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Tumor budding in cervical carcinoma: Associations with some clinical and pathological factors 宫颈癌肿瘤出芽:与一些临床和病理因素的关系
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.2298/aoo200124003s
N. Stanulovic, T. Ivković-Kapicl, A. Mandić, B. Gutic
Background: Tumor budding is recognized as an important independent prognostic factor in colorectal carcinoma. The aim of this study was to evaluate the grade of tumor budding and association with other clinical and pathological features in patients with cervical carcinoma. Material and methods: We evaluated pathohistological data from 91 cervical carcinoma patients (mean age: 53.8 years) who underwent radical hysterectomy and pelvic lymphatic dissection at the Oncology Institute of Vojvodina between January 2010 and December 2018. Tumor budding was evaluated in invasive front of the tumor. Based on the number of bud counts/10 high power field, three groups were formed: with no budding, with less than 15 buds, and with more than 15 buds. Results: Eighty (87.91%) of evaluated cervical carcinomas were squamous-cell type, while 12.09% were adenocarcinomas. All carcinomas were graded (HG1-HG3). Average diameter of the tumors was 25 mm (81.6% < 4 cm and 18.4% > 4 cm). Metastases in lymph nodes were present in 30 (32.9%) cases. Based on the number of bud counts/10 high power field there were 35.1% with no budding, 32.9% with less than 15 buds and 37.3% with more than 15 buds. There was a significant association between tumor budding grade and histological grade (p=0.04), as well as with tumor budding grade and the diameter of the tumor (p=0.04). Conclusion: As a quantitative measure of cancer cell dissociation, tumor budding is associated with poor prognosis in cervical carcinoma and should be considered as a prognostic factor.
背景:肿瘤出芽被认为是结直肠癌重要的独立预后因素。本研究的目的是评估宫颈癌患者肿瘤出芽的分级及其与其他临床和病理特征的关系。材料和方法:我们评估了2010年1月至2018年12月期间在伏伊伏丁那肿瘤研究所接受根治性子宫切除术和盆腔淋巴清扫的91例宫颈癌患者(平均年龄:53.8岁)的病理组织学资料。在肿瘤侵袭性前方评估肿瘤出芽。根据芽数/10高倍场分为无芽、芽数小于15和芽数大于15三组。结果:80例(87.91%)宫颈癌为鳞状细胞型,12.09%为腺癌。所有肿瘤分级(HG1-HG3)。肿瘤平均直径为25mm (< 4cm占81.6%,< 4cm占18.4%)。淋巴结转移30例(32.9%)。从芽数/10高倍场来看,未出芽的占35.1%,少于15芽的占32.9%,大于15芽的占37.3%。肿瘤出芽分级与组织学分级有显著相关性(p=0.04),与肿瘤出芽分级和肿瘤直径有显著相关性(p=0.04)。结论:肿瘤出芽作为癌细胞游离的定量指标,与宫颈癌预后不良有关,应作为预后因素考虑。
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引用次数: 1
Synovial sarcoma of the popliteal fossa 腘窝滑膜肉瘤
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.2298/AOO200915001K
B. Knežević, R. Srećković, A. Vulović, S. M. Jandric-Kocic
at the time of diagnosis. The patient underwent an extensive surgical resection of tumor with ex-tempore biopsy. Macroscopically, the mass measuring 5×5.5×4 cm was firm, relatively well-circumscribed, and lobulated with a gray-white cut surface. Pathohistological findings showed high-grade primary malignant mesenchymal tumor of the biphasic synovial sarcoma type, cystic subtype that was positive for CK AE1/AE3 focally, CK7 diffuse, CK19 focally, EMA focally-diffuse-1, Vimentin diffuse, Bcl-2 diffuse, CD99 diffuse, Ki-67 positive in > 70% of resection margin and TTF-1, CD34, and CK20 negative. The pathological findings were with viable cells on the margins, so the wide excision was followed by radiotherapy treatment with a total dose of 50 Gray in 25 fractions locally over five weeks. The tumor recurred locally within one year - a follow-up MRI scan after 9 months showed a dominant tumor of 7x7x6.5 cm and one smaller tumor in the distal femoral epiphysis. Tumors had smooth, well defined follow up after one year revealed tumor recurrence. Neurovascular bundle involvement was detected, but without adjacent bone and muscular invasion and above-the-knee partial amputation of the left leg was performed. The intervention resulted in a remission of the neoplastic process and the patient was scheduled for regular check-ups. Broad surgical resection of the tumor with negative margins was the primary treatment in this case. Mutilating operations are necessary when anatomical structures around the tumor do not allow complete reintervention.
