Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma d...Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.展开更多
BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incid...BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako,Mali.To assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years(1987-2015)of activity of the population-based registry of the Bamako district.METHODS Data obtained since the inception of the registry in 1987 through 2015 were stratified into three periods(1987-1996,1997-2006,and 2007-2015).Age-standardized rates were estimated by direct standardization using the world population.Incidence rate ratios and the corresponding 95%confidence intervals(CI)were estimated using the early period as the reference(1987-1996).Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period(from 1987 to 2015).RESULTS Among males,the age-standardized incidence rates significantly decreased from 19.41(1987-1996)to 13.12(1997-2006)to 8.15(2007-2015)per 105 person-years.The incidence rate ratio over 28 years was 0.42(95%CI:0.34-0.50),and the annual percentage change was-4.59[95%CI:(-6.4)-(-2.7)].Among females,rates dropped continuously from 7.02(1987-1996)to 2.57(2007-2015)per 105 person-years,with an incidence rate ratio of 0.37(95%CI:0.28-0.45)and an annual percentage change of-5.63[95%CI:(-8.9)-(-2.3)].CONCLUSION The population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years.This trend does not appear to result from biases or changes in registration practices.This is the first report of such a decrease in an area of high incidence of liver cancer in Africa.This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.展开更多
文摘Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.
文摘BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako,Mali.To assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years(1987-2015)of activity of the population-based registry of the Bamako district.METHODS Data obtained since the inception of the registry in 1987 through 2015 were stratified into three periods(1987-1996,1997-2006,and 2007-2015).Age-standardized rates were estimated by direct standardization using the world population.Incidence rate ratios and the corresponding 95%confidence intervals(CI)were estimated using the early period as the reference(1987-1996).Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period(from 1987 to 2015).RESULTS Among males,the age-standardized incidence rates significantly decreased from 19.41(1987-1996)to 13.12(1997-2006)to 8.15(2007-2015)per 105 person-years.The incidence rate ratio over 28 years was 0.42(95%CI:0.34-0.50),and the annual percentage change was-4.59[95%CI:(-6.4)-(-2.7)].Among females,rates dropped continuously from 7.02(1987-1996)to 2.57(2007-2015)per 105 person-years,with an incidence rate ratio of 0.37(95%CI:0.28-0.45)and an annual percentage change of-5.63[95%CI:(-8.9)-(-2.3)].CONCLUSION The population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years.This trend does not appear to result from biases or changes in registration practices.This is the first report of such a decrease in an area of high incidence of liver cancer in Africa.This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.