Well-differentiated Type Research Articles

The investigation of B12 deficiency leading to the serendipitous diagnosis of gastric carcinoid tumour

Gastric carcinoid is a rare type of gastric malignancy accounting for around 7% of all gastrointestinal neuroendocrine tumours (NETs). While most gastric NETs (gNETs) are readily visible through direct visualisation by upper endoscopy, around 25% of gastric carcinoids are invisible because they are located in the submucosal gastric regions of the body and fundus. gNETs located in the intra-mucosal areas can be identified by gastric mapping; this can be done by taking random gastric biopsies from the antrum, body and fundus. We report a case of a well-differentiated gastric NET type 1 with atrophic gastritis diagnosed on upper endoscopy and pathological immunohistochemistry staining.

A Colorectal Adenocarcinoma With Obstruction in a 26-Year-Old Man: A Case Report in an Unlikely Age Group

Colorectal cancer affects the rectum or large bowel, including the appendix. This type of cancer develops from the colorectal mucosa, with adenocarcinoma being the most common form, accounting for over 95% of cases. It typically affects individuals aged 50 years or older. However, this report highlights a case of colorectal adenocarcinoma that occurred at a young age, despite no family history. Unfortunately, the cancer was initially missed during check-ups because of the unlikely age group, resulting in a delayed diagnosis. The patient, who presented with an obstruction, underwent surgical interventions. Upon further examination, the histopathological tests revealed that the patient had well-differentiated type I colorectal adenocarcinoma.

Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature

IntroductionPapillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon.Case presentationHerein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space.ConclusionsPapillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC.

Histology Shift in Esophageal Cancer Between Biopsies and Resections After Neoadjuvant Therapy: A Pilot Study.

Preoperative neoadjuvant therapy followed by resection is the mainstay treatment for locally advanced esophageal adenocarcinoma. We recently observed the histology shift from predominant esophageal adenocarcinoma in the biopsy to neuroendocrine neoplasm with or without adenocarcinoma in the post-treatment resection. The underlying mechanism of this finding is uncertain, and there is limited information in the literature. A total of 11 patients were identified: 10 patients received presurgical chemoradiation and 1 with chemotherapy. All biopsies were diagnosed with adenocarcinoma. When neuroendocrine immunomarkers were retrospectively performed on 5 biopsies, 2 showed focal positivity, although the classic neuroendocrine morphology was not readily appreciated. All resections contained neuroendocrine neoplasm, including 8 of well-differentiated type and 3 of neuroendocrine carcinomas. Two post-treatment esophagectomies consisted of neuroendocrine neoplasm only without residual adenocarcinoma. Upon follow-up, 8 patients died of the disease (median survival = 26 months), and 3 patients were alive after a median follow-up of 14 months. The overall median survival time was better than the reported esophageal neuroendocrine carcinoma (15 months). The 5-year observed survival rate was 11.3%, which was lower than the Surveillance, Epidemiology, and End Results 5-year survival rate of adenocarcinoma (21.8%). We reported a small series of esophageal adenocarcinoma that showed histology shift between biopsy and esophagectomy after neoadjuvant therapy. Our limited data suggest that prognosis of this group is different than the conventional adenocarcinoma. Awareness of this morphological change reminds pathologists to examine the biopsy specimens thoroughly, because recognition of neuroendocrine neoplasm, especially high-grade neuroendocrine component, might potentially affect pre- and post-surgical regimens.

Dynamics of HOXA10 expression in ectopic endometrium of a mouse model of endometriosis

Introduction: Homeobox gene A10 (HOXA10) is a transcription factor that plays a key role in maintaining endometrial homeostasis. In women with endometriosis, HOXA10 expression is downregulated, which is thought to cause progesterone resistance. However, it is unknown whether this downregulation is a cause or consequence of endometriosis. Materials and Methods: In this study, we used a mouse model of endometriosis and demonstrated that compared to the normal endometrium, the expression of HOXA10 is progressively downregulated during lesion development (from day 10 to day 65). Results: We observed that the expression of HOXA10 is lower in both well-differentiated and mixed types of endometriosis. During lesion development, the levels of HOXA10 were initially downregulated in epithelial cells more than in stromal cells. However, as the lesion development progressed further, the stromal expression was drastically reduced. While the nucleocytoplasmic ratio of HOXA10 was identical between control and endometriosis lesions at the initial stages, at later time points, HOXA10 remained largely nuclear, with little expression in the stroma. Conclusion: We conclude that the downregulation of HOXA10 is a consequence of endometriosis and may contribute toward its pathogenesis.

