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Critical Reviews in Toxicology Nov 2022Existing literature suggests an association between chronic cadmium (Cd) exposure and the induction of DNA damage and genotoxicity. However, observations from individual... (Meta-Analysis)
Meta-Analysis Review
Existing literature suggests an association between chronic cadmium (Cd) exposure and the induction of DNA damage and genotoxicity. However, observations from individual studies are inconsistent and conflicting. Therefore current systematic review aimed to pool evidence from existing literature to synthesize quantitative and qualitative corroboration on the association between markers of genotoxicity and occupational Cd exposed population. Studies that evaluated markers of DNA damage among occupationally Cd-exposed and unexposed workers were selected after a systematic literature search. The DNA damage markers included were chromosomal aberrations (chromosomal, chromatid, sister chromatid exchange), Micronucleus (MN) frequency in mono and binucleated cells (MN with condensed chromatin, lobed nucleus, nuclear buds, mitotic index, nucleoplasmatic bridges, pyknosis, and karyorrhexis), comet assay (tail intensity, tail length, tail moment, and olive tail moment), and oxidative DNA damage (8-hydroxy-deoxyguanosine). Mean differences or standardized mean differences were pooled using a random-effects model. The Cochran- test and statistic were used to monitor heterogeneity among included studies. Twenty-nine studies with 3080 occupationally Cd-exposed and 1807 unexposed workers were included in the review. Cd among the exposed group was higher in blood [4.77 μg/L (-4.94-14.48)] and urine samples [standardized mean difference 0.47 (0.10-0.85)] than in the exposed group. The Cd exposure is positively associated with higher levels of DNA damage characterized by increased frequency of MN [7.35 (-0.32-15.02)], sister chromatid exchange [20.30 (4.34-36.26)], chromosomal aberrations, and oxidative DNA damage (comet assay and 8OHdG [0.41 (0.20-0.63)]) compared to the unexposed. However, with considerable between-study heterogeneity. Chronic Cd exposure is associated with augmented DNA damage. However, more extensive longitudinal studies with adequate sample sizes are necessary to assist the current observations and promote comprehension of the Cd's role in inducing DNA damage. CRD42022348874.
Topics: Humans; Cadmium; Micronucleus Tests; Occupational Exposure; DNA Damage; Chromosome Aberrations
PubMed: 36802997
DOI: 10.1080/10408444.2023.2173557 -
EJIFCC Nov 2019Breast cancer is the most common malignancy in women worldwide. In this systematic review 28 studies were taken into account, in order to evaluate the role of DNA... (Review)
Review
Breast cancer is the most common malignancy in women worldwide. In this systematic review 28 studies were taken into account, in order to evaluate the role of DNA content and cell cycle phases, measured by flow cytometry in breast cancer. Presence of aneuploidy and S-phase fraction have been extensively studied as a prognostication tool. With the current dawn of the age of intraoperative flow cytometry the present systematic review provide an insight of the current role of flow cytometry in breast cancer and future horizons.
PubMed: 31814815
DOI: No ID Found -
Obesity Surgery Nov 2020The number of bariatric procedures has increased notably, with incidental findings such as gastrointestinal stromal tumors (GISTs) being observed in 2%. The number of... (Review)
Review
The number of bariatric procedures has increased notably, with incidental findings such as gastrointestinal stromal tumors (GISTs) being observed in 2%. The number of studies dealing with incidental findings during bariatric surgery (BS), especially GISTs, is scarce. This review aims to summarize the evidence about GIST diagnosis during BS, and to establish recommendations for the management and follow-up of these patients. A systematic literature search from January 2000 to March 2020 was performed. Retrospective cohort studies, case series, case reports, reviews, and conference abstracts were considered eligible. The present systematic review focused on a descriptive analysis of the data included in the articles selected. The calculated incidence was 0.65%. A change in operative plan was observed in 5% of the cases. In 98% of the cases, GISTs were gastric, with a mean size of 10.3 mm. The mitotic index was < 5 in 99%. Accordingly, all patients were classified as having a very low or low risk of recurrence. R0 resection was achieved in 100% of cases. The incidence of GISTs in patients with MO submitted to BS is considerably higher than in the general population. The diagnosis is related to the depth of preoperative work, the exhaustiveness of the intraoperative examination, and the meticulousness of the histopathological analysis. Although GISTs have a low risk of recurrence and it was previously unnecessary to modify the surgical technique, we recommend that bariatric surgeons are aware of the diagnosis and management of incidental GISTs.
Topics: Bariatric Surgery; Gastrointestinal Stromal Tumors; Humans; Neoplasm Recurrence, Local; Obesity, Morbid; Retrospective Studies
PubMed: 32710370
DOI: 10.1007/s11695-020-04853-1 -
Human Pathology Feb 2024Differentiated high-grade thyroid carcinomas (DHGTCs) are a new diagnostic entity most recently defined in the 2022 World Health Organization's (WHO) Classification of...
