BACKGROUND The differences in histopathology and molecular biology between right colon cancer(RCC)and left colon cancer(LCC)were first reported in the literature by Bufill in 1990.Since then,a large number of studies ...BACKGROUND The differences in histopathology and molecular biology between right colon cancer(RCC)and left colon cancer(LCC)were first reported in the literature by Bufill in 1990.Since then,a large number of studies have confirmed their differences in epidemiology,clinical presentation,comorbidities and biological behaviours,which may be related to the difference in prognosis and overall survival(OS)between the two groups.AIM To investigate statistically significant differences between Greek patients with LCC and RCC.METHODS The present observational study included 144 patients diagnosed with colon cancer of any stage who received chemotherapy in a Greek tertiary oncology hospital during a 2.5-year period.Clinical information,comorbidities,histopathologic characteristics and molecular biomarkers were collected from the patients’medical records retrospectively,while administered chemotherapy regimens,targeted agents,progression-free survival(PFS)periods with first-and second-line chemotherapy and OS were recorded retroactively and prospectively.Data analysis was performed with the SPSS statistical package.RESULTS Eighty-six males and 58 females participated in the study.One hundred(69.4%)patients had a primary lesion in the left colon,and 44(30.6%)patients had a primary lesion in the right colon.Patients with RCC were more likely to display anaemia than patients with LCC[odds ratio(OR)=3.09],while LCC patients were more likely to develop rectal bleeding(OR=3.37)and a feeling of incomplete evacuation(OR=2.78)than RCC patients.Considering comorbidities,RCC patients were more likely to suffer from diabetes(OR=3.31)and coronary artery disease(P=0.056)than LCC patients.The mucinous differentiation rate was higher in the right-sided group than in the left-sided group(OR=4.49),as was the number of infiltrated lymph nodes(P=0.039),while the percentage of high-grade differentiation was higher in the group of patients with left-sided colon cancer than in RCC patients(OR=2.78).RAS wild-type patients who received anti-epidermal growth factor receptor(EGFR):Treatment experienced greater benefit(PFS:16.5 mo)than those who received anti-vascular endothelial growth factor treatment(PFS:13.7 mo)(P=0.05),while among RAS wild-type patients who received anti-EGFR treatment,LCC patients experienced greater benefit(PFS:15.8 mo)than the RCC subgroup(PFS:5.5 mo)in the first-line chemotherapy setting(P=0.034).BRAF-mutant patients had shorter PFS(9.3 mo)than BRAF wild-type patients(14.5 mo)(P=0.033).RCC patients showed a shorter tumour recurrence period(7.7 mo)than those with LCC(14.5 mo)(P<0.001),as well as shorter(OS)(58.4 mo for RCC patients;82.4 mo for LCC patients)(P=0.018).CONCLUSION RCC patients present more comorbidities,worse histological and molecular characteristics and a consequently higher probability of tumour recurrence,poor response to targeted therapy and shorter OS than LCC patients.展开更多
BACKGROUND Microglandular hyperplasia(MGH)is a proliferation of endocervical glands,related to estrogen stimulation,mainly occurring in the reproductive age group.The differential diagnosis includes endometrial adenoc...BACKGROUND Microglandular hyperplasia(MGH)is a proliferation of endocervical glands,related to estrogen stimulation,mainly occurring in the reproductive age group.The differential diagnosis includes endometrial adenocarcinoma with MGH-like pattern(MGA),a distinction that may be particularly problematic in curettage specimen.CASE SUMMARY A 57-year-old,postmenopausal woman was admitted in our hospital for surgical treatment.She had been diagnosed with a uterine leiomyoma,after complaints of irregular vaginal bleeding.She underwent dilatation and curettage(D&C)and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy.D&C were compatible with MGA.Histologically,a proliferation of small glands,without intervening stroma,with mucin production,accumulation of neutrophils in the gland lumen and stroma,mild nuclear atypia and rare mitoses,were seen.In the hysterectomy specimen,the endometrium was thickened,but without apparent tumor formation.On microscopic examination,a residual similar adenocarcinoma was seen in the isthmus and more conventional-of endometrioid and mucinous type,in the rest of the endometrium.CONCLUSION MGH-like proliferation with mild cytologic atypia,detected in the endometrial curettage specimen of a postmenopausal woman,should alert pathologists for MGA of the endometrium.VIM,p16,PAX-2,CD10 and CD34 may help in the differential diagnosis.展开更多