Orbital liposarcoma: a retrospective, single-center study of thirteen patients.

To explore the clinical and pathological characteristics of thirteen patients with orbital liposarcoma. The clinical history data of thirteen patients diagnosed as orbital liposarcoma at Beijing Tongren Hospital, from 2006 to 2021 were collected and analyzed. The data includes age, gender, affected orbital side, course of disease, status of disease (primary or recurrent), clinical manifestations, preoperative visual acuity, operative treatment, the relations between liposarcoma and surrounding tissue, longest diameter of liposarcoma, histological subtype, immunohistochemical indicators, follow-up treatment and prognosis. The initial symptoms are diverse. Proptosis is the most frequent chief complaint and the others included vision loss, epiphora, diplopia, and eyelid palpable mass. Results of imaging examination [computed tomography (CT) or magnetic resonance imaging (MRI)] showed orbital mass. In terms of treatment, 10 patients received tumor resection, and the mean longest diameter of the tumor was 3.39±1.36 cm. The other 3 patients had optic nerve invaded, so they received orbital exenteration. Pathological examination results confirmed the diagnose of liposarcoma for 13 patients. Six patients displayed as myxoid type, and three patients in each type of dedifferentiated and well-differentiated type. One patient was verified as pleomorphic, which was a rare type of liposarcoma. All of the patients showed Vimentin positive, and most showed CD34 and S-100 positive. Besides, four patients showed smooth muscle actin positive. All thirteen patients were alive. Orbital liposarcoma is a rare disease and it has no specific clinical manifestation. The diagnosis of liposarcoma should be considered when proptosis and orbital mass occurred in orbit. It is recommended to perform pathological examination to achieve early detection and early treatment.

Mixed-type Retroperitoneal Liposarcoma—A Combination of the Well-differentiated and Myxoid Types: Case Report and Literature Review

Mixed-type Retroperitoneal Liposarcoma—A Combination of the Well-differentiated and Myxoid Types: Case Report and Literature Review

Remote sensing monitoring of mining tailings in the fluvial-estuarine-coastal ocean continuum of the Lower Doce River Valley (Brazil)

Water clarity is a key parameter of aquatic ecosystems impacted by mining tailings. Tracking down tailings dispersion along the river basin requires a regional monitoring approach. The longitudinal fluvial connectivity, river-estuary-coastal ocean, and the lateral connectivity, river-floodplain-alluvial lakes are interconnected by hydrological flows, particularly during high fluvial discharge. The present study aims to track the dispersal of iron ore tailing spill, from the collapse of the Fundão dam (Mariana, MG, Brazil), on November 5, 2015, in the Lower Doce River Valley. A semi-empirical model of turbidity data, as a water clarity proxy, and multispectral remote sensing data (MSI Sentinel-2), based on different hydrological conditions and well-differentiated water types, yielded an accuracy of 92%. Five floods (> 3187m3s-1) and five droughts (< 231m3s-1) events occurred from 2013 to 2020. The flood of January 2016 occurred one month after the mining slurries reached the coast, intruding tailings on some alluvial and coastal plain lakes with highly turbid waters (> 400 NTU). A fluvial plume is formed in the inner shelf adjoining the river mouth on high flow. The dispersion of river plume was categorized as plume core (turbidity > 200 NTU), plume core and inner shelf waters (100-199 NTU), other shelf water (50-99 NTU), and offshore waters (< 50 NTU). Fluvial discharge and local winds are the main drivers for river plume dispersion and transport of terrigenous material along the coast. This work provides elements for evaluating the impact of mining tailings and an approach for remote sensing regional monitoring of surface water quality.

