Common Histological Type Research Articles

Adult genitourinary sarcoma: analysis using hospital-based cancer registry data in Japan

BackgroundGenitourinary sarcomas are rare in adults and few large-scale studies on adult genitourinary sarcoma are reported. We aimed to elucidate the clinical characteristics, survival outcomes, and prognostic factors for overall survival of adult genitourinary sarcoma in Japan.MethodsA hospital-based cancer registry data in Japan was used to identify and enroll patients diagnosed with genitourinary sarcoma in 2013. The datasets were registered from 121 institutions.ResultsA total of 116 men and 39 women were included, with a median age of 66 years. The most common primary site was the kidney in 47 patients, followed by the paratestis in 36 patients. The most common histological type was liposarcoma in 54 patients, followed by leiomyosarcoma in 25 patients. The 5-year overall survival rates were 57.6%. On univariate analysis, male gender, paratestis as primary organ, and histological subtype of liposarcoma were predictive of favorable survival while primary kidney, bladder, or prostate gland location were predictive of unfavorable survival. On multivariate analysis, primary paratestis was an independent predictor of favorable survival while primary kidney, bladder, or prostate gland were independent predictors of unfavorable survival.ConclusionsThis is the first report showing the clinical characteristics and survival outcomes of adult genitourinary sarcoma in Japan using a real-world large cohort database.

CLINICOPATHOLOGICALCHARACTERISTICS OF NASOPHARYNGEALCARCINOMA AT CENTRAL GENERAL HOSPITAL PROF. DR. I.G.N.G. NGOERAH DENPASAR IN 2021-2022

ABSTRACT
 
 Nasopharyngeal carcinoma (NPC) epidemiologically occupies the fourth position as the highest number of malignancy cases in Bali, Indonesia. The most common histological type of NPC cases are non-keratinizing squamous cell carcinoma (NKSCC) undifferentiated subtype. This research aims to know the clinicopathological aspect of nasopharyngeal carcinoma at Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar in 2021-2022 regarding the distribution of age range, gender, education, occupation, clinical stage, histological type, as well as the results of anamnesis. The research design is a descriptive study of 70 cases of NPC at Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar from 2021 to 2022. Samples were collected retrospectively from secondary data using a total sampling technique through a cross-sectional study, samples were obtained from medical record data and hospital management system of Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar. In this study, the most cases of NPC were found in the range of 51-60 years old (32.9%), male sex (65.7%), high school education status (48.6%), private employee employment (32.9%), anamnesis results of a lump in the neck (77.1%), stage IVA (40%), and with the histological type of NKSCC undifferentiated subtype (90%). Men have twice the risk of suffering from NPC compared to women, most cases have complained of a lump in the neck and other symptoms such as nasal congestion, tinnitus, headaches. The most common histological type found is the NKSCC undifferentiated subtype, which mostly occurs in advanced stages of an IVA.
 Keywords : Clinicopathology, NPC, Nasopharynx

Clinical and Imaging Characteristics of Metastatic Orbital Tumours in North China.

This study was designed to review the primary sites, clinical manifestations, imaging features, treatments, and outcomes of 36 patients with orbital metastasis in North China. This was a retrospective review of 36 patients with orbital metastasis at Tianjin Eye Hospital between January 2010 and December 2020 in North China as well as a review of the literature. Thirty-six patients were included in the study; 17 were male, and 19 were female, with an age range of 1-82 years (average 54.9 ± 19.8 years). All the tumours were unilateral. The mean duration from the onset of orbital signs to presentation at the hospital was 2.4 months (range 1-10 months). Breast carcinoma, gastrointestinal tract carcinoma, and lung carcinoma were the most common histological types. Proptosis, ocular pain, and diplopia were the most common clinical manifestations. The superior orbit was the most common quadrant involved. All patients received comprehensive therapy, including surgery, radiotherapy, or chemotherapy. The average follow-up time was 2.45 years (range 7 months to 5.5 years). Ten patients in this study died as a result of disseminated metastasis from the primary tumour. In North China, the most common primary cancer that metastasizes to the orbit is breast cancer, followed by gastrointestinal tract carcinoma and lung cancer. The increasing trend of orbital gastrointestinal tract metastases in North China in recent years is noteworthy. The survival rate of patients with orbital metastasis of neuroblastoma is low.

