ObjectiveTo observe the clinical and pathological features of choroidal malignant melanoma (CM). MethodsA retrospective case study. From 2011 to 2021, paraffin specimens from 15 eyes of 15 CM patients diagnosed by pathological examination in the Department of Pathology, the Second Affiliated Hospital of Soochow University were included in the study. The age, gender, clinical manifestations, treatment plan and pathological examination results of patients were collected retrospectively through the hospital information system. The clinical characteristics, immunohistochemical staining and molecular pathological characteristics were analyzed. ResultsAmong the 15 cases, 8 males and 7 females. The average age was 61. All patients were monocular paroxysm. There were 8 cases of decreased vision, blurred vision and dark shadow in front of the eyes; 1 case had red eye, lacrimation and purulent secretion; 2 cases had visual loss and no light perception; 4 cases had retinal detachment. The average diameter of the tumors was 1.4 cm. The general appearance of the tumor was hemispherical, “mushroom-shaped” or flat diffuse. Most of the tumor cells were arranged in solid, flaky and cross clusters, and some of them were arranged in false “chrysanthemum form” around the blood vessels with necrosis. In 15 eyes, spindle-cell type, epithelioid type and mixed cell type were 6, 2 and 7 eyes, respectively. The cytoplasm was partly double stained or eosinophilic, partly clear, and partly rich in pigment. The cells had poor adhesion, marked atypia, rough chromatin, frequent mitotic figures, and prominent nucleoli . Immunohistochemical staining was positive for HMB45, SOX10, S100 and Melan-A in 15 patients, but negative for epithelial markers AE1/3, lymphatic markers LCA, neuroendocrine markers CgA and Syn. Genetic testing results showed that none of the patients found C-KIT, BRAF, NRAS gene mutations. Fifteen patients were followed up for 8-96 months, of which 12 survived and 3 died after recurrence and/or metastasis. ConclusionCM has no specific clinical clinical manifestations, and he diagnosis depends on histological morphology and immunohistochemical staining.
Perivascular epithelioid cell tumor (PEComa) is a multi-potential tumor based on mesenchymal cells distributed around capillaries. The main affected population is female, and the clinical manifestations are not specific. It can affect all parts of the body. There are more PEComa in the uterus and very few PEComa in the liver. Due to its low incidence, clinicians lack awareness of it. Based on the relevant literature, this article reviews the clinicopathological features, imaging features, molecular phenotypes, diagnosis, differential diagnosis, and treatment of liver PEComa, so as to strengthen the understanding of the disease, prevent missed diagnosis and misdiagnosis, and guide clinical work.
ObjectiveTo explore the association of pretreatment hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer (NSCLC) patients. MethodsThe PubMed, EMbase, Web of Science, VIP, CNKI and WanFang databases were searched from the inception to July 12, 2021 for relevant literatures. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS) score. The relative risk (RR) and hazard ratio (HR) with 95% confidence interval (CI) were combined to assess the relationship between pretreatment hyponatremia and clinicopathological and prognostic characteristics. The prognostic indicators included the overall survival (OS) and progression-free survival (PFS). All statistical analysis was conducted by the STATA 15.0 software. ResultsA total of 10 high-quality studies (NOS score≥6 points) involving 10 045 patients were enrolled and all participants were from Asian or European regions. The pooled results demonstrated that male [RR=1.18, 95%CI (1.02, 1.36), P=0.026], non-adenocarcinoma [RR=0.86, 95%CI (0.81, 0.91), P＜0.001] and TNM Ⅲ-Ⅳ stage [RR=1.17, 95%CI (1.12, 1.21), P＜0.001] patients were more likely to experience hyponatremia. Besides, pretreatment hyponatremia was significantly related to worse OS [HR=1.83, 95%CI (1.53, 2.19), P＜0.001] and PFS [HR=1.54, 95%CI (1.02, 2.34), P=0.040]. Pretreatment hyponatremia was a risk factor for poor prognosis of NSCLC patients. ConclusionMale, non-adenocarcinoma and advance stage NSCLC patients are more likely to experience hyponatremia. Meanwhile, the pretreatment sodium level can be applied as one of the prognostic evaluation indicators in NSCLC and patients with hyponatremia are more likely to have poor survival. However, more researches are still needed to verify above findings.