在诊断的时候。患者接受了广泛的手术切除肿瘤和颞外活检。宏观上,直径为5×5.5×4 cm的肿块坚固,边界相对清晰,分叶状,表面呈灰白色切割。病理组织学结果显示:高级别原发性恶性间质肿瘤为双期滑膜肉瘤型,囊性亚型,CK AE1/AE3局灶性、CK7弥漫性、CK19局灶性、EMA局灶弥漫性-1、Vimentin弥漫性、Bcl-2弥漫性、CD99弥漫性、Ki-67在切除边缘70%呈阳性,TTF-1、CD34、CK20阴性。病理发现边缘有活细胞,因此广泛切除后进行放射治疗,总剂量为50格雷,局部25份,持续5周。肿瘤在一年内局部复发- 9个月后的随访MRI扫描显示一个7x7x6.5 cm的显性肿瘤和一个较小的股骨远端骨骺肿瘤。一年后肿瘤复发,随访顺利。检测到神经血管束受累,但没有相邻骨和肌肉侵犯,并对左腿膝上部分截肢。干预导致肿瘤进程缓解,患者被安排定期检查。广泛手术切除阴性边缘的肿瘤是本病例的主要治疗方法。当肿瘤周围的解剖结构不允许完全再介入时,必须进行手术。
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引用次数: 0
Cross-cultural adaptation and validation of the cancer survivors’ unmet needs measure among gynecological cancer patients in Indonesia 印度尼西亚妇科癌症患者癌症幸存者未满足需求测量的跨文化适应与验证
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190531011h
H. Haryani, Yati Afiyanti, B. Besral, D. Gayatri, Kemala Rita Wahidi, Hana Pramiasti, Ariesta Milanti
Background: The number of gynecological cancer survivors in Indonesia is growing, yet little is recognized about their supportive care needs due to a lack of validated assessment to measure them. This study aimed to culturally adapt the Cancer survivors? unmet needs into Indonesian language and to test its validity and reliability for Indonesian gynecological cancer patients. Methods: We performed the translation and adaptation of the Cancer survivors? unmet needs based on Beaton?s cross-cultural adaptation process of self-report measure. We then evaluated the psychometric properties of Cancer survivors? unmet needs -Indonesian with 298 participants from three hospitals across Indonesia. Results: Five factors were extracted from Exploratory Factor Analysis with factor loading >0.4. Cancer survivors? unmet needs - Indonesian had negative correlations with The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, indicating that the higher score of unmet needs resulted in the lower score of quality of life. The Cronbach?s ? coefficient for the Cancer survivors? unmet needs - Indonesian ranged from 0.75-0.95. Conclusions: The Cancer survivors? unmet needs - Indonesian version offers a valid and reliable scale for assessing supportive care needs among Indonesian gynecological cancer patients. The Cancer survivors? unmet needs-Indonesian could help clinicians to assess supportive care needs among Indonesian gynecological cancer patients. The low-resource countries such as Indonesia could use the evidence from the Cancer survivors? unmet needs assessment to develop the supportive care service in the clinical settings.
