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Background: This study was to investigate the prevalence of preoperative rim enhancement, and its association with clinicopathological features, relapse, and survival profiles in Chinese basal-like...

As a novel group of non-coding RNAs, long non-coding RNA (lncRNAs) can substantially regulate various biological processes. Downregulated tumor-suppressive lncRNAs and upregulated oncogenic lncRNAs (onco-lncRNAs) have been implicated in gastric cancer (GC) development. These dysregulations have been associated with decreased chemosensitivity, inhibited apoptosis, and increased tumor migration in GC. Besides, growing evidence indicates that lncRNAs can be a valuable diagnostic and prognostic biomarker, and their expression levels are substantially associated with the clinicopathological features of affected patients. The current study aims to review the recent findings of the tumor-suppressive lncRNAs and onco-lncRNAs in GC development and highlight their therapeutic, diagnostic, and prognostic values in treating GC cells. Besides, it intends to highlight the future direction of lncRNAs in treating GC.

Objectives: To analyze intraoperative and postoperative complications according to Clavian-Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent surgery in a tertiary center. Material and methods: We retrospectively reviewed the database of 469 patients that underwent surgery for patients who underwent extra facial TLH from 2013 to 2020. Results: A total of 86 (18.3%) peri-postoperative complications were observed. The incidence of intraoperative complications was 2% (n = 10). The overall conversion rate to open surgery was 1.9% (n = 9). A total of 76 postoperative complications were observed in 61 patients (14.3%). The incidence of minor (Grade I [n = 16, 3.4%] and II [n = 42, 8.9%]) and major complications (Grade III [n = 15, 3.2%], IV [n = 2, 0.4%] and V [n = 1, 0.2 %]) were 12.3% and 3.8%, respectively. A higher BMI and performing surgery at the first step of learning are found to be associated with intraoperative and postoperative complications (p < 0.05). Postoperative complications related to having a history of the cesarean section, additional comorbidities, and uterine weight ≥ 300 g (p < 0.05). Conclusions: The implementation of TLH by experienced surgeons appears to have remarkable advantages over open surgery. However, the risk factor for complications should be taken into account by surgeons in the learning curve in selecting the appropriate patient for surgery.

BACKGROUND: CD10 and CD15 expression has been reported in several tumors. Whether CD10 and CD15 have a role in colorectal mucinous and signet ring adenocarcinoma (MSA) tumorigenesis is not yet known. OBJECTIVE: We aimed to investigate the role of CD10 and CD15 expression in mucinous colorectal adenoma-carcinoma sequence (ACS) and determine if there is any clinical and prognostic significance associated with their expression. METHODS: Seventy-five cases of colorectal MSA, and 9 cases of adenoma samples were collected. Manual TMA blocks were constructed and immunohistochemistry for CD10 and CD15 was done. RESULTS: Compared to adenomas, CD15 expression was significantly higher in MSA (p= 0.002), in contrast to CD10 expression. CD15 positivity was significantly associated with microsatellite stable (MSS) tumors (p= 0.018). The association between CD10 positivity and fungating tumor growth showed marginal significance. Unlike CD10, CD15 positivity showed significant association with overall survival of colorectal MSA patients. CONCLUSIONS: CD15 expression seems to have a role in mucinous colorectal ACS, with significant impact on the survival of MSA patients. Further studies are suggested to identify any genetic alterations that may underlie a potential association with disease progression.

Accumulating evidence support that aberrant methylation of various cancer-related genes plays an important role in the initiation and progression of colorectal cancer (CRC). This study aims to validate the accuracy of methylation specific polymerase chain reaction (MSP) to assess frequency and distribution of GSTP1, CDKN2A, RASSF1A, and WIF1 methylation and analyze their correlation with clinicopathological variables in sporadic adenocarcinomatous CRC. Of the 248 CRC tissues, methylation was identified in 7.7% for GSTP1, 22.2% for CDKN2A, 33.1% for RASSF1A, and 54.4% for WIF1. Hypermethylation of CDKN2A, RASSF1A, and WIF1 was significantly associated with adenocarcinoma (p< 0.001), mucinous adenocarcinoma (p< 0.001), and signet-ring cell adenocarcinoma subtypes (p = 0.017), respectively. Both CDKN2A and WIF1 methylations were more common in stage II (p = 0.012 for CDKN2A and p = 0.010 for WIF1) and absence of lymph node metastasis (p = 0.011 for CDKN2A and p = 0.012 for WIF1) but were less common in stage III (p = 0.016 for CDKN2A and p = 0.010 for WIF1). RASSF1A methylation was associated with moderate differentiation (p = 0.038). These findings suggest that methylation of CDKN2A, RASSF1A, and WIF1 may significantly contribute to CRC pathogenesis and may be considered as valuable biomarkers for accessing the development and progression of particular subtypes of colorectal cancer. [ J Adv Biotechnol Exp Ther 2021; 4(3.000): 305-310]

BACKGROUND Although small colorectal neoplasms (< 10 mm) are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms (≥ 10 mm), some are invasive to the submucosa. AIM To clarify the clinicopathological features of small T1 colorectal cancers. METHODS Of 32025 colorectal lesions between April 2001 and March 2018, a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size: a small group (< 10 mm) and a large group (≥ 10 mm). We compared clinicopathological factors including lymph node metastasis (LNM) between the two groups. RESULTS The incidence of small T1 cancers was 10.1% (116/1152). The percentage of initial endoscopic treatment in small group was significantly higher than in large group (< 10 mm 74.1% vs ≥ 10 mm 60.2%, P < 0.01). In the surgical resection cohort (n = 798), the rate of LNM did not significantly differ between the two groups (small 12.3% vs large 10.9%, P = 0.70). In addition, there were also no significant differences between the two groups in pathological factors such as histological grade, vascular invasion, or lymphatic invasion. CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers, the requirement for additional surgical resection should be determined according to pathological findings, regardless of tumor size.

Background Metabolic syndrome (MetS) was a risk factor for papillary thyroid cancer (PTC). Whether MetS impacts the aggressiveness of PTC is still unclear. We carried out this study to clarify this issue. Methods We evaluated 745 consecutive PTC patients treated with surgery. Patients were divided into three groups based on their number of MetS components: patients without any MetS components, patients with 1–2 MetS components, and patients with 3–5 MetS components. The clinical features and histological aggressiveness of PTC at the time of diagnosis were evaluated. Results A total of 745 patients were included in this study. And, 145 patients had three or more metabolic components and were diagnosed as MetS. MetS was a risk factor for larger tumors (OR = 2.29, 95% CI: 1.31–4.03), more lymph node metastasis (OR = 1.97, 95% CI: 1.11–3.51), and later clinical stage (OR = 7.92, 95% CI: 1.59–39.34) after correction for age, sex, and thyroid-stimulating hormone (TSH) level and body mass index (BMI). Conclusion In our hospital-based cohort study MetS was associated with the aggressiveness of PTC. This association was still significant after adjusting for age, sex, TSH, and BMI.

