The association of carcinoid tumors of the rectum with myelofibrosis: Report of two cases

Two patients with myelofibrosis, a primary malignancy of the hematopoietic system, have developed carcinoid tumors of the rectum. This development is rare, as rectal carcinoids are more often associated with other carcinomas of the gastrointestinal tract. Rectal carcinoid tumors are, in general, less commonly associated with second malignancies than are carcinoid tumors of foregut and midgut origin     

Contributions of nuclear medicine to the therapy of malignant tumors

Radionuclides are applied in oncology for diagnosis and therapy. The former demands gamma — emitting radionuclides for labeling specific substrates for localizing malignant tissue and for analyzing tumor metabolism in vivo. Here, positron emission tomography (PET) may register in vivo the metabolism, for example, of glucose, amino acids, and receptors and of potentially useful cytotoxic agents. The advantage of the positron emitting radionuclides of carbon, nitrogen and fluorine is the labeling of substrates without changing substrate specificity within the metabolic reaction chain; also, substrate concentration in situ may be quantified. With regard to therapy radionuclides that emit -and -particles or decay by electron capture with the Auger effect, are administered in ionic form or with tumor seeking substrates. Examples are radioiodine for treating thyroid malignancy and radiophosphorus for myelopoliferative diseases. Organically bound radionuclides are given as labeled ligands for specific receptors, such as meta-iodo-benzylguanidine (MIBG) for treating the catecholamine producing tumors phaeochromocytoma and neuroblastoma and labeled monoclonal antibodies for tumors specific receptors. Highly localized energy depositions come from Auger emitters such as¹²⁵I and by the neutron capture therapy, where boron-10 in the tumor cell is exposed to thermal neutrons for initiating the B¹⁰ (n; ) Li⁷ reaction, especially for treating neuro- and glioblastoma and melanoma. Endogenous radiotherapy with radionuclides rely on the success of delivering a proper amount of energy into individual tumor cells with optimal protection of normal tissue. The inevitable heterogeneity of energy deposition events from such approaches demands careful dosimetric assessment for which the classical methods of dosimetry for percutaneous radiotherapy are not applicable.The Journal of Cancer Research and Clinical Oncology publishes in loose succession Editorials and Guest editorials on current and/or controversial problems in experimental and clinical oncology. These contributions represent exclusively the personal opinion of the author The Editors     

肿瘤标记物在恶性嗜铬细胞瘤诊断和治疗中的研究进展

HER2、VEGF、hTERT、HSP90、Ki-67是与嗜铬细胞瘤密切相关的肿瘤标记物,其过度表达可作为临床上鉴别良性及恶性嗜铬细胞瘤的参考指标.近年来,针对肿瘤标记物的靶向性治疗逐渐成为研究热点.临床试验证明,用VEGF的靶向性药物舒尼替尼治疗恶性嗜铬细胞瘤可收到很好的疗效.曲妥珠单抗、Gamitrinibs以及针对肿瘤标记物的基因治疗亦为治疗恶性嗜铬细胞瘤带来了希望.     

甲状腺恶性肿瘤诊断和治疗的热点讨论

对近年有关甲状腺恶性肿瘤的实验室检查的诊断手段和包括手术、核素、放射、化学治疗及甲状腺激素抑制等治疗方法的资料作一介绍及评论。     

mdig基因功能与恶性肿瘤

肿瘤是多基因病,对癌基因作用及调控机制的研究已成为热点。矿物粉尘诱导基因(mineral dust induced gene,mdig)是新发现的肿瘤相关基因,过表达于多种恶性肿瘤,可促进癌细胞增殖,参与癌细胞侵袭、转移。研究 mdig 将进一步揭示肿瘤发生、发展机制,协助临床诊断,提供肿瘤治疗新思路和方法,以期评估、改善肿瘤预后。现将 mdig 基因功能及在肿瘤中的研究进展作一综述,并对未来研究趋势予以展望。     

原发性胆囊恶性肿瘤的B超诊断及B超误诊病例分析

目的分析老年组胆囊恶性癌肿的声像图特点及B超误诊原因,探讨早期B超诊断。方法回顾性分析了经B超诊断,并经手术、病理证实37例老年胆囊恶性肿瘤病例。结果本组B超诊断符合率为75．7％(28/37),误诊率为24．3％。经B超检查发现而手术者,预后好。仅从声像图特征难以区别胆囊腺癌与非腺癌类肿瘤。结论病人早期就诊行B超检查可以改善预后。     

