Differences in pathology and mutational status among colorectal cancer (CRC) patients pre-, post-, and during screening age.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3596-3596
Author(s):  
Gustavo Dos Santos Fernandes ◽  
Allan Andresson Lima Pereira ◽  
Gabriella Pereira Braga ◽  
Brenda Pires Gumz ◽  
Marcela Crosara Alves Texeira ◽  
...  
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Stage Iv ◽  
Signet Ring Cell ◽  
Screening Tests ◽  
Braf Mutations ◽  
Pathology Laboratory ◽  
Mutational Status ◽  
Mutational Profiling ◽  
Central Pathology

3596 Background: Screening protocols for CRC are broadly recommended and effective in reducing mortality. However, populations from different age groups can harbor distinct pathological and molecular profiles that can also be influenced by screening and polyp resection, especially in older ages. Methods: We retrospectively analyzed tumors from stage IV CRC patients from a central pathology laboratory in Brazil that is a reference for mutational profiling countrywide. Patients were classified into age groups as the following: pre-screening (PrSA; <45yo), screening(SA; 45-75yo) and post-screening age (PoSA; >75yo). Every tumor has been centrally reviewed by the pathologist. Groups were compared regarding clinicopathologic features and presence of RAS and BRAF mutations. Results: We included 1244 pts (164 PrSA, 919 SA and 161 PoSA). There were no difference among groups regarding sidedness(p= .68)and KRASmutations (p=.0.97). Stage IV at diagnose (p =.001), presence of signet-ring cell component (p< .001) along with poorly differentiated tumors (p= .006) were most found on young patients, while BRAFand NRASmutations where significantly more common among PosSA (table). Conclusions: PosSA and PreSA CRCs seem to present a distinct profile from SA populations, including differences in the molecular and pathologic aspects. This could impact the frequency of screening tests among different age groups. [Table: see text]

scholarly journals Clinicopathological review of epithelial ovarian tumors in young females and reproductive and survival outcome: Ten years expierence from a tertiary center

2016 ◽  
Author(s):  
Kusum Lata ◽  
Nutan Agarwal ◽  
Neerja Bhatla ◽  
Alka Kriplani
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Survival Outcome ◽  
Ovarian Tumors ◽  
Tertiary Referral Hospital ◽  
Young Females ◽  
Presenting Symptoms ◽  
Tertiary Center

Objective: To find out the prevalence of epithelial ovarian tumors in young females and correlation with reproductive and survival outcome. Design: Retrospective study. Setting: Tertiary referral hospital. Methods: A retrospective analysis of females from 9-35 year of age group treated for ovarian tumors between January 2003 to July 2013 was performed. Variables studied included age, presenting symptoms, imaging, tumor markers, surgical findings, type of surgery, histopathology reports and follow-up. Main Outcome Measures: Histopathological variant, FIGO stage, reproductive and survival outcome. Results: A total of 155 patients were found to have ovarian tumors. Mean age at time of diagnosis was 24.9 ± 1.8 years (range 9-35). Clinical presentation in majority of the cases was abdominal pain in 68 (43.8%), ascites in 13 (8.3%) mass in abdomen in 25 (16%), followed by irregular menstrual cycles in 15 (9.6%), infertility in 18 (11.6%) 12 (7.7%) were found to be incidental on ultrasound examination while 4 women were found to have virilising symptoms. There were 76 (49.1%) cases of epithelial ovarian tumors, 6 (0.03%) of borderline tumors and 30 (19.3%) were of malignant ovarian tumors while 40 (25.8%) were benign. Stage IA (N = 80), Stage I 8 (n = 2), Stage III (N = 6) and Stage IV (N = 12). Females were further subdivided into three age groups 9-15 years, 15-25 years and 25 to 35 years for determining outcome of epitheliail tumors. Reproductive and survival outcome were studied in each stage. Conclusions: Limited data exists about the histological type distribution, surgical treatment and overall survival of epithelial ovarian tumors in women aged below 35 years. Young patients have higher overall progression-free survival and a better clinical outcome than older patients. Any women presenting with pain and nonspecific symptoms should be investigated and evaluated properly.