Jiaqi Zhang, Yeye Chen, Lei Liu, Mengxin Zhou, Cheng Huang, Chao Guo, Shanqing Li Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of ChinaCorrespondence: Shanqing LiDepartment of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel +86 13801388072Fax +86 1069152632Email lishanqing@pumch.cnBackground: Given the lack of evidence-supported guidance for therapeutic recommendations of primary mediastinal malignant germ cell tumors (PMMGCTs), our study aimed to investigate the clinicopathological features, treatment strategies, and prognostic factors of PMMGCTs.Methods: We carried out a consecutive retrospective evaluation on a series of patients diagnosed with PMMGCTs in Peking Union Medical College Hospital from January 2000 to August 2020.Results: A total of 58 patients were eligible, consisting of 51 males and seven females. There were 15 patients with seminomas, 39 with nonseminomatous germ cell tumors (NSGCTs), and four with mixed germ cell tumors (GCTs). The 5-year overall survival was 45%, with a median survival time of 32.37 months. Except for the lost follow-up of seven patients, a univariate analysis of overall survival on the remaining patients showed significant differences in pathological type (mixed GCTs were regarded as NSGCTs) (p=0.036), tumor size (> 11cm) (p=0.006), and other sites metastases (OSM) (p=0.001), respectively. Multivariate Cox regression analysis revealed that OSM and surgical resection were independently associated with overall survival in all kinds of PMMGCTs.Conclusion: OSM was an independent risk factor for patients with PMMGCTs. Surgery was proved to contribute to long-term survival. More in-depth clinical evidence is urgently needed to guide the treatment of PMMGCTs.Keywords: primary mediastinal malignant germ cell tumors, surgery, prognosis

Introduction: Pilomatrixoma is a relatively rare, benign tumor arising from the hair root matrix. It is found frequently on the head and neck, with most involving the eyebrow in the periocular region. In contrast, eyelid pilomatrixoma is less common, and often clinically misdiagnosed. Here, we present clinical and histological data from 19 pilomatrixomas arising in the eyelid. Methods: The study represents a retrospective study of eyelid pilomatrixoma diagnosed at our institution since 1981. All slides were reviewed, and demographic as well as clinical data were obtained. Results: Patient ages ranged from 2 to 63 years (mean 24 years), including 12 (63%) females and 7 (37%) males. Eight (42%) and 4 (21%) cases arose in the first and second decades of life, respectively. Upper eyelid involvement was found in 14 (74%) of cases. Microscopically, the tumors were characterized by basaloid and shadow cells accompanied by calcification and foreign body giant cells. Conclusions: Eyelid pilomatrixoma is rarely suspected clinically, and can be mistaken for cyst, chalazion, sebaceous carcinoma, and other tumors. Physicians should consider the possibility of pilomatrixoma in the eyelid area, especially in children or young female patients. Complete excision is curative, and diagnosis can generally be established by histopathological examination.

BACKGROUND Ovarian carcinoma is one of the most lethal malignancies. Their histogenesis and complex pathogenesis remain largely unknown in spite of the many studies and research carried out in the field. The receptors for female sex hormones are implicated in the pathogenesis of ovarian tumours in many studies. This concept points out the necessity of developing a highly affected targeted therapy, which requires a proper understanding of the pathogenesis of the tumours. This study was done to evaluate the expression of these receptors on the primary epithelial tumours of the ovary and explore the possible correlation with clinical and pathological features. METHODS A hundred cases of primary epithelial tumours of the ovary were selected; tissue samples were taken from appropriate areas and processed. Tissues were cut into sections of three to five-micron thickness. Sections from the tissues were stained and examined. Once the histological type was clear, the receptor expression was assessed with immunohistochemistry markers. RESULTS Among the hundred tumours studied, serous tumours were the commonest, accounting for 65 % followed by mucinous tumours which constituted 34 %. Clear cell tumours accounted for 1 %. Endometrioid and transitional cell tumours were still rarer. Among these, oestrogen receptor (ER) was expressed in 78.5 % of serous tumours and progesterone receptor (PR) was expressed in 64.6 % of serous tumours. CONCLUSIONS Serous tumours were seen to show maximum expression of the hormone receptors among the surface tumours of ovaries. Furthermore, the expression of the receptors was more consistently seen in high-grade tumours. This finding may be of help in designing personalized hormone therapy in epithelial tumours. KEY WORDS Surface Epithelial Tumours, Receptors, ER, PR.

Background We aimed to analyze the clinicopathological features and outcomes of patients with gastric-type of HPV-independent endocervical adenocarcinoma (GAS HPVI ECA), and compare them with non-GAS HPVI ECA cases. Methods Thirty-eight GASs [including 17 minimal deviation adenocarcinoma (MDA), 21 non-MDA GAS] and 17 non-GAS HPVI ECAs were studied. Data of clinical features, pathological characteristics, treatment, and outcomes were evaluated. Results The median age of patients with GAS and non-GAS HPVI ECA was 46 and 48 years, respectively (p = 0.93). Compared with non-GAS HPVI ECAs, GAS had more common complains of vaginal watery discharge (p = 0.04). GAS cases were also associated with higher clinical stage (p = 0.036), more common in deeper cervical stromal invasion (p = 0.002) and lymphoavascular invasion (p = 0.044). GAS was associated with worse median progression-free survival (PFS) (p = 0.02) and median overall survival (OS) (p = 0.03) over patients with non-GAS HPVI ECAs. MDA had similar clinical and pathological features and prognosis compared with non-MDA GAS. Of note, serum CA19–9 levels were significantly higher in GAS than that in non-GAS HPVI ECA cases. Conclusions GAS cases were more likely to have high risk pathological factors and poorer PFS and OS compared with non-GAS HPVI ECAs. Serum CA19–9 may be helpful for diagnosis and screening in patients with GAS.

Background Combined small cell lung cancer (c-SCLC) distinguishes itself from small cell lung cancer (SCLC) due to its inclusion of both SCLC and non-small cell lung cancer (NSCLC) components. Few studies have compared clinicopathological characteristics, prognosis and factors affecting survival. We therefore addressed the issues in this study. Patients and Methods A total of 400 c-SCLC and 20,841 SCLC patients were enrolled using SEER database. Difference in clinicopathological characteristics of SCLC and c-SCLC patients was analyzed using chi-square. Kaplan–Meier was applied to compare their survival before and after propensity score matching (PSM). Cox regression model was adopted to assess the impact of different clinical variables on survival. Logistic regression was applied to identify risk factors for c-SCLC and SCLC patients. Results Differences in race, sex, T stage, N stage, surgery, bone, brain and liver metastasis were detected between c-SCLC and SCLC patients. c-SCLC patients had better overall survival (OS) than SCLC patients before PSM. Age, race, sex, T stage, N stage, surgery, bone, brain, liver and lung metastasis were prognostic factors affecting OS for c-SCLC and SCLC (P < 0.05). However, a significant OS benefit was not observed in c-SCLC after adjusting for clinicopathological variables (HR, 0.950; 95% CI, 0.842–1.073; P=0.411). No significant OS difference was found between c-SCLC and SCLC patients after PSM (P = 0.789). c-SCLC patients had lower risk of lymph node (OR: 0.555; 95% CI: 0.439–0.703; P < 0.001) and liver metastasis (OR: 0.591; 95% CI: 0.448–0.779; P < 0.001), whereas had no significant differences in bone and brain metastasis risks (P > 0.05) compared with SCLC patients. Conclusion The prognosis of c-SCLC did not significantly differ from that of SCLC if clinicopathological characteristics are controlled. Better prognosis for c-SCLC patients over SCLC patients may be ascribed to fewer liver and lymph node metastases upon diagnosis.

