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Background: Merkel cell carcinoma (MCC) is a rare and highly aggressive form of skin cancer. However, there is limited research on the clinicopathological features of early‐onset MCC (EOMCC) and the differences between EOMCC and late‐onset MCC (LOMCC). Our objective was to evaluate the clinicopathological features and cancer‐specific survival (CSS) of EOMCC. Methods: Our cohort study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2018, to December 31, 2020. Data from 1941 patients who were diagnosed with primary cutaneous MCC were included. We then divided the patients with MCC into two groups: those with EOMCC (526 patients) and those with LOMCC (1415 patients). CSS is used as the primary outcome. Results: The EOMCC group exhibited trends toward advanced tumor progression, an expanded surgical scope, increased lymph node retrieval, intensified radiotherapy, greater utilization of systemic therapy, and a better prognosis. Multivariate analysis revealed that LOMCC (HR 3.305 [2.002–5.456], P < 0.001), advanced T stage (HR 1.430 [1.139–1.797], P = 0.002), advanced N stage (HR 1.522 [1.221–1.897], P < 0.001), M1 stage (HR 2.587 [1.480–4.521], P < 0.001), and radiation (HR 0.586 [0.410–0.837], P = 0.003) were significantly associated with CSS. Among these factors, EOMCC/LOMCC was most strongly associated with CSS, indicating that LOMCC is an independent risk factor for CSS. Interestingly, we found that regional EOMCC and localized or in situ LOMCC had almost completely overlapping survival curves (Plog‐rank = 0.620). Additionally, we observed that the TNM staging + age model was a more accurate predictor of CSS among MCC patients than using TNM staging alone. Conclusions: We found that EOMCC has distinct clinicopathological features compared to LOMCC. EOMCC is associated with better CSS. The combination of TNM staging and age was more accurate for predicting patient outcomes than TNM staging alone. [ABSTRACT FROM AUTHOR]

Gamma-butyrobetaine hydroxylase (BBOX1) plays a pivotal role in catalyzing the final stage of L-carnitine biosynthesis. Recently, increasing number of studies have reported that BBOX1 is weakly expressed in tumor cells and exhibits antitumor activity. The role of BBOX1 in Hepatoblastoma (HB) has yet to be determined. To substantiate this, we have investigated BBOX1 expression and its clinical relevance in HB, and explored how BBOX1 might inhibit the occurrence and development of HB. The GSE104766 and GSE131329 datasets were used to screen for the core gene BBOX1 in HB and to analyze differences in expression between hepatoblastoma and normal tissues. Based on the clinicopathological features of the GSE131329 dataset, the connections between the expression of BBOX1 and the clinicopathological feature of HB patients were determined. After BBOX1 was overexpressed, CCK-8 and colony formation assays were employed to assess cell proliferation and wound healing experiments were utilized to assess cell migration. The presence of cell apoptosis, cell cycle changes, and reactive oxygen species (ROS) was assayed using flow cytometry. Compared with normal tissues, the expression of BBOX1 in hepatoblastoma tissues was notably decreased. Dysregulated expression of BBOX1 was indicated as a prognostic risk factor closely linked to clinical stag of patients with HB. Furthermore, following BBOX1 overexpression, cell proliferation and migration are decreased, the cell cycle is arrested, and ROS are attenuated. BBOX1 has suppressive effects on HepG2 cells, potentially through its ability to hinder cancer cell proliferation, arrest cell cycle progression, and decrease ROS levels, suggesting its potential as a novel prognostic biomarker and therapeutic candidate for hepatoblastoma. [ABSTRACT FROM AUTHOR]

Abstract Introduction Survival comparisons among patients with liver metastases from pancreatic and rectal neuroendocrine tumors (NETs) were limited, and the efficacy of observation rules in patients undergoing hepatectomy for neuroendocrine liver metastases (NELMs) was unknown. This study aims to distinguish these characteristics and clarify the effects of the observation rules on NELMs. Methods Clinical data were separately collected from patients with pancreatic and rectal NELMs at medical centers in both Japan and China. The Japanese cohort followed the observation rules for the resection of NELMs. A comparative analysis was conducted on clinical characteristics and prognosis features such as overall survival time (OS) and disease-free survival interval (DFS-I). Results Enrollment included 47 and 34 patients from Japan and China, respectively. Of these, 69 and 12 patients had tumors originating from the pancreas and rectum, respectively. The OS time in patients undergoing primary tumor resection was significantly longer; however, the OS time between the patients undergoing and not undergoing radical resection of liver metastasis was the same. In asynchronous NELMs, patients with rectal (R)-NELMs showed a significantly higher proportion of type III NELMs. Additionally, the median DFS-I of asynchronous R-NELMs was longer than the recommended follow-up time, with 71.4% of them classified as G2. In the Japanese cohort, patients who adhered to the observation rules exhibited a longer median DFS after hepatectomy for NELMs compared with their counterparts. Conclusion Although curative surgery is crucial for primary lesions, personalized approaches are required to manage NELMs. Extended overall follow-ups and shortened follow-up intervals are recommended for G2 stage rectal NETs. The observation rules for NELMs require further validation with a larger sample size.

Primary endometrial squamous cell carcinoma (PESCC) is a rare malignant tumor. To investigate the clinical and pathological features of PESCC, two cases of PESCC in Fujian Maternal and Child Health Hospital were retrospectively studied and the literatures were reviewed. Both of the two cases were menopausal women aged 57-62 years, clinically presenting with "vaginal discharge". Case 1 was a non-keratinising squamous cell carcinoma with high-risk HPV infection. Tumor infiltrated in deep myometrium with multifocal intravascular thrombus and macro metastases to one pelvic lymph node (1/15) and abdominal aortic lymph node (1/1). Lung metastasis occurred 36 months after the surgery. After surgical resection and without postoperative supplemental therapy, the patient remained tumor-free for 110 months to date. Case 2 had a history of breast cancer for 5 years and long-term intake of aromatase inhibitor drugs without HPV infection. It was a keratinized squamous cell carcinoma. Tumor also infiltrated in deep myometrium with multifocal intravascular thrombus and one pelvic lymph node metastasis (1/18), However, no metastasis was seen elsewhere. To date, the patient survived for 16 months without tumor after surgery. Both of the two cases expressed squamous epithelial markers P40, P63, and CK5/6, but neither expressed PAX8 or PR. Case 1 had diffuse expression of P16, wild-type P53, and ER-negative. Case 2 had negative P16, mutant P53, and focal positive ER. PESCC is often associated with HPV infection and low estrogen levels. However, studies in the literatures have found that P16 expression is not always consistent with HPV infection, indicating that PESCC cannot be easily classified as HPV-associated or non-dependent like cervical cancer. There are two main patterns of P16 and P53 expression, P16- positive/P53 wild-type and P16-negative/P53-mutant, but no positive expression of both has been seen so far. It is worth noting that we reported the second case of PESCC with a history of breast cancer, where the patient had been taking the oral aromatase inhibitor drug (exemestane) for a long period of time to reduce the estrogen level, indicating the low estrogen level may be also a key factor in the pathogenesis of PESCC. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the correlation between DCE-MRI, R2*, IVIM, and clinicopathological features of rectal cancer. Methods: This was a prospective study, enrolling 42 patients with rectal cancer, 20 of whom underwent rectal mesorectal excision. Dynamic contrast-enhanced magnetic resonance imaging scanning was performed preoperatively in all patients, and additional preoperative scanning of R2* imaging and intravoxel incoherent motion was performed in those who underwent surgery. Artificially delineate the ROI around the tumor. Functional magnetic resonance index parameters Ktrans, Ve, R2*, D, D*, and f were estimated by computer software to analyze postoperative pathological reports of patients undergoing total mesenteric resection. Correlation and significance analyses of imaging metrics and pathologic features were performed by GraphPad Prism 9 to assess statistical significance. Results: DEC-MRI, R2*, and IVIM have certain application values in the distance from the lower margin of the tumor to the anorectal ring, imaging T stage and N stage, tumor markers CEA and CA199, immunohistochemical indexes Ki-76 and P53, lymph node cancer metastasis, and rectal fascia status (P < 0.05). Conclusion: DEC-MRI, R2*, and IVIM provide reliable quantitative parameters for preoperative clinicopathological evaluation of patients with rectal cancer. [ABSTRACT FROM AUTHOR]

Objective: To explore the expression and significance of arachidonate 12⁃lipoxygenase (ALOX12) in cancer tissues of colon cancer patients. Methods: Tumor and peritumoral tissues of 257 colon cancer patients were retrospectively collected, and the expression of ALOX12 was detected by immunohistochemistry (IHC) to compare the differences in expression within the tumor and peritumoral tissues, and the relationship between ALOX12 expression and clinicopathological features of colon cancer was analyzed. The 5⁃year overall survival (OS) of the patients was analyzed using Kaplan⁃Meier curves, and the factors affecting the 5⁃year OS of the patients were investigated by univariate and multivariate Cox regression analyses. Results: ALOX12 was more positively expressed in tumors compared to peritumoral tissues (63.8% vs. 33.1%), and the difference was statistically significant (P < 0.001). The expression of ALOX12 was not significantly correlated with the patient’s age, gender, and tumor site (P > 0.05), but was strongly correlated with TNM staging and lymph node metastasis (P < 0.05). Five⁃year OS of patients with high expression of ALOX12 was markedly lower than those patients with low expression of ALOX12 (P < 0.001). Single variable and multivariate Cox analyses indicated that age, TNM staging, lymph node metastasis, and ALOX12 expression were independent factors influencing the 5-year OS rate (P < 0.05). Conclusion: High expression of ALOX12 is associated with TNM staging and lymph node metastasis of colon cancer, which can serve as a biomarker to predict the patient’s condition and prognosis. [ABSTRACT FROM AUTHOR]

This study presents the case of a 40-year-old male patient after renal transplantation. The CT scan revealed a large mass in the lower abdomen and pelvis, with a branch of the right external iliac artery intersecting the growth. After a comprehensive examination, it was shown that the mass originated from the transplanted kidney, and a radical nephrectomy (including the mass) was performed. We document a case of atypical angiomyolipoma (AAM) occurring in a transplanted kidney. This article reports the case study and a brief literature review of the clinical presentation, diagnosis and treatment of AAM.