ObjectiveTo investigate the expression of CD133 protein in primary lesions of gastric cancer and its clinical significance. MethodsThe expressions of CD133 protein in the primary lesion of tumor and normal gastric mucosa tissues confirmed by using histopathologic examination of 99 patients were detected by immunohistochemical staining. The correlation of CD133 protein expression with the clinicopathologic parameters and features after operation were analyzed. ResultsPositive cells of CD133 protein were localized in the gland parietal and cell membrane surface. The expression of CD133 protein in the cancer and normal gastric mucosa tissues were 29.29% (29/99) and zero, respectively (P=0.000). Expression of CD133 protein in tumor with diameter gt;5 cm was significantly higher than that in the tumor with diameter ≤5 cm (P=0.041). The expression of CD133 protein was correlated with TNM stage (P=0.044), lymph node metastasis (P=0.017), lymphatic vessel invasion (P=0.000), and vascular invasion (P=0.000). Logistic regression analysis revealed that invasion depth of tumor (P=0.011), lymph node metastasis (P=0.043), and TNM stage (P＝0.049) were independent risk factors for CD133 protein expression. Survival time of patients with positive expression of CD133 protein was significantly shorter than that negative expression of CD133 protein (P＝0.046). Cox proportial hazard regression model analysis demonstrated that lymph node metastasis (P=0.042), TNM stage (P=0.046), and positive expression of CD133 protein (P=0.046) were independent risk factors for patients survival. ConclusionThe CD133 protein expression in primary lesions is closely related with development, metastasis, and prognosis of gastric cancer.
Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
ObjectiveTo detect the expression of Krüppel like factor 8 (KLF8) in breast cancer tissues and cells and to explore the clinical significance of KLF8.Methods① The Oncomine database was used to analyze the differential expression of KLF8 mRNA in the breast cancer tissues. The Kaplan-Meier Plotter database was used to analyze the relationship between KLF8 mRNA expression and prognosis (relapse free survival, overall survival, post-progression survival, and distant metastasis-free survival) of patients with breast cancer. ② The quantitative real-time PCR (qRT-PCR) and Western blot were used to detect the KLF8 expression levels in the 16 clinical patients with breast cancer and 7 breast cancer cell lines (MDA-MB-231, MCF-12A, Hs-578T, MCF-7, BT-474, MDA-MB-453, ZR-75-30) and normal breast epithelial cell lines MCF-10A, and the immunofluorescence was used to further detect the localization of KLF8 expression in the 2 breast cancer cell lines with higher KLF8 expression level. ③ The immunohistochemistry was used to detect the expression of KLF8 protein in 135 cases of breast cancer tissue microarrays, and the relationships between KLF8 protein expression and clinicopathologic characteristics or overall survival were analyzed.Results① The Oncomine database showed that KLF8 mRNA expression in the breast cancer tissues was higher than that in the normal breast tissues (P<0.001). The median KLF8 mRNA expression level was taken as the cut-off point for high or low KLF8 expression. The results of Kaplan-Meier Plotter data analysis showed that the prognosis (relapse free survival, overall survival, postprogression survival, and distant metastasis-free survival) of patients with low KLF8 mRNA expression were better than those of patients with high KLF8 mRNA expression (P<0.05). ② The results of qRT-PCR and Western blot all showed that the KLF8 mRNA and protein expression levels in the breast cancer tissues were higher than those in the adjacent normal tissues (P=0.002, P<0.001). In addition, the Western blot results showed that the expression of KLF8 protein in the 7 breast cancer cell lines was higher than that in the normal breast epithelial cell lines MCF-10A respectively, and KLF8 protein mainly expressed in the cytoplasm of breast cancer cells and highly expressed in the nuclear of a few cells. ③ There were 63 cases of high KLF8 expression and 72 cases of low KLF8 expression by the immunohistochemical analysis of 135 patients with breast cancer tissue microarray (the H-score of the immunohistochemical test results was 75 as the cut-off point, H-score >75 was the high KLF8 expression and H-score ≤75 was the low KLF8 expression), the differences of statuses of estrogen receptor (ER) and progesterone receptor (PR) between the patient with high KLF8 expression and low KLF8 expression were significant (P<0.05). The Kaplan-Meier survival curve analysis showed that the prognosis of patients with high KLF8 expression was worse than that of patients with low KLF8 expression (P=0.002). The univariate analysis showed that the TNM stage, statuses of ER and PR, and KLF8 expression were related to the prognosis of patients with breast cancer (P<0.05), further multivariate Cox proportional hazards regression analysis indicated that the later stage of TNM and high KLF8 expression were the independent risk factors (P<0.05).ConclusionsThe results of this study suggest that KLF8 highly expresses in both breast cancer tissues and breast cancer cells, which is related to the statuses of ER and PR and prognosis of patients with breast cancer. KLF8 might be involved in the progression of breast cancer as an oncogenic gene, or it might provide a new direction for prognosis judgment and molecular targeted therapy of breast cancer.
