-
Head & Neck Sep 2023In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science,... (Review)
Review
In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched to access cases of SPA in salivary glands. One hundred and thirty cases of SPA were found across 61 selected articles. SPA affected mainly the parotid gland of adults with a mean age of 44.6 years old, with a slight preference for females. The lesion was usually presented as a painless firm mass with a long period of evolution. Histologically, they are well-delimitated lesions composed of acinar and ductal elements with a variety of cytomorphologic features surrounded by a densely collagenized stroma. PI3K was the most common gene mutation related to SPA. SPA is a benign condition that mainly affects the parotid gland of female patients and it is usually treated by surgical resection with a good prognosis.
Topics: Adult; Humans; Female; Parotid Gland; Adenoma; Sclerosis
PubMed: 37403748
DOI: 10.1002/hed.27435 -
Reviews in Endocrine & Metabolic... Dec 2023Knowledge of ectopic insulinomas comes from single cases. We performed a systematic review through PubMed, Web of Science, Embase, eLibrary and ScienceDirect of all...
Knowledge of ectopic insulinomas comes from single cases. We performed a systematic review through PubMed, Web of Science, Embase, eLibrary and ScienceDirect of all cases reported in the last four decades. We also describe one unreported patient. From 28 patients with ectopic insulinoma, 78.6% were female and mean age was 55.7 ± 19.2 years. Hypoglycaemia was the first symptom in 85.7% while 14.3% complained of abdominal pain or genital symptoms. Median tumour diameter was 27.5 [15-52.5] mm and it was localised by CT (73.1%), MRI (88.9%), [Ga]Ga-DOTA-exedin-4 PET/CT (100%), Ga-labelled-DOTA-conjugated somatostatin analogue PET/TC (100%), somatostatin receptor scintigraphy (40%) and endoscopic ultrasound (50%). Ectopic insulinomas were located at duodenum (n = 3), jejunum (n = 2), and one respectively at stomach, liver, appendix, rectum, mesentery, ligament of Treitz, gastrosplenic ligament, hepatoduodenal ligament and splenic hilum. Seven insulinomas were affecting the female reproductive organs: ovary (n = 5), cervix (n = 2) and remaining tumours were at retroperitoneum (n = 3), kidney (n = 2), spleen (n = 1) and pelvis (n = 1). 89.3% underwent surgery (66.7% surgery vs. 33.3% laparoscopy) and 16% underwent an ineffective pancreatectomy. 85.7% had localized disease at diagnosis and 14.3% developed distant metastasis. Median follow-up time was 14.5 [4.5-35.5] months and mortality was reported in 28.6% with median time until death of 60 [5-144] months. In conclusion, ectopic insulinomas are presented as hypoglycaemia with female preponderance. Functional imaging [Ga]Ga-DOTA-exedin-4 PET/CT and Ga-labelled-DOTA-conjugated somatostatin analogue PET/TC have very high sensitivity. Clinicians should be alert to the possibility of extra-pancreatic insulinomas when classic diagnostic tests and intraoperative pancreas exploration failed to locate the tumour.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Gallium Radioisotopes; Hypoglycemia; Insulinoma; Pancreatic Neoplasms; Positron Emission Tomography Computed Tomography; Somatostatin
PubMed: 37434098
DOI: 10.1007/s11154-023-09824-2 -
Colorectal Disease : the Official... Jun 2022Metabolic syndrome (MetS) is a cluster of factors including obesity, hypertension, diabetes, hypercholesterolemia and hyperlipidaemia. It has been associated with an... (Meta-Analysis)
Meta-Analysis Review
AIM
Metabolic syndrome (MetS) is a cluster of factors including obesity, hypertension, diabetes, hypercholesterolemia and hyperlipidaemia. It has been associated with an increased risk of colorectal neoplasia. This systematic review and meta-analysis assessed the association between MetS and (i) recurrence of adenomas or occurrence of CRC in patients with prior adenomas, and (ii) survival in patients with CRC.
METHOD
MEDLINE, Embase, Scopus and Web of Science were searched up to 22 November 2019. Two authors independently conducted title and abstract screening; full text of eligible studies was evaluated. Where ≥3 studies reported effect measures for a specific outcome, meta-analysis using random effects model was conducted. I was used to assess between-study heterogeneity. Quality appraisal was undertaken with the Newcastle-Ottawa Score.
