Case series of gastrointestinal stromal tumors with lymph nodes metastasis: unusual presentations

Gastrointestinal stromal tumor (GIST) is a rare cancer of the gastrointestinal tract, it occurred about 0.1-3.0% of all gastrointestinal neoplasms. Accounted about 10% of small-bowel tumors, and 10-15% of all sarcomas. Liver is a common hematogenous spread in GIST. However, metastasis to lymph nodes is consider extremely rare and routine lymph node dissection for GIST tumor was not recommended. Hence, we reported a case series of GIST that metastasize to lymph node along our experience in our center, hospital Taiping, Malaysia from 2010 until 2020. Hereby we report total of 3 out of 18 GIST cases that we encountered confirmed through histopathology the existence of lymph node metastasis.

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The effect of miRNAs and MALAT1 related with the prognosis of Her-2 positive breast cancer patients with lymph node metastasis

10.21203/rs.2.24153/v1 ◽

2020 ◽

Author(s):

Zhao Hongcan ◽

Yang Hongjian ◽

Zhang Xiping

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

High Expression ◽

Expression Level ◽

Lymph Nodes Metastasis ◽

Node Metastasis ◽

Her 2 ◽

Proliferation And Invasion ◽

Low Expression

Abstract Background: To analyze and screen the miRNAs associated with lymph node metastasis of breast cancer (BC), and to explore the roles of these miRNAs in the proliferation, invasion and prognosis of BC. Methods: MicroRNAs associated with lymph node metastasis in Her-2 positive BC was screened by TCGA database. The qRT-PCR was used to verify theses 5 miRNAs in 30 cases of Her-2 positive BC with lymph node metastasis of different degree. The tumor tissue samples were divided into non-lymph node metastasis group, ≤ 3 lymph node metastasis group and > 3 lymph node metastasis group. In addition, 10 cases of paracancerous tissues were considered as paracancerous control group. Pearson correlation analysis was used to analysis the relationship of 5 miRNAs and MALAT1 with Her-2 positive BC patients' clinicopathological characteristics and prognosis. CCK8 and Transwell experiments were used to detect the effects of miR-143 and miR-455 on the proliferation and invasion of Her-2 positive BC cells (MDA-MB-453). Results: Five kinds of miRNA (miR-143, miR-196a, miR-455, miR-9 and miR-92a) related with Her-2 positive BC with lymph node metastasis were screened by TCGA database. The detecting results of qRT-PCR showed that the levels of miR-143, miR-196a, miR-9 and MALAT1 increased with the increased number of lymph nodes. The expression level of miR-143 in the group of ≤ 3 lymph nodes metastasis and > 3 lymph nodes metastasis was significantly higher than that in the group of non-lymph nodes metastasis (P<0.001), and that in the group of > 3 lymph nodes metastasis was significantly higher than that in the group of ≤ 3 lymph nodes metastasis (P<0.001). The expression level of miR-196a in the group of ≤ 3 lymph nodes metastasis and > 3 lymph nodes metastasis was significantly higher than that in the group of non-lymph nodes metastasis (P<0.001), and that in the group of > 3 lymph nodes metastasis was significantly higher than that in the group of ≤ 3 lymph nodes metastasis (P<0.001). The expression level of miR-455 in the group of ≤ 3 lymph nodes metastasis and > 3 lymph nodes metastasis was significantly lower than that in the group of non-lymph nodes metastasis (P<0.001), and that in the group of > 3 lymph nodes metastasis was significantly lower than that in the group of ≤ 3 lymph nodes metastasis (P<0.001). The expression level of MALAT1 in the group of ≤ 3 lymph nodes metastasis and > 3 lymph nodes metastasis was significantly higher than that in the group of non-lymph nodes metastasis (P<0.001), and that in the group of > 3 lymph nodes metastasis was significantly higher than that in the group of ≤ 3 lymph nodes metastasis (P<0.01). Pearson correlation analysis showed that the expression levels of miR-455-5p, miR-196a-5p and MALAT1 were negatively correlated, positively correlated and positively correlated with the pathological stages of Her-2 positive BC, respectively. The results of survival analysis showed that RFS of patients with high expression of miR-196a, miR-92a and MALAT1 was significantly lower than that of patients with low expression (P<0.05), and OS and RFS of patients with high expression of miR-9 were significantly lower than those of patients with low expression, while OS and RFS of patients with high expression of miR-455 were significantly higher than those of patients with low expression (P<0.05). Cytological experiments showed that up regulation of miR-455 significantly inhibited the proliferation and invasion of BC cells, while down regulation of miR-143 significantly inhibited the proliferation and invasion of BC cells and the expression of MALAT1 (P<0.05). Conclusion: High expression of miR-143, miR-9, miR-196a, MALAT1 and low expression of miR-455 are related to the degree of lymph node metastasis of Her-2-positive BC patients, indicating poor prognosis. Down-regulation of miR-455 and up-regulation of miR-143 and MALAT1 can promote the cell proliferation and invasion of Her-2-positive BC.