Objective To investigate the relationship between the expression of Zeste White 10 interactor（ZWINT）and Cyclin-dependent kinase 2（CDK2）and clinicopathological features in breast cancer，and evaluate their pathological diagnostic values in breast cancer. Methods GEPIA database was utilized to analyze the difference in the expression of ZWINT between breast cancer and normal breast tissues and assess the correlation between ZWINT and CDK2 expression in breast cancer. Kaplan-Meier Plotter database was employed to predict the relationship between ZWINT expression and clinical prognosis of breast cancer patients. Paraffin-embedded pathological specimens of 84 cases of breast cancer and paired paracancerous tissues and fresh specimens of 20 cases of breast cancer and paired paracancerous tissues were collected. Quantitative real-time polymerase chain reaction（RT-qPCR）and immunohistochemical staining were used to detect the expression levels of ZWINT and CDK2 mRNA and protein in breast cancer and paracancerous normal breast tissues，to analyze the relationship between ZWINT and CDK2 expression levels and clinicopathological features of breast cancer. Association analysis was used to analyze the correlation between ZWINT and CDK2. Receiver operating characteristic（ROC）curve was delineated to evaluate the values of ZWINT and CDK2 in the pathological diagnosis of breast cancer. Results The results of database analysis showed that ZWINT was highly expressed in breast cancer tissues and there was a positive correlation between the expression of ZWINT and CDK2 in breast cancer（rs = 0.600，P < 0.001）. The expression of ZWINT was closely correlated with clinical prognosis of breast cancer patients（all P < 0.05）. The test results of 84 cases showed that the expression levels of ZWINT and CDK2 mRNA and protein in breast cancer tissues were higher than those in para-carcinoma tissues（both P < 0.05），and high expression was closely correlated with tumor size，tumor stage and lymph node metastasis（all P < 0.05）. Association analysis revealed that the degree of association of Φ and Cramer V coefficient test under symmetric measurements was the same as 0.322（P = 0.003），while the column linkage number was 0.306（P = 0.003）. The expression levels of ZWINT and CDK2 proteins were closely correlated. The areas under the ROC curve of ZWINT and CDK2 were 0.886 and 0.818，which yielded high diagnostic values for breast cancer. Conclusions ZWINT and CDK2 expression levels are closely correlated the occurrence，development and prognosis of breast cancer. Detection of ZWINT and CDK2 contributes to pathological diagnosis of breast cancer.

Introduction: Solid adenocarcinoma represents a notably aggressive subtype of lung adenocarcinoma. Amidst the prevailing inclination towards conservative surgical interventions for diminutive lung cancer lesions, the critical evaluation of this subtype's malignancy and heterogeneity stands as imperative for the formulation of surgical approaches and the prognostication of long-term patient survival. Methods: A retrospective dataset, encompassing 2406 instances of non-solid adenocarcinoma (comprising lepidic, acinar, and papillary adenocarcinoma) and 326 instances of solid adenocarcinoma, was analyzed to ascertain the risk factors concomitant with diverse histological variants of lung adenocarcinoma. Concurrently, RNA-sequencing data delineating explicit pathological subtypes were extracted from 261 cases in the TCGA database and 188 cases in the OncoSG database. This data served to illuminate the heterogeneity across lung adenocarcinoma (LUAD) specimens characterized by differential histological features. Results: Solid adenocarcinoma is associated with an elevated incidence of pleural invasion, microscopic vessel invasion, and lymph node metastasis, relative to other subtypes of lung adenocarcinoma. Furthermore, the tumor microenvironment (TME) in solid pattern adenocarcinoma displayed suboptimal oxygenation and acidic conditions, concomitant with augmented tumor cell proliferation and invasion capacities. Energy and metabolic activities were significantly upregulated in tumor cells of the solid pattern subtype. This subtype manifested robust immune tolerance and capabilities for immune evasion. Conclusion: This present investigation identifies multiple potential metrics for evaluating the invasive propensity, metastatic likelihood, and immune resistance of solid pattern adenocarcinoma. These insights may prove instrumental in devising surgical interventions that are tailored to patients diagnosed with disparate histological subtypes of LUAD, thereby offering valuable directional guidance. [ABSTRACT FROM AUTHOR]

【Abstract】 Objective To investigate the relationship between the expression of Zeste White 10 interactor( ZWINT) and Cyclin-dependent kinase 2( CDK2) and clinicopathological features in breast cancer, and evaluate their pathological diagnostic values in breast cancer. Methods GEPIA database was utilized to analyze the difference in the expression of ZWINT between breast cancer and normal breast tissues and assess the correlation between ZWINT and CDK2 expression in breast cancer. Kaplan-Meier Plotter database was employed to predict the relationship between ZWINT expression and clinical prognosis of breast cancer patients. Paraffinembedded pathological specimens of 84 cases of breast cancer and paired paracancerous tissues and fresh specimens of 20 cases of breast cancer and paired paracancerous tissues were collected. Quantitative real-time polymerase chain reaction( RT-qPCR) and immunohistochemical staining were used to detect the expression levels of ZWINT and CDK2 mRNA and protein in breast cancer and paracancerous normal breast tissues, to analyze the relationship between ZWINT and CDK2 expression levels and clinicopathological features of breast cancer. Association analysis was used to analyze the correlation between ZWINT and CDK2. Receiver operating characteristic( ROC) curve was delineated to evaluate the values of ZWINT and CDK2 in the pathological diagnosis of breast cancer. Results The results of database analysis showed that ZWINT was highly expressed in breast cancer tissues and there was a positive correlation between the expression of ZWINT and CDK2 in breast cancer( rs = 0.600, P < 0.001) . The expression of ZWINT was closely correlated with clinical prognosis of breast cancer patients( all P < 0.05) . The test results of 84 cases showed that the expression levels of ZWINT and CDK2 mRNA and protein in breast cancer tissues were higher than those in para-carcinoma tissues( both P < 0.05), and high expression was closely correlated with tumor size, tumor stage and lymph node metastasis( all P < 0.05) . Association analysis revealed that the degree of association of Φ and Cramer V coefficient test under symmetric measurements was the same as 0.322( P = 0.003), while the column linkage number was 0.306( P = 0.003) . The expression levels of ZWINT and CDK2 proteins were closely correlated. The areas under the ROC curve of ZWINT and CDK2 were 0.886 and 0.818, which yielded high diagnostic values for breast cancer. Conclusions ZWINT and CDK2 expression levels are closely correlated the occurrence, development and prognosis of breast cancer. Detection of ZWINT and CDK2 contributes to pathological diagnosis of breast cancer. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies on cancer of unknown primary (CUP) mainly focus on treatment and prognosis in western populations and lacked clinical evaluation of different IHC markers, so this study aimed to evaluate characteristics of CUP and recommend a diagnostic strategy from a single center in China. Methods and results Data of 625 patients with CUP were retrospectively collected and reviewed. The patients ranged in age from 20 to 91 years, with a female-to-male ratio of 1.3:1. The predominant histological type was poor or undifferentiated adenocarcinomas (308; 49.3%). The results of Canhelp-Origin molecular testing for the identification of the tissue of origin in 262 of 369 patients (71.0%) were considered predictable (similarity score > 45), with the most common predicted primary tumor site being the breast (57, 21.8%). Unpredictable molecular results correlated with more aggressive clinical parameters and poor survival. Thee positivity rates of several targeted antibodies (GATA3, GCDFP15, TTF1, Napsin A, and PAX8), based on the clinically predicted site, were lower than those reported for the corresponding primary tumors. Nonetheless, TRPS1 and INSM1 were reliable markers of predicted breast carcinoma (75.0%) and neuroendocrine tumors (83.3%), respectively. P16 expression, as well as HPV and EBER testing contributed significantly to the diagnosis of squamous cell carcinomas. Survival analysis revealed that older ages (> 57), ≥ 3 metastatic sites, non-squamous cell carcinomas, bone/liver/lung metastases, unpredictable molecular results, and palliative treatment correlated with poor overall survival. Conclusions We recommend a CUP diagnostic strategy involving the use of targeted antibody panels as per histological findings that is potentially applicable in clinical practice. The markers TRPS1, INSM1, and P16 expression, as well as HPV and EBER testing are particularly valuable in this aspect. Molecular testing is also predictive of survival rates.

