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С целью анализа результатов тактики хирургического лечения первичных опухолей позвоночника на основе соответствующих шкал (ASIA, SINS, Bilsky) и с учетом расположения опухолей в различных сегментах позвоночного столба был проведен ретроспективный анализ 43 больных с первичными доброкачественными и злокачественными опухолями позвоночника. Изучены результаты лечения в зависимости от гистологического типа новообразований и возможности радикализма удаления опухолей в пределах здоровых тканей. Установлено, что в случае своевременного радикального хирургического лечения возможно предотвратить неврологические осложнения, улучшить состояние больных с существующими неврологическими расстройствами, восстановить нормальные анатомические взаимосвязи в пораженном позвоночном сегменте и создать надежную, жесткую стабилизацию позвоночника, что впоследствии дает возможность пациентам продлить жизнь и улучшить ее качество.

Introduction: Gastric adenocarcinoma is the most common gastric malignancy (over 90% of gastric cancers) and remains a global public health problem. The aim of the study was to determine the epidemiological and histopathological aspects of gastric adenocarcinoma in Brazzaville. Material and Methods: The epidemiological and histopathological profile is determined through a descriptive study, collecting retrospective data spread over a period of 11 years (January 2008- December 2018), based on consultation of the departmental histology registers. pathological anatomy and cytology. For each case, age, sex, location, pTNM stage, location and histological type were collected. Results: 93 histologically confirmed gastric adenocarcinomas were collected during the 11-year period. The mean age of the patients was 54.5 years. The sex ratio was 2 in favor of men. The antral and fundal localization were more frequent (74.2% and 20.4% respectively). Of the 2 operative parts collected, one was T2N1 and the other T1N0. Tubular adenocarcinoma was the most common histologic type (51.6%), followed by independent cell adenocarcinoma (34.4%), papillary adenocarcinoma (11.8%), and mucinous adenocarcinoma (2, 2%). Conclusion: gastric tubular adenocarcinoma was the most common histological type in Brazzaville. Key words: epidemiology, gastric adenocarcinoma, histological type.

El adenocarcinoma mamario triple positivo es aquel que tiene positividad para receptores de estrógeno, progesterona y Her 2 Neu. Se ha descrito un comportamiento más agresivo. En este estudio se identificaron los casos de adenocarcinoma triple positivo entre los años 2012-2018, diagnosticados en el Servicio de Patología del Hospital General de Enfermedades del Instituto Guatemalteco de Seguridad Social, Guatemala. En el periodo de estudio hubo 1590 casos de carcinoma de mama, y se hallaron 77 casos triple positivos, con mayor prevalencia entre los 50 y 59 años de edad. El tipo histológico más frecuente fue el ductal sin patrón específico (96.1%). El grado histológico II fue el más frecuente. El Ki 67 fue positivo en 79.2% y el P53 en 42.9% de los casos.

In clinical practice, exhaled air analysis is a promising approach for diagnosing lung cancer due to a possibility of rapid and noninvasive sampling. We analyzed the exhaled air of 80 patients with lung cancer to identify differences in the profiles of volatile organic compounds in patients with different histological types and localization of cancer using gas chromatography–mass spectrometry. Some volatile organic compounds and their ratios have been identified, statistically signficant differences in concentrations of which have been found in samples with different localization and histological type.

Sarcomas are rare tumours that represent less than 1% of all malignant tumours in adults. Liposarcomas are among the most common malignant mesenchymal tumours. They are preferentially located in the limbs and the retroperitoneum. Liposarcomas primarily arising in the digestive tract are exceptional with a few cases reported in the literature. Their clinical presentation is variable and the symptoms are not specific. Anatomopathological examination remains the gold standard for the diagnosis and the classification of these tumours, which are divided into 5 histological types according to the 5th edition of the WHO classification of soft tissue tumours. We report two observations of unusual digestive liposarcomas, located in the oesophagus and the colon, emphasizing the variability of the diagnostic challenges, depending on the clinical presentation, the histological type and the analysed material.

In the study of 125 patients after radical surgery for non-small cell lung cancer (NSCLC), distinctive clinicopathological parameters of this disease were found. Thus, the majority of patients with NSCLC were smokers (73%), men had significantly higher rate of the disease than women (80% vs 20%). Patients of different sex varied by the tumor histological type: squamous cell carcinoma was characteristic of male patients (70%), while adenocarcinoma predominated in women (80%). Authors conclude that the described incidence patterns and the association of NSCLC with significant clinical features are comparable with the literature data, which indicates the absence of significant changes over the past 8 years. Survival rates of the patients after radical surgery for NSCLC also coincided with results of the previous studies. Overall survival rate varied by the stage of the disease, smoking status, and the tumor histological type: patients with earlier stage at diagnosis, never-smokers and patients with adenocarcinoma rather than squamous cell carcinoma were associated with a more favorable prognosis. The heterogeneity of the patients who survived 5 years after surgical treatment was shown: the group included patients not only with stage I of the disease, but also with more advanced II and even III stages of the disease. Finally, the absence of gender differences in the overall survival of the patients with NSCLC was demonstrated; this fact differs from the literature data on the better survival of female patients compared to men. The authors suggest that the result may indicate the emergence of factors in the Russian population that improve the course of disease in men or adversely affect the disease in women.

BACKGROUND Ovarian tumours are the common cause of morbidity and mortality in women worldwide. Primary epithelial ovarian tumours comprise the majority. Cluster differentiation 44 (CD-44) is a trans-membrane glycoprotein which plays a role in cell- cell interaction, adhesion and migration, leading to the progression and metastasis of tumour. E-cadherin is another cell adhesion molecule which plays an important role in neoplastic progression. So, it is necessary to find out the relationship of CD-44 and E-cadherin expression with histological types and tumour differentiation, which might predict the prognosis. The present study was undertaken to assess the pattern of expression of CD-44 and E-cadherin in primary epithelial tumours of ovary and to determine the relationship between their expression with age, histological type and tumour differentiation. METHODS This is a cross-sectional study conducted in the Department of Pathology, Government Medical College, Thrissur; a tertiary care institution. Histological types and tumour differentiation for each case was determined from haematoxylin and eosin sections. Immunohistochemical stain for CD-44 and E-cadherin was done. Pattern of expression was studied and a semi quantitative score was calculated. Expression of both markers was then compared with the age, histological type and tumour differentiation. RESULTS Out of 57 cases studied, majority of the patients had serous (21 cases) or mucinous tumours (20 cases). The mean age group was 54.5 years. CD-44 expression was significantly correlated with tumour differentiation but there was no correlation found with age and histological type. In E-cadherin expression, there was no correlation with age, histological type and tumour differentiation. CONCLUSIONS For primary epithelial tumours, expression of CD-44 could be an indicator for tumour progression, invasiveness or distant metastasis. Poorly differentiated tumours with increased expression may be helpful in predicting disease progression. Target therapy can be employed in such cases. In case of E-cadherin which is said to be a prognostic marker, more studies help in bridging the gap between prognosis and outcome. KEYWORDS CD-44, E-cadherin, Immunohistochemistry, Epithelial Ovarian Tumours f

