RESUMEN
AIM: Primary Signet Ring Cell Carcinoma (SRCC) of the bladder accounts for only 1%â4% of all bladder malignancies. To date, few studies have been conducted to investigate the characteristics of SRCC. This study aimed to investigate the clinical features and treatments of SRCC and explore the independent risk factors of survival in SRCC patients. PATIENTS AND METHODS: A retrospective study was conducted on 32 eligible patients. The survival rate was calculated with the Kaplan-Meier method, and the COX proportional hazards model was used to investigate the independent risk factors of prognosis. RESULTS: In the present study, the 1-year and 2-year survival rates of SRCC patients were 53.1% and 9.4%, respectively. The TNM stage, tumor differentiation, and metastasis after treatment were risk factors for the prognosis of SRCC patients (p < 0.05), while surgical treatment, chemotherapy, and positive GATA3 expression were protective for prognosis (p < 0.05). Multivariate analysis showed that GATA3 was an independent protective factor for prognosis (p < 0.05), and T-stage was an independent risk factor (p < 0.05). CONCLUSIONS: Primary SRCC of the bladder is highly malignant and has a poor prognosis. Its clinical and imaging findings are usually non-specific. Early radical cystectomy and postoperative adjuvant systemic chemotherapy are helpful to improve the survival rate. T-stage is an independent risk factor for survival, and positive GATA3 expression is protective for primary SRCC of the bladder.
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Carcinoma de Células en Anillo de Sello , Neoplasias de la Vejiga Urinaria , Humanos , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/mortalidad , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/mortalidad , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Factores de Riesgo , Adulto , Estadificación de Neoplasias , Estimación de Kaplan-Meier , Pronóstico , Tasa de Supervivencia , Modelos de Riesgos Proporcionales , Anciano de 80 o más AñosRESUMEN
BACKGROUND: Preoperative chemotherapy has been increasingly used in locally advanced gastric cancer (LAGC). However, the prognostic factors are still insufficient. This study aimed to investigate the prognostic significance of pathological response of the primary tumor to neoadjuvant chemotherapy (NACT) and the lymph node status after NACT. METHODS: Data from 160 patients with LAGC treated with NACT followed by gastrectomy and met the inclusion criteria between March 2016 and December 2019 were retrospectively reviewed. Pathological evaluation after NACT was based on the grade of pathological response of the primary tumor and the status of lymph node. Survival curves for overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method, and the log-rank test was used to compare survival difference. Univariate and multivariate analyses for prognostic factors were based on the Cox regression. RESULTS: Among 160 selected cases, 90 had pathological response (PR), while 70 had no pathological response (nPR) to NACT. Smaller tumor size was presented in PR group, which also had lower level of signet ring cell features, compared to nPR group (all p < 0.05). Based on the status of lymph nodes, nodal status (-) group showed smaller tumor size, lower depth of tumor invasion, better differentiated degree, lower level of signet ring cell features, lower rate of lymphatic and venous invasion and less advanced ypTNM stage (all p < 0.05). Survival was equivalent between PR and nPR group (all p > 0.05), while patients with no lymph node metastasis had better DFS than that with lymph node metastasis (HR 0.301, 95% CI 0.194-0.468, p = 0.002). Multivariable Cox regression analysis identified that lymph node status after NACT was an independent prognostic factor associated with survival (OS: hazard ratio 1.756, 95% CI 1.114-3.278, p = 0.029; DFS: hazard ratio 1.901, 95% CI 1.331-3.093, p = 0.012). CONCLUSION: Lymph node status is a potential independent prognostic factor for LAGC patients treated with NACT and may be more efficient than pathological response in primary tumor.
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Carcinoma de Células en Anillo de Sello , Neoplasias Gástricas , Humanos , Estadificación de Neoplasias , Neoplasias Gástricas/patología , Estudios Retrospectivos , Terapia Neoadyuvante , Pronóstico , Ganglios Linfáticos/patología , Carcinoma de Células en Anillo de Sello/patologíaRESUMEN
Primary signet-ring cell carcinoma of the urinary bladder is a rare tumor. The overall incidence is approximately 0.12-0.6% of all urinary bladder malignancies. The majority of the patients present in an advanced stage with a uniformly grim prognosis. As signet-ring cell carcinomas are more common in the gastrointestinal tract, a possibility of metastasis needs to be considered. Here we report, a 42-year-old patient who presented with hematuria and was diagnosed with a urinary bladder tumor. The patient was managed with partial cystectomy and pelvic lymph node dissection. The histopathological examination confirmed primary signet-ring cell carcinoma of the urinary bladder.