Juanzi Zeng,1,2 Wenwei Fan,3 Jiaquan Li,1,2 Guowu Wu,1,2 Heming Wu2 1Department of Medical Oncology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 3Department of Gastroenterology, Dongguan Eighth People’s Hospital, Dongguan, People’s Republic of ChinaCorrespondence: Heming Wu, Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, No. 63 Huangtang Road, Meijiang District, Meizhou, People’s Republic of China, Email wuheming1986@126.comBackground: The occurrence, progression, and prognosis of colorectal cancer (CRC) are regulated by EGFR-mediated signaling pathways. However, the relationship between the core genes (KRAS/NRAS/BRAF/PIK3CA) status in the signaling pathways and clinicopathological characteristics of CRC patients in Hakka population remains controversial.Methods: Patients were genotyped for KRAS (codons 12, 13, 61, 117, and 146), NRAS (codons 12, 61, 117, and 146), BRAF (codons 600), and PIK3CA (codons 542, 545 and 1047) mutations. Clinical records were collected, and clinicopathological characteristic associations were analyzed together with mutations of studied genes.Results: Four hundred and eight patients (256 men and 152 women) were included in the analysis. At least one mutation in the four genes was detected in 216 (52.9%) patients, while none was detected in 192 (47.1%) patients. KRAS, NRAS, BRAF, and PIK3CA mutation status were detected in 190 (46.6%), 11 (2.7%), 10 (2.5%), 34 (8.3%) samples, respectively. KRAS exon 2 had the highest proportion (62.5%). Age, tumor site, tumor size, lymphovascular invasion, and perineural invasion were not associated with gene mutations. KRAS mutations (adjusted OR 1.675, 95% CI 1.017– 2.760, P=0.043) and NRAS mutations (adjusted OR 5.183, 95% CI 1.239– 21.687, P=0.024) appeared more frequently in patients with distant metastasis. BRAF mutations (adjusted OR 7.224, 95% CI 1.356– 38.488, P=0.021) and PIK3CA mutations (adjusted OR 3.811, 95% CI 1.268– 11.455, P=0.017) associated with poorly differentiated tumor.Conclusion: KRAS/NRAS mutations are associated with distant metastasis and BRAF/PIK3CA mutations are associated with poor tumor differentiation in CRC. And the results provided a better understanding between clinicopathological characteristics and gene mutations in CRC patients.Keywords: colorectal cancer, KRAS, NRAS, BRAF, PIK3CA, clinicopathological feature

Enteric duplication is a rare malformation of the digestive tract, while colonic duplication is even rarer in adults. This paper reports one case, a 22-years old female, presented with a peritoneal cystic mass lesion measured 15 cm×10 cm. The lesion was found to be from the mesentery of the colon during surgery, and sharply demarcated. It was revealed by histopathology that the cystic wall was characterized by colonic muscularis propria and mucosa layer, in which epithelium showed low-grade dysplasia, accompanied by inflammatory reactions, and lack of distinct differentiation components into other organs. Colonic duplication with epithelial low-grade dysplasia was diagnosed. The author will analyze the clinicopathological features of colonic duplication combined with literature review.

Background: Previous studies on cancer of unknown primary (CUP) mainly focus on treatment and prognosis in western populations and lacked clinical evaluation of different IHC markers, so this study aimed to evaluate characteristics of CUP and recommend a diagnostic strategy from a single center in China. Methods and results: Data of 625 patients with CUP were retrospectively collected and reviewed. The patients ranged in age from 20 to 91 years, with a female-to-male ratio of 1.3:1. The predominant histological type was poor or undifferentiated adenocarcinomas (308; 49.3%). The results of Canhelp-Origin molecular testing for the identification of the tissue of origin in 262 of 369 patients (71.0%) were considered predictable (similarity score > 45), with the most common predicted primary tumor site being the breast (57, 21.8%). Unpredictable molecular results correlated with more aggressive clinical parameters and poor survival. Thee positivity rates of several targeted antibodies (GATA3, GCDFP15, TTF1, Napsin A, and PAX8), based on the clinically predicted site, were lower than those reported for the corresponding primary tumors. Nonetheless, TRPS1 and INSM1 were reliable markers of predicted breast carcinoma (75.0%) and neuroendocrine tumors (83.3%), respectively. P16 expression, as well as HPV and EBER testing contributed significantly to the diagnosis of squamous cell carcinomas. Survival analysis revealed that older ages (> 57), ≥ 3 metastatic sites, non-squamous cell carcinomas, bone/liver/lung metastases, unpredictable molecular results, and palliative treatment correlated with poor overall survival. Conclusions: We recommend a CUP diagnostic strategy involving the use of targeted antibody panels as per histological findings that is potentially applicable in clinical practice. The markers TRPS1, INSM1, and P16 expression, as well as HPV and EBER testing are particularly valuable in this aspect. Molecular testing is also predictive of survival rates. [ABSTRACT FROM AUTHOR]

Abstract Background Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor that mostly arises from the pelvic and perineal soft tissues. Few studies reported its characteristics and outcomes previously due to its rarity and challenges of treatments. This study aimed to investigate the clinical characteristics as well as surgical and short-term survival outcomes of primary abdominopelvic AAM. Methods Medical records of patients who were admitted to surgery with pathological confirmation of primary abdominopelvic AAM at Peking University International Hospital from January 2016 through December 2021 were retrospectively retrieved from our retroperitoneal tumor database. Demographics, operative outcomes and pathological findings were collected. Patients received followed-up routinely after the surgery. Survival probabilities were calculated and determined through Kaplan–Meier analysis. Results A total of 12 consecutive patients (male/female 4:8) were included in this study. The median age was 45 years old. The clinical presentation varied among individuals, consisting of 2 abdominal discomforts, 4 constipations, 1 lumbago, 1 prolonged menstruation, and 1 buttock swelling. R0/R1 resection was achieved in 100% of patients. Postoperatively, 50% of patients developed various complications including 3 fistulas and 3 wound infections. No operative mortality was observed. Histopathology of all patients was suggestive of AAM. Immunohistochemistry was done with a 91.7% positive rate for estrogen and progesterone receptors. The median recurrence-free survival time was 38 months. There were no cases of deceased or presented with distal metastasis during a median of 42 months’ follow-up. Conclusions The clinical manifestations of abdominopelvic AAM are mostly atypical. Surgical resection with curative intents remains the mainstay treatment of this disease, which was strongly suggested in experienced sarcoma centers due to the high probability of severe postoperative complications. In addition, long-term follow-up is necessary due to the high rate of local recurrences.

Abstract Background To investigate the correlation between the clinical and pathological characteristics and outcomes in patients with eyelid malignant tumors underwent wide local excision. Methods This retrospective study included 141 cases of eyelid malignant neoplasms from January 2010 to December 2015 in Shanxi eye hospital. Demographic and clinical information were collected. The Kaplan–Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. Cox proportional regression models were used to calculate the hazard ratios (HR) of total recurrence rate and metastasis rate. Results Overall, there were 141 eyelid malignant neoplasms cases aged 65.34 ± 9.69 (range, 41—88) years old. The duration time range was from 1 to 828 (61.09 ± 122.21) months. Basal cell carcinoma (BCC) is the most common of all eyelid malignancies, accounting for 84 (59.5%), followed by Sebaceous gland carcinoma (SGC, 41, 29%), Squamous Cell Carcinoma (SCC, 11, 7.8%), Malignant Melanoma (MM, 3, 2.1%)。On cox-regression analysis, pathological classification (HR 1.959; 95% CI 1.012–3.790; p = 0.046) and eyelid tumor surgery history (HR 17.168; 95% CI 1.889–156.011; p = 0.012) were independently associated with recurrence in patients with eyelid malignant neoplasm. Pathological classification (HR 2.177; 95% CI 1.423 -3.331; p

Objective: To investigate the relationship between genetic characteristics of pivotal driver genes and clinicopathological features in pancreatic ductal adenocarcinoma(PDAC). Methods: Mutations in related genes in 269 PDAC patients were detected with targeted sequencing, and the relationship between the genetic status of pivotal driver genes (KRAS、TP53、SMAD4 and CDKN2A) and clinicopathological features (including age, tumor differentiation, and prognosis, etc) were analyzed. Results: Among 269 patients, KRAS, TP53, SMAD4 and CDKN2A mutations were identified in 222 cases (82.53%), 148 cases (55.02%), 41 cases (15.24%) and 30 cases (11.15%) respectively. KRAS mutations were missense mutations, of which 94.59% occurred in codon 12 of exon 2 and 5.41% in codon 61 in exon 3. KRAS mutation might be correlated with age, with a mutation rate of 80.09% in patients younger than 70 years old and 93.75% in patients older than 70 years old (P