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RA04.05: PREVALENCE OF LYMPH-NODE METASTASIS IN T1B ESOPHAGEAL SQUAMOUS CELL CANCER: IMPLICATIONS FOR ADDITIONAL RADIOTHERAPY DESIGN FOLLOWING ENDOSCOPIC SUBMUCOSAL DISSECTION

Diseases of the Esophagus ◽

10.1093/dote/doy089.ra04.05 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 26-26

Author(s):

Jun Liu ◽

Xiaolong Fu ◽

Hongxuan Li ◽

Yan Cheng ◽

Zhigang Li

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Endoscopic Submucosal Dissection ◽

Squamous Cell ◽

Clinical Target Volume ◽

Target Volume ◽

Lymph Nodes Metastasis ◽

Node Metastasis ◽

Submucosal Dissection

Abstract Background Endoscopic submucosal dissection (ESD) can be used as a less invasive treatment option for early esophageal cancer. But how to prevent lymph node metastasis is essential in these patients. This study aimed to analyze prevalence of lymph nodes metastasis for T1b thoracic esophageal squamous cell carcinoma(TESCC) patients treated in Shanghai Chest Hospital(SCH) and to propose a clinical target volume (CTV) for additional radiotherapy Clinical Target Volume design following endoscopic submucosal dissection(ESD) in these patients. Methods From 2012 to 2017, consecutive patients with T1b TESCC patients who underwent complete resection in SCH were identified. The prevalence of lymph-node metastasis were assessed and evaluated whether these metastasis areas would be encompassed by our proposed CTV. We proposed lymph-node stations (JEOG) 101, 104, 105, 106, 107 for upper TESCC, lymph-node stations 106, 107, 108, 1, 2, 3, 7, 8, 9, 10 for middle TESCC, and lymph-node stations110, 112, 1, 2, 3, 7, 8, 9, 10 for lower TESCC. Results There were 240 patients (80.4% male) who met the inclusion criteria, with a mean age of 62 ± 7 years. Of the total, 27.1%(65/240) patients presented with lymph nodes metastasis. Single lymph-node and single station lymph-node metastasis among positive nodes patients were 63.1%(41/65) and 70.8%(46/65), respectively.Tumor length exceeding 20mm and poor tumor differentiation but not age, gender, tumor position and tumor thrombus were independently associated with the risk of nodal disease. Among positive nodes patients, 89.2% (58/65) lymph-node metastasis for T1b TESCC patients could be covered by proposed CTV. Conclusion Prevalence of lymph node metastasis is high in patients with T1b TESCC. It seemed additional radiotherapy after ESD for those patients with high risk factors is needed to prevent lymph node metastasis. Majority positive nodes area could be covered by our proposed CTV. However, the value of radiotherapy and the proposed CTV should be investigated in further prospective studies. Disclosure All authors have declared no conflicts of interest.

