AIM:To investigate whether abnormal expression of β-catenin in conjunction with overexpression of cyclinD1, c-myc and matrix metalloproteinase-7 (MMP-7) correlated with the carcinogenesis, metastasis and prognosis of...AIM:To investigate whether abnormal expression of β-catenin in conjunction with overexpression of cyclinD1, c-myc and matrix metalloproteinase-7 (MMP-7) correlated with the carcinogenesis, metastasis and prognosis of pancreatic cancer, and to analyze the relationship of β-catenin expression with cyclinDl, c-myc and MMP-7 expression. METHODS: Using immunohistochemistry,we examined the expression of β-catenin, cyclinD1,c-myc and MMP-7 in 47 pancreatic adenocarcinoma tissues, 12 pancreatic intraepithelial neoplasia (PanIN) and 10 normal pancreases, respectively. Proliferation cell nuclear antigen was also tested as the index of proliferative activity of pancreatic cancer cells. RESULTS: In 10 cases of normal pancreatic tissues, epithelial cells showed equally strong membranous expression of β-catenin protein at the cell-cell boundaries, but the expression of cyclinDl, c-myc and MMP-7 was negative. The expression of β-catenin, cyclinD1, c-myc and MMP-7 in PanIN and pancreatic adenocarcinoma tissues had no significant difference [6/12 and 32/47 (68.1%), 6/12 and 35/47 (74.5%), 5/12 and 33/47 (70.2%), 7/12 and 30/47 (63.8%), respectively]. The abnormal expression of β-catenin was significantly correlated to metastasis and one-year survival rate of pancreatic cancer, but had no relation with size, differentiation and cell proliferation. The expression of cyclinD1 was correlated with cell proliferation and extent of differentiation, but not with size, metastasis and one-year survival rate of the pancreatic cancer. The expression of c-myc was not correlated with size, extent of differentiation, metastasis and 1-year survival rate, but closely with cell proliferation of pancreatic cancer. The overexpression of MMP-7 was significantly associated with metastasis and 1-year survival rate of pancreatic cancer,but not with size, extent of differentiation and cell proliferation.There was a highly significant positive association between abnormal expression of β-catenin and overexpression of cyclinD1, c-myc and MMP-7 not only in PanIN (r= 1.000, 0.845, 0.845), but also in pancreatic cancer (r= 0.437, 0.452, 0.435). CONCLUSION: The abnormal expression of β-catenin plays a key role in the carcinogenesis and progression of human pancreatic carcinoma by up-regulating the expression of cyclinDl, c-myc and MMP-7, resulting in the degradation of extracellular matrix and uncontrolled cell proliferation and differentiation,β-catenin abnormal expression and MMP-7 overexpression may be considered as two useful markers for determining metastasis and prognosis of human pancreatic cancer.展开更多
An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing ...An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.展开更多
Liposarcomas are rare soft tissue tumors, commonly affecting the lower limbs and less commonly the retroperitoneum. Although other organs can be affected,the pancreas is one of the rarest, and metastasis at presentati...Liposarcomas are rare soft tissue tumors, commonly affecting the lower limbs and less commonly the retroperitoneum. Although other organs can be affected,the pancreas is one of the rarest, and metastasis at presentation has never been reported. We describe the case of a 76-year-old gentleman presenting with abdominal pain and an abdominal mass. Imaging confirmed a primary tumor in the body and tail of the pancreas, with a metastatic deposit in the mesentery adjacent to the second part of the duodenum. Biopsy confirmed a liposarcoma, and subsequently a complete surgical excision was achieved. He then received adjuvant radiotherapy and has remained disease free for the next 26 mo.展开更多
Pancreatic tumors are primary in most of the cases. Pancreatic metastases associated with other primary malignancies, especially pancreatic metastasis of leiomyosarcoma, are uncommon. A 66-year-old woman underwent sur...Pancreatic tumors are primary in most of the cases. Pancreatic metastases associated with other primary malignancies, especially pancreatic metastasis of leiomyosarcoma, are uncommon. A 66-year-old woman underwent surgical resection of malignant mesenchymoma （70% osteosarcoma and 30% leiomyosarcoma） in the right thigh. In the postoperative period, a pancreatic mass was identified radiologically by abdominal computed tomography. Pylorus-preserving pancreaticoduodenectomy was performed. The surgical specimen revealed leiomyosarcoma metastasized to the pancreas. A metastatic nodule on the remnant pancreatic tail was discovered 9 mo after the first pancreatic resection, and distal pancreatectomy was performed. Cases of pancreatic metastasis from leiomyosarcoma are extremely rare, especially when the tumor was resectable. We report here a unique case of pancreatic metastasis from a leiomyosarcoma in the dght thigh that had been treated surgically.展开更多