Abstract Objective Pancreatic adenocarcinoma (PAAD) is a leading cause of cancer-related mortality in adults. Syndecan-4 (SDC4) is involved in cancer pathogenesis. Therefore, this study aimed to explore the expression and clinical significance of SDC4 in PAAD. Methods Differentially expressed genes (DEGs) between PAAD and normal pancreas were screened from the GTEx and TCGA databases, and the correlationship between the DEGs and prognosis were analyzed. The prognostic value of the screened SDC4, SERPINE1, and SLC2A1 was evaluated using the Kaplan–Meier curve and SDC4 was subsequently selected as the better candidate. Also, SDC4 expression was analyzed in PAAD tissues, the other risk factors affecting postoperative survival were analyzed using Cox regression analysis, and SDC4-mediated pathways enrichment was identified by GSVA and GSEA. SDC4 expression in PAAD tissues and adjacent normal tissues of selected PAAD patients was detected by RT-qPCR and immunohistochemistry. The correlation between SDC4 and clinical features was evaluated by the χ2 test. Results SDC4 was highly expressed in PAAD tissues. Elevated SDC4 was correlated with reduced overall survival. SDC4 enrichment pathways included spliceosome function, proteasome activity, pentose phosphate pathway, base excision repair, mismatch repair, DNA replication, oxidative phosphorylation, mitotic spindle formation, epithelial-mesenchymal transition, and G2M checkpoints. SDC4 was elevated in PAAD tissues of PAAD patients compared with adjacent normal tissues. High SDC4 expression was related to metastatic differentiation, TNM stage, lymphatic metastasis, and lower 3-year survival rate. SDC4 was an independent risk factor affecting postoperative survival. Conclusion SDC4 was highly expressed in PAAD and was related to clinicopathological features and poor prognosis, which might be an important index for PAAD early diagnosis and prognosis.

Background: Zolbetuximab (IMAB362) is under investigation for treating advanced gastrointestinal tumors because it targets Claudin18.2 (CLDN18.2). CLDN18.2 is a promising molecule along with the presence of human epidermal growth factor receptor 2 in gastric cancer. This study evaluated cell block (CB) preparations of serous cavity effusions for the feasibility for CLDN18.2 protein expression and compared the results with those of biopsy or resection specimens. The association of CLDN18.2 expression in effusion samples and the clinicopathological features were also investigated. Methods: Cytological effusion specimens and matched surgical pathology biopsy or resection specimens of 43 gastric and gastroesophageal junctional cancer cases were stained for CLDN18.2 expression and quantified using immunohistochemistry based on the manufacturer's instructions. Results: Positive staining was detected in 34 (79.1%) tissue and 27 (62.8%) effusion CB samples in this study. When "positivity" was defined as moderate‐to‐strong staining in ≥40% viable tumor cells, CLDN18.2 expression was observed in 24 (55.8%) tissue and 22 (51.2%) effusion CB samples. A cutoff of 40% for CLDN18.2 positivity was used to demonstrate high concordance (83.7%) between cytology CB and tissue specimens. The results showed that CLDN18.2 expression in effusion specimens correlated with tumor size (p =.021) but not with sex, age at diagnosis, primary tumor location, staging, Lauren phenotype, cytomorphologic features, or Epstein‐Barr virus infection. Cytological effusions with or without CLDN18.2 expression did not significantly affect overall survival. Conclusions: This study's results show that serous body cavity effusions may be suitable for CLDN18.2 biomarker testing; however, discordant cases should be interpreted cautiously. This study aimed to assess the feasibility of using cell blocks prepared from a serous cavity effusion sample along with biopsy and resection specimens from relevant surgical pathology to confirm Claudin18.2 expression by immunohistochemistry. The results demonstrated that there was high concordance (83.7%) of Claudin18.2 immunoperoxidase results between cytology effusion cell block and tissue specimens when a cutoff of 40% was used for Claudin18.2 positivity. [ABSTRACT FROM AUTHOR]

Calponin is an actin filament-associated regulatory protein that can inhibit the activity of myosin)ATPase and stabilize the dynamics of the actin cytoskeleton. Although calponin 2 has been reported to play roles in several cancers, whether it takes part in the progression of esophageal cancer still remains unknown. To explore the pathologic significance of calponin 2 in esophageal squamous cell carcinoma, the expression level of calponin 2 proteins in the tumor tissue of 190 esophageal squamous cell carcinoma patients was examined with immunohistochemistry while the expression level of calponin 2 messenger ribonucleic acid was analyzed by using the data from The Cancer Genome Atlas database. Both the calponin 2 messenger ribonucleic acid and protein level were increasingly expressed in the tumor tissues of esophageal squamous cell carcinoma patients compared with the adjacent non-tumor tissue and correlated negatively with the tumor grade. Patients with higher calponin 2 in the tumor tissue were found to have longer overall survival time. Calponin 2 was shown to be an independent factor influencing the overall survival of the esophageal squamous cell carcinoma patients. Methylation analysis based on MethSurv database revealed a methylation site in the body of calponin 2 gene, which was associated with a better prognosis. Further, in esophageal cancer tumor tissue, calponin 2 gene was found to co-express with genes associated with tight junction and the expression level of calponin 2 was observed to correlate significantly with the number of infiltrating immune cells. These results supported the idea that calponin 2 is involved in esophageal cancer and may function as a tumor inhibitor probably through modulating cancer cells tight junction and tumor immunity. [ABSTRACT FROM AUTHOR]

Background: Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor that mostly arises from the pelvic and perineal soft tissues. Few studies reported its characteristics and outcomes previously due to its rarity and challenges of treatments. This study aimed to investigate the clinical characteristics as well as surgical and short-term survival outcomes of primary abdominopelvic AAM. Methods: Medical records of patients who were admitted to surgery with pathological confirmation of primary abdominopelvic AAM at Peking University International Hospital from January 2016 through December 2021 were retrospectively retrieved from our retroperitoneal tumor database. Demographics, operative outcomes and pathological findings were collected. Patients received followed-up routinely after the surgery. Survival probabilities were calculated and determined through Kaplan–Meier analysis. Results: A total of 12 consecutive patients (male/female 4:8) were included in this study. The median age was 45 years old. The clinical presentation varied among individuals, consisting of 2 abdominal discomforts, 4 constipations, 1 lumbago, 1 prolonged menstruation, and 1 buttock swelling. R0/R1 resection was achieved in 100% of patients. Postoperatively, 50% of patients developed various complications including 3 fistulas and 3 wound infections. No operative mortality was observed. Histopathology of all patients was suggestive of AAM. Immunohistochemistry was done with a 91.7% positive rate for estrogen and progesterone receptors. The median recurrence-free survival time was 38 months. There were no cases of deceased or presented with distal metastasis during a median of 42 months' follow-up. Conclusions: The clinical manifestations of abdominopelvic AAM are mostly atypical. Surgical resection with curative intents remains the mainstay treatment of this disease, which was strongly suggested in experienced sarcoma centers due to the high probability of severe postoperative complications. In addition, long-term follow-up is necessary due to the high rate of local recurrences. [ABSTRACT FROM AUTHOR]

Background: Cholangiocarcinoma is the most common primary cancer of liver in North-Eastern region of Thailand. Human epidermal growth factor receptor-2 (HER-2) overexpression is a poor prognostic factor of many types of cancer but there is limited data in cholangiocarcinoma. The present study aimed to investigate prevalence of HER-2 overexpression in cholangiocarcinoma and analyzed its association with overall survival and clinicopathological features. Materials and Methods: The present study was retrospective cohort analytical single-centered study which included adult patients with cholangiocarcinoma in Srinagarind Hospital, Khon Kaen, Thailand. Archived pathological tissue diagnosed as cholangiocarcinoma were stained for HER-2 using a labeled streptavidin biotin peroxidase method with the polyclonal antibody (Dako A0485) and classified into positive and negative group as, in the present study, 3+ and 0, 1+, 2+ by immunohistochemistry results, respectively. Prevalence of HER-2 overexpression was presented with percentage and 95% confidence interval (95% CI). Results: A total of 93 cases, of which 71% were male, were included. Mean age was 63 and 62 years in HER-2 positive and negative groups, respectively. The proportion of intrahepatic was more than extrahepatic cholangiocarcinoma (72% vs. 28%). HER-2 positive was revealed 10 cases, as 10.8% (95% CI 5.3% to 18.9%). Most cases were early to locally advance stage (89% vs. 90%) Median overall survival was not reach in HER-2 positive group compared with 30.9 months in negative group (hazard ratio 0.39; 95% CI 0.12 to 1.21; p 0.089). Conclusion: Among patients with cholangiocarcinoma, 1 of 10 cases had HER-2 overexpression. [ABSTRACT FROM AUTHOR]

Acral melanocytic neoplasms, including acral melanocytic nevus and acral melanoma, are common melanocytic lesions in Asian populations. Both lesions occur on the volar surface of the hands and feet, and on nail units. Acral melanocytic nevi occur on the arch area of the sole, whereas acral melanomas frequently occur on weight-bearing areas of the sole, and on the fingernails. Therefore, the development of acral melanoma may be associated with chronic pressure, physical stress, or trauma. Dermoscopy is a useful adjunctive diagnostic tool for differential diagnosis. Acral melanocytic nevus is characterized by a parallel furrow pattern, whereas acral melanoma has a parallel ridge pattern. Genetic alterations are also different between the two types of lesion. BRAF and NRAS mutations are common in acral melanocytic nevus, whereas acral melanoma shows lower rates of KIT, NF1, BRAF, and NRAS mutations and remarkable copy number variations in genes such as CCND1, CDK4, hTERT, PAK1, and GAB2. Sentinel lymph node biopsy is important for staging and prognosis. Contemporary treatments for melanoma include targeted therapy for mutations and immunotherapy, such as anti-PD1 inhibitors.

