目的:分析高级别胃肠胰神经内分泌肿瘤(high-grade G3 gastroenteropancreatic neuroendocrine tumors,GEP NET G3)的临床病理特征及生存预后影响因素。方法:回顾性分析2012年9月至2019年7月间北京大学肿瘤医院收治的86例GEP NET G3,收...目的:分析高级别胃肠胰神经内分泌肿瘤(high-grade G3 gastroenteropancreatic neuroendocrine tumors,GEP NET G3)的临床病理特征及生存预后影响因素。方法:回顾性分析2012年9月至2019年7月间北京大学肿瘤医院收治的86例GEP NET G3,收集临床病理及随访资料,采用单因素Log-rank检验和多因素Cox回归模型进行预后影响因素分析。结果:86例GEP NET G3的原发肿瘤部位包括胰腺(40例)、胃肠(37例)以及原发肿瘤不明(9例)。镜检肿瘤均分化良好,呈器官样、巢状生长,局灶可见假腺样、细条索样或缎带样结构。免疫组织化学分析显示,肿瘤的Ki-67指数范围为21%~60%,中位值为30%,生长抑素受体2(somatostatin receptor type 2,SSTR2)的阳性率为83.9%(26/31),在检测病例中没有发现微卫星不稳定和P53异常表达(分别为0/24、0/11)。生存分析表明,获得随访的76例患者,27例患者死亡,中位生存时间为48.6(26.6~70.6)个月,确诊时有无远处转移和能否进行根治性手术切除对患者的总生存影响差异有统计学意义(P<0.05),但患者的年龄、性别、原发肿瘤部位、确诊时血清神经元特异性烯醇化酶(neuron specific enolase,NSE)水平以及Ki-67指数对患者的总生存影响无显著差异(P>0.05)。多因素分析显示,确诊时有远处转移是影响患者生存的独立危险因素(P=0.01;HR=7.33,95%CI:1.56~34.10)。结论:GEP NET G3的确诊依赖于组织病理学和免疫组织化学检测,易发生远处转移是其临床特点和主要的预后影响因素。展开更多
Objective:To investigate the correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma(LADC)patients.Methods:We reviewed 428 consecutive,surgically resected cas...Objective:To investigate the correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma(LADC)patients.Methods:We reviewed 428 consecutive,surgically resected cases of LADC from October 2015 to December 2016 from our center.PD-L1 expression was evaluated based on tumor proportion score(TPS).Correlation and co-occurrence of PD-L1 expression level with those of classical driver genes,such as EGFR,ALK,ROS-1,and KRAS and with clinical variables and disease-free survival(DFS)were analyzed.Results:Seventy of the 428 cases(16.4%)showed TPS≥1%,and 21 cases(4.9%)showed TPS≥50%.PD-L1 positive expression was significantly associated with male gender,smoking,advanced TNM stage,and solid histologic subtype.Both TPS≥1% and ≥50%were correlated with the absence of an EGFR mutation(P<0.001)and the presence of ALK rearrangement(P=0.024).KRAS mutation was associated with TPS≥50%(P=0.035).PD-L1 positivity commonly overlapped with the alterations of classical driver oncogenes(58.5%with TPS≥1% and 42.9% with TPS≥50%).Approximately three-quarters of PD-L1 positive cases co-occurred with classical therapeutic-gene aberrations in cases with stage III/IV cancer or cancer progression.LADC could be divided into four subgroups based on the expression profile of current routine biomarkers for potential therapeutic strategies.Conclusions:PD-L1 expression is not only closely correlated with classic gene alterations but also commonly overlaps with the aberrations of classical driver oncogenes in Chinese LADC patients.These findings provide a useful overview of clinical strategies that rely on the profile of routinely used molecular biomarkers.展开更多
文摘目的:分析高级别胃肠胰神经内分泌肿瘤(high-grade G3 gastroenteropancreatic neuroendocrine tumors,GEP NET G3)的临床病理特征及生存预后影响因素。方法:回顾性分析2012年9月至2019年7月间北京大学肿瘤医院收治的86例GEP NET G3,收集临床病理及随访资料,采用单因素Log-rank检验和多因素Cox回归模型进行预后影响因素分析。结果:86例GEP NET G3的原发肿瘤部位包括胰腺(40例)、胃肠(37例)以及原发肿瘤不明(9例)。镜检肿瘤均分化良好,呈器官样、巢状生长,局灶可见假腺样、细条索样或缎带样结构。免疫组织化学分析显示,肿瘤的Ki-67指数范围为21%~60%,中位值为30%,生长抑素受体2(somatostatin receptor type 2,SSTR2)的阳性率为83.9%(26/31),在检测病例中没有发现微卫星不稳定和P53异常表达(分别为0/24、0/11)。生存分析表明,获得随访的76例患者,27例患者死亡,中位生存时间为48.6(26.6~70.6)个月,确诊时有无远处转移和能否进行根治性手术切除对患者的总生存影响差异有统计学意义(P<0.05),但患者的年龄、性别、原发肿瘤部位、确诊时血清神经元特异性烯醇化酶(neuron specific enolase,NSE)水平以及Ki-67指数对患者的总生存影响无显著差异(P>0.05)。多因素分析显示,确诊时有远处转移是影响患者生存的独立危险因素(P=0.01;HR=7.33,95%CI:1.56~34.10)。结论:GEP NET G3的确诊依赖于组织病理学和免疫组织化学检测,易发生远处转移是其临床特点和主要的预后影响因素。
基金supported by the National Natural Science Foundation of China (Grant No. 81871860)
文摘Objective:To investigate the correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma(LADC)patients.Methods:We reviewed 428 consecutive,surgically resected cases of LADC from October 2015 to December 2016 from our center.PD-L1 expression was evaluated based on tumor proportion score(TPS).Correlation and co-occurrence of PD-L1 expression level with those of classical driver genes,such as EGFR,ALK,ROS-1,and KRAS and with clinical variables and disease-free survival(DFS)were analyzed.Results:Seventy of the 428 cases(16.4%)showed TPS≥1%,and 21 cases(4.9%)showed TPS≥50%.PD-L1 positive expression was significantly associated with male gender,smoking,advanced TNM stage,and solid histologic subtype.Both TPS≥1% and ≥50%were correlated with the absence of an EGFR mutation(P<0.001)and the presence of ALK rearrangement(P=0.024).KRAS mutation was associated with TPS≥50%(P=0.035).PD-L1 positivity commonly overlapped with the alterations of classical driver oncogenes(58.5%with TPS≥1% and 42.9% with TPS≥50%).Approximately three-quarters of PD-L1 positive cases co-occurred with classical therapeutic-gene aberrations in cases with stage III/IV cancer or cancer progression.LADC could be divided into four subgroups based on the expression profile of current routine biomarkers for potential therapeutic strategies.Conclusions:PD-L1 expression is not only closely correlated with classic gene alterations but also commonly overlaps with the aberrations of classical driver oncogenes in Chinese LADC patients.These findings provide a useful overview of clinical strategies that rely on the profile of routinely used molecular biomarkers.