Background & objective: The role Ki-67 as a prognostic marker has been studied in many cancers in many studies. However, only few studies reported the prognostic role of Ki-67 in colorectal carcinoma (CRC) with contradictory opinions. The present study was undertaken to assess the Ki-67 proliferation index (PI) in tissue sections of CRC and to investigate the relationship between the proliferative activity and histological type, grade and stage of the tumour. Methods: The present cross-sectional descriptive study was conducted in the Department of Pathology, Rajshahi Medical College, Rajshahi over a period of two years from September 2017 to August 2019. All clinically suspected cases of CRC and later confirmed by histopathology were the study population. A total 44 such cases were included in the study. Tissue sections from 44 formalin-fixed and paraffin-embedded tumor specimens were examined at the Department of Pathology of Rajshahi Medical College, Rajshahi. The cases were histologically classified, graded (WHO) and staged according to TNM and modified Dukes’ staging system. Ki-67 proliferation index was calculated immunohistochemically using the monoclonal antibody MIB-1, and were studied under light microscope. Expression of Ki-67 was calculated as a percentage of labeled nuclei per 500 cells counted in consecutive five high-power fields in the most reactive areas of the slides. The staining results were categorized into groups using a cut-off value of Ki-67 determined by ROC curve analysis. Results: In the present study the cases with high Ki-67 PI were significantly associated with high grade colorectal carcinoma (p = 0.005). TNM Stage-II and Stage-III tumours were more likely to be associated with high Ki-67 PI than those with low Ki-67 PI (p < 0.001). A significant association was observed between Ki-67 immuno-expression and modified Dukes’ staging of the tumours with Stage C being highly associated with high Ki-67 PI (p < 0.001). But histologic tumor type (mucinous and non-mucinous) was not found to be associated with Ki-67 proliferation index. Based on Receiver Operating Characteristic (ROC) curve analysis tumors with nuclear immunoreactivity ≥ 25% were considered as high proliferation index (PI) and < 25% as low PI. The Ki-67 at a cut-off value of >25% had high sensitivity (85.7%) in differentiating high grade CRC from the low-grade tumors but its specificity was moderate (67.6%) with overall diagnostic accuracy being 70.5%. Conclusion: The study concluded that cases with high Ki-67 PI are significantly associated with high grade CRC (poorly differentiated) than the cases with low grade CRC (well and moderately differentiated). TNM Stage-II & Stage-III and modified Dukes’ stage C also more often tend to be associated with high Ki-67 PI than with low Ki-67 PI. Ibrahim Card Med J 2020; 10 (1&2): 33-39

Introduction Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. The purpose of this study was to investigate the morphological patterns of testicular tumours as seen on modern US imaging and correlate these with histology. Methods The imaging features of 50 testicular tumours were analysed and compared with histology. The US appearance was categorized into 15 distinct morphological patterns. Results Patient’s age ranged from 0.5 to 85 years. Of the 50 tumours in our series, 49 were malignant. Nearly half of the malignancies were seminomatous germ cell tumours (SGCTs). Tumours ranged in size from 10 to 130 mm with considerable overlap of size between tumours of different histological type. Even small (10 mm) tumours in our cohort were malignant. SGCTs demonstrated a narrower range of morphological appearances than non‐seminomatous germ cell tumours (NSGCTs). Calcification was common in both SGCT and NSGCTs. Multicomponent cystic‐solid appearance was only seen in NSGCTs. Conclusion The differentiation of testicular tumours with US continues to be challenging. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising research direction., Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising novel research direction.

Background: The morbidity of thyroid cancer is gradually increasing, meanwhile, the average age of the morbidity population also becomes younger. Mechanisms genomic variations serve an important function for the pathogenesis of many cancer types. Pleckstrin and sec7 domain-containing 3 (PSD3), also known as EFA6R, was shown to be associated with some cancers such as acute myeloid leukemia, breast cancer metastasis, and astrocytoma. But it was unknown that whether PSD3 took effect and how did it work in thyroid cancer. Methods: We guessed that PSD3 might play an important role in thyroid cancer by consulting previous literature. Then, we analyzed the level of PSD3 expression in thyroid malignancy and the connection with clinical manifestation in The Cancer Genome Atlas (TCGA). And RNA extraction, reverse transcription, and real-time quantitative polymerase chain reaction (qRt-PCR) of 40 pairs of local samples were done to verify the result of TCGA. Then, PSD3 was knocked down by small interfering RNA (siRNA) for flowing functional experiments. Results: Bioinformatics and qRt-PCR analysis shown PSD3 was overexpressed in papillary thyroid cancer (PTC) and connected with the histological type (P=0.009) and risk of lymph node metastasis (P=0.016). In vitro assays, we confirmed that down-regulation PSD3 could not only suppress the cell proliferation, colony formation, cell migration, cell invasion, and G1/S cell cycle transition but also promote apoptosis in PTC cells. Conclusion: PSD3 promotes proliferation, migration, invasion, and G1/S transition while inhibits apoptotic in PTC and a possible biomarker in PTC.

Summary Background The aim of this study was to evaluate the incidence and histological type of lesions affecting the ovaries and to analyze employed methods of invasive treatment. Materials & Methods Medical records of patients who were treated surgically for ovarian tumors in the years 2015–2019 were reviewed. The study group was comprised of 31 female patients. Results During 5 years time, there were 31 girls in the age from 3 months to 17 years hospitalized in the department. The mean age was 11 years. Histopathological examination was performed in all of these cases. 12 patients were diagnosed with malignant lesion, 19 with benign lesion. The most commonly diagnosed malignant tumors were a dysgerminoma and a mixed germ cell tumor. In the group of benign lesions, the most frequent tumor type was mature teratoma. The first occurring symptom was abdominal pain. Some of the lesions were diagnosed accidentally during ultrasonography. The diagnostics was expanded depending on the size of the tumor, staging and clinical condition of the patient. All the patients were treated surgically, 16 of them underwent laparoscopic surgery. Torsion of the ovary or oviduct was observed in 3 cases. Chemotherapy was introduced in 8 cases as complementary treatment. Conclusions The most commonly diagnosed tumor was mature teratoma. Ultrasonography is the most frequent method of the ovaries’ examination. Ovarian lesions are characterized by non-specific clinical symptoms, which is associated with prevalent incidental detection during ultrasonography.

IntroductionLung cancer has a poor prognosis that varies internationally when assessed by the two major histological subgroups (non-small cell (NSCLC) and small cell (SCLC)).Method236 114 NSCLC and 43 167 SCLC cases diagnosed during 2010–2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK were included in the analyses. One-year and 3-year age-standardised net survival (NS) was estimated by sex, histological type, stage and country.ResultsOne-year and 3-year NS was consistently higher for Canada and Norway, and lower for the UK, New Zealand and Ireland, irrespective of stage at diagnosis. Three-year NS for NSCLC ranged from 19.7% for the UK to 27.1% for Canada for men and was consistently higher for women (25.3% in the UK; 35.0% in Canada) partly because men were diagnosed at more advanced stages. International differences in survival for NSCLC were largest for regional stage and smallest at the advanced stage. For SCLC, 3-year NS also showed a clear female advantage with the highest being for Canada (13.8% for women; 9.1% for men) and Norway (12.8% for women; 9.7% for men).ConclusionDistribution of stage at diagnosis among lung cancer cases differed by sex, histological subtype and country, which may partly explain observed survival differences. Yet, survival differences were also observed within stages, suggesting that quality of treatment, healthcare system factors and prevalence of comorbid conditions may also influence survival. Other possible explanations include differences in data collection practice, as well as differences in histological verification, staging and coding across jurisdictions.