Carcinoid tumors of the pancreas

Summary   Conclusion. The diagnosis of a pancreatic carcinoid should be based on the measurement of serotonin in serum or its demonstration in the tumor and/or by the measurement of its derivative (5-HIAA) in urine. Carcinoid of the pancreas is a rare but definite entity; usually having metastasized by the time of diagnosis. The term “serotonin-producing tumor of the pancreas” has been suggested as an alternative designation for “pancreatic carcinoid.” Background. The literature on carcinoid tumors of the pancreas is confusing because much of it preceded the development of the more specific immunological, chemical and staining techniques currently available. Methods. 43 case reports were collected from the world’s literature, based on a demonstrable pancreatic neuroendocrine tumor plus a positive finding of at least one of the following without another dominant hormone being demonstrated: elevation of 5-Hydroxytryptamine (5-HT) (serotonin) in the serum or detected in tumor tissue, and/or elevation of 5-Hydroxyindole acetic acid (5-HIAA) in the urine. In addition to these two hormone-specific assays, information was collected on the silver-staining properties of the tumor; properties which have traditionally been associated with carcinoid tumors. Positive silver staining in tumor cells (argyrophilic and/or argentaffin reaction) is strongly indicative of the carcinoid tumor but the findings are less specific than the hormone assays and immunohistologic stains. Results. In this review of 43 cases, including two current ones, the pancreatic carcinoid tumor has the following important features:

原发性胆囊恶性肿瘤的B超诊断及B超误诊病例分析

目的分析老年组胆囊恶性癌肿的声像图特点及Ｂ超误诊原因，探讨早期Ｂ超诊断。方法回顾性分析了经Ｂ超诊断，并经手术、病理证实３７例老年胆囊恶性肿瘤病例。结果本组Ｂ超诊断符合率为７５．７％（２８／３７），误诊率为２４．３％。经Ｂ超检查发现而手术者，预后好。仅从声像图特征难以区别胆囊腺癌与非腺癌类肿瘤。结论病人早期就诊行Ｂ超检查可以改善预后。     

Chemotherapy for malignant brain tumors of astrocytic and oligodendroglial lineage

To date, surgery and irradiation remain the standard therapies for anaplastic astrocytoma (AA, WHO grade III) and glioblastoma multiforme (GBM, WHO grade IV). Due to infiltrative tumor growth a complete surgical resection is never achieved and more than 90% of the tumors will recur within 2 cm of the primary tumor location. Postoperative radiotherapy prolongs survival but is not curative and prognosis remains poor with only a few patients being alive 2 years after diagnosis. Over the past decades multiple trials dealt with the question of whether chemotherapy (CT) may influence the outcome of malignant brain tumor patients. In general, the results have been disappointing with one exception: chemosensitivity and prolonged survival after CT have been demonstrated for tumors of oligodendrogial lineage. Drugs showing some activity in malignant brain tumors and therapeutic concepts will be discussed. Received: 2 May 2000 / Accepted: 28 May 2000     

Serum sialic acid in malignant tumors,bacterial infections,and chronic liver diseases

Summary The total serum sialic acid concentration was determined in 2,264 persons with various malignant tumors, bacterial infections, rheumatic diseases, and chronic liver diseases, and in a control group. The thiobarbiturate method according to Warren was used [34].The upper limit (95% percentile) in the control group was 2.23 mol/ml. Higher values were found in the groups with neoplasms (mean: 3.04 mol/ml), inflammatory diseases (e.g., pneumonia: 3.02 mol/ml), and active rheumatoid arthritis (3.05 mol/ml). In the group with malignant diseases, the sialic acid concentration at the time of diagnosis was highest for bronchial carcinoma (3.29 mol/ml) and lowest for breast cancer (2.58 mol/ml). In chronic liver diseases the mean sialic acid level was lower than in a heterogeneous group of noninflammatory and nonneoplastic diseases.The estimation of the serum sialic acid concentration could be useful in the detection of tumor burden and metastases, and in the evaluation of the later course and prognosis of malignant neoplasms if bacterial/inflammatory and active rheumatoid processes can be excluded.     

FOXA在消化系统恶性肿瘤中的作用研究进展

FOXA又称叉头盒转录因子A,最初是从大鼠肝核细胞中发现并提取,分为FOXA1、FOXA2、FOXA3,在胚胎发育、代谢、分化、生长等多个方面发挥着重要作用.近年来研究表明,FOXA在肿瘤代谢、增殖、迁延和转移特别是在上皮间充质转化(EMT)进程中发挥着重要的调节作用.该文对FOXA在消化系统恶性肿瘤中的作用研究进展作...     

Prediction of Risk of Malignancy of Gastrointestinal Stromal Tumors by Endoscopic Ultrasonography

Background/Aims

The accurate preoperative prediction of the risk of malignancy of gastrointestinal stromal tumors (GISTs) is difficult. The aim of this study was to determine whether tumor size and endoscopic ultrasonography (EUS) features can preoperatively predict the risk of malignancy of medium-sized gastric GISTs.