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Analysis of Clinical Prognostic Variables for Triple Negative Breast Cancer Histological Grading and Lymph Node Metastasis

Journal of Medical Informatics and Decision Making ◽

10.14302/issn.2641-5526.jmid-18-2488 ◽

2018 ◽

Vol 1 (1) ◽

pp. 14-36 ◽

Cited By ~ 2

Author(s):

Ana Cernea ◽

Juan Luis Fernández-Martínez ◽

Enrique J. deAndrés-Galiana ◽

José A. Galván ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Triple Negative ◽

Histological Grade ◽

Prognostic Variables ◽

Ki67 Expression ◽

Lymph Nodes Metastasis ◽

Node Metastasis

Background: Triple Negative Breast Cancer (TNBC) is a type of breast cancer with very bad prognosis. Predicting the histological grade (HG) and the lymph nodes metastasis is crucial for developing more suitable treatment strategies. Methods: We present the main clinical and pathological variables to predict the histological grade and lymph nodes metastasis via novel machine learning techniques. These variables are currently being used for prognosis and treatment in medical practice. This analysis was performed using a database of 102 Caucasian women diagnosed with TNBC. The results were cross-validated using random simulations of this dataset. Results: HG was predicted with an accuracy of 93.8% using a list of 6 prognostic variables with significant implications: Ki67 expression, use of Oral contraceptives, Col11A1 expression, Col11A1 score, E-cad truncated and Tumor size. The lymph nodes metastasis was predicted with an accuracy of almost 85% using only 6 prognostic variables: Vascular invasion, Tumor size, Perineural invasion, Age at diagnosis, Ki67 expression, and Col11A1 score. This analysis also served to establish the median signatures of the groups with and without lymph node metastasis, and proved the existence of a kind of small-size tumors (around 2.15 cm) with lymph node metastasis but not showing vascular and perineural invasions and higher protein Col11A1 score. Besides, these signatures proved to be very stable. Conclusions: The additional information conveyed by the prognostic variables found in these two classification problems provides new insight about the genesis and progression of this disease and can be used in medical practice to improve decisions in patient diagnosis and further treatment.

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Clinical Relevance and Management of Recurrent Laryngeal Nerve Inlet Zone Lymph Nodes Metastasis in Papillary Thyroid Cancer

Frontiers in Endocrinology ◽

10.3389/fendo.2021.653184 ◽

2021 ◽

Vol 12 ◽

Author(s):

Guibin Zheng ◽

Guochang Wu ◽

Haiqing Sun ◽

Chi Ma ◽

Yawen Guo ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Recurrent Laryngeal Nerve ◽

Laryngeal Nerve ◽

Nodal Disease ◽

Lateral Node ◽

Lateral Node Metastasis ◽

Lymph Nodes Metastasis ◽

Node Metastasis ◽

Inlet Zone

BackgroundRecurrent nodal disease often occurs in recurrent laryngeal nerve inlet zone (RLNIZ), leading to difficult surgical management.MethodsMedical records of 947 patients with PTC and 33 patients with recurrent PTC were retrospectively reviewed. Totally 169 sides of RLNIZ dissection in 152 patients (17 cases were bilateral and 135 cases were unilateral) with primary surgery and 4 patients with structural recurrent disease were included for the analysis.ResultsThe rate of lymph node metastasis in RLNIZ was 31.3% (47/150). The incidence of transient hypoparathyroidism was 5.9% and no RLN injury and permanent hypoparathyroidism occurred. RLNIZ lymph nodes metastasis (LNM) was significantly associated with age <45 years, larger tumor size, number of CNLNM, and lateral node metastasis. CNLNM and lateral node metastasis were independent risk factors for RLNIZ LNM. Recurrent nodal disease in RLNIZ was identified in four of 33 patients and permanent recurrent laryngeal nerve (RLN) injury was observed in one of four patients.ConclusionLymph nodes in RLNIZ are usually involved in patients with heavy tumor burden and can be removed safely at initial surgery. Once central or lateral LNM was confirmed preoperatively or intraoperatively, RLNIZ lymph node dissection should be carefully performed to reduce the rate of structural recurrence in the central compartment.

