Expression of Programmed Death Ligand 2 in Patients with Thymoma and Thymomatous Myasthenia Gravis

Abstract Purpose: The purpose of this study was to examine the expression of PD-L2 in thymoma and thymomatous myasthenia gravis (MG). Methods: The records of 70 patients with thymoma who underwent surgical resection between January 2017 and December 2018 were retrospectively reviewed. Thymoma PD-L2 expression was evaluated by immunohistochemistry (IHC) staining. Associations between PD-L2 expression and clinicopathological features were examined. Results: PD-L2 expression was positive in 41 patients (58.6%) and negative in 29 patients (41.4%). Of the patients, 33 had thymomatous MG. Patients with MG were more likely to be ≤ 50 years of age (69.70% vs. 35.14%), have higher WHO type (84.85% vs. 64.86%), smaller tumor size (4.09 ± 2.33 vs. 6.47 ± 2.42 cm), have positive PD-L2 expression (78.79% vs. 40.54%), and have higher PD-L2 expression intensity, ratio, and score (all, P < 0.05). Positive PD-L2 expression was associated with higher WHO type, higher Masaoka-Koga stage, smaller tumor size, ectopic thymus, and MG (all, P < 0.05). Factors significantly associated with MG were age > 50 years (OR = 0.09, 95% CI: 0.02 to 0.39), tumor size > 5 cm (OR = 0.22, 95% CI: 0.06 to 0.82), and positive PD-L2 expression (OR = 9.25, 95% CI: 1.93 to 44.30) (all, P < 0.05; Table 3).Conclusion: Thymoma PD-L2 expression is significantly associated with thymomatous MG and WHO histological type B2 and B3.

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Small Neuroendocrine Tumors of the Whole Gastrointestinal Tract Performed Endoscopic or Surgical Resections Also Show Positive for Lymphovascular Invasion

Digestion ◽

10.1159/000517282 ◽

2021 ◽

pp. 1-8

Author(s):

Haruna Miyashita ◽

Takuji Yamasaki ◽

Yoshihiro Akita ◽

Yoshitaka Ando ◽

Yuki Maruyama ◽

...

Keyword(s):

Surgical Resection ◽

Neuroendocrine Tumors ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Distant Metastases ◽

High Rate ◽

Ki 67 ◽

Primary Endpoints ◽

Invasion Impact ◽

Prognostic Stratification

Background and Aims: In gastrointestinal neuroendocrine tumors (GI-NETs), tumor size and grading based on cellular proliferative ability indicate biological malignancy but not necessarily clinically efficient prognostic stratification. We analyzed tumor size- and grading-based prevalence of lymphovascular invasion in GI-NETs to establish whether these are true biological malignancy indicators. Methods: We included 155 cases (165 lesions), diagnosed histologically with GI-NETs, that had undergone endoscopic or surgical resection. Patient age, sex, method of treatment, tumor size, invasion depth, lymphovascular invasion positivity according to Ki-67 index-based neuroendocrine tumor grading, distant metastases, and outcome were evaluated. The primary endpoints were the prevalence of lymphovascular invasion according to tumor size and grading. Results: Overall, 24.8% were positive for lymphovascular invasion. There was a high rate of lymphovascular invasion positivity even among grade 1 cases (22.8%). The rate of lymphovascular invasion was 3.4% for grade 1 cases <5 mm, with a lymphovascular invasion rate of 8.7% for those 5–10 mm. Lymphovascular invasion ≤10% required a tumor size ≤8 mm, and lymphovascular invasion ≤5% required a tumor size ≤6 mm. A cutoff of 6 mm was identified, which yielded a sensitivity of 79% and a specificity of 63%. Even small GI-NETs grade 1 of the whole GI tract also showed positive for lymphovascular invasion. Conclusions: GI-NETs ≤10 mm had a lymphovascular invasion prevalence exceeding 10%. The lymphovascular invasion impact in GI-NET development is incompletely understood, but careful follow-up, including consideration of additional surgical resection, is crucial in cases with lymphovascular invasion.

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Prognostic and clinicopathological significance of hypoxia-inducible factors 1α and 2α in hepatocellular carcinoma: a systematic review with meta-analysis

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920987071 ◽

2021 ◽

Vol 13 ◽

pp. 175883592098707

Author(s):

Carolina Méndez-Blanco ◽

Paula Fernández-Palanca ◽

Flavia Fondevila ◽

Javier González-Gallego ◽

José L. Mauriz

Keyword(s):