Our knowledge in vascular anomalies has grown tremendously in the past decade with the identification of key molecular pathways and genetic mutations that drive the development of vascular tumors and vascular malformations. This has led us to better understand the pathogenesis of vascular lesions, refine their diagnosis and update their classification while also exploring the opportunity for a targeted molecular treatment. This paper aims to provide an overview of venous malformations (VM) in childhood. Specific entities include common VMs, cutaneo-mucosal VM, blue rubber bleb nevus syndrome or Bean syndrome, glomuvenous malformation, cerebral cavernous malformation, familial intraosseous vascular malformation and verrucous venous malformation. The clinicopathological features and the molecular basis of each entity are reviewed.

INTRODUCTION The aim of this study was to determine the impact of preoperative prognostic nutritional index (PNI) value and skeletal muscle area (SMA) on short-term outcomes of patients with gastric cancer. PATIENTS AND METHODS A total of 107 patients underwent gastrectomy due to gastric cancer between January 2016 and December 2019 were retrospectively analyzed. The patients were divided into groups according to the determined PNI and SMA cutoff values. Clinicopathological features and short-term results were compared. RESULTS Overall morbidity was 29% (n = 31) in patients who underwent gastrectomy. Preoperative PNI value was ranged from 24.5 to 61.5 (median, 49.5). Preoperative SMA values were ranged respectively from 55.7 to 142 (median, 98.9) in women and 77.5 to 203.3 (median, 129.3) in men. It was observed that the risk of postoperative complications increased in patients with low PNI (OR 0.270, p = .003). The average postoperative length of hospital stay was 12.1 days. The longer postoperative hospital stay was seen in lower PNI group (PNI ≤ 48, 15.1 days vs. PNI> 48, 10 days; p = .033). Clavien-Dindo classification was high in patients with low PNI and sarcopenia (PNI ≤ 48, p = .004 and Sarcopenia, p = .006). Likewise, mortality was significantly increased in patients with low PNI and sarcopenia (PNI ≤ 48, 20% vs. PNI > 48, 0%; p

Aims Perivascular epithelioid cell tumours (PEComas) are rare mesenchymal tumours that coexpress smooth muscle and melanocytic markers. They have a predilection for gynaecological organs, where they present a unique diagnostic challenge, because of morphological and immunohistochemical overlap with more common smooth muscle and stromal tumours. Limited information regarding the natural history, owing to the rarity of this tumour, makes accurate risk stratification difficult. We aimed to review clinicopathological features of gynaecological PEComa and compare accuracy of five different classification systems for prediction of prognosis. Methods and results We have described the clinicopathological features of 13 new cases and tested five prognostic algorithms in a total of 67 cases of gynaecological PEComa. Receiver operating characteristic curves were constructed and areas under the curve (AUCs) were calculated to evaluate predictive accuracy. The modified gynaecological-specific algorithm showed high sensitivity and specificity and yielded the highest AUC (0.864). It's earlier version, the gynaecological-specific algorithm, suffered from lower specificity (AUC = 0.843). The post-hoc McNemar test confirmed significant differences between the performances of the modified gynaecological-specific algorithm and the gynaecological-specific algorithm (P = 0.008). The original Folpe algorithm for PEComas of all sites showed low specificity, had a lower AUC (0.591), and was inapplicable in 18% of cases. Its two later versions (the revised Folpe algorithm and the modified Folpe algorithm) also yielded lower AUCs (0.690 and 0.591, respectively). Conclusion We have shown that the modified gynaecological-specific algorithm predicts the clinical outcome of gynaecological PEComa with high accuracy, and have validated its use for prognostic stratification of gynaecological PEComa.

Dysplasia and intramucosal esophageal squamous cell carcinoma (ESCC) frequently go unnoticed with white-light endoscopy and, therefore, progress to invasive tumors. If suitable targets are available, fluorescence molecular endoscopy might be promising to improve early detection. Microarray expression data of patient-derived normal esophagus (n = 120) and ESCC samples (n = 118) were analyzed by functional genomic mRNA (FGmRNA) profiling to predict target upregulation on protein levels. The predicted top 60 upregulated genes were prioritized based on literature and immunohistochemistry (IHC) validation to select the most promising targets for fluorescent imaging. By IHC, GLUT1 showed significantly higher expression in ESCC tissue (30 patients) compared to the normal esophagus adjacent to the tumor (27 patients) (p &lt, 0.001). Ex vivo imaging of GLUT1 with the 2-DG 800CW tracer showed that the mean fluorescence intensity in ESCC (n = 17) and high-grade dysplasia (HGD, n = 13) is higher (p &lt, 0.05) compared to that in low-grade dysplasia (LGD) (n = 7) and to the normal esophagus adjacent to the tumor (n = 5). The sensitivity and specificity of 2-DG 800CW to detect HGD and ESCC is 80% and 83%, respectively (ROC = 0.85). We identified and validated GLUT1 as a promising molecular imaging target and demonstrated that fluorescent imaging after topical application of 2-DG 800CW can differentiate HGD and ESCC from LGD and normal esophagus.

Increasing recognition of the heterogeneous nature of endometrial cancer, the excellent prognosis of low-risk cases and improvements in risk stratification offer opportunities for innovative, personalised follow-up strategies. This review article outlines the evidence base for alternative follow-up strategies in the different risk categories of endometrial cancer, cancer survivorship programmes and considers future directions in endometrial cancer follow-up, including emerging new techniques, such as the liquid biopsy, and opportunities for combining molecular and clinicopathological features to personalise endometrial cancer follow-up.

Recently, mutation profiles provided new insights into comprehensive understanding of TC biology by Next Generation Sequencing (NGS). We explored association between mutation profiles and clinicopathological features in Chinese patients with thyroid cancer (TC). Two hundred and twenty‐five formalin‐fixed, paraffin‐embedded tissue specimens from surgically removed thyroid samples were detected with 15 target genes by NGS. Mutation profiles and clinicopathological features were analyzed. Two hundred and seven mutations including two hundred mutations in 81.40% papillary thyroid carcinoma samples, three mutations in 50.00% MTC samples, and four mutations in 100% anaplastic thyroid carcinoma samples were detected. There were 19.56% samples without any mutations in target genes, 69.78% samples harbored mutations in single gene, 9.78% samples carried two gene mutations, and 0.89% samples had triple different gene mutations. For PTC, BRAF mutations were predominant, TERT mutations are more prevalent in advanced PTC and RET fusion was only observed among the PTC. For MTC, RET point mutations were predominant. For samples carried more than one gene mutations, the allelic frequency of mutants were almost similar. Multiple mutations in TC patients were significantly more frequent in cases of patients aged 55 and over (p