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Humanos , Masculino , Adulto , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células en Anillo de Sello/patología , CistectomíaRESUMEN
Colorectal cancer is the third most common cancer in the world and the fourth most common cause of death related to cancer. Signet ring cell carcinoma represents an uncommon histological type for rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. We present the case of a young man diagnosed with signet ring cell rectal carcinoma. He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3 months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.
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Neoplasias de la Médula Ósea/secundario , Carcinoma de Células en Anillo de Sello/secundario , Neoplasias del Ojo/secundario , Hemorragia Gastrointestinal/patología , Neoplasias del Recto/patología , Neoplasias Cutáneas/secundario , Adulto , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/patología , Colonoscopía , Diagnóstico Tardío/efectos adversos , Progresión de la Enfermedad , Hemorragia Gastrointestinal/diagnóstico por imagen , Humanos , Masculino , Cuidados Paliativos , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/tratamiento farmacológico , Pérdida de PesoRESUMEN
PURPOSE: Emerging data have shown that patients with left-sided cancers have better survival than patients with right-sided cancers in terms of metastatic colorectal cancer. However, the available information and findings remain limited and contradictory in localized colorectal cancer. This study aimed to evaluate the clinical characteristics and prognosis of primary tumor location (PTL) in colorectal cancer. METHODS: Patients' diagnoses were identified using the Surveillance, Epidemiology, and End Result database between 2006 and 2015. The analyses were further stipulated to patients with primary cancer site, histology, and stage information. The correlations between PTL and overall survival (OS) were assessed. RESULTS: Compared with left-sided tumors, right-sided tumors were more likely to develop into T3 cancers (50.0% vs. 44.8%), T4 cancers (15.8% vs. 12.3%), mucinous or mucin-producing adenocarcinoma (10.8% vs. 5.0%), and signet ring cell carcinoma (1.4% vs. 0.7%), P < 0.01, respectively. Patients with right-sided tumors showed inferior OS (56.1% vs. 60.2%), and the hazard ratio was 1.224 (95% CI, 1.208-1.241, P < 0.001) in all stages. Stage-specific Cox regression analysis revealed that patients with right-sided tumors also showed inferior OS in every stage (respectively, P < 0.05) than left-sided tumors. CONCLUSIONS: This study demonstrated that the prognoses of patients with left-sided cancers were better than those of patients with right-sided cancers regardless of stage. PTL can be a prognosis factor in colorectal cancer. We encourage developing clinical and translational studies to elucidate the causative relationship between PTL and prognosis.
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Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Estadificación de Neoplasias , Adenocarcinoma Mucinoso/mortalidad , Adenocarcinoma Mucinoso/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células en Anillo de Sello/mortalidad , Carcinoma de Células en Anillo de Sello/patología , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Programa de VERF , Factores Sexuales , Tasa de SupervivenciaRESUMEN
AIM: Prognostic differences between major histologic gastric cancer groups, intestinal and diffuse are uncertain, since cellular components in each of them possibly have different behaviors. MATERIALS & METHODS: We reviewed 198 gastric cancer patients charts diagnosed from January 2003 to December 2015 in a tertiary hospital. Multivariate Cox proportional survival models were used to evaluate the impact of histologic groups on overall survival. RESULTS: About a third had the signet-ring cell carcinoma (SRCC). In a comparison of the different histologic subtypes, SRCC had the worst prognosis of all. The median durations of survival for patients with stage III and stage IV were 19.7 and 7.7 months, respectively. CONCLUSION: Signet-ring cell component seem to have a relevant role in defining prognosis for gastric cancer.