Hepatocellular Carcinoma ◽

Subgroup Analysis ◽

Tumor Size ◽

Vasculogenic Mimicry ◽

Disease Free Survival ◽

Clinicopathological Features ◽

Hypoxia Inducible Factors ◽

Free Survival ◽

Node Metastasis ◽

Clinicopathological Significance

Background: Hepatocellular carcinoma (HCC) is a highly recurrent tumor after resection and has been closely related to hypoxia. Hypoxia-inducible factors 1α and 2α (HIF-1α and HIF-2α) have been shown to contribute to tumor progression and therapy resistance in HCC. We evaluated the prognostic and clinicopathological significance of HIF-1α and HIF-2α in HCC patients. Methods: We systematically searched Embase, Cochrane, PubMed, Scopus and Web of Science (WOS) from inception to 1 June 2020 for studies evaluating HIF-1α and/or HIF-2α expression in HCC. Selected articles evaluate at least one factor by immunohistochemistry (IHC) in HCC patients who underwent surgical resection, and its relationship with prognosis and/or clinicopathological features. Study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CDR42020191977). We meta-analyzed the data extracted or estimated according to the Parmar method employing STATA software. We evaluated the overall effect size for the hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI), as well as heterogeneity across studies with the I2 statistic and chi-square-based Q test. Moreover, we conducted subgroup analysis when heterogeneity was substantial. Publication bias was assessed by funnel plot asymmetry and Egger’s test. Results: HIF-1α overexpression was correlated with overall survival (OS), disease-free survival (DFS)/recurrence-free survival (RFS) and clinicopathological features including Barcelona Clinic Liver Cancer (BCLC), capsule infiltration, intrahepatic metastasis, lymph node metastasis, tumor–node–metastasis (TNM), tumor differentiation, tumor number, tumor size (3 cm), vascular invasion and vasculogenic mimicry. We also detected a possible correlation of HIF-1α with alpha-fetoprotein (AFP), cirrhosis, histological grade, tumor size (5 cm) and albumin after subgroup analysis. Initially, only DFS/RFS appeared to be associated with HIF-2α overexpression. Subgroup analysis denoted that HIF-2α overexpression was related to OS and capsule infiltration. Conclusions: HIF-1α and HIF-2α overexpression is related to poor OS, DFS/RFS and some clinicopathological features of HCC patients, suggesting that both factors could be useful HCC biomarkers.

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Clinical features and outcomes of combined hepatocellular carcinoma and cholangiocarcinoma versus hepatocellular carcinoma versus cholangiocarcinoma after surgical resection: a propensity score matching analysis

BMC Gastroenterology ◽

10.1186/s12876-020-01586-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chih-Wen Lin ◽

Tsung-Chin Wu ◽

Hung-Yu Lin ◽

Chao-Ming Hung ◽

Pei-Min Hsieh ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Resection ◽

Disease Free Survival ◽

Clinicopathological Features ◽

Free Survival ◽

Before And After ◽

Disease Free

Abstract Background Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups. Methods We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan–Meier analysis. Results In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7–61.2], 62.3 months (CI: 42.1–72.9), and 36.2 months (CI: 15.4–56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM. Conclusion The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.

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Tumor Tissue MIR92a and Plasma MIRs21 and 29a as Predictive Biomarkers Associated with Clinicopathological Features and Surgical Resection in a Prospective Study on Colorectal Cancer Patients

Journal of Clinical Medicine ◽

10.3390/jcm9082509 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2509

Author(s):

Masahiro Fukada ◽

Nobuhisa Matsuhashi ◽

Takao Takahashi ◽

Nobuhiko Sugito ◽

Kazuki Heishima ◽

...

Keyword(s):

Colorectal Cancer ◽

Prospective Study ◽

Surgical Resection ◽

Tumor Tissue ◽

Lymphatic Invasion ◽

Clinicopathological Features ◽

Stage Iii ◽

Sample Type ◽

Significant Difference ◽

A Prospective Study

Cancer-related microRNAs (miRNAs) are emerging as non-invasive biomarkers for colorectal cancer (CRC). This study aimed to analyze the correlation between the levels of tissue and plasma miRNAs and clinicopathological characteristics and surgical resection. This study was a prospective study of CRC patients who underwent surgery. Forty-four sample pairs of tissue and plasma were analyzed. The miRNA levels were evaluated by RT-qPCR. The level of tumor tissue MIR92a showed a significant difference in CRC with lymph node metastasis, stage ≥ III, and high lymphatic invasion. In preoperative plasma, there were significant differences in CRC with stage ≥ III (MIR29a) and perineural invasion (MIR21). In multivariate analysis of lymphatic invasion, the levels of both preoperative plasma MIR29a and tumor tissue MIR92a showed significant differences. Furthermore, in cases with higher plasma miRNA level, the levels of plasma MIRs21 and 29a were significantly decreased after the operation. In this study, there were significant differences in miRNAs levels with respect to the sample type, clinicopathological features, and surgical resection. The levels of tumor tissue MIR92a and preoperative plasma MIR29a may have the potential as a biomarker for prognosis. The plasma MIRs21 and 29a level has the potential to be a predictive biomarker for treatment efficacy.

