Histo-and clinico-pathological analysis of a large series of triple-negative breast cancer in a single center in China:Evidences on necessity of histological subtyping and grading

Objective: To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer(TNBC) patients serials based on the latest understanding of its clinico-pathological diversity, and to provide more information to clinicians to improve precision of individualized treatment of TNBC.Methods: A retrospective analysis was performed on patients with TNBC at Breast Disease Center, Peking University First Hospital between January 2010 and December 2019. Histo-and clinico-pathological characteristics were analyzed by Chi-square test and Student's t-test, and prognoses were calculated using KaplanMeier method and a Cox proportionate hazards model. Bonferroni correction was used to correct for multiple comparison.Results: Conventional type of TNBC(c TNBC) were identified in 73.7% of 582 TNBC, while special type of TNBC(s TNBC) were 26.3%, including 71 apocrine carcinoma, 20 medullary carcinoma, 31 metaplastic carcinoma, 18 invasive lobular carcinoma, 7 invasive micropapillary carcinoma, 5 adenoid cystic carcinoma and 1 acinic cell carcinoma. Compared to s TNBC, c TNBC was associated with high histologic grade(P<0.001) and lower androgen receptor(AR) expression(P<0.001). TNM stage of low-grade c TNBC was significantly lower than that of high-grade c TNBC(P=0.002). Although no significant difference, there was a trend that the rate of 5-year disease-free survival(DFS) and 5-year overall survival(OS) were longer in high-grade c TNBC than in high-grade s TNBC(P=0.091 and 0.518), and were longer in low-grade s TNBC than in high-grade s TNBC(P=0.051 and0.350). Metaplastic carcinomas showed larger tumor size(P=0.008) and higher proliferative Ki67 index(P=0.004)than c TNBCs.Conclusions: Results from our cohort imply that sub-categorization or subtyping and histological grading could be meaningful in pathological evaluation of TNBC, and need to be clarified in more large collections of TNBC.

喉神经内分泌癌临床病理学分析

神经分泌癌是一种由神经内分泌细胞分化而来的特殊的恶性肿瘤，尤其是喉神经内分泌癌（1aryngeal neuroendocrine carcinoma．LNEC）发生率极低。本病首先由Goldman（1969年）报道，目前国外共报道650例。近20年来随着诊疗技术的进步，本病的相关报道有所增多，但多属于个例报道．目前国内外对本病仍无系统的认识。

Histopathological classification and follow-up analysis of chronic atrophic gastritis

BACKGROUND The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention,and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying pathological diagnosis,which is of great significance for the treatment of precision gastric diseases,the improvement of the early diagnosis rate of gastric cancer,and the reduction of missed diagnosis rate and misdiagnosis rate.AIM To perform a histopathological classification and follow-up analysis of chronic atrophic gastritis(CAG).METHODS A total of 2248 CAG tissue samples were collected,and data of their clinical characteristics were also gathered.Based on these samples,the expression levels of Mucin 1(MUC1),MUC2,MUC5AC,and MUC6 in CAG tissue were tested by immunohistochemical assay.Moreover,we followed these patients for up to four years.The difference between different stages of gastroscopic biopsy was observed.RESULTS Through observation,it is believed that CAG should be divided into four types,simple type,hyperplasia type,intestinal metaplasia(IM)type,and intraepithelial neoplasia(IEN)type.Simple CAG accounted for 9.1%(205/2248),which was more common in elderly people over 60 years old.The main change was that the lamina propria glands were reduced in size and number.Hyperplastic CAG accounted for 29.1%(654/2248),mostly occurring between 40 and 60 years old.The main change was that the lamina propria glands were atrophy accompanied by glandular hyperplasia and slight expansion of the glands.IM CAG accounted for 50.4%(1132/2248),most of which increased with age,and were more common in those over 50 years.The atrophy of the lamina propria glands was accompanied by significant IM,and the mucus containing sialic acid or sulfate was distinguished according to the nature of the mucus.The IEN type CAG accounted for 11.4%(257/2248),which developed from the previous types,with severe gland atrophy and reduced mucus secretion,and is an important precancerous lesion.CONCLUSION The histological typing of CAG is convenient to understand the property of lesion,determine the follow-up time,and guide the clinical treatment.

Do the existing staging systems for primary liver cancer apply to combined hepatocellular carcinoma-intrahepatic cholangiocarcinoma?

Background:The incidence of combined hepatocellular carcinoma-intrahepatic cholangiocarcinoma(cHCC-ICC)is relatively low,and the knowledge about the prognosis of cHCC-ICC remains obscure.In the study,we aimed to screen existing primary liver cancer staging systems and shed light on the prognosis and risk factors for cHCC-ICC.Methods:We retrospectively reviewed 206 cHCC-ICC patients who received curative surgical resection from April 1999 to March 2017.The correlation of survival measures with the histological types or with tumor staging systems was determined and predictive values of tumor staging systems with cHCC-ICC prognosis were compared.Results:The histological type was not associated with overall survival(OS)(P=0.338)or disease-free survival(DFS)(P=0.843)of patients after curative surgical resection.BCLC,TNM for HCC,and TNM for ICC stages correlated with both OS and DFS in cHCC-ICC(all P<0.05).The predictive values of TNM for HCC and TNM for ICC stages were similar in terms of predicting postoperative OS(P=0.798)and DFS(P=0.191)in cHCC-ICC.TNM for HCC was superior to BCLC for predicting postoperative OS(P=0.022)in cHCC-ICC.Conclusion:The TNM for HCC staging system should be prioritized for clinical applications in predicting cHCC-ICC prognosis.

Clinicopathologic features and prognostic factors of malignant eyelid tumors

AIM:To investigate the clinical characteristics and prognosis of patients with malignant eyelid tumors.·METHODS:This was a retrospective,non-randomized,clinical reviews.Between January,2002 and December,2011,75 cases with histologically confirmed malignant eyelid tumors were evaluated.Patients’ charts were reviewed for clinical information,treatment procedure,and disease course.Survival analysis in terms of recurrence-free survival was performed using age,sex,location of tumor and histopathological type.The followup ranged from 1 to 78 months(mean=21 months).·RESULTS:The 75 eyelid tumors included 35 basal cell carcinoma(BCC,46.7%),22 sebaceous gland carcinoma(SGC,29.3%),7 squamous cell carcinoma(SCC,9.3%),10 malignant melanoma(MM,13.3%),and 1 Merkel cell carcinoma(MCC,1.3%).Recurrence developed in 17cases(22.7%).The recurrence rate of BCC(4/35,11.4%)was significant lower than MM(6/10,60.0%,P 【0.001).The mean interval of recurrence was 21 months(range 3-62) for all eyelid tumors.Tumor located at canthus had higher recurrence rate(50%) compared with those located at eyelid(19%,P 【0.05).Histological type was independent variable for recurrence by Cox regression analysis.·CONCLUSION:It is important to achieve a negative tumor margin in canthus located malignant eyelid tumor.Clinicians should have a high level of suspicion for recurrence according to histological type when treating patients with eyelid tumor.