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Carcinoma de Células en Anillo de Sello/mortalidad , Carcinoma de Células en Anillo de Sello/patología , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Anciano , Anciano de 80 o más Años , Carcinoma de Células en Anillo de Sello/terapia , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Neoplasias Gástricas/terapia , Tasa de SupervivenciaRESUMEN
Background: Chronic idiopathic inflammatory bowel disease (IBD) is a significant risk factor for the development of intestinal adenocarcinoma. The underlying molecular alterations in IBD-associated intestinal adenocarcinoma remain largely unknown. Methods: We compared the clinicopathologic and molecular features of 35 patients with 47 IBD-associated intestinal adenocarcinomas with a consecutive series of 451 patients with sporadic colorectal carcinoma identified at our institution and published data on sporadic colorectal carcinoma. Results: c-MYC amplification was the most frequent molecular alteration identified in 33% of IBD-associated intestinal adenocarcinoma that is a significantly higher frequency than in sporadic colorectal carcinoma (8%) (P = 0.0001). Compared to sporadic colorectal carcinoma, IBD-associated intestinal adenocarcinomas more frequently demonstrated mucinous differentiation (60% vs 25%, P < 0.001) and signet ring cell differentiation (28% vs 4%, P < 0.001). Mucinous and signet ring cell differentiation were significantly associated with the presence of c-MYC amplification (both with P < 0.05). HER2 positivity (11%), KRAS exon 2 or 3 mutation (10%), and IDH1 mutation (7%) were less commonly observed in IBD-associated intestinal adenocarcinoma. There was an association between poor survival and HER2 status with 3 of 4 patients having HER2-positive adenocarcinoma dead of disease at last clinical follow-up; however, no statistically significant survival effect was identified for any of the molecular alterations identified. Conclusions: We demonstrate that IBD-associated intestinal adenocarcinomas have a high frequency of c-MYC amplification that is associated with mucinous and signet ring cell differentiation. Many of the identified molecular alterations have potential therapeutic relevance, including HER2 amplification, IDH1 mutation, and low frequency KRAS mutation.
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Adenocarcinoma Mucinoso/genética , Carcinoma de Células en Anillo de Sello/genética , Neoplasias Colorrectales/genética , Enfermedades Inflamatorias del Intestino/genética , Inestabilidad de Microsatélites , Adenocarcinoma Mucinoso/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células en Anillo de Sello/patología , Diferenciación Celular/genética , Neoplasias Colorrectales/patología , Análisis Mutacional de ADN , Femenino , Humanos , Enfermedades Inflamatorias del Intestino/complicaciones , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Modelos de Riesgos Proporcionales , Proteínas Proto-Oncogénicas c-myc/genética , Proteínas Proto-Oncogénicas p21(ras)/genética , Receptor ErbB-2/genéticaAsunto(s)
Carcinoma de Células en Anillo de Sello/terapia , Neoplasias del Colon/terapia , Adulto , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/patología , Neoplasias del Colon/diagnóstico por imagen , Neoplasias del Colon/patología , Femenino , Humanos , Masculino , Cuidados Paliativos , Pronóstico , Negativa del Paciente al TratamientoAsunto(s)
Adenocarcinoma/patología , Esofagectomía/efectos adversos , Complicaciones Posoperatorias/patología , Neoplasias Gástricas/patología , Adenocarcinoma/diagnóstico por imagen , Adulto , Esófago de Barrett/complicaciones , Esófago de Barrett/cirugía , Carcinoma de Células en Anillo de Sello/patología , Femenino , Humanos , Complicaciones Posoperatorias/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Resumen Introducción El carcinoma gástrico de células en anillo de sello (CGCAS) es un tipo histopatológico, que tiene menor respuesta a la quimioterapia (QT) y un peor pronóstico en los pacientes con cáncer gástrico (CG) avanzado. Se desconoce los valores diagnósticos de la presencia de células en anillo de sello (CAS) en la biopsia endoscópica, para el diagnóstico de CGCAS. Objetivo Determinar los valores diagnósticos de la presencia de CAS en la biopsia endoscópica para el diagnóstico de CGCAS en la biopsia de la pieza operatoria. Material y Método Estudio retrospectivo de pruebas