Differential clinical associations of BRAF and NRAS mutations among histologic types of cutaneous melanomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20034-e20034
Author(s):  
David Stockman ◽  
Michael T. Tetzlaff ◽  
Tariq Al-Zaid ◽  
Carlos A. Torres-Cabala ◽  
Amanda Dawn Bucheit ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Stage Iv ◽  
Braf V600e ◽  
Nras Mutation ◽  
Braf Mutations ◽  
Mutation Status ◽  
Mutational Status ◽  
Significant Difference ◽  
Clinical Associations ◽  
Histologic Types

e20034 Background: Previous studies have investigated whether BRAF and NRAS mutation status in melanoma correlate with histologic parameters and overall survival (OS), but evaluation of mutation groups irrespective of specific mutation among histologic types of melanoma has led to variability in the reproducibility of results. We tested the hypothesis that different histologic types of melanoma (nodular [NM] and superficial spreading [SSM]) have distinct clinical associations with specific BRAF and NRAS mutations. Methods: Primary tumor histology, BRAF/NRAS mutation status, and clinical outcomes were collected for 195 patients (pts) with stage III or IV disease. Clinical associations with specific mutations were determined separately for patients with NM (n=105) and SSM (n=90) histologic types of primary cutaneous melanomas. Results: Mutational status in NM: 69 BRAF (66%), 19 NRAS (18%), & 17 wild-type (WT;16%). Specific BRAF mutations in NM: V600E 50 (75%), V600K 13 (19%), V600R 4 (6%). Specific NRAS mutations in NM: Q61K 6 (32%), Q61L 2 (11%), Q61R 8 (42%); other 3 (16%). Mutation status in SSM: 45 BRAF (50%), 24 NRAS (27%), 21 WT (23%). Specific BRAF mutations in SSM: V600E 32 (71%), V600K 12 (24%), V600R 0. Specific NRAS mutations in SSM: Q61K 2 (8%), Q61L 5 (21%), Q61R 12 (50%). The distribution of specific BRAF (p=0.21) and NRAS (p=0.29) mutations between NM and SSM was not significantly different. Among NM pts, pts with activating NRAS mutations had shorter OS from the diagnosis of Stage IV melanoma than WT (HR 3.42, p=0.02) and BRAF (HR 2.40, p=0.009). There was no significant difference for BRAF pts vs WT (HR 1.43, p=0.47). Among SSM patients, neither NRAS (HR 1.3, p=0.53) nor BRAF(HR 0.54, p=0.16) were significantly associated with OS compared to WT. Comparison of patients with BRAF V600E vs V600K showed significant association for OS from stage 4 in SSM pts (HR 0.24, p=0.01), but not in NM pts (HR 0.64, p=0.36). Conclusions: The prognostic significance of BRAF and NRAS mutations on OS from stage IV differed for pts with NM and SSM primaries. Further investigation of the histologic types of melanoma with specific BRAF and NRAS mutations in a larger series is necessary to validate these apparent impacts on patient outcomes.

scholarly journals The Mutational Landscape of Acute Myeloid Leukaemia Predicts Responses and Outcomes in Elderly Patients from the PETHEMA-FLUGAZA Phase 3 Clinical Trial

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2458
Author(s):  
Rosa Ayala ◽  
Inmaculada Rapado ◽  
Esther Onecha ◽  
David Martínez-Cuadrón ◽  
Gonzalo Carreño-Tarragona ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Older Patients ◽  
Young Patients ◽  
Tumor Burden ◽  
Phase Iii ◽  
Mutational Status ◽  
Mutational Profiling ◽  
Subgroup Analyses ◽  
Treatment Responses ◽  
Acute Myeloid

We sought to predict treatment responses and outcomes in older patients with newly diagnosed acute myeloid leukemia (AML) from our FLUGAZA phase III clinical trial (PETHEMA group) based on mutational status, comparing azacytidine (AZA) with fludarabine plus low-dose cytarabine (FLUGA). Mutational profiling using a custom 43-gene next-generation sequencing panel revealed differences in profiles between older and younger patients, and several prognostic markers that were useful in young patients were ineffective in older patients. We examined the associations between variables and overall responses at the end of the third cycle. Patients with mutated DNMT3A or EZH2 were shown to benefit from azacytidine in the treatment-adjusted subgroup analysis. An analysis of the associations with tumor burden using variant allele frequency (VAF) quantification showed that a higher overall response was associated with an increase in TET2 VAF (odds ratio (OR), 1.014; p = 0.030) and lower TP53 VAF (OR, 0.981; p = 0.003). In the treatment-adjusted multivariate survival analyses, only the NRAS (hazard ratio (HR), 1.9, p = 0.005) and TP53 (HR, 2.6, p = 9.8 × 10−7) variants were associated with shorter overall survival (OS), whereas only mutated BCOR (HR, 3.6, p = 0.0003) was associated with a shorter relapse-free survival (RFS). Subgroup analyses of OS according to biological and genomic characteristics showed that patients with low–intermediate cytogenetic risk (HR, 1.51, p = 0.045) and mutated NRAS (HR, 3.66, p = 0.047) benefited from azacytidine therapy. In the subgroup analyses, patients with mutated TP53 (HR, 4.71, p = 0.009) showed a better RFS in the azacytidine arm. In conclusion, differential mutational profiling might anticipate the outcomes of first-line treatment choices (AZA or FLUGA) in older patients with AML. The study is registered at ClinicalTrials.gov as NCT02319135.