Purpose: To investigate the clinicopathological features, diagnosis, treatment, and prognosis of multiple synchronous distinct subtypes of primary thyroid carcinomas. Methods: The clinical data of 68 cases of synchronous carcinomas of the thyroid (STC) admitted to the Department of Thyroid Surgery in our hospital from January 2013 to December 2021 were reviewed. According to the pathological type, they were divided into the Synchronous differentiated and differentiated thyroid Carcinoma (SDDTC) group (42 cases), the Synchronous medullary and differentiated thyroid Carcinoma (SMDTC) group (18 cases), and the Synchronous Anaplastic and differentiated thyroid Carcinoma (SADTC)group (8 cases). The diagnosis, treatment, and survival of patients in each group were analyzed. Results: Women with coexisting thyroid cancer were predominant (59 cases). Most of the symptoms were found on physical examination (47.1%) and neck mass (45.6%). The median age of patients in the SDDTC group, SADTC group, and SMDTC group was 47.5 (28–74) years old, 68.5 (26–75) years old, and 56.5 (39–74) years old. The age of the SADTC group and SMDTC group was older than that of the SDDTC group (P = 0.04, P = 0.03), and the rate of lymph node metastasis in groups SADTC (62.5%) and SMDTC (55.6%) was higher than in group SDDTC (21.4%). The disease course time, tumor location, clinical stage, and mortality of the SADTC group were significantly different from those of the SDDTC group and SMDTC group (P < 0.05). The overall survival of patients with synchronous carcinomas of the thyroid was 6–105 months, and the median overall survival was 38.5 months. The tumor-free survival was 0–90 months, 19.1% of patients developed distant metastasis, 11.8% of patients had postoperative recurrence, as well as the survival rate was estimated 91.18%. Cox model multivariate analysis showed that cervical lateral lymph node metastasis and tumor stage III/IV were independent risk factors for progression-free survival(PFS). The comparison results of the survival curves showed that the overall survival (OS)of the patients in the SADTC group was significantly worse (P < 0.01), while there was no significant difference in the PFS of different pathological types (χ2 = 5.024, P = 0.081).The OS of different treatment methods was significantly different (P = 0.002), but there was no significant difference in OS between local recurrence and distant metastases with or without surgery (χ2 = 0.954, P = 0.329). Conclusions: The STC has relatively unique clinical characteristics, and most patients can get a better prognosis after radical surgery. Pathological type, lateral cervical lymph node metastasis, tumor stage, and treatment are important factors which affect the prognosis of the disease. Since there are two distinct tumors with different aggressiveness, treatment options, and prognosis, individualized management is required. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the occurrence rate of unexpected breast cancer (UEBC) mimicking benign lesions [Breast Imaging Reporting and Data System (BI-RADS) category 3 or 4a] using ultrasound-guided vacuum-assisted excision biopsy (US-VAEB), and explored the factors responsible for late diagnosis of T2 stage UEBC. Materials and methods: We collected clinicopathologic data and preoperative US imaging features within 3 months before US-VAEB of patients who were diagnosed with UEBC from January 2002 to September 2022. The UEBC were divided into T1 and T2 stageUEBC. The US imaging features as well as clinical and pathological information of T1 and T2 stage UEBC were compared to explore the factors responsible for late diagnosis of T2 stage UEBC. Results: Breast cancer was diagnosed in 91 of 19 306 patients who underwent US-VAEB. We excluded eight patients with breast cancer assigned to BI-RADS 4b category by preoperative US, and two for whom US imaging records were unavailable. Finally, we enrolled 81 patients. The occurrence rate of UEBC after US-VAEB was 0.42%(81/19296). Of the 81 cases of UEBC, 22 were at T2 stage. The ratio of T2 stage UEBC was 27.2%. The differences in risk factor of breast cancer and routine breast US screening between T1 and T2 stage UEBC were significant [96.6% (57/59) vs 81.8% (18/22), 44.1% (26/59) vs 13.6% (3/22), respectively, P<0.05). Conclusion: UEBC was rarely detected by US-VAEB. Most cases of T2 stage UEBC were diagnosed late because of the absence of routine US screening and risk factors for breast cancer. Stricter clinical management regulations for breast lesions and performing regular US screening may be helpful to reduce T2 stage UEBC. [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, the antibody-drug conjugate (ADC) of Human Epidermal Growth Factor Receptor 2 (HER2) has been found to play an important role in some HER2-negative cancers as in it did in HER2-positive patients. Therefore, a more detailed and suitable classification of HER2 is needed. Our study revealed that HER2-low colorectal cancer tumors did not show an intermediate state of HER2 expression in clinicopathology and prognosis. HER2-low colorectal cancer tumors are like HER2-zero tumors, with a lower proportion of perineural invasion, lower tumor stage and more RAS/BRAF mutation, compared with HER2-high tumors. Multivariate analysis and propensity score matching also revealed that HER2-high expression was an independent prognostic factor of disease-free survival. Our study indicated that the routine examination of HER2 status is needed in early-stage colorectal cancer. The encouraging effects of HER2-ADC in patients with HER2-low expression cancers indicated the classical classifications based on positive and negative HER2 might no longer be suitable. However, the biology and prognosis of colorectal cancer patients with different HER2 expression status were still not clear. This is a multi-center retrospective study that included patients with histologically confirmed colorectal cancer and determined HER2 status who received radical surgical resection. HER2 immunohistochemistry (IHC) 1+ and IHC 2+ groups were combined and defined as a HER2-low group because of the concordance of clinicopathological characteristics. As compared with the HER2-high group, both the HER2-zero and the HER2-low group had less tumor with perineural invasion (14.3%, 13.1% vs. 31.6%, p = 0.001 and p < 0.001), less stage III disease (41.8%, 39.9% vs. 56.1%, p = 0.044 and p = 0.022), more RAS/BRAF mutation (52.1%, 49.9% vs. 19.5%, p < 0.001 and p < 0.001) and better disease-free survival (DFS) (3y-DFS rate of 78.7%, 82.4% vs. 59.3%, p < 0.001 and p < 0.001). Multivariate analysis and propensity score matching also revealed that HER2-high expression was an independent prognostic factor of DFS. In conclusion, our study revealed that HER2-low colorectal cancer tumors are close to HER2-zero tumors, but different from HER2-high tumors. The routine examination of HER2 IHC is needed in early-stage colorectal cancer. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinicopathological features of recurrent and de novo focal segmental glomerulosclerosis (FSGS) after kidney transplantation. Methods Thirty-four recipients pathologically diagnosed with FSGS by renal allograft biopsy were enrolled in this clinical trial. According to the detection of primary diseases of renal allografts and circulating permeability factors, 34 recipients were divided into the recurrent FSGS group (n=12) and de novo FSGS group (n=22). The differences of clinical indexes and the degree of pathological injury of renal allografts were compared between two groups. Results There was no significant difference in the mesangial hyperplasia score, glomerulosclerosis rate, renal tubular atrophy score, interstitial fibrosis score and podocyte proliferation rate between two groups (all P>0.05). In the recurrent FSGS group, segmental glomerulosclerosis rate of the recipients was 0.10 (0.08, 0.27), lower than 0.19 (0.13, 0.33) in the de novo FSGS group (P<0.05). No significant difference was found in the incidence of antibody-mediated rejection, drug-induced renal tubular injury and BK virus infection between two groups (all P>0.05). The incidence of T cell-mediated rejection in the recurrent FSGS group was 17%, lower than 55% in the de novo FSGS group (P<0.05). Immunohistochemical staining showed that the infiltrating inflammatory cells in the renal allografts were mainly T lymphocytes. The positive rates of C4d deposition in peripheral capillaries between the recurrent and de novo FSGS groups were 33% (4/12) and 32% (7/22), with no significant difference (P>0.05). Immunofluorescence results revealed IgM deposition in the segmental glomerulosclerosis area of renal allografts in most cases. Electron microscopy showed extensive fusion or segmental distribution of podocytes in the glomerulus of renal allografts. Conclusions The degree of renal functional injury and the incidence of T cell-mediated rejection in the recurrent FSGS group are lower than those in the de novo FSGS group. Comprehensive analysis of preoperative and postoperative clinical manifestations, laboratory testing and pathological examination of kidney transplant recipients contribute to early diagnosis and treatment of recurrent and de novo FSGS. [ABSTRACT FROM AUTHOR]

Background: Hepatoid adenocarcinoma of the stomach (HAS) is a rare subtype of gastric cancer with poor prognosis, and its clinicopathological features are not well understood, so the pathology from the clinical biopsy is easily misdiagnosed, especially for special or atypical HAS. We present an extremely rare early HAS with signet ring cell carcinoma and evaluate its clinicopathological features. Case presentation: A 51-year-old female patient of Chinese Han ethnicity with upper abdominal pain for 5 years and worsened abdominal pain for 1 month was admitted to our hospital. Esophagogastroduodenoscopy showed a submucosal tumor-like elevated lesion with central depression in the greater curvature of the junction between the antrum and body. Histopathological examination from the biopsy revealed medium-low-differentiation adenocarcinoma with signet ring cell carcinoma. Radical gastrectomy was performed, and the final diagnosis was early HAS with signet ring cell carcinoma. Conclusions: HAS with signet ring cell carcinoma is a special type of HAS and extremely rare. It is first presented for this extremely rare type of HAS, which contributes to strengthen the understanding for the clinicopathological characteristics of HAS and especially promote early detection of HAS. [ABSTRACT FROM AUTHOR]