Background Growing evidence encourages the preventive role of vitamin D in pancreatic carcinoma (PC). Meanwhile, the prognostic or predictive role needs more investigations. This study aimed to evaluate the correlation between serum vitamin D levels and the clinicopathological features with the outcome in advanced pancreatic carcinoma (APC). Materials and methods The current prospective study included 176 patients with APC. Assessing 25-hydroxy vitamin D is the most accurate method to measure the serum vitamin D levels. Serum vitamin D levels Results Serum vitamin D insufficiency and deficiency were detected in 28.4% and 31.8%, respectively. A large tumor size, higher grade, liver metastasis, higher serum level of CA 19-9, poor ECOG PS, and low overall response rate (ORR) were associated with lower serum vitamin D levels (p = 0.000). The median follow-up period was 7.6 months (range 0.6–18.6). The ORR was 23.2%, 54%, and 82.9% of vitamin D deficiency, insufficiency, and normal levels of vitamin D, respectively. The median OS was 11.4 months for patients with normal serum vitamin D levels, compared with 2.7 and 7.03 months for serum vitamin D deficiency and insufficiency, respectively. Conclusions Among patients with APC, serum vitamin D levels are considered a promising prognostic factor. It is associated with various poor prognostic features and worse survival outcome.

Purpose An increasing number of studies have reported a significant association between long non-coding RNAs (lncRNAs) dysregulation and pancreatic cancers. In the present study, we aimed to gather articles to evaluate the prognostic value of long non coding RNA in pancreatic cancer. Experimental design We systematically searched all eligible articles from databases of PubMed, Web of Science, and Scopus to meta-analysis of published articles and screen association of multiple lncRNAs expression with clinicopathology and/or survival of pancreatic cancer. The pooled hazard ratios (HRs) and their 95% confidence intervals (95% CIs) were used to analysis of overall survival, disease-free survival and progression-free survival were measured with a fixed or random effects model. Results A total of 39 articles were included in the present meta-analysis. Our results showed that dysregulation of lncRNAs were linked to overall survival (39 studies, 4736 patients HR = 0.41, 95% CI 0.25 ± 0.58, random-effects in pancreatic cancer. Moreover, altered lncRNAs were also contributed to progression-free survival (8 studies, 1180 patients HR: 1.88, 95% CI (1.35–2.62) and disease-free survival (2 studies, 285 patients, HR: 6.07, 95% CI 1.28–28.78). In addition, our findings revealed the association between dysregulated RNAs and clinicopathological features in this type of cancer. Conclusions In conclusion, dysregulated lncRNAs could be served as promising biomarkers for diagnosis and prognosis of pancreatic cancer.

RAS mutations (HRAS, NRAS, and KRAS) are among the most common oncogenes, and around 19% of patients with cancer harbor RAS mutations. Cells harboring RAS mutations tend to undergo malignant transformation and exhibit malignant phenotypes. The mutational status of RAS correlates with the clinicopathological features of patients, such as mucinous type and poor differentiation, as well as response to anti-EGFR therapies in certain types of human cancers. Although RAS protein had been considered as a potential target for tumors with RAS mutations, it was once referred to as a undruggable target due to the consecutive failure in the discovery of RAS protein inhibitors. However, recent studies on the structure, signaling, and function of RAS have shed light on the development of RAS-targeting drugs, especially with the approval of Lumakras (sotorasib, AMG510) in treatment of KRASG12C-mutant NSCLC patients. Therefore, here we fully review RAS mutations in human cancer and especially focus on emerging strategies that have been recently developed for RAS-targeting therapy.

Objective Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

Objective: This cross-sectional study aims to report the clinicopathological features of Gulf Cooperation Council (GCC) patients with Gastric Cancer (GC). Patients and Methods: This cross-sectional study evaluated patients from GCC countries presenting with GC, treated at the University of Texas MD Anderson Cancer Center, Houston, Texas from 1981 to 2015. After obtaining an Institutional Review Board (IRB) approval to conduct this cross-sectional study, the data were collected from the charts of 96 consecutive GCC patients diagnosed with GC according to electronic and paper medical records (for cases prior to the implementation of the electronic medical records): The charts were reviewed for demographic data, clinical data, diagnostic tools, endoscopic location of the tumour and clinicopathological features of the GC. Statistical analyses were performed by using SPSS version 20. Numerical data were presented as mean +/- standard deviation (SD) (For normally distributed data); median and range (For not normally distributed data). Nominal data were expressed by percentages. Results: 96 patients identified with histologically confirmed gastric carcinoma from Saudi Arabia (KSA) (40%), UAE (26%), Qatar (16%) Kuwait (10%), Oman (3%) and Bahrain (2%). The median age was 54.5 years and 40 patients (42%) were less than 50 years of age. 61% of the patients were of male gender and 39% were female. Intestinal type was the most common histological type in 61% of cases, 30% had signet cell histology. The aggressive signet ring histology is the most common (71.4%) in younger patients (Age < 50) in this cohort. Out of those 28 patients tested for HER-2 amplification, 6 (20%) were found to be amplified. Finally, 76% of the patients presented with stage IV disease. Conclusion: GC tends to present in advanced stages in GCC population with median duration from first symptoms to diagnosis was 9.3 months (2 to 18 months). GC in patients from GCC countries is diagnosed at 10 years earlier than in Western population. Intestinal‐type histology is most common similar to the western population, yet aggressive histology (signet ring) is high in younger population. HER-2 amplification rate is similar to Western populations. This is the first study to report these findings in GCC population with gastric cancer. Further collaboration and research are needed across the GCC countries to better characterize GC in this region and to understand the early onset pattern of GC observed in this report.

Background: Even with the advances in the diagnosis and treatment of breast malignancy, to date breast cancer is still the number one cause of death in women in Pakistan. Various researches proved that prolonged inflammatory conditions played a part in progression of malignancy, these factors also promote growth leading to poor prognosis. This study shows the analysis of peripheral blood neutrophil to lymphocyte ratio (NLR) in breast malignancy and its association with disease characteristics Methods: The cross-sectional study was done in Liaquat National Hospital and Medical College, Karachi. Pakistan. A total of 2059 female patient population with breast cancer hit the criteria. The patients were asked to undergo a complete blood count with leukocyte differential preoperatively. Patients’ complete data was collected preoperatively including specimen-related histopathology reports. Patients excluded were those with clinical evidence of ongoing active infection/sepsis, any blood disorders, any previous or ongoing inflammatory or autoimmune diseases, and steroid therapy. Results: No association was seen between the NLR with the age, grade, and luminal subtypes. However, NLR had a significant association with the size and stage of the disease. With an increase in NLR, the stage increased. Conclusion: The study identifies the usefulness of the NLR ratio, which in the future can be used as a diagnostic adjunct in the preoperative workup of patients with breast malignancy.

