Survivin is a protein that is highly expressed in a vast number of malignancies,but is minimally expressed in normal tissues. It plays a role as an inhibitor of cell death in cancer cells,thus facilitating the growth ...Survivin is a protein that is highly expressed in a vast number of malignancies,but is minimally expressed in normal tissues. It plays a role as an inhibitor of cell death in cancer cells,thus facilitating the growth of these cells. In the case of gastric cancer,survivin is over-expressed in tumor cells and plays a role in the carcinogenesis process. Several studies on gastric cancer have indicated that there is a relationship between survivin expression and the ultimate behavior of the carcinoma. Since the expression pattern of survivin is selective to cancer cells,it has been described as an "ideal target" for cancer therapy. Currently,several pre-clinical and clinical trials are on-going to investigate the effects of interfering with survivin function in cancer cells as a biologic therapy. Survivin is a potentially significant protein in the diagnosis,prognosis and treatment of gastric tumors.展开更多
With an estimated incidence of only 1-2 cases in every 1 million people,hepatic epithelioid hemangioendothelioma(HEHE)is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and ...With an estimated incidence of only 1-2 cases in every 1 million people,hepatic epithelioid hemangioendothelioma(HEHE)is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and histiocyte-like vascular endothelial cells in mucus or a fibrotic matrix.HEHE is characterized as a low-to-moderate grade malignant tumor and is classified into three types:solitary,multiple,and diffuse.Both the etiology and characteristic clinical manifestations of HEHE are unclear.However,HEHE has a characteristic appearance on imaging including ultrasound,magnetic resonance imaging,and positron emission tomography/computerized tomography.Still,its diagnosis depends mainly on pathological findings,with immunohistochemical detection of endothelial markers cluster of differentiation 31(CD31),CD34,CD10,vimentin,and factor VIII antigen as the basis of diagnosis.Hepatectomy and/or liver transplantation are the first choice for treatment,but various chemotherapeutic drugs are reportedly effective,providing a promising treatment option.In this review,we summarize the literature related to the diagnosis and treatment of HEHE,which provides future perspectives for the clinical management of HEHE.展开更多
Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains poor.This can be partly attributed to the fact that the m...Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains poor.This can be partly attributed to the fact that the majority of HCCs are diagnosed at intermediate or advanced stages.Availability of circulating biomarkers able to detect HCC at early stages could improve patients'prognosis.At present,however,alpha fetoprotein or des-g-carboxyprothrombin are unable to reliably detect HCC at early stages and better circulating biomarkers are needed.Circulating tumor DNA(ctDNA)and non-coding RNAs(ncRNAs)are emerging as promising biomarkers to achieve the goal.Genetic and epigenetic alterations in ctDNA allow to pinpoint tumor-specific biomarkers,reveal tumor heterogeneity,help monitor tumor evolution over time and assess therapy efficacy.It remains to be fully evaluated the possibility of detecting these biomarkers at early tumor stages.Circulating ncRNAs are quantitative biomarkers with potential use in diagnostic,prognostic and predictive clinical settings.They may help to reveal HCC at early stages.However,because of heterogeneous and sometimes conflicting reported results,they still require validation and standardization of pre-analytical and analytical approaches before clinical applications could be envisaged.展开更多
Hepatocellular carcinoma (HCC) is one of the most common and fatal cancer in the world. HCC frequently presents with advanced disease, has a high recurrence rate and limited treatment options, which leads to very poor...Hepatocellular carcinoma (HCC) is one of the most common and fatal cancer in the world. HCC frequently presents with advanced disease, has a high recurrence rate and limited treatment options, which leads to very poor prognosis. This warrants urgent improvement in the diagnosis and treatment. Liver biopsy plays very important role in the diagnosis and prognosis of HCC, but with technical advancements and progression in the field of imaging, clinical guidelines have restricted the role of biopsy to very limited situations. Biopsy also has its own problems of needle tract seeding of tumor, small risk of complications, technical and sampling errors along with interpretative errors. Despite this, tissue analysis is often required because imaging is not always specific, limited expertise and lack of advanced imaging in many centers and limitations of imaging in the diagnosis of small, mixed and other variant forms of HCC. In addition, biopsy confirmation is often required for clinical