OBJECTIVES Overlapping survival curves for N1b (multiple N1 stations), N2a2 (single N2 station + N1 involvement) and N2a1 (skip N2 metastasis) limit the current tumour–node–metastasis (TNM) node (N) subclassification for node involvement. We validated externally the proposed subclassification. METHODS Clinical records from a multicentric database comprising 1036 patients with pulmonary adenocarcinoma (ADC) or squamous cell carcinoma with N1/N2 involvement who underwent, from January 2002 to December 2014, complete lung resections were retrospectively reviewed. Patients were categorized according to the 8th TNM N subclassification proposal. Histological type, number of resected nodes (#RN) and adjuvant therapy (ADJ) were considered limiting factors. RESULTS No difference in the 5-year overall survival (-OS) was noted between N1b and N2a1 (49.6% vs 44.8%, P = 0.72); instead, the 5-year-OS was significantly improved in patients with squamous cell carcinoma (63% in N1b vs 30.7% in N2a1, P = 0.04). In patients with ADC, the 5-year-OS was better in those with N2a1 than with N1b (50.6% vs 37.5%, P = 0.09). When we compared N1b with N2a2, the 5-year-OS was statistically significant (49.6% vs 32.8%, P = 0.02); considering only patients with squamous cell carcinoma (63% vs 25.8%, P = 0.003), #RN >10 (63.2% vs 35.3%, P = 0.05) and without ADJ (56.4% vs 24.5%, P = 0.02), the 5-year-OS was significantly different. Differences were not significant for ADC, #RN 10 (5-year-OS 49.8% vs 32.1%, P = 0.03) without ADJ. CONCLUSIONS Histological type, ADJ and #RN are relevant prognostic factors in N + non-small-cell lung cancer. Considering these results, we may better interpret the prognosis prediction limits of the proposed 8th TNM subclassification for the N descriptor.

INTRODUCCION: El cancer colorrectal ocupa el tercer lugar a nivel mundial entre las neoplasias malignas. El tratamiento utilizado depende entre otros factores de la localizacion, y va desde la escision local hasta una reseccion abdominoperineal y se puede acompanar de tratamiento neoadyuvante y adyuvante, dependiendo del estadiaje. Los objetivos de este estudio fueron, determinar el tipo histologico mas comun del cancer de recto, establecer el estadio mas frecuente del cancer de recto y conocer el tratamiento quirurgico mas empleado en el cancer de recto y sus complicaciones.MATERIALES Y METODOS: Se realizo un estudio descriptivo transversal, con un total de 160 pacientes del Servicio de Cirugia digestiva del Hospital SOLCA, Guayaquil – Ecuador, durante el periodo comprendido entre Enero 2011 y Diciembre 2016, diagnosticados de cancer de recto histologicamente e intervenidos quirurgicamente.RESULTADOS: El sexo femenino fue el mas afectado con 65.7 %, el 63.1% de los pacientes se diagnosticaron en estadio III, el diagnostico histologico de adenocarcinoma fue el mas comun (73.7%), se localizo a nivel bajo en el 67.5 % de los pacientes. Se realizo cirugia programada en el 83.7 %, colostomia derivativa en el 48.8 % y las principales complicaciones registradas fueron las relacionadas con la ostomia en el 9.4% de la poblacion. La mortalidad inmediata corresponde al 1.2 % y la tardia corresponde al 8.1 %.CONCLUSION: El presente estudio, permitio evidenciar que el cancer de recto afecto principalmente a mujeres, a pacientes mayores de 60 anos. La mayoria de pacientes se diagnosticaron en estadios avanzados (III), con histologia de adenocarcinoma. La colostomia derivativa fue la tecnica quirurgica mas utilizada y la mayoria de pacientes con necesidad de terapia neoadyuvante. Las complicaciones mas frecuentes fueron las relacionadas con las ostomias. Management of Colorectal Cancer, Surgical Experience. Hospital SOLCA, Guayaquil – Ecuador BACKGROUND: Colorectal cancer is the third most common among malignant neoplasms worldwide. Treatment choice depends on the location of the tumor, among other factors, and varies from local excision to abdominoperineal resection, adjuvant or neoadjuvant therapy can be needed, depending on clinical stage. The purpose of this study was to determine the most common histological type of rectal cancer, establish the most frequent clinical stage at diagnosis, the most common surgical technique and complications.METHODOLOGY: A cross-sectional study was carried out, with 160 patients treated in the digestive surgery service of Hospital SOLCA, Guayaquil – Ecuador, between January 2011 and December 2016, with colorectal cancer histologically diagnosed and treated surgically.RESULTS: Female sex was the most affected, with 65.7%, 63.1% of the patients were diagnosed at stage III, adenocarcinoma was the most common histological type (73.7%), the tumor was more frequently located at a low level, in 67.5% of the patients. Surgery was scheduled for 83.7% of the patients, derivative colostomy was the most common surgical procedure for treatment (48.8%), and the most common complications were those related to the ostomy, in 9.4% of the patients. Immediate mortality was 1.2% and late mortality was 8.1%.CONCLUSION: This study evidenced that colorectal cancer affected with more frequency to women, mainly to people over 60 years old. Most of the patients were diagnosed with advanced clinical stage (III) carcinoma, most frequently adenocarcinoma. Derivative colostomy was the procedure of choice for most of the patients, most of them needed neoadjuvant therapy too. The most common postsurgical complications were those related to ostomies.

Clanek pojednava o nových možnostech lecby nemalobuněcneho karcinomu plic v pokrocilem, tedy metastazujicim stadiu. Kazuistika popisuje připad pacientky s pokrocilým metastazujicim pleomorfnim karcinomem plic, ktera byla lecena pembrolizumabem. Výsledky terapie timto tzv. blokatorem kontrolnich bodů imunitni reakce jsou zřetelne na přiložených CT scanech hrudniku. Nasledně jsou rozebrana indikacni kriteria teto terapie a naznacena možna budoucnost a sirsi použiti imunoterapie v onkologicke lecbě.

Squamous cell carcinoma (SCC) of the breast is a rare entity of breast cancer, with a very poor prognosis, and whose pathophysiology is still unwell established. Therapeutic management is very heterogeneous due to its incomplete understanding. Nevertheless, it seems that two histological entities can be distinguished: pure SCC close to the cutaneous origin, and metaplastic squamous breast cancer (MSBC). The aim of this study is therefore to assess the difference in survival according to the histological type (SCC or MSBC) and to describe the demographic, clinical, and therapeutic characteristics of the two underlying populations. Our data came from a monocentric retrospective series of 39 patients treated between 1985 and 2018 at the Gustave Roussy Institute (France) for a breast SCC. Of the 39 patients included, 64% had MSBC and 36% had a pure form. The overall and recurrence-free survival at 3 years [CI 95%] was 72.3% [56.9%; 87.0%] and 67.2% [51.2%; 83.2%], respectively. The overall 3-year survival of patients with MSBC was significantly lower than that with pure SCC: HR [CI 95%] 9.5 [1.2; 73.1], p = 0.008. The 3-year recurrence-free survival of patients with MSBC was also poorer: HR [CI 95%] 11.9 [1.6; 90.7], p = 0.002. Patients with MSBC also tended to be younger, have a large lesion size, and be more metastatic. The histological nature of SCC seems to bring fundamental new elements to the therapeutic management as it impacts recurrence and survival. It should therefore be better characterized at diagnosis in order to possibly adapt treatments.