Anoikis-related gene signature is associated with immune infiltration and predicts the prognosis of non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) is the most common histological type of lung cancer. With the in-depth exploration of cell death manners, numerous studies found that anoikis is an important mechanism that associated with treatment. Therefore, we aimed to explore the prognostic value and treatment guidance of anoikis in NSCLC patients. In the current study, we first constructed a prognostic model based on the anoikis-related genes based on bulk RNA-sequencing and single-cell RNA-sequencing (scRNA-seq) dataset. Then, immuno-correlations of anoikis-related risk scores (ARGRS) were analyzed. In addition, HMGA1, a risky gene in ARGRS, was further explored to define its expression and immuno-correlation. Results showed that patients with higher ARGRS had worse clinical outcomes. Moreover, the five genes in the prognostic model were all highly expressed on tumor cells. Moreover, further analysis found that the ARGRS was negatively correlated with ImmuneScore, but positively with tumor purity. Besides, patients in the ARGRS-high group had lower levels of immunological characteristics, such as the immune-related signaling pathways and subpopulations. Additionally, in the immunotherapy cohorts, patients with the ARGRS-high phenotype were more resistant to immunotherapy and tended to not achieve remission after treatment. Last, HMGA1 was chosen as the representative biomarker, and analysis of the in-house cohort showed that HMGA1 was highly expressed in tumor tissues and correlated with decreased T cell infiltration. To sum up, ARGRS was correlated with a desert tumor microenvironment and identified immune-cold tumors, which can be a novel biomarker for the recognition of immunological characteristics and an immunotherapeutic response in NSCLC.

Comparative analysis of breast cancer characteristics in young premenopausal and postmenopausal women in Ghana

Breast cancer is increasingly common among young women in Ghana. BCa is heterogeneous with unique traits that impact causes, prognostic, and predictive outcomes of patients before and after menopause. However, limited evidence exists on differences between young premenopausal (YPM) and postmenopausal cases in Ghana. This study compared breast tumour characteristics between YPM women (under 35 years) and postmenopausal women. We conducted a prospective cross-sectional study involving 140 BCa-diagnosed women at the Breast Care Clinic of Komfo Anokye Teaching Hospital (KATH), Kumasi from November 2019 to June 2021. Thirty-one (22.1%) of participants were YPM and 109 (77.9%) were postmenopausal. The median ages for YPM and postmenopausal were 32.0 (range: 25.0–35.0) and 57.0 (48.0–86.0) respectively. Invasive carcinoma was the most common histological type (97.1%). Left tumour location was the most frequent in both groups (51.6% for YPM and 51.8% for postmenopausal). Lumps detected were frequently in the outer upper quadrant in both groups (61.3% and 56.0%). The majority of the YPM women (80.7%) and postmenopausal women (87.0%) had stage III and IV diseases. Most YPM (64.5%) and postmenopausal women (64.4%) exhibited triple-negative breast cancer (TNBC). Both YPM 13 (56.6%) and postmenopausal participants 40 (56.3%) exhibited a predominantly partial response to neo-adjuvant chemotherapy but YPM women (21.7%) experienced disease progression than the postmenopausal women (12.7%). The study highlights consistent tumour characteristics and advanced clinical stages at diagnosis in both groups with a higher prevalence of TNBC. TNBC and HER2+ subtypes respond better to Anthracycline-based neoadjuvant chemotherapy. Establishing Breast Care Clinics in district and regional hospitals for early detection is crucial and further studies are warranted to understand the higher TNBC prevalence in black Africans and re-evaluate breast education programs to address the persistently late presentations.

Clinicopathologic Features and Prognoses of Male Patients With Breast Cancer.