Immunosuppressed patients may be affected by a wide range of lymphoproliferative disorders (LPDs) ranging from self-limiting disorders to malignant lymphoid proliferations. These LPDs may be associated with systemic immune disorders, develop following organ transplantation or occur in the background of other forms of iatrogenic immunosuppression. Lymphotropic viruses, including Epstein-Barr virus (EBV) and human herpesvirus-8 (HHV8), have been associated with the pathogenesis of distinct LPDs. The resulting classification of this group of disorders is very complex and inconsistent, with several new and emerging entities. Consequently, the diagnosis of an LPD, especially in an immunosuppressed patient, and its subsequent clinical management usually represent an important pitfall in daily clinical and pathology work. Therefore, the aim of this review was to use the available literature to describe the clinicopathological features of the most important benign LPDs that may be diagnosed in the head and neck region of immunosuppressed patients. Original clinical and microscopic images were used to illustrate some of these entities.

IL-6 is reported to be the main upstream activator, instead of the downstream target of JAK2/STAT3. This study is intended to explore the correlation of IL-6 and JAK2/STAT3 signaling pathway with clinicopathological features and prognosis in nasopharyngeal carcinoma (NPC). First, NPC tissues and normal nasopharyngeal epithelial tissues were obtained from 117 NPC patients. Next, we detected expression levels of IL-6 in serum and those of STAT3, p-STAT3, JAK2, p-JAK2 and CyclinD1 in tissues. A follow-up was conducted in all the patients and the survival was analyzed. To verify the correlation of IL-6 and JAK2/STAT3 pathway, CNE-1 and SUNE1 NPC cells were interpreted with IL-6 and JAK2/STAT3 signaling pathway inhibitor AG490 to detect cell viability, migration and invasion. We observed thatIL-6 increased in serum of NPC patients. The expressions of IL-6, STAT3, p-STAT3, JAK2, p-JAK2 and CyclinD1 in NPC tissues were higher and correlated with TNM stage and lymph node metastasis (LNM). Survival rates were reduced in patients with positive expressions of IL-6, STAT3, p-STAT3, JAK2, p-JAK2 and CyclinD1. LNM and positive expressions of IL-6 and p-STAT3 were risk factors for poor prognosis of NPC. Besides, recombinant human IL-6 promoted cell proliferation, invasion and migration while AG490 inhibited cell proliferation, invasion and migration in CNE-1 and SUNE1 NPC cells. The results demonstrated that increased IL-6 expression and the activated JAK2/STAT3 signaling pathway had effects on prognosis and reduced the survival time in NPC patients, which provide a potential target for the treatment of NPC.

Objectives: This study aimed to report the clinicopathological features, management and long-term outcomes of patients with gastrointestinal stromal tumours (GISTs) in Oman. Methods: This retrospective study was conducted on patients treated for GIST between January 2003 and December 2017 at three tertiary referral centres in Muscat, Oman. All patients with confirmed histopathological diagnoses of GIST and followed-up at the centres during this period were included. Relevant information was retrieved from hospital records until April 2019. Results: A total of 44 patients were included in the study. The median age was 55.5 years and 56.8% were female. The most common primary site of disease was the stomach (63.6%) followed by the jejunum/ileum (18.2%). Two patients (4.5%) had c-Kit-negative, discovered on GIST-1-positive disease. A total of 24 patients (54.5%) presented with localised disease and eight (33.3%) were classified as being at high risk of relapse. Patients with metastatic disease received imatinib in a palliative setting, whereas those with completely resected disease in the intermediate and high-risk groups were treated with adjuvant imatinib. Of the six patients (13.6%) with progressive metastatic disease, of which four had mutations on exon 11 and one on exon 9, while one had wild-type disease. Overall, rates of progression-free survival and overall survival (OS) at 100 months were 77.4% and 80.4%, respectively. Rates of OS for patients with localised and metastatic disease were 89.9% and 80.2%, respectively. Conclusion: The presenting features and outcomes of patients with GISTs in Oman were comparable to those reported in the regional and international literature. Keywords: Gastrointestinal Stromal Tumors; Proto-Oncogene Proteins c-kit; Protein Kinase Inhibitors; Imatinib; Adjuvant Chemotherapy; Survival Rate; Oman.

Background and Objectives Primary diaphragm tumors are rare. The aim of this study was to explore the clinicopathological features of primary diaphragm tumor patients who underwent surgical treatment in our center to improve the diagnosis and treatment of this disease. Methods Clinical data of patients with primary diaphragm tumor who underwent surgery in our hospital from 2004 to 2019 were reviewed and analyzed. Results A total of 18 patients were enrolled. The male:female ratio was 8:10, and the median age was 58 years old (35–74 years old). Most patients included in this study had no typical clinical symptoms. Nine tumor cases were distributed in the left and right diaphragms separately, whereas 11 cases were located at the diaphragm angle. The diaphragm of 12 patients was reconstructed by direct suture. All postoperative pathologies showed that the tumors were benign, and cysts were observed in most of the cases (5/18). Conclusions There are no difference in distribution of gender and distribution on both sides of the diaphragm. In addition, primary diaphragm tumor is common in middle‐age patients. Most cases occur in the diaphragm angle and are characterized by cyst lesions. Surgical resection is an effective treatment option for primary diaphragm tumor., The aim of this study was to explore the clinicopathological features of primary diaphragm tumor patients who underwent surgical surgery in our center. We reviewed and analyzed clinical data of patients with primary diaphragm tumor who underwent surgery in our center from 2004 to 2019. A total of 18 patients were enrolled. We found most patients included in this study had no typical clinical symptoms. Nine tumor cases were distributed in the left and right diaphragms separately, whereas 11 cases were located at the diaphragm angle. All postoperative pathologies showed that the tumors were benign, and cysts were observed in most of the cases.

Background: Interleukin-6 (IL6) is one of the main cytokines produced by cancer-associated fibroblasts (CAFs). IL6 is linked with cancer progression and poor prognosis by activating cancer cells and modifying the cancer microenvironment. However, little is known about the expression of IL6 in tumor budding (TB) and its association with TB in colorectal adenocarcinoma. Methods: The clinicopathological and prognostic significance of IL6 in TB was examined using a tissue microarray consisting of 36 patient samples of TB in CA. IL6 mRNA was detected by RNAscope kit. Patients were stratified into negative and positive IL6 expression groups. Results: IL6 expression was overwhelmingly observed in CAFs but was negligible in cancer cells. In the IL6-positive group in CAFs, TB grade was higher than in the IL6-negative group (P=0.0161). There was a significant difference in overall survival (OS) between CA cases in the IL6-positive group and the IL6-negative group (log rank test, P=0.0367). Cox proportional hazard regression model revealed that the IL6-negative group (OR = 0.25; 95% CI: 0.05–0.96; P=0.0440) had better OS for CA than the IL6-positive group. Conclusions: TB may be affected by IL6 expression, and IL6 expression in CAFs at TB may make IL6 an important prognostic marker.