Methods

Surgically resected, 2 to 5 cm gastric GIST patients were enrolled and retrospectively reviewed. EUS features, such as heterogeneity, hyperechoic foci, calcification, cystic change, hypoechoic foci, lobulation, and ulceration, were evaluated. Tumors were grouped in 1 cm intervals. The correlations of tumor size or EUS features with the risk of malignancy were evaluated.

Results

A total of 75 patients were enrolled. The mean tumor size was 3.43±0.92 cm. Regarding the risk of malignancy, 51 tumors (68%) had a very low risk, and 24 tumors (32%) had a moderate risk. When the tumors were divided into three groups in 1 cm intervals, the proportions of tumors with a moderate risk were not different between the groups. The preoperative EUS features also did not differ between the very low risk and the moderate risk groups.

Conclusions

Tumor size and EUS features cannot be used to preoperatively predict the risk of malignancy of medium-sized gastric GISTs. A preoperative diagnostic modality for predicting risk of malignancy is necessary to prevent the overtreatment of GISTs with a low risk of malignancy.     

Study on vasculogenic mimicry in malignant esophageal stromal tumors

AIM： To investigate whether malignant esophageal stromal tumors contain PAS-positive patterned matrix-associated vascular channels, which are lined by tumor cells, but not vascular endothelial cells. That is vasculogenic mimicry （VM） independent of tumor angiogenesis. METHODS： Thirty-six tissue samples of malignant esophageal stromal tumors were analyzed. Tissue sections were stained for Vascular endothelial growth factor （VEGF）, CD31 and periodic acid Schiff （PAS）. The level of VEGF, the microvascular density （MVD） and the vasculogenic mimicry density （VMD） were determined. RESULTS： PAS-positive patterned matrix-associated vascular channels were detected in 33.3% （12/36） of tumor samples. Within these patterned channels, red blood cells were found. The level of VEGF and the MVD in tumors containing patterned channels were significantly higher than those in tumors not containing patterned channels （P 〈 0.05）. At the same time, the malignant degree of tumors was higher, the proportions of tumors containing patterned channels were not only more, but also in the each kind of tumors containing patterned channels. CONCLUSION： In malignant esophageal stromal tumors, a VM mechanism causes some tumor cells to deform themselves and secrete extracellular matrix; thus, PAS-positive patterned matrix-associated vascular channels appear and supplying blood to the tumors to sustain their growth and metastasis.     

血管内皮生长因子和肿瘤特异性生长因子对恶性肿瘤的诊断价值

目的　探讨血管内皮生长因子 (VEGF)和肿瘤特异性生长因子 (TSGF)联合检测对恶性肿瘤诊断的价值。方法　采用酶联免疫吸附试验 (ELISA)和化学法分别检测了 10 4例恶性肿瘤 ,3 0例良性疾病患者和 3 0例正常血清中的VEGF和TSGF的含量。结果　恶性肿瘤患者血清中VEGF和TSGF的含量均明显高于正常对照组及良性疾病组 (P <0 0 1)。恶性肿瘤患者血清VEGF的阳性率为 84 6% ,TSGF的阳性率为 85 6% ,两者总阳性率为 94 2 %。结论　研究资料血清VEGF和TSGF含量异常有助于恶性肿瘤的诊断     

Methylation profile in benign,borderline and malignant ovarian tumors

Purpose Promoter hypermethylation is a common phenomenon in neoplasm. The aims of this study were (a) to compare the methylation profiles in different types of ovarian tumors and (b) to determine the possible relationship between the methylation status and different clinicopathologic characteristics. Methods We examined the promoter methylation status of 9 tumor suppressor genes (RARβ2, TMS1, RIZ1, P15, P16, PTEN, MINT31, APC and HIC1) in 89 ovarian cancers, 16 borderline ovarian tumors, 19 benign ovarian tumors, 16 normal ovarian tissue and 5 ovarian cancer cell lines. The methylation status was examined with respect to clinicopathologic characteristics of the ovarian cancer patients. Results Methylation indices for ovarian cancer, borderline ovarian tumor, benign ovarian tumor, normal ovarian tissue and ovarian cancer cell lines were 28.8, 20.1, 10.5, 11.8 and 42.2%, respectively. It was significantly higher in ovarian cancer, borderline ovarian tumor and ovarian cancer cell lines (X ² test, P < 0.001, P = 0.01 and P < 0.001, respectively) than benign or normal ovarian tissues. In ovarian cancer, concurrent methylation of at least two genes (CM2) was associated with early stage disease (X ² test, P = 0.035) and less recurrence (X ² test, P = 0.020). When the methylation statuses of the nine genes as well as CM2 were included in multivariate Cox Regression analysis, CM2 was the only independent predictor for survival (P = 0.013). Conclusion CM2 was an independent predictor for survival in ovarian cancer.     

