14 results on '"Gyeong Hoon Kang"'
Search Results
2. A comparative prognostic performance of definitions of Crohn-like lymphoid reaction in colorectal carcinoma
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Younghoon Kim, Jeong Mo Bae, Jung Ho Kim, Nam-Yun Cho, and Gyeong Hoon Kang
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colorectal neoplasms ,crohn-like lymphoid reaction ,histology ,prognosis ,Pathology ,RB1-214 - Abstract
Background The prognostic potential of Crohn-like lymphoid reaction (CLR) in colorectal carcinoma (CRC) has been investigated through the assessment of different criteria. Methods The prognostic impact of CLR was investigated in 636 CRC patients to compare methods from previously published articles. These methods included CLR measured by number of lymphoid aggregates (LAs) (CLR count), LA size greater than or equal to 1 mm (CLR size), CLR density with a cutoff value of 0.38, and subjective criteria as defined by intense CLR. Results In univariate survival analysis, CLR-positive CRC as defined by the four aforementioned methods was associated with better overall survival (OS) (hazard ratio [HR], 0.463; 95% confidence interval [CI], 0.305 to 0.702; p < .001; HR, 0.656; 95% CI, 0.411 to 1.046; p = .077; HR, 0.363; 95% CI, 0.197 to 0.669; p = .001; and HR, 0.433; 95% CI, 0.271 to 0.690; p < .001, respectively) and disease-free survival (DFS) (HR, 0.411; 95% CI, 0.304 to 0.639; p < .001; HR, 0.528; 95% CI, 0.340 to 0.821; p = .004; HR, 0.382; 95% CI, 0.226 to 0.645, p = .004; and HR, 0.501; 95% CI, 0.339 to 0.741; p < .001, respectively) than CLR-negative CRC, regardless of criteria with the exception of OS for CLR density. In multivariate analysis, two objective criteria (CLR count and CLR density) and one subjective criterion (intense CLR) for defining CLR were considered independent prognostic factors of OS and DFS in CRC patients. Conclusions CLR has similar traits regardless of criteria, but CLR-positivity should be defined by objective criteria for better reproducibility and prognostic value.
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- 2021
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3. Immune landscape and biomarkers for immuno-oncology in colorectal cancers
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Jeong Mo Bae, Seung-Yeon Yoo, Jung Ho Kim, and Gyeong Hoon Kang
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colorectal neoplasms ,tumor immune microenvironment ,immunotherapy ,microsatellite instability ,Pathology ,RB1-214 - Abstract
Recent advances in immuno-oncology have increased understanding of the tumor immune microenvironment (TIME), and clinical trials for immune checkpoint inhibitor treatment have shown remission and/or durable response in certain proportions of patients stratified by predictive biomarkers. The TIME in colorectal cancer (CRC) was initially evaluated several decades ago. The prognostic value of the immune response to tumors, including tumor-infiltrating lymphocytes, peritumoral lymphoid reaction, and Crohn’s-like lymphoid reaction, has been well demonstrated. In this review, we describe the chronology of TIME research and review the up-to-date high-dimensional TIME landscape of CRC. We also summarize the clinical relevance of several biomarkers associated with immunotherapy in CRC, such as microsatellite instability, tumor mutational burden, POLE/POLD mutation, consensus molecular subtype, and programmed death-ligand 1 expression.
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- 2020
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4. Evolving pathologic concepts of serrated lesions of the colorectum
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Jung Ho Kim and Gyeong Hoon Kang
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adenoma ,colonic polyps ,colorectal neoplasms ,serrated pathway ,serrated polyp ,Pathology ,RB1-214 - Abstract
Here, we provide an up-to-date review of the histopathology and molecular pathology of serrated colorectal lesions. First, we introduce the updated contents of the 2019 World Health Organization classification for serrated lesions. The sessile serrated lesion (SSL) is a new diagnostic terminology that replaces sessile serrated adenoma and sessile serrated polyp. The diagnostic criteria for SSL were revised to require only one unequivocal distorted serrated crypt, which is sufficient for diagnosis. Unclassified serrated adenomas have been included as a new category of serrated lesions. Second, we review ongoing issues concerning the morphology of serrated lesions. Minor morphologic variants with distinct molecular features were recently defined, including serrated tubulovillous adenoma, mucin-rich variant of traditional serrated adenoma (TSA), and superficially serrated adenoma. In addition to intestinal dysplasia and serrated dysplasia, minimal deviation dysplasia and not otherwise specified dysplasia were newly suggested as dysplasia subtypes of SSLs. Third, we summarize the molecular features of serrated lesions. The critical determinant of CpG island methylation development in SSLs is patient age. Interestingly, there may be ethnic differences in BRAF/KRAS mutation frequencies in SSLs. The molecular pathogenesis of TSAs is divided into KRAS and BRAF mutation pathways. SSLs with MLH1 methylation can progress into favorable prognostic microsatellite instability-positive (MSI+)/CpG island methylator phenotype-positive (CIMP+) carcinomas, whereas MLH1-unmethylated SSLs and BRAF-mutated TSAs can be precursors of poor-prognostic MSI−/CIMP+ carcinomas. Finally, based on our recent data, we propose an algorithm for stratifying risk subgroups of non-dysplastic SSLs.