Background "Diffuse midline glioma, H3 K27M-mutant" (DMG) mainly arises within the pontine, thalamic, and spinal cord regions. Because of the rarity of spinal cord gliomas, the general knowledge surrounding DMGs is mainly based on pontine and thalamic gliomas, whereas tumor location tends to influence the clinicopathological features and prognosis. Objective To determine the clinicopathological characteristics and molecular profiles of DMGs located in the spinal cord. Methods The clinical and molecular pathologic features and prognosis were comprehensively analyzed in a series of 44 patients with spinal cord DMGs. Results The median age was 36 yr, and 88.7% of patients (39/44) were adults (≥18 yr). Histopathologically, malignant grades included grade II (16 cases), grade III (20 cases), and grade IV (8 cases). Compared with patients with histological grade IV, patients with lower histological grade (grade II/III) were older (37 vs 24 yr, P = .020) and were associated with longer overall survival (24.1 vs 8.6 mo, P = .007). All 30 tested tumors were isocitrate dehydrogenase (IDH) wild type, and 96% of cases (22/23) presented with unmethylated O6-methylguanine-DNA methyltransferase. Univariate and multivariate analyses showed that histological grade and presurgery McCormick Scale scores were independent prognostic factors for overall survival, whereas extensive surgical resection and chemoradiotherapy were not significantly associated with improved survival. The most frequent anatomic locations were the cervical enlargement (C4-T1, n = 16) and conus medullaris (T12-L1, n = 13), which exhibited distinctive clinical characteristics and molecular features. Conclusion The findings provide guidelines for the evidence-based practice of the specialized management of spinal cord DMGs.

Background Programmed cell death ligand 1 (PD-L1) is a known prognostic and therapeutic marker in malignant tumors. This meta-analysis aimed to investigate the association of PD-L1 expression with the clinicopathological parameters and survival outcomes of gastrointestinal neuroendocrine neoplasms (NENs). Methods PubMed, EMBASE, Web of Science, OVID Medline, the Cochrane Library, and Google Scholar were searched for relevant studies June 30, 2020. Studies reporting PD-L1 immunohistochemistry of gastrointestinal NEN with associated survival data or clinicopathological parameters were included. Results In total, 10 studies were included. Odd ratios (ORs) were combined to evaluate association between PD-L1 expression and clinicopathological parameters. Hazard ratios (HR) and standard errors were combined to evaluate the association between PD-L1 expression and overall survival. PD-L1 expression was significantly associated with higher tumor grade [OR: 3.42; 95% confidence interval (CI): 2.00–5.85, P

Background/aim The histopathological variability of each type of pituitary adenoma (PA) that causes growth hormone (GH) excess influences the phenotype, radiological characteristics and therapy response of acromegaly patients. We correlated the immunohistochemical (IHC) features of GH-secreting PAs with their clinical, laboratory and imaging data. Patients and methods We included 32 patients with documented acromegaly; tumour specimens were histologically and IHC examined: anterior pituitary hormones, pituitary-specific transcription factor-1 (PIT-1), Ki-67 labelling index were evaluated. Results Macroadenomas represented 93.75%. Post-surgery disease control negatively correlated with the maximum initial tumour diameter (p=0.04). Ki-67 did not predict remission. No correlation was found between GH serum levels and IHC expression (p=0.45). PIT-1 was positive in all specimens, two had a weak expression. Four were considered PIT-1 positive plurihormonal adenomas and several had unusual IHC combinations. Conclusion PIT-1 accurately classifies GH-secreting PAs. The IHC classification as well as radiological dimensions and extent influence disease control, probably being the best prognosis factors.

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is categorized into four distinct types: the gastric, intestinal, pancreatobiliary, and oncocytic. Each type is associated with specific clinicopathological features. We aimed to uncover the molecular mechanisms underlying the development of these types of IPMN. We obtained 103 lesions of various types, including 49 gastric, 26 intestinal, 22 pancreatobiliary, and 6 oncocytic lesions, from 43 IPMNs, including 36 with multiple types. Comparative analysis was performed by targeted sequencing of 37 genes in different lesion types within each pancreas. Gastric-type low-grade lesions were observed in all 36 tumors with multiple types, with 245 mutations identified across all samples. The average number of mutations was significantly different between different lesion grades and types: 1.88 for low-grade lesions, 2.77 for high-grade lesions, and 2.38 for invasive lesions (p = 0.0067); and 1.96 for gastric-type lesion, 2.92 for intestinal-type lesion, 2.73 for pancreatobiliary-type lesion, and 2.17 for oncocytic-type lesion (p = 0.0163). Tracing of mutations between lesions containing multiple types in the same pancreas suggested three developmental pathways, denoted as “progressive”, “divergent”, and “independent”. The progressive and divergent pathways indicate an ancestral lesion that was mostly gastric-type and low-grade may progress or diversify into lesions of other types and/or higher grades. The independent pathway suggests that some high-grade lesions of any type may develop independently. These findings suggest that gastric-type low-grade lesions have a risk of progression into high-grade lesions of other types. Therefore, low-grade gastric-type IPMNs should be under constant surveillance.

Background: RET (rearranged during transfection) is a transmembrane receptor tyrosine kinase and a receptor for the GDNF-family ligands. It plays the role of a tumor suppressor in colorectal cancer. Therefore, it is expected that RET gene becomes downregulated in colorectal cancer (CRC). In this study, we evaluated immuno-histochemical expression of RET in CRC and assessed its correlation with some of the clinicopathological features to study the prognostic value in CRC. Materials and Methods: In total, 60 cases of colorectal cancer (CRC) from the patients who underwent surgical gastroenterology operations were randomly selected. The samples included one tumor-rich section per case and one adjacent tumor-free section as the normal control for that case. Then, immunohistochemistry (ICH) was performed for RET on all the samples and the expression of RET was analyzed. Furthermore, the correlation of RET with clinicopathological features including age, gender, location of the tumor, grade, and stage was evaluated. Results: The expression of RET caused significant downregulation in cancer samples compared to the normal control ones (P = 0.002). This downregulation increased in correlation to both grade and metastasis to lymph nodes (P = 0.03 & 0.02 respectively). However, no correlation was found between the expression of RET and gender as well as location of the tumor. Conclusion: RET may be considered as a protein marker in CRC detection and prognosis.