Background & Objective: Long non-coding RNAs play critical roles in the initiation and development of gastric cancer (GC). The aim of this study was to assess the expression of NKILA and NFKB genes and the relationship between their expressions with clinical characteristics in gastric cancer. Also, relative expression of lncRNAsNKILA, compared NFKB in GC tissues was evaluated. Materials & Methods: This cross-sectional study was performed on 50 gastric formalin-fixed paraffin-embedded tumor tissue samples and 50 normal tissues. The RNA level of lncRNAsNKILA and NFKB genes was assessed using the quantitative real-time polymerase chain reaction. B2M was used as an internal control. The 2 -ΔΔCq method was used to determine the expression fold changes. Results: A significant association was observed between the levels of NKILA, in gastric tumor tissues compared with normal tissues (Mean = 2.087, p= 0.0484). The relative expression of the NFKB gene revealed no statistically significant difference between the gastric tumor tissues compared with normal tissues (P=0.3728). In addition, clinicopathologic data compared with NKILA and NFKBmRNA expression levels in gastric cancer tissues showed no significant association. Here, we found no significant association between the level of NKILA expression compared with NFKB mRNA level in gastric cancer tissues (R=0.03; P=0.2355). Conclusion: Our results showed that NKILA had a significant association with GC. Our findings also revealed that NKILA expression was not correlated with NFKB mRNA level in GC tissues.

Background: To investigate the correlation between the clinical and pathological characteristics and outcomes in patients with eyelid malignant tumors underwent wide local excision.Methods: This retrospective study included 141 cases of eyelid malignant neoplasms from January 2010 to December 2015 in Shanxi eye hospital. Demographic and clinical information were collected. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. Cox proportional regression models were used to calculate the hazard ratios (HR) of total recurrence rate and metastasis rate.Results: Overall, there were 141 eyelid malignant neoplasms cases aged 65.34 ± 9.69 (range, 41-88) years old. The duration time range was from 1 to 828 (61.09 ± 122.21) months. Basal cell carcinoma (BCC) is the most common of all eyelid malignancies, accounting for 84 (59.5%), followed by Sebaceous gland carcinoma (SGC, 41, 29%), Squamous Cell Carcinoma (SCC, 11, 7.8%), Malignant Melanoma (MM, 3, 2.1%)。On cox-regression analysis, pathological classification (HR 1.959; 95% CI 1.012-3.790; p = 0.046) and eyelid tumor surgery history (HR 17.168; 95% CI 1.889-156.011; p = 0.012) were independently associated with recurrence in patients with eyelid malignant neoplasm. Pathological classification (HR 2.177; 95% CI 1.423 -3.331; p < 0.001) was independently associated with metastasis in patients with eyelid malignant neoplasm. Recurrence and metastasis were most likely to occur in 3 years after surgery.Conclusion: Wide local excision is an effective and economical treatment for eyelid malignant neoplasms. The prognosis is mainly related to pathological types, eyelid tumor surgical history and TNM stages. [ABSTRACT FROM AUTHOR]

Aim: Cyst‐like lesions in the mandible rarely develop into malignancies, and the reported incidence is between 0.3% and 2%. The present study describes a rare case of primary intraosseous squamous cell carcinoma of the mandible arising from an odontogenic cyst. Materials and Methods: An 80‐year‐old male was referred to Trieste University Maggiore Hospital (Trieste, Italy), with acute pain in the left retromolar area. An initial examination revealed extra oral swelling without paresthesia of the IAN. Following an intraoral examination, the oral mucosa was edematous, percussion pain was experienced on the lower left second molar. Panoramic radiography revealed a retained lower left wisdom tooth and an irregular radiolucent area between the lower left second molar and the mandibular angle with clear margins. Computed tomography revealed diffuse bone resorption and an extensive loss of cortical bone on the lingual side. Results: A biopsy was performed during the surgery to remove the second lower left molar and the wisdom tooth, the pathological diagnosis was of squamous cell carcinoma arising from the epithelial lining of the odontogenic cyst. MRI with contrast agent was also performed. Shortly after the patient has been proposed a complete resective surgery of the mass including the infiltrated areas and then a reconstructive part to restore the function and aesthetic. Conclusion: The follow‐up of a large inflammatory cyst is essential for early diagnosis of malignant neoplasm. This approach allows lower invasive treatments and major survival of these patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between Excision repair crosscomplementation 1 (ERCC1) expression, clinicopathological features, and breast cancer prognosis in patients treated with trastuzumab. Further, we aim to explore the immune status of ERCC1 in breast cancer. Methods: The data were retrieved from publicly available databases like the Cancer Genome Atlas, Therapeutically Applicable Research to Generate Effective Treatments, and the Genotype-Tissue Expression. The data was used to perform differential expression analyses between tumor and normal tissues in pan-cancers, immune-related analysis, homologous recombination deficiency (HRD), tumor mutation burden, and microsatellite instability. A total of 210 patients with HER2 over-expressing breast cancer from the Fourth Hospital of Hebei Medical University between January 2013 to December 2015 were enrolled in the study. Ten adjacent normal tissues were used to study the expression pattern of ERCC1 in normal tissues. Immunohistochemistry was performed to study ERCC1 expression and immune cell infiltration in different status of ERCC1 expression. Further, the correlation between ERCC1 expression, immune cell infiltration clinicopathological features, and the prognosis of patients with breast cancer was analyzed. Results: The immune analysis revealed a significant correlation between CD8+ T cell, CD4+ T cell, T helper cell, macrophages, mast cells, and ERCC1 expression. Spearman analysis show that ERCC1 expression is related to macrophages and T cells. A close correlation was observed between increased ERCC1 expression and high tumor immune dysfunction and exclusion (TIDE) score as well as HRD. The results revealed a significant correlation among ERCC1, chemotherapy and estrogen receptor (ER; P < 0.05) expression. Univariate survival analysis revealed a significant correlation (P < 0.05) between that ERCC1 and ER expression, blood vessel invasion, and disease-free survival (DFS). ERCC1 and ER expression, tumor size, blood vessel invasion, pathological type, and lymph node metastases significantly correlated (P < 0.05) with overall survival in patients. Multivariate regression analysis revealed that ERCC1 expression and chemotherapy were independent factors that influence DFS. ERCC1 expression and vascular tumor thrombus were independent influencing factors that influence OS. Conclusion: A correlation was observed between high ERCC1 expression and poor patient prognosis. High ERCC1 expression also influences the efficacy of immunotherapy and chemotherapy. [ABSTRACT FROM AUTHOR]

Objective: Pancreatic adenocarcinoma (PAAD) is a leading cause of cancer-related mortality in adults. Syndecan-4 (SDC4) is involved in cancer pathogenesis. Therefore, this study aimed to explore the expression and clinical significance of SDC4 in PAAD.Methods: Differentially expressed genes (DEGs) between PAAD and normal pancreas were screened from the GTEx and TCGA databases, and the correlationship between the DEGs and prognosis were analyzed. The prognostic value of the screened SDC4, SERPINE1, and SLC2A1 was evaluated using the Kaplan-Meier curve and SDC4 was subsequently selected as the better candidate. Also, SDC4 expression was analyzed in PAAD tissues, the other risk factors affecting postoperative survival were analyzed using Cox regression analysis, and SDC4-mediated pathways enrichment was identified by GSVA and GSEA. SDC4 expression in PAAD tissues and adjacent normal tissues of selected PAAD patients was detected by RT-qPCR and immunohistochemistry. The correlation between SDC4 and clinical features was evaluated by the χ2 test.Results: SDC4 was highly expressed in PAAD tissues. Elevated SDC4 was correlated with reduced overall survival. SDC4 enrichment pathways included spliceosome function, proteasome activity, pentose phosphate pathway, base excision repair, mismatch repair, DNA replication, oxidative phosphorylation, mitotic spindle formation, epithelial-mesenchymal transition, and G2M checkpoints. SDC4 was elevated in PAAD tissues of PAAD patients compared with adjacent normal tissues. High SDC4 expression was related to metastatic differentiation, TNM stage, lymphatic metastasis, and lower 3-year survival rate. SDC4 was an independent risk factor affecting postoperative survival.Conclusion: SDC4 was highly expressed in PAAD and was related to clinicopathological features and poor prognosis, which might be an important index for PAAD early diagnosis and prognosis. [ABSTRACT FROM AUTHOR]

