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Cancer Medicine Jan 2020Primary pure mucinous adenocarcinoma of the lung (PMA) is a rare subtype. However, correlations between clinicopathological features and genetic phenotypes with survival...
BACKGROUND
Primary pure mucinous adenocarcinoma of the lung (PMA) is a rare subtype. However, correlations between clinicopathological features and genetic phenotypes with survival have not been described comprehensively.
METHODS
Pure mucinous adenocarcinoma patient information collected from the Surveillance, Epidemiology, and End Results (SEER) database, the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University (FDZSH), and the Cancer Genome Atlas (TCGA) were extracted, evaluated, and compared with other lung adenocarcinomas (LUAD) patient data. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed to explore the functional importance of underlying molecular changes. Overall survival (OS) was evaluated with the Kaplan-Meier method. Univariate and multivariate analysis through Cox proportional hazard regression identified risk factors that predicted OS, and the results were used to construct a nomogram to predict OS for PMA patients.
RESULTS
Overall, 3622 patients, 41 patients, and 15 patients with PMA were identified from the SEER, FDZSH, and TCGA databases, respectively. There were 345 differentially expressed genes, 30 differentially mutated genes and 72 differentially methylated genes were identified between PMA and other LUAD samples. In the SEER database, PMA had a better prognosis compared to other LUAD. Compared with patients with other LUAD, patients with PMA exhibited unique clinicopathological features, including fewer grade III/IV tumors, less pleural invasion, more early-stage cancer, and more lower lobe carcinomas. Multivariate analyses showed that age, race, T stage, N stage, surgery, and chemotherapy were independent risk factors. The nomogram had a calibration index of 0.724.
CONCLUSIONS
Our research identified unique clinicopathological characteristics and genetic phenotypes for PMA and other LUAD. The nomogram accurately predicted OS.
Topics: Adenocarcinoma, Mucinous; Aged; Biomarkers, Tumor; Databases, Factual; Female; Follow-Up Studies; Genotype; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Nomograms; Phenotype; Retrospective Studies; Risk Factors; SEER Program; Survival Rate
PubMed: 31769218
DOI: 10.1002/cam4.2726 -
Journal of Ovarian Research Feb 2022Ovarian mucinous carcinoma is a disease that requires unique treatment. But for a long time, guidelines for ovarian serous carcinoma have been used for the treatment of...
BACKGROUND
Ovarian mucinous carcinoma is a disease that requires unique treatment. But for a long time, guidelines for ovarian serous carcinoma have been used for the treatment of ovarian mucinous carcinoma. This study aimed to construct and validate nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in patients with ovarian mucinous adenocarcinoma.
METHODS
In this study, patients initially diagnosed with ovarian mucinous adenocarcinoma from 2004 to 2015 were screened from the Surveillance, Epidemiology, and End Results (SEER) database, and divided into the training group and the validation group at a ratio of 7:3. Independent risk factors for OS and CSS were determined by multivariate Cox regression analysis, and nomograms were constructed and validated.
RESULTS
In this study, 1309 patients with ovarian mucinous adenocarcinoma were finally screened and randomly divided into 917 cases in the training group and 392 cases in the validation group according to a 7:3 ratio. Multivariate Cox regression analysis showed that the independent risk factors of OS were age, race, T_stage, N_stage, M_stage, grade, CA125, and chemotherapy. Independent risk factors of CSS were age, race, marital, T_stage, N_stage, M_stage, grade, CA125, and chemotherapy. According to the above results, the nomograms of OS and CSS in ovarian mucinous adenocarcinoma were constructed. In the training group, the C-index of the OS nomogram was 0.845 (95% CI: 0.821-0.869) and the C-index of the CSS nomogram was 0.862 (95%CI: 0.838-0.886). In the validation group, the C-index of the OS nomogram was 0.843 (95% CI: 0.810-0.876) and the C-index of the CSS nomogram was 0.841 (95%CI: 0.806-0.876). The calibration curve showed the consistency between the predicted results and the actual results, indicating the high accuracy of the nomogram.
CONCLUSION
The nomogram provides 3-year and 5-year OS and CSS predictions for patients with ovarian mucinous adenocarcinoma, which helps clinicians predict the prognosis of patients and formulate appropriate treatment plans.
Topics: Adenocarcinoma, Mucinous; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Area Under Curve; CA-125 Antigen; Child; Female; Humans; Kaplan-Meier Estimate; Marital Status; Membrane Proteins; Middle Aged; Neoplasm Grading; Neoplasm Staging; Nomograms; Ovarian Neoplasms; Prognosis; Proportional Hazards Models; ROC Curve; Race Factors; Risk Factors; SEER Program; Survival Rate; Young Adult
PubMed: 35168642
DOI: 10.1186/s13048-022-00958-6 -
Surgical Endoscopy Jun 2023Accurate evaluation of intraductal papillary mucinous neoplasm (IPMN) is necessary to inform clinical decision-making. But it is still difficult to distinguish benign... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND AIMS
Accurate evaluation of intraductal papillary mucinous neoplasm (IPMN) is necessary to inform clinical decision-making. But it is still difficult to distinguish benign and malignant IPMN preoperatively. This study aims to evaluate the utility of EUS to predict the pathology of IPMN.