Objective To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer (TNBC) patients serials based on the latest understanding of its clinico-pathological diversity, and to provide more information to clinicians to improve precision of individualized treatment of TNBC. Methods A retrospective analysis was performed on patients with TNBC at Breast Disease Center, Peking University First Hospital between January 2010 and December 2019. Histo- and clinico-pathological characteristics were analyzed by Chi-square test and Student’s t-test, and prognoses were calculated using Kaplan-Meier method and a Cox proportionate hazards model. Bonferroni correction was used to correct for multiple comparison. Results Conventional type of TNBC (cTNBC) were identified in 73.7% of 582 TNBC, while special type of TNBC (sTNBC) were 26.3%, including 71 apocrine carcinoma, 20 medullary carcinoma, 31 metaplastic carcinoma, 18 invasive lobular carcinoma, 7 invasive micropapillary carcinoma, 5 adenoid cystic carcinoma and 1 acinic cell carcinoma. Compared to sTNBC, cTNBC was associated with high histologic grade (P

Testicular cancer occurs in the testes of the male reproductive system and is the most common cancer in adolescent and young adult (AYA) men. However, recently, there have been more cases of testicular cancer in men older than 40 years. Therefore, trends of testicular cancer during the past 40 years were retrospectively examined, focusing on age and histology. Patients who were diagnosed with testicular cancer at our institution between 1980 and 2019 were enrolled in this study. The patients were divided into groups by the year of diagnosis (1980s, 1990s, 2000s, and 2010s), age at diagnosis (14, 15 to 39, and older than 40 years), and histological type (seminoma and non-seminoma). A total of 563 patients were diagnosed with testicular cancer over the 40-year period. The median age at diagnosis increased continuously, from 28 years to 31 years, 34 years, and 38 years in each period, respectively (p < 0.001). Moreover, most testicular cancer patients were of the AYA generation, whereas the ratio of patients older than 40 years increased significantly since 2000 (p < 0.001). The relative proportion of seminoma also increased more than 50% since 2000. In the seminoma group, median age increased from 31 years to 41 years during the 40-year period (p < 0.001). In conclusion, the age at diagnosis is rising for testicular cancer patients. Clinicians should recognize that testicular cancer affects not only the AYA generation, but there has been a shift to older than 40 years, especially in seminoma.

Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old female patient with a localized well-differentiated adenocarcinoma that developed in a retrorectal cystic hamartoma. The patient was submitted to surgery (a Kraske procedure), with an R1 resection, followed by adjuvant radio-chemotherapy. After 23 months of follow up, the patient remains free from disease recurrence. Given the rarity of this entity, this case allows us to reflect on the differential diagnosis, therapeutic approach and patients’ follow-up.

Double-positive vasculitis with anti-polynuclear cytoplasm (ANCA) and anti-glomerular basement membrane (GBM) antibodies is a rare entity of systemic vasculitis defined by the presence of ANCA and anti-GBM antibodies. The gradual accumulation of clinical and therapeutic data shows the usefulness of identifying and differentiating this entity from the two vasculitis respectively associated with the isolated presence of each of these two antibodies. Indeed, the double-positive ANCA and anti-GBM vasculitis appears to associate the characteristics of the demography and the extra-renal and pulmonary involvement of the ANCA-associated vasculitis on the one hand, and of the histological type and severe renal prognosis of the anti-MBG vasculitis on the other hand, with the renal involvement which is the only involvement consistently observed in double-positive vasculitis. The aim of this focus is to describe the epidemiological, clinico-biological, histological and prognostic characteristics of this entity, in light of recent literature and ongoing therapeutic changes in the two eponymous vasculitis.

Background Post therapeutic surveillance of head and neck neoplasms is a still debated issue in the current literature: although different works tried to establish frequency, modality, and efficacy of a routine follow-up, little evidence has been produced, in particular considering only sinonasal malignancies. Methods A retrospective review of patients treated for sinonasal malignancies in a single tertiary center and followed through a regular program of follow-up was carried out. Rate of recurrence, location, timing, diagnosis, and salvage treatment were the main data analyzed. Results Of note, 417 patients were included in the study and 117 experienced at least one relapse. Staging, histological type, and previous treatment represent the main clinical factors to be considered to stratify patient's risk of recurrence. Conclusion A regular post therapeutic surveillance can provide an early recurrence detection for patients treated for sinonasal malignancies, offering opportunity for salvage treatment in a high percentage of patients.

Breast cancer in young women requires special vigilance because of the unique condition and complex management that is involved. The indication for chemotherapy should not be based on age alone but in association with the biological characteristics of the tumour. In addition, age is not considered as demonstrated predictor of chemosensitivity. The choice of adjuvant or neoadjuvant chemotherapy should be guided by the histological type of the tumour, the stage of the tumour and the patient's comorbidities. In this subgroup of patients, the recommendations for the use of molecular signatures follow those of the general population. This manuscript summarizes the main data and recommendations on the management of breast cancer in young women in term of chemotherapy.

Our pathological study of a case of poorly differentiated lymphocyte‐rich hepatocellular carcinoma suggested that immune checkpoint inhibitor may be an effective therapy. The histological type is an important factor in determining treatment choices., We presented a rare case of poorly differentiated lymphocyte‐rich hepatocellular carcinoma. In this case, multiple small foci of programmed cell death ligand 1 positive inflammatory cell clusters were founded around glypican 3‐positive tumor cells.

Purpose of the studywas to investigate the role of the tumor degree, localization and histological type of tumor at the level of long-term survival by 25-year retrospective observation in women with external genitalia cancer. Materials and methods. 557 medical records of patients treated in National Cancer Institute have been analyzed during the period of 1993–2018 years. Impact of the differentiation degree, localization and histological type on the long-term survival value has been evaluated. Results. It has been proved that the long-term survival value decreased by 27.3% during transition from high (G3) to intermediate (G2) tumor grade, by 10.8% during transition from intermediate (G2) to low (G1) tumor grade. The overall level of 25-year survival retrospectively constituted 45.0% with G3 tumor grade, 31.0% with G2, and 26.0% with G1 tumor grade (p The highest mortality has been demonstrated with total affection (66.7%), as well as with lesions of several zones (80.9%). The multiple Kaplan-Meier survival analysis showed that the most unfavorable localization was the area of labia minora, where the probability of survival at 25-year-long observation was 6.0% versus 23.0% for the primary tumor localization in the area of labia majora, and versus 35.0% in the vulvar region localization. Conclusion. The highest rates of cancer mortality are verified in non-differentiated forms of tumor (100.0%) and for sarcoma (63.6%) depending on the morphological form of primary tumor. Mortality rate was more than 50.0% for all forms of squamous cell cancer. Carcinoma and adenocarcinoma with a level of mortality by 20.6 % and 21.4% respectively were more favorable compared to the other morphological forms.