BACKGROUND
Differentiated high-grade thyroid carcinomas (DHGTCs) are a new diagnostic entity most recently defined in the 2022 World Health Organization's (WHO) Classification of Endocrine and Neuroendocrine Tumors. This new entity has been minimally described in the literature, and additional cases classified as such are missing.
MATERIALS AND METHODS
Cases of DHGTCs diagnosed at our institution from 2012 to 2022 were identified, and the following were reviewed: cytologic and histologic diagnoses, ancillary testing, immunohistochemical staining, treatments, and patient outcomes. Immunohistochemical staining for Ki67 was performed on selected cases lacking this immunostain. A systematic literature review of the English literature on DHGTCs from 2013 to 2023 was performed using PubMed and Embase.
RESULTS
Case cohort included 32 cases of DHGTCs, with an average age of 52.6 years (range 17-84 years) and a male:female ratio of 1.3:1. All cases underwent fine needle aspiration (FNA) and were categorized by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) as follows: 14 cases as malignant (43.8 %), 10 as follicular neoplasm (31.3 %), 5 as atypia of undetermined significance (15.6 %), 2 as suspicious for malignancy (6.2 %), and 1 as non-diagnostic (3.1 %). The average tumor size was 5.15 cm, and most were papillary thyroid carcinoma (28, 87.5 %), with classic subtype being the most common. Twenty-one cases revealed tumor necrosis and the mitotic activity in lesions without necrosis averaged to 5.5 mitoses per 2 mm (range 0-7). The average Ki67 proliferative index was 5.6 %. Extrathyroidal extension was seen in 17, angioinvasion in 21, lymphatic invasion in 7, and perineural invasion in 1 case. Foci of solid or trabecular growth were identified in five cases. Lymph node metastases at the time of diagnosis were noted in 10 cases and 7 demonstrated distant metastases or locoregional recurrence. To date, 25 patients are alive, and one has died from disease.
CONCLUSIONS
Our institutional experience demonstrates that DHGTC is a rare, but aggressive thyroid tumor subtype that requires consideration in the setting of a well-differentiated thyroid neoplasm to appropriately assess for possible disease recurrence and determination of patient prognosis.
Topics: Humans; Male; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Ki-67 Antigen; Thyroid Neoplasms; Thyroid Cancer, Papillary; Necrosis; Adenocarcinoma, Follicular; Retrospective Studies
PubMed: 38244615
DOI: 10.1016/j.humpath.2024.01.002 -
Pediatric Surgery International Sep 2021Gastrointestinal stromal tumor (GIST) is a rare cancer of mesenchymal origin mostly seen in adult and elderly populations. Therefore, the prognostic and therapeutic... (Review)
Review
Gastrointestinal stromal tumor (GIST) is a rare cancer of mesenchymal origin mostly seen in adult and elderly populations. Therefore, the prognostic and therapeutic features of pediatric GIST are not clearly defined. Clinical knowledge has been largely extrapolated from case series and adult studies. In this systematic review, we aimed to analyze the health outcome metrics of pediatric GIST. Medline and Embase databases were searched using relevant key terms. The original search retrieved 1,892 titles; 27 studies with 184 patients (68% female) were included for final review. The primary tumors were located in the stomach (165/184, 90%), small bowel (12/184, 7%), and elsewhere (7/184, 4%). Individual patient data were available in 125 cases with a median follow-up of 6.7 years. All patients underwent surgical resection, which varied from wide local excision to total gastrectomy. There were 12 deaths (10%), 65 (52%) patients were alive with no evidence of disease, and 31 cases (25%) were alive with disease. Tumor size > 5 cm, high mitotic index, and spindle morphology were predictive of mortality. Pediatric GIST has a more favorable prognosis and different characteristics versus adult tumors. There is a crucial need for international consensus and specific pediatric guidelines for the treatment of this rare tumor.