diagnósticas. Se incluyeron los pacientes con CG operados en forma consecutiva entre 1996-2016. Se calculó los valores diagnósticos de la presencia de CAS en la biopsia endoscópica para el diagnóstico de CGCAS en la biopsia definitiva. Se utilizaron intervalos de confianza (IC) del 95%. Resultados Se incluyeron 851 pacientes. Un 16,3% tuvieron CAS en la biopsia endoscópica y la prevalencia de CGCAS fue de 16,4%. Los valores diagnósticos de la presencia de CAS de la biopsia endoscópica para el diagnóstico de CGCAS fueron: Valor predictivo positivo (VPP) de 56,1% (IC 95%, 47,8-64,1%); Valor predictivo negativo (VPN) de 91,3% (IC 95%, 89-93,1%); sensibilidad de 55,7% (IC 95%, 47,4-63,7%); especificidad de 91,4% (IC 95%, 89,1%-93,3%); Likelihood ratio (LR) positivo de 6,5 (IC 95%, 4,9-8,6); LR negativo de 0,48 (IC 95%, 0,4-0,6); probabilidad post-test positivo fue de 56,1% (IC 95%, 47,8-64,1%) y probabilidad post-test negativo fue de 8,7% (IC 95%, 6,9-11%). Conclusiones La presencia de CAS en la biopsia endoscópica es insuficiente para el diagnóstico de un CGCAS. La ausencia de CAS en la biopsia endoscópica tiene un alto valor predictivo negativo.
Introduction Signet-ring cell carcinoma (SRCC) of the stomach is a histopathological type that has less response to chemotherapy and worse prognosis in patients with advanced gastric cancer, than other types of gastric carcinomas. Diagnostic value of the presence of signet-ring cells (SRC) in the endoscopic biopsy for the diagnosis of SRCC of the stomach, are unknown. Objectives To calculate the diagnostic values of the presence of SRC in endoscopic biopsy for the diagnosis of SRCC of the stomach in a definitive surgical specimen biopsy. Materials and Methods Retrospective diagnostic test study to determine the value of the presence of SRC in the endoscopic biopsy for the diagnosis of SRCC of the stomach in the surgical specimen biopsy. Inclusion criteria: Patients who underwent gastric surgery between 1996-2016. We calculated positive and negative predictive values (PPV and NPV), sensitivity, specificity, and positive and negative likelihood ratio (LR+ and LR−) of the presence of SRC in the endoscopic biopsy that predicts the diagnosis of SRCC of the stomach in the definitive biopsy. Confidence intervals (CI) of 95% were defined. Results The diagnostic values of the presence of SRC in endoscopic biopsy to diagnose SRCC of the stomach in the surgical specimen biopsy were: PPV of 56.1% (95% CI, 47.8-64.1%), NPV of 91.3% (95% CI, 89-93.1%), sensitivity of 55.7% (95% CI, 47.4-63.7%), specificity of 91.4% (95% CI, 89.1-93.3%), LR+ of 6.5 (95% CI, 4.9-8.6) and LR- of 0.48 (95% CI, 0.4-0.6), a positive post-test probability of 56.1% (95% CI, 47.8-64.1%), and a negative post-test probability of 8.7% (95% CI, 6.9-11%). Conclusions The presence of SRC in the endoscopic biopsy is not sufficient to diagnose SRCC of the stomach. The absence of SRC in the endoscopic biopsy has a high negative predictive value.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Neoplasias Gástricas/patología , Biopsia/métodos , Endoscopía del Sistema Digestivo/métodos , Carcinoma de Células en Anillo de Sello/patología , Biopsia/instrumentación , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
We report a rare case of diffuse type of gastric cancer with signet ring cells in 10 years old boy who was admitted with a 12 months history with weight loss, dysphagia to solids first and to liquids later, anorexia, fatigue, dizziness, vomiting and later, with pain in the left upper quadrant. On examination, he appeared pale, malnourished, with café-au- lait spots over the trunk and extremities. Laboratory tests showed; Hb 7.5 g, albumin 2.62 g, Thevenon positive on stools. Abdominal ultrasound examination showed periaortic masses and diffuse space occupying lesions in the liver. Endoscopic examination of the stomach showed multiple elevated tumor lesions. One located at 3 cm on the subcardial region presented irregular borders, partially eroded, that bleed easily when rubbing its surface. Multiple biopsy samples were taken. They showed a diffuse gastric signet cell type carcinoma of the stomach. Immunohistochemistry was positive to CK 8. The patient died a year later with wide spread metastasis. The boy was born through a normal delivery after a normal pregnancy to a primipara mother. His family history recorded a grandmother aunt dying of gastric cancer.