Introduction- Colorectal carcinoma is common tumor with sporadic as well as familial association like Familial Adenomatous Polyposis (FAP) MUTYH-associated polyposis (MAP) and Lynch syndrome. Genetic analysis remains the gold standard for diagnosis of familial colorectal carcinomas. Aim- The present study was conducted in a tertiary care cancer hospital in India to evaluate Clinicopathological features in resected cases of colorectal cancer cases and their correlation withMLH1, MSH2, MSH6 & PMS2 by Immunohistochemistry. Material & Methods- The present study was carried out in department of pathology at regional cancer tertiary centre from February 2019 to June 2020. The cases were selected on basis of inclusion & exclusion criteria.MSH2, MSH6, MLH1 & PMS2 was assessed in all 100 cases, Results- The average age of the patients suffering from colorectal carcinoma (53 years) with male preponderance was noted. (M:F=1.9:1). Most common clinical symptoms were Abdominal pain (82%) . 9% of patient had a family history of cancer ( 5% GIT and 4% Non-GIT). Serum CEA level was ranging from 0.39 to 475. Mean CEA level was 28.3 and with 43.8 standard deviation. Ulceroproliferative (53%) is the most common type of growth pattern. Most common type was Adenocarcinoma (NOS) 70% & most common grade was Moderately Differentiated (56%). Intratumoral Lymphocytic response (ITL) was seen in 78% cases.70% cases were in < 10% range & 8% cases were in >10% range. Most common tumor stage was T3 (57%) & most common TNM stage was stage II (42%). Lymph node metastasis was seen in 42% cases. Out of 100 cases, 86% cases were MMR procient & 14% cases were MMR decient. We found combined loss of (MSH2+MSH6) in 3 cases (21.4%) , combined loss of (MLH1+PMS2) in 5 cases (35.7%), Combined loss of all the 4 markers in 2 cases (14.3%), Isolated loss of MSH2 in 1 (7.14%), & Isolated loss of MSH6 in 1 (7.14%), isolated loss of MLH1 in 1 (7.14%) & isolated loss of PMS2 in 1 (7.14%). Conclusion- MSI cases correlated with Family history of cancer, Moderate degree of Differentiation, Adenocarcinoma (NOS) type, Intratumoral Lymphocytic Inltrate, Ulceroproliferative growth pattern & Right side lesion. There was no difference in MMR protein loss based on patients age, gender, treatment history, tumor stage , lymph node metastasis & TNM staging. The Clinicopathological features and IHC dictate in selection of cases for MSI testing in a resource limited developing countries where lack of expertise and cost are concerns.

Leydig cell tumours (LCT) are rare testicular neoplasms that usually follow a benign clinical course. Due to the aggressive, difficult-to-treat nature of metastatic disease arising from a small percentage of LCTs, it is imperative to understand and recognize how to identify those tumours which exhibit features that predict malignant behaviour in order to guide initial surgical and oncological management. By using the well-described high-risk histopathological features of Leydig cell tumours as guidance, the management of LCTs has evolved to commonly include testis-sparing surgery (TSS), in patients who historically would have undergone a complete orchidectomy. Thus, assessment of the clinicopathological features of Leydig cell tumours allows for optimal management of this rare disease, whilst modern technologies and surgical techniques have altered the potential treatment landscape. This does not replace the need for the urologist and medical oncologist to remain vigilant in the risk-stratification of patients presenting with these rare testicular sex cord stromal tumours. We present three cases of patients diagnosed with Leydig cell tumours in a single institution in Dublin, Ireland, between 2016 and 2020 and discuss how the clinicopathological features dictate the management and subsequent follow-up for patients presenting with these rare tumours.

The aim of this study was to determine the clinicopathological features of papillary thyroid carcinomas (PTC) without extrathyroidal extension (ETE) and with lymph node metastasis (LNM). PTC1 cm increased the risk of LNM by 2.161 times compared to papillary thyroid microcarcinoma. The risk increased by 3.774 times in males and 1.553 times in the presence of multifocality. Presence of vascular invasion (VI) increased the risk of LNM by 3.093 times in patients without capsular invasion (CI). Clinicians should be careful about possible LNM in patients with large primary tumor diameter, multifocal tumors, CI and VI.

Background Gliosarcoma (GSM) is a distinct and aggressive variant of glioblastoma multiforme (GBM) with worse prognosis and few treatment options. It is often managed with the same treatment modalities with temozolomide (TMZ) as in GBM. However, the therapeutic benefits on GSM from such treatment regimen is largely unknown. Patient-derived xenograft (PDX) models have been used widely to model tumor progression, and subsequently to validate biomarkers and inform potential therapeutic regimens. Here, we report for the first time the successful development of a PDX model of secondary GSM. Methods Tissue obtained from a tumor resection revealed a secondary GSM arising from GBM. The clinical, radiological, and histopathological records of the patient were retrospectively reviewed. Samples obtained from surgery were cultured ex vivo and/or implanted subcutaneously in immunocompromised mice. Histopathological features between the primary GBM, secondary GSM, and GSM PDX are compared. Results In explant culture, the cells displayed a spindle-shaped morphology under phase contrast microscopy, consistent with the sarcomatous component. GSM samples were subcutaneously engrafted into immunocompromised mice after single-cell suspension. Xenografts of serial passages showed enhanced growth rate with increased in vivo passage. We did not observe any histopathological differences between the secondary GSM and its serial in vivo passages of PDX tumors. Conclusions Our PDX model for GSM retained the histopathological characteristics of the engrafted tumor from the patient. It may provide valuable information to facilitate molecular and histopathological modelling of GSM and be of significant implication in future research to establish precise cancer medicine for this highly malignant tumor.

Aspergillosis is important in poultry production and human health but difficulty in its ante mortem diagnosis in addition to the unsuccessful outcome of most management options has made the disease a lingering nightmare to farmers. This study presents the clinicopathological features and management of aspergillosis in some poultry farms in Jos metropolis, Nigeria. Thirteen cases of aspergillosis from 12 poultry farms were confirmed and managed from April, 2019 to March, 2020 with 7.6% cases in a mixed turkey-broiler farm, 15.4% in broilers and 76.9% in layers. The ages affected ranged from 3 weeks to 21 weeks with 69.2% cases in pullet grower birds of 10 – 21 weeks compared to young chicks, 3 – 9 weeks with 30.8%. The rainy season accounted for 61.8% cases while mortality ranged from 1.0% to 17.4%. The clinical features were consistent and included dyspnoea; inappetence; retarded growth and mortality. While necropsy showed consolidated lungs with caseous nodules; liver with raised grayish or yellowish irregular nodules; peritonitis with the peritoneum and air sacs laced with caseous nodules; diphtheritic membrane and caseous nodules on intestinal mucosa; haemorrhagic bursitis with granulomata; caseous nodules on osseous tissues as well as nodules on the skin and skeletal muscles. Confirmatory diagnoses of aspergillosis were made by culturing nodules on Sabouraud’s Dextrose Agar. Antifungal susceptibility testing showed CuSO4 to be more susceptible which was used at the dosage of 3g/10L of drinking water for at least 7 days in all the cases. Concurrent bacterial infections were seen in some of the cases and were treated concurrently with antibiotics based on susceptibility testing while farmers using moldy feeds were asked to withdraw such feeds. Conclusively, aspergillosis is prevalent in Jos metropolis with severe impact on production and may be a silent killer disease in poultry due to constraints in diagnosis and its management. Keywords: Aspergillosis, clinicopathological features, Jos, management, Nigeria, poultry