RESULTS
The search identified 1,764 articles, 55 underwent full text screening, resulting in a total of 15 eligible studies. Five studies reported on metachronous neoplasia, with differing outcomes precluded a meta-analysis. No consistent relationship between MetS and metachronous neoplasia was found. Ten studies reported on survival outcomes. MetS was associated with poorer CRC-specific survival (HR = 1.8, 95% CI: 1.04-3.12, I = 92.7%, n = 3). Progression-free survival was also worse but this did not reach statistical significance (HR = 1.12, 95% CI: 0.89-1.42, I = 85.6%, n = 3). There was no association with overall survival (HR = 1.04, 95% CI: 0.94-1.15, I = 43.7%, n = 7). Significant heterogeneity was present but subgroup analysis did not account for this.
CONCLUSION
MetS is associated with poorer CRC-specific survival, but evidence is inconsistent on metachronous neoplasia. Further research is warranted to better understand the impact of MetS on the adenoma-carcinoma pathway.
Topics: Adenoma; Colorectal Neoplasms; Humans; Metabolic Syndrome; Obesity
PubMed: 35156283
DOI: 10.1111/codi.16092 -
Oral Oncology Oct 2022Carcinoma ex Pleomorphic Adenoma (CXPA) is a rare primary salivary gland malignancy, typically arising from a pre-existing pleomorphic adenoma. This systematic review... (Review)
Review
OBJECTIVES
Carcinoma ex Pleomorphic Adenoma (CXPA) is a rare primary salivary gland malignancy, typically arising from a pre-existing pleomorphic adenoma. This systematic review examines prognostic factors affecting overall survival (OS) in major and minor salivary gland CXPA.
MATERIALS AND METHODS
Systematic review of MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, and Open Grey databases from inception to 31st March 2022 for all English-language literature pertaining to 'carcinoma ex pleomorphic adenoma'. All study types with greater than five patients with CXPA of the major and minor salivary glands were eligible for inclusion.
RESULTS
Of 8143 studies, 39 studies (n = 5637 patients) meeting the inclusion criteria were included. Median OS at one, three, five, and ten years were 90.0 %, 72.0 %, 61.9 %, and 45.0 % respectively for all CXPA. Higher staging, T stage, nodal disease, grading, and invasion ≥ 1.5 mm had worse outcomes. Histological subtype, perineural invasion, and radiotherapy did not demonstrate a consistent trend. Three studies were evaluated to have high risk of bias, and was removed for sensitivity analysis.
CONCLUSION
Survival outcomes worsen with time for all salivary gland CXPA. Further research on histopathological features and the utility of radiation therapy is required to guide patient selection for more aggressive treatment.
REGISTRATION
CRD42021238544 (PROSPERO).
Topics: Adenocarcinoma; Adenoma, Pleomorphic; Humans; Prognosis; Salivary Gland Neoplasms; Salivary Glands, Minor
PubMed: 35921695
DOI: 10.1016/j.oraloncology.2022.106052 -
International Journal of Environmental... Apr 2021PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus were searched in January 2021 in order to retrieve evidence assessing the association between dietary fibre... (Meta-Analysis)
Meta-Analysis Review
PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus were searched in January 2021 in order to retrieve evidence assessing the association between dietary fibre intake and the risk of colorectal adenoma in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the reporting of results. Only primary observational studies were included. Publication bias was estimated through the Egger's test and the visual inspection of the funnel plot. Heterogeneity between studies was calculated with I statistics. The search strategy identified 683 papers, 21 of which were included in our meta-analysis. Having evaluated a total of 157,725 subjects, the results suggest a protective effect of dietary fibre intake against colorectal adenoma. Effect Size (ES) was [0.71 (95% CI = 0.68-0.75), = 0.000)]. Moderate statistical heterogeneity (Chi = 61.68, df = 23, I = 62.71%, = 0.000) was found. Findings show a statistically significant ( = 0.000) and robust association between a higher intake of dietary fibre and a lower risk of colorectal adenoma, considering both the prevalent and incident risk. Moreover, the meta-regression analysis showed a borderline significant negative linear correlation between the amount of dietary fibre intake and colorectal adenoma. Lastly, we performed a subgroup analysis by sex, showing a higher protective effect for men.
Topics: Adenoma; Adult; Colorectal Neoplasms; Dietary Fiber; Humans; Male; Physical Examination
PubMed: 33920845
DOI: 10.3390/ijerph18084168 -
The Laryngoscope Mar 2024Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignant salivary gland tumor. Although multiple reviews have been published on salivary gland malignancies, it has... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignant salivary gland tumor. Although multiple reviews have been published on salivary gland malignancies, it has been a decade since the last dedicated systematic review pertaining to CXPA alone was published. This study examines molecular factors in CXPA diagnosis.