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- 2020
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5. Standardized Pathology Report for Colorectal Cancer, 2nd Edition
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Baek-hui Kim, Joon Mee Kim, Gyeong Hoon Kang, Hee Jin Chang, Dong Wook Kang, Jung Ho Kim, Jeong Mo Bae, An Na Seo, Ho Sung Park, Yun Kyung Kang, Kyung-Hwa Lee, Mee Yon Cho, In-Gu Do, Hye Seung Lee, Hee Kyung Chang, Do Youn Park, Hyo Jeong Kang, Jin Hee Sohn, Mee Soo Chang, Eun Sun Jung, So-Young Jin, Eunsil Yu, Hye Seung Han, and Youn Wha Kim
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colorectal neoplasms ,pathology report ,standardization ,protocol ,Pathology ,RB1-214 - Abstract
The first edition of the ‘Standardized Pathology Report for Colorectal Cancer,’ which was developed by the Gastrointestinal Pathology Study Group (GIP) of the Korean Society of Pathologists, was published 13 years ago. Meanwhile, there have been many changes in the pathologic diagnosis of colorectal cancer (CRC), pathologic findings included in the pathology report, and immunohistochemical and molecular pathology required for the diagnosis and treatment of colorectal cancer. In order to reflect these changes, we (GIP) decided to make the second edition of the report. The purpose of this standardized pathology report is to provide a practical protocol for Korean pathologists, which could help diagnose and treat CRC patients. This report consists of “standard data elements” and “conditional data elements.” Basic pathologic findings and parts necessary for prognostication of CRC patients are classified as “standard data elements,” while other prognostic factors and factors related to adjuvant therapy are classified as “conditional data elements” so that each institution could select the contents according to the characteristics of the institution. The Korean version is also provided separately so that Korean pathologists can easily understand and use this report. We hope that this report will be helpful in the daily practice of CRC diagnosis.
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- 2020
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6. Clinicopathological Characterization and Prognostic Implication of SMAD4 Expression in Colorectal Carcinoma
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Seung-Yeon Yoo, Ji-Ae Lee, Yunjoo Shin, Nam-Yun Cho, Jeong Mo Bae, and Gyeong Hoon Kang
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Biomarker ,SMAD4 ,Colorectal neoplasms ,Prognosis ,Pathology ,RB1-214 - Abstract
Background SMAD family member 4 (SMAD4) has gained attention as a promising prognostic factor of colorectal cancer (CRC) as well as a key molecule to understand the tumorigenesis and progression of CRC. Methods We retrospectively analyzed 1,281 CRC cases immunohistochemically for their expression status of SMAD4, and correlated this status with clinicopathologic and molecular features of CRCs. Results A loss of nuclear SMAD4 was significantly associated with frequent lymphovascular and perineural invasion, tumor budding, fewer tumor-infiltrating lymphocytes, higher pT and pN category, and frequent distant metastasis. In contrast, tumors overexpressing SMAD4 showed a significant association with sporadic microsatellite instability. After adjustment for TNM stage, tumor differentiation, adjuvant chemotherapy, and lymphovascular invasion, the loss of SMAD4 was found to be an independent prognostic factor for worse 5-year progression-free survival (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.01 to 1.60; p=.042) and 7-year cancer-specific survival (HR, 1.45; 95% CI, 1.06 to 1.99; p=.022). Conclusions We confirmed the value of determining the loss of SMAD4 immunohistochemically as an independent prognostic factor for CRC in general. In addition, we identified some histologic and molecular features that might be clues to elucidate the role of SMAD4 in colorectal tumorigenesis and progression.
