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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 -
Clinical Neurology and Neurosurgery Sep 2020Primary intracranial Rhabdoid meningioma (PIRM) is an uncommon subtype of WHO grade III meningioma. Given its rarity, its risk factors and management strategies are...
Primary intracranial Rhabdoid meningioma (PIRM) is an uncommon subtype of WHO grade III meningioma. Given its rarity, its risk factors and management strategies are still unclear. Therefore, we aimed to assess the risk factors and outcomes for patients with PIRM and proposed an appropriate treatment. Ovid, Medline, Embase, Pubmed, Web of Science and Cochrane database were used to search for articles published between January 1998 and October 2019. Search terms combined "intracranial", "brain", and "cerebral" with "rhabdoid meningioma" or "WHO grade III meningioma". The entire cohort included 27 males (51.9 %) and 25 females (48.1 %) with an age ranging from 2 to 77 years (median 44 years). The size of tumor ranged from 1.3 to 7.4 cm (mean 4.3 cm). The Ki-67 proliferation index ranged from 1 % to 90 % (mean 15 %). In the whole cohort, gross total resection (GTR) and non-GTR were achieved in 63.5 % (33 cases) and 36.5 % (19 cases) patients, respectively. Twenty-five patients (48.1 %) had the postoperative radiotherapy, and 5 patients (9.6 %) had postoperative chemotherapy. Nineteen patients (39.6 %) developed recurrences, 4 patients (7.7 %) developed distant metastasizes, and 13 patients (25.0 %) died. GTR was associated with favorable overall survival (p = 0.008). The 1-, 3-, and 5-year progression-free survival rates were 84.6 %, 59.4 %, and 49.6 %, respectively; and the 1-, 3- and 5- year overall survival rates in the entire group were 91.4 %, 83.5 % and 68.9 %, respectively. GTR is recommend as the initial treatment option for PIRMs, contributing to acute histological diagnosis and prolonging long-term survival.
Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Kaplan-Meier Estimate; Ki-67 Antigen; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Mitotic Index; Neoplasm Grading; Neurosurgical Procedures; Prognosis; Progression-Free Survival; Proportional Hazards Models; Retrospective Studies; Treatment Outcome; Tumor Burden; Young Adult
PubMed: 32516684
DOI: 10.1016/j.clineuro.2020.105971 -
Translational Cancer Research Aug 2023Neuroendocrine neoplasm (NEN) is a group of rare tumors. Among which, gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common group. The World Health...
BACKGROUND
Neuroendocrine neoplasm (NEN) is a group of rare tumors. Among which, gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common group. The World Health Organization (WHO) classified these tumors into three different grades (G1, G2, and G3) based on Ki-67 and mitotic rate, and updated the classification in 2019. Several previous studies proved that Ki-67 was related to tumor prognosis, but others still reported that Ki-67 had no predictive value for tumor prognosis. There are different conclusions between studies regarding the correlation between Ki-67 and tumor prognosis, and there is a lack of studies about this correlation of GEP-NENs. Further analysis is still needed to evaluate the prognostic value of Ki-67 in GEP-NENs, to provide reference for clinical decisions.
METHODS
A total of 303 studies were retrieved that included Ki-67, GEP-NENs, prognosis, survival, and other subject terms and keywords. We excluded studies that did not show complete Ki-67 index, number of patients and 5-year survival data available for meta-analysis, non-cohort studies, articles published before 2000 or not published in English. Fifteen studies were finally included to assess the value of Ki-67 in the prognosis of patients with GEP-NENs using a random-effects model.
RESULTS
The cumulative 5-year survival rate for GEP-NEN G1 (Ki-67 ≤2%), G2 (Ki-67 2-20%) and G3 (Ki-67 >20%) was 86%, 65%, 25% respectively. The 5-year survival rate of GEP-NEN G1 (Ki-67 <3%, first revised in WHO classification 2017, redefined WHO classification 2019) and G1 (Ki-67 ≤2%, WHO classification 2010) was 97% and 84% respectively.
CONCLUSIONS
The overall prognosis of GEP-NENs patients showed a decreasing trend with the increase of Ki-67, which confirmed the significance of Ki-67 index as a prognostic marker for the prognosis of GEP-NENs. Increasing the cut-off value of Ki-67 index for G1 grade from ≤2% to <3% according to WHO classification 2019 did not significantly decrease the 5-year survival rate.
PubMed: 37701110
DOI: 10.21037/tcr-23-248 -
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 -
Annals of Diagnostic Pathology Oct 2022To describe the clinicopathological features and differential diagnoses of 15 cases of superficial myofibroblastoma, a rare mesenchymal tumor involving the lower female...
OBJECTIVE
To describe the clinicopathological features and differential diagnoses of 15 cases of superficial myofibroblastoma, a rare mesenchymal tumor involving the lower female genital tract.
METHODS
The clinicopathological data and immunohistochemical findings were retrospectively analyzed in 15 cases of superficial myofibroblastoma. Meanwhile, a systematic literature review was conducted.
RESULTS
The age of patients ranged from 34 to 73 years (median, 49 years). Most patients presented with nodular or polypoid masses ranging in size from 0.4 cm to 6.5 cm. Twelve tumors were located in the vagina, two in the vulva, and one in the cervix. Microscopically, the tumor was located in the subepithelial tissue, with a clear boundary and without capsule on the surface. The tumor cells were spindle, oval, stellate or wavy, and arranged in various architectural patterns of reticular, fascicular, wavy and disorderly patterns. There were no obvious cellular atypia and mitotic figures. Thin collagen fibers and thin-walled vessels could be observed in all cases. Most cases were diffusely and strongly reactive to Vimentin (12/12), Desmin (14/15), ER (15/15) and PR (13/14). Variable immunoreactivity for CD34 (8/15), Caldesmon (2/8), SMA (4/14) and CD99 (4/5) were observed. The tumors showed a low Ki67 proliferative index (≤5 %). Follow-up information was available in 10 patients and there was no evidence of recurrence or metastasis.
CONCLUSIONS
Superficial myofibroblastoma is a rare benign tumor that originates from the hormone-sensitive, subepithelial mesenchymal tissue of the lower female genital tract, and should be differentiated from other mesenchymal tumors.
Topics: Adult; Aged; Biomarkers, Tumor; Calmodulin-Binding Proteins; Collagen; Desmin; Female; Hormones; Humans; Ki-67 Antigen; Middle Aged; Neoplasms, Muscle Tissue; Retrospective Studies; Vagina; Vimentin
PubMed: 35907316
DOI: 10.1016/j.anndiagpath.2022.152010