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Carcinoma de Células en Anillo de Sello/diagnóstico , Neoplasias Gástricas/diagnóstico , Carcinoma de Células en Anillo de Sello/patología , Niño , Resultado Fatal , Humanos , Masculino , Neoplasias Gástricas/patologíaRESUMEN
We aimed to analyze gastric signet ring cell (SRC) carcinoma subtypes by investigating gastric and intestinal phenotypic marker expression, and explore the relationship between phenotype and K-ras mutation. Immunohistochemistry was performed on 163 SRC carcinoma patient specimens to detect gastric (MUC1, MUC5AC, and MUC6) and intestinal (MUC2 and CDX2) phenotypic markers, and tumors were classified into gastric (G), intestinal (I), and gastrointestinal (GI) phenotypes. DNA was extracted from the formalin-fixed, paraffin-embedded tumor samples, and K-ras mutations in codons 12, 13, and 61 were identified using polymerase chain reaction-based direct DNA sequencing. G, GI, and I phenotypes were observed in 63 (38.6%), 71 (43.5%), and 29 cases (17.8%), respectively. Expression of MUC2 was significantly associated with invasion depth and lymph node metastasis (P = 0.001 and 0.002, respectively), whereas that of CDX2 significantly corresponded to tumor size and submucosal invasion (P = 0.004 and 0.001, respectively). MUC5AC expression was inversely associated with gastric wall invasion (P = 0.001). Intestinal phenotypic marker expression was positively associated with gastric wall invasion and lymph node metastasis. K-ras mutations, all of which were in codon 12, were detected in 20 (12.27%) tumors, were significantly associated with the I phenotype, and exhibited an inverse relationship with MUC5AC and MUC6 expression. I-phenotype SRC carcinomas should be distinguished from those of the G phenotype because of their increased malignancy regarding invasion and metastasis, and higher K-ras aberration rate. The different K-ras mutation frequencies observed imply distinct genetic mechanisms in the carcinogenesis of I- and G-phenotype gastric SRC carcinomas.
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Carcinoma de Células en Anillo de Sello/genética , Genes ras , Mutación , Fenotipo , Neoplasias Gástricas/genética , Biomarcadores de Tumor , Factor de Transcripción CDX2/genética , Factor de Transcripción CDX2/metabolismo , Carcinoma de Células en Anillo de Sello/clasificación , Carcinoma de Células en Anillo de Sello/patología , Codón/genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucinas/genética , Mucinas/metabolismo , Tasa de Mutación , Metástasis de la Neoplasia , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/patologíaRESUMEN
El objetivo del presente estudio fue presentar un caso extremadamente raro de adenocarcinoma gástrico difuso con células en anillo de sello en un niño de 10 años. Se presenta un niño de 10 años, con un tiempo de enfermedad de 12 meses con sintomatología de disfagia a sólidos, luego a líquidos, pérdida de peso, anorexia, astenia, mareos, vómitos y dolor en el hipocondrio izquierdo. Presenta desnutrición crónica, marcada palidez y máculas "café con leche" en tronco y extremidades. Los exámenes de laboratorio evidenciaron 7,5 gr de hemoglobina, albúmina 2,62 gr, thevenon en heces positivo. Una ecografía abdominal mostró masas periaórticas y lesiones difusas a nivel hepático. A la endoscopía se observó lesión elevada esófago-gástrica que obstruye la luz. A nivel subcardial tumoración de 3 cm de bordes irregulares, superficie erosionada y sangrante al roce. Se realizó biopsia múltiple. Murió un año después por metástasis generalizada. Nació de parto normal, de madre primigesta, con 3 500 gr de peso. Antecedentes familiares: tía abuela materna falleció de cáncer gástrico. La biopsia mostró un adenocarcinoma difuso con presencia de células en anillo de sello, PAS positivo y a la inmunohistoquímica fue positiva a la CK 8.