Topics: Adult; Aged; Child; Female; Gastrointestinal Stromal Tumors; Humans; Intestine, Small; Male; Prognosis; Retrospective Studies; Treatment Outcome
PubMed: 34081161
DOI: 10.1007/s00383-021-04931-0 -
Asian Journal of Surgery Jan 2020The purpose of this study is to assess the clinical outcomes and prognostic factors for survival of patients with duodenal gastrointestinal stromal tumors (GIST) who... (Meta-Analysis)
Meta-Analysis Review
The purpose of this study is to assess the clinical outcomes and prognostic factors for survival of patients with duodenal gastrointestinal stromal tumors (GIST) who underwent pancreaticoduodenectomy (PD) or local resection (LR). PubMed database was searched for relevant studies. A meta-analysis was performed with Review Manager 5.3 software. Twenty-seven observational studies involving 1103 patients were included in the review. The overall morbidity and 30-day mortality was 27% and 0.5% respectively. The median (range) 5-year overall survival (OS) and disease-free survival (DFS) rates were 87% (60-100%) and 71% (44-100%) respectively. In meta-analyses, factors associated with shorter DFS included male sex, mitotic index >5/50 high-power fields, high risk, tumor size >5 cm, and the PD procedure. Factors associated with shorter OS included mitotic index >5/50 high-power fields and tumor size >5 cm. Patients in PD group had a higher incidence of mitotic index >5/50 HPF, a higher incidence of high-risk classification, a higher incidence of tumors in the second portion of the duodenum, a larger tumor size, a longer duration of operation, more intraoperative blood loss, a greater blood transfusion requirement, a higher morbidity rate, a longer hospital stay, and an increased recurrence rate than those in LR group. In conclusion, the current literature review demonstrates that the postoperative prognosis of duodenal GIST is promising and mainly affected by tumor factors. The choice of the surgical approach should depend on the anatomical location and tumor size.
Topics: Digestive System Surgical Procedures; Gastrointestinal Neoplasms; Gastrointestinal Stromal Tumors; Humans; Pancreaticoduodenectomy; Prognosis; Treatment Outcome
PubMed: 30853211
DOI: 10.1016/j.asjsur.2019.02.006 -
Annals of Surgical Oncology Dec 2016Most patients with melanoma have a thin (≤1.00 mm) lesion. There is uncertainty as to which patients with thin melanoma should undergo sentinel lymph node (SN)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Most patients with melanoma have a thin (≤1.00 mm) lesion. There is uncertainty as to which patients with thin melanoma should undergo sentinel lymph node (SN) biopsy. We sought to quantify the proportion of SN metastases in patients with thin melanoma and to determine the pooled effect of high-risk features of the primary lesion on SN positivity.
METHODS
Published literature between 1980 and 2015 was searched and critically appraised. Primary outcome was the proportion of SN metastases in patients with thin cutaneous melanoma. Secondary outcomes included the effect of high-risk pathological features of the primary lesion on the proportion of SN metastases. Summary measures were estimated by Mantel-Haenszel method using random effects meta-analyses.
RESULTS
Sixty studies (10,928 patients) met the criteria for inclusion. Pooled SN positivity was 4.5 % [95 % confidence interval (CI) 3.8-5.2 %]. Predictors of a positive SN were: thickness ≥0.75 mm [adjusted odds ratio (AOR) 1.90 (95 % CI 1.08-3.34); with a likelihood of SN metastases of 8.8 % (95 % CI 6.4-11.2 %)]; Clark level IV/V [AOR 2.24 (95 % CI 1.23-4.08); with a likelihood of 7.3 % (95 % CI 6.2-8.4 %)]; ≥1 mitoses/mm [AOR 6.64 (95 % CI 2.77-15.88); pooled likelihood 8.8 % (95 % CI 6.2-11.4 %)]; and the presence of microsatellites [unadjusted OR 6.94 (95 % CI 2.13-22.60); likelihood 26.6 % (95 % CI 4.3-48.9 %)].
CONCLUSIONS
The pooled proportion of SN metastases in thin melanoma is 4.5 %. Thickness ≥0.75 mm, Clark level IV/V, mitoses, and microsatellites significantly increased the odds of SN positivity and should prompt strong consideration of SN biopsy.
Topics: Humans; Lymph Nodes; Lymphatic Metastasis; Melanoma; Mitotic Index; Patient Selection; Risk Factors; Sentinel Lymph Node Biopsy; Skin Neoplasms; Tumor Burden
PubMed: 26932710
DOI: 10.1245/s10434-016-5137-z -
Journal of Clinical Pathology Jul 2016Gastroenteropancreatic neuroendocrine tumours (GEP NETs) are classified according to tumour mitotic count or Ki-67 labelling index (LI). (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Gastroenteropancreatic neuroendocrine tumours (GEP NETs) are classified according to tumour mitotic count or Ki-67 labelling index (LI).
AIMS
To systematically review articles reporting the prognosis of patients by Ki-67 LI and thereby improve the ability of clinicians to prognosticate for their patients.
METHOD
265 abstracts were identified relating Ki-67 and survival. After exclusion criteria were applied, 22 articles remained. Articles were excluded if they described non-human specimens, were non-English language, published prior to 2000, reported non-GEP NETs, reported subgroups selected by treatment modality or included <20 cases. Random-effects meta-analysis was used to combine studies to estimate survival proportions.