文摘BACKGROUND The differences in histopathology and molecular biology between right colon cancer(RCC)and left colon cancer(LCC)were first reported in the literature by Bufill in 1990.Since then,a large number of studies have confirmed their differences in epidemiology,clinical presentation,comorbidities and biological behaviours,which may be related to the difference in prognosis and overall survival(OS)between the two groups.AIM To investigate statistically significant differences between Greek patients with LCC and RCC.METHODS The present observational study included 144 patients diagnosed with colon cancer of any stage who received chemotherapy in a Greek tertiary oncology hospital during a 2.5-year period.Clinical information,comorbidities,histopathologic characteristics and molecular biomarkers were collected from the patients’medical records retrospectively,while administered chemotherapy regimens,targeted agents,progression-free survival(PFS)periods with first-and second-line chemotherapy and OS were recorded retroactively and prospectively.Data analysis was performed with the SPSS statistical package.RESULTS Eighty-six males and 58 females participated in the study.One hundred(69.4%)patients had a primary lesion in the left colon,and 44(30.6%)patients had a primary lesion in the right colon.Patients with RCC were more likely to display anaemia than patients with LCC[odds ratio(OR)=3.09],while LCC patients were more likely to develop rectal bleeding(OR=3.37)and a feeling of incomplete evacuation(OR=2.78)than RCC patients.Considering comorbidities,RCC patients were more likely to suffer from diabetes(OR=3.31)and coronary artery disease(P=0.056)than LCC patients.The mucinous differentiation rate was higher in the right-sided group than in the left-sided group(OR=4.49),as was the number of infiltrated lymph nodes(P=0.039),while the percentage of high-grade differentiation was higher in the group of patients with left-sided colon cancer than in RCC patients(OR=2.78).RAS wild-type patients who received anti-epidermal growth factor receptor(EGFR):Treatment experienced greater benefit(PFS:16.5 mo)than those who received anti-vascular endothelial growth factor treatment(PFS:13.7 mo)(P=0.05),while among RAS wild-type patients who received anti-EGFR treatment,LCC patients experienced greater benefit(PFS:15.8 mo)than the RCC subgroup(PFS:5.5 mo)in the first-line chemotherapy setting(P=0.034).BRAF-mutant patients had shorter PFS(9.3 mo)than BRAF wild-type patients(14.5 mo)(P=0.033).RCC patients showed a shorter tumour recurrence period(7.7 mo)than those with LCC(14.5 mo)(P<0.001),as well as shorter(OS)(58.4 mo for RCC patients;82.4 mo for LCC patients)(P=0.018).CONCLUSION RCC patients present more comorbidities,worse histological and molecular characteristics and a consequently higher probability of tumour recurrence,poor response to targeted therapy and shorter OS than LCC patients.
文摘BACKGROUND Microglandular hyperplasia(MGH)is a proliferation of endocervical glands,related to estrogen stimulation,mainly occurring in the reproductive age group.The differential diagnosis includes endometrial adenocarcinoma with MGH-like pattern(MGA),a distinction that may be particularly problematic in curettage specimen.CASE SUMMARY A 57-year-old,postmenopausal woman was admitted in our hospital for surgical treatment.She had been diagnosed with a uterine leiomyoma,after complaints of irregular vaginal bleeding.She underwent dilatation and curettage(D&C)and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy.D&C were compatible with MGA.Histologically,a proliferation of small glands,without intervening stroma,with mucin production,accumulation of neutrophils in the gland lumen and stroma,mild nuclear atypia and rare mitoses,were seen.In the hysterectomy specimen,the endometrium was thickened,but without apparent tumor formation.On microscopic examination,a residual similar adenocarcinoma was seen in the isthmus and more conventional-of endometrioid and mucinous type,in the rest of the endometrium.CONCLUSION MGH-like proliferation with mild cytologic atypia,detected in the endometrial curettage specimen of a postmenopausal woman,should alert pathologists for MGA of the endometrium.VIM,p16,PAX-2,CD10 and CD34 may help in the differential diagnosis.