背景:印度尼西亚妇科癌症幸存者的数量正在增长,但由于缺乏有效的评估来衡量他们的支持性护理需求,因此对他们的支持性护理需求知之甚少。这项研究旨在适应癌症幸存者的文化。将未满足的需求翻译成印尼语,并测试其对印尼妇科癌症患者的效度和信度。方法:我们对癌症幸存者进行翻译和适应。基于比顿的未满足需求?自我报告测量的跨文化适应过程。然后我们评估了癌症幸存者的心理测量特征?未满足的需求——印度尼西亚,来自印度尼西亚三家医院的298名参与者。结果:探索性因子分析提取因子5个,因子负荷> . 0.4。癌症幸存者?未满足的需求-印度尼西亚语与欧洲癌症研究和治疗组织生活质量问卷- c30呈负相关,表明未满足的需求得分越高,生活质量得分越低。克伦巴赫?年代?癌症幸存者的系数?未满足的需求——印尼语范围为0.75-0.95。结论:癌症幸存者?未满足的需求——印尼版为评估印尼妇科癌症患者的支持性护理需求提供了一个有效和可靠的量表。癌症幸存者?未满足的需求-印度尼西亚可以帮助临床医生评估印度尼西亚妇科癌症患者的支持性护理需求。资源匮乏的国家,如印度尼西亚,是否可以利用来自癌症幸存者的证据?未满足需求评估,以发展临床环境中的支持性护理服务。
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引用次数: 4
Adjuvant application of trastuzumab in HER2 positive breast cancer and impact on time to relapse 曲妥珠单抗在HER2阳性乳腺癌中的辅助应用及对复发时间的影响
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo181112006d
Nikolina Dukić, Z. Gojković, Jelena Vladičić-Mašić, S. Mašić, Nenad Lalović, S. Popovic
Received 2018-11-12 Received in revised form 2019-05-22 Accepted 2019-05-29 INTRODUCTION Breast cancer is the most common malignant disease in women (1). It makes up about 26.5% of all newly discovered malignancies in the European female population and is responsible for 17.5% of the deaths. In males, this type of cancer is rare (one man per 100 women) (2). The frequency of the disease differs in various parts of the world. It is rarely seen before the age of 30, it rises with age and reaches its maximum around the age of 50 (3). The incidence of breast cancer in the world increases by 1-2% per year, and it is estimated that in the first decade of the third millennium, almost one million of women will suffer from breast cancer (4). However, in spite of the increasing possibilities of treatment, survival depends primarily on the extent and stage of the disease at the time of detection. In the early stage of the disease in which the largest number of patients is detected, healing is quite possible. Still, 24-30% of patients with lymph node negative and 50-60% with lymph node positive breast cancer will develop relapse. At the moment of diagnosis metastatic disease is present in 6-10% of patients (5). Treatment of breast cancer is multidisciplinary. Combination of surgical treatment, radiation and systemic therapeutic treatment ensure good results in patient survival. The type and order of particular treatments must be planned multidisciplinary by surgeons-oncologists, radiotherapists and internists-oncologists (6). Clinical features of tumor such as size, the existence of tumor cells in the armpit lymph nodes, and distant metastases are considered essential in determining prognosis and choices of treatment. Prognostic factors, derived from breast tissue after biopsy or surgery, have significance in measuring tumor aggressiveness and general disease prognosis. The standard prognostic parameters are patient (menopausal status, age) and tumor related (tumor size, histological type, axillary lymphatic status, tumor gradient, ER, PR and HER2 status). Some of them (ER, PR and HER2 status) have a predictive value because the best therapeutic modality is chosen based on these. According to St. Gallen Consensus and ESMO recommendations from year 2013 breast cancers fall into different types according to histopathological findings and results of predictive and prognostic tests. Based on this, specific therapeutic approach is recommended. When luminal A type patient receive only endocrine therapy, and chemotherapy is considered only in cases of high risk tumor (with four or more positive lymph nodes, tumor size T3 or tumor grade 3). When luminal B-like type (HER2 negative) patient is treated using chemotherapy and endocrine therapy. When luminal B-like (HER2 positive) patient is treated using chemotherapy, anti-HER2 and endocrine therapy. In case of non-luminal (HER2 positive) breast cancer type chemoand anti-HER2 therapy is recommended. In patients with basa