A rare case of non-treated fetal–type hepatoblastoma for five years stayed without metastases in a young boy

Hepatoblastoma is the most common malignant neoplasm of the liver in infancy. In this paper, we present a rare case of non-treated hepatoblastoma in an 18-month-old baby male who presented with an asymptomatic abdominal mass associated with elevated Alpha-fetoprotein. Contrast-enhanced CT revealed a solid mass located in the left lobe of the liver, measuring about 6 × 6 cm, and not enhancing the contrast. US-guided Tru-cut biopsy was performed which showed pure epithelial fetal-type hepatoblastoma. The parents refused neoadjuvant chemotherapy and the connection was disconnected with them because of the ongoing crisis in Syria. After five years, the patient returned with the same clinical picture. CT scan was repeated which revealed the same tumor without metastases. The decision was made to do a left hepatectomy after another confirmation with a surgical biopsy. Histopathological examination showed a multifocal pure epithelial-fetal well-differentiated type of hepatoblastoma with a favorable grade. Moreover, surgical margins and liver capsule appeared free, and the tumor was considered in Stage 1 accordingly. To this date, the boy was followed up with serial US and Alpha-fetoprotein (AFP)levels without signs of recurrence. Hepatoblastoma with pure fetal-type histology can be treated with complete surgical excision without neoadjuvant or adjuvant chemotherapy if the tumor was resected completely because this type of neoplasm is slow growing and has a good prognosis.

PMON38 Severe Refractory Hypoglycemia in a Patient with Metastatic Neuroendocrine Tumor

Abstract Background Neuroendocrine tumors(NETs) differ in origin, location, behavior and response to treatment. In most cases, they secrete hormones or vasoactive substances. Pancreatic NETs (PNETs) are rare tumors and account for 1-2% of all pancreatic tumors. They arise from the endocrine tissue of the pancreas. Fifty to seventy percent of PNETs are not functioning. Functioning tumors can secrete insulin, glucagon, gastrin, vasoactive intestinal peptide depending on their origin. Insulinomas are the most common type of PNETs with an incidence rate of 1-4 per 1000,000 per year. They are usually indolent tumors and rarely malignant. Insulinomas are characterized by fasting hypoglycemia with elevated serum insulin and c-peptide levels. Symptoms can range in severity from confusion, visual changes, palpitations, diaphoresis, and tremulousness to seizures, amnesia or coma. Clinical Case We report a case of a 71 year old male who was referred for an evaluation of ongoing hypoglycemia. He was diagnosed with metastatic carcinoid cancer by fine needle aspiration of the tail of pancreas and liver which showed a well-differentiated neuroendocrine type tumor. A month later, the patient underwent an exploratory laparotomy, pancreatectomy, splenectomy, appendectomy. PNET was identified in the spleen and pancreas. Less than a year later, the neuroendocrine cancer metastasized to the thoracic vertebrae (T8 Biopsy: Positive stains: Pancytokeratin, CD56, Synaptophysin, Chromogranin and Ki-67 [20%]). He received chemotherapy with doxorubicin and streptozocin. He had multiple interventional radiology guided liver chemoembolization. Throughout this time, his hypoglycemia rapidly worsened requiring aggressive medical management. His lab findings (hemoglobin A1C 5.4%, serum glucose 114 mg/dL, c-peptide 26 ng/mL [4.4ng/mL UNL], GFR&amp;gt;60 ml/min/1.73 m2, random insulin levels 123 mIU (24.9 mIU UNL) with serum glucose 108 mg/mL, serum chromogranin A 2616 ng/mL [102 ng/mL UNL]) and clinical progression suggested that his PNETs were insulin producing. He was started on sandostatin and later on diazoxide to control his blood glucose levels. Use of Diazoxide lead to anasarca. Patient was not able to tolerate prolonged fasting due to hypoglycemia that continued to worsen. He required multiple admissions with IV dextrose administration. Later, octreotide was stopped due to concerns of paradoxical hypoglycemia due to glucagon suppression and hypoglycemia initially improved. However, a few weeks later hypoglycemia again worsened and we decided to increase the diazoxide and furosemide. The patient's hypoglycemia continued to progress in frequency and severity and his overall condition continued to deteriorate. The patient therefore chose hospice care and passed away shortly after. Conclusion This is a rare case of rapidly progressing metastatic PNET with severe refractory hypoglycemia in a patient despite treatment with multiple modalities. More research is needed to further characterize PNETs and improve current available management. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Epstein-Barr Virus Infection as Significant Predisposing Factor and Post-Radiotherapy Prognostic Indicator among Libyan Patients with Nasopharyngeal Cancer