Breast cancer is rare in men and is managed using strategies similar to those for breast cancer in women. This study retrospectively analyzed the clinicopathological features, treatment, and survival of male breast cancer (MBC). A total of 66 patients with MBC admitted into Xijing Hospital from August 2006 to March 2024 were reviewed. Data were collected from patients' hospital records and breast cancer database of Xijing Hospital. The incidence of MBC tended to increase from 2018, with affected individuals being older than those with female breast cancer (FBC). The most common histological type of MBC was invasive carcinoma, with positive hormone receptor status. A total of 62 (93.9%) patients with MBC underwent modified radical mastectomy. Chemotherapy was administered to 39 (59.1%) patients, while endocrine therapy was received by 14 patients (21.2%) and radiotherapy by nine patients (13.6%). Survival analysis indicated that the median overall survival (OS) of patients with MBC was 46.7 months (0.9-184.8 months). As of the latest data, 58 patients (87.9%) with MBC are alive. Factors significantly associated with survival included age (χ2 = 3.856, p = .050), estrogen receptor (χ2 = 10.427, p = .005), molecular types (χ2 = 10.641, p = .031), P63 (χ2 = 2.631, p < .001), and endocrine therapy (χ2 = 31.167, p < .001). These findings provide valuable insights into MBC within the Chinese population and serve as a reference for the standard treatment of MBC.

Risk Factors Affecting Clinical Outcomes of Low-risk Early-stage Human Papillomavirus-Associated Endocervical Adenocarcinoma Treated by Surgery Alone: Application of Silva Pattern.

This study aimed to report the clinical outcomes and risk factors for survival of patients with low-risk early-stage human papillomavirus-associated (HPVA) endocervical adenocarcinoma (EAC) treated with surgery alone. This retrospective study obtained the clinicopathological data of patients with early-stage HPVA EAC who underwent surgery between 2012 and 2018. The Silva pattern of invasion was determined by reviewing pathology slides. Locoregional recurrence-free survival (RFS), RFS, and overall survival were calculated, and the risk factors for survival were analyzed. One hundred seventeen patients with a median follow-up of 5.2 years (0.5-9.7yr) were included. The most common histologic type was usual (94/117, 80.3%). The Silva pattern was A in 79 patients (67.5%), B in 30 (25.6%), and C in 8 (6.8%). The 5-year locoregional RFS, RFS, and overall survival rates were 92.4%, 87.8%, and 97.2%, respectively. The presence of intermediate-risk factors and Silva pattern C were significantly associated with worse survival. Based on these findings, patients were categorized into 2 groups: Group 1 (Silva pattern A or Silva pattern B without intermediate-risk factors) and Group 2 (Silva pattern B with intermediate-risk factors or Silva pattern C ). Group 2 showed significantly worse outcomes than Group 1, including the 5-year locoregional RFS (98.6% vs 68.0%), RFS (96.4% vs 54.6%), and overall survival (100.0% vs 86.5%). In conclusion, surgery alone for early-stage HPVA EAC resulted in favorable outcomes. Consideration of the Silva pattern, in addition to well-known risk factors, could help in precise risk group stratification of low-risk, early-stage HPVA EAC.

Association of Four Interleukin-8 Polymorphisms (-251 A>T, +781 C>T, +1633 C>T, +2767 A>T) with Ovarian Cancer Risk: Focus on Menopausal Status and Endometriosis-Related Subtypes.

Interleukin-8 (IL-8) is involved in the regulation of inflammatory processes and carcinogenesis. Single-nucleotide polymorphisms (SNPs) within the IL-8 gene have been shown to alter the risks of lung, gastric, or hepatocellular carcinomas. To date, only one study examined the role of IL-8 SNPs in ovarian cancer (OC), suggesting an association between two IL-8 SNPs and OC risk. In this study, we investigated four common IL-8 SNPs, rs4073 (-251 A>T), rs2227306 (+781 C>T), rs2227543 (+1633 C>T), and rs1126647 (+2767 A>T), using the restriction fragment length polymorphism (PCR-RFLP) technique. Our study included a cohort of 413 women of Central European descent, consisting of 200 OC patients and 213 healthy controls. The most common (73.5%) histological type was high-grade serous OC (HGSOC), whereas 28/200 (14%) patients had endometriosis-related (clear cell or endometrioid) OC subtypes (EROC). In postmenopausal women, three of the four investigated SNPs, rs4073 (-251 A>T), rs2227306 (+781 C>T), and rs2227543 (+1633 C>T), were associated with OC risk. Furthermore, we are the first to report a significant relationship between the T allele or TT genotype of SNP rs1126647 (+2767 A>T) and the EROC subtype (p = 0.02 in the co-dominant model). The TT homozygotes were found more than twice as often in EROC compared to other OC subtypes (39% vs. 19%, p = 0.015). None of the examined SNPs appeared to influence OC risk in premenopausal women, nor were they associated with the aggressive HGSOC subtype or the stage of disease at the initial diagnosis.

