Satya Das, Chanjuan Shi, Tatsuki Koyama, Yi Huang, Raul Gonzalez, Kamran Idrees, Christina Edwards Bailey, Jordan Berlin
Objective: Well-differentiated small-intestinal neuroendocrine tumors (SI-NETs) tend to be biologically indolent. Despite this tendency, they have a predilection for metastasis. Peritoneal involvement is quite common as is unfortunately peritoneal carcinomatosis (PC). PC is a dreaded metastatic complication due to the significant morbidity it creates for patients as well as well as increasing their mortality risk. The risk factors for PC development in SI-NETs remain understudied; however, one such factor may be the presence of mesenteric tumor deposits (MTDs).
Methods: We performed a retrospective analysis on 208 well-differentiated SI-NET patient samples, the majority with mesenteric masses, from the pathology archives of Vanderbilt University Medical Center. We sought to explore whether MTD presence was associated with PC, what other patient determinants were associated with PC and prognostic implication of these determinants.
Results: Patients with MTDs had an OR of 3.9 (CI 1.6, 10.9) for PC compared to patients without MTDs in the analysis. Patients who developed PC fared more poorly than those who did not (p=0.044).
Conclusion: Our analysis, to the best of our knowledge, is the first to demonstrate an association between MTD presence and PC in this patient subgroup. We believe this finding warrants prospective evaluation given the possible therapeutic implications of being able to stratify SI-NET patients by their risk for developing PC based upon MTD presence.
目的：分化良好的小肠神经内分泌肿瘤（SI-NETs）在生物学上往往是不活跃的。尽管有这种倾向，但它们却有转移的倾向。腹膜受累很常见，不幸的是腹膜癌变（PC）也很常见。腹膜癌是一种可怕的转移性并发症，因为它会给患者带来严重的发病率，并增加他们的死亡风险。SI-NET 发生 PC 的风险因素仍未得到充分研究，但其中一个因素可能是肠系膜肿瘤沉积物（MTD）的存在：我们对范德比尔特大学医学中心病理档案中的 208 例分化良好的 SI-NET 患者样本进行了回顾性分析，其中大部分患者有肠系膜肿块。我们试图探究MTD的存在是否与PC相关、患者的其他决定因素与PC的相关性以及这些决定因素对预后的影响：结果：与分析中无 MTD 的患者相比，有 MTD 的患者 PC OR 为 3.9（CI 1.6，10.9）。出现 PC 的患者比未出现 PC 的患者表现更差（P=0.044）：据我们所知，我们的分析首次证明了在这一患者亚群中存在 MTD 与 PC 之间的关联。我们认为这一发现值得进行前瞻性评估，因为根据MTD的存在对SI-NET患者进行PC发病风险分层可能具有治疗意义。
{"title":"Peritoneal Carcinomatosis in Well-Differentiated Small-Intestinal Neuroendocrine Tumors with Mesenteric Tumor Deposits.","authors":"Satya Das, Chanjuan Shi, Tatsuki Koyama, Yi Huang, Raul Gonzalez, Kamran Idrees, Christina Edwards Bailey, Jordan Berlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Well-differentiated small-intestinal neuroendocrine tumors (SI-NETs) tend to be biologically indolent. Despite this tendency, they have a predilection for metastasis. Peritoneal involvement is quite common as is unfortunately peritoneal carcinomatosis (PC). PC is a dreaded metastatic complication due to the significant morbidity it creates for patients as well as well as increasing their mortality risk. The risk factors for PC development in SI-NETs remain understudied; however, one such factor may be the presence of mesenteric tumor deposits (MTDs).</p><p><strong>Methods: </strong>We performed a retrospective analysis on 208 well-differentiated SI-NET patient samples, the majority with mesenteric masses, from the pathology archives of Vanderbilt University Medical Center. We sought to explore whether MTD presence was associated with PC, what other patient determinants were associated with PC and prognostic implication of these determinants.</p><p><strong>Results: </strong>Patients with MTDs had an OR of 3.9 (CI 1.6, 10.9) for PC compared to patients without MTDs in the analysis. Patients who developed PC fared more poorly than those who did not (p=0.044).</p><p><strong>Conclusion: </strong>Our analysis, to the best of our knowledge, is the first to demonstrate an association between MTD presence and PC in this patient subgroup. We believe this finding warrants prospective evaluation given the possible therapeutic implications of being able to stratify SI-NET patients by their risk for developing PC based upon MTD presence.</p>","PeriodicalId":73814,"journal":{"name":"Journal of medical & surgical pathology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175957/pdf/nihms-1025300.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37862981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01Epub Date: 2016-07-05DOI: 10.4172/2472-4971.1000131
Mohamed A Zayed, Scott D Harring, Dana R Abendschein, Chandu Vemuri, Dongsi Lu, Lisa Detering, Yongjian Liu, Pamela K Woodard
Objective: Natriuretic peptide receptor-C (NPR-C/NPR-3) is a cell surface protein involved in vascular remodelling that is up-regulated in atherosclerosis. NPR-C expression has not been well characterized in human carotid artery occlusive lesions. We hypothesized that NPR-C expression correlates with intimal features of vulnerable atherosclerotic carotid artery plaque.
