Objective To investigate the prognostic differences and decision-making role in postoperative radiotherapy of four molecular subtypes in pT1-2N1M0 stage breast cancer. Methods The clinicopathological data of 1526 patients with pT1-2N1M0 breast cancer treated at West China Hospital of Sichuan University between 2008 and 2018 were retrospectively analyzed. χ2 test was used to compare the clinicopathological features among patients with different molecular subtypes. Kaplan-Meier survival analysis and log-rank test were used to draw the survival curves and compare the overall survival (OS) and breast cancer-specific survival (BCSS) among patients with different molecular subtypes. Cox regression model was used to determine the influencing factors of OS of patients after radical mastectomy. Results Among the 1526 patients with pT1-2N1M0 breast cancer, there were 674 cases (44.2%) of Luminal A subtype, 530 cases (34.7%) of Luminal B subtype, 174 cases (11.4%) of human epidermal growth factor receptor 2 (Her-2) overexpression subtype, and 148 cases (9.7%) of triple-negative subtype. The 5-year OS rates of Luminal A, Luminal B, Her-2 overexpression and triple negative patients were 98.6%, 94.3%, 95.5% and 91.2%, respectively (χ2=11.712, P=0.001), and the 5-year BCSS rates were 99.3%, 94.6%, 95.5% and 92.5%, respectively (χ2=18.547, P<0.001). Multiple Cox regression analysis showed that menstrual status [hazard ratio (HR)=0.483, 95% confidence interval (CI) (0.253, 0.923), P=0.028] and whether endocrine therapy [HR=2.021, 95%CI (1.012, 4.034), P=0.046] were prognostic factors for the 5-year OS rate of breast cancer patients after radical mastectomy (P<0.05). However, it failed to reveal that Luminal subtypes and postoperative radiotherapy were prognostic factors for the 5-year OS rate (P>0.05). Conclusions In pT1-2N1M0 breast cancer patients, the 5-year OS rate and 5-year BCSS rate in triple-negative patients are the lowest. The relationship between Luminal classification, postoperative radiotherapy and survival in patients after radical mastectomy needs further study in the future.
Objective To investigate the relationship between thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and clinicopathological features of breast cancer. Methods Thyroid function data, general clinical data and data reflecting pathological characteristics of breast cancer of 136 breast cancer patients admitted to the Department of Breast and Thyroid Surgery, People’s Hospital of Wuhan University from December 2019 to April 2022 were collected. According to the TPOAb and TGAb antibody levels of patients, 136 breast cancer patients were divided into positive group (antibody level ≥60 U/mL) and negative group (antibody level < 60 U/mL). The general clinical data, thyroid function, breast cancer markers, tumor size, pathological classification, clinical TNM stage, lymph node metastasis and immunohistochemical index expression characteristics of the two groups were analyzed. Results There was no statistically significant difference between the TPOAb positive group and the TPOAb negative group, as well as between the TgAb positive group and the TgAb negative group in terms of age, previous chronic medical history, surgical medical history and menstrual status of breast cancer patients (P>0.05), and there was no significant difference in the results of preoperative ultrasound and molybdenum target examination (P>0.05).Compared with the TPOAb negative group, the level of triiodothyronine (T3) in the TPOAb positive group was lower (P=0.020), and the level of thyroidstimulating hormone (TSH) was higher (P=0.001). TSH level in the TgAb positive group was higher than that in the TgAb negative group (P=0.036). There was no significant difference in tumor markers (carcinoembryonic antigen, carbohydrate antigen 125 and 153) and the number of lymph nodes cleared during operation between the positive and negative groups of TPOAb and TgAb (P>0.05). Compared with the respective negative groups, there was no significant difference tumor size, pathological classification, clinical TNM stage, lymph node metastasis, pathological molecular classification, and the expression of ER, PR and Ki-67 in the TPOAb positive group and the TgAb positive group (P>0.05). The positive rate of HER-2 expression in the TPOAb positive group was higher than that in the TPOAb negative group (P=0.033). There was no significant difference in HER-2 expression between the TgAb positive group and the TgAb negative group (P>0.05). There was no significant difference between the TPOAb positive group and the TPOAb negative group, as well as the TgAb positive group and the TgAb negative group in terms of chemotherapy, invasive carcinoma with carcinoma in situ, with benign lesions and nerve invasion (P>0.05). There was no significant difference between TPOAb positive group and negative group in vascular tumor thrombus rate and single cancer focus rate (P>0.05). Compared with the TgAb negative group, the TgAb positive group had a lower vascular tumor thrombus rate (P=0.034) and a higher single cancer focus rate (P=0.045). Conclusions Thyroid autoantibodies positive breast cancer patients have lower T3 level and higher TSH level, and the positive expression of thyroid autoantibodies is related to HER-2 expression, vascular tumor thrombus and the number of tumor foci in breast cancer. It suggests that thyroid autoantibodies TPOAb and TgAb may have an impact on the prognosis of breast cancer.