Background and Objectives: Libya is one of the North African countries which constitute an area of nasopharyngeal carcinoma endemicty, particularly at the north part of Libya as compared to its south portion. Although from the clinical as well as histopathological presentation, there is no uniquely specific pattern of appearance, but there is high deficiency in the data that confirm the possible predisposing factors which may play a role in the development of this common variety of head and neck cancer at this country, and whether these factors affecting the patients response to treatment. Therefore this study was conducted to elucidate the suggestion of the role of Epstein-Barr Virus (EBV) in the risk of nasopharyngeal cancer at Libyan population; the results were correlated with the radiotherapy response and the improvement in the post-therapy prognostic value. Patients and Methods: Sixteen patients aged 9-80 years presented at ENT department -Althowra central teaching hospital-elbyda-Libya at period from September- 2005 up to January-2014 with variable patterns of clinical presentation suggestive nasopharyngeal carcinoma. All patients were evaluated radio- logically as well as endoscopically, the diagnosis was confirmed by the biopsy and further histo-pathological assessment. For all patients the serological elucidation for IgG and IgM anti-EBV antibodies was done, and the results were correlated with the age of the incidence, sex of the incidence, the pattern of clinical presentation, the pattern of histo-pathological presentation, the response to the radiotherapy, the rate of the recurrence, and five years survival. Results: 88% of the patients showed significant increase of serum IgG against Viral Capsid Antigen (VCA) of EBV. 83% of the cases presented with cervical masses and unilateral otitis media with effusion. 86% of cases showed lympho-epithelioma as histo-pathological pattern. On the other hand among all patients, those patients with lympho-epithelioma showed significant response to the concomitant radio- chemotherapy (100%) with high survival rate exceed five years. Conclusion: The EBV infection can be considered as one of main predisposing factors of nasopharyngeal carcinoma at Libyan population. As it was noted from this presenting study that the induction of the cancer by EBV is mainly due to chronic infection rather than acute infection and this was confirmed by significant elevation of serum IgG rather than IgM. In addition it was postulated that the EBV infection most likely to be associated with lympho-epithelioma variety of histo-pathology rather than well-differentiated type, and as it was elucidated via this study that the association of the cancer with EBV infection increased the sensitivity of the tumor to concomitant radio-chemotherpy, thus this will improve the five years survival after the treatment.

Increased expression of Nrf2 and elevated glucose uptake in pheochromocytoma and paraganglioma with SDHB gene mutation

BackgroundPheochromocytomas (PCC) and paragangliomas (PGL) are catecholamine-producing neuroendocrine tumors. According to the World Health Organization Classification 2017, all PCC/PGL are considered to have malignant potential. There is growing evidence that PCC/PGL represent a metabolic disease that leads to aerobic glycolysis. Cellular energy metabolism involves both transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) and succinate dehydrogenase (SDH) subtypes, but the association of these substances with PCC/PGL is largely unknown.MethodsWe investigated SDHB gene mutation and protein expressions for SDHB and Nrf2 in surgical specimens from 29 PCC/PGL. We also assessed preoperative maximum standard glucose uptake (SUVmax) on [18F]fluorodeoxy-glucose positron emission tomography and mRNA levels for Nrf2.ResultsAmong 5 PCC/PGL with a PASS Score ≥ 4 or with a moderately to poorly differentiated type in the GAPP Score, 4 were metastatic and found to be SDHB mutants with homogeneous deletion of SDHB protein. SDHB mutants showed a higher expression of Nrf2 protein and a higher preoperative SUVmax than non-SDHB mutants with a PASS < 4 or a well-differentiated GAPP type. Furthermore, protein expression of Nrf2 was positively associated with preoperative SUVmax. The Nrf2 mRNA level positively correlated with malignant phenotype, higher expression for Nrf2 protein and SDHB gene mutant, but negatively correlated with expression for SDHB protein. There was also a positive correlation between Nrf2 mRNA level and SUVmax.ConclusionThese results suggest that activation of Nrf2 and elevated metabolism play roles in PCC/PGL with malignant potential that have SDHB gene mutation and SDHB deficiency.