Simple Summary Invasive lobular breast cancer (ILC) is a special type of breast cancer (BC) that was first described in 1941. The diagnosis of ILC is made by microscopy of tumor specimens, which reveals a distinct morphology. This review recapitulates the developments in the microscopic assessment of ILC from 1941 until today. We discuss different concepts of ILC, provide an overview on ILC variants, and highlight advances which have contributed to a better understanding of ILC as a special histologic spectrum of tumors. Abstract Invasive lobular breast cancer (ILC) is the most common special histological type of breast cancer (BC). This review recapitulates developments in the histomorphologic assessment of ILC from its beginnings with the seminal work of Foote and Stewart, which was published in 1941, until today. We discuss different concepts of ILC and their implications. These concepts include (i) BC arising from mammary lobules, (ii) BC growing in dissociated cells and single files, and (iii) BC defined as a morpho-molecular spectrum of tumors with distinct histological and molecular characteristics related to impaired cell adhesion. This review also provides a comprehensive overview of ILC variants, their histomorphology, and differential diagnosis. Furthermore, this review highlights recent advances which have contributed to a better understanding of the histomorphology of ILC, such as the role of the basal lamina component laminin, the molecular specificities of triple-negative ILC, and E-cadherin to P-cadherin expression switching as the molecular determinant of tubular elements in CDH1-deficient ILC. Last but not least, we provide a detailed account of the tumor microenvironment in ILC, including tumor infiltrating lymphocyte (TIL) levels, which are comparatively low in ILC compared to other BCs, but correlate with clinical outcome. The distinct histomorphology of ILC clearly reflects a special tumor biology. In the clinic, special treatment strategies have been established for triple-negative, HER2-positive, and ER-positive BC. Treatment specialization for patients diagnosed with ILC is just in its beginnings. Accordingly, ILC deserves greater attention as a special tumor entity in BC diagnostics, patient care, and cancer research.

Primary adrenal lymphoma (PAL) is a rare subtype of all non-Hodgkin lymphomas in several literature reviews [1,2]. In those reports, the most common histological type of PAL was diffuse large B-cel...

Background The low accuracy of preoperative diagnosis of lymph node metastasis in gastric cancer (GC) complicates decisions on patient indication for neoadjuvant chemotherapy. Methods We investigated the use of preoperative clinical diagnosis of lymph node involvement (cN) in GC patients compared with postoperative pathological diagnosis. Results In a series of 265 patients enrolled at the University of Yamanashi Hospital, the overall sensitivity was 44.4% and specificity was 93.4% of CT for detecting lymph node metastasis. The positive and negative predictive values were 80.0% and 73.8%, respectively. The negative predictive value was lower for undifferentiated adenocarcinoma than that for differentiated adenocarcinoma (64.9% vs. 78.7%, p = 0.034). In cT2 ≤ and cN2 ≤ GC, overdiagnosis of lymph node metastasis was significantly more frequent in patients with differentiated (50.0%) than in undifferentiated (13.3%) adenocarcinoma (p = 0.046). Conclusions Diagnostic accuracy of lymph node involvement depended on histological type and cT-stage. Thus, considering preoperative histological type in GC, it may be useful to decide treatment plan.

Aim Focal cortical dysplasia (FCD) is a common cause of refractory epilepsy in children and adolescents. Epilepsy surgery is a treatment option for FCD. This study aimed to investigate the relationship between postsurgical outcomes and FCD types according to the International League Against Epilepsy (ILAE) classification and assess prognostic factors in pediatric and adolescent epilepsy surgery. Methods We retrospectively analyzed 92 children and adolescents with a proven pathological diagnosis of FCD who underwent resective surgery at our epilepsy center between August 2012 and September 2015. The patients were followed up for at least 1 year to evaluate the surgical outcomes, and a multivariable regression analysis was performed to identify risk factors of seizure relapse. Results After surgery, 53.3% of the patients were completely seizure-free during the entire follow-up period. The FCD types, incomplete resection of the epileptic cortex, and use of intracranial electrode were independent risk factors of seizure recurrence. The patients with FCD type II had relatively favorable surgical outcomes compared to the patients with FCD type I. The difference in the postoperative outcome between patients with FCD types III and I was not significant. Conclusion There is a significant association between FCD types and surgical outcomes in children and adolescents with epilepsy. These findings provide guidance for the optimization of surgical strategies.

Introduction and Objective: The objective of this study was to describe the clinic-epidemiological characteristics of the nasopharyngeal carcinoma in Cantabria (Spain) and to compare it with previous studies performed. Material and methods: A retrospective study of nasopharyngeal carcinomas diagnosed in Marqués de Valdecilla Hospital (Santander, Cantabria, Spain) between 2004 and 2015 was made, determining the following variables: age, occupation, toxics, outcome symptoms, treatment and clinical evolution. Results: 45 patients with ages range between 35 and 85 were diagnosed of nasopharyngeal carcinoma, with an incidence of 0,71/100000H/year. 38 were men (84,5%) and 7 were women (15,6%). The fifties decade was the most frequent period of diagnosis. Otological symptoms were the main clinical outcome (40%), followed by cervical adenopathy (26,6%). Undifferentiated carcinoma was the most common histological type (68,9%), being diagnosed in advanced stages. Conclusions: Nasopharyngeal carcinoma is an uncommon tumour in Cantabria being more frequent in males in their fifties. Its clinical presentation, often nonspecific, results in advanced stages diagnose. The most common histological type (undifferentiated carcinoma). Introducción y objetivo: Analizar las características clínico-epidemiológicas de los carcinomas de nasofaringe en Cantabria (España) y compararlas con estudios previos realizados. Material y métodos: Se realizó un análisis retrospectivo de los casos diagnosticados de carcinoma de nasofaringe en el Hospital Universitario Marqués de Valdecilla (Santander, Cantabria, España), entre los años 2004 y 2015. De las historias clínicas se obtuvieron las siguientes variables: edad al diagnóstico, profesión, hábitos tóxicos, clínica de presentación, tratamiento realizado y evolución clínica. Resultados: 45 pacientes con edades comprendidas entre los 35 y los 85 años fueron diagnosticados de carcinoma de nasofaringe en el citado periodo (incidencia 0,71/100000H/año); 38 eran varones (84,5%) y 7 eran mujeres (15,6%), encontrándose la edad media de presentación en la década de los 50 (28,9%). Los síntomas más frecuentes de presentación fueron los óticos (40%), seguidos de las adenopatías cervicales (26,6%). En cuanto al tipo histológico el carcinoma indiferenciado (68,9%) fue el más habitual. En la mayor parte de los casos el diagnóstico se realizó en estadio avanzado. Discusión y conclusiones: El carcinoma de nasofaringe es un tumor infrecuente en Cantabria, apareciendo sobre todo en varones en la quinta década de la vida. Su forma de presentación, a menudo inespecífica, da lugar a que su diagnóstico se realice normalmente en fases avanzadas.

