scholarly journals Pathological cytomorphologic features and the percentage of ALK FISH-positive cells predict pulmonary adenocarcinoma prognosis: a prospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fenge Jiang ◽  
Congcong Wang ◽  
Ping Yang ◽  
Ping Sun ◽  
Jiannan Liu
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Signet Ring Cell ◽  
Pulmonary Adenocarcinoma ◽  
Cell Group ◽  
Alk Rearrangement ◽  
Anaplastic Lymphoma ◽  
Signet Ring ◽  
Ring Cell ◽  
Alk Positive

Abstract Background We conducted a study to explore the relationship between pathological cytomorphologic features and the percentage of anaplastic lymphoma kinase (ALK)-positive cells to better predict pulmonary adenocarcinoma prognosis with crizotinib treatment. Patients and methods We investigated 60 cases of patients with ALK-positive advanced or metastatic non-small cell lung cancer (NSCLC). Immunohistochemistry was performed to screen for ALK rearrangement. Fluorescence in situ hybridization (FISH) was used to detect the percentage of ALK-positive cells. The primary objectives of the study were the progression-free survival (PFS), the 3-year overall survival, and the 3-year overall survival (OS) rates. The secondary objectives of the study were the disease control rate (DCR) and the overall response rate (ORR). Results We compared the pathological cytomorphologic features of 60 cases of ALK-positive pulmonary adenocarcinoma, of which 21 cases were ALK-positive with signet ring cell cytomorphologic characteristics. There were statistical differences in the ORR (p = 0.019), DCR (p = 0.032), and PFS (p = 0.047) between the signet ring cell group and group without signet ring cells. Of these, 37 cases were ALK-positive with EML4 (echinoderm microtubule associated protein like 4)-ALK high percentage of positivity group. These cases benefited more from crizotinib treatment in the ORR (p = 0.046) and achieved a longer PFS (p = 0.036) compared to those with EML4-ALK low percentage of positivity group. Conclusions Signet ring cell cytomorphologic characteristics of pulmonary adenocarcinoma are associated with the percentage of ALK-positive cells. Signet ring cell cytomorphologic characteristics and the percentage of ALK-positive cells might predict the prognosis of pulmonary adenocarcinoma with crizotinib treatment. Trial registration The study was approved by the Institutional Review Board (Medical Ethics Committee of Yantai Yuhuangding Hospital). The registration number is NO.2016[193].

Investigation of anaplastic lymphoma kinase (ALK) translocations in gastric and esophageal signet ring cell carcinomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15106-e15106
Author(s):  
Jill Miller ◽  
Zhihua Peng ◽  
Rebecca Wilcox ◽  
Mark Evans ◽  
Kumarasen Cooper ◽  
...  
Keyword(s):  
Anaplastic Lymphoma Kinase ◽  
Tissue Bank ◽  
Signet Ring Cell ◽  
Fish Analysis ◽  
Gi Tract ◽  
Multiple Cancer ◽  
Anaplastic Lymphoma ◽  
Signet Ring ◽  
Ring Cell ◽  
Alk Positive

e15106 Background: Anaplastic lymphoma kinase (ALK) fusion oncogenes are present in multiple cancer types. The inversion of echinoderm microtubule associated protein like 4 (EML4) and ALK genes on chromosome 2 is present in a subset of non-small cell lung cancer (NSCLC) patients. ALK mutated lung cancers demonstrate a significantly higher incidence of signet ring cell histology than compared to ALK-negative tumors. Based on the histological similarities of ALK positive NSCLC and signet ring cell carcinomas (SRCC) of the GI tract, we hypothesized that gastric and/or esophageal SRCC may also harbor ALK translocations. Methods: Thirty-five formalin-fixed, paraffin-embedded (FFPE) tissue specimens of SRCC originating from esophageal, GE junction or gastric locations were obtained from the Fletcher Allen Healthcare (Burlington, Vermont) tissue bank following Internal Review Board guidelines. Confirmation of SRCC or adenocarcinoma with signet ring cell features was confirmed by a board certified, gastrointestinal pathologist. SRCC specimens were analyzed by fluorescence in situ hybridization (FISH) analysis using an ALK (2p23) break-apart probe (Kreatech Diagnostics). Results: The FISH analysis revealed no evidence of ALK translocation: all thirty-five (100%) SRCC specimens showed intact (yellow) ALK FISH signals. Conclusions: These data indicate that despite histological similarities between SRCC of the GI tract and ALK positive NSCLC, ALK translocations are unlikely to be a significant contributor to gastric and esophageal SRCC molecular etiology. Further genomic investigations are on-going. This study was performed with funding received from the Lake Champlain Cancer Research Organization.