High-Voltage LC-Parallel Resonant Converter with Current Control to Detect Metal Pollutants in Water through Glow-Discharge Plasma

This paper presents a high-voltage power source to produce glow-discharge plasma in the frame of a specific application. The load has two well-differentiated types of behavior. To start the system, it is necessary to apply a high voltage, up to 15 kV, to produce air-dielectric breakdown. Before that, the output current is zero. Contrarily, under steady state, the output voltage is smaller (a few hundred volts) while the load requires current-source behavior to maintain a constant glow in the plasma. The amount of current must be selectable by the operator in the range 50–180 mA. Therefore, very different voltage gains are required, and they cannot be easily attained by a single power stage. This work describes why the LC-parallel resonant topology is a good single stage alternative to solve the problem, and shows how to make the design. The step-up transformer is the key component of the converter. It provides galvanic isolation and adapts the voltage gain to the most favorable region of the LC topology, but it also introduces non-avoidable reactive components for the resonant net, determining their shape and, to some extent, their magnitude. In the paper, the transformer’s constructive details receive special attention, with discussion of its model. The experimental dynamic tests, carried out to design the control, show load behavior that resembles negative resistance. This fact makes any control loop prone to instability. To compensate this effect, a resistive ballast is proposed, eliminating its impact on efficiency with a novel filter design, based on an inductor, connected in series with the load beyond the voltage-clamping capacitor. The analysis includes a mathematical model of the filtering capacitor discharge through the inductor during the breakdown transient. The model provides insight into the dimensions of the inductor, to limit the discharge current peak and to analyze the overall performance on steady state. Another detail addressed is the balance among total weight, efficiency and autonomy, which appears if the filter inductor is substituted for a larger battery in autonomous operation. Finally, a comprehensive set of experimental results on the real load illustrate the performance of the power source, showing waveforms at breakdown and at steady state (for different output currents). Additionally, the detector’s constructive principles are described and its experimental performance is explored, showing results with two different types of metallic pollutants in water.

TUBB3 immunostaining improves the diagnostic accuracy of oral liquid-based cytology in squamous cell carcinoma.

Although class III beta-tubulin (TUBB3) is not expressed in normal epithelium, its expression in cancers of some organs has been reported. Herein, we investigated the expression pattern and expression levels of TUBB3 in oral squamous cell carcinoma (SCC), and assessed whether TUBB3 immunostaining could improve the diagnostic accuracy of oral scraping liquid-based cytology (LBC). Paraffin sections of biopsies from 107 patients with primary SCC and 30 patients with squamous papilloma of the tongue or gingiva were immunostained for TUBB3. In addition, 15 LBC samples obtained from the study participants with SCC were immunostained for TUBB3. Seven LBC samples were false-negative. The TUBB3 expression level in each sample was evaluated and classified as 3+, 2+, 1+, or 0. TUBB3 expression was confirmed in 91.6% of paraffin-embedded SCC specimens. Clear and diffuse positivity (2+ or above) was observed in 77.6% of the total cases. In the well-differentiated type, tumour cells in the middle layer of the parenchyma specifically expressed TUBB3. In almost LBC samples, cancerous intermediate cells showed immunopositivity similar to that of paraffin samples, even if cellular atypia was not clear in Papanicolaou staining. TUBB3 immunostaining is useful for diagnosing oral SCC in scraping LBC, especially when samples consist of intermediate cells with little morphological change. Moreover, TUBB3 immunostaining could improve the diagnostic accuracy of oral scraping LBC by reducing false-negatives.

Piperlongumine, a Potent Anticancer Phytotherapeutic, Induces Cell Cycle Arrest and Apoptosis In Vitro and In Vivo through the ROS/Akt Pathway in Human Thyroid Cancer Cells

