Rare synchronous colorectal carcinoma with three pathological subtypes: A case report and review of the literature

BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the number of pathological types of SCRC is usually no more than two.It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes.Here,we report a rare case of SCRC with three pathological subtypes.CASE SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month.Colonoscopy displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ileocecum.Subsequently,she underwent total colectomy,abdominoperineal resection for rectal cancer,and ileostomy.After operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the rectum.She is now recovering well and continues to be closely monitored during follow-up.CONCLUSION Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.

Study on the Differences of Endocrine and Metabolic Characteristics in Clinical Subtypes of PCOS

Objective To investigate the differences of endocrine and metabolic characteristics in PCOS women among different subtypes. Methods A total of 249 PCOS women were classified into 4 subtypes by Rotterdam criteria： hyperandrogenism （HA） and oligo-ovulation/anovulation （0） and PCO ultrasonography （P） （HA＋O＋P, group A, 111 women）; HA＋O （group B, 9 women）; HA＋P （group C, 22 women） and O＋P （group D, 107 women）. Another 110 infertii＇e women with tubal defects constituted a control group. Endocrine and metabolic characteristics were compared among the 5 groups. PCOS women were then reclassified into 2 groups, according to whether they have hyperandrogenism or not. Endocrine ond metabolic characteristics were then compared again. Results The levels of androstenedione （A）, testosterone （T） and LH/FSH were the highest in group A and group C, secondly in group D, the lowest was in control group. A, T and LH/FSH were the highest in hyperandrogenism group, secondly in non- hyperandrogenism group, whereas the control was the lowest. Menstrual cycle and BMI correlated with glucose and lipid metabolism but showed no correlateion with T and A. Hyperandrogenism group had higher fasting glucose （FG）, glucose at 60 min （G60） and glucose levels under the curve （GLUAUC） and lower disposition index （DI） than non-hyperandrogenism group, however, menstrual cycle, BMI and the lipid indicators had no difference. Conclusion Hyperandrogenism is an important characteristic in F＇COS women. Thus it might be used to classify PCOS into 2 subgroups. Hyperandrogenism and lipid disorders for the formation of PCOS often coexist but each has individual pathogenesis.

Identification of prognostic indicators,diagnostic markers, and possible therapeutic targets among LIM homeobox transcription factors in breast cancer

Background:Breast cancer(BRCA)is the most common malignant tumor among women worldwide.Despite advances in treatment,many patients still die from a lack of effective diagnostic and prognostic markers and powerful therapeutic targets.LIM homeobox genes(LHXs)play vital roles in regulating the development of various organisms.However,there are limited reports regarding their roles in the diagnosis,prognosis,and treatment of BRCA.Methods:UALCAN,Kaplan–Meier plotter,cBioPortal,GeneMANIA,STRING,DAVID 6.8,TRRUST v2,LinkedOmics,and TIMER were utilized to analyze differential expression,prognostic value,genetic alteration,neighbor gene network,transcription factor targets,kinase targets,and immune cell infiltration of LHXs in BRCA patients.Results:LHX gene expression patterns are clear in BRCA and its different subtypes.Further analyses indicated that this altered expression is possibly affected by genetic and/or epigenetic changes.The prognostic and diagnostic values of certain LHXs are unique to different BRCA subtypes.LHXs are mainly involved in the regulation of differentiation and development,and their neighbor genes are primarily involved in cancer‐related pathways.Moreover,most LHXs are closely correlated with immune cell infiltration.Furthermore,LHXs may exert their functions by regulating a series of transcription factor and kinase targets.Conclusions:LHXs are unique diagnostic and prognostic markers and participate in cancer through different signaling pathways and/or regulatory mechanisms in BRCA.This study provides potential applications of LHXs for the diagnosis,prognosis,and treatment of BRCA and its different subtypes.