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Acta Cytologica 2024The diagnosis of salivary gland secretory carcinoma (SC) in fine-needle aspiration specimens is challenging because its low-grade nature makes it difficult to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The diagnosis of salivary gland secretory carcinoma (SC) in fine-needle aspiration specimens is challenging because its low-grade nature makes it difficult to differentiate it from various benign or malignant salivary gland neoplasms. Currently, the gold standard is demonstration of ETV6-NTRK3 fusion gene. However, the decision for ordering this costly molecular testing can be facilitated by the correct recognition of its cytomorphological features. The aim of the review was to determine the accuracy of fine-needle aspiration cytology (FNAC) in diagnosis of salivary gland SC. The secondary objective was to recognize varied cytomorphological patterns, characteristic features of SC and differentiate it from other neoplasms.
METHODS
PubMed/MEDLINE, Science Direct, Embase, Cochrane review, and PROSPERO databases were searched for studies having the following key search terms: ("secretory carcinoma of salivary gland" OR "mammary analogue secretory carcinoma of salivary gland") AND ("Cytology" OR "Cytological features" OR "aspirate" OR "cytodiagnosis") published in the time frame of 2010 to June 2023. Studies reporting cytological features of the salivary gland tumors which were confirmed/diagnosed as SC on molecular investigation, were included in the systematic review. Finally, seventeen studies reporting a total of 45 cases were included in the metanalysis.
RESULTS
The sensitivity of the FNAC in diagnosing SC in salivary gland is 27.7% (95% CI: 16.6-42.5%). The LR+ (positive likelihood ratio) was 0.654 (0.344-1.245), LR- (negative likelihood ratio) was 1.023 (0.538-1.946), and diagnostic odds ratio was 0.421 (0.129-1.374). The molecular testing and/or immunohistochemistry performed on cell block increased the diagnostic accuracy.
CONCLUSION
Recognition of subtle cytomorphological patterns, i.e., papillary formation, clusters, and singly dispersed cells along with presence of fine intracytoplasmic vacuolations were the characteristic findings in majority of cases, confirmed with diagnostic molecular profiling. This may be helpful in identification of this rare entity with limited published literature and help in increasing diagnostic accuracy.
Topics: Humans; Biopsy, Fine-Needle; Salivary Gland Neoplasms; Female; Predictive Value of Tests; Salivary Glands; Adult; Male; Reproducibility of Results; Biomarkers, Tumor; Middle Aged; Carcinoma; Mammary Analogue Secretory Carcinoma; Oncogene Proteins, Fusion; Young Adult; Adolescent; Cytodiagnosis; Aged; Diagnosis, Differential; Child; Cytology; ETS Translocation Variant 6 Protein; Receptor, trkC
PubMed: 38228123
DOI: 10.1159/000536249 -
Zhonghua Wei Chang Wai Ke Za Zhi =... May 2024The incidence of early-onset colorectal cancer (EOCRC) is increasing globally; however, the molecular characteristics and prognosis of sporadic EOCRC are unclear. In... (Meta-Analysis)
Meta-Analysis
The incidence of early-onset colorectal cancer (EOCRC) is increasing globally; however, the molecular characteristics and prognosis of sporadic EOCRC are unclear. In this systematic review and meta-analysis, we aimed to investigate the incidence of gene mutations and their association with cancer survival in sporadic EOCRC, focusing on six common gene mutations ( and ). Ovid Embase and Ovid Medline electronic databases were searched for studies involving patients with sporadic EOCRC (i.e., diagnosed with colorectal cancer before the age of 50 years and with no evidence of hereditary syndromes predisposing to colorectal cancer). The included articles were evaluated using quality assessment tools. Meta-analysis was performed using random-effects and fixed-effects models. Cochran's Q statistic and the I2 index were used to assess heterogeneity. The incidence of the six common gene mutations listed above in sporadic EOCRC and their association with cancer survival were evaluated. (1) . A total of 34 articles were included in this meta-analysis. The incidence of gene mutation was 36% (from 13 articles, 95%CI: 19%-55%, =0.043); of gene mutation 30% (from 26 articles, 95%CI: 24%-35%, =0.190); of gene mutation 7% (from 18 articles, 95%CI: 5%-11%, =0.422); of gene mutation 4% (from five articles, 95%CI: 3%-5%, =0.586); of gene mutation 6% (from six articles, 95%CI: 4%-10%, =0.968); and of gene mutation 59% (from 13 articles, 95%CI: 49%-68%, =0.164). (2) Association between gene mutations and survival in sporadic EOCRC A total of six articles were included in this meta-analysis. Compared with wild-type mutant was significantly associated with increased overall mortality risk in patients with EOCRC (pooled HR=2.85, 95%CI: 1.45-5.60, =0.002). Subgroup analysis showed that the incidence of gene mutation was higher in Eastern than in Western countries, whereas the incidence of , and gene mutations was lower. There was no significant difference in the incidence of PTEN gene mutation between different regions. Compared with colorectal cancer occurring in the general population, the incidence of and mutations is lower in EOCRC, whereas the incidence of mutation remains consistent. mutation is associated with increased overall mortality risk in patients with EOCRC.
Topics: Humans; Adenomatous Polyposis Coli Protein; Colorectal Neoplasms; GTP Phosphohydrolases; Incidence; Membrane Proteins; Mutation; Prognosis; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins p21(ras); PTEN Phosphohydrolase; Tumor Suppressor Protein p53
PubMed: 38778689
DOI: 10.3760/cma.j.cn441530-20240304-00083 -
Journal of Chemotherapy (Florence,... Feb 2020The impact of KRAS mutation status on outcomes of metastatic colorectal cancer (mCRC) treated with anti-angiogenic agents is controversial. A total of 4,066 mCRC... (Meta-Analysis)
Meta-Analysis
The impact of KRAS mutation status on outcomes of metastatic colorectal cancer (mCRC) treated with anti-angiogenic agents is controversial. A total of 4,066 mCRC patients from nine randomized controlled trials (RCTs) were included for analysis. The pooled results showed that the use of anti-angiogenic agents significantly improved progression-free survival (PFS) in mCRC patients with KRAS wide type (HR 0.63, 95%CI: 0.53-0.75, p<0.001) or mutated (HR 0.55, 95%CI: 0.38-0.79, p=0.001). In addition, the use of anti-angiogenic agents significantly improved overall survival (OS) in mCRC patients with KRAS wide type (HR 0.78, 95%CI: 0.70-0.86, p<0.001) or KRAS mutant status (HR 0.87, 95%CI: 0.77-0.98, p=0.018). No publication bias was detected for OS and PFS in mCRC patients. The findings of this study show that the use of anti-angiogenic agents significantly improved PFS and OS in mCRC independent of K-RAS gene status. KRAS gene status does not significantly influence the activity of antiangiogenic agents.
Topics: Angiogenesis Inhibitors; Colorectal Neoplasms; Humans; Mutation; Progression-Free Survival; Proto-Oncogene Proteins p21(ras); Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 31838964
DOI: 10.1080/1120009X.2019.1692282