Background: Hypertension (HTN) is known to increase the risk of thyroid cancer. However, few studies have explored the association between HTN and the prognostic factors of papillary thyroid cancer (PTC). Methods: We retrospectively evaluated 2838 PTC patients treated with surgery at our center between January 2017 and September 2020. The association between both HTN and antihypertensive drug use and the clinicopathological features of the PTC patients was analyzed. The odds ratios (ORs) were estimated using both univariate and multivariate logistic regression models, which were adjusted for the patients' age, sex, and thyroid-stimulating hormone level. Results: A total of 2838 patients were enrolled in this study, including 409 patients with HTN. In the multivariate analysis, HTN was associated with larger tumor size [OR = 1.51, 95% confidence interval (CI): 1.10–2.07], lymph node metastasis (OR = 1.43, 95% CI: 1.02–1.99), and higher tumor stages (OR = 1.79, 95% CI: 1.12–2.86). There was no statistical difference between females >40 years of age and any pathological features, while a positive association was observed between older males and larger tumors (OR = 1.87, 95% CI: 1.01–3.45), and lymph node metastasis (OR = 2.01, 95% CI: 1.08–3.73). No statistical difference was found in the effects of taking alone calcium channel blockers, angiotensin-converting enzyme inhibitors/angiotensin II-receptor blockers, and their combination on the pathological features of PTC. Conclusion: PTC patients with HTN, particularly males of age >40, tend to have invasive features. Common antihypertension therapy appears to exert no effect on the pathological characteristics of these patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) located in the isthmus. Methods The clinical and pathological data of 477 cases with PTMC diagnosed pathologically were retrospectively analyzed. Differences in PTMC between isthmus and lateral lobe were compared. Results Multivariate analysis showed that there were significantly difference in cancer capsule contact (30.5% vs. 10.4%, P=0.001) and lymph node metastasis (LNM) (42.7% vs. 18.7%, P

Acral melanocytic neoplasms, including acral melanocytic nevus and acral melanoma, are common melanocytic lesions in Asian populations. Both lesions occur on the volar surface of the hands and feet, and on nail units. Acral melanocytic nevi occur on the arch area of the sole, whereas acral melanomas frequently occur on weight-bearing areas of the sole, and on the fingernails. Therefore, the development of acral melanoma may be associated with chronic pressure, physical stress, or trauma. Dermoscopy is a useful adjunctive diagnostic tool for differential diagnosis. Acral melanocytic nevus is characterized by a parallel furrow pattern, whereas acral melanoma has a parallel ridge pattern. Genetic alterations are also different between the two types of lesion. BRAF and NRAS mutations are common in acral melanocytic nevus, whereas acral melanoma shows lower rates of KIT, NF1, BRAF, and NRAS mutations and remarkable copy number variations in genes such as CCND1, CDK4, hTERT, PAK1, and GAB2. Sentinel lymph node biopsy is important for staging and prognosis. Contemporary treatments for melanoma include targeted therapy for mutations and immunotherapy, such as anti-PD1 inhibitors. [ABSTRACT FROM AUTHOR]

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Background and purpose: Dysembryoplastic neuroepithelial tumor (DNT) is a rare and benign mixed neuronal-glial tumor. This paper was to study the clinicopathological features and the key points of differential diagnosis of DNT. Methods: The data of 6 cases with DNT diagnosed by pathological examination in The First Affiliated Hospital of Soochow University and Suzhou Municipal Hospital from March 2009 to January 2021 were collected, the clinicopathological features, imaging characteristics and immunohistochemical phenotype were retrospectively analyzed, and the patients were followed up. Results: The main symptoms of the patients were limb convulsions and epilepsy. Four tumors were located in temporal lobe, 1 in parietal lobe, and 1 in frontal lobe. On magnetic resonance imaging (MRI), tumors mainly showed cystic lesions with septum and “triangle sign”, T1-hypointensity and T2-hyperintensity. Peripheral edema was inconspicuous. The histopathological hallmarks were so called specific glioneuronal element with myxoid matrix, floating neurons or proliferative astrocytes scattering among oligodendrocyte-like cells, which distributed in bundles, nests, microcysts with focal calcification. Immunohistochemistry showed that scattered neurons expressed Syn, NeuN and MAP2, oligodendrocyte-like cells expressed Olig-2 and S-100, and GFAP was expressed in proliferative astrocytes. The expression of P53 was wild-type. The index of Ki-67 was less than or equal to 2%. All patients received surgical treatment without radiotherapy or chemotherapy. Five patients were followed up, and one of them had recurrent epilepsy 3 years after operation. Conclusion: DNT can be cured by surgery, and it can be diagnosed by combination of clinical features, imaging examination and pathology without the need for radiation and chemotherapy.

Glomus tumor is a rare mesenchymal neoplasm arising from the modified smooth muscle cells of the glomus body. Primary crissum glomus tumor is extremely rare without any published in the literature. In this article, we report the first case of primary crissum glomus tumor in an 80-year-old man with recurrent anal pain for 8 years, increased pain for 1 year. Rectal MRI for inflammatory lesions (sinus tract). Microscopic examination showed the tumor cells were arranged in sheets and nests, surrounding blood vessels and nerve bundles. At high magnification, the neoplastic cells show regular round shape with light eosinophilic and translucent cytoplasm. The cell boundary is clear, the nucleus is round and located in the center. The stroma of the tumor shows hyaline degeneration. Immunohistochemically, the tumor cells were positive for smooth muscle actin, h-caldesmon, Calponin, synaptophysin, Collagen IV and CD34, but completely negative for HMB45, S100, EMA, desmin, CgA and CD56. The histologic features and immunohistochemical profile supported a diagnosis of primary crissum glomus tumor. The patient was asymptomatic and disease free after the procedure.

Purpose: Long non-coding RNAs (LncRNAs) play a critical role in the initiation and development of Gastric Cancer (GC). The aim of this study was to consider the expression of NEAT1, lincRNA-ROR and Oct4 and finally evaluate the correlation between their expression and clinical characteristics in Iranian patients with GC. Methods: This cross-sectional study was performed on 41 gastric tumor tissue samples with matched normal adjacent tumor tissues. The RNA level of lncRNA NEAT1 and lincRNA ROR and Oct4 genes were assessed using the quantitative Real-time polymerase chain reaction. B2M was used as an internal control. Also, the relative expression of lncRNA NEAT1 and lincRNA ROR compared Oct4 in GC tissues was evaluated. The 2-ΔΔCq method was used to determine the expression fold changes. Results: A significant association was observed between the levels of lincRNA ROR and Oct4 genes in gastric tumor tissues comparing normal adjacent tissues (Mean=1.558, p=0.014), (Mean=3.337, p<0.001) and (Mean=4.385, p<0.001), respectively. In addition, clinicopathological data comparing with lncRNAs and Oct4 mRNA expression levels in gastric cancer tissues showed no significant association. Here, we found that significant association between the levels of lincRNA ROR expression comparing oct4 mRNA level in gastric cancer tissues (R=0.417; P=0.024). Conclusion: Our results showed that lincRNA ROR and Oct4 have a significant association in gastric cancer. Also, our results indicate the first suggestion that lincRNA ROR expression correlated with oct4 mRNA level in gastric cancer tissues. [ABSTRACT FROM AUTHOR]

Numerous long noncoding RNAs (lncRNAs) have been identified as powerful regulators of human diseases. The lncRNA FOXD3-AS1 is a novel lncRNA that was recently shown to exert imperative roles in the initialization and progression of several diseases. Emerging studies have shown aberrant expression of FOXD3-AS1 and close correlation with pathophysiological traits of numerous diseases, particularly cancers. More importantly, FOXD3-AS1 was also found to ubiquitously impact a range of biological functions. This study aims to summarize the expression, associated clinicopathological features, major functions and molecular mechanisms of FOXD3-AS1 in human diseases and to explore its possible clinical applications. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinicopathological features and prognosis of ovarian granulosa cell tumor (GCT) in children. Methods • The clinicopathologic and follow-up data of 8 patients with ovarian GCT in Shanghai Children's Hospital from June 2008 to June 2018 were collected and retrospectively studied to summarize the clinicopathological features and analyze the prognosis. Results • The age of onset in this group ranged from 2 to 12 years with median age of 6.5 years. Two cases were adult granulosa cell tumor (AGCT) and six cases were juvenile granulosa cell tumor (JGCT). The first symptoms were abdominal pain or abdominal mass. Six patients were complicated with symptoms of precocious puberty, including 5 cases of true precocious puberty and 1 case of pseudo precocious puberty. The levels of peripheral blood sex hormones changed to varying degrees. Gross examination showed that the tumor masses ranged from 4 to 22 cm in the greatest dimension (average 12.8 cm). All of the 8 tumors were mixed solid-cystic in appearance. Under light microscope, AGCT showed obvious nuclear sulcus and microfollicular structure, containing eosinophilic substances, namely characteristic Call-Exner bodies. JGCT had follicular structures of different sizes, containing basophilic secretions. The inner layer of the follicular wall was composed of granular cells, which could be surrounded by follicular membrane cells. No Call-Exner bodies were found, and nuclear sulcus were rare. The results of immunohistochemistry showed that a-inhibin and CD99 were positive, and epithelial membrane antigen (EMA) were negative in all the cases. In 5 cases calretinin were positive, and in 5 cases cytokeratin (CK) were positive. Ki-67 proliferation index was 5%-50%. There were 3 estrogen receptor (ER) positive cases and 6 progesterone receptor (PR) positive cases. Forkhead transcription factor 2 (FOXL2) was highly expressed in 2 cases of AGCT and 6 cases of JGCT. SRY-box transcription factor 9 (SOX9) positive cells were scattered in 2 cases of AGCT and 3 cases of JGCT. All the cases were treated with standard surgery. Tumor rupture or metastasis was found in 5 cases, and ascites was suspiciously positive in 1 case. Eight children with ovarian GCT were followed up for 19-155 months, and all of them survived in good health. Conclusion The clinical features of AGCT and JGCT in children's ovaries are similar and have typical histopathological features respectively. The selection of suitable immunohistochemical detection method is helpful for differential diagnosis of ovarian tumors in children. The prognosis of ovarian GCT in children is good even with tumor rupture after radical surgery. [ABSTRACT FROM AUTHOR]

