What Is a Gastrointestinal Carcinoid Tumor?
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The Homeobox Intestinal Differentiation Factor CDX2 Is Selectively Expressed in Gastrointestinal Adenocarcinomas
Modern Pathology (2004) 17, 1392–1399 & 2004 USCAP, Inc All rights reserved 0893-3952/04 $30.00 www.modernpathology.org The homeobox intestinal differentiation factor CDX2 is selectively expressed in gastrointestinal adenocarcinomas Vassil Kaimaktchiev1, Luigi Terracciano2, Luigi Tornillo2, Hanspeter Spichtin3, Dimitra Stoios2, Marcel Bundi2, Veselina Korcheva1, Martina Mirlacher2, Massimo Loda4, Guido Sauter2 and Christopher L Corless1 1OHSU Cancer Institute and Department of Pathology, Oregon Health & Science University, Portland, OR, USA; 2Institute of Pathology, University Hospital Basel, Basel, Switzerland; 3Institute of Clinical Pathology, Basel, Switzerland and 4Department of Pathology, Brigham & Women’s Hospital, Boston, MA, USA CDX2 is a homeobox domain-containing transcription factor that is important in the development and differentiation of the intestines. Based on recent studies, CDX2 expression is immunohistochemically detectable in normal colonic enterocytes and is retained in most, but not all, colorectal adenocarcinomas. CDX2 expression has also been documented in a subset of adenocarcinomas arising in the stomach, esophagus and ovary. In this study, we examined CDX2 expression in a series of large tissue microarrays representing 4652 samples of normal and neoplastic tissues. Strong nuclear staining for CDX2 was observed in 97.9% of 140 colonic adenomas, 85.7% of 1109 colonic adenocarcinomas overall and 81.8% of 55 mucinous variants. There was no significant difference in the staining of well-differentiated (96%) and moderately differentiated tumors (90.8%, P ¼ 0.18), but poorly differentiated tumors showed reduced overall expression (56.0%, Po0.000001). Correspondingly, there was an inverse correlation between CDX2 expression and tumor stage, with a significant decrease in staining between pT2 and pT3 tumors (95.8 vs 89.0%, Po0.012), and between pT3 and pT4 tumors (89.0 vs 79.8%, Po0.016). -
Carcinoid) Tumours Gastroenteropancreatic
Downloaded from gut.bmjjournals.com on 8 September 2005 Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours J K Ramage, A H G Davies, J Ardill, N Bax, M Caplin, A Grossman, R Hawkins, A M McNicol, N Reed, R Sutton, R Thakker, S Aylwin, D Breen, K Britton, K Buchanan, P Corrie, A Gillams, V Lewington, D McCance, K Meeran, A Watkinson and on behalf of UKNETwork for neuroendocrine tumours Gut 2005;54;1-16 doi:10.1136/gut.2004.053314 Updated information and services can be found at: http://gut.bmjjournals.com/cgi/content/full/54/suppl_4/iv1 These include: References This article cites 201 articles, 41 of which can be accessed free at: http://gut.bmjjournals.com/cgi/content/full/54/suppl_4/iv1#BIBL Rapid responses You can respond to this article at: http://gut.bmjjournals.com/cgi/eletter-submit/54/suppl_4/iv1 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at the service top right corner of the article Topic collections Articles on similar topics can be found in the following collections Stomach and duodenum (510 articles) Pancreas and biliary tract (332 articles) Guidelines (374 articles) Cancer: gastroenterological (1043 articles) Liver, including hepatitis (800 articles) Notes To order reprints of this article go to: http://www.bmjjournals.com/cgi/reprintform To subscribe to Gut go to: http://www.bmjjournals.com/subscriptions/ Downloaded from gut.bmjjournals.com on 8 September 2005 iv1 GUIDELINES Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours J K Ramage*, A H G Davies*, J ArdillÀ, N BaxÀ, M CaplinÀ, A GrossmanÀ, R HawkinsÀ, A M McNicolÀ, N ReedÀ, R Sutton`, R ThakkerÀ, S Aylwin`, D Breen`, K Britton`, K Buchanan`, P Corrie`, A Gillams`, V Lewington`, D McCance`, K Meeran`, A Watkinson`, on behalf of UKNETwork for neuroendocrine tumours .............................................................................................................................. -
Pancreatic Cancer
PANCREATIC CANCER What is cancer? Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells develop because of damage to DNA. This substance is in every cell and directs all its activities. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. Many times though, a person’s DNA becomes damaged by exposure to something in the environment, like smoking. Cancer usually forms as a tumor. Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow. Often, cancer cells travel to other parts of the body, where they begin to grow and replace normal tissue. This process is called metastasis. Regardless of where a cancer may spread, however, it is always named for the place it began. -
What You Should Know About Familial Adenomatous Polyposis (FAP)