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Age, tumor size, type of surgery, and gender predict survival in early stage (stage I and II) non-small cell lung cancer after surgical resection

Lung Cancer ◽

10.1016/j.lungcan.2009.08.008 ◽

2010 ◽

Vol 68 (3) ◽

pp. 398-402 ◽

Cited By ~ 32

Author(s):

Mohit Agarwal ◽

Govinda Brahmanday ◽

Gary W. Chmielewski ◽

Robert J. Welsh ◽

K.P. Ravikrishnan

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Surgical Resection ◽

Tumor Size ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Size Type ◽

And Gender ◽

Type Of Surgery

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Androgen receptors in hepatocellular carcinoma and surrounding liver: relationship with tumor size and recurrence rate after surgical resection

Journal of Hepatology ◽

10.1016/0168-8278(95)80217-7 ◽

1995 ◽

Vol 22 (6) ◽

pp. 616-622 ◽

Cited By ~ 23

Author(s):

Loreto Boix ◽

Antoni Castells ◽

Jordi Bruix ◽

Manel Solé ◽

Concepció Brú ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Recurrence Rate ◽

Surgical Resection ◽

Tumor Size ◽

Androgen Receptors

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A Retrospective Study of Superficial Type Atypical Lipomatous Tumor

Frontiers in Medicine ◽

10.3389/fmed.2020.609515 ◽

2020 ◽

Vol 7 ◽

Author(s):

Emi Mashima ◽

Yu Sawada ◽

Natsuko Saito-Sasaki ◽

Kayo Yamamoto ◽

Shun Ohmori ◽

...

Keyword(s):

Surgical Resection ◽

Tumor Size ◽

Clinical Characteristics ◽

Clinical Manifestations ◽

Tumor Location ◽

Atypical Lipomatous Tumor ◽

Lipomatous Tumor ◽

Physical Examinations ◽

Superficial Type ◽

Well Differentiated

Atypical lipomatous tumor (ALT) has been defined as a well-differentiated liposarcoma exhibiting a higher frequency of a local recurrence after surgical resection. ALT is mainly classified into deep type and superficial type. Compared with deep type ALT, superficial type ALT is rarely observed. One of the most important issues is that little has been known about superficial type ALT and it is not easy to predict the presence of superficial type ALT before surgical resection. To clarify the clinical manifestations of superficial type ALT, we examined 15 cases with superficial type ALT and 118 cases with benign lipoma, and analyzed their differences in clinical characteristics and the findings of MRI test. In clinical characteristics, the tumor size of superficial type ALT was significantly greater than that of benign lipoma, and superficial type ALT showed a significantly higher frequency of the tumor size of more than 4 cm. Superficial type ALT exhibited poor tumor mobility and hardness with elastic soft. In addition, a significantly higher frequency of tumor location of superficial type ALT was observed in extremities. Among tumor sites at the trunk, buttocks, and shoulder were high frequent location in superficial type ALT. In an MRI examination, superficial type ALT exhibited a significantly higher frequency of the septal structures compared with benign lipoma. The combinations of clinical characteristics, including physical examinations, MRI, and histological examinations, are helpful for the diagnosis of superficial type ALT.

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Hepatic epithelioid hemangioendothelioma: case series of a rare vascular tumor mimicking metastases

Diagnostic Pathology ◽

10.1186/s13000-020-01039-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Nasir Ud Din ◽

Shabina Rahim ◽

Tamana Asghari ◽

Jamshid Abdul-Ghafar ◽

Zubair Ahmad

Keyword(s):

Surgical Resection ◽

Case Series ◽

Liver Function Tests ◽

Vascular Tumor ◽

Metastatic Carcinoma ◽

Epithelioid Hemangioendothelioma ◽

Clinicopathological Features ◽

University Hospital ◽

Detailed Review

Abstract Background Hepatic epithelioid hemangioendothelioma is an extremely rare malignant vascular tumor which is often multifocal and, in many cases, discovered incidentally. Here, we describe the clinicopathological features of hepatic epithelioid hemangioendothelioma cases seen in our practice and present a detailed review of the published literature. Methods All cases of hepatic epithelioid hemangioendothelioma diagnosed in Department of Pathology and Laboratory Medicine, Aga Khan University Hospital between January 1, 2006 and December 31, 2019 were included in the study. Slides were reviewed and follow up was obtained. Results Seven cases were reported during the study period. There were 4 females and 3 males. Age range was 20 to 77 years, mean age was 45 years. Three patients presented with right upper abdominal pain; 1 patient presented with jaundice while 3 patients were asymptomatic. In all 7 cases, lesions were identified on imaging studies. In 5 cases, liver lesions were multifocal. Clinical differential diagnosis in all cases was metastatic carcinoma and multifocal hepatocellular carcinoma. Liver function tests were normal in 5 cases. In 1 patient, tumor had already metastasized to the right lung. On histological examination of liver core biopsies performed in all 7 cases, classic histological features of epithelioid hemangioendothelioma were seen. Tumor cells expressed positivity for vascular markers (CD 34, CD31 and ERG) and were negative for cytokeratins, Hep par 1 and Glypican 3. Surgical resection was not performed in any of the 7 cases and all patients were treated by chemotherapy. Follow up was available in 5 cases. Of these, 3 patients died of disease and another patient was alive with metastases in both lungs, omentum and colon. Conclusion Clinicopathological features of the 7 cases in our series and detailed review of published literature is presented. Prognosis was bad in our cases most likely due to fact that surgical resection could not be performed in any of the cases owing to lack of surgical expertise for liver tumor surgery in most parts of the country.

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