Immune evasion in lung metastasis of leiomyosarcoma: upregulation of EPCAM inhibits CD8+ T cell infiltration

BackgroundLeiomyosarcomas are among the most common histological types of soft tissue sarcoma (STS), with no effective treatment available for advanced patients. Lung metastasis, the most common site of distant metastasis, is the primary prognostic factor. We analysed the immune environment targeting lung metastasis of STS to explore new targets for immunotherapy.MethodsWe analysed the immune environment of primary and lung metastases in 38 patients with STS using immunohistochemistry. Next, we performed gene expression analyses on primary and lung metastatic tissues from six patients with leiomyosarcoma. Using human leiomyosarcoma cell lines, the effects of the identified genes on immune cells were assessed in vitro.ResultsImmunohistochemistry showed a significant decrease in CD8+ cells in the lung metastases of leiomyosarcoma. Among the genes upregulated in lung metastases, epithelial cellular adhesion molecule (EPCAM) showed the strongest negative correlation with the number of CD8+ cells. Transwell assay results showed that the migration of CD8+ T cells was significantly increased in the conditioned media obtained after inhibition or knock down of EPCAM.ConclusionsEPCAM was upregulated in lung metastases of leiomyosarcoma, suggesting inhibition of CD8+ T cell migration. Our findings suggest that EPCAM could serve as a potential novel therapeutic target for leiomyosarcoma.

Evaluation of a real-world clinico-genomics database of patients with upper gastrointestinal (GI) malignancies in Japan.

400 Background: The genomic profile of gastrointestinal (GI) cancers provides essential information for precision medicine, however, there is limited availability of real-world data in Asian populations as they are not well-represented in most publicly accessible clinico-genomic databases. In this retrospective study, we evaluated the clinical and genomic characteristics of upper GI cancer patients in the database from an academia-industry collaborative nationwide cancer genome screening project in Japan. Methods: The Screening Projectfor Individualized Medicine in Japan (J-SCRUM) GI-SCREEN enrolled advanced GI cancer patients from 26 sites before planned or during systemic therapy from 2015 to 2019. Archived formalin-fixed paraffin-embedded tumor tissue was analyzed by next-generation sequencing (NGS) using Oncomine Cancer Research Panel and Oncomine Comprehensive Assay. Patients with gastric (GC), esophageal (EC) and pancreatic (PC) cancers were identified in the database. The frequency of key actionable genomic alterations in each cancer cohort was explored and compared to similar upper GI cohorts in The Cancer Genome Atlas (TCGA), a publicly available genomics database initiated in 2005 and concluded sample collection in 2013 with most samples from White cancer patients. Results: A total of 872 GC (mean age at registration [SD]: 64y [12]; percent males: 65%), 265 EC (64y [9]; 78%) and 495 PC (64y [10]; 60%) patients were identified. The majority (&gt;70%) of samples were obtained from primary sites. Adenocarcinoma was the most common histological type for GC (85%) ad PC (76%), while squamous cell (76%) was the most common among EC patients. In the GC cohort, the prevalence of key actionable genomic alterations in J-SCRUM GI-SCREEN vs TCGA (N = 380) was, TP53 mutation (49% vs 49%), ERBB2 amplification (14% vs 13%), PIK3CA mutation (11% vs 14%), MYC amplification (9% vs 12%) and MET amplification (2% vs 3%). In the EC cohort, the prevalence in J-SCRUM vs TCGA (N = 182) was TP53 mutation (77% vs 87%), NFE2L2 mutation (21% vs 10%), PIK3CA mutation (9% vs 9%) and CDKN2A mutation (8% vs 8%). In the PC cohort, the prevalence in J-SCRUM vs TCGA (N = 150) was KRAS hotspot mutation (90% vs 93%), KRAS G12D (43% vs 41%), KRAS G12V (32% vs27%), TP53 mutation (58% vs 64%), BRCA1/2 deleterious mutation (5% vs 5%), ATM deleterious mutation (6% vs 5%) and MYC amplification (5% vs 5%). Conclusions: As part of a nationwide cancer genome screening project, J-SCRUM GI SCREEN database provides comprehensive genomic information for Asian population (Japan). The prevalence of key actionable gene alterations in each tumor type was highly comparable between J-SCRUM GI-SCREEN and TCGA data.