DATA SOURCES
MEDLINE, CINAHL, Embase, Scopus, Web of Science (BIOSIS), Cochrane CENTRAL, Health Collection (Informit), OpenDOAR, and GreyNet International.
REVIEW METHODS
Systematic review and meta-analysis from inception to October 31, 2022 for all English language studies pertaining to "carcinoma ex pleomorphic adenoma." Predicted incidence of each biomarker was calculated with meta-analysis. Comparison against pleomorphic adenoma (PA) and salivary duct carcinoma (SDC) when reported within the same study are performed. Risk of bias performed with JBI tool for prevalence studies.
RESULTS
Of 19151 unique studies undergoing abstract screening, 55 studies (n = 1322 patients) underwent data analysis. Biomarkers with >3 studies were p53, HER2, AR, EGFR, PLAG1, ERBB, ER, PR, HMGA2, p16, p63, a-SMA, RAS, PTEN, PDL1, BRAF, PIK3CA, and c-kit. Highest incidence was seen in AR, EGFR, p16, and p53. Significant differences were demonstrated compared with PA and SDC. There was high heterogeneity and overall high risk of bias within studies.
CONCLUSION
Molecular factors are an area of interest in the diagnosis of CXPA. Our study results support examining CXPA as a discrete cohort in future targeted therapy trials. Laryngoscope, 134:1042-1053, 2024.
Topics: Humans; Adenoma, Pleomorphic; Tumor Suppressor Protein p53; Biomarkers, Tumor; Salivary Gland Neoplasms; Adenocarcinoma; ErbB Receptors
PubMed: 37610148
DOI: 10.1002/lary.30993 -
Endocrine Practice : Official Journal... Jan 2023To review diagnostic imaging modalities for parathyroid cystic adenomas (PCA). Since PCAs are a rare (0.5%-1%) subclass of parathyroid adenomas, and due to their cystic... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To review diagnostic imaging modalities for parathyroid cystic adenomas (PCA). Since PCAs are a rare (0.5%-1%) subclass of parathyroid adenomas, and due to their cystic component, imaging modalities known to be efficient for diagnosing solid adenomas might fail in localizing them.
METHODS
We conducted a systematic review using the PubMed and Cochrane databases for English articles on PCAs published between 1995 and 2020. A meta-analysis of the retrieved data was performed.
RESULTS
Overall, 39 studies, reporting on a total of 160 patients, were included in the analysis. Two thirds (68%) of the patients were female, with a mean age of 53.9 years. A single cystic adenoma was detected in 98.1% of cases. The mean blood calcium corrected for albumin level was 12.6 ± 2.7 mg/dL, and the mean parathyroid hormone level was 565.5 ± 523.8 pg/mL. The mean PCA sizes as measured by ultrasound (US), computed tomography (CT), and ex vivo measurement were 4.8 ± 3.6, 5.2 ± 3.2, and 3.5 cm, respectively. The median weight was 8.1 g. PCA was detected in 86% of US examinations; 100% of US-guided fine needle aspiration, 4-dimensional computed tomography (4D-CT), or magnetic resonance imaging examinations; and 61% of 99m-technetium sestamibi scan with single-photon emission computed tomography ((99m)Tc-SPECT). (99m)Tc-SPECT showed a significantly lower diagnostic rate than US (odds ratio, 3.589), US-guided fine needle aspiration, CT combined with 4D-CT, and the combination of US, CT, 4D-CT, and magnetic resonance imaging (P < .001).
CONCLUSION
Although US and 4D-CT showed a significantly high rate in diagnosing PCA, (99m)Tc-SPECT showed a lower PCA diagnostic rate. These findings suggest that larger cystic lesions suspected as PCAs should be further evaluated using 4D-CT rather than (99m)Tc-SPECT.
Topics: Humans; Female; Middle Aged; Male; Parathyroid Neoplasms; Parathyroid Glands; Technetium Tc 99m Sestamibi; Four-Dimensional Computed Tomography; Adenoma; Retrospective Studies; Tomography, Emission-Computed, Single-Photon; Radiopharmaceuticals
PubMed: 36370985
DOI: 10.1016/j.eprac.2022.11.004 -
International Journal of Dermatology Jul 2022Eccrine tumors are a rare cutaneous adnexal neoplasm originating from the sweat glands. The periungual region represents an uncommon localization for these neoplasms. We... (Review)
Review
Eccrine tumors are a rare cutaneous adnexal neoplasm originating from the sweat glands. The periungual region represents an uncommon localization for these neoplasms. We analyzed all published demographic, clinical, and treatment data on periungual eccrine tumors. A systematic review following PRISMA guidelines was performed of articles published prior to March 2021. Articles were included in the review if a full-text English version was available. Of the surveyed literature, 27 full-text case reports were included in the final analysis. Benign eccrine poroma and porocarcinoma were the most common tumor subtypes (nine and eight cases, respectively). Males were only affected by poroma and porocarcinoma, while females were affected by all tumor subtypes. The first toe was the most common lower extremity affected. Misdiagnosis led to delayed treatment in 25% of cases. As such, while periungual eccrine neoplasms are rare diagnoses, the nonspecific presentations of these growths raise concerns about misdiagnosis and delayed treatment. Further research is needed related to sex-differences in the epidemiology of these growths and into the prevalence of the first toe as a location. These tumors should be considered in the differential diagnosis for nail unit afflictions.