Projected future risk of leukemia and brain tumors from unnecessary brain CT scans: a multi-center study in Iran

2020 ◽  
Author(s):  
A. Asgari ◽  
A.A. Parach ◽  
F. Bouzarjomehri ◽  
F. Shirani-Takabi ◽  
A.H. Mehrparvar ◽  
...  
Keyword(s):  
Brain Cancer ◽  
Age Groups ◽  
Young Patients ◽  
Ct Scans ◽  
Brain Ct ◽  
Males And Females ◽  
And Gender ◽  
Multi Center Study ◽  
Gender Groups ◽  
Probability Of Cancer

Introduction: Computer Tomography (CT) scans can deliver a relatively high radiation dose to the patient, therefore radiation protection for this modality is paramount. The present study determined the frequency of no abnormality detected (NAD) brain CT scans and probability of cancer induction in different age groups and genders. Methods: In this study, brain CT reports were used to identify any findings as abnormality detected (AD) and others as NAD. Then probability of future leukemia and brain cancer was estimated for different age and gender groups. Results: On average, in 65% of the cases the results were NAD (56% and 76% among males and females, respectively). Among children, 79% of the reports were NAD. The total number of projected brain cancers was 1.8 and 1.3 for males and females, respectively. The number of projected leukemia cases was 0.75 and 0.7 for males and females, respectively. For pediatric patients, brain CT scans can lead to leukemia cases about 4.5 times more often than adults. Conclusion: Brain CT scans can lead to additional cases of brain cancer and leukemia. A significant fraction of brain CTs were NAD (non-pathologic) and could practically be replaced by other radiation-free imaging modalities, especially in pediatric and young patients.

scholarly journals Evidence-Based Second-Line Treatment in RAS Wild-Type/Mutated Metastatic Colorectal Cancer in the Precision Medicine Era

2021 ◽  
Vol 22 (14) ◽  
pp. 7717
Author(s):  
Guido Giordano ◽  
Pietro Parcesepe ◽  
Giuseppina Bruno ◽  
Annamaria Piscazzi ◽  
Vincenzo Lizzi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Checkpoint Inhibitors ◽  
Line Treatment ◽  
Second Line ◽  
Wild Type ◽  
First Line ◽  
Braf Mutations ◽  
Mutational Status ◽  
First Line Treatment

Target-oriented agents improve metastatic colorectal cancer (mCRC) survival in combination with chemotherapy. However, the majority of patients experience disease progression after first-line treatment and are eligible for second-line approaches. In such a context, antiangiogenic and anti-Epidermal Growth Factor Receptor (EGFR) agents as well as immune checkpoint inhibitors have been approved as second-line options, and RAS and BRAF mutations and microsatellite status represent the molecular drivers that guide therapeutic choices. Patients harboring K- and N-RAS mutations are not eligible for anti-EGFR treatments, and bevacizumab is the only antiangiogenic agent that improves survival in combination with chemotherapy in first-line, regardless of RAS mutational status. Thus, the choice of an appropriate therapy after the progression to a bevacizumab or an EGFR-based first-line treatment should be evaluated according to the patient and disease characteristics and treatment aims. The continuation of bevacizumab beyond progression or its substitution with another anti-angiogenic agents has been shown to increase survival, whereas anti-EGFR monoclonals represent an option in RAS wild-type patients. In addition, specific molecular subgroups, such as BRAF-mutated and Microsatellite Instability-High (MSI-H) mCRCs represent aggressive malignancies that are poorly responsive to standard therapies and deserve targeted approaches. This review provides a critical overview about the state of the art in mCRC second-line treatment and discusses sequential strategies according to key molecular biomarkers.

Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

scholarly journals Age-Related Alteration of Risk Profile, Inflammatory Response, and Angiographic Findings in Patients with Acute Coronary Syndrome

2009 ◽  
Vol 3 ◽  
pp. CMC.S2118 ◽  
Author(s):  
Hala Mahfouz Badran ◽  
Mohamed Fahmy Elnoamany ◽  
Tarek Salah Khalil ◽  
Mostafa Mohamed Ezz Eldin
Keyword(s):  
Inflammatory Response ◽  
Age Groups ◽  
Young Patients ◽  
Risk Profile ◽  
High Morbidity ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
Group I ◽  
Hs Crp ◽  
Angiographic Findings

Background Coronary artery disease (CAD) is a major public health problem which in turn imposes a significant burden on health care systems because of high morbidity and mortality. Although the multifactorial etiology of CAD increases with age, but in recent years, the incidence is increasing among younger age groups. Objectives In this study we aimed to evaluate the effect of age on risk profile, inflammatory response and the angiographic findings in patients with ACS. Patients and Methods The study comprised 253 ACS patients. Seventy six (30%) with UA, 56 (22%) with NSTEMI and 121(48%) with STEMI diagnosis. The value of Hs-CRP, lipid profile, cardiac enzymes, risk factors, EF% and angiographic score were analyzed and compared in different age groups. Results Group 1 (n = 68) with age <45 years, group II (n = 110) with age ≥45-<65 years and group III (n = 75) ≥65 years. Group I had more prevalence of male sex, smoking, family history, hypertriglyceridemia and low levels of HDL (P < 0.01), higher incidence of STEMI (P < 0.01) and lower prevalence of UA (P < 0.01). Diabetes mellitus, hypertension, and female gender were more common in older groups. Hs-CRP was significantly lower in the young age (group I). Group I showed a preponderance of single-vessel disease, lower coronary atherosclerotic score and prevalent left anterior descending artery (LAD) involvement compared with older age groups. Hs-CRP was positively correlated to severity of CAD only in older groups. Stepwise multiple regression analysis showed that age, male gender, cardiac enzymes and EF% were common predictors of multivessel disease. Smoking was independent predictor in young patients <45 years while diabetes and Hs-CRP was the key predictor in older patient groups. Conclusion Young patients with ACS had different clinical, angiographic and biochemical profile. Hs-CRP peak concentration did not correlate with angiographic findings in young patients that could be attributed to different risk profile and discrete underlying mechanism.

scholarly journals Prevalence of Brucellosis in Dairy Cattle in Organized and Smallholder Farms in Some Selected Areas of Bangladesh

2014 ◽  
Vol 12 (2) ◽  
pp. 167-171
Author(s):  
MAS Sarker ◽  
MS Rahman ◽  
MT Islam ◽  
AKMA Rahman ◽  
MB Rahman ◽  
...  
Keyword(s):  
Age Groups ◽  
Dairy Farm ◽  
Economic Loss ◽  
Screening Tests ◽  
Ring Test ◽  
Serum Samples ◽  
Smallholder Farms ◽  
Three Samples ◽  
Holstein Friesian ◽  
Confirmatory Tests

Brucellosis causes a great economic loss to the livestock industries through abortion, infertility,birth of weak and dead offspring, increased calving interval and reduction of milk yield and it is endemic in Bangladesh. In this study we collected milk and blood samples simultaneously from533 cows of Central Cattle Breeding and Dairy Farm, Savar, Dhaka and different Upazilas of Gaibandha and Mymensingh District. Five hundred thirty three samples were examined for antibodies to Brucella using the Milk Ring Test (MRT) and Rose Bengal Test (RBT). Overall 2.62 % of milk samples were positive according to MRT, while2.06 % of the serum samples were positive to the RBT. Only 6 (1.13 %) of the samples were positive for both test (MRT and RBT). Out of 312 samples only 10 (3.20 %) were positive to MRT while 8(2.06%) were positive to RBT in Holstein Friesian cross (p>0.05) on the other hand out of 221 samples only 4 (1.80%) were positive to MRT while 3(1.35%) were positive to RBT in Sahiwal cross. The prevalence of brucellosis was significantly higher in the age group of > 5 years than other age groups (p?0.01) on both test (MRT 2.75%and RBT 2.25%).Based on parity, significantly higher prevalence (MRT 2.93% and RBT 2.44%) of MRT and RBT were obtainedin parity 3-5in comparison to other parity group (p?0.01). It is, however, obvious that although the MRT is 1st-line screening tests for brucellosis in cows in some countries, their lack of specificity is of concern. Therefore, the requirement for other confirmatory tests that are more specific should be used for the diagnosis of the disease, especially in Bangladesh.DOI: http://dx.doi.org/10.3329/bjvm.v12i2.21280 Bangl. J. Vet. Med. (2014). 12 (2): 167-171 

scholarly journals The New Changes In The 7th Ajcc/Uicc Staging System Of Gastric Carcinomas