Objective To establish a nomogram for predicting the distant metastasis risk of pancreatic neuroendocrine tumors(pNETs)in elderly patients.Methods We extracted data of patients with diagnosis of pNETs at age≥65 years...Objective To establish a nomogram for predicting the distant metastasis risk of pancreatic neuroendocrine tumors(pNETs)in elderly patients.Methods We extracted data of patients with diagnosis of pNETs at age≥65 years old between 1973 and 2015 from the Surveillance,Epidemiology,and End Results(SEER)database.All eligible patients were divided randomly into a training cohort and validation cohort.Uni-and multivariate logistic regression analyses were performed on the training cohort to identify independent factors for distant metastasis.A nomogram was developed based on the independent risk factors using rms packages of R software,and was validated internally by the training cohort and externally by the validation cohort using C-index and calibration curves.Results A total of 411 elderly patients were identified,of which 260 were assigned to training cohort and 151 to validation cohort.Univariate and multivariate logistic regression analyses indicated the tumor site(body/tail of pancreas:odds ratio[OR]=2.282;95%confidence interval[CI]:1.174–4.436,P<0.05),histological grade(poorly differentiated/undifferentiated:OR=2.600,95%CI:1.266–5.339,P<0.05),T stage(T2:OR=8.913,95%CI:1.985–40.010,P<0.05;T3:OR=11.830,95%CI:2.530–55.350,P<0.05;T4:OR=68.650,95%CI:8.020–587.600,P<0.05),and N stage(N1:OR=3.480,95%CI:1.807–6.703,P<0.05)were identified as independent risk factors for distant metastasis of pNETs in elderly.The nomogram exhibited good predicting accuracy,with a C-index of 0.809(95%CI:0.757–0.861)in internal validation and 0.795(95%CI:0.723–0.867)in external validation,respectively.The predicted distant metastasis rates were in satisfactory agreement with the observed values by the calibration curves.Conclusion The nomogram we established showed high discriminative ability and accuracy in evaluation of distant metastasis risk in elderly pNETs patients,and could provide a reference for individualized tumor evaluation and treatment decision in elderly pNETs patients.展开更多
基金Supported by the Foundation of Shandong Education Committee,No. 03K02
文摘AIM:To investigate whether abnormal expression of β-catenin in conjunction with overexpression of cyclinD1, c-myc and matrix metalloproteinase-7 (MMP-7) correlated with the carcinogenesis, metastasis and prognosis of pancreatic cancer, and to analyze the relationship of β-catenin expression with cyclinDl, c-myc and MMP-7 expression. METHODS: Using immunohistochemistry,we examined the expression of β-catenin, cyclinD1,c-myc and MMP-7 in 47 pancreatic adenocarcinoma tissues, 12 pancreatic intraepithelial neoplasia (PanIN) and 10 normal pancreases, respectively. Proliferation cell nuclear antigen was also tested as the index of proliferative activity of pancreatic cancer cells. RESULTS: In 10 cases of normal pancreatic tissues, epithelial cells showed equally strong membranous expression of β-catenin protein at the cell-cell boundaries, but the expression of cyclinDl, c-myc and MMP-7 was negative. The expression of β-catenin, cyclinD1, c-myc and MMP-7 in PanIN and pancreatic adenocarcinoma tissues had no significant difference [6/12 and 32/47 (68.1%), 6/12 and 35/47 (74.5%), 5/12 and 33/47 (70.2%), 7/12 and 30/47 (63.8%), respectively]. The abnormal expression of β-catenin was significantly correlated to metastasis and one-year survival rate of pancreatic cancer, but had no relation with size, differentiation and cell proliferation. The expression of cyclinD1 was correlated with cell proliferation and extent of differentiation, but not with size, metastasis and one-year survival rate of the pancreatic cancer. The expression of c-myc was not correlated with size, extent of differentiation, metastasis and 1-year survival rate, but closely with cell proliferation of pancreatic cancer. The overexpression of MMP-7 was significantly associated with metastasis and 1-year survival rate of pancreatic cancer,but not with size, extent of differentiation and cell proliferation.There was a highly significant positive association between abnormal expression of β-catenin and overexpression of cyclinD1, c-myc and MMP-7 not only in PanIN (r= 1.000, 0.845, 0.845), but also in pancreatic cancer (r= 0.437, 0.452, 0.435). CONCLUSION: The abnormal expression of β-catenin plays a key role in the carcinogenesis and progression of human pancreatic carcinoma by up-regulating the expression of cyclinDl, c-myc and MMP-7, resulting in the degradation of extracellular matrix and uncontrolled cell proliferation and differentiation,β-catenin abnormal expression and MMP-7 overexpression may be considered as two useful markers for determining metastasis and prognosis of human pancreatic cancer.