ObjectiveTo detect expressions of transient receptor potential channel C5 (TRPC5) and microRNA-320a (miR-320a) in thyroid cancer and explore clinical significances of them in thyroid cancer.MethodsThe expressions of TRPC5 and miR-320a mRNA in the thyroid cancer were investigated by searching the Ualcan database. While the expressions of TRPC5 and miR-320a mRNA in 80 cases of thyroid cancer, 35 cases of thyroid adenoma and 32 cases of normal thyroid tissues adjacent to thyroid adenoma tissues in the Zhengzhou Seventh People’s Hospital from March 2014 to March 2015 were tested. Real time PCR was used to detect the expressions of TRPC5 mRNA and miR-320a mRNA in the various tissues and Western blot was used to detect the TRPC5 protein in the thyroid cancer tissues. Therelationships between the expressions of TRPC5 and miR-320a mRNAs and clinicopathologic features of thyroid cancer were analyzed. The correlation between expressions of TRPC5 and miR-320a mRNA was analyzed by Pearson method. The risk factors influencing the prognosis were analyzed by univariate and multivariate Cox proportional hazards regression model.ResultsThe results of Ualcan database showed that the expression level of TRPC5 mRNA in the thyroid cancer was higher than that in the normal thyroid tissue (P<0.001), while the expression level of miR-320a mRNA was lower than that in the normal thyroid tissue (P<0.001). The results of clinical cases showed that the expression level of TRPC5 mRNA was significantly higher, while the expression of miR-320a mRNA was significantly lower in the thyroid cancer tissues as compared with the normal thyroid tissues (P<0.05). There was a negative correlation between the expression level of TRPC5 and miR-320a mRNA in the thyroid cancer (r=−0.653, P<0.001). The expressions of TRPC5 and miR-320a mRNA were correlated with the degree of differentiation, lymph node metastasis, and TNM stage (P<0.05). Kaplan-Meier survival curve analysis found that the patients with higher expression level of TRPC5 and lower expression level of miR-320a showed the poor prognosis, and multivariate analysis found that the lower tumor differentiation, later TNM stage, with lymph node metastasis, higher expression level of TRPC5 mRNA, and lower expression level of miR-320a mRNA were the risk factors affecting prognostic survival (P<0.05).ConclusionsFrom the database and clinical case data, it is concluded that TRPC5 mRNA is highly expressed, while miR-320a mRNA is lowly expressed in thyroid cancer tissues, and expressions of TRPC5 and miR-320a mRNA are related to degree of tumor differentiation, lymph node metastasis, TNM staging, and prognosis in patients with thyroid cancer. TRPC5 and miR-320a mRNA might be used as potential indicators for clinical and prognostic monitoring.
