Early Detection Of Adenocarcinoma Research Articles

A molecular breakthrough: early detection of adenocarcinoma with HPV DNA methylation

A molecular breakthrough: early detection of adenocarcinoma with HPV DNA methylation

1510 Positive Fecal Immunochemical Testing in Detection of Mantle Cell Lymphoma With Gastrointestinal Involvement

INTRODUCTION: Current colorectal cancer (CRC) screening guidelines are directed at early detection of adenocarcinoma via stool testing or direct endoscopic or radiologic visualization. Compared to a colonoscopy, fecal immunochemical Testing (FIT), a non-invasive test that detects hemoglobin in stool by immunoassay, has similar CRC detection rates. We report a case of mantle cell lymphoma (MCL) involving the gastrointestinal tract (GIT) in a patient diagnosed through routine CRC screening. CASE DESCRIPTION/METHODS: A 70 year-old male with a history of diverticulitis was referred for urgent colonoscopy following a positive FIT. He reported a seven-month history of right upper quadrant abdominal pain, pruritus, and a 19 pound unintentional weight loss. He denied fever, night sweats, melena, hematochezia, and family history of malignancy. Physical exam did not reveal splenomegaly and lymphadenopathy. Notable labs included normocytic anemia and a normal LDH. Colonoscopy showed congested, nodular and thickened mucosal folds in the terminal ileum, ascending colon, and cecum. Random biopsies revealed diffuse atypical lymphoid infiltrates in a multiple lymphomatous polyposis pattern with cyclin D1, CD5 and CD20 immunohistochemical positivity consistent with MCL. PET-CT detected bone marrow and diffuse lymph node involvement. He tolerated six cycles of lymphoma-directed chemotherapy with complete metabolic response on imaging. DISCUSSION: Extranodal disease at primary presentation accounts for 25% of patients with MCL. Microscopic gastrointestinal involvement in MCL at presentation is widely underestimated and has been documented in up to 80% of cases at the time of diagnosis, suggesting that MCL has a propensity to home to the GIT. Clinically, most patients with MCL with GIT involvement are asymptomatic, but can also present with abdominal pain, altered bowel habits, and gastrointestinal bleeding. To date, annual FIT testing has been used solely as a screening test for CRC. The role of non-invasive stool testing such as FIT, and its detection of other primary malignancies involving the gastrointestinal tract besides CRC, has not been studied and requires further investigation.

Identification of A Panel of Serum microRNAs as Biomarkers for Early Detection of Lung Adenocarcinoma.

Introduction: Since currently no sensitive and specific biomarkers for early detection of lung adenocarcinoma (AD) exist and the majority of AD patients are diagnosed at late stages of disease, the development of effective screening tests for early-stage lung AD is urgently needed. Serum microRNAs (miRNAs) have been documented as novel noninvasive biomarkers in tumor diagnosis; thus, we studied the profile of serum miRNA in AD patients in order to identify the differentially expressed miRNAs as potential biomarkers for early detection of AD.Patients and Methods: Serum samples were collected from 180 AD patients and 180 age- and sex-matched healthy controls. Serum miRNA profiling was performed by low-density array (LDA) using RNA extracted from blood samples of 20 patients and 20 controls. To validate the selected miRNAs, a stem-loop based RT-qPCR assay was used and serum samples from 160 patients and 160 controls were examined.Results: Profiling data showed 11 differentially expressed miRNAs in the serum samples from AD patients compared with the controls. Among them, 6 selected miRNAs in AD patients, including miR-103, miR-146a, miR-151, miR-21, miR-221, miR-222, and miR-223, were validated by RT-qPCR. In particular, the top three, miR-146a, miR-222, and miR-223, were confirmed to be significantly expressed in stage I/II AD patients compared with healthy controls.Conclusion: A panel of miRNAs with miR-146a, miR-222 and miR-223 could be used as potential noninvasive biomarkers for early detection of AD.