Simple SummaryThere is no effective treatment currently available for patients with anaplastic, recurrent papillary, or follicular thyroid cancers. Reactive oxygen species (ROS) are believed to hold promise as a new therapeutic strategy for multiple human cancers. However, studies on ROS inducers for human thyroid cancer treatment are scarce. This study assesses the anticancer activity and the detailed downstream mechanisms of piperlongumine, a ROS inducer, in human thyroid cancer cells. We demonstrate that piperlongumine inhibits cell proliferation, regulates the cell cycle, and induces cellular apoptosis in various types of human thyroid cancer cells. The antihuman thyroid cancer activity of piperlongumine was through ROS induction, and it further suppressed the downstream Akt signaling pathway to elevate mitochondria-dependent apoptosis. A mouse xenograft study demonstrated that piperlongumine was safe and could inhibit tumorigenesis in vivo. The present study provides strong evidence that piperlongumine can be used as a therapeutic candidate for human thyroid cancers.Thyroid cancer (TC) is the most common endocrine malignancy, and its global incidence has steadily increased over the past 15 years. TC is broadly divided into well-differentiated, poorly differentiated, and undifferentiated types, depending on the histological and clinical parameters. Thus far, there are no effective treatments for undifferentiated thyroid cancers or advanced and recurrent cancer. Therefore, the development of an effective therapeutic is urgently needed for such patients. Piperlongumine (PL) is a naturally occurring small molecule derived from long pepper; it is selectively toxic to cancer cells by generating reactive oxygen species (ROS). In this study, we demonstrate the potential anticancer activity of PL in four TC cell lines. For this purpose, we cultured TC cell lines and analyzed the following parameters: Cell viability, colony formation, cell cycle, apoptosis, and cellular ROS induction. PL modulated the cell cycle, induced apoptosis, and suppressed tumorigenesis in TC cell lines in a dose- and time-dependent manner through ROS induction. Meanwhile, an intrinsic caspase-dependent apoptosis pathway was observed in the TC cells under PL treatment. The activation of Erk and the suppression of the Akt/mTOR pathways through ROS induction were seen in cells treated with PL. PL-mediated apoptosis in TC cells was through the ROS-Akt pathway. Finally, the anticancer effect and safety of PL were also demonstrated in vivo. Our findings indicate that PL exhibits antitumor activity and has the potential for use as a chemotherapeutic agent against TC. This is the first study to show the sensitivity of TC cell lines to PL.

Antizyme inhibitor 2 (AZIN2) associates with better prognosis of head and neck minor salivary gland adenoid cystic carcinoma.

The key regulator of the polyamine biosynthetic pathway is ornithine decarboxylase (ODC). ODC is activated by antizyme inhibitor 1 (AZIN1) and 2 (AZIN2). AZIN1 and recently AZIN2 have been related to cancer; however, their functions in adenoid cystic carcinoma (ACC) have not been studied. We performed immunohistochemical study on minor salivary and mucous gland ACC tissue samples of patients treated at the Helsinki University Hospital (Helsinki, Finland) during 1974-2012. We scored AZIN1 and 2 immunoexpression in 42 and 45 tumor tissue samples, respectively, and correlated them with clinicopathological factors and survival. Enhanced AZIN2 expression was associated with better survival. In addition, both AZINs were seen more commonly in cribriform and tubular than in solid growth patterns. AZIN1 expression did not correlate with the studied clinicopathological factors. It seems that AZIN2 expression is higher in cancer tissue with secretory functions. In ACC tissue, high AZIN2 expression could be related to well-differentiated histological type which still has a functioning vesicle transportation system. Thus, AZIN2 could be a prognostic factor for better survival of ACC patients.

The role of PI3K signaling pathway and its associated genes in papillary thyroid cancer

BackgroundOne of the well-differentiated types of thyroid cancer is papillary thyroid cancer (PTC), often developed by genetic mutations and radiation.MethodsIn this study, the public NCBI-GEO database was systematically searched. The eligible datasets were the targets for biomarker discovery associated with PI3K signaling pathway.ResultsOnly two datasets were suitable and passed the inclusion criteria. The meta-analysis outcomes revealed eleven upregulation and thirteen downregulation genes differentially expressed between PTC and healthy tissues. Moreover, the outcomes for survival and disease-free rates for each gene were illustrated.ConclusionsThe present research suggests a panel signature of 24 gene biomarkers in diagnosing the PTC.

Cytoplasmic-only Expression of Maspin Predicts Unfavorable Prognosis in Patients With Pancreatic Ductal Adenocarcinoma.

