Indian Journal of Surgical Oncology最新文献

Benign prostatic hyperplasia (BPH) and prostatic cancer both represent prostate lesions affecting males. These conditions occur due to the presence of inflammation within the prostate gland. This inflammatory process causes tissue injury and cellular modifications, which are primarily through the cytokine synthesis and secretion. Distinctly, IL-6 (interleukin 6) emerges as a vital part in prostate disease, exerting a profound influence on its development. In addition, the anti-inflammatory cytokines' inclusion, such as tumor necrosis factor beta-1 (TGFβ-1), is evident in the development of both benign prostatic hyperplasia and prostatic cancer. In recent discoveries, researchers are more focused on complex interaction between IL-6 and TGFβ-1 in the prostate pathophysiology. The article aims to assess the IL-6 and TGFβ-1 immunohistochemical expression in prostatic benign and malignant lesions. Formalin-fixed samples that were encapsulated in paraffin were utilized in this work. They were collected from the department of histopathology et al.-Ramadi-Teaching Hospital from patients who were diagnosed with hyperplasia and carcinoma of the prostate. To detect the expression of TGFβ-1 and IL-6, immunohistochemical analysis was performed on the tissue sections. The intensity of stromal staining was determined to assess the stromal expression. Concerning prostate cancer, the relationship between cytokine expression and the Gleason index score was discussed in this work. The results confirm that the TGFβ-1 was presented in the epithelial and stromal components of prostate tissue with a higher concentration in the stroma. The TGFβ-1 stromal expression was increased in cases of benign hyperplastic changes in comparison to prostate carcinoma (p < 0.05). On the contrary, the epithelial expression of TGFβ-1 did not show any significant differences between the two cases. On the other hand, IL-6 expression was localized in the epithelial component, with higher levels observed in prostate cancer in comparison to hyperplasia. There was no substantial correlation found between the Gleason score and IL-6 expression. According to our results, the immunohistochemical detection of both TGFβ-1 and IL-6 exhibited variations between benign and malignant samples.

Bayesian network (BN) models are graphical structures called the directed acyclic graphs, which model the probabilistic dependencies between variables. In the context of predictive modeling, BN models can intuitively represent the collective contribution of factors in predicting an outcome variable. This study is aimed at developing a BN model in predicting the two-year mortality of patients diagnosed with squamous cell carcinoma of oral cavity (OCSCC). The secondary data for the study was obtained from a published cohort study conducted within the institute after ethical approval. The strength of association of the potential prognostic factors with the outcome variable was determined using multiple logistic regression. The hybrid BN model based on expert opinion and association matrix (BN-H) was developed. The conditional dependencies between the variables were incorporated as the thickness of edges between nodes. Multiple logistic regression (MLR) and BN models based on tree augmented (TAN), expectation maximization (EM), and gradient boosting (GB) method was developed for comparison. Gini coefficient, sensitivity, specificity, misclassification rate, and area under the ROC curve were estimated in both training and testing data for comparison. Age, smoking, alcohol, stage of the cancer, and treatment modality were found be significant prognostic factors for mortality. The association matrix determined that there were significant inter-dependencies between variables. The BN-H model was found to have a comparable predictive accuracy to the MLR model. Bayesian network model developed with expert opinion and appropriate association matrix can be an alternative to existing predictive models for binary outcome.

Supplementary information: The online version contains supplementary material available at 10.1007/s13193-024-02164-w.