SUCCOR morbidity: complications in minimally invasive versus open radical hysterectomy in early cervical cancer

ObjectiveThe aim of this study was to compare the incidence of intra-operative and post-operative complications in open and minimally invasive radical hysterectomy for patients with early-stage cervical cancer.MethodsData were collected...

Molecular Profiling for Bethesda III to VI Nodules: Results of a Multicenter International Retrospective Study

ObjectiveMolecular testing is a well-established tool that assists in the management of thyroid nodules. We describe our experience using molecular testing of thyroid nodules with Bethesda III to VI cytology. MethodsThis is a retrospective multicenter, multinational study of thyroid nodules that underwent preoperative molecular profiling with ThyGenX/ThyGeNEXT or ThyroSeq V3 between 2015 and 2022. The clinical characteristics and mutational profiles of tumors were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations. Molecular alterations were categorized into 3 main phenotypes: BRAF-like, RAS-like, and non-BRAF-non-RAS (NBNR). ResultsOverall, 784 patients who had surgery were included, of which 603 (76.2%) were females. The most common histologic type was papillary thyroid cancer (PTC) with 727 (91.9%) cases. In total, 205 (28.2%) cases showed an aggressive subtype of PTC (eg, tall cell and hobnail). BRAF-like alterations were most likely to be found in Bethesda V and VI nodules and show extrathyroidal extension (ETE), nodal disease, and/or aggressive subtypes of PTC (P < .001 for all). RAS-like alterations were more commonly found in Bethesda III and IV nodules and were less likely to show ETE, nodal disease, and/or aggressive histology (P < .001 for all). NBNR alterations were more commonly found in Bethesda III and IV nodules and were less likely to show ETE, nodal disease, and/or aggressive subtypes of PTC. However, they were rarely but significantly associated with poorly differentiated thyroid cancer (P < .005). ConclusionMolecular testing of thyroid nodules can help determine the likelihood of malignancy and classify nodules into several tumor phenotypes, predicting their behaviors and potentially allowing for a more tailored treatment. NBNR alterations should be managed with caution.

Comparison of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios with epithelial ovarian cancer stages

Objectives: Epithelial ovarian cancer (EOC) is the most common histologic type among ovarian cancers. It is usually diagnosed at an advanced stage and the prognosis worsens. The aim of our study was to investigate the predictive value of serum platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), which are systemic inflammatory response markers in EOC stages. Methods: In this study, 140 patients diagnosed with primary EOC in İzmir Katip Çelebi University Atatürk Training and Research Hospital Gynecology and Obstetrics Clinic between 01.01.2012-01.07.2019 were included. The cases were staged using the FIGO 2014 Ovarian Cancer Staging system. Whether the PLR and NLR values were different between the stages were analyzed with appropriate statistical analysis methods. Results: A total of 140 patients, 54 were in the early stage (Stage I: 47; Stage II: 7) and 86 were in the advanced stage (Stage III: 73; Stage IV: 13). The PLR and NLR values differed between the four stages (p = 0.003 and p = 0.032, respectively). The PLR value was different between the early and advanced stages (p = 0.033), the AUC value was 0.607, the optimum cut-off was 220, the sensitivity was 47%, and the specificity was 81% in the early and advanced stage discrimination. Accordingly, the Odds ratio of PLR for advanced EOC was 3.82 (95% CI: 1.70-8.57, p = 0.0011). Conclusions: The NLR and PLR values were found to have a prognostic value in the discrimination of EOC stages. It has been determined that PLR value may play a predictive role in advanced EOC before surgery.