scholarly journals Gastric signet ring cell carcinoma

2020 ◽  
Vol 2 (4) ◽  
pp. Press
Author(s):  
Vitorino Modesto Santos ◽  
Laura Campos Modesto
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Advanced Stage ◽  
Elderly Male ◽  
Free Survival ◽  
Significant Difference ◽  
Signet Ring ◽  
Ring Cell

Zemni I et al. reviewed clinic and pathological characteristics and outcomes of gastric signet ring cell carcinomas (J Gastric Surg 2020; 2(3):71-78) focusing on the major prognostic factors of progression-free survival and overall survival including hypoproteinemia, tumor size, stenosis, advanced stage, and recurrence. The majority of patients were males under 60 years of age. The data were compared with those of non-signet ring cell gastric carcinomas. There was no significant difference in the 5 years overall survival between the compared groups. The increasing incidence of aggressive tumors in an advanced stage with poor outcome is emphasized and additional comments are about gastric signet ring cell tumors that affected a female and an elderly male.

Signet Ring Cell Histology Confers Worse Overall Survival in Treated Esophageal Adenocarcinoma

2021 ◽  
Vol 111 (1) ◽  
pp. 214-222 ◽  
Author(s):  
Andrew Tang ◽  
Jesse Rappaport ◽  
Siva Raja ◽  
Alejandro C. Bribriesco ◽  
Monisha Sudarshan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Adenocarcinoma ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

scholarly journals Impact of ALK Inhibitors in Patients With ALK-Rearranged Nonlung Solid Tumors

2021 ◽  
pp. 756-766
Author(s):  
Yuki Takeyasu ◽  
Hitomi S. Okuma ◽  
Yuki Kojima ◽  
Tadaaki Nishikawa ◽  
Maki Tanioka ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Kinase Inhibitors ◽  
Objective Response ◽  
Progression Free Survival ◽  
Complete Response ◽  
Alk Rearrangement ◽  
Free Survival ◽  
Anaplastic Lymphoma ◽  
Treatment Interruptions ◽  
Alk Positive

PURPOSE Anaplastic lymphoma kinase ( ALK) rearrangement is a well-known driver oncogene in non–small-cell lung cancer and has also been identified in other types of tumors. However, there is limited evidence on the clinical response to ALK tyrosine kinase inhibitors (TKIs), such as alectinib and crizotinib, in rare tumors with ALK fusion. We evaluated the therapeutic effect of ALK-TKIs in rare ALK-rearranged tumors. PATIENTS AND METHODS Between April 2012 and April 2019, clinical outcomes and characteristics of patients with ALK-rearranged nonlung solid tumors who received ALK-TKIs (alectinib and/or crizotinib) outside of clinical trials were reviewed. Expression and/or rearrangement of ALK was evaluated by immunohistochemistry, fluorescence in situ hybridization, and next-generation sequencing. The tumor response was assessed according to RECIST (version 1.1). Progression-free survival was estimated from initial ALK-TKI initiation until progression. RESULTS We identified seven patients (inflammatory myofibroblastic tumors, n = 3; ALK-positive histiocytosis, n = 1; histiocytic sarcoma, n = 1; osteosarcoma, n = 1; and parotid adenocarcinoma, n = 1), with a median age of 17 years. Two rare ALK fusions, namely, CTNNA1-ALK and ITSN2-ALK, were identified. As initial ALK-TKI therapy, five patients received alectinib and two received crizotinib. The objective response rate for the initial ALK-TKI therapy was 85.7% (95% CI, 44 to 97), including two patients who received alectinib and achieved complete response. The median progression-free survival was 8.1 months (range, 1.7 to not estimable). There were no treatment interruptions or dose reductions because of adverse events caused by alectinib. CONCLUSION This study highlights the potential benefit of ALK-TKIs, especially alectinib, in patients with ALK-rearranged nonlung solid tumors.

scholarly journals Incidence and Prognostic significance of Signet Ring Cell Histology in Gastric Cancer. A cross sectional study from Turkey: Pure Signet Ring Cell Histology in Gastric Cancer

2020 ◽  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Poor Prognosis ◽  
Prognostic Significance ◽  
Good Prognosis ◽  
Signet Ring Cell ◽  
Stage I ◽  
Stage Iii ◽  
Signet Ring ◽  
Ring Cell

Purpose: The present study aims to evaluate the incidence of signet ring cell (SRC) histology in patients with gastric cancer and its prognostic significance on the disease stage. Methods: Between November 2006 and September 2019, 309 patients were reviewed retrospectively in Kartal Koşuyolu High Specialization Training and Research Hospital Gastroenterology Surgery clinic in Turkey and the clinicopathological features and survival status were examined in the presence of ring cell histology. Results: Of the patients, 71.4% had gastric cancer with a non-SRC histology and 28.6% had an SRC histology. The presence of an SRC histology was found to be associated with young age (p=0.007), advanced depth of wall invasion (p=0.001), number of positive lymph nodes (p=0.022) and presence of vascular invasion (p=0.044). The presence of an SRC histology was associated with good prognosis in patients with stage I gastric cancer (p=0.045), but with poor prognosis in patients with stage III disease (p=0.034). The study found no significant association between stage II disease and overall survival. Conclusions: The present study found survival to be associated with good prognosis in stage I, and poor prognosis in stage III among patients with gastric cancer with SRC histology. No prognostic significance could be established for overall survival.