乳腺癌是女性中最常见的恶性疾病(1),约占欧洲女性新发现恶性肿瘤的26.5%,占死亡人数的17.5%。在男性中,这种类型的癌症是罕见的(每100名女性中有1名男性)(2)。这种疾病在世界各地的发病率不同。很少看到在30岁之前,它随着年龄的上升,达到最大的50岁(3),乳腺癌的发病率在世界上每年增加1 - 2%,据估计,在第三年的第一个十年,近一百万的女性患乳腺癌(4)。然而,尽管治疗的可能性增加,生存主要取决于疾病的程度和阶段的检测。在发现患者最多的疾病早期,治愈是很有可能的。然而,24-30%的淋巴结阴性和50-60%的淋巴结阳性乳腺癌患者会复发。在诊断时,6-10%的患者存在转移性疾病(5)。乳腺癌的治疗是多学科的。手术治疗、放射治疗和全身治疗相结合,保证了患者良好的生存效果。特定治疗的类型和顺序必须由外科肿瘤学家、放射治疗师和内科肿瘤学家共同规划(6)。肿瘤的临床特征,如大小、腋窝淋巴结中肿瘤细胞的存在以及远处转移被认为是决定预后和治疗选择的必要因素。来自活检或手术后乳腺组织的预后因素在衡量肿瘤侵袭性和一般疾病预后方面具有重要意义。标准预后参数为患者(绝经状态、年龄)和肿瘤相关(肿瘤大小、组织学类型、腋窝淋巴状态、肿瘤梯度、ER、PR和HER2状态)。其中一些指标(ER, PR和HER2状态)具有预测价值,因为根据这些指标选择最佳治疗方式。根据圣加仑共识和ESMO 2013年的建议,乳腺癌根据组织病理学发现和预测和预后测试结果分为不同类型。在此基础上,建议采取特定的治疗方法。当管腔A型患者仅接受内分泌治疗,仅在高危肿瘤(四个及以上淋巴结阳性,肿瘤大小为T3或肿瘤分级为3)时才考虑化疗。当管腔b样(HER2阴性)患者同时接受化疗和内分泌治疗时。当腔内b样(HER2阳性)患者接受化疗、抗HER2和内分泌治疗时。对于非腔型(HER2阳性)乳腺癌,推荐化疗和抗HER2治疗。基底样(三阴性)癌患者应应用化疗(7)。
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引用次数: 1
Nodular lesion in the tongue: A rare case of low grade myofibroblastic sarcoma 舌部结节状病变:一例罕见的低级别肌纤维母细胞肉瘤
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190827009t
Jefferson Tenório Rocha, Frederico Medeiros Buhatem, Machado Orsini de, S. Pinto
Low grade myofibroblastic sarcoma is an atypical myofibroblastic malignant neoplasm that rarely affects the oral cavity and presents a challenging histological diagnosis. Here we report the case of a 38-year-old woman who had a nodular and symptomatic lesion on the lateral border of the tongue. After the biopsy, the histopathological analysis revealed a spindle cell lesion with fascicular and storiform pattern. We performed immunohistochemical analysis that showed intense labeling for vimentin, smooth muscle actin and moderate labeling for calponin and S-100. We emphasize the rarity of low grade myofibroblastic sarcoma such as a nodular lesion on the tongue and the need for accurate diagnosis.
低级别肌纤维母细胞肉瘤是一种不典型的肌纤维母细胞恶性肿瘤,很少影响口腔,是一种具有挑战性的组织学诊断。在这里我们报告的情况下,38岁的妇女谁有一个结节和症状性病变的外侧边界的舌头。活检后,组织病理学分析显示梭形细胞病变,呈束状和故事状。我们进行了免疫组织化学分析,结果显示波形蛋白、平滑肌肌动蛋白被强烈标记,钙钙蛋白和S-100被适度标记。我们强调罕见的低级别肌纤维母细胞肉瘤,如结节病变的舌头和需要准确的诊断。
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引用次数: 1
Association of a large vulvar tumor in a in a young premenopausal woman with recurrent pseudoangiomatous stromal hyperplasia of the breasts 年轻绝经前妇女的大外阴肿瘤与乳房复发性假性血管瘤间质增生的关系
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190603008k
A. M. Knickerbocker, D. Timmons, Y. Tjendra, S. Garzon, J. Carugno
Pseudoangiomatous stromal hyperplasia is a benign proliferative lesion of the breast tissue that typically affects women in the reproductive age. Pseudoangiomatous stromal hyperplasia usually presents as a localized, painless, firm mass or as a diffuse thickened area of the breast. Rarely, it can arise along the embryonic milk line, up to the anogenital region, where it simulates angiosarcomas. Awareness of this uncommon condition is important in order to avoid unnecessary aggressive excisional surgical procedures. For this purpose, we present a case of nodular pseudoangiomatous stromal hyperplasia arising in the vulva in a patient with recurrent pseudoangiomatous stromal hyperplasia of the breast.
