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.

Correlation between clinicopathological parameters of lung adenocarcinoma and lymph node metastasis

Objective The aim of the study was to study the correlation between the clinicopathological parameters of lung adenocarcinoma and lymph node metastasis and identify the risk factors of lymph node metastasis.Methods The data of 258 patients with postoperative lung adenocarcinoma(mainly based on their pathological data)were collected and analyzed,and their basic information was counted.Results Maximum tumor diameter was found to be an independent risk factor for lymph node metastasis.The larger the maximum diameter of the tumor in patients with lung adenocarcinoma,the higher the likelihood of lymph node metastasis.Solid predominant adenocarcinoma with mucin production is as an independent risk factor for superior mediastinal and subcarinal lymph node metastasis.Primary adenocarcinomas in the lower lobe of the lung may have a higher rate of lymph node metastasis than those in the upper lobe.Conclusion The known pathological subtypes of lung adenocarcinoma can be used for the prediction of lymph node metastasis in various regions and guide the dissection of lymph nodes that would improve patients’prognosis.

Replication and Pathology of Duck Influenza Virus Subtype H9N2 in Chukar

To investigate the susceptibility of Chukars to duck avian influenza virus H9N2 and explore their role in interspecies transmission of influenza viruses.Chukars were inoculated with duck avian influenza viruses H9N2.

Triple negative breast cancer: special histological types and emerging therapeutic methods

Triple negative breast cancer(TN BC)is a complex and malignant breast cancer subtype that lacks expression of the estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(H ER2),thereby making therapeutic targeting difficult.TNBC is generally considered to have high malignancy and poor prognosis.However,patients diagnosed with certain rare histomorphologic subtypes of TNBC have better prognosis than those diagnosed with typical triple negative breast cancer.In addition,with the discovery and development of novel treatment targets such as the androgen receptor(AR),PI3K/AKT/mTOR and AMPK signaling pathways,as well as emerging immunotherapies,the therapeutic options for TNBC are increasing.In this paper,we review the literature on various histological types of TNBC and focus on newly developed therapeutic strategies that target and potentially affect molecular pathways or emerging oncogenes,thus providing a basis for future tailored therapies focused on the mutational aspects of TNBC.

Association of the p73 Gene G4C14-to-A4T14 Polymorphism with Increased Gastric Cancer Risk in a Northwestern Chinese Population

OBJECTIVE To evaluate the p73 gene G4C14-to-A4T14 double nucleotide polymorphism with both increased gastric cancer(GC) risk and different histological subtypes of GC in a northwestern Chinese population. METHODS Genotyping of the polymorphism of the p73 gene was conducted with PCR-CTPP. RESULTS All 385 GC patients including 305 diffuse-type and 80 intestinal-type cases and 412 healthy controls were investigated.The frequencies of p73 AT/AT,AT/GC,and GC/GC genotypes were 28.1%,47.1%,and 24.8% in the controls,and were 22.0%,45.0%,and 33.0% in GC cases respectively;the GC/GC homozygote frequency was higher in GC cases,mainly in diffuse type compared to the controls with OR=1.71(1.16～2.51) and 1.87 (95%CI,1.24～2.81) respectively.The results showed that carriers of the p73 G4A GC/GC homozygote had a 1.71-time higher risk of GC,especially of the diffuse-type GC compared to the controls. The carriers of the AT/GC heterozygote also had a slightly increased risk of GC cancer,mainly on intestinal-type GC.This is the first report that the p73 G4A double-nucleotide polymorphism is associated with an increased risk of diffuse-type gastric cancer. CONCLUTION The p73 G4A GC/GC genotype is associated with an increased risk of gastric cancer,especially of the GC diffuse-type.