What you should know about Familial Adenomatous Polyposis (FAP) FAP is a very rare condition that accounts for about 1% of new cases of colorectal cancer. People with FAP typically develop hundreds to thousands of polyps (adenomas) in their colon and rectum by age 30-40. Polyps may also develop in the stomach and small intestine. Individuals with FAP can develop non-cancerous cysts on the skin (epidermoid cysts), especially on the scalp. Besides having an increased risk for colon polyps and cysts, individuals with FAP are also more likely to develop sebaceous cysts, osetomas (benign bone tumors) of the jaw, impacted teeth, extra teeth, CHRPE (multiple areas of pigmentation in the retina in the eye) and desmoid disease. Some individuals have milder form of FAP, called attenuated FAP (AFAP), and develop an average of 20 polyps at a later age. The risk for cancer associated with FAP If left untreated, the polyps in the colon and rectum will develop in to cancer, usually before age 50. Individuals with FAP also have an increased risk for stomach cancer, papillary thyroid cancer, periampullary carcinoma, hepatoblastoma (in childhood), and brain tumors. The risks to family members FAP is caused by mutations in the Adenomatous Polyposis Coli (APC) gene. Approximately 1/3 of people with FAP do not have family history of the disease, and thus have a new mutation. FAP is inherited in a dominant fashion. Children of a person with an APC mutation have a 50% risk to inherit the mutation. Brothers, sisters, and parents of individuals with FAP should also be checked to see if they have an APC mutation. -
Tumour-Agnostic Therapy for Pancreatic Cancer and Biliary Tract Cancer
diagnostics Review Tumour-Agnostic Therapy for Pancreatic Cancer and Biliary Tract Cancer Shunsuke Kato Department of Clinical Oncology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; [email protected]; Tel.: +81-3-5802-1543 Abstract: The prognosis of patients with solid tumours has remarkably improved with the develop- ment of molecular-targeted drugs and immune checkpoint inhibitors. However, the improvements in the prognosis of pancreatic cancer and biliary tract cancer is delayed compared to other carcinomas, and the 5-year survival rates of distal-stage disease are approximately 10 and 20%, respectively. How- ever, a comprehensive analysis of tumour cells using The Cancer Genome Atlas (TCGA) project has led to the identification of various driver mutations. Evidently, few mutations exist across organs, and basket trials targeting driver mutations regardless of the primary organ are being actively conducted. Such basket trials not only focus on the gate keeper-type oncogene mutations, such as HER2 and BRAF, but also focus on the caretaker-type tumour suppressor genes, such as BRCA1/2, mismatch repair-related genes, which cause hereditary cancer syndrome. As oncogene panel testing is a vital approach in routine practice, clinicians should devise a strategy for improved understanding of the cancer genome. Here, the gene mutation profiles of pancreatic cancer and biliary tract cancer have been outlined and the current status of tumour-agnostic therapy in these cancers has been reported. Keywords: pancreatic cancer; biliary tract cancer; targeted therapy; solid tumours; driver mutations; agonist therapy Citation: Kato, S. Tumour-Agnostic Therapy for Pancreatic Cancer and 1. -
Diet, Nutrition, Physical Activity and Stomach Cancer
Analysing research on cancer prevention and survival Diet, nutrition, physical activity and stomach cancer 2016 Revised 2018 Contents World Cancer Research Fund Network 3 1. Summary of Panel judgements 9 2. Trends, incidence and survival 10 3. Pathogenesis 11 4. Other established causes 14 5. Interpretation of the evidence 14 5.1 General 14 5.2 Specific 15 6. Methodology 15 6.1 Mechanistic evidence 16 7. Evidence and judgements 16 7.1 Low fruit intake 16 7.2 Citrus fruit 19 7.3 Foods preserved by salting 21 7.3.1 Salt-preserved vegetables 21 7.3.2 Salt-preserved fish 23 7.3.3 Salt-preserved foods 24 7.3.4 Foods preserved by salting: Summary 26 7.4 Processed meat 27 7.5 Alcoholic drinks 30 7.6 Grilled (broiled) and barbecued (charboiled) animal foods 35 7.7 Body fatness 36 7.8 Other 41 8. Comparison Report 42 9. Conclusions 42 Acknowledgements 44 Abbreviations 46 Glossary 47 References 52 Appendix: Criteria for grading evidence for cancer prevention 57 Our Cancer Prevention Recommendations 61 WORLD CANCER RESEARCH FUND NETWORK OUR VISION We want to live in a world where no one develops a preventable cancer. OUR MISSION We champion the latest and most authoritative scientific research from around the world on cancer prevention and survival through diet, weight and physical activity, so that we can help people make informed choices to reduce their cancer risk. As a network, we influence policy at the highest level and are trusted advisors to governments and to other official bodies from around the world. -