Old Wine in a New Bottle: Our Experience with Indwelling Pleural Catheters in Malignant Pleural Effusion

Abstract Background: Malignant pleural effusions indicate advanced stage of cancer and making the treatment decisions difficult for the treating physicians. There are multiple treatment options for the treatment of malignant pleural effusion including pleurodesis, thoracocentesis, indwelling pleural catheters (IPCs), and pleural decortication surgeries. However, there is a considerable number of patients who are not candidates for either pleurodesis or have repeated thoracocentesis, these patients can be carefully selected for management with IPCs. Aims and Objectives: To establish the use of indwelling pleural catheter in malignant pleural effusions. Materials and Methods: Patients who are not candidates for either pleurodesis or have repeated thoracocentesis, these patients can be carefully selected for management with IPCs. This is a prospective study of 23 patients with underlying trapped lung or recurrent pleural effusions who have been treated with IPCs from January 2021 to December 2022. We have used Rocket pleural catheter in this study. Results: The common primary malignancy was from lungs with the most common histologic type being adenocarcinoma type. We had good improvement in symptoms and have observed minor complications in about 21% of the individuals. Conclusion: IPC can be considered a good treatment option for patients with malignant pleural effusion with trapped lungs and patients with recurrent pleural effusions.

Pathologic response evaluation of localized or locally advanced esophageal carcinoma to induction chemotherapy followed by preoperative concurrent chemotherapy and hypofractionated radiotherapy: a clinical trial.

Esophageal cancer is a therapeutic challenge in most healthcare systems. Most patients present with locally advanced disease at diagnosis. Concurrent chemoradiotherapy (CRT) is the standard treatment for locally advanced esophageal carcinoma. Since achieving a complete pathological response in postoperative specimens following neoadjuvant therapy is associated with improved patient survival, this study was designed to evaluate the pathologic response of localized or locally advanced esophageal carcinoma to induction chemotherapy followed by preoperative concurrent chemotherapy and hypofractionated radiotherapy (HFR). This single-arm clinical trial (IRCT20210623051676N1) evaluated patients with squamous cell carcinoma or adenocarcinoma of the esophagus, stage cT2-T4a N0 M0 or cT1-T4a N+ M0. Patients received 3-5 cycles of weekly induction chemotherapy with the paclitaxel (50 mg/m2) and carboplatin (AUC=2) regimen, followed by weekly concurrent CRT with the same chemotherapy regimen. The radiation dose was 40 Gy, delivered over 16 fractions, 5 days per week (2.5 Gray/fraction). Patients underwent surgery 4-6 weeks after completion of CRT. The surgical specimens were evaluated for pathological response. A p-value of < 0.05 was considered significant in all analyses. Out of 54 patients enrolled in this study, 45 completed the neoadjuvant protocol. Of these 45 patients, 32 underwent surgery and were finally analyzed. The mean age of the patients was 59.9 ± 8.6 years (range, 37-75 years). The location of the tumor was in the mid-thoracic esophagus in most patients (21, 65.6%) and the most common histological type was SCC (29, 90.6%). The median number of induction and concurrent chemotherapy cycles was 5 (4.8 ± 1.3 course, range, 1-10) and 3 (2.6 ± 0.8 course, range, 0-4), respectively. Among 45 patients who completed the neoadjuvant protocol, the most common toxicities were grade 3 neutropenia (15.6%), acute renal failure (4.4%), and odynophagia (37.8%). Nearly two-thirds of the patients experienced complete or near-complete responses (71.9%, 23 patients). Partial response was reported in 6 patients (18.8%) and poor response in 3 patients (9.4%). Preoperative induction chemotherapy followed by HFR with concurrent chemotherapy has low toxicity and side effects, good tolerance, and significant efficacy in the treatment of patients with esophageal cancer. https://irct.behdasht.gov.ir/trial/59930, identifier NCT05745545.

The Role of Lymphovascular Space Invasion and Cytology in the Prognosis of Endometrial Cancer.