ObjectiveTo investigate the correlation between UBE2Q1 expression and clinicopathologic features and prognosis of lung adenocarcinoma. MethodsThis study retrospectively chose the cancer tissue and para-carcinoma tissue samples of 74 patients with stage I to III lung adenocarcinoma who received radical resection in Nanjing Chest Hospital from January 2013 to December 2016. Immunohistochemistry staining was used to detect the expression level of UBE2Q1, and patients were divided into high-expression group and low-expression group according to the Immunohistochemistry staining score. The correlation of UBE2Q1 expression level and clinicopathological characteristics was analyzed by Chi-square test. Kaplan-Meier survival curve analyzed the correlation between UBE2Q1 and prognosis of lung adenocarcinoma patients. The risk factors affecting the survival of lung adenocarcinoma patients were analyzed by univariate and multivariate Cox proportional risk models. ResultsUBE2Q1 was highly expressed in lung adenocarcinoma tissues, and the expression level was correlated with tumor diameter, lymph node metastasis, and TNM stage (P<0.05), and did not correlate with patients’ gender, age, smoking history, and tumor differentiation (P>0.05). The results of the Kaplan-Meier survival analysis showed that patients with low expression of UBE2Q1 compared with those with high expression of UBE2Q1 had longer DFS and OS (both P<0.05). Cox proportional risk model showed that tumor diameter, lymph node metastasis, TNM stage, and high UBE2Q1 expression were the risk factors for DFS and OS, among which TNM stage was an independent risk factor. ConclusionUBE2Q1 was highly expressed in lung adenocarcinoma tissues and correlated with large tumor diameter, lymph node metastasis, late TNM stage and poorer prognosis in lung adenocarcinoma, and UBE2Q1 was a risk factor for lung adenocarcinoma.
Perivascular epithelioid cell tumor (PEComa) is a multi-potential tumor based on mesenchymal cells distributed around capillaries. The main affected population is female, and the clinical manifestations are not specific. It can affect all parts of the body. There are more PEComa in the uterus and very few PEComa in the liver. Due to its low incidence, clinicians lack awareness of it. Based on the relevant literature, this article reviews the clinicopathological features, imaging features, molecular phenotypes, diagnosis, differential diagnosis, and treatment of liver PEComa, so as to strengthen the understanding of the disease, prevent missed diagnosis and misdiagnosis, and guide clinical work.
Objective To compare the differences in clinicopathological features, molecular phenotypes, and prognosis between atypical type A thymoma (AAT) and classic type A thymoma (TAT), and to clarify the aggressive nature of AAT. Methods The data of AAT patients (AAT group) and classic TAT patients (TAT group) who underwent surgical resection for thymoma at West China Hospital of Sichuan University between January 2016 and November 2024 were retrospectively collected. Comparisons on the clinical data, histopathology, immunohistochemistry (CD20, Ki-67), GTF2I mutation status, and survival outcomes were performed between the two groups. Results A total of 53 patients were enrolled, including 22 in the AAT group and 31 in the TAT group. There was no significant difference in age, sex, or initial presenting symptoms between the two groups (P>0.05). Compared with the TAT group, the AAT group had larger tumors [(5.6±2.7) vs. (4.1±2.0) cm, P=0.043], a lower proportion of Masaoka stage Ⅰ (31.6% vs. 61.3%, P=0.041), and worse survival outcomes [progression-free survival: hazard ratio (HR)=2.87, 95% confidence interval (CI) (1.42, 5.81), P=0.004; overall survival: HR=1.96, 95%CI (1.02, 3.78), P=0.013]. Pathologically, the AAT group showed more mitotic figures (mean 6/2 mm2), and tumor necrosis was observed in 45.5% of cases. There was no statistically significant difference in the CD20 expression rate (20.0% vs. 41.9%), Ki-67 index [(11.0±6.0)% vs. (8.0±6.9)%], or GTF2I mutation rate (86.7% vs. 92.3%) between the two groups (P>0.05). Conclusions AAT is a subtype of TAT with distinct aggressive pathological features, including higher mitotic activity, a tendency for necrosis, and a greater propensity for recurrence and metastasis. Pathological diagnosis should integrate morphology and molecular testing to guide more aggressive treatment and follow-up strategies.