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- 2019
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7. CpG Island Methylation in Sessile Serrated Adenoma/Polyp of the Colorectum: Implications for Differential Diagnosis of Molecularly High-Risk Lesions among Non-dysplastic Sessile Serrated Adenomas/Polyps
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Ji Ae Lee, Hye Eun Park, Seung-Yeon Yoo, Seorin Jeong, Nam-Yun Cho, Gyeong Hoon Kang, and Jung Ho Kim
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Colorectal neoplasms ,DNA methylation ,Serrated lesion ,Serrated pathway ,Serrated polyp ,Pathology ,RB1-214 - Abstract
Background Although colorectal sessile serrated adenomas/polyps (SSA/Ps) with morphologic dysplasia are regarded as definite high-risk premalignant lesions, no reliable grading or risk-stratifying system exists for non-dysplastic SSA/Ps. The accumulation of CpG island methylation is a molecular hallmark of progression of SSA/Ps. Thus, we decided to classify non-dysplastic SSA/Ps into risk subgroups based on the extent of CpG island methylation. Methods The CpG island methylator phenotype (CIMP) status of 132 non-dysplastic SSA/Ps was determined using eight CIMP-specific promoter markers. SSA/Ps with CIMP-high and/or MLH1 promoter methylation were regarded as a high-risk subgroup. Results Based on the CIMP analysis results, methylation frequency of each CIMP marker suggested a sequential pattern of CpG island methylation during progression of SSA/P, indicating MLH1 as a late-methylated marker. Among the 132 non-dysplastic SSA/Ps, 34 (26%) were determined to be high-risk lesions (33 CIMP-high and 8 MLH1-methylated cases; seven cases overlapped). All 34 high-risk SSA/Ps were located exclusively in the proximal colon (100%, p = .001) and were significantly associated with older age (≥ 50 years, 100%; p = .003) and a larger histologically measured lesion size (> 5 mm, 100%; p = .004). In addition, the high-risk SSA/Ps were characterized by a relatively higher number of typical base-dilated serrated crypts. Conclusions Both CIMP-high and MLH1 methylation are late-step molecular events during progression of SSA/Ps and rarely occur in SSA/Ps of young patients. Comprehensive consideration of age (≥ 50), location (proximal colon), and histologic size (> 5 mm) may be important for the prediction of high-risk lesions among non-dysplastic SSA/Ps.
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- 2019
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8. Prognostic Impact of Depends on Combined Tumor Location and Microsatellite Instability Status in Stage II/III Colorectal Cancers Treated with Adjuvant Chemotherapy
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Hyeon Jeong Oh, Jung Ho Kim, Jeong Mo Bae, Hyun Jung Kim, Nam-Yun Cho, and Gyeong Hoon Kang
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Colorectal neoplasms ,Fusobacterium ,Gastrointestinal microbiome ,Prognosis ,Pathology ,RB1-214 - Abstract
Background This study aimed to investigate the prognostic impact of intratumoral Fusobacterium nucleatum in colorectal cancer (CRC) treated with adjuvant chemotherapy. Methods F. nucleatum DNA was quantitatively measured in a total of 593 CRC tissues retrospectively collected from surgically resected specimens of stage III or high-risk stage II CRC patients who had received curative surgery and subsequent oxaliplatin-based adjuvant chemotherapy (either FOLFOXor CAPOX). Each case was classified into one of the three categories: F. nucleatum–high, –low, or –negative. Results No significant differences in survival were observed between the F.nucleatum–high and –low/negative groups in the 593 CRCs (p = .671). Subgroup analyses according to tumor location demonstrated that disease-free survival was significantly better in F.nucleatum–high than in –low/negative patients with non-sigmoid colon cancer (including cecal, ascending, transverse, and descending colon cancers; n = 219; log-rank p = .026). In multivariate analysis, F. nucleatum was determined to be an independent prognostic factor in non-sigmoid colon cancers (hazard ratio, 0.42; 95% confidence interval, 0.18 to 0.97; p = .043). Furthermore, the favorable prognostic effect of F. nucleatum–high was observed only in a non-microsatellite instability-high (non-MSI-high) subset of non-sigmoid colon cancers (log-rank p = 0.014), but not in a MSI-high subset (log-rank p = 0.844), suggesting that the combined status of tumor location and MSI may be a critical factor for different prognostic impacts of F. nucleatum in CRCs treated with adjuvant chemotherapy. Conclusions Intratumoral F. nucleatum load is a potential prognostic factor in a non-MSI-high/non-sigmoid/non-rectal cancer subset of stage II/III CRCs treated with oxaliplatin-based adjuvant chemotherapy.