Background: Downregulation of PTENP1 was reported in different malignant tumors. However, the function and significance of PTENP1 in the clinical pathology and prognosis of tumors are not very clear. Therefore, we performed this research to analyze and elucidate the correlations between the PTENP1 expression and clinical pathological parameters and outcome of patients in different types of cancer. Methods: Literature on PTENP1 was retrieved from PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang, Springer, Ovid, and Medline databases. Pooled ORs (odds ratios) or HRs (hazard ratios) with 95% CIs were utilized to examine the relationship between the PTENP1 and clinical pathological traits and outcome of patients with different tumor types. Results: Eight studies comprising 1,047 patients were enrolled and analyzed in this research. Down-regulation of PTENP1 was correlated with differentiation (OR: 2.57; 95% CI: 1.14 - 5.80), TNM stage (OR: 0.24; 95% CI: 0.13 - 0.43), and LNM (OR: 0.27; 95% CI: 0.14 - 0.52). Moreover, PTENP1 expression level was correlated with OS in the eight types of tumors (pooled HR: 0.49; 95% CI: 0.39, 0.61). Conclusions: Low expression of PTENP1 might predict poor prognosis in patients with various carcinomas. PTENP1 may play an important role as a new prognostic indicator in patients with different malignant tumors. [ABSTRACT FROM AUTHOR]

Abstract Background Due to their rarity, the clinicopathological characteristics and prognostic factors of spinal cord gliomas are still unclear. Here, we aimed to clarify these issues in a cohort of 108 spinal cord astrocytomas. Methods We characterized the clinicopathological characteristics, including 2016 World Health Organization (WHO) grade, age, sex, location, segment length, resection, pre‐ and postsurgery, Modified McCormick Scale (MMS), radio‐ and chemotherapy, and Ki‐67 and H3 K27M mutations, in 108 spinal cord astrocytomas through heatmaps. The Cox regression analysis and Kaplan‐Meier curves were used to study the prognostic value of these clinicopathological features. Results There are a total 38 H3 K27M‐mutant tumors, including 31 cases with histological grade II/III tumors. The age of low‐grade astrocytoma patients (WHO grade I/II, n = 54) was significantly younger (27.0 vs 35.5 years, P = .001) than those with high‐grade tumors (WHO grade III/IV, n = 54). All patients underwent surgical resection with neurophysiological monitoring, and the surgery did not result in significant changes in MMS. The presurgery MMS was associated with overall survival in the high‐grade subgroup (P = .008) but not in the low‐grade subgroup (P = .312). While, the high content of resection improved the survival of only patients with low‐grade astrocytomas (P = .016) but not those with high‐grade astrocytomas (P = .475). Both the low‐grade and high‐grade astrocytomas had no obvious benefit from neither adjuvant chemotherapy nor radiotherapy (all P > .05). Conclusions We characterized the clinicopathological characteristics and their prognostic values in 108 spinal cord astrocytomas, which could help with evidence‐based management of spinal cord astrocytomas.

Shuanghuan Liu,1 Yunquan Guo,2,3 Bin Li,1 Huijuan Zhang,2 Rong Zhang,1 Shan Zheng2 1Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Pathology, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, People’s Republic of ChinaCorrespondence: Bin LiDepartment of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, South Panjiayuan Residential, Beijing, Chaoyang 100021, People’s Republic of ChinaTel/ Fax +86-10-8778-8275Email libin@cicams.ac.cnShan ZhengDepartment of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, South Panjiayuan Residential, Beijing, Chaoyang 100021, People’s Republic of ChinaTel +86-10-8778-7514Fax +86-10-8771-8709Email zhengshan@cicams.ac.cnPurpose: To avoid misdiagnosis, clinicopathological features were analyzed in cases of cervical mucinous adenocarcinoma with solitary ovarian metastatic masses.Patients and Methods: Three cases misdiagnosed as primary ovarian adenocarcinoma before surgery were filtered from the database of the Cancer Hospital/Chinese Academy of Medical Sciences from January 1998 to December 2016. The clinical data were thoroughly collected and compared, and both frozen and paraffin-embedded pathological sections were reviewed by two expert pathologists.Results: None of the patients experienced cervical contact bleeding, and no typical cervical neoplasms were found. The cervical canals were slightly thickened in two patients, as detected by either palpation or imaging. The high-risk human papillomavirus (HPV) test results were all negative, and the thin-prep cytologic test (TCT) screened only one case of atypical glandular epithelial cells. All cases were indicative of higher serum CA19-9 levels (79.49– 6124 U/mL). The ovarian masses showed no regular laterality, while they were all cystic or solid-cystic. Their pathological sections indicated a benign appearance of the capsule tissue with well-differentiated mucinous glands infiltrating the ovarian cortex with focal necrosis.Conclusion: Attention should be paid to cervical examinations before and during surgery for cervical mucinous adenocarcinoma with a metastatic ovarian mass as the first manifestation. Such patients may gain a better prognosis after active treatment.Keywords: cervical mucinous adenocarcinoma, metastatic ovarian mucinous adenocarcinoma, solitary ovarian metastasis, occult primary lesion, misdiagnosis, clinicopathological feature

Numerous long noncoding RNAs (lncRNAs) have been identified as powerful regulators of human diseases. The lncRNA FOXD3-AS1 is a novel lncRNA that was recently shown to exert imperative roles in the initialization and progression of several diseases. Emerging studies have shown aberrant expression of FOXD3-AS1 and close correlation with pathophysiological traits of numerous diseases, particularly cancers. More importantly, FOXD3-AS1 was also found to ubiquitously impact a range of biological functions. This study aims to summarize the expression, associated clinicopathological features, major functions and molecular mechanisms of FOXD3-AS1 in human diseases and to explore its possible clinical applications.

Background: As the overall survival of patients with cancer continues to improve, the incidence of second primary malignancies seems to be increasing. Previous studies have shown controversial results regarding the survival of patients with primary lung cancer with previous extrapulmonary malignancies. This study aimed to determine the clinical picture and outcomes of this particular subgroup of patients.Materials and Methods: We included 2,408 patients who underwent pulmonary resection for primary lung cancer at our institute between January 1, 2011 and December 30, 2017 in this retrospective study. Medical records were extracted and clinicopathological parameters and postoperative prognoses were compared between patients with lung cancer with and without previous extrapulmonary malignancies.Results: There were 200 (8.3%) patients with previous extrapulmonary malignancies. Breast cancer (30.5%), gastrointestinal cancer (17%), and thyroid cancer (9%) were the most common previous extrapulmonary malignancies. Age, sex, a family history of lung cancer, and preoperative carcinoembryonic antigen levels were significantly different between the two groups. Patients with previous breast or thyroid cancer had significantly better overall survival than those without previous malignancies. Conversely, patients with other previous extrapulmonary malignancies had significantly poorer overall survival (p < 0.001). The interval between the two cancer diagnoses did not significantly correlate with clinical outcome.Conclusion: Although overall survival was lower in patients with previous extrapulmonary malignancies, previous breast or thyroid cancer did not increase mortality. Our findings may help surgeons to predict prognosis in this subgroup of patients with primary lung cancer.

Cholangiolocarcinoma (CLC) is an extremely rare tumor classified as a subtype of small duct-type intrahepatic cholangiocarcinoma (iCCA). There are few detailed reports on CLC and the prognostic impact of tumor heterogeneity is not clear. Between April 2006 and June 2022, of the 774 primary liver cancer resection cases who presented at Kanazawa University Hospital, 14 patients were pathologically diagnosed with CLC through immunohistochemical analysis of their molecular and biological features. Clinicopathological features and prognoses were evaluated retrospectively. Additionally, tumor heterogeneity was assessed and tumors were classified into pure and partial types according to the CLC component proportion in a single tumor. Chronic liver disease was observed in nine patients (64.3%). All tumors were mass-forming, and pathological R0 resection was achieved in 11 patients (78.6%). Tumor heterogeneity was classified as pure in 11 (78.6%) and partial in three (21.4%) patients. The median follow-up was 59.5 months (12–114 months). There was no difference in the 5-year disease-specific survival rates between the pure and partial (90.0% vs. 100.0%; P=0.200) types, but rates were significantly higher in the R0 resection group compared with those in the R1 resection group (100.0% vs. 50.0%; P=0.025). In conclusion, these results suggest that it is important for CLC patients to achieve curative resection, and CLC may have a good prognosis regardless of the proportion of CLC components in a single tumor. [ABSTRACT FROM AUTHOR]