假性血管瘤间质增生是乳腺组织的一种良性增生性病变,通常影响育龄妇女。假性血管瘤间质增生通常表现为局部、无痛、坚硬的肿块或乳腺弥漫性增厚区域。极少数情况下,它可以沿着胚胎乳汁线出现,直到肛门生殖器区域,在那里它模拟血管肉瘤。意识到这种不常见的情况是重要的,以避免不必要的侵略性切除手术。为此目的,我们提出一个病例结节性假性血管瘤间质增生出现在外阴的病人复发性乳腺假性血管瘤间质增生。
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引用次数: 0
Local recurrence after surgery of locally advanced rectal cancer treated with or without preoperative chemoradiotherapy 术前放化疗或不放化疗对局部晚期直肠癌术后局部复发的影响
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190717010d
M. Djurić, D. Lukić, Z. Radovanovic, Aleksandar Ðermanovic, M. Ranisavljevic, B. Gutic
Introduction: The ?gold standard? for patients with locally advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. Aim: Evaluation of local recurrence after surgery for locally advanced rectal cancer. Methods and patients: Retrospective study included 189 patients, who were operated at Oncology Institute of Vojvodina from January 1st 2012 until December 31st 2017. Patients were divided into two groups. In the first group 73 patients who received chemoradiotherapy were included, while 116 patients without neoadjuvant treatment were in the second group. All patients were diagnosed with locally advanced rectal cancer. The existence of operable metastases in the liver and/or lungs did not exclude patients from the study. Patients who had undergone resection of the rectum by Miles, Hartmann or local tumor excision were excluded from the study. Results: The median follow-up period was 48 months (range 13-84). In total, 23 (12.2%) patients developed local recurrence. In the chemoradiotherapy group, 15.1% (11 of 73 patients) had a local recurrence, as compared with 10.3% (12 of 116 patients) in the group without neoadjuvant treatment. In both groups, there were no correlation between rate of local recurrence with other clinical and pathological parameters such as gender, tumor location, T and N stage, histological differentiation, or lymphovascular and perineural invasion (p>0.05). We confirmed significant association between circumferential resection margin with local recurrence in patients who were treated by preoperative chemoradiation (p=0.014). Conclusion: This study has not shown reduced risk of local recurrence after neoadjuvant therapy most likely due to small number of patients. Despite our results, neoadjuvant treatment followed by surgery remains the best treatment protocol for patients with locally advanced rectal cancer.
导言:金本位?局部晚期直肠癌患者采用新辅助放化疗后手术治疗。目的:评价局部进展期直肠癌术后局部复发情况。方法和患者:回顾性研究纳入2012年1月1日至2017年12月31日在伏伊伏丁那肿瘤研究所手术的189例患者。患者分为两组。第一组73例接受放化疗的患者,第二组116例未接受新辅助治疗的患者。所有患者均被诊断为局部晚期直肠癌。肝脏和/或肺部可手术转移的存在并未将患者排除在研究之外。接受过Miles、Hartmann直肠切除术或局部肿瘤切除术的患者被排除在研究之外。结果:中位随访时间为48个月(范围13-84)。共有23例(12.2%)患者出现局部复发。在放化疗组,15.1%(73例患者中的11例)局部复发,而在没有新辅助治疗的组中,10.3%(116例患者中的12例)局部复发。两组局部复发率与其他临床病理参数如性别、肿瘤位置、T、N分期、组织学分化、淋巴血管及神经周围浸润等均无相关性(p < 0.05)。我们证实术前放化疗患者的环切缘与局部复发有显著相关性(p=0.014)。结论:本研究未显示新辅助治疗后局部复发风险降低,这很可能是由于患者数量少。尽管我们的结果,新辅助治疗后手术仍然是局部晚期直肠癌患者的最佳治疗方案。
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引用次数: 0
Epidemiological and pathological characteristics of post-surgical cases of invasive breast cancer among ethnicities of Iran in 2018: A single center cross-sectional study 2018年伊朗各民族浸润性乳腺癌术后病例的流行病学和病理特征:一项单中心横断面研究
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190626007s
S. Sayad, Seyyed Ahmadi Amir, Reza Nekouian, M. Panahi, K. Anbari