We report a rare case of diffuse type of gastric cancer with signet ring cells in 10 years old boy who was admitted with a 12 months history with weight loss, dysphagia to solids first and to liquids later, anorexia, fatigue, dizziness, vomiting and later, with pain in the left upper quadrant. On examination, he appeared pale, malnourished, with café-au-lait spots over the trunk and extremities. Laboratory tests showed; Hb 7.5 g, albumin 2.62 g, Thevenon positive on stools. Abdominal ultrasound examination showed periaortic masses and diffuse space occupying lesions in the liver. Endoscopic examination of the stomach showed multiple elevated tumor lesions. One located at 3 cm on the subcardial region presented irregular borders, partially eroded, that bleed easily when rubbing its surface. Multiple biopsy samples were taken. They showed a diffuse gastric signet cell type carcinoma of the stomach. Immunohistochemistry was positive to CK 8. The patient died a year later with wide spread metastasis. The boy was born through a normal delivery after a normal pregnancy to a primipara mother. His family history recorded a grandmother aunt dying of gastric cancer.
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Niño , Humanos , Masculino , Neoplasias Gástricas/diagnóstico , Carcinoma de Células en Anillo de Sello/diagnóstico , Neoplasias Gástricas/patología , Resultado Fatal , Carcinoma de Células en Anillo de Sello/patologíaAsunto(s)
Neoplasias de los Conductos Biliares , Carcinoma de Células en Anillo de Sello , Tumor de Klatskin , Anciano , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/cirugía , Femenino , Humanos , Tumor de Klatskin/patología , Tumor de Klatskin/cirugíaAsunto(s)
Anciano , Femenino , Humanos , Neoplasias de los Conductos Biliares , Carcinoma de Células en Anillo de Sello , Tumor de Klatskin , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/cirugía , Tumor de Klatskin/patología , Tumor de Klatskin/cirugíaRESUMEN
BACKGROUND: Gastric cancer is the fourth most common cancer and the second leading cause of cancer-related deaths worldwide. Gastric cancer is characterized by high levels of invasion and metastasis. Increasing attention is being focused on discovering molecular markers for the diagnosis of gastric cancer and for predicting its prognosis. The objective of the present study was to evaluate Nurr1 expression in gastric cancer and to assess its correlation with clinicopathological parameters and prognosis in gastric cancer patients. METHODS: Tissue samples were obtained from 120 gastric cancer patients. We investigated Nurr1 expression in human normal and gastric cancer tissues using real-time reverse transcription polymerase chain reaction (qRT-PCR), western blotting, and immunohistochemistry. We determined the association between Nurr1 and recurrence, prognosis and patient clinicopathological parameters. Univariate and multivariate survival analyses with a Cox's proportional hazards regression model were used to identify independent factors related to recurrence and prognosis. RESULTS: The immunohistochemical, qRT-PCR and western blot analyses revealed that Nurr1 expression was increased in gastric cancer tissues compared with normal gastric tissue (P < 0.05). Nurr1 expression was significantly correlated with the tumor size, depth of tumor invasion, lymph node metastasis, recurrence, and distant metastasis of gastric cancer (P < 0.05). Moreover, Nurr1-high patients also exhibited poorer overall survival (OS) and disease-free survival compared with Nurr1-low patients (P < 0.01). The univariate and multivariate survival analyses suggested that Nurr1 expression (P = 0.011), histology (P = 0.018), depth of tumor invasion (P = 0.037), and presence of lymph node metastasis (P = 0.031) were independent prognostic factors for recurrence. In addition, Nurr1 expression (P = 0.007), depth of tumor invasion (P = 0.014), lymph node metastasis (P = 0.044), distant metastasis (P = 0.023), and recurrence (P = 0.011) were independent prognostic factors of OS in gastric cancer patients. CONCLUSIONS: The Nurr1 protein may be useful as a marker of recurrence, metastasis, and poor prognosis following curative resection in patients with gastric cancer.