scholarly journals Clinical Efficacy of Radiotherapy Combined with Surgery for Locally Advanced Gastric Signet-Ring-Cell Carcinoma: A SEER Database Analysis

2021 ◽  
Author(s):  
Xiaohan Lin ◽  
Biyu Chen ◽  
Wei Zheng ◽  
Shugang Yang ◽  
Guangwei Zhu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cell Carcinoma ◽  
Clinical Efficacy ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Seer Database ◽  
Signet Ring ◽  
Ring Cell

Abstract Background: The objective of this study was to assess the clinical efficacy of radiotherapy combined with surgery for locally advanced gastric signet-ring-cell carcinoma (GSRCC). Methods: Clinical data of patients with locally advanced GSRCC diagnosed by postoperative pathology from 2000-2016 were collected from the US Surveillance, Epidemiology and End Results (SEER) database. All the enrolled patients were divided into three groups according to treatment type: surgery alone (S; N=727), surgery with preoperative radiotherapy (RT+S; N=138), surgery with postoperative radiotherapy (S+RT; N=548). Results: The median overall survival (OS) time in S, RT+S and S+RT group was 19, 26 and 33 months, respectively; the overall survival (OS) rate was 19.5%, 26.9% and 34.0%, respectively; the median cancer-specific survival (CSS) time was 29, 31 and 43 months, respectively; and the CSS rate was 32,4%, 35.3% and 43.6%, respectively. After performing propensity score matching (PSM), it was found that the OS rate was significantly lower in S group than in RT+S or S+RT group (all P<0.05) and the CSS rate was lower in the SA group than in the S+RT group (P<0.0001) while there was no significant difference between S and RT+S groups. The OS and CSS were not significantly different between RT+S and S+RT groups. Cox multivariate analysis showed that radiotherapy was an independent prognostic factor for OS and CSS of locally advanced GSRCC.Conclusions: Compared to surgery alone, surgery combined with preoperative or postoperative radiotherapy is beneficial to the long-term survival of patients with locally advanced GSRCC.

The effects of combined modality therapy on stage II-III primary gastric signet ring cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16530-e16530
Author(s):  
Yang Li ◽  
Yantao Tian ◽  
Zhikai Zhu
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Combined Modality Therapy ◽  
Tumor Location ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Ajcc Stage ◽  
Signet Ring ◽  
Ring Cell

e16530 Background: To date, there is no well-defined standard of care for gastric signet ring cell carcinoma (GSRC). Clinical guidelines support that combined modality therapy (CMT) on localized gastric cancer, but this may not be appropriate for GSRC as it was generally found to be chemo-resistant. We conducted a population-based study to examine the effects of therapeutic strategies on survival outcomes by using the Surveillance, Epidemiology, and End Results (SEER) data. Methods: Analyses included primary GSRC patients with stage II-III who survived more than 6 months, and were diagnosed between 2006 and 2016 from SEER data.CMT were categorized as gastrectomy group, adjuvant CT group (gastrectomy with adjuvant chemotherapy), neoadjuvant RT group (gastrectomy with neoadjuvant radiotherapy combined adjuvant chemotherapy), and adjuvant CRT group (gastrectomy with chemoradiotherapy). Survival analyses were conducted by Kaplan-Meier method and multivariate Cox proportional hazards models, adjusted for age, gender, race, marital status, histology, AJCC stage, tumor location, and lymph nodes removed. Models were stratified by gender, AJCC stage, lymph nodes removed and tumor location. Results: Of the 1,717 cases of stage II-III primary GSRC, the mean age was 66.9 (SD: 11.0) years, over a half were male (52.8%), and the majority were white (66.0%). A total of 39.9% received adjuvant CRT. The five-year overall survival (OS) rate was 34.6% for this treatment, and 29.6% for adjuvant CT group, 25.4% for adjuvant CRT group, only 23.8% for the gastrectomy group. The median OS of patients treated with adjuvant CRT was significantly longer than that of the gastrectomy group (33 vs 24 months, aHR = 0.71, 95%CI = 0.60,0.84). Although the crude model showed a significant association between adjuvant CT and total survival (cHR = 0.81, 95%CI = 0.68,0.96), the effect measure turned null in the multivariable and sub-group analysis. Independent prognostic factors were adjuvant CRT, ≥60 years old, AJCC stage, and > 20 lymoh nodes removed. Conclusions: In this study, GSRC patients with stage II-III experienced improved overall survival after receiving adjuvant CRT, which provides several treatment implications. Future clinical trials considering adjuvant CRT will be needed to verify the conclusion derived from this study.