Aim. To study the immediate and long - term results of treatment of patients with a primary operable breast cancer, depending on the morphological and biological characteristics of the tumor. Materials and methods. The retrospective study included 974 patients aged from 30 to 82 years (a mean age of54.5 years) with a primary operable breast cancer (T1-2N0-1M0) observed from 2005 to 2012. The overall survival (OS) and disease - free survival (DFS) were studied depending on the histological type, molecular - biological subtype of breast cancer, axillary status, lymphovascular invasion, tumor histologic grade, proliferation index (by Ki-67 staining) and HER2 protein expression. Statistical data processing included a comparison of the frequencies of the studied traits, analysis of survival curves by the Kaplan-Meier method.Results. Indicators of a 5-year OS and 5 and 10-year OS and DFS were lower in carcinomas of mixed type compared with invasive carcinoma of no special type ( p =0.03) and invasive lobular carcinoma ( p =0.01). In the absence of metastases in regional lymph nodes, indicators of 5 and 10-year OS were higher compared with the macrometastatic involvement of one ( p =0.02) or two or more lymph nodes ( p =0.004): 96.0% and 89.3%; 95.4% and 79.0%; 88.9% and 79.3%, respectively. A similar trend has been noted for indicators of 5 and 10-year DFS. The OS in the absence of metastases in the lymph nodes was greater with the luminal B HER2-positive subtype and triple - negative breast cancer. The degree of malignancy of the tumor had no effect on OS. The probability of disease recurrence was significantly higher in patients with a degree of G3 compared with G1 ( p =0.00001) and G2 ( p =0.002): the rates of 5 and 10-year - old DFS were: 84.8 and 55.0%; 94.1 and 86.0%; 88.9 and 72.2%, respectively. The expression of HER2 and Ki-67 proliferation index influenced the DFS without affecting the OS.Conclusions. The morphological factors deteriorating the OS and DFS of patients with primary operable breast cancer are the presence of macrometastases in regional lymph nodes, the defeat of two or more lymph nodes, the presence of lymphovascular invasion, mixed histological form of breast cancer. The subtypes with a more aggressive course include: HER2-positive tumors, triple negative breast cancer.

We assessed the utility of the tumor doubling time (TDT) for predicting the histological type of thymic epithelial tumors. We retrospectively reviewed 130 patients with thymic epithelial tumors who underwent computed tomography two or more times before surgery. The patients were divided into low-risk thymoma (types A, AB and B1), high-risk thymoma (types B2 and B3) and thymic carcinoma (thymic carcinoma and thymic neuroendocrine tumor) groups. In the 96 patients who showed tumor enlargement, the relationship between the histological type and the TDT of the tumor was investigated. The study population included 55 men and 41 women from 26 to 82 years of age. The TDT of the thymic carcinoma group (median 205 days) was significantly shorter in comparison to the low-risk thymoma (median 607 days) and high-risk thymoma (median 459 days) groups. No significant differences were observed between the low-risk thymoma and high-risk thymoma groups. When we set the cutoff time for differentiating thymic carcinoma group from thymoma at 313 days, the sensitivity and specificity were 83.8% and 82.1%, respectively. The TDT is a useful parameter for differentiating between thymoma and thymic carcinoma group.

Aim Appendiceal mucinous neoplasms are rare, and thus the literature is sparse with regard to histological types, staging, and prognosis. In particular, it is unclear how long‐term outcome may differ between mucinous adenocarcinomas and other adenocarcinomas. In the present study, we aimed to investigate the histological types and stages of appendiceal neoplasms, and to evaluate the prognostic impacts of these factors in patients with mucinous adenocarcinomas and non‐mucinous adenocarcinomas. Methods Patients with appendiceal tumors diagnosed between 2007 and 2016 were retrospectively identified from the databases of 19 institutions in the Clinical Study Group of Osaka University, Colorectal Group. Results A total of 266 patients with appendiceal tumors were identified, of whom 130 had pathologically diagnosed adenocarcinomas, including 57 with mucinous adenocarcinomas and 73 with non‐mucinous adenocarcinomas. Five‐year overall survival (OS) rates were 64.5% for mucinous adenocarcinomas, and 49.0% for non‐mucinous adenocarcinomas. OS was significantly shorter among patients with non‐mucinous adenocarcinomas compared to mucinous adenocarcinomas. Among patients with mucinous adenocarcinomas, 5‐year OS rates were 53.6% for stage 0/I, 82.6% for II/III, and 48.4% for IV. Among patients with non‐mucinous adenocarcinomas, 5‐year OS rates were 90.9% for stage 0/I, 68.8% for II/III, and 7.1% for IV. Analysis of patients with stage IV disease revealed significantly shorter OS among patients with non‐mucinous adenocarcinomas compared to mucinous adenocarcinomas. Conclusion Our present findings showed a better prognosis in patients with mucinous adenocarcinomas compared to non‐mucinous adenocarcinomas. In this setting, Union for International Cancer Control staging was associated with prognosis for non‐mucinous adenocarcinomas, but not for mucinous adenocarcinomas.

We report the rare case of an adenoma of the nonpigmented ciliary epithelium (NPCE). A 67-year-old healthy man presented with a regularly shaped and nonpigmented mass at the iris root of his right eye. His best-corrected visual acuity was 1.5 with normal intraocular pressure. During observation, the size of the tumor remained stable for 1.5 years but then rapidly grew, extending through the iris, and gradually enlarged to the point of compressing the iris. Ultimately, an iridocyclectomy with scleral resection under a lamellar scleral flap was performed. The histopathologic features of the resected tissue were consistent with adenoma of the NPCE. Histopathological analysis showed that the tumor consisted of both tubular and solid components. There were solid lesions inside of the ciliary epithelium and tubular lesions outside. We observed positive immunoreactivity to vimentin and cytokeratin CK (AE1/AE3) and negative reactivity to S-100 and CD68, both rarely associated with adenoma of NPCE. During 1 year of follow-up after the iridocyclectomy, no signs of tumor recurrence were observed.

Aim: The purpose of this study is to evaluate the prevalence of the immunohistochemical subtypes of breast cancer among Lao women by using immunohistochemistry (according to the St. Gallen 2017 guidelines) and to study their correlation to clinicopathological features in order to help guide better treatment plans for patients. Materials and methods: Formalin-fixed and paraffin embedded tissue blocks of 76 cases of primary invasive breast cancer were retrieved from the University of Health Sciences, Vientiane, Lao PDR, from 2013 to 2016. Patients’ information and previous histological reports were reviewed. Immunohistochemistry was done using antibodies against estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu) and Ki-67 (MIB-1). Results: The mean age of the patients was 49 years, and the major histologic type was invasive ductal carcinoma, NOS (90.7%). The proportion of each subtype was hormone receptor-positive and HER2-negative, 44.7%; hormone receptor-positive and HER2-positive, 3.9%; hormone receptor-negative and HER2-positive, 13.2%; and triple-negative, 38.2%. ER was positive in 40.8% of the cases, while PR was positive in 47.4%. More than half of the cases were poorly differentiated cancer (65.8%), followed by moderately differentiated (34.2%). Tumors presented with pT2 (60.5%), followed by pT3 (25.0%) and pT4 (7.9%). Conclusion: Breast cancer among Lao women is characterized by a large percentage of the triple-negative subtype that is less susceptible to hormonal treatments. The empirical treatment with tamoxifen should be reconsidered since it would be less effective to these patients. More importantly, basic pathology services should be the first requirement in Lao PDR in order to provide adequate care.