METHODS
Patients with IPMN who underwent endoscopic ultrasound within 3 months before surgery were collected from six centers. Logistic regression model and random forest model were used to determine risk factors associated with malignant IPMN. In both models, 70% and 30% of patients were randomly assigned to the exploratory group and validation group, respectively. Sensitivity, specificity, and ROC were used in model assessment.
RESULTS
Of the 115 patients, 56 (48.7%) had low-grade dysplasia (LGD), 25 (21.7%) had high-grade dysplasia (HGD), and 34 (29.6%) had invasive cancer (IC). Smoking history (OR = 6.95, 95%CI: 1.98-24.44, p = 0.002), lymphadenopathy (OR = 7.91, 95%CI: 1.60-39.07, p = 0.011), MPD > 7 mm (OR = 4.75, 95%CI: 1.56-14.47, p = 0.006) and mural nodules > 5 mm (OR = 8.79, 95%CI: 2.40-32.24, p = 0.001) were independent risk factors predicting malignant IPMN according to the logistic regression model. The sensitivity, specificity, and AUC were 0.895, 0.571, and 0.795 in the validation group. In the random forest model, the sensitivity, specificity, and AUC were 0.722, 0.823, and 0.773, respectively. In patients with mural nodules, random forest model could reach a sensitivity of 0.905 and a specificity of 0.900.
CONCLUSIONS
Using random forest model based on EUS data is effective to differentiate benign and malignant IPMN in this cohort, especially in patients with mural nodules.
Topics: Humans; Endosonography; Carcinoma, Pancreatic Ductal; Pancreatic Intraductal Neoplasms; Adenocarcinoma, Mucinous; Retrospective Studies; Pancreatic Neoplasms
PubMed: 36881188
DOI: 10.1007/s00464-022-09752-3 -
International Journal of Molecular... Sep 2020Pancreatic ductal adenocarcinoma is one of the most lethal human cancers. Its precursor lesions include pancreatic intra-epithelial neoplasia, mucinous cystic neoplasm,... (Review)
Review
Pancreatic ductal adenocarcinoma is one of the most lethal human cancers. Its precursor lesions include pancreatic intra-epithelial neoplasia, mucinous cystic neoplasm, and intraductal papillary mucinous neoplasm (IPMN). IPMNs usually present as an incidental finding at imaging in 2.6% of the population and, according to the degree of dysplasia, they are classified as low- or high-grade lesions. Since the risk of malignant transformation is not accurately predictable, the management of these lesions is based on morphological and clinical parameters, such as presence of mural nodule, main pancreatic duct dilation, presence of symptoms, or high-grade dysplasia. Although the main genetic alterations associated to IPMNs have been elucidated, they are still not helpful for disease risk stratification. The growing body of genomic and epigenomic studies along with the more recent development of organotypic cultures provide the opportunity to improve our understanding of the malignant transformation process, which will likely deliver biomarkers to help discriminate between low- and high-risk lesions. Recent insights on the topic are herein summarized.
Topics: Adenocarcinoma, Mucinous; Animals; Humans; Neoplasm Grading; Pancreatic Intraductal Neoplasms; Pancreatic Neoplasms; Risk Assessment
PubMed: 32887490
DOI: 10.3390/ijms21176386 -
The Korean Journal of Gastroenterology... Dec 2020This study examined the clinical features and prognosis of patients with mucinous gastric carcinoma (MGC), non-mucinous gastric carcinoma (NMGC), and signet ring cell...
BACKGROUND/AIMS
This study examined the clinical features and prognosis of patients with mucinous gastric carcinoma (MGC), non-mucinous gastric carcinoma (NMGC), and signet ring cell gastric carcinoma (SRC).
METHODS
A retrospective cohort study was performed, enrolling 65 patients with MGC from January 2007 to December 2016. During the same period, 1,814 patients with histologically proven gastric cancers underwent curative or palliative operations. One hundred and ninety-five NMGC patients were selected as the 1:3 age- and sex-matched control groups. In addition, 200 SRC patients were identified. This study evaluated the demographic features of the patients, pathologic features of the tumor, and the predictive factors, such as the recurrence-free survival and overall survival.