Lymphovascular space invasion (LVSI) and cytology are both independent and strong prognostic factors in endometrial cancer. This study aims to highlight the impact of LVSI and cytology positivity on prognosis, in addition to molecular classification. A retrospective review was conducted on the records of 223 patients with endometrial cancer diagnosed between January 2011 and January 2021. The inclusion criteria stipulated that the patients were diagnosed with endometrial cancer by endometrial biopsy and were operated in the clinic. The exclusion criteria included sarcoma in the postoperative pathology report results or synchronous tumor. Staging was performed according to the Fédération internationale de gynécologie et d'obstétrique (FIGO) 2009 criteria. Cytology (using 50 cc saline) was obtained upon entry into the peritoneal cavity. In 20 patients, saline was not used due to the presence of ascites in the abdomen. The Kaplan-Meier method was employed to evaluate overall survival and progression-free survival. Survival rates were compared in terms of cytology and LVSI. After analyzing the postoperative pathology results, it was found that the mean tumor size was 4.03 ± 2.3 cm. The most common histological type was endometrioid carcinoma, with stage IA being the most common stage. Out of 223 patients with endometrial cancer, the overall survival rate was 82.4%, and the progression-free survival rate was 88.3%. For patients negative for LVSI, the progression-free survival rate was 93%, while for LVSI-positive patients, it was 77.3% (p < 0.001). Additionally, the progression-free survival rate for patients negative for cytology was 90.4%, whereas for cytology-positive patients, it was 77.1% (p < 0.05). In our study, we observed that LVSI positivity and cytology positivity also reduced the overall survival rate. We aimed to highlight that, in addition to molecular classification, cytology positivity and LVSI positivity are still highly significant and independent factors in prognosis.

Immunohistochemical Expression of PD-L1 in Core Biopsy Samples of Non Small Cell Lung Cancer and its Association with Histopathological and Clinicoradiological Parameters

Introduction: Lung cancer is one of the most common causes of cancer-related mortality worldwide. In addition to chemotherapy, immunotherapy has yielded favourable outcomes in advanced, surgically non resectable Non Small Cell Lung Carcinoma (NSCLC). The inhibition of immune checkpoints by monoclonal antibodies targeting Programmed Death 1 (PD-1) and Programmed Death Ligand 1 (PD-L1) plays a pivotal role in preventing the downregulation of antitumour immunity. Aim: To study the expression of PD-L1 in NSCLC cases from core biopsy specimens and its association with histological types, grades of tumour along with clinicoradiological parameters (age, sex, smoking status, and radiological location of the tumour). Materials and Methods: This ambispective study was done in the Pathology Department of Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India, over two years from October 2020 to August 2022. The authors studied 35 cases of histopathologically and Immunohistochemically (IHC) diagnosed NSCLC. Partial or complete membranous staining of any intensity in ≥1% of tumour cells was considered positive in IHC. The Tumour Proportion Scoring (TPS) used for PD-L1 reporting was as follows: TPS &lt;1%: negative, TPS 1-49%: low positive expression, and TPS ≥50%: high positive expression. Microsoft excel and Statistical Package for Social Sciences (SPSS) version 25.0 software were used for statistical analysis. Results: The most common age group was 61-70 years (12 cases; 34.29%), with a male predominance 24 (68.60). Chronic smokers (16 cases; 45.71%) were commonly affected. Squamous Cell Carcinoma (SCC) was the common histological type (21 cases; 60%). Overall, 14 cases (40.0%) showed low (1-49%) and 5 cases (14.30%) showed high (≥50%) positive TPS of PD-L1 expression, respectively. Three cases (27.3%) of Grade 2 SCC and one case (10%) of Grade 3 SCC expressed high positivity. There was a statistical association between PDL1 expression and male sex (p-value 0.01), positive smoking history (p-value 0.048), and SCC (p-value 0.032). Conclusion: The PD-L1 expression is associated with increased tumour proliferation, aggressiveness, as well as shorter survival period in advanced NSCLC. The present study showed a significant association of PD-L1 expression in males, chronic smokers, and SCC. As per the existing literature, its association with clinicoradiological parameters is not clear. Future research with a larger cohort study, along with other predictive biomarkers, is highly desired to reach conclusive evidence.

Deep Learning for Subtypes Identification of Pure Seminoma of the Testis.

The most critical step in the clinical diagnosis workflow is the pathological evaluation of each tumor sample. Deep learning is a powerful approach that is widely used to enhance diagnostic accuracy and streamline the diagnosis process. In our previous study using omics data, we identified 2 distinct subtypes of pure seminoma. Seminoma is the most common histological type of testicular germ cell tumors (TGCTs). Here we developed a deep learning decision making tool for the identification of seminoma subtypes using histopathological slides. We used all available slides for pure seminoma samples from The Cancer Genome Atlas (TCGA). The developed model showed an area under the ROC curve of 0.896. Our model not only confirms the presence of 2 distinct subtypes within pure seminoma but also unveils the presence of morphological differences between them that are imperceptible to the human eye.