2013 ◽  
Vol 59 (3) ◽  
pp. 165-168 ◽  
Author(s):  
Ioana Hălmaciu ◽  
Simona Gurzu ◽  
B A Suciu ◽  
S I Comișel ◽  
L Dénes ◽  
...  
Keyword(s):  
Stage Iv ◽  
Staging System ◽  
Cancer Staging ◽  
Signet Ring Cell ◽  
Gastric Carcinomas ◽  
Staging Systems ◽  
Signet Ring ◽  
Ring Cell ◽  
Uicc Staging System ◽  
New System

Abstract Objective: The aim of this study was to analyze in parallel the 6th and the newest 7th AJJCC/UICC (American Joint Committee on Cancer/ International Union Against Cancer) staging system in order to highlight changes brought by the new staging system. Methods: We analyzed data obtained retrospectively from 134 hospitalized patients diagnosed with gastric carcinomas, who underwent surgery at the Surgery Clinics of the County Emergency Clinical Hospital of Tîrgu Mureș, Romania between 2008-2010. The data have been obtained from histopathology reports, and the analyzed parameters were the following: age, gender and pTNM staging. For all cases included in the study restaging was performed according to the 7th AJJCC/UICC staging system. Results: 71.66% of cases were adenocarcinomas, 7.46% mucinous adenocarcinoma, 14.17% signet ring cell carcinoma, and 6.71% undifferentiated carcinoma. The signet ring cell carcinomas predominated before 65 years of age (p = 0.003). Compared to the 6th staging system, in the new system pT2 percentages decreased significantly from 38.8% to 6.71%, and pT4 increases from 11.19% to 55.97% (p <0.0001). The pN3 cases increased from 20.9% to 45.52%, because all cases classified as pN2 in the old staging system, became pN3 in the new system. Some of the pN1 cases turned into pN2 in the new system (p = 0.004). Stage IV cases also decreased from 29.85% to 14.94%, due to regrouping of stage III. Conclusions: There are significant changes between the two staging systems. The new staging system aims to achieve a better postoperative follow-up.

scholarly journals Analysis of the reliability of patient COVID-19 screening data compared against their actual test data

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110429
Author(s):  
Abdulaziz M Albargi ◽  
Ali A Assiry ◽  
Hammam A Bahammam ◽  
Mohand Y Alassiri ◽  
Anand Marya ◽  
...  
Keyword(s):  
Data Collection ◽  
Dental Treatment ◽  
Descriptive Analysis ◽  
Age Groups ◽  
Screening Tests ◽  
Dental Clinic ◽  
Significant Difference ◽  
The Status ◽  
Feasible Option ◽  
Pre Treatment

Objectives: This study aimed to evaluate the truthfulness of patients about their pre-appointment COVID-19 screening tests at a dental clinic. Methods: A total of 613 patients were recruited for the study from the dental clinic at the Faculty of Dentistry, Najran University, Saudi Arabia. The data collection was done in three parts from the patients who visited the hospital to receive dental treatment. The first part included the socio-demographic characteristics of the patients and the COVID-19 swab tests performed within the past 14 days. The second part was the clinical examination, and the third part was a confirmation of the swab test taken by the patient by checking the Hesen website using the patient ID. After data collection, statistical analysis was carried out using SPSS 26.0. Descriptive analysis was done and expressed as mean, standard deviation, frequency, and percentage (%). A cross-tabulation, also described as a contingency table, was used to identify trends and patterns across data and explain the correlation between different variables. Results: It was seen from the status of the swab test within 14 days of the patient's arrival at the hospital for the dental treatment that 18 (2.9%) patients lied about the pre-treatment swab test within 14 days, and 595 (97.1%) were truthful. The observed and expected counts showed across genders and diagnosis a statistically significant difference ( p < 0.001), and there was no significant difference seen across different age groups ( p = 0.064) of the patients. Conclusions: Dental healthcare workers are worried and assume a high risk of COVID-19 infection as the patients are not truthful about the pre-treatment COVID-19 swab test. Routine rapid tests on patients and the healthcare staff are a feasible option for lowering overall risks.

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