P-247 Quantitative proteomic exploration of biomarkers for early detection of adenocarcinoma of the lung

P-247 Quantitative proteomic exploration of biomarkers for early detection of adenocarcinoma of the lung

Detection and discrimination of preneoplastic and early stages of lung adenocarcinoma using hnRNP B1 combined with the cell cycle-related markers p16, cyclin D1, and Ki-67

Heterogeneous nuclear ribonucleoprotein B1 (hnRNP B1), an RNA binding protein, is a useful marker for early detection of lung squamous cell carcinoma because it is overexpressed in the early stages of lung cancer, including bronchial dysplasia, a premalignant lesion of lung squamous cell carcinoma. In the case of adenocarcinoma, we investigated the utility of hnRNP B1 for both detection of early adenocarcinoma and discrimination of non-invasive lesion, atypical adenomatous hyperplasia (AAH) from adenocarcinoma. hnRNP B1, cyclin D1, p16, and Ki-67 were analyzed in lung adenocarcinoma tissues and divided into early and overt adenocarcinoma and AAH, using immunohistochemistry. The intensity of these molecular markers was compared among three groups and also analyzed for 4 patients who showed both adenocarcinoma and AAH. Thirty-six of 54 (67%) adenocarcinoma patients showed positive staining of hnRNP B1: 14/20 (70%) early adenocarcinoma and 22/34 (65%) overt adenocarcinoma. In contrast, overexpression of hnRNP B1 in non-invasive lesion, AAH was observed in only 9% (1/11). Overexpression of cyclin D1 and decrease of p16 were frequently observed in both adenocarcinoma and AAH. These results suggest that hnRNP B1 would be a candidate of molecular marker for detection of early lung adenocarcinoma. In addition, combined analysis of hnRNP B1 and cell cycle-related genes, such as cyclin D1 and p16, might aid in discrimination of AAH from early adenocarcinoma.

PROSTATE-SPECIFIC ANTIGEN DENSITY

Nearly 20 years have passed since PSA was definitively identified. Throughout this period, its clinical application as a tumor marker has expanded significantly. Today, besides monitoring prostate cancer therapy, PSA is being used extensively in mass screening programs for early detection of adenocarcinoma of the prostate and has become the most important tumor marker in urologic oncology. Although of unquestionable importance, PSA is not the perfect marker because of its lack of efficacy in discriminating BPH from prostate cancer. In order to enhance its sensibility, specificity, and predictive value, a series of variables influencing PSA levels have been studied and new parameters developed to correct discrepancies or confounding factors. Recognition of the relationship between PSA, prostate volume, and their interference with serum PSA levels made possible the development of the PSAD concept. Its wide application in different sets of patients for diagnostic and staging purposes resulted in enough data to demonstrate its usefulness and cost effectiveness as a second-line screening parameter, helping to distinguish BPH from prostate cancer in patients with PSA levels in the intermediate area, and avoiding some unnecessary biopsies. Even though PSAD does not offer a definitive solution for prostate cancer screening or management, its association with all the other diagnostic methods may offer the best way to assess the population at risk and assure their well-being (Fig. 5).

Early gastric lymphoma: A clinicopathologic study of ten patients, literature review, and comparison with early gastric adenocarcinoma

Improved diagnostic techniques have increased early detection of gastric lymphoma as well as the early detection of adenocarcinoma. However, clinicopathologic features of early gastric lymphoma are presently undefined. Clinicopathologic features of 10 patients with early gastric lymphoma were compared with the same features of 180 patients with early gastric adenocarcinoma. In addition, 46 articles were reviewed to evaluate clinicopathologic differences. Early gastric lymphoma was found in 29.2% of the patients who underwent surgery for gastric lymphoma. Early gastric lymphoma was associated with lymph node involvement in 29.9% of the patients, superficial spreading tumors in 48.6%, and multifocal lesions in 40%. These rates are greater than those in patients with adenocarcinomas (P < 0.05%). The survival rate was identical in both groups. Early gastric lymphoma may develop into large, multifocal tumors, accompanied by lymph node involvement. Surgical treatment with a wide resection of the stomach and extensive lymph node dissection is necessary for early gastric lymphomas.