RESULTS
Authors used varied methods in which to present 5-year survival, with often limited survival information. This reduced the number of studies that could be included in the meta-analysis. 5-year survival for patients with grade 1 and 2 GEP NETs were estimated to be 89% (95% CI 85% to 92%, m=12 studies, n=977 participants) and 70% (95% CI 62% to 79%, m=9, n=726), respectively. Using an alternative grade 1/2 boundary of 5%, 5-year survival rates for Ki-67≤5% and 5-20% were estimated as 89% (95% CI 84% to 94%, m=7, n=654) and 51% (95% CI 44% to 59%, m=4, n=183), respectively. For Ki-67>20%, 5-year survival was estimated to be 25% (95% CI 12% to 38%, m=10, n=208).
CONCLUSIONS
Standardisation of grade boundaries has allowed us to combine data from multiple studies and amass a body of evidence linking Ki-67 and survival.
Topics: Biomarkers, Tumor; Disease-Free Survival; Humans; Ki-67 Antigen; Mitotic Index; Neuroendocrine Tumors; Prognosis; Survival Rate
PubMed: 26680267
DOI: 10.1136/jclinpath-2015-203340 -
European Journal of Surgical Oncology :... Jul 2017The identification of small (<2 cm) gastrointestinal stromal tumors (GISTs) is increasingly recognized. The malignancy potential is not absent. However, data on risk is... (Review)
Review
INTRODUCTION
The identification of small (<2 cm) gastrointestinal stromal tumors (GISTs) is increasingly recognized. The malignancy potential is not absent. However, data on risk is scarce. The aim was to review the existing data on perceived risk of small GISTs in population-based studies.
METHODS
A combined review of small GISTs (<2 cm) in a population-based dataset compared with a systematic review of available population-based studies.
RESULTS
About one in every four (27%) patient has a small GIST, of which 79% were incidental in presentation, and all had a low-risk mitoses index (<5/hpf). The small GISTs had C-KIT mutations in exon 11 or 9 (66%), none had mutation in PDGFRA, and 33% were non-KIT/PDGFRA. The rate of small GISTs increased for each advancing age group. None of the small GISTs had a recurrence nor were there any GIST-specific deaths during follow-up. A "small GIST" rate at one-fourth of all GISTs reported was corroborated in other population-based studies from Norway, Iceland and Korea. Common to studies reporting mitosis index were an almost universal finding of very low-risk in small GISTs, with very few recurrences and an excellent long-term survival reported to 95-100% in several series.
DISCUSSION
One in every four GIST diagnosed is a small GIST (<2 cm). Small GISTs are increasingly found with advanced age and have an overall excellent prognosis. Defining true risk-features for proper surveillance and treatment strategy is needed in order to avoid over- and under-treatment.
Topics: Age Factors; Aged; Cell Transformation, Neoplastic; Gastrointestinal Neoplasms; Gastrointestinal Stromal Tumors; Humans; Middle Aged; Mitotic Index; Neoplasm Recurrence, Local; Norway; Proto-Oncogene Proteins c-kit; Receptor, Platelet-Derived Growth Factor alpha; Survival Rate; Tumor Burden
PubMed: 28222971
DOI: 10.1016/j.ejso.2017.01.240 -
Environmental Science and Pollution... Jun 2022Insecticides stand out as the most dangerous pesticides, and many of them can cause cytotoxic and genotoxic effects in organisms. For this reason, a systematic review... (Meta-Analysis)
Meta-Analysis
Insecticides stand out as the most dangerous pesticides, and many of them can cause cytotoxic and genotoxic effects in organisms. For this reason, a systematic review was performed focusing on the effect of insecticides on Allium cepa system by two ways: (1) a scientometric study to identify trends and gaps in the literature on the evaluation of insecticides to guide future research efforts and (2) a meta-analytical approach compiling the information to obtain an overall result about insecticide effect on A. cepa. It was found that there is an increasing production of articles in this research area. The H-index of our data set was 11, with an average of 13.72 citations per item. The leader country in this research area was India, followed by Turkey and Brazil. The best cited research area was "Environmental Sciences" and "Environmental Sciences and Ecology," followed by "Cell Biology." The most used keywords were genotoxicity, pesticides, and insecticide. The meta-analytical test showed that the number of micronuclei found in onion cells treated with insecticides is higher than that in untreated ones, and the use of pesticides reduced the mitotic index. In conclusion, it is evident the need for more studies about biotechnology, nanotechnology, and biopesticides to develop safer pesticides.
Topics: Chromosome Aberrations; Insecticides; Mitotic Index; Onions; Pesticides; Plant Roots
PubMed: 35089509
DOI: 10.1007/s11356-021-15953-5