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A practical nomogram predicting the prognosis of hepatocellular carcinoma patients with lymph node metastasis: A population-based analysis

10.21203/rs.3.rs-27749/v1 ◽

2020 ◽

Author(s):

Kai Zhang ◽

Changcheng Tao ◽

Jianxiong Wu ◽

Weiqi Rong

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Cox Regression ◽

Lymph Nodes Metastasis ◽

Node Metastasis ◽

Independent Risk Factors

Abstract Background: Lymph node (LN) metastasis is associated with poor survival outcomes in patients with hepatocellular carcinoma (HCC) patients and because of the reported low probability of lymph node metastasis, research into the Anchorprognoses of such patients is difficult to conduct. In this study, we aimed to develop a nomogram model to predict the prognosis of HCC patients with lymph node metastasis. Methods: HCC patients diagnosed with LN metastasis from 2010 to 2015 were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate Cox regression and lasso regression were used to screen prognostic factors. Cox multiple-factor analysis was used to investigate the independent risk factors for survival. We developed a prognostic nomograms using these independent risk factors. The predictive performance of our nomogram model was evaluated according to the concordance index (C-index) and calibration curve. The net clinical benefit was assessed via decision curve analysis (DCA). Patients were divided into different risk groups according to the model. A survival curve was drawn using the Kaplan-Meier method and the difference was compared by the log-rank test. Results: There were 944 patients in the training cohort and 402 patients in the validation cohort. Grade, T stage, surgery to the liver, chemotherapy, radiation recode, AFP, fibrosis score, tumor size group, M stage were selected as independent prognostic factors, and we developed nomograms using these variables. The calibration curves for probability of survival showed good agreement between the prediction by our model and actual observation in both the training and validation groups. DCA indicated that the nomogram had positive net benefits. Conclusions: The nomogram can accurately predict the prognosis of HCC patients with lymph nodes metastasis and provide a reasonable basis for treatment. Keywords: Hepatocellular carcinoma, prognosis, lymph nodes metastasis, prediction model, nomogram

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Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽

10.3390/cancers13040757 ◽

2021 ◽

Vol 13 (4) ◽

pp. 757

Author(s):

Sanaz Samiei ◽

Renée W. Y. Granzier ◽

Abdalla Ibrahim ◽

Sergey Primakov ◽

Marc B. I. Lobbes ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Mr Images ◽

Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

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Increased Expression of VANGL1 is Predictive of Lymph Node Metastasis in Colorectal Cancer: Results from a 20-Gene Expression Signature

Journal of Personalized Medicine ◽

10.3390/jpm11020126 ◽

2021 ◽

Vol 11 (2) ◽

pp. 126

Author(s):

Noshad Peyravian ◽

Stefania Nobili ◽

Zahra Pezeshkian ◽

Meysam Olfatifar ◽

Afshin Moradi ◽

...

Keyword(s):

Gene Expression ◽

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Candidate Genes ◽

Case Series ◽

Gene Expression Signature ◽

Gene Panel ◽

Expression Levels ◽

Node Metastasis

This study aimed at building a prognostic signature based on a candidate gene panel whose expression may be associated with lymph node metastasis (LNM), thus potentially able to predict colorectal cancer (CRC) progression and patient survival. The mRNA expression levels of 20 candidate genes were evaluated by RT-qPCR in cancer and normal mucosa formalin-fixed paraffin-embedded (FFPE) tissues of CRC patients. Receiver operating characteristic curves were used to evaluate the prognosis performance of our model by calculating the area under the curve (AUC) values corresponding to stage and metastasis. A total of 100 FFPE primary tumor tissues from stage I–IV CRC patients were collected and analyzed. Among the 20 candidate genes we studied, only the expression levels of VANGL1 significantly varied between patients with and without LNMs (p = 0.02). Additionally, the AUC value of the 20-gene panel was found to have the highest predictive performance (i.e., AUC = 79.84%) for LNMs compared with that of two subpanels including 5 and 10 genes. According to our results, VANGL1 gene expression levels are able to estimate LNMs in different stages of CRC. After a proper validation in a wider case series, the evaluation of VANGL1 gene expression and that of the 20-gene panel signature could help in the future in the prediction of CRC progression.

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