RESULTS
The recurrence rates were significantly high in MGC than in NMGC or SRC (both p<0.01). The proportion of early gastric cancer was lower in the MGC group than in the other groups (p<0.01). In addition, metastatic lymph nodes were found more frequently in the MGC group (p<0.01), and the proportion of initial pT4, M1 stage, was highest in the MGC group. The recurrence-free survival and overall survival in the MGC group were significantly lower than those in the NMGC or SRC. Subgroup analysis showed that patients with the same American Joint Committee on Cancer (AJCC) stage of each cancer group showed a similar prognosis.
CONCLUSIONS
MGC frequently presents an advanced stage with an unfavorable prognosis compared to NMGC or SRC. On the other hand, MGC of the same AJCC stage had a similar prognosis to NMGC and SRC.
Topics: Adenocarcinoma, Mucinous; Carcinoma, Signet Ring Cell; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Stomach Neoplasms
PubMed: 33199672
DOI: 10.4166/kjg.2020.098 -
BMC Gastroenterology Nov 2023Appendiceal tumors represent a range of histologies that vary in behavior. Recommendations for treatment with appendectomy versus right hemicolectomy (RHC) for different...
BACKGROUND
Appendiceal tumors represent a range of histologies that vary in behavior. Recommendations for treatment with appendectomy versus right hemicolectomy (RHC) for different tumor types are evolving and sometimes conflicting. This study sought to characterize variation in the United States around surgical treatment of major appendiceal tumor types over time and describe differences in outcomes based on procedure.
METHODS
Patients diagnosed with appendiceal goblet cell adenocarcinoma (GCA), mucinous adenocarcinoma, neuroendocrine neoplasm (NEN), or non-mucinous adenocarcinoma from 2004-2017 were identified in the National Cancer Database. Trends in RHC over time and predictors of RHC were identified. Surgical outcomes for each histologic type and stage were compared.
RESULTS
Of 18,216 patients, 11% had GCAs, 34% mucinous adenocarcinoma, 31% NENs, and 24% non-mucinous adenocarcinoma. Rate of RHC for NEN decreased from 68% in 2004 to 40% in 2017 (p = 0.008) but remained constant around 60-75% for other tumor types. Higher stage was associated with increased odds of RHC for all tumor types. RHC was associated with higher rate of unplanned readmission (5% vs. 3%, p < 0.001) and longer postoperative hospital stay (median 5 days vs. 3 days, p < 0.001). On risk-adjusted analysis, RHC was significantly associated with increased survival versus appendectomy for stage 2 disease of all tumor types (HRs 0.43 to 0.63) and for stage 1 non-mucinous adenocarcinoma (HR = 0.56).
CONCLUSIONS
Most patients with appendiceal tumors undergo RHC, which is associated with increased readmission, longer length of stay, and improved survival for stage 2 disease of all types. RHC should be offered selectively for appendiceal tumors.
Topics: Humans; Adenocarcinoma, Mucinous; Appendectomy; Appendiceal Neoplasms; Colectomy; Neuroendocrine Tumors; Retrospective Studies; Treatment Outcome; United States
PubMed: 37978348
DOI: 10.1186/s12876-023-03019-4 -
Biochimica Et Biophysica Acta. Reviews... Aug 2019A prominent mucinous phenotype is observed in 10-15% of all colorectal cancers (CRCs). They are associated with a proximal location, and more commonly observed among... (Review)
Review
A prominent mucinous phenotype is observed in 10-15% of all colorectal cancers (CRCs). They are associated with a proximal location, and more commonly observed among tumors with mismatch repair defects and a promoter CpG methylator phenotype. However, none of these features has been clearly linked mechanistically to this mucinous subtype. Here, we propose that bacterial biofilms could represent a currently unappreciated contributor to mucinous CRC formation. The colonic microbiome and biofilms in particular, are emerging as important factors in tumor initiation and progression. Intriguingly, biofilms preferentially accompany proximal tumors, suggesting that there may be a direct mechanistic link with mucinous CRCs.
Topics: Adenocarcinoma, Mucinous; Biofilms; Biomarkers, Tumor; Colorectal Neoplasms; CpG Islands; DNA Methylation; Humans; Microsatellite Instability
PubMed: 31201828
DOI: 10.1016/j.bbcan.2019.05.009 -
BMC Cancer Apr 2020To investigate the clinical and pathological characteristics of appendiceal mucinous adenocarcinoma with peritoneal metastasis and analyze the prognostic factors. (Clinical Trial)
Clinical Trial
BACKGROUND
To investigate the clinical and pathological characteristics of appendiceal mucinous adenocarcinoma with peritoneal metastasis and analyze the prognostic factors.
METHODS
A retrospective analyses of clinicopathological features of 50 patients with appendiceal mucinous adenocarcinoma with peritoneal metastasis from January, 2013 to December, 2017 in Aerospace Central Hospital, Beijing, China. Survival data calculation and comparison were respectively performed with the Kaplan-Meier method and the log-rank test. The Cox proportional hazards regression method was used for multivariate survival analyses.