Methods: To test this hypothesis, we evaluated NPR-C expression by immunohistochemistry (IHC) in carotid endarterectomy (CEA) specimens isolated from 18 patients. The grade, location, and co-localization of NPR-C in CEA specimens were evaluated using two tissue analysis techniques.
Results: Relative to minimally diseased CEA specimens, we observed avid NPR-C tissue staining in the intima of maximally diseased CEA specimens (65%; p=0.06). Specifically, maximally diseased CEA specimens demonstrated increased NPR-C expression in the superficial intima (61%, p=0.17), and deep intima (138% increase; p=0.05). In the superficial intima, NPR-C expression significantly co-localized with vascular smooth muscle cells (VSMCs) and macrophages. The intensity of NPR-C expression was also higher in the superficial intima plaque shoulder and cap regions, and significantly correlated with atheroma and fibroatheroma vulnerable plaque regions (β=1.04, 95% CI=0.46, 1.64).
Conclusion: These findings demonstrate significant NPR-C expression in the intima of advanced carotid artery plaques. Furthermore, NPR-C expression was higher in vulnerable carotid plaque intimal regions, and correlate with features of advanced disease. Our findings suggest that NPR-C may serve as a potential biomarker for carotid plaque vulnerability and progression, in patients with advanced carotid artery occlusive disease.
目的：钠尿肽受体-C（NPR-C/NPR-3）是一种参与血管重塑的细胞表面蛋白，在动脉粥样硬化中被上调。在人类颈动脉闭塞病变中，NPR-C 的表达尚未得到很好的描述。我们假设 NPR-C 的表达与易损动脉粥样硬化颈动脉斑块的内膜特征相关：为了验证这一假设，我们通过免疫组化（IHC）评估了从 18 名患者分离的颈动脉内膜切除术（CEA）标本中 NPR-C 的表达。我们使用两种组织分析技术对 CEA 标本中 NPR-C 的等级、位置和共定位进行了评估：结果：相对于轻度病变的CEA标本，我们在重度病变的CEA标本内膜中观察到了大量的NPR-C组织染色（65%；P=0.06）。具体来说，病变最严重的 CEA 标本在浅层内膜（61%，p=0.17）和深层内膜（138%；p=0.05）中的 NPR-C 表达增加。在浅层内膜，NPR-C 的表达明显与血管平滑肌细胞（VSMC）和巨噬细胞共定位。在浅层内膜斑肩和斑盖区域，NPR-C的表达强度也较高，并与动脉粥样斑块和纤维粥样斑块易损斑块区域明显相关（β=1.04，95% CI=0.46，1.64）：这些研究结果表明，NPR-C在晚期颈动脉斑块内膜中表达明显。此外，NPR-C 在易损颈动脉斑块内膜区域的表达量更高，并与晚期疾病的特征相关。我们的研究结果表明，NPR-C 可作为晚期颈动脉闭塞性疾病患者颈动脉斑块脆弱性和进展的潜在生物标志物。
{"title":"Natriuretic Peptide Receptor-C is Up-Regulated in the Intima of Advanced Carotid Artery Atherosclerosis.","authors":"Mohamed A Zayed, Scott D Harring, Dana R Abendschein, Chandu Vemuri, Dongsi Lu, Lisa Detering, Yongjian Liu, Pamela K Woodard","doi":"10.4172/2472-4971.1000131","DOIUrl":"10.4172/2472-4971.1000131","url":null,"abstract":"<p><strong>Objective: </strong>Natriuretic peptide receptor-C (NPR-C/NPR-3) is a cell surface protein involved in vascular remodelling that is up-regulated in atherosclerosis. NPR-C expression has not been well characterized in human carotid artery occlusive lesions. We hypothesized that NPR-C expression correlates with intimal features of vulnerable atherosclerotic carotid artery plaque.</p><p><strong>Methods: </strong>To test this hypothesis, we evaluated NPR-C expression by immunohistochemistry (IHC) in carotid endarterectomy (CEA) specimens isolated from 18 patients. The grade, location, and co-localization of NPR-C in CEA specimens were evaluated using two tissue analysis techniques.</p><p><strong>Results: </strong>Relative to minimally diseased CEA specimens, we observed avid NPR-C tissue staining in the intima of maximally diseased CEA specimens (65%; p=0.06). Specifically, maximally diseased CEA specimens demonstrated increased NPR-C expression in the superficial intima (61%, p=0.17), and deep intima (138% increase; p=0.05). In the superficial intima, NPR-C expression significantly co-localized with vascular smooth muscle cells (VSMCs) and macrophages. The intensity of NPR-C expression was also higher in the superficial intima plaque shoulder and cap regions, and significantly correlated with atheroma and fibroatheroma vulnerable plaque regions (β=1.04, 95% CI=0.46, 1.64).</p><p><strong>Conclusion: </strong>These findings demonstrate significant NPR-C expression in the intima of advanced carotid artery plaques. Furthermore, NPR-C expression was higher in vulnerable carotid plaque intimal regions, and correlate with features of advanced disease. Our findings suggest that NPR-C may serve as a potential biomarker for carotid plaque vulnerability and progression, in patients with advanced carotid artery occlusive disease.</p>","PeriodicalId":73814,"journal":{"name":"Journal of medical & surgical pathology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989919/pdf/nihms806713.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9856564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号