Maspin is a tumor-suppressor protein expressed in >90% of pancreatic ductal adenocarcinoma (PDAC) cases. We aimed to assess the prognostic value of subcellular localization of maspin. Ninety-two resected PDAC specimens were immunohistochemically analyzed. Cytoplasmic-only expression observed in >10% of the tumor was defined as maspin-positive. The maspin-positive status (21.7%) was inversely correlated with well-differentiated histological type and indicated a shorter recurrence-free survival (RFS) and overall survival (OS). Cox's multivariate analysis showed that maspin-positive status was an independent factor for shorter RFS and OS. Maspin was localized to cytoplasm in AsPC-1 cells, but to both nucleus and cytoplasm in BxPC-3 cells. In AsPC-1 cells, cell invasion was significantly reduced in response to maspin suppression via transfection with siRNA targeting maspin, whereas no reduction was observed in BxPC-3 cells. Cytoplasmic-only expression of maspin could be an independent unfavorable prognostic indicator for patients with PDAC.

Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population.

BACKGROUND: Esophageal cancer ranks eighth among the most prevalent cancers globally and is the sixth leading cause of mortality from malignancy worldwide; it is the 7th most prevalent malignancy in males and the 6th most prevalent malignancy in females. In Pakistan, the incidence is 4.1 per 100 000 with the province of Baluchistan having the greatest incidence.OBJECTIVE: Report trends and characteristics of esophageal cancer in Pakistan over the past 10 years.DESIGN: Cross-sectional, retrospective review of medical records.SETTING: Tertiary care hospital.PATIENTS AND METHODS: The study included all patients admitted with a diagnosis of esophageal carcinoma with a mass lesion or luminal narrowing. The records were for the period from January 2011 to September 2020.MAIN OUTCOME MEASURES: Gender, histopathological types/differentiation along with clinical/laboratory findings.SAMPLE SIZE: 1009 with a mean (standard deviation) age of 49.3 (14.2) and a median (interquartile range of 50 (22) years (443 males and 566 females with age of 51.0 [20] years and 47.9 [23.8] years, respectively). The male-to-female ratio was 1:1.2.RESULTS: Most patients (82.7%) had squamous cell carcinomas with a male-to-female ratio of 1:2; the remainder had adenocarcinomas with a male-to-female ratio of 4:1 (P<.001). Dysphagia, weight loss, and vomiting were the most prevalent symptoms. More adenocarcinoma masses were located distally compared with squamous cell carcinomas (P=.030), lesions were most likely to be ulcerated (P=.910). Luminal narrowing was slightly more frequent in squamous cell carcinoma (P=.215), thickening was more prominently circumferential in the adenocarcinomas. In squamous cell carcinoma, the most common variant was moderately differentiated while moderate to poorly differentiated variants were more common in adenocarcinoma. In the survival analysis, squamous cell carcinoma (P=.014 vs adenocarcinoma), particularly the well-differentiated type (P=.018 vs other variants), projected a better prognosis.CONCLUSION: Our study reports the most recent trends of esophageal carcinoma in this region.LIMITATIONS: Lack of metastatic workup, TNM staging, and mode of treatment, along with the overlapping pattern of histological variants.CONFLICT OF INTEREST: None.

Clinico-pathological Spectrum of Oral Cavity Lesions at a Tertiary Care Center in Central Nepal: A Descriptive Cross-sectional Study.

Head and neck cancer is the sixth most common cancer in the world. The disease burden is increasing at an alarming rate in developing Southeast Asian countries. This study aims to report the histopathological spectrum of oral cavity lesions at a tertiary cancer center in central Nepal. This study included all those cases of oral cavity lesions, of which diagnostic biopsy was done from January 2018 to December 2019. The data were retrieved from the Department of Pathology of BP Koirala Memorial Cancer Hospital. The study proposal was approved by the Institutional Review Committee at BPKMCH (Ref: 247/2020) on 28th June 2020. Convenience sampling was done. Data was analyzed using Statistical Package for the Social Sciences version 20 using descriptive statistics. A total of 851 cases of oral cavity lesions were included in this study. The mean age of the study population was 55.9 years, with male to female ratio of 3:1. Malignant lesions composed of 472 (55.5%) cases followed by premalignant lesion of 104 (12%). More than 453 (95%) malignant cases were squamous cell carcinoma, of which 342 (75%) were a well-differentiated type. The buccal cavity is the most common site of malignant lesion 212 (45%), followed by tongue 96 (20%) and lower gingivobuccal region 86 (18%). Malignant lesions are the most common histopathological findings in the oral cavity lesion with squamous cell carcinoma type. Oral cancer is common cancer that can be prevented and cured if detected early.