The objective of the study is to explore the correlation between inflammation indices (NLR, MLR, PLR) and prognostic factors (myometrial infiltration, LVSI, grading) in FIGO 2023 stage I endometrial carcinoma. From August 2023 to March 2024, a prospective study was conducted on 163 women diagnosed with stage I endometrial cancer. The research methods were established a priori and authorized through evaluation by the Ethics Committee of the individual centers (IRB 30661/2022 of 31/03/2022). The study was then registered on the clinicaltrials.gov platform under NCT05657483. Blood samples were collected preoperatively to measure the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR). Histopathological data on myometrial infiltration, LVSI, and grading were also analyzed. NLR values were 2.07, 2.35, and 2.68 for no infiltration, < 50%, and ≥ 50% myometrial infiltration, respectively (p = 0.033). MLR values were 0.20, 0.23, and 0.26 for the same categories (p = 0.029). PLR values were 119, 140, and 146 (p = 0.043). For LVSI, NLR was 2.17 in negative and 3.23 in diffuse (p = 0.010), while MLR showed 0.20 vs 0.24 (p = 0.054), and PLR showed 125 vs 141 (p = 0.033). Multivariate analysis indicated myometrial infiltration had the strongest correlation with inflammation indices (beta 0.07, CI 95% 0.01-0.13, p = 0.041). Inflammation indices (NLR, MLR, PLR) significantly correlate with myometrial infiltration, LVSI positivity, and higher grading in early-stage endometrial carcinoma, with myometrial infiltration showing the strongest association. These findings suggest that inflammation indices could aid in the prognostic evaluation of endometrial carcinoma. Further research is needed to understand the prognostic implications fully.

Adenoid cystic carcinoma, predominantly a tumour of salivary gland, very rarely affects the breast. Very few cases have been reported in literature and there is no optimal consensus on management. In this narrative review, we report a case of adenoid cystic carcinoma breast treated with surgery followed by adjuvant chemotherapy and radiation therapy. It is an indolent tumour with very low predilection for lymphatic dissemination. A balanced translocation in MYB-NFIB fusion gene appears to be fundamental in the pathogenesis. Surgery forms the mainstay treatment option followed by adjuvant radiation in high risk cases, as extrapolated from studies in salivary gland tumour.

Aim: To find the association between cholecystectomy and colorectal cancer.

Methodology: This is a case control study which consisted of 138 cases and 140 controls. This study was conducted with the ethical approval of the ethics committee and has also received the ICMR STS grant. Data of 138 patients who were diagnosed with colorectal cancer in the last 5 years were analyzed for a history of cholecystectomy. Those who developed colorectal cancer within a year of their cholecystectomy were excluded from the study to minimize protopathic bias. The control group was composed of healthy individuals. Data extracted was organized in Microsoft Excel and was analyzed about the main objective. Chi-square test was used to find the association between cholecystectomy and colorectal cancer.

Results: The percentage of cholecystectomy in the colorectal cancer group was 6.5% vs 2.1% in the control group (P value = 0.072). There were no statistically significant associations between diabetes, hypertension, CKD, alcohol intake or smoking, and the incidence of colorectal cancer.

Conclusion: Based on our study, there is no evidence to support an association between colorectal cancer and cholecystectomy.

[This corrects the article DOI: 10.1007/s13193-025-02188-w.].

Gleason grading system was first introduced in the 1960s by Dr. Donald Gleason and has since been used worldwide for the grading of prostate cancer. Over the years it has undergone several modifications but has still retained its status as the most popular scoring system for prostate. Using a systematic literature review, we aim to highlight the changes the Gleason scoring has undergone, their strengths and limitations as well the future directives. Gleason scoring underwent major changes from its original conception in the International Society of Urologic Pathology (ISUP) consensus meetings held in 2005, 2014 and 2019. The latest change in Gleason scoring makes it possible to report the scoring, help alleviate patient anxiety and has shown good reproducibility and less inter-user variability. Gleason scoring system is a popular tool among pathologists and clinicians alike owing to its flexibility, utility and dependability. With advancements in the medical field and the use of artificial intelligence, it is expected to undergo further tempering.

