EBV-Positive Gastric Adenocarcinomas: A Distinct Clinicopathologic Entity With a Low Frequency of Lymph Node Involvement

2004 ◽  
Vol 22 (4) ◽  
pp. 664-670 ◽  
Author(s):  
Josine van Beek ◽  
Axel zur Hausen ◽  
Elma Klein Kranenbarg ◽  
Cornelis J.H. van de Velde ◽  
Jaap M. Middeldorp ◽  
...  
Keyword(s):  
Lymph Node ◽  
Residual Disease ◽  
Low Frequency ◽  
Proximal Part ◽  
Lymph Node Involvement ◽  
Clinicopathologic Features ◽  
Gastric Carcinomas ◽  
Barr Virus ◽  
Gastric Adenocarcinomas ◽  
Genomic Aberrations

Purpose Epstein-Barr virus (EBV) is detected in a substantial subgroup of gastric adenocarcinomas worldwide. We have previously reported that these EBV-positive gastric carcinomas carry distinct genomic aberrations. In the present study, we analyzed a large cohort of EBV-positive and EBV-negative gastric adenocarcinomas for their clinicopathologic features to determine whether they constitute a different clinical entity. Patients and Methods Using a validated polymerase chain reaction/enzyme immunoassay–based prescreening method in combination with EBER1/2-RNA in situ hybridization, EBV was detected in the tumor cells of 7.2% (n = 41) of the gastric carcinomas from the Dutch D1D2 trial (N = 566; mean follow-up, 9 years). EBV status was correlated with clinicopathologic features collected for the Dutch D1D2 trial. Results EBV-positive gastric carcinomas occurred significantly more frequently in males (P < .0001) and in younger patients (P = .012). Most were of the intestinal type according to the Laurén classification (P = .047) or tubular according to the WHO classification (P = .006) and located in the proximal part of the stomach (P < .0001). A significantly lower tumor-node-metastasis system-stage (P = .026) was observed in the patients with EBV-carrying carcinomas, which was solely explained by less lymph node (LN) involvement (P = .034) in these cases. In addition, a better prognosis, as reflected by a longer disease-free period (P = .04) and a significant better cancer-related survival (P = .02), was observed for these patients, which could be explained by less LN involvement, less residual disease, and younger patient age. Conclusion EBV-carrying gastric adenocarcinomas are a distinct entity of carcinomas, characterized not only by unique genomic aberrations, but also by distinct clinicopathologic features associated with significantly better prognosis.

Recurrent Genomic Aberrations in Gastric Carcinomas Associated with Helicobacter pylori and Epstein-Barr Virus

2002 ◽  
Vol 11 (3) ◽  
pp. 127-134 ◽  
Author(s):  
Wing Y. Chan ◽  
Yong Liu ◽  
Christine Y. S. Li ◽  
Enders K. W. Ng ◽  
John H. S. Chow ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Epstein Barr Virus ◽  
Gastric Carcinomas ◽  
Barr Virus ◽  
Genomic Aberrations ◽  
Epstein Barr

Are Papillary Microcarcinomas of the Thyroid Gland Revealed by Cervical Adenopathy More Aggressive?

2010 ◽  
Vol 76 (3) ◽  
pp. 306-311 ◽  
Author(s):  
Bassam Abboud ◽  
Ronald Daher ◽  
Ghassan Sleilaty ◽  
Gerard Abadjian ◽  
Claude Ghorra
Keyword(s):  
Lymph Node ◽  
Total Thyroidectomy ◽  
Excisional Biopsy ◽  
Cervical Lymph Node Metastasis ◽  
Needle Aspiration ◽  
Lymph Node Involvement ◽  
Clinicopathologic Features ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes

Therapeutic attitudes for papillary thyroid microcarcinoma (PTMC) range from observation alone to aggressive management. Clinicopathologic features, therapeutic options, and follow-up results are described in a series of PTMC revealed by cervical adenopathies. Twelve patients were enrolled in this retrospective study. They were all treated by total/near-total thyroidectomy with dissection of suspect cervical lymph nodes followed by radioactive iodine (RAI) and suppressive L-thyroxine therapies. Mean age at diagnosis was 32 years with a mean elapsed time to diagnosis of 45.3 months. Fine needle aspiration cytology and excisional biopsy of the lymph node led to a diagnosis in all cases. Cervical mass was ipsilateral to primary tumor in six patients (50%). Multifocality, bilaterality, and capsular invasion were encountered in 66.7, 66.7, and 41.7 per cent of patients, respectively. Lymph node involvement was bilateral in seven patients (58.3%) of whom thyroid foci were unilateral in two. No complications of thyroidectomy were encountered. At 60-month-follow up, no recurrence or metastasis was noted. PTMC revealed by cervical lymph node metastasis shows aggressive clinicopathologic features. They must be considered as papillary thyroid cancers and managed by total/near-total thyroidectomy with bilateral lymph node exploration followed by RAI therapy and suppressive L-thyroxine doses.

Prediction of Nonsentinel Lymph Node Involvement in Patients with a Positive Sentinel Lymph Node in Malignant Melanoma

2007 ◽  
Vol 73 (7) ◽  
pp. 674-678 ◽  
Author(s):  
Andrew J. Page ◽  
Grant W. Carlson ◽  
Keith A. Delman ◽  
Douglas Murray ◽  
Andrea Hestley ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Residual Disease ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
Melanoma Cells ◽  
Tumor Burden ◽  
Node Involvement ◽  
Nonsentinel Lymph Node

Completion lymph node dissection (CLND) is routinely performed after metastatic melanoma is detected at sentinel lymph node (SLN) biopsy. Nonsentinel lymph node (NSLN) involvement is found in less than one-third of the cases. Possible predictors of NSLN involvement are examined. A retrospective review of 70 patients with a positive SLN biopsy for melanoma and drainage to one lymphatic basin was performed. The size of metastatic deposits was defined as macrometastases (>2 mm), micrometastases (≤2 mm), a cluster of cells (10–30 grouped cells) in the subcapsular space or interfollicular zone, or isolated melanoma cells (1–20 or more individual cells) in sub-capsular sinuses. Tumor stage, ulceration, SLN tumor burden, mitoses, number of positive SLNs, and total number of lymph nodes removed were examined as predictors of NSLN involvement after CLND. Two additional models based on SLN tumor burden and the number of nodes biopsied were designed. Nineteen patients (24.3%) were found to have NSLN metastases after CLND. Tumor stage, ulceration, SLN tumor burden, mitoses, number of positive SLN, and number of lymph nodes removed were not statistically significant. Residual disease at CLND stratified by SLN tumor burden was: isolated melanoma cells, 0; cluster of cells, 8 (38.1%); ≤2 mm, 5 (20.8%); and >2 mm, 6 (27.3%). A comparison of the means for the models was not predictive of NSLN involvement. None of the risk factors or models examined could predict nonsentinel lymph node involvement with melanoma. The SLN sample and minimal SLN metastatic disease when defined as isolated clusters of cells warrant further study as a potential indicator against CLND after positive SLN.

Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

2020 ◽  
Vol 22 (1) ◽  
pp. 43-46
Author(s):  
Mst Jesmen Nahar ◽  
Md Mahiuddin Matubber ◽  
Md Mahbubur Rahman ◽  
Md Mahbubur Rahman ◽  
Syed Muhammad Baqul Billah ◽  
...  
Keyword(s):  
Lymph Node ◽  
Clinical Picture ◽  
Preoperative Evaluation ◽  
Lymph Node Involvement ◽  
Lesion Detection ◽  
Clinical Feature ◽  
P Value ◽  
Operative Finding ◽  
Node Involvement ◽  
Carcinoma Stomach

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc. Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach. Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant. Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=<0.001). In the similar manner USG assessment of lesion detection (p=<0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy. Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision. Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46

Sign in / Sign up

Export Citation Format

Share Document