Assessment of Clinicopathological Profile and Receptor Status of Breast Cancer Patients at a Tertiary Care Centre in Uttarakhand, India: A Prospective Cohort Study

Introduction: Breast carcinoma has become a major public health problem among both urban and rural populations in India. The management of breast carcinoma depends on hormone receptor status and the pathological properties of the tissue, which serve as important prognostic markers. Aim: The aim of this study was to analyse the clinicopathological parameters and receptor status in breast cancer patients in the Garhwal Region of Uttarakhand. Materials and Methods: This prospective cohort study involved 51 patients who underwent modified radical mastectomy for breast carcinoma at the Department of General Surgery, Government Doon Medical College, Dehradun, Uttarakhand, India. The study was conducted over a period of two years and seven months, from May 2018 to December 2020. Various parameters such as age, side and quadrant of breast involvement, TNM stage, histological grade, receptor status, molecular subtypes, and axillary lymph node status were evaluated. The data was tabulated using Microsoft Excel 2007. The distribution of various receptors in tumour specimens was compared with clinicopathological variables and expressed as percentages. Results: The mean age of the study participants was 52.54±13.24 years, with a male to female ratio of 2:98. In this study, the majority of females (62.74%) belonged to the age group of 40 to 60 years. Left breast carcinoma showed a slightly higher prevalence (52.94%) than right breast carcinoma (47.05%), and the upper outer quadrant was the most commonly involved (50.98%). Infiltrating ductal carcinoma, not otherwise specified, was the most common histological type observed in all patients. The majority of patients (84.31%) had tumour sizes less than 5 cm. Grade-II tumours were the most frequent grade, observed in 34 cases (66.66%). Among the tumour stages, T2 stage accounted for the highest frequency (67%), followed by T3. The authors found that the highest frequency of tumours belonged to N0 stage (29.41%), followed by N1, N2, and N3, respectively. The corresponding rates of luminal A, luminal B, triple-negative, and Human Epidermal Growth Factor Receptor 2 (HER-2)/neu enriched subtypes were 5 (14.7%), 3 (8.82%), 11 (32.5%), and 3 (8.82%), respectively. The cases negative for Oestrogen Receptor (ER) and Progesterone Receptor (PR) were found to have high-grade disease on histological evaluation. Conclusion: The higher percentage of Grade-II and III tumours observed in this study highlights the need to increase health awareness in this area in order to decrease morbidity and mortality. The study recommends that Immunohistochemistry (IHC) classification serves as an important prognostic factor in breast cancer patients.

Breast Carcinoma: Correlation of Molecular Subtypes with Histopathologic Characteristics

Context: Breast carcinoma is a heterogenous disease and similar histological subtypes may exhibit different behavior and treatment response. The molecular classification may provide better prognostic, predictive and therapeutic information than histological classification. The study aimed at evaluating the distribution of molecular subtypes of breast cancer and its association with prognostic factors. Method: This prospective cross-sectional study was conducted on breast cancer cases, over a period of 2 years, at M.S. Ramaiah Medical College and Hospitals, Bengaluru. The resection specimens were evaluated for histopathological features. Immunohistochemical analysis for ER, PR, Her2neu and Ki-67 expression was performed to identify molecular subtypes. Correlation of molecular subtypes with histopathological prognostic factors was done by Chi- square test or Fischer’s exact test. Results: A total of 85 cases were evaluated and classified into Luminal A (50.6%), Basal like (27%), Luminal B (11.8%) and HER-2 enriched (10.6%) molecular subtypes. Invasive ductal carcinoma was the commonest histologic type across all the molecular subtypes. Majority of low-grade tumors were Luminal A and most of high-grade tumors were Basal like (p= 0.004). HER-2 enriched and Basal like tumors were relatively more frequent in ≤ 50 years of age and Luminal A tumors exhibited less frequent lymph node metastasis. However, these associations fell short of statistical significance. Conclusion: Luminal A tumors are the most common molecular subtype. Statistically significant correlation exists between histologic grade and molecular subtype. There is no significant correlation between molecular subtype and age, tumor size, nodal metastasis, pathological T stage and TNM stage. Keywords: Basal like, Breast carcinoma, HER2­Enriched, Luminal A, Luminal­ B, Molecular subtypes