Topics: Diagnosis, Differential; Eccrine Porocarcinoma; Female; Humans; Male; Poroma; Skin Neoplasms; Sweat Gland Neoplasms
PubMed: 34494261
DOI: 10.1111/ijd.15893 -
Cancers Jun 2021Gut microbiota plays an important role in human health. It may promote carcinogenesis and is related to several diseases of the gastrointestinal tract. This study of... (Review)
Review
Gut microbiota plays an important role in human health. It may promote carcinogenesis and is related to several diseases of the gastrointestinal tract. This study of microbial dysbiosis in the etiology of colorectal adenoma aimed to investigate the possible causative role of microbiota in the adenoma-carcinoma sequence and its possible preventive role. A systematic, PRISMA-guided review was performed. The PubMed database was searched using "adenoma microbiota" and selecting original articles between January 2010 and May 2020 independently screened. A higher prevalence of Proteobacteria, Fusobacteria, and Bacteroidetes phyla was observed in the fecal luminal and mucosa-associated microbiota of patients with adenoma. However, other studies provided evidence of depletion of , , and . Results on the relationship between adenoma endoscopic resection and microbiota were inconsistent. In conclusion, none of the analyzed studies developed a predictive model that could differentiate adenoma from non-adenoma patients, and therefore, to prevent cancer progression. The impact of adenoma's endoscopic resection on microbiota was investigated, but the results were inconclusive. Further research in the field is required.
PubMed: 34205378
DOI: 10.3390/cancers13123061 -
Clinical Gastroenterology and... Sep 2022Colonoscopy quality indicators provide measurable assessments of performance, but significant provider-level variations exist. We performed a systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND & AIMS
Colonoscopy quality indicators provide measurable assessments of performance, but significant provider-level variations exist. We performed a systematic review and meta-analysis to assess whether endoscopist specialty is associated with adenoma detection rate (ADR) - the primary outcome - or cecal intubation rate, adverse event rates, and post-colonoscopy colorectal cancer rates.
METHODS
We searched EMBASE, Google Scholar, MEDLINE, and the Cochrane Central Registry of Controlled Trials from inception to December 14, 2020. Two reviewers independently screened titles and abstracts. Citations underwent duplicate full-text review, with disagreements resolved by a third reviewer. Data were abstracted in duplicate. The DerSimonian and Laird random effects model was used to calculate pooled odds ratios (ORs) with respective 95% confidence intervals (CIs). Risk of bias was assessed using Risk of Bias in Non-randomised Studies of Interventions.
RESULTS
Of 11,314 citations, 36 studies representing 3,500,832 colonoscopies were included. Compared with colonoscopies performed by gastroenterologists, those by surgeons were associated with lower ADRs (OR, 0.81; 95% CI, 0.74-0.88) and lower cecal intubation rates (OR, 0.76; 95% CI, 0.63-0.92). Compared with colonoscopies performed by gastroenterologists, those by other (non-gastroenterologist, non-surgeon) endoscopists were associated with lower ADRs (OR, 0.91; 95% CI, 0.87-0.96), higher perforation rates (OR, 3.02; 95% CI, 1.65-5.51), and higher post-colonoscopy colorectal cancer rates (OR, 1.23; 95% CI, 1.14-1.33). Substantial to considerable heterogeneity existed for most analyses, and overall certainty in the evidence was low according to the Grading of Recommendations, Assessment, Development, and Evaluations framework.
CONCLUSION
Colonoscopies performed by surgeons or other endoscopists were associated with poorer quality metrics and outcomes compared with those performed by gastroenterologists. Targeted quality improvement efforts may be warranted.
Topics: Adenoma; Cecum; Colonoscopy; Colorectal Neoplasms; Gastroenterologists; Humans
PubMed: 34450297
DOI: 10.1016/j.cgh.2021.08.029