Objective
To investigate the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome (PJS) in Chinese cases.
Methods
The clinical and pathological data of 295 patients with PJS who were treated in Air Force General Hospital from Nov. 1994 to Aug. 2017 were retrospectively analyzed and a multifactor statistical study was carried out on.
Results
Two hundreds and ninety-five patients with PJS belonged to 7 nationalities and came from 26 provinces and urban areas. 99.0% (292/295) of the patients had black spots on the lip and buccal mucosa, and the median occurrence time was 2 years old (0–33 years). The median age of inital diagnosis and treatment was 15 years old (1–45 years). The median interval time between the occurrence of black spots and abdominal symptoms was about 10 years (0–45 years). PJS hamartoma polyps were found in alimentary canals of 293 patients (99.3%), and 96.9% distributed in the duodenum and small intestine (n=284), 90.4% distributed in the colorectal (n=265), 79.9% distributed in the stomach (n=234). Patients of black spot appearing at age <3 years and (or) initial treatment at age <14 years were classified as early-onset subtype, otherwise they could be included in delayed-onset subtype.
Conclusions
The clinical features of PJS are prominent and the harm of PJS hamartoma polyps is serious. The black spots on the lip and buccal mucosa can be used as an early warning signal to divide the PJS patients into 2 clinical subtypes, which should be differentiated in clinical therapy and follow-up strategy.
Objective To conclude the CT manifestations and pathological features of low-grade appendiceal mucinous neoplasms. Methods We reviewed the clinical and CT findings of 24 patients with low-grade appendiceal mucinous neoplasms, who were confirmed by pathology within 1 month after CT examination in SichuanProvincial People’s Hospital from January 2018 to December 2020. The distribution, morphological characteristics, cyst wall and internal characteristics, CT value and enhancement characteristics of tumors were be detected in detail. Results ① Distribution: of the 24 patients, 22 patients located in the appendix area of the right lower quadrant, 2 patients located in the right middle abdomen, and 2 patients located in the pelvic cavity. ② Morphological characteristics: of the 24 patients, 15 patients manifested as tubular, 3 patients manifested as ellipsoidal, 5 patients manifested as saccular, and 1 patient manifested as irregular shape. The average length of tumors was about 6.4 cm (4.2–12.0 cm), and the average short diameter of tumors was about 2.2 cm (0.8–5.0 cm). The short diameter of 17 patients were more than 1.5 cm. ③ The cyst wall and internal characteristics: all the 24 patients demonstrated as cystic mass, 6 patients had evenly thin and smooth cyst wall, and other 18 patients had uneven cyst wall. Of all the patients,8 patients had arc-shaped, punctate or eggshell-like calcification. ④ The CT value and enhancement characteristics: 24 patients examined by plain CT scan, 22 patients showed uniform low density (the CT value were 7–25 HU), 2 patients contained some slightly high density, 16 patients examined by enhanced CT, the cyst wall, separation, or mural nodules of 8 patients were slightly or moderately enhanced. ⑤ Pathological results: of all the gross specimens, 15 patients showed tubular dilation, 9 patients showed partial or complete dilation as cystic mass. All the 24 patients had gelatinous or mucinous contents. Microscopically, all the patients showed low-grade mucinous epithelial hyperplasia, submucosa, and mucosal muscle atrophy, accompanied by fibrosis or calcification. Conclusion Low-grade appendiceal mucinous neoplasms show some specific CT manifestations, recognize these features can improve the accuracy of preoperative CT.