Immunohistochemical analysis of nm23 protein expression in malignant bone tumors

Expression levels of nm23 protein in 72 malignant bone tumors comprising 41 osteosarcomas, 22 chondrosarcomas, 6 Ewing's sarcomas, and 2 malignant fibrous histiocytomas were examined immunohistochemically, using anti-nm23 protein polyclonal antibody, and compared with 51 cases of benign bone tumors or tumor-like lesions. Malignant bone tumors showed significantly higher nm23 protein expression than benign bone tumors or tumor-like lesions (P<0.0001). In chondrosarcoma, nm23 expression increased in high-grade tumors (grade I versus grade II and III:P=0.0229). In the cases of osteosarcoma, however, grade IV osteosarcomas showed decreased expression of nm23 compared with grade III tumors (P=0.0122). There was no significant relationship between nm23 expression and histological type. nm23 expression had no correlation with metastatic potential in osteosarcoma, although the therapy was not uniform in our cases. Furthermore, in 6 cases of osteosarcoma and 1 case of Ewing's sarcoma, there was no clear tendency for a decrease of nm23 in the metastatic sites compared with primary sites, as reported in breast cancer. These results showed that, in contrast to reports on breast cancer and experimental models, nm23 protein expression in human bone tumors may be associated with malignant potentiality, except in cases of osteosarcoma.     

Rare tumors of the colon and rectum: a national review

Background Most literature available on rare colorectal cancer (CRC) is from case series reports. This population-based evaluation is the first comprehensive look at four rare histologic types of CRC, allowing comparisons with the more common adenocarcinoma for clinical and pathological features and survival rates. Materials and ethods All patients diagnosed with carcinoid (n=2,565), malignant lymphoma (n=955), non-carcinoid neuroendocrine (n=455), squamous cell (n=437), and adenocarcinoma (n=164,638) in SEER cancer database (1991–2000) were analyzed. Evaluation of age-adjusted incidence rate, stage at presentation, and 5-year relative survival were determined for each histologic subtype. Results All rare histologic subtypes had younger mean age than adenocarcinomas (70 years; p<0.05). Lymphoma was more common in males (65.1%; P<0.01). Incidence rates in 2000 per million were: carcinoid 10.6, lymphoma 3.5, neuroendocrine 2.0, squamous 1.9, and adenocarcinoma 496.3. The annual percent change in incidence for each rare tumor increased significantly during the 10 years (range: 3.1–9.4%, p<0.05), except squamous cell carcinoma (5.9%, p>0.05). Squamous (93.4%) and carcinoid (73.7%) tumors occurred more often in the rectum; lymphoma (79.0%), neuroendocrine (70.8%), and adenocarcinoma (70.1%) occurred more often in the colon (P<0.01). Carcinoids presented at earlier stage (localized/regional, 90.5%) more often than adenocarcinoma (80.6%; p<0.01), but squamous cell (82.1%; p=0.50), lymphoma(70.6%; p<0.01), and neuroendocrine (37.8%; p<0.01) presented at earlier stage similarly or less often than adenocarcinoma. Relative 5-year survival rate was highest for carcinoid (91.3%), and lowest for neuroendocrine tumors (21.4%). Conclusion This study provides the first population-based analysis of the epidemiology, tumor characteristics, and survival rates for rare CRC. Presented at 2004 ASCRS Meeting, Dallas, Texas.     

The size of well differentiated pancreatic neuroendocrine tumors correlates with Ki67 proliferative index and is not associated with age

BackgroundConcerns exist about a conservative management of well-differentiated nonfunctioning small pancreatic neuroendocrine tumors (NF-PanNET) in young patients and when preoperative Ki67 proliferative index is ≥3%.AimTo evaluate an association between age, tumor size and grading in patients with sporadic NF-PanNET who underwent curative resection.MethodsPatients who underwent surgery for sporadic NF-PanNET (excluding G3) were retrospectively analyzed. Linear regression analysis was performed to evaluate a possible correlation between continuous variables, whereas multiple logistic regression analysis was performed for determining predictors of NF-PanNET-G2.ResultsOverall, 235 patients with NF-PanNET-G1/G2 were included. The median largest radiological diameter was 25 mm. Age correlated neither with tumor size (P = 0.675) nor with Ki67 index (P = 0.376). On multivariate linear regression analysis, factors independently associated with Ki67 index were NF-PanNET size (P = 0.031), perineural invasion (P = 0.004), microvascular invasion (P = 0.001) and necrosis (P = 0.009). The most accurate NF-PanNET size for predicting NF-PanNET-G2 was 25 mm. On multivariate analysis, a NF-PanNET size >25 mm was independently associated with the risk of having a PanNET-G2 (P = 0.025).ConclusionNo correlations exist between age and NF-PanNET size or proliferative index. Therefore, an a priori aggressive attitude is not justified in young patients with small NF-PanNET, as a long-life expectancy is probably unlikely to increase the risk of malignant transformation.