scholarly journals Clinical Characteristics and Prognostic Analysis of Patients With Signet Ring Cell Gastric Carcinoma

2020 ◽  
Vol 19 ◽  
pp. 153303382098381
Author(s):  
Jia Mi Yu ◽  
Zhou Wei Zhan ◽  
Jing Xian Zhen ◽  
Xiao Jie Wang ◽  
Yu Chen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Gastroesophageal Junction ◽  
Tumor Stage ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

We do not know the clinical and prognostic factors that influence the survival of patients with gastric signet ring cell carcinoma (SRC). Therefore, a retrospective review was undertaken of 219 patients with SRC who had undergone gastrectomy between January 2009 and December 2012 in our hospital. Patient age, sex, TNM stage, vessel carcinoma embolus, perineural invasion, tumor site and operation type, postoperative chemotherapy, and five-year overall survival were recorded and evaluated. In our study, 93 cases (42.5%) were signet ring cell carcinoma only, and 126 cases (57.5%) were signet ring cell carcinoma coexisting with other components (such as adenocarcinoma or mucus adenocarcinoma). Eighty-three patients were female, 136 were male, 46 occurred at the gastroesophageal junction (21.0%), 63 at the fundus/body (28.8%), 80 were antrum/pylorus (36.5%), and 30 were whole stomach (13.7%). The prognosis of gastric antrum/ pylorus cancer was the best (P < 0.05). There were 133 patients (60.7%) with stage III, and the single factor analysis showed that the earlier the stage, the better the prognosis. The overall five-year survival rate was 30.1% in all patients. One-hundred and 41 patients (64.4%) received D2 radical surgery, 64 (29.2%) received D1 radical operation, and 14 (6.4%) received palliative resection, and the patients who received D2 had the best overall survival (P < 0.05). The survival time of the paclitaxel-based regimen in postoperative adjuvant chemotherapy tended to be prolonged. There was no statistical difference in overall survival between the percentage of signet-ring cells and sex. In summary, age, tumor stage, and surgical resection combined with D2 lymphadenectomy were independent prognostic factors for SRC. Adjuvant chemotherapy with a paclitaxel-based regimen may improve the survival of patients with SRC.

Clinicopathologic Characteristics of Malignant Mesotheliomas Arising in Patients With a History of Radiation for Hodgkin and Non-Hodgkin Lymphoma

2013 ◽  
Vol 31 (36) ◽  
pp. 4544-4549 ◽  
Author(s):  
Lucian R. Chirieac ◽  
Justine A. Barletta ◽  
Beow Y. Yeap ◽  
William G. Richards ◽  
Tamara Tilleman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Signet Ring Cell ◽  
Control Group ◽  
Clinicopathologic Characteristics ◽  
Non Hodgkin Lymphoma ◽  
Signet Ring ◽  
History Of ◽  
Ring Cell ◽  
Diffuse Malignant Mesothelioma

Purpose Studies have reported an association between pleural diffuse malignant mesothelioma (PDMM) and chest radiation for lymphoma. The clinicopathologic characteristics of malignant mesotheliomas arising in these patients have not been established. Patients and Methods We studied 1,618 consecutive patients diagnosed with pleural PDMM from July 1993 to February 2008 and identified patients with a history of radiation for Hodgkin and non-Hodgkin lymphoma. We evaluated the histology in the surgical resection specimens and compared clinicopathologic features with overall survival. Results We identified 22 patients who developed PDMM after chest radiation as part of their treatment for lymphoma (mean latency time, 21.4 years; 95% CI, 17.0 to 25.8 years). Asbestos bodies in lymphoma-associated PDMM were lower than in asbestos-associated PDMM (median count, 15 v 325 bodies, respectively; P < .001) and similar to an unexposed control group (median count, 15 v 10 bodies, respectively; P = .6). Seventeen lymphoma-associated PDMMs (77%) were epithelioid and five (23%) were biphasic. Seven PDMMs (32%) had unusual histologies (pleomorphic, myxoid, clear cell, and signet ring cell). Patients with lymphoma-associated PDMM were younger than patients with asbestos-associated PDMM (median age, 45 v 64 years, respectively; P < .001) and had a significantly longer overall survival time (median, 32.5 v 12.7 months, respectively; P = .018). In multivariate analysis, independent favorable predictors for overall survival were history of prior radiation (P = .022), female sex (P < .001), age ≤ 65 years (P = .005), cytoreductive surgery (P < .001), and epithelioid histology (P < .001). Conclusion Patients with lymphoma-associated PDMM are likely to have unusual histologic features, are significantly younger, and seem to have a longer overall survival compared with patients with asbestos-associated PDMM.

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