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Adenocarcinoma/genética , Regulación Neoplásica de la Expresión Génica , Ganglios Linfáticos/patología , Recurrencia Local de Neoplasia/genética , Miembro 2 del Grupo A de la Subfamilia 4 de Receptores Nucleares/genética , Neoplasias Gástricas/genética , Adenocarcinoma/metabolismo , Adenocarcinoma/patología , Adenocarcinoma Mucinoso/genética , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/patología , Adulto , Anciano , Anciano de 80 o más Años , Western Blotting , Carcinoma de Células en Anillo de Sello/genética , Carcinoma de Células en Anillo de Sello/metabolismo , Carcinoma de Células en Anillo de Sello/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Invasividad Neoplásica , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia/metabolismo , Miembro 2 del Grupo A de la Subfamilia 4 de Receptores Nucleares/metabolismo , Pronóstico , Modelos de Riesgos Proporcionales , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patología , Carga Tumoral , Adulto JovenRESUMEN
Hereditary diffuse gastric cancer is an autosomal dominant syndrome associated to CDH1 gene mutation that affects at least 30% of CDH1+ families, with a penetrance of 80% at 80 years, and multifocal signed ring cell in most of the cases. The suggested treatment is a prophylactic total gastrectomy with Roux-en-Y esophagojejunostomy, malignancy sing must be imperative a gastrectomy.
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Biomarcadores de Tumor/genética , Cadherinas/genética , Carcinoma de Células en Anillo de Sello/genética , Síndromes Neoplásicos Hereditarios/genética , Neoplasias Gástricas/genética , Cuidados Posteriores/métodos , Antígenos CD , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/cirugía , Gastrectomía , Gastroscopía , Humanos , Mutación , Síndromes Neoplásicos Hereditarios/diagnóstico por imagen , Síndromes Neoplásicos Hereditarios/patología , Síndromes Neoplásicos Hereditarios/cirugía , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
Gastric cancer is a disease with a heterogeneous pathology; its pathological mechanisms remain unclear because there is a poor understanding of its etiology. In this study, we identified differentially expressed microRNAs (miRNAs) among various gastric cancer subtypes. miRNA microarray analysis and bioinformatic analysis were used to compare miRNA expression between the signet-ring cell carcinoma and tubular adenocarcinoma subtypes of gastric cancer. Thirteen dysregulated miRNAs were identified in signet-ring cell carcinoma compared with tubular adenocarcinoma: miR-30a, miR-26b, miR-381, let-7i, miR-29c, miR-543, miR-499-3p, miR-628-3p, miR-524-5p, miR-181b, miR-1914, miR-663b, and miR-676. This is the first time that miR-499-3p, miR-628-3p, miR-524-5p, and miR-1914 have been identified in gastric cancer tissues. Bioinformatic analysis using target prediction algorithms indicated that these miRNAs are directly involved in gastric cancer pathogenesis and have different pathological mechanisms in various subtypes of signet-ring cell carcinoma and tubular adenocarcinoma. The miRNA expression patterns in different gastric adenocarcinoma subtypes may help discriminate between signet-ring cell and tubular gland cancer or other gastric cancer subtypes that would otherwise be difficult to identify using routine histological and immunohistochemical analyses. These preliminary data should be verified in further prospective studies.
Asunto(s)
Adenocarcinoma/genética , Carcinoma de Células en Anillo de Sello/genética , MicroARNs/biosíntesis , Neoplasias Gástricas/genética , Adenocarcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células en Anillo de Sello/patología , Línea Celular Tumoral , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , MicroARNs/genética , Análisis por Micromatrices , Persona de Mediana Edad , Estudios Prospectivos , Neoplasias Gástricas/patologíaRESUMEN
Krukenberg tumor is a malignancy in the ovary from a primary lesion in the gastrointestinal tract and a metastatic signet ring cell adenocarcinoma to the ovary. Stomach is the most common primary site, but other organs can serve as a primary site. The lymphatic system is the most likely route for metastasis. CA 125 levels can be used for screening for early detection of ovarian metastasis as well as for monitoring the course of disease. The prognosis of Krukenberg tumor is poor and no curative treatment is currently available.