Background Breast cancer is the second most common cancer in the world and most frequent among women. Tumor-infiltrating lymphocytes (TILs) can impact tumor progression and response to therapies. Here we aimed to study TILS using the International Immunooncology Biomarkers Working Group guidelines and correlating the TILS with clinicopathological characteristics, disease free and overall survival in non-metastatic breast cancer patients. Methods Non metastatic breast cancer patients (N = 86) who presented to our department between (2013 - 2015) were retrospectively evaluated. The assessment of TILS distribution was based on the TILS International Working Group 2014 recommendations. The eligible patients were reviewed retrospectively regarding the demographic status and clinical parameters and primary treatment information were extracted from the medical records. For all of the available patients, disease-free survival (DFS) and overall survival (OS) were calculated. Results In the study the majority of the patients were 45 years of age or less. The TILS percentage was measured using image analysis. All samples had a range of 1-100%, with a mean 22%. There was 9.3% of the patients having lymphocyte predominant breast cancer (≥50%), while 90.3% had TILS percentage of We noticed that there is a subgroup of patients with exceptionally high TILS, (called LPBC with TILS ≥50%) had a beneficial response to treatment and confers additional survival benefit; every incremental increase of 10% also resulted in benefit to treatment and delayed relapse. High level of TILS associated with delayed relapse and a survival benefit. Conclusions We demonstrated that increasing TILS confer a relapse free benefit of breast cancer patient, regardless of the tumor subtype, indicating that TILS represent an breast cancer the patients. Keywords Tumor-infiltrating lymphocyte, Breast cancer, outcome of management Table 1:FinalNTumor infiltrating lymphocytes (TILS %)Min. - Max.Mean ± SD.MedianERNegative (0)212.0 - 100.027.33 ± 28.9318.0Weak (1+)63.0 - 40.019.67 ± 16.2917.0Moderate (2++)135.0 - 62.024.38± 20.6317.0Strong (3+++)451.0 - 87.019.78 ± 17.9217.0N/A15.0PRNegative (0)282.0 - 100.024.86 ± 26.1916.50Weak (1+)36.0 - 12.08.33 ± 3.217.0Moderate (2++)171.0 - 87.022.12 ± 22.1017.0Strong (3+++)371.0 - 62.021.68 ± 17.5518.0N/A15.0HER-2Negative (0)441.0 - 100.022.84 ± 22.9717.50Weak (1+)16.0Moderate (2++)114.0 - 87.025.09 ± 23.7625.0Strong (3+++)232.0 - 65.018.70 ± 17.1312.0N/A74.0 - 53.026.71 ± 22.1225.0BC subtypesLuminal A401.0 - 62.021.28 ± 17.9217.50Luminal B242.0 - 87.019.75 ± 18.9013.50Her2 Enriched104.0 - 65.023.20 ± 21.3616.50Triple -ve112.0 - 100.031.09 ± 35.0819.0N/A15.0 Citation Format: Neamat Elsayed Hegazy, Haitham Mohsen Abdel Motal, Hanan Yehia Tayel, Abdelsalam A Ismail. Correlation of Tumor-infiltrating lymphocytes with clinicopathological features and treatment outcomes in non-metastatic breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-46.

Background: The PALB2 gene is recognized as one of the most clinically relevant moderate to high penetrance breast cancer (BC) predisposition genes. Its product, PALB2, plays a crucial role in the homologous recombination pathway as a partner and localizer of BRCA2. Previous studies have reported significant frequencies of germline PALB2 and BRCA2 pathogenic variants (PVs) in Hispanic populations. However, no study has yet compared the baseline clinicopathological features of Mexican BC patients who carry PVs in these closely related genes. Methods: Medical records of BC patients from two centers located in Monterrey, Mexico who underwent a next-generation sequencing panel for BC predisposition genes (APC, ATM, BRCA1, BRCA2, BRIP1, CHEK2, CDH1, CDKN2A, MLH1, MSH2, MSH6, MUTYH, NF1, PALB2, PMS2, PTEN, RAD50, RAD51C, RAD51D, TP53) based on NCCN recommendations were reviewed. Patients with germline PVs in PALB2 or BRCA2 were considered eligible. Fisher’s exact and Mann Whitney U tests were employed to evaluate differences between groups based on mutation status. Results: Between 2014 and 2019, a total of 8 PALB2 (1.8%) and 24 BRCA2 (5.5%) pathogenic mutation carriers were identified from 437 BC cases. Baseline clinicopathological features are shown in Table 1. Overall, no statistically significant differences were observed between groups. The most common germline PVs were c.2167_2168delAT, p.Met723fs, frameshift mutation for PALB2 (57% of cases) and c.274C>T, p.Gln92Ter, nonsense mutation for BRCA2 (30% of cases). Of note, one male BC case occurred in a PALB2 mutation carrier, representing 13% (1/8) of BC cases in this carrier group and the only male BC case (out of three) associated with a germline PV. Conclusion: This is the first report detailing the clinicopathological features of Mexican BC patients with germline PALB2 PVs. According to our findings, BC tumors in PALB2 mutation carriers share similar baseline characteristics with those diagnosed in BRCA2 mutation carriers. Long-term follow-up is required in order to determine if prognosis is similar between groups and to further solidify the clinical relevance of germline PALB2 PVs in the Mexican population. Baseline clinicopathological features of PALB2 and BRCA2 mutation carriers with BCPALB2 mutation carriersBRCA2 mutation carriersMedian age at diagnosis (years)3938Median body mass index (kg/m2)2326Family history of BCYes5 (63%)19 (79%)No3 (38%)5 (21%)Clinical stageI2 (25%)2 (8%)II5 (63%)11 (46%)III08 (33%)IV1 (13%)3 (13%)Histological typeIDC6 (75%)22 (92%)Non-IDC2 (25%)2 (8%)Histological gradeG11 (13%)5 (21%)G24 (50%)10 (42%)G33 (38%)6 (25%)Missing03 (13%)Molecular subtypeHR+/HER2-6 (75%)11 (46%)HR+/HER2+04 (17%)HR-/HER2+00HR-/HER2-2 (25%)9 (38%)LateralityUnilateral8 (100%)21 (88%)Bilateral03 (13%) Citation Format: Alejandro Aranda-Gutierrez, Ana S Ferrigno, Juan Carlos A. García Marrufo, Mariana Moncada-Madrazo, Analy Gomez-Picos, Cynthia Villarreal-Garza, Dione Aguilar. Clinicopathological features of PALB2 and BRCA2 mutation carriers with breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS16-29.

To investigate the clinicopathological features of sporadic amyloid transthyretin (ATTR) amyloidosis.We evaluated 1698 serial Japanese forensic autopsy patients. The extent and amount of ATTR deposition in the 16 cardiac regions, including the conduction system, were semiquantitatively evaluated. Ward's hierarchical cluster analysis was applied to classify the cases into subgroups. Also, the relationship between ATTR and amyloid atrial natriuretic factor (AANF) was evaluated.Forty-four cardiac ATTR amyloidosis patients (mean age 85.4 ± 5.7 years; 22 men) without history of hereditary polyneuropathy were identified (2.6% of all patients, 8.8% of those aged ≥80 years). All the 44 patients were not in the bedridden state and died-out-of-hospital scenarios. Of these, 10 (23%) were sudden death. Cluster analysis classified the patients into three groups (mild, atria-predominant and the severe deposition group). Amyloid deposition had already started simultaneously from each atrium and ventricle; however, the atrial septum and basilar ventricular septum were the sites that revealed the most frequent deposition. Also, a possible association between ATTR and AANF deposits was identified.Sporadic ATTR amyloidosis patients might already be susceptible to a risk for sudden death even from an early-phase. Also, ATTR amyloid deposition in such cases might progress with a certain degree of regularity.