Objective To explore clinicopathologic features and prognostic factors of different pathological types of advanced gastric cancer. Methods The clinicopathologic data of 98 patients with advanced gastric cancer who underwent radical gastrectomy in Suqian People’s Hospital, Nanjing Drum Tower Hospital Group, Affiliated to Nanjing University Medical School in 2011 were analyzed retrospectively. There were 53 cases of gastric adenocar-cinoma, 30 cases of mucinous adenocarcinoma, and 15 cases of signet ring cell carcinoma among them. The differences of clinicopathologic characteristics and prognosis were compared among different pathological types of advanced gastric cancer. Results ① There were no significant differences in terms of the gender, age, nerve invasion, and degree of differentiation among the three groups (P>0.05), there were significant differences in terms of the tumor diameter, tumor location, radical surgery type, regional lymph node metastasis, lymphatic cancer embolus, depth of invasion, and pTNM stage among the three groups (P<0.05). ② The results of the univariate analysis showed that the prognosis of gastric adenocarcinoma was associated with the tumor diameter, tumor location, radical surgery type, regional lymph node metastasis, depth of invasion, or pTNM stage (P<0.05); the prognosis of mucinous adenocarcinoma was associated with the radical surgery type, regional lymph node metastasis, or pTNM stage (P<0.05); the prognosis of signet ring cell carcinoma was associated with the regional lymph node metastasis, depth of invasion, and pTNM stage (P<0.05). ③ The results of the Cox multivariate analysis showed that the tumor location (P=0.016), regional lymph node metastasis (P=0.042), invasion depth (P=0.021), and pTNM stage (P=0.009) were the independent risk factors of prognosis for the gastric adenocarcinoma; the regional lymph node metastasis was the independent risk factor of prognosis for gastric mucinous adenocarcinoma (P=0.000); the tumor invasion depth (P=0.032) and regional lymph node metastasis (P=0.002) were the independent risk factors of prognosis for signet ring cell carcinoma. ④ The follow-up time was 60 months. The median follow-up time was 32 months in the gastric adenocarcinoma, 43 months in the mucinous adenocarcinoma, 23 months in the signet ring cell carcinoma, the 5-year accumulated survival rate was 30.2%, 23.3%, and 26.7% respectively. The comparison of survival curves of these three different pathological types of gastric cancer had no significant difference (P=0.131). Conclusion Clinical and pathological features of patients with different pathological types of advance gastric cancer present some differences, and prognostic factors are also different, but regional lymph node metastasis is a common prognostic factor for different pathological types of advanced gastric cancer.
ObjectiveTo compare the clinicopathological characteristics of breast invasive micropapillary carcinoma (IMPC) with different composition ratios, and analyze the relationship between proportion of micropapillary carcinoma components and the prognosis of IMPC. Methods The related data of 121 patients with invasive ductal carcinoma (IDC) complicated with IMPC who were treated in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from August 2016 to August 2020 were collected. With micropapillary carcinoma accounting for 50%, the patients were divided into IMPC <50% group and IMPC ≥50% group. The correlation between related clinicopathological features and prognosis of patients was analyzed. Results There were 85 patients in the IMPC <50% group and 36 patients in the IMPC ≥50% group. The analysis results showed that there was no significant differences between the two groups in menstrual status, histological grade, molecular typing, TNM stage, age, immunohistochemical expression, neoadjuvant therapy, nerve invasion, nipple invasion, and skin invasion (P>0.05). The rate of lymphatic vessel invasion (LVI) in the IMPC ≥50% group was 83.33% (30/36), which was significantly higher than 61.18% (52/85) in the IMPC <50% group, and the difference between the two groups was statistically significant (χ2=5.684, P=0.017). Kaplan-Meier survival curve was drawn, and the analysis results showed that the 3-year cumulative disease-free survival (DFS) of IMPC patients was correlated with the number of lymph node metastasis and LVI (P<0.05). And with the estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular typing, proportion of micropapillary carcinoma components and histological grade were unrelated (P>0.05). The results of multivariate Cox risk regression analysis showed that the number of lymph node metastases and LVI were independent prognostic factors affecting DFS in patients. Conclusions When the proportion of IMPC component is ≥50%, the LVI rate of tumor is higher than that of IMPC component <50%. The number of lymph node metastasis and LVI are independent prognostic factors affecting DFS in IMPC patients.