SUMMARY: Veterinary oncology is very important nowadays to get a better understanding of human carcinogenesis. Estrogen receptor, progesterone receptor and Human Epidermal Growth Factor receptor 2 are frequently evaluated by immunohistochemistry (HIC) in human breast tumor. WT1 is an oncogene, its overexpression has been detected in leukemia and diverse solid tumors like breast cancer, lung cancer and mesothelioma in humans. WT1 expression was evaluated in 15 canine breast tumors (CBT) diagnosed by histopathological analysis to find its relationship with neoplasia and malignancy. IHC and RT-PCR were performed in CBT tissues. Fisher´s test was used to analyze WT1 relationship with malignancy. Of the 15 tumors, 9 (60 %) were diagnosed as benign and 6 (40 %) were malignant. With IHC, WT1 expression was positive only in biopsies diagnosed as malignant. Expression of WT1 by RT-PCR was detected in 14 of the 15 tumors (93.33 %) as well as in control healthy mammary gland. Clinical significance: This study describes for the first time a close correlation between CBT and a positive result for WT1 expression with IHC; hence, it can be used as a biomarker for this neoplasia and as an indicator of malignancy. RT-PCR analysis also showed to be good option to detect WT1 expression. These results will be useful to further investigations to elucidate WT1-related signaling pathways in CBT. Also to know molecules that regulate the translation of this protein as a marker for tumor progression.

Canine mammary neoplasms (CMNs) are the most frequent lesions and in female dogs. However, studies correlating pathological criteria with clinical evolution in female dogs with mammary neoplasms are scarce. The present study aims to present epidemiological, clinical-pathological and overall survival data to help establish the prognosis and understand the biological behavior of CMNs. A total of 1539 cases were included (85% malignant and 13% benign). Tumor size was an important prognostic factor and was associated with overall patient survival (P< 0.0001). Most dogs diagnosed with malignant neoplasms (83%) had initial clinical staging, although 17% had regional or distant metastases at the time of diagnosis and lower overall survival (P< 0.0001). Carcinoma in mixed tumor was the most frequent histological type and had a better prognosis. Solid carcinomas, micropapillary carcinomas and carcinosarcomas were considered histological types with aggressive biological behavior and were associated with a worse prognosis and lower overall survival (P< 0.0001). RESUMO Neoplasias mamárias caninas (NMCs) são as lesões mais frequentes em cadelas. Estudos que correlacionam os critérios patológicos com a evolução clínica em cadelas com neoplasias mamárias são escassos. Este estudo objetiva apresentar dados epidemiológicos, clínico-patológicos e de sobrevida global fornecendo informações que auxiliam a estabelecer o prognóstico e a compreender o comportamento biológico de NMCs. Foram incluídos 1539 casos, 85% malignos e 13% benignos. O tamanho tumoral foi um importante fator prognóstico, sendo associado com a sobrevida global das pacientes (P

Background: Thyroid malignancy is the most frequent endocrine malignant tumor whose incidence is still increasing. Mechanisms genomic variations play a major part in the pathogenesis of many types of malignancy. Synaptotagmin 12 (SYT12) is a member gene of the synaptotagmins family and SYT12's variants were shown to be associated with some malignancies. Nevertheless, SYT12's specific function and probable clinical value in papillary cancer were still unknown. Methods: We conducted complete genome sequence of 39 pairs PTC malignant neoplasm and matched non-neoplastic tissues. We found that SYT12 was significantly overexpressed in thyroid malignancy. Next, we investigated the expression level of SYT12 and the relation between clinical information and SYT12 expression in thyroid cancer in the Cancer Genome Atlas (TCGA). QRt-PCR of else 40 pairs local verified cohort was performed to confirm the sequencing data and TCGA cohort. Then, we used small interfering RNA (si-RNA) to knock down the expression of SYT12 in PTC cells. Finally, proliferation, cell colony formation, migration, invasion, and apoptosis assays were done to demonstrate the function of SYT12. Results: SYT12 is significantly overexpressed and higher expression of SYT12 upsurges the risk of lymph node metastatic and incidence rate of primary neoplasm multivariate focus type and classical histological type for PTC patients in TCGA cohort. In vitro experiments, the results of functional assays presented that knock-down of SYT12 inhibited the cell proliferation, cell colony formation, trans-well migration, and trans-well invasion and promoted cell apoptotic in PTC cell lines. Conclusion: SYT12 was a novel oncogene that promotes thyroid carcinoma progression and metastasis potential and a potential biomarker for diagnosis and treatment in PTC.

The aim of this study was to compare overall survival (OS) rates at different pN stages of NSCLC depending on tumor characteristics and to assess the applicability of saliva biochemical markers as prognostic signs. The study included 239 patients with NSCLC (pN0-120, pN1-51, pN2-68). Saliva was analyzed for 34 biochemical indicators before the start of treatment. For pN0, the tumor size does not have a prognostic effect, but the histological type should be taken into account. For pN1 and pN2, long-term results are significantly worse in squamous cell cancer with a large tumor size. A larger volume of surgical treatment reduces the differences between OS. The statistically significant factors of an unfavorable prognosis at pN0 are the lactate dehydrogenase activity &lt, 1294 U/L and the level of diene conjugates &gt, 3.97 c.u. (HR = 3.48, 95% CI 1.21–9.85, p = 0.01541), at pN1, the content of imidazole compounds &gt, 0.296 mmol/L (HR = 6.75, 95% CI 1.28–34.57, p = 0.00822), at pN2 levels of protein &lt, 0.583 g/L and Schiff bases &gt, 0.602 c.u., as well as protein &gt, 0.583 g/L and Schiff bases &lt, 0.602 c.u. (HR = 2.07, 95% CI 1.47–8.93, p = 0.04351). Using salivary biochemical indicators, it is possible to carry out stratification into prognostic groups depending on the lymph node metastasis.

Distinguishing undifferentiated-type from differentiated-type early gastric cancers (EGC) is crucial for determining the indication of endoscopic resection. We aimed to investigate the diagnostic performance of white-light endoscopy (WLE) and magnifying narrow-band imaging (M-NBI) for the histological type of EGC.In this multicenter prospective study, patients with histologically proven cT1 EGC, macroscopically depressed or flat type, size ≥5 mm, and without erosion/ulcer, were recruited. The diagnostic criterion of WLE for undifferentiated-type EGC was pale color. The M-NBI algorithm was created based on microsurface and microvascular patterns, and lesions with absent microsurface pattern and opened-loop microvascular patterns were diagnosed as undifferentiated-type. The center of the lesion was defined as the evaluation point and was initially evaluated by WLE, then by M-NBI, and a biopsy specimen was taken as a reference standard. The primary and key secondary endpoints were overall diagnostic accuracy and specificity, respectively.In total, 167 lesions (122 differentiated-type and 45 undifferentiated-type EGCs) in 167 patients were analyzed. The overall accuracy, sensitivity, specificity, and positive likelihood ratio of WLE for undifferentiated-type cancer were 80%, 69%, 84%, and 4.4, respectively, and those of M-NBI were 82%, 53%, 93%, and 7.2, respectively. There was no significant difference in overall accuracy (The use of M-NBI did not improve the accuracy of WLE for the diagnosis of depressed/flat undifferentiated-type EGCs but improved the specificity. It may reduce surgical overtreatment by preventing misdiagnosis of differentiated-type EGC as undifferentiated-type.