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- 2019
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9. Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma
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Hye Eun Park, Seungyeon Yoo, Jeong Mo Bae, Seorin Jeong, Nam-Yun Cho, and Gyeong Hoon Kang
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Synchronous colorectal carcinoma ,Multiple colorectal carcinoma ,Clinical outcome ,T category ,Pathology ,RB1-214 - Abstract
Background Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. Methods Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant chemotherapy and/or radiotherapy and who are not associated with familial adenomatous polyposis were selected and 99 tumors from them were subjected to clinicopathologic and molecular analysis. Ninety-two cases of solitary colorectal carcinoma (CRC) were selected as a control considering the distributions of types of surgeries performed on patients with SCRC and T categories of individual tumors from SCRC. Results SCRC with multiple advanced tumors was significantly associated with more frequent nodal metastasis (p = .003) and distant metastasis (p = .001) than solitary CRC. KRAS mutation, microsatellite instability, and CpG island methylator phenotype statuses were not different between SCRC and solitary CRC groups. In univariate survival analysis, overall and recurrence-free survival were significantly lower in patients with SCRC than in patients with solitary CRC, even after adjusting for the extensiveness of surgical procedure, adjuvant chemotherapy, or staging. Multivariate Cox regression analysis revealed that tumor multiplicity was an independent prognostic factor for overall survival (hazard ratio, 4.618; 95% confidence interval, 2.126 to 10.030; p < .001), but not for recurrence-free survival (p = .151). Conclusions Findings suggested that multiplicity of advanced T category–tumors might be associated with an increased risk of nodal metastasis and a risk factor for poor survival, which raises a concern about the guideline of American Joint Committee on Cancer’s tumor-node-metastasis staging that T staging of an index tumor determines T staging of SCRC.
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- 2018
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10. Prognostic Significance of EPHB2 Expression in Colorectal Cancer Progression
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Bo Gun Jang, Hye Sung Kim, Weon Young Chang, Jeong Mo Bae, and Gyeong Hoon Kang
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EPHB2 ,Colorectal neoplasms ,Immunohistochemistry ,Prognosis ,Pathology ,RB1-214 - Abstract
Background A receptor tyrosine kinase for ephrin ligands, EPHB2, is expressed in normal colorectal tissues and colorectal cancers (CRCs). The aim of this study was to investigate EPHB2 expression over CRC progression and determine its prognostic significance in CRC. Methods To measure EPHB2 mRNA and protein expression, real-time polymerase chain reaction and immunohistochemistry were performed in 32 fresh-frozen and 567 formalin-fixed paraffin-embedded CRC samples, respectively. We further investigated clinicopathological features and overall and recurrence-free survival according to EPHB2 protein expression. Results The EPHB2 level was upregulated in CRC samples compared to non-cancerous tissue in most samples and showed a strong positive correlation with AXIN2. Notably, CD44 had a positive association with both mRNA and protein levels of EPHB2. Immunohistochemical analysis revealed no difference in EPHB2 expression between adenoma and carcinoma areas. Although EPHB2 expression was slightly lower in invasive fronts compared to surface area (p < .05), there was no difference between superficial and metastatic areas. EPHB2 positivity was associated with lymphatic (p < .001) and venous (p = .001) invasion, TNM stage (p < .001), and microsatellite instability (p = .036). Kaplan–Meier analysis demonstrated that CRC patients with EPHB2 positivity showed better clinical outcomes in both overall (p = .049) and recurrence-free survival (p = .015). However, multivariate analysis failed to show that EPHB2 is an independent prognostic marker in CRCs (hazard ratio, 0.692; p = .692). Conclusions Our results suggest that EPHB2 is overexpressed in a subset of CRCs and is a significant prognostic marker.