文摘An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.
文摘Liposarcomas are rare soft tissue tumors, commonly affecting the lower limbs and less commonly the retroperitoneum. Although other organs can be affected,the pancreas is one of the rarest, and metastasis at presentation has never been reported. We describe the case of a 76-year-old gentleman presenting with abdominal pain and an abdominal mass. Imaging confirmed a primary tumor in the body and tail of the pancreas, with a metastatic deposit in the mesentery adjacent to the second part of the duodenum. Biopsy confirmed a liposarcoma, and subsequently a complete surgical excision was achieved. He then received adjuvant radiotherapy and has remained disease free for the next 26 mo.
文摘Pancreatic tumors are primary in most of the cases. Pancreatic metastases associated with other primary malignancies, especially pancreatic metastasis of leiomyosarcoma, are uncommon. A 66-year-old woman underwent surgical resection of malignant mesenchymoma （70% osteosarcoma and 30% leiomyosarcoma） in the right thigh. In the postoperative period, a pancreatic mass was identified radiologically by abdominal computed tomography. Pylorus-preserving pancreaticoduodenectomy was performed. The surgical specimen revealed leiomyosarcoma metastasized to the pancreas. A metastatic nodule on the remnant pancreatic tail was discovered 9 mo after the first pancreatic resection, and distal pancreatectomy was performed. Cases of pancreatic metastasis from leiomyosarcoma are extremely rare, especially when the tumor was resectable. We report here a unique case of pancreatic metastasis from a leiomyosarcoma in the dght thigh that had been treated surgically.
文摘Objective To establish a nomogram for predicting the distant metastasis risk of pancreatic neuroendocrine tumors(pNETs)in elderly patients.Methods We extracted data of patients with diagnosis of pNETs at age≥65 years old between 1973 and 2015 from the Surveillance,Epidemiology,and End Results(SEER)database.All eligible patients were divided randomly into a training cohort and validation cohort.Uni-and multivariate logistic regression analyses were performed on the training cohort to identify independent factors for distant metastasis.A nomogram was developed based on the independent risk factors using rms packages of R software,and was validated internally by the training cohort and externally by the validation cohort using C-index and calibration curves.Results A total of 411 elderly patients were identified,of which 260 were assigned to training cohort and 151 to validation cohort.Univariate and multivariate logistic regression analyses indicated the tumor site(body/tail of pancreas:odds ratio[OR]=2.282;95%confidence interval[CI]:1.174–4.436,P<0.05),histological grade(poorly differentiated/undifferentiated:OR=2.600,95%CI:1.266–5.339,P<0.05),T stage(T2:OR=8.913,95%CI:1.985–40.010,P<0.05;T3:OR=11.830,95%CI:2.530–55.350,P<0.05;T4:OR=68.650,95%CI:8.020–587.600,P<0.05),and N stage(N1:OR=3.480,95%CI:1.807–6.703,P<0.05)were identified as independent risk factors for distant metastasis of pNETs in elderly.The nomogram exhibited good predicting accuracy,with a C-index of 0.809(95%CI:0.757–0.861)in internal validation and 0.795(95%CI:0.723–0.867)in external validation,respectively.The predicted distant metastasis rates were in satisfactory agreement with the observed values by the calibration curves.Conclusion The nomogram we established showed high discriminative ability and accuracy in evaluation of distant metastasis risk in elderly pNETs patients,and could provide a reference for individualized tumor evaluation and treatment decision in elderly pNETs patients.