ObjectiveTo understand the research status of diagnosis and treatment of gastric hepatoid adenocarcinoma (GHA) in order to provide a reference for clinical.MethodThe relevant literatures on diagnosis and treatment of GHA at home and abroad in recent years were searched and reviewed.ResultsThe GHA was a special type of gastric cancer with adenoid and hepatocyte differentiations, and the incidence of GHA in all gastric cancers was less than 1%. The histological morphology of GHA was similar to that of hepatocellular carcinoma, which was often accompanied by elevated serum alpha-fetoprotein and was prone to lymph node and liver metastases. The radical surgery and adjuvant chemotherapy were the most important treatment methods. However, even when the radical resection was performed, the recurrence and metastasis were still common, and there was no standard chemotherapy regimen for GHA at present.ConclusionsGHA is a special subtype of gastric cancer with high malignancy, which has rapid clinical progress and poor prognosis. Pathomorphology is the gold standard for the diagnosis of GHA. The therapy of GHA is a comprehensive treatment based on operation and chemotherapy, and gene molecular characteristics and targeted therapy are the research directions in future.
ObjectiveTo analyze the relation between age and postoperative pathological features of patients with colorectal cancer from Database from Colorectal Cancerr （DACCA）. MethodsThe data in DACCA were updated on January 5, 2022. The patients were selected from DACCA according to the established screening conditions, then were divided into ≤35, 35–59, and ≥60 years old groups. The differences of postoperative pathological （p） TNM （pTNM）, pT, pN, pM stages, perineural invasion （PNI）, high-risk factors grade, and tumor regression grade （TRG） among the three age groups were analyzed, and the correlation between them was analyzed. ResultsAfter screening, 5 628 data rows were enrolled, of whom 196 patients were <35 years old, 2 382 patients were 35–59 years old, and 3 050 patients were >59 years old. Statistical analysis showed that: ① There were statistical differences in the proportions of pN stage, PNI, and high-risk factors grade in the patients of different age groups （H=27.867, P<0.001; H=6.248, P=0.044; H=19.712, P<0.001, respectively）; However, it was not found that there were statistical differences in the proportions of pTNM, pT, pM stages, and TRG after neoadjuvant therapy among different age patients （H=0.920, P=0.631; H=4.923, P=0.085; H=2.272, P=0.321; H=2.337, P=0.311, respectively）. The Spearman correlation analysis results showed that there was a weakly negative correlation between the age and pN stage or grade of high-risk factors （rs=–0.070, P<0.001; rs=–0.067, P<0.001, respectively） and a weakly positive correlation between age and TRG after neoadjuvant therapy （rs=0.100, P=0.009）. ConclusionDACCA data analysis finds that patients of different age groups shows a negative correlation trend with pN stage or grade of high-risk factors and a positive correlation trend with TRG, which needs to be further verified.
ObjectiveTo summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma (PMBC), and to retrospectively analyze the prognosis and the prognostic factors.
MethodsNinety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively.
Results① Clinicopathological characteristics:These patients accounted for 1.48% (94/6 330) of all breast cancer patients who treated in our hospital during the same period. They were all female,with a median age of 45 years old (29-85 years)and median duration of 90 d (5-2920 d). A proportion of 63.83% (60/94) of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% (58/68) tumors were in T1-T2 staging, and 82.80% (77/93) tumors were node-negative. A proportion of 1.05% (1/95) tumors had metastasized at diagnosis. A proportion of 92.54% (62/67) tumors were in Ⅰ-Ⅱ staging, 84.34% (70/83) tumors were estrogen receptor (ER) positive, 74.70% (62/83) were progesterone receptor (PR) positive, and 20.25% (16/79) were human epidermal growth factor receptor 2 (HER-2/neu) positive. A proportion of 6.32% (6/95) of tumors had breast-conserving surgery. ② Preoperative diagnosis:The detection rate of malignance were 60.87% (14/23), 83.33% (40/48), and 100% (18/18), respectively for patients who were examined with mammography, ultrasonography, and mammography+ultrasonography, and there was significant difference between the three groups (P=0.006). ③ Prognosis and prognostic factors:The follow-up rate was 80.85% (76/94). Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year and ten-year overall survival rate (OS) were 98.50%, both five-year and ten-year disease-free survival rate (DFS) were 95.80%. There was no lymph node involvement in patients of T1 phase, and no recurrence, metastasis or death occurred during the follow-up. The univariate analysis showed that the disease course, T staging, TNM staging, and HER-2/neu status were statistically significant prognostic factors for DFS situation (P<0.050).
ConclusionsCases in this group displayed indolent behavior and favorable prognosis which are similar to western populations. The disease course, T staging, TNM staging, and HER-2/neu status appear to be significant predictors of worse prognosis. The combination of mammography and ultrasonography could largely improve the diagnostic accuracy, and breast-conserving therapy may be recommended for patients with no contraindications.