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- 2018
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11. Overexpression of POSTN in Tumor Stroma Is a Poor Prognostic Indicator of Colorectal Cancer
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Hyeon Jeong Oh, Jeong Mo Bae, Xian-Yu Wen, Nam-Yun Cho, Jung Ho Kim, and Gyeong Hoon Kang
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Colorectal neoplasms ,POSTN ,Immunohistochemistry ,Stromal overexpression ,Clinicopathological characters ,Prognosis ,Pathology ,RB1-214 - Abstract
Background Tumor microenvironment has recently drawn attention in that it is related with tumor prognosis. Cancer-associated fibroblast also plays a critical role in cancer invasiveness and progression in colorectal cancers. Periostin (POSTN), originally identified to be expressed in osteoblasts and osteoblast-derived cells, is expressed in cancer-associated fibroblasts in several tissue types of cancer. Recent studies suggest an association between stromal overexpression of POSTN and poor prognosis of cancer patients. Methods We analyzed colorectal cancer cases for their expression status of POSTN in tumor stroma using immunohistochemistry and correlated the expression status with clinicopathological and molecular features. Results High level of POSTN expression in tumor stroma was closely associated with tumor location in proximal colon, infiltrative growth pattern, undifferentiated histology, tumor budding, luminal necrosis, and higher TNM stage. High expression status of POSTN in tumor stroma was found to be an independent prognostic parameter implicating poor 5-year cancer-specific survival and 5-year progression-free survival. Conclusions Our findings suggest that POSTN overexpression in tumor stroma of colorectal cancers could be a possible candidate marker for predicting poor prognosis in patients with colorectal cancers.
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- 2017
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12. Pathologic Factors Associated with Prognosis after Adjuvant Chemotherapy in Stage II/III Microsatellite-Unstable Colorectal Cancers
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Jung Ho Kim, Jeong Mo Bae, Hyeon Jeong Oh, Hye Seung Lee, and Gyeong Hoon Kang
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Chemotherapy, adjuvant ,Colorectal neoplasms ,Pathology ,Microsatellite instability ,Prognosis ,RB1-214 - Abstract
Background: Although there are controversies regarding the benefit of fluoropyrimidine-based adjuvant chemotherapy in patients with microsatellite instability–high (MSI-H) colorectal cancer (CRC), the pathologic features affecting postchemotherapeutic prognosis in these patients have not been fully identified yet. Methods: A total of 26 histopathologic and immunohistochemical factors were comprehensively evaluated in 125 stage II or III MSI-H CRC patients who underwent curative resection followed by fluoropyrimidine-based adjuvant chemotherapy. We statistically analyzed the associations of these factors with disease-free survival (DFS). Results: Using a Kaplan- Meier analysis with log-rank test, we determined that ulceroinfiltrative gross type (p=.003), pT4 (p
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- 2015
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13. Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma
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Seungyeon Yoo, Jeong Mo Bae, Nam Yun Cho, Gyeong Hoon Kang, Hye Eun Park, and Seorin Jeong
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Oncology ,Synchronous colorectal carcinoma ,medicine.medical_specialty ,Histology ,Colorectal cancer ,medicine.medical_treatment ,Multiple colorectal carcinoma ,Pathology and Forensic Medicine ,Familial adenomatous polyposis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,lcsh:Pathology ,Survival analysis ,CpG Island Methylator Phenotype ,Proportional hazards model ,business.industry ,Clinical outcome ,Hazard ratio ,Microsatellite instability ,medicine.disease ,Radiation therapy ,030220 oncology & carcinogenesis ,T category ,030211 gastroenterology & hepatology ,Original Article ,business ,lcsh:RB1-214 - Abstract
BACKGROUND Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. METHODS Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant chemotherapy and/or radiotherapy and who are not associated with familial adenomatous polyposis were selected and 99 tumors from them were subjected to clinicopathologic and molecular analysis. Ninety-two cases of solitary colorectal carcinoma (CRC) were selected as a control considering the distributions of types of surgeries performed on patients with SCRC and T categories of individual tumors from SCRC. RESULTS SCRC with multiple advanced tumors was significantly associated with more frequent nodal metastasis (p = .003) and distant metastasis (p = .001) than solitary CRC. KRAS mutation, microsatellite instability, and CpG island methylator phenotype statuses were not different between SCRC and solitary CRC groups. In univariate survival analysis, overall and recurrence-free survival were significantly lower in patients with SCRC than in patients with solitary CRC, even after adjusting for the extensiveness of surgical procedure, adjuvant chemotherapy, or staging. Multivariate Cox regression analysis revealed that tumor multiplicity was an independent prognostic factor for overall survival (hazard ratio, 4.618; 95% confidence interval, 2.126 to 10.030; p < .001), but not for recurrence-free survival (p = .151). CONCLUSIONS Findings suggested that multiplicity of advanced T category-tumors might be associated with an increased risk of nodal metastasis and a risk factor for poor survival, which raises a concern about the guideline of American Joint Committee on Cancer's tumor-node-metastasis staging that T staging of an index tumor determines T staging of SCRC.