Background: Present study aimed to investigate immunohistochemical parameters in post-surgical cases of invasive breast cancer. Methods: In this single center cross-sectional study we investigated ethnicity, familial history, type of cancer, stage of cancer, lymph node positivity, bilateral involvement, metastasis and immunohistochemical parameters (estrogen and progesterone receptor, human epidermal growth factor receptor 2, as well as frequency of triple positive and triple negative patients merely based on immunohistochemical parameters). Results: Frequency of positive familial history was 27.42% (16.31-38.52%). Lymph node involvement was detected in 55.93% (43.26-68.60%) of the cases. Frequency of positive HER2 was 38.60% (25.96-51.23%). There were 17.54% (7.67-27.42%) of triple positive and 7.02% (0.39-13.65%) of triple negative cases. The most common stage at the time of diagnosis was stage 3 with 43.33% (30.79-55.87%) frequency. In Lur/Lak population higher frequency of positive HER2 cases was detected whereas in Mazani population frequency of positive HER2 cases was low (p=0.0291). Conclusions: These results could contribute to understanding of breast cancer patterns among different ethnicities. In order to draw clear conclusion future investigations have to be done in several health centers, for longer time periods and with larger number of patients.
背景:本研究旨在探讨浸润性乳腺癌术后的免疫组织化学参数。方法:在本单中心横剖面研究中,我们调查了种族、家族史、癌症类型、癌症分期、淋巴结阳性、双侧受损伤、转移和免疫组织化学参数(雌激素和孕激素受体、人表皮生长因子受体2,以及仅基于免疫组织化学参数的三阳性和三阴性患者的频率)。结果:家族病史阳性率为27.42%(16.31 ~ 38.52%)。55.93%(43.26 ~ 68.60%)的病例有淋巴结累及。HER2阳性率为38.60%(25.96 ~ 51.23%)。三阴阳性率为17.54%(7.67 ~ 27.42%),三阴阳性率为7.02%(0.39 ~ 13.65%)。诊断时以3期最常见,占43.33%(30.79 ~ 55.87%)。Lur/Lak人群HER2阳性检出率较高,Mazani人群HER2阳性检出率较低(p=0.0291)。结论:这些结果有助于了解不同种族的乳腺癌模式。为了得出明确的结论,未来的调查必须在几个保健中心进行,时间更长,患者人数更多。
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引用次数: 6
Distribution of histopathological types of thyroid tumors in 1999-2015 compared to 1966-1988 year period 1999-2015年甲状腺肿瘤组织病理类型的分布与1966-1988年的比较
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.2298/aoo190402005m
T. Makazlieva, O. Vaskova, Aleksandra Nikolovska, V. Stefanovska
Background: The most common thyroid tumors originate from the epithelial follicular cells. Etiology involved in the development of thyroid carcinoma is multifactorial, including external influences and genetic predisposition. Aim: The objective of our study was to analyze the distribution of the histopathological types of thyroid carcinoma during 1999- 2015 year period, to evaluate papillary and follicular thyroid carcinoma ratio and to compare thyroid carcinoma types with the data from prior epidemiological study referring to the period from 1966 -1988. Methods: A retrospective analysis was performed. The trend for thyroid carcinoma cases was evaluated in the time period of 50 years. Percentages of different histopathological types of thyroid carcinoma were presented and papillary and follicular thyroid carcinoma ratio was calculated for the two evaluated periods. Results: A total number of 422 thyroid carcinoma patients were diagnosed in the 1999-2015 year period vs. 323 patients in the period from 1966-1988. Analysis revealed no statistically significant difference in histopathological types of thyroid carcinoma during 1999-2015 year period, but statistically significant difference was detected between the two analyzed periods with a significant increase of papillary and follicular thyroid carcinoma ratio (from 3.1 to 7.3), and a significant reduction of anaplastic thyroid carcinomas cases in the more recent evaluated period (1999-2015). Conclusion: The analysis of the fifty-year-period in population of North Macedonia showed an increase in number of thyroid carcinoma cases, especially papillary and reduction of follicular thyroid carcinoma and anaplastic thyroid carcinomas cases. Further, genetic profiling studies could be useful in evaluating possible mechanisms behind this shift in histopathology of the thyroid carcinomas.