To investigate the clinical value of CTR, CEA, histological type, Ki-67 and EGFR in detecting pathological lymph node metastasis (pN) in clinical stage IA (cIA) lung adenocarcinoma and to construct a pN Nomogram model. A total of 374 cIA lung adenocarcinoma patients who had undergone thoracoscopic radical resection with Systematic mediastinal lymph node dissection (SMLD) in the Department of Thoracic Surgery of the Affiliated Hospital of Qingdao University between January 2018 to January 2020 were retrospectively reviewed. The patients were divided into pN(+) and pN(-) groups. Univariate and multivariate Logistic regression analyses were used to analyze the independent risk factors of pN in lung cancer patients. The ROC curve was used to compare the accuracy of CTR, CEA and Ki-67 in predicting pN. R software was used to construct a Nomogram prediction model based on multivariate Logistic regression analysis of the pN risk. The C-index was calculated, and a calibration curve was drawn to judge the calibration degree of the model. The preoperative and intraoperative examinations showed that CTR (OR 570.406, P＜0.001), CEA (OR 1.239, P＜0.001) and micropapillary adenocarcinoma (OR 86.712, P＜0.001) were independent risk factors of pN. Immunohistochemical analysis and gene detection showed that Ki-67 index (OR 4.832, P＜0.001) and EGFR mutations, such as exon 19 (OR 10.319, P＜0.001), exon 21 (OR 7.163, P＜0.001) and exon 19+20 mutations (OR 570.406, P＜0.001), were significant factors in predicting pN. CTR, CEA, histological type, Ki-67 index, and EGFR mutations are the predictive factors of pN in cT1a-3aN0M0 lung adenocarcinoma patients. SMLD is recommended to improve patients’ postoperative survival rate when preoperative CTR≥0.775, CEA＞2.52μg/L or intraoperative rapid freezing pathology shows micropapillary components.

Background: Spindle cell carcinoma (SpCC) of the breast is a rare histological type, a subtype of metaplastic carcinoma characterized by atypical spindle cell and epithelial carcinoma. The proportions of the spindle cell and epithelial components vary among tumours. Due to its rarity, biological characteristics of this disease have been poorly studied. Methods: In total, 10 patients with SpCC were surgically treated at our institution from January 2007 to December 2018. We retrospectively investigated these SpCC cases, focusing on the differences between spindle cell and epithelial components. Microsatellite status was also examined. Results: Nine cases were triple-negative breast cancer (TNBC). The rates of high tumour grade were 70% in spindle cell components and 56% in epithelial components ( P = .65), while the mean Ki67 labelling index were 63% and 58%, respectively ( P = .71). Mean programmed death ligand 1 (PD-L1) expression in these components was 11% and 1%, respectively ( P = .20). All 10 tumours were microsatellite stable. Patient outcomes of triple-negative SpCC did not differ from those of propensity-matched patients with conventional TNBC. Conclusions: Spindle cell components showed higher values in factors examined, although there was no statistically significant difference. Our data reveal that these 2 components of SpCC may be of different biological nature.

Pure mucinous breast carcinoma (PMBC) is characterized by clusters of tumor cells floating in abundant extracellular mucin and can be classified into paucicellular (Type A) and hypercellular (Type B) subtypes. However, the clinicopathological and genomic differences between these two subtypes have not been well characterized. We retrospectively investigated the clinicopathologic features of 45 cases of surgically removed PMBC (31 Type A and 14 Type B). We also performed whole-exome sequencing (WES) in eight cases of PMBC. We found that Type B PMBC occurs at an older age and shows more aggressive clinical behavior than Type A. WES analysis revealed that HYDIN was the most frequently mutated gene in both types of PMBC. Although Type B PMBC showed a tendency toward more frequent genetic alterations, there were no statistically significant differences between the two subtypes in single nucleotide variants or insertions or deletions of bases associated with moderate or high effects. Our results provide additional evidence that PMBCs are clinicopathologically and genetically heterogeneous and lack pathognomonic genetic alterations. Further, Type B PMBC is more frequently associated with lymph node metastasis than Type A.

BACKGROUND: Gleason score (GS) is one of the stronger prognostic factors and is integral to the management of prostate carcinoma. Subsequent modifications, recommended by the International Society of Urological Pathology in 2005 and 2014, enabled accurate prediction of prognosis. The present study investigated GS variation trend of patients with prostate carcinoma from 1996 to 2019 and offered an overview of GS changes with age, specimen type, histopathological type and serum prostate specific antigen (PSA). METHODS: One thousand three hundred and seventy-six patients, admitted to Peking University People’s Hospital in 1996 to 2019, were divided into 1996 to 2006, 2007 to 2015 and 2016 to 2019 groups. Data, including demographic characteristics, GS, primary and secondary grade and percentage of primary and secondary grade of each group, were collected and analyzed. The population distribution and average of GS was evaluated, after segmented and stratified by age, type of specimen, histopathological type and PSA. RESULTS: The average of age and PSA of each cohort had no obvious change. The average of total GS fluctuated among three cohorts with statistically significant differences. The distribution of age and PSA did not differ among cohorts. The distribution of total and primary GS shifted, with more patients detected as total GS higher than 6 (86.1%), and more primary grade higher than 3 (56.7%) in 2016–2019. After segmented and stratified by age, specimen type, histological type and PSA, the population percentage of GS over 6 was significantly higher in 2016–2019 than 1996–2006 and 2007–2015 in patients aged younger than 80 years (age

Introduction: Thyroid cancer is one of the most common cancers amongst all endocrine cancers. Incidence of thyroid malignancy is about 3-4% of all malignancy in India and 80% of thyroid malignancy belongs to Papillary Thyroid Carcinoma (PTC). Factors affecting the prognosis of PTC include patient’s gender, age, histological findings, tumour size, lymph node metastasis, extrathyroidal extension, and remote metastasis. Presence of B-type RAF V600E (BRAF V600E) mutation in thyroid carcinoma patients tends to present with more aggressive clinicopathological behaviours of PTC, prompting more aggressive radioiodine treatment. Aim: To find out the frequency of occurrence and expression of BRAF V600E mutation by Immunohistochemistry (IHC) in thyroid cancer and its association with histological type and Tumour Nodes Metastases (TNM) Staging. Materials and Methods: The present observational retrospective study included patients treated for thyroid carcinoma between January 2014 to February 2019 at RL Jalappa hospital and Research centre, Kolar, Karnataka, India. The IHC was done with rabbit monoclonal anti-BRAF V600E antibody IgG Clone RM8 (VE1). Clinical records, Fine Needle Aspiration Cytology (FNAC) diagnosis were analysed for 45 thyroid carcinoma cases. Immunopositivity was scored positive when unambiguous clear cytoplasmic staining for the antibody was observed in tumour cells. Categorical data was presented in the form of frequencies and proportions and continuous data was presented as mean and standard deviation. The t-test were applied to find out the difference in means among the groups. The p-value