RESULTS
Cytoreduction for appendiceal mucinous adenocarcinoma was conducted on 50 patients (24 males and 26 females), with a median age of 52.5 years at the time of surgery (range 31-71 years). The median overall survival (OS) time was 24 months, with 2-,3- and 5-year survival rates of 53, 24 and 8%, respectively. At the last follow-up in December 2018, 13 patients were still alive. Multivariate analysis revealed that patients who had low Ki-67 expression (less than 50%) and CCR (completeness of cytoreduction) 0/1/2 score had significantly better OS rate than their respective counterparts.
CONCLUSIONS
Ki-67 expression statue and CCR score could be employed as the prognosis prediction in patients with appendiceal mucinous adenocarcinoma.
Topics: Adenocarcinoma, Mucinous; Adult; Aged; Appendiceal Neoplasms; Biomarkers, Tumor; China; Combined Modality Therapy; Cytoreduction Surgical Procedures; Disease Management; Female; Follow-Up Studies; Humans; Hyperthermia, Induced; Ki-67 Antigen; Male; Middle Aged; Peritoneal Neoplasms; Prognosis; Retrospective Studies; Survival Rate
PubMed: 32252683
DOI: 10.1186/s12885-020-06787-4 -
Diagnostic Pathology Apr 2023Mucinous carcinoma (MC) is a histological subtype of ovarian cancer that has a worse prognosis at advanced stages than the most prevalent histological subtype,...
BACKGROUND
Mucinous carcinoma (MC) is a histological subtype of ovarian cancer that has a worse prognosis at advanced stages than the most prevalent histological subtype, high-grade serous carcinomas. Invasive patterns have been recognized as prognostic factors for MCs. MCs with infiltrative invasion were more aggressive than those with expansile invasion. MC with an expansile pattern exhibited behavior similar to mucinous borderline tumors (MBT). However, genomic analysis of invasive patterns is insufficient. This study aimed to compare genetic information between groups with MC and infiltrative invasion (Group A) and those with MC with expansile invasion or MBT (Group B).
METHODS
Ten cases each of MC with infiltrative invasion, MC with expansile invasion, and MBT between 2005 and 2020 were identified. Deoxyribonucleic acid (DNA) extraction from formalin-fixed paraffin-embedded tissues was performed, and cases with DNA fragmentation or the possibility of DNA fragmentation were excluded. Mutant base candidates and tumor mutation burden (TMB) values (mutations/megabase) were calculated.
RESULTS
After assessing the quality of purified DNA, seven cases of MC with infiltrative invasion, five cases of MC with expansile invasion, and three cases of MBT were included. More patients in group A experienced recurrence or progression (p < 0.01) and died of disease (p = 0.03). Moreover, the TMB value was statistically higher in group A than in group B (p = 0.049). There were no statistical differences in the incidence of the mutations of KRAS, TP53, and CREBBP. KRAS, TP53, and CREBBP mutations were discovered in 8/15 (53.3%), 6/15 (40.0%), and 5/15 (33.3%) cases, respectively.
CONCLUSIONS
Genetic analysis revealed that Group A had higher TMB than Group B. Therefore, this result might be useful for future treatment.
Topics: Female; Humans; Retrospective Studies; Proto-Oncogene Proteins p21(ras); Neoplasm Staging; Adenocarcinoma, Mucinous; Neoplasms, Cystic, Mucinous, and Serous; Ovarian Neoplasms; Carcinoma, Ovarian Epithelial; DNA
PubMed: 37081552
DOI: 10.1186/s13000-023-01340-w -
Cureus May 2023Mucinous adenocarcinoma is a rare lung cancer that can mimic the appearance of infectious pneumonia on imaging. The present report describes the case of an 88-year-old...
Mucinous adenocarcinoma is a rare lung cancer that can mimic the appearance of infectious pneumonia on imaging. The present report describes the case of an 88-year-old man who presented with a cough that was not responsive to treatment. Based on chest X-ray findings consistent with pneumonia, he was treated with oral antibiotics. After the patient's symptoms did not improve, a computed tomography scan was performed, which showed a confluent consolidation in the left lower lung and a cavitation suggestive of pneumonia. The patient was then admitted to the hospital to receive intravenous antibiotics. Although his cough continued, laboratory findings were within normal ranges and bacterial cultures were negative. He underwent two bronchoscopy procedures with bronchoalveolar lavage and was diagnosed with parainfluenza and rhinovirus/enterovirus, for which he was treated with prolonged antibiotics and steroids. His symptoms still failed to improve, and a bronchoscopy with cryobiopsy was performed, with a positive result for mucinous adenocarcinoma. This case illustrates the need to distinguish mucinous adenocarcinoma from pneumonia to improve the early diagnosis of this rare cancer and patient outcomes.
PubMed: 37351238
DOI: 10.7759/cureus.39343