Papillary thyroid carcinoma and follicular thyroid carcinoma both are collectively referred as well-differentiated thyroid carcinomas (WDTC). Both carcinoma types carry an excellent prognosis except in cases with aggressive backgrounds or clinicopathological features. We herein investigated survival rates and various prognostic factors in patients with WDTC. In this retrospective study, a total of 602 patients diagnosed as having WDTC, who had undergone total thyroidectomy with or without neck dissection and had received adequate radioactive iodine treatment from January, 2006, to December, 2008 were included. Data were collected by medical record review. Size of the tumor (p < 0.001) and extrathyroidal extension (p < 0.001) were factors for developing regional lymph node metastasis. Nodal metastasis N0 (central compartment) and N1 (lateral compartment) did not adversely affect 7-year overall survival (p < 0.8). For both regional metastasis (p = 0.001) and distant metastasis (p = 0.025), age > 55 years adversely affected overall survival. No significant difference was found in 7-year overall survival between patients with gross and microscopic extrathyroidal extension (77.6% vs. 74.5%, p = 0.18), 10-year overall survival with gross and microscopic extrathyroidal extension was also non-significant (71.1% vs. 81.3%, p = 0.509). There was no role of prophylactic central compartment neck dissection in treating patients with WDTC. Overall survival at 3, 5, 7 years, and 10 years were 94.2%, 88.8%, 85.2%, and 82.7%, respectively. It can be concluded that the survival was adversely influenced by advanced age (> 55 years). Moreover, poor long-term overall survival and disease-free survival were observed in our study population owing to advanced stage carcinoma (extrathyroidal extension and lymph node metastasis) at presentation.

Treatment for colorectal cancer has improved significantly over the last few decades. The feasibility of treating colorectal cancer recurrence is also increasing. The surveillance protocol applied influences the pattern of diagnosis of recurrence. Adherence to intense follow up protocols may be challenged by limitation of resource, pointing to the scope of forming tailored strategies. The objectives were to determine the rate of salvage, disease-free and overall survival, the types of local therapy applied, morbidity associated with radical local treatment, and the factors influencing survival of patients followed up using a low intensity regimen after curative treatment for recurrent colorectal cancer. We included patients diagnosed with colorectal cancer recurrence from January 2010 to December 2016 at the institute. The clinicopathological and treatment details were collected. Treatment outcomes were analyzed and compared with the baseline characteristics. Of 109 recurrences, 26 (23.8%) were offered curative therapy. Locoregional treatment modalities consisted of four cases of pelvic exenteration (18.2%), four (18.2%) resections of peritoneal deposits including two (9.1%) multivisceral resections, four (18.2%) hepatic resections, two (9.1%) lung metastasectomies, one (4.5%) retroperitoneal lymph node dissection, and two (4.5%) ablative procedures. Four (18.2%) and one (4.5%) cases received chemoradiotherapy and systemic therapy alone. Surgical resection had 6.2% Clavien-Dindo grade III, 25% grade II, and 25% grade I morbidities. With a median follow-up of 95 months, the median DFS and OS were 48 months and 55 months for curatively treated patients. The rate of curative therapy was low in a low-intensity follow-up regimen (23.8%). Yet, curative treatment including complex resections offers a survival advantage with acceptable morbidity rates, in select patients with limited disease affecting a single region.

Cell signaling pathways are important in different biological processes such as cell survival, proliferation, differentiation, as well as tumorigenesis. The complex interactions between genes and signaling pathways have a role in the progression and development of malignancies. Our aim in this study was to explore the concomitant expression of GLI1 and VENTX genes in esophageal squamous cell carcinoma (ESCC) and evaluate its relevance with clinicopathological features. Levels of GLI1 and VENTX mRNA expression in 50 ESCC patients were compared to the correlated margin normal tissues using relative comparative RT-qPCR. A significant correlation between the mRNA expression of GLI1 and VENTX was observed in ESCC patients (P = 0.003, P $<0.05$ ). Expression of GLI1 was significantly increased in samples with high levels of VENTX mRNA expression. Moreover, a significant correlation between VENTX and GLI1 was detected in non-metastatic early tumors (stages I and II). The significant correlation between these genes in non-metastasized early tumors indicates the importance of GLI1 and VENTX concomitant expression as a value for early ESCCs. It may be extrapolated that VENTX through the BMP pathway activates the expression of GLI1 followed by aggressive phenotype in ESCC.