taken into consideration as a differential diagnosis of liver lesions in malignancies. It underlines the importance of intraoperative frozen section for liver lesions of unknown origin.

关键词： Von Meyenburg complexes Bile duct hamartomas Esophageal carcinoma Liver metastasis

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Micro RNAs as lung cancer biomarkers

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World Journal of Clinical Oncology 2014年第4期5卷 604-620页

作者： Valerio Del Vescovo Margherita Grasso Mattia Barbareschi Michela A Denti Laboratory of RNA Biology and Biotechnology Centre for Integrative Biology University of Trento Unit of surgical pathology Laboratory of Molecular Pathology Trentino Biobank S.Chiara Hospital

Lung cancer is the leading cause of cancer mortality worldwide. Its high mortality is due to the poor prognosis of the disease caused by a late disease presentation, tumor heterogeneities within histological subtypes, and the relatively limited understanding of tumor biology. Importantly, lung cancer histological subgroups respond differently to some chemotherapeutic substances and side effects of some therapies appear to vary between subgroups. Biomarkers able to stratify for the subtype of lung cancer, prognosticate the course of disease, or predict the response to treatment are in high demand. In the last decade, microR NAs(miR NAs), measured in resected tumor samples or in fine needle aspirate samples have emerged as biomarkers for tumor diagnosis, prognosis and prediction of response to treatment, due to the ease of their detection and in their extreme specificity. Moreover, miR NAs present in sputum, in plasma, in serum or in whole blood have increasingly been explored in the last five years as less invasive biomarkers for the early detection of cancers. In this review we cover the increasing amounts of datathat have accumulated in the last ten years on the use of miR NAs as lung cancer biomarkers.

关键词： Lung cancer Non-small cell lung carcinomas MicroRNAs Biomarkers

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Tissue microarray-chip featuring computerized immunophenotypical characterization more accurately subtypes ampullary adenocarcinoma than routine histology

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World Journal of Gastroenterology 2020年第43期26卷 6822-6836页

作者： Matteo Palmeri Niccola Funel Gregorio Di Franco Niccolo Furbetta Desiree Gianardi Simone Guadagni Matteo Bianchini Luca E Pollina Claudio Ricci Marco Del Chiaro Giulio Di Candio Luca Morelli General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Division of surgical pathology University-Hospital of PisaPisa 56124Italy Department of surgical MedicalMolecular Pathology and Critical AreaUniversity of PisaPisa 56124Italy Department of Surgery University of ColoradoDenverCO 80045United States

BACKGROUND Ampullary adenocarcinomas(AACs)are heterogeneous tumors currently classified into three important sub-classes(SC):Intestinal(INT),Pancreato-Biliary(PB)and Mixed-Type(MT).The different subgroups have similar clinical presentation and are treated by pancreatoduodenectomy with curative ***,they respond differently to chemotherapy and have different prognostic *** SC are often difficult to identify with conventional histology *** clinical outcome of all three remains unclear,particularly for *** To identify two main subtypes of AACs,using an immunohistochemical(IHC)score based on CDX2,CK7 and *** Tissue samples from 21 patients who had undergone resection of AAC were classified by HE histology and IHC expression of CDX2,CK7 and CK *** IHC score was obtained for each marker by counting the number of positive cells(0=no stained cells;150%)and their intensity(1=weak;2=moderate and 3=strong).A global score(GS)was then obtained by summation of the IHC scores of each *** MT tumors were grouped either with the INT or PB group based on the predominant immuno-molecular phenotype,obtaining only two AACs *** overall survival in INT and PB patients was obtained by Kaplan-Meier *** Histological parameters defined the AACs subtypes as follows:15%INT,45%PB and 40%*** IHC expression and the GS,75%and 25%of MT samples were assigned to either the INT or the PB *** mean value of the GS was 9.5(range 4-16).All INT samples had a GS above the average,distinct from the PB samples which had a GS score significantly below the average(P=0.0011).The INT samples were identified by high expression of CDX2 and CK20,whereas PB samples exhibited high expression of CK7 and no expression of CK20(P=0.0008).The INT group had a statistically significant higher overall survival than in the PB group(85.7 mo vs 20.3 mo,HR:8.39;95%CI:1.38 to 18.90;P=0.0152).CONCLUSION The combination of histopathological a