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- 2018
14. Pathologic Factors Associated with Prognosis after Adjuvant Chemotherapy in Stage II/III Microsatellite-Unstable Colorectal Cancers
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Hyeon Jeong Oh, Jeong Mo Bae, Gyeong Hoon Kang, Jung Ho Kim, and Hye Seung Lee
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Histology ,Colorectal cancer ,Bioinformatics ,MLH1 ,Colorectal neoplasms ,Pathology and Forensic Medicine ,Germline mutation ,PMS2 ,Pathology ,lcsh:Pathology ,Medicine ,neoplasms ,business.industry ,Microsatellite instability ,medicine.disease ,Prognosis ,digestive system diseases ,MSH6 ,Fluorouracil ,MSH2 ,Cancer research ,Original Article ,business ,Chemotherapy, adjuvant ,medicine.drug ,lcsh:RB1-214 - Abstract
In the current management strategy for colorectal cancer (CRC), fluoropyrimidine-based adjuvant chemotherapy is generally recommended for all patients with stage III CRC and for a subset of patients with high-risk stage II CRC [1]. However, some previous studies have reported that in patients with microsatellite instability–high (MSI-H) CRC, adjuvant chemotherapy based on fluorouracil, which is the most commonly used intravenous fluoropyrimidine agent, had little or no benefit [2]. Although the mechanisms underlying and the factors determining this poor response to fluorouracil-based adjuvant chemotherapy in MSIH CRC patients remain incompletely understood, previous in vitro experiments have revealed that intact DNA mismatch repair function is necessary for fluorouracil to induce apoptotic effects on cancer cells [3,4]. This finding supports the observed resistance of patients with MSI-H CRC to fluorouracil-based adjuvant chemotherapy. MSI-H CRC is characterized by unique pathologic features, including predilections for proximal tumor location, mucinous histology, medullary tumor morphology, signet ring cell tumor component, poor tumor differentiation, tumor-infiltrating lymphocytes, Crohn-like lymphoid reaction and peritumoral lymphoid reaction [5]. Molecularly, MSI-H CRC is caused by DNA mismatch repair deficiency, which is usually due to the inactivation of at least one of the mismatch repair genes, including MLH1, MSH2, MSH6, and PMS2, by germline mutation or acquired promoter hypermethylation [2]. Recent investigations have also determined that germline EPCAM deletion-induced MSH2 epimutation can be one of the causes of Lynch syndromeassociated MSI-H CRC [6,7]. In addition, it is well known that sporadic MSI-H CRC is closely associated with MLH1 methylation, CpG island methylator phenotype and BRAF V600E mutations [2]. Based on the pathologic and molecular heterogeneity of MSI-H CRC, it is strongly expected that there may be pathologic or molecular factors affecting prognostic heterogeneity and differential chemotherapy responses in MSI-H CRC [2]. In this context, our previous investigation revealed that the concurrent loss of caudal type homeobox 2 (CDX2) and cytokeratin 20 (CK20) expression in tumors indicates an aggressive clinical phenotype that is associated with early death or tumor recurrence in patients with MSI-H CRC [8]. Ricciardiello et al. [9] previously reported that in CRC patients, MSI-H status is associated with high expression of thymidylate synthase (TS), the target molecule for fluorouracil. Accordingly, this finding could be a putative underlying mechanism of resistance to fluorouracil chemotherapy in MSI-H CRC patients [9], although this has not been clearly shown [10-12]. Recently, Dorard et al. [13] demonstrated that mutant HSP110 expression and its causal mutation, HSP110 T17 microsatellite deletions, can be prognostic and predictive markers in MSI-H CRC [13]. Furthermore, we have also identified the usefulness of wild-type HSP110 (HSP110wt) immunohistochemistry (IHC) for prognostication in MSI-H CRC [14]. MSI-H CRC is associated with various features, but definitive pathologic or molecular factors that can be used to predict the response to adjuvant chemotherapy in patients with MSI-H CRC have yet to be fully identified. Therefore, we decided to investigate the comprehensive pathologic features that are potentially associated with postchemotherapeutic prognosis in MSI-H CRC patients. Through this intensive analysis, we anticipated identifying the major determining factors for chemotherapy response in MSI-H CRC patients that would be helpful for predicting patient prognosis and establishing treatment strategies in the clinical setting.
- Published
- 2015
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