trials of new drugs and targeted therapies. Tissue biomarkers along with certain morphological features, phenotypes and immune-phenotypes that serve as important prognostic and outcome predictors and as decisive factors for therapy decisions, add to the continuing role of histopathology. Advancements in cancer biology and development of molecular classification of HCC with clinic pathological correlation, lead to discovery of HCC phenotypic surrogates of prognostic and therapeutically significant molecular signatures. Thus tissue characteristics and morphology based correlates of molecular subtypes provide invaluable information for management and prognosis. This review thus focuses on the importance of histopathology and resurgence of role of biopsy in the diagnosis, management and prognostication of HCC.展开更多
Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a dis...Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.展开更多
BACKGROUND Angiosarcoma(AS)is a rare and highly aggressive soft tissue disease that most commonly arises in deep soft tissues.There are only a few reported cases of AS involving the ovary and even fewer reports of the...BACKGROUND Angiosarcoma(AS)is a rare and highly aggressive soft tissue disease that most commonly arises in deep soft tissues.There are only a few reported cases of AS involving the ovary and even fewer reports of the underlying molecular abnormalities.Here,we briefly review two cases of primary ovarian AS(oAS)with specific molecular events and immune checkpoints.The clinical features and prognosis of the disease,diagnosis,differential diagnosis,and new treatment approaches are discussed based on a literature review.CASE SUMMARY Case 1:A 51-year-old female patient was admitted with right lower limb pain for 5 mo,and lower abdominal pain with hematuria for 1 mo.Partial removal of rectus abdominis muscle and fascia,partial hysterectomy,bilateral salpingooophorectomy,and inguinal and pelvic lymphadenectomy were performed.Pathology revealed primary oAS.Fluorescence in situ hybridization revealed c-MYC gene amplification.MESNA+ADM+IFO+DTIC(MAID)regimen was administered,but stable disease was achieved.The patient died 1 mo later.Case 2:A 41-year-old female patient presented with fatigue,nausea,decreased appetite,and diffuse abdominal pain.On physical examination,the abdomen was distended and a complex cystic mass was palpable in the right pelvic cavity.Pathology revealed primary oAS.MAID chemotherapy was administered and programmed death ligand 1(PD-L1)staining was performed on the tumor samples.The patient benefited from anti-PD-1 immunotherapy and is alive without any evidence of disease 27 mo off therapy in follow-up.CONCLUSION Long-term survival benefit for primary oAS can be achieved by alternative therapeutic strategies using pathological indicators to inform treatment.展开更多
文摘Survivin is a protein that is highly expressed in a vast number of malignancies,but is minimally expressed in normal tissues. It plays a role as an inhibitor of cell death in cancer cells,thus facilitating the growth of these cells. In the case of gastric cancer,survivin is over-expressed in tumor cells and plays a role in the carcinogenesis process. Several studies on gastric cancer have indicated that there is a relationship between survivin expression and the ultimate behavior of the carcinoma. Since the expression pattern of survivin is selective to cancer cells,it has been described as an "ideal target" for cancer therapy. Currently,several pre-clinical and clinical trials are on-going to investigate the effects of interfering with survivin function in cancer cells as a biologic therapy. Survivin is a potentially significant protein in the diagnosis,prognosis and treatment of gastric tumors.
基金Supported by the Projects of Department of Science and Technology of Jilin Province,No.20180622004JC.
文摘With an estimated incidence of only 1-2 cases in every 1 million people,hepatic epithelioid hemangioendothelioma(HEHE)is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and histiocyte-like vascular endothelial cells in mucus or a fibrotic matrix.HEHE is characterized as a low-to-moderate grade malignant tumor and is classified into three types:solitary,multiple,and diffuse.Both the etiology and characteristic clinical manifestations of HEHE are unclear.However,HEHE has a characteristic appearance on imaging including ultrasound,magnetic resonance imaging,and positron emission tomography/computerized tomography.Still,its diagnosis depends mainly on pathological findings,with immunohistochemical detection of endothelial markers cluster of differentiation 31(CD31),CD34,CD10,vimentin,and factor VIII antigen as the basis of diagnosis.Hepatectomy and/or liver transplantation are the first choice for treatment,but various chemotherapeutic drugs are reportedly effective,providing a promising treatment option.In this review,we summarize the literature related to the diagnosis and treatment of HEHE,which provides future perspectives for the clinical management of HEHE.