背景:最常见的甲状腺肿瘤起源于上皮滤泡细胞。甲状腺癌的病因是多因素的,包括外部影响和遗传易感性。目的:分析1999- 2015年甲状腺癌组织病理类型的分布,评估甲状腺乳头状癌和滤泡癌的比例,并将甲状腺癌类型与1966 -1988年既往流行病学研究数据进行比较。方法:回顾性分析。在50年的时间里,甲状腺癌病例的趋势被评估。计算两个评估期不同组织病理类型甲状腺癌的百分比,并计算乳头状和滤泡状甲状腺癌的比例。结果:1999-2015年期间诊断的甲状腺癌患者总数为422例,而1966-1988年期间诊断为323例。分析显示,1999-2015年期间甲状腺癌的组织病理类型差异无统计学意义,但两个分析期间的差异有统计学意义,乳头状和滤泡状甲状腺癌的比例显著增加(从3.1增加到7.3),在最近的评估期间(1999-2015年),间变性甲状腺癌的病例显著减少。结论:对北马其顿50年人口的分析表明,甲状腺癌病例数增加,特别是乳头状甲状腺癌和滤泡性甲状腺癌和间变性甲状腺癌病例数减少。此外,基因谱研究可能有助于评估甲状腺癌组织病理学转变背后的可能机制。
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引用次数: 0
Dual checkpoint inhibitor induced autoimmune encephalitis 双检查点抑制剂诱导自身免疫性脑炎
Q4 Medicine Pub Date : 2019-01-01 DOI: 10.2298/AOO181230003E
Natalie Elkayam, Shaurya Sharma
Immune checkpoint inhibitor therapy has become increasingly more used as a treatment modality for solid organ tumors. Nivolumab, anti-PD-1 and Ipilimumab, anti-CTLA-4 monoclonal antibodies are checkpoint inhibitors with well described immune related toxicities. Immune specific neurotoxicity is rare and not well elucidated in literature. We present a case of severe autoimmune encephalitis in a patient with metastatic renal cell carcinoma treated with both Nivolumab and Ipilimumab. A 53-year-old man with metastatic renal cell carcinoma presented due to visual and auditory hallucinations of sudden onset, confusion and weakness. Initial imaging and diagnostic workup did not demonstrate a clear source. However, a neurological etiology was suspected. It was concluded that the patient had autoimmune encephalitis induced by dual check point inhibitor therapy. This was further strengthened by his rapid response to systemic corticosteroid therapy. We present a summary of this case and its management and a review of literature on dual checkpoint inhibitor induced neurological adverse effects.
免疫检查点抑制剂治疗越来越多地被用作实体器官肿瘤的治疗方式。Nivolumab,抗pd -1和Ipilimumab,抗ctla -4单克隆抗体是检查点抑制剂,具有良好的免疫相关毒性。免疫特异性神经毒性是罕见的,在文献中没有很好的阐明。我们提出了一例严重的自身免疫性脑炎患者转移性肾细胞癌用纳伏单抗和伊匹单抗治疗。一例53岁男性转移性肾细胞癌患者,因突然发作的视觉和听觉幻觉、意识模糊和虚弱而就诊。最初的影像和诊断检查没有明确的来源。然而,怀疑是神经学病因。结论为双检查点抑制剂治疗所致自身免疫性脑炎。他对全身皮质类固醇治疗的快速反应进一步加强了这一点。我们对该病例及其处理进行总结,并对双检查点抑制剂诱导神经系统不良反应的文献进行回顾。
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引用次数: 1
期刊
Archive of Oncology
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