Persistent increase and improved survival of stage I lung cancer based on a large-scale real-world sample of 26,226 cases

Background:Lung cancer prevails and induces high mortality around the world.This study provided real-world information on the evolution of clinicopathological profiles and survival outcomes of lung cancer,and provided survival information within stage I subtypes.Methods:Patients pathologically confirmed with lung cancer between January 2009 and December 2018 were identified with complete clinicopathological information,molecular testing results,and follow-up data.Shifts in clinical characteristics were evaluated usingχ^(2)tests.Overall survival(OS)was calculated through the Kaplan-Meier method.Results:A total of 26,226 eligible lung cancer patients were included,among whom 62.55%were male and 52.89%were smokers.Non-smokers and elderly patients took increasingly larger proportions in the whole patient population.The proportion of adenocarcinoma increased from 51.63%to 71.80%,while that of squamous carcinoma decreased from 28.43%to 17.60%.Gene mutations including EGFR(52.14%),KRAS(12.14%),and ALK(8.12%)were observed.Female,younger,non-smoking,adenocarcinoma patients and those with mutated EGFR had better survival prognoses.Importantly,this study validated that early detection of early-stage lung cancer patients had contributed to pronounced survival benefits during the decade.Patients with stage I lung cancer,accounted for an increasingly considerable proportion,increasing from 15.28%to 40.25%,coinciding with the surgery rate increasing from 38.14%to 54.25%.Overall,period survival analyses found that 42.69%of patients survived 5 years,and stage I patients had a 5-year OS of 84.20%.Compared with that in 2009-2013,the prognosis of stage I patients in 2014-2018 was dramatically better,with 5-year OS increasing from 73.26%to 87.68%.Regarding the specific survival benefits among stage I patients,the 5-year survival rates were 95.28%,93.25%,82.08%,and 74.50%for stage IA1,IA2,IA3,and IB,respectively,far more promising than previous reports.Conclusions:Crucial clinical and pathological changes have been observed in the past decade.Notably,the increased incidence of stage I lung cancer coincided with an improved prognosis,indicating actual benefits of early detection and management of lung cancer.

Genetic insights into thymic carcinomas and thymic neuroendocrine neoplasms denote prognosis signatures and pathways

Background:Thymic carcinomas(TCs)and thymic neuroendocrine neoplasms(TNENs)are two aggressive subtypes of thymic malignancy.Traditional therapy for advanced TCs and TNENs has limited outcome.New genomic profiling of TCs and TNENs might provide insights that contribute to the development of new treatment approaches.Methods:We used gene panel sequencing technologies to investigate the genetic aberrations of 32 TC patients and 15 TNEN patients who underwent surgery at Shanghai Chest Hospital between 2015 and 2017.Patient samples were sequenced using a 324-gene platform with licensed technologies.In this study,we focused on clinically relevant genomic alterations(CRGAs),which are previously proven to be pathogenic alterations,to identify the pathology-specific mutational patterns,prognostic signatures of TCs and TNENs.Results:The mutational profiles between TCs and TNENs were diverse.The genetic alterations that ranked highest in TCs were in CDKN2A,TP53,ASXL1,CDKN2B,PIK3C2G,PTCH1,and ROS1,while those in TNENs were in MEN1,MLL2,APC,RB1,and TSC2.Prognostic analysis showed that mutations of ROS1,CDKN2A,CDKN2B,BRAF,and BAP1 were significantly associated with worse outcomes in TC patients,and that mutation of ERBB2 indicated shortened disease-free survival(DFS)and overall survival(OS)in TNEN patients.Further investigation found that the prognosis-related genes were focused on signal pathways of cell cycle control,chromatin remodeling/DNA methylation,phosphoinositide 3-kinases(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR),and receptor tyrosine kinase(RTK)/RAS/mitogen-activated protein kinase(MAPK)signaling.Conclusion:We profiled the mutational features of 47 Chinese patients with thymic malignancy of diverse pathologic phenotypes to uncover the integrated genomic landscape of these rare tumors,and identified the pathology-specific mutational patterns,prognostic signatures,and potential therapeutic targets for TCs and TNENs.