基金This work was supported by funds from the Italian Association for Cancer Research and from the University of Ferrara to Negrini M.
文摘Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains poor.This can be partly attributed to the fact that the majority of HCCs are diagnosed at intermediate or advanced stages.Availability of circulating biomarkers able to detect HCC at early stages could improve patients'prognosis.At present,however,alpha fetoprotein or des-g-carboxyprothrombin are unable to reliably detect HCC at early stages and better circulating biomarkers are needed.Circulating tumor DNA(ctDNA)and non-coding RNAs(ncRNAs)are emerging as promising biomarkers to achieve the goal.Genetic and epigenetic alterations in ctDNA allow to pinpoint tumor-specific biomarkers,reveal tumor heterogeneity,help monitor tumor evolution over time and assess therapy efficacy.It remains to be fully evaluated the possibility of detecting these biomarkers at early tumor stages.Circulating ncRNAs are quantitative biomarkers with potential use in diagnostic,prognostic and predictive clinical settings.They may help to reveal HCC at early stages.However,because of heterogeneous and sometimes conflicting reported results,they still require validation and standardization of pre-analytical and analytical approaches before clinical applications could be envisaged.
文摘Hepatocellular carcinoma (HCC) is one of the most common and fatal cancer in the world. HCC frequently presents with advanced disease, has a high recurrence rate and limited treatment options, which leads to very poor prognosis. This warrants urgent improvement in the diagnosis and treatment. Liver biopsy plays very important role in the diagnosis and prognosis of HCC, but with technical advancements and progression in the field of imaging, clinical guidelines have restricted the role of biopsy to very limited situations. Biopsy also has its own problems of needle tract seeding of tumor, small risk of complications, technical and sampling errors along with interpretative errors. Despite this, tissue analysis is often required because imaging is not always specific, limited expertise and lack of advanced imaging in many centers and limitations of imaging in the diagnosis of small, mixed and other variant forms of HCC. In addition, biopsy confirmation is often required for clinical trials of new drugs and targeted therapies. Tissue biomarkers along with certain morphological features, phenotypes and immune-phenotypes that serve as important prognostic and outcome predictors and as decisive factors for therapy decisions, add to the continuing role of histopathology. Advancements in cancer biology and development of molecular classification of HCC with clinic pathological correlation, lead to discovery of HCC phenotypic surrogates of prognostic and therapeutically significant molecular signatures. Thus tissue characteristics and morphology based correlates of molecular subtypes provide invaluable information for management and prognosis. This review thus focuses on the importance of histopathology and resurgence of role of biopsy in the diagnosis, management and prognostication of HCC.
文摘Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.
文摘BACKGROUND Angiosarcoma(AS)is a rare and highly aggressive soft tissue disease that most commonly arises in deep soft tissues.There are only a few reported cases of AS involving the ovary and even fewer reports of the underlying molecular abnormalities.Here,we briefly review two cases of primary ovarian AS(oAS)with specific molecular events and immune checkpoints.The clinical features and prognosis of the disease,diagnosis,differential diagnosis,and new treatment approaches are discussed based on a literature review.CASE SUMMARY Case 1:A 51-year-old female patient was admitted with right lower limb pain for 5 mo,and lower abdominal pain with hematuria for 1 mo.Partial removal of rectus abdominis muscle and fascia,partial hysterectomy,bilateral salpingooophorectomy,and inguinal and pelvic lymphadenectomy were performed.Pathology revealed primary oAS.Fluorescence in situ hybridization revealed c-MYC gene amplification.MESNA+ADM+IFO+DTIC(MAID)regimen was administered,but stable disease was achieved.The patient died 1 mo later.Case 2:A 41-year-old female patient presented with fatigue,nausea,decreased appetite,and diffuse abdominal pain.On physical examination,the abdomen was distended and a complex cystic mass was palpable in the right pelvic cavity.Pathology revealed primary oAS.MAID chemotherapy was administered and programmed death ligand 1(PD-L1)staining was performed on the tumor samples.The patient benefited from anti-PD-1 immunotherapy and is alive without any evidence of disease 27 mo off therapy in follow-up.CONCLUSION Long-term survival benefit for primary oAS can be achieved by alternative therapeutic strategies using pathological indicators to inform treatment.