关键词： Ampullary adenocarcinoma Histo-molecular phenotype Prognostic CK7 CK20 CDX2

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Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin

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World Journal of Gastroenterology 2013年第26期19卷 4166-4171页

作者： Helena Monzón Montserrat Forné Maria Esteve Mercé Rosinach Carme Loras Jorge C Espinós Josep M Viver Antonio Salas Fernando Fernández-Baares departments of Gastroenterology Hospital Universitari Mútua Terrassa Centro de Investigación Biomédica en Red de Enfer-medades Hepáticas y Digestivas (CIBERehd) departments of pathology Hospital Universitari Mútua Terrassa

AIM: To assess the aetiological role of Helicobacter pylori (H. pylori) infection in adult patients with ironrefractory or iron-dependent anaemia of previously unknown origin. METHODS: Consecutive patients with chronic irondeficient anaemia (IDA) with H. pylori infection and a negative standard work-up were prospectively evaluated. All of them had either iron refractoriness or iron dependency. Response to H. pylori eradication was assessed at 6 and 12 mo from follow-up. H. pylori infection was considered to be the cause of the anaemia when a complete anaemia resolution without iron supplements was observed after eradication. RESULTS: H. pylori was eradicated in 88 of the 89 patients. In the non-eradicated patient the four eradicating regimens failed. There were violations of protocol in 4 patients, for whom it was not possible to ascertain the cause of the anaemia. Thus, 84 H. pylori eradicated patients (10 men; 74 women) were available to assess the effect of eradication on IDA. H. pylori infection was considered to be the aetiology of IDA in 32 patients (38.1%; 95%CI: 28.4%-48.8%). This was more frequent in men/postmenopausal women than in premenopausal women (75% vs 23.3%; P < 0.0001) with an OR of 9.8 (95%CI: 3.3-29.6). In these patients, anaemia resolution occurred in the first follow-up visit at 6 mo, and no anaemia or iron deficiency relapse was observed after a mean follow-up of 21 ± 2 mo. CONCLUSION: Gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients.

关键词： Helicobacter pylori Iron-deficiency anaemia Iron refractoriness Gluten-sensitive enteropathy Menopause

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A rabbit model of non- cirrhotic portal hypertension by repeated injections of E. coli through indwelling cannulation of the gastrosplenic vein

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 417-422页

作者： Swati Omanwar Moattar R. Rizvi Rachna Kathayat Brij K. Sharma Giryesh K. Pandey Mohammad A. Alam Veena Malhotra Shiv K. Sarin departments of Gastroenterology G. B. Pant Hospital New Delhi India departments of pathology G. B. Pant Hospital New Delhi India

BACKGROUND: Non-cirrhotic portal hypertension is acommon cause of portal hypertension in developing coun-tries. To understand its etiopathogenesis we developed ananimal model by repeated portal endotoxemia inducedthrough the gastrosplenic ***: Twenty-nine rabbits (1.5-2.0 kg) were divid-ed into control (group n = 13) and experimental ( groupn = 16) groups. Heat killed E. coli were injected throughan indwelling cannula into the gastrosplenic vein in pre-sensitized animals. The animals were sacriflced at 1, 3 and6 ***: The mean portal pressure in group animalswas significantly (P < 0. 05) higher than in group at 1(17.5 ±3.4 vs 10.4±2.2 mmHg), 3 (17.8±1.3 vs7.2 +3.6mmHg), and 6 (19.8±3.1 vs 10.3±4.8 mmHg) ***, the mean splenic weight in group was signifi-cantly greater than in group (P <0.05). Histopathologi-cally, the spleen showed medullary congestion, hemosid-rin-laden macrophages and mild fibrosis. Histologically,the liver had normal parenchyma with mild portal lympho-cytic infiltrates and kupffer cell hyperplasia. No significantanomalies were detected by liver function ***: The rabbit model showed significantsplenomegaly with a persistent increase in portal pressureand mild fibrosis without hepatic parenchymal injury, quiteakin to non-cirrhotic portal fibrosis as seen in humans. Re-current intra-abdominal infection may play an importantrole in the pathogenesis of non-cirrhotic portal fibrosis.

关键词： non-cirrhotic portal fibrosis non-cirrhotic portal hypertension portal hypertension variceal bleeding portal pressure animal models idiopathic portal hypertension

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