Case Report Metastasis of Pancreatic Cancer Within Primary Colon Cancer by Overtaking the Stromal Microenvironment
Int J Clin Exp Pathol 2018;11(6):3141-3146 www.ijcep.com /ISSN:1936-2625/IJCEP0075771 Case Report Metastasis of pancreatic cancer within primary colon cancer by overtaking the stromal microenvironment Takeo Nakaya1, Hisashi Oshiro1, Takumi Saito2, Yasunaru Sakuma2, Hisanaga Horie2, Naohiro Sata2, Akira Tanaka1 Departments of 1Pathology, 2Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan Received March 10, 2018; Accepted April 15, 2018; Epub June 1, 2018; Published June 15, 2018 Abstract: We report a unique case of a 74-old man, who presented with double cancers, showing metastasis of pancreatic cancer to colon cancer. Histopathological examination after surgery revealed that the patient had as- cending colon cancer, which metastasized to the liver (pT4N0M1), as well as pancreatic cancer (pT2N1M1) that metastasized to the most invasive portion of the colon cancer, namely the serosal to subserosal layers. Although the mechanisms for this scenario have yet to be elucidated, we speculate that the metastatic pancreatic carcinoma overtook the stromal microenvironment of the colon cancer. Namely, the cancer microenvironment enriched by can- cer-associated fibroblasts, which supported the colon cancer, might be suitable for the invasion and engraftment by pancreatic carcinoma. The similarity of histological appearance might make it difficult to distinguish metastatic pancreatic carcinoma within colon cancer. Furthermore, the metastasis of pancreatic carcinoma in colon carcinoma might be more common, despite it not having been previously reported. Keywords: Cancer metastasis, metastatic pancreatic cancer, colon cancer, double cancer, tumor microenviron- ment Introduction Case report Prevention and control of cancer metastasis is Clinical history one of the most important problems in cancer care [1-4]. -
The SOLID-TIMI 52 Randomized Clinical Trial
RM2007/00497/06 CONFIDENTIAL The GlaxoSmithKline group of companies SB-480848/033 Division: Worldwide Development Information Type: Protocol Amendment Title: A Clinical Outcomes Study of Darapladib versus Placebo in Subjects Following Acute Coronary Syndrome to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) (Short title: The Stabilization Of pLaques usIng Darapladib- Thrombolysis In Myocardial Infarction 52 SOLID-TIMI 52 Trial) Compound Number: SB-480848 Effective Date: 26-FEB-2014 Protocol Amendment Number: 05 Subject: atherosclerosis, Lp-PLA2 inhibitor, acute coronary syndrome, SB-480848, darapladib Author: The protocol was developed by the members of the Executive Steering Committee on behalf of GlaxoSmithKline (MPC Late Stage Clinical US) in conjunction with the Sponsor. The following individuals provided substantial input during protocol development: Non-sponsor: Braunwald, Eugene (TIMI Study Group, USA); Cannon, Christopher P (TIMI Study Group, USA); McCabe, Carolyn H (TIMI Study Group, USA); O’Donoghue, Michelle L (TIMI Study Group, USA); White, Harvey D (Green Lane Cardiovascular Service, New Zealand); Wiviott, Stephen (TIMI Study Group, USA) Sponsor: Johnson, Joel L (MPC Late Stage Clinical US); Watson, David F (MPC Late Stage Clinical US); Krug-Gourley, Susan L (MPC Late Stage Clinical US); Lukas, Mary Ann (MPC Late Stage Clinical US); Smith, Peter M (MPC Late Stage Clinical US); Tarka, Elizabeth A (MPC Late Stage Clinical US); Cicconetti, Gregory (Clinical Statistics (US)); Shannon, Jennifer B (Clinical Statistics (US)); Magee, Mindy H (CPMS US) Copyright 2014 the GlaxoSmithKline group of companies. All rights reserved. Unauthorised copying or use of this information is prohibited. 1 Downloaded From: https://jamanetwork.com/ on 09/24/2021 RM2007/00497/06 CONFIDENTIAL The GlaxoSmithKline group of companies SB-480848/033 Revision Chronology: RM2007/00497/01 2009-OCT-08 Original RM2007/00497/02 2010-NOV-30 Amendment 01: The primary intent is to revise certain inclusion and exclusion criteria. -
Pancreatic Cancer
A Patient’s Guide to Pancreatic Cancer COMPREHENSIVE CANCER CENTER Staff of the Comprehensive Cancer Center’s Multidisciplinary Pancreatic Cancer Program provided information for this handbook GI Oncology Program, Patient Education Program, Gastrointestinal Surgery Department, Medical Oncology, Radiation Oncology and Surgical Oncology Digestive System Anatomy Esophagus Liver Stomach Gallbladder Duodenum Colon Pancreas (behind the stomach) Anatomy of the Pancreas Celiac Plexus Pancreatic Duct Common Bile Duct Sphincter of Oddi Head Body Tail Pancreas ii A Patient’s Guide to Pancreatic Cancer ©2012 University of Michigan Comprehensive Cancer Center Table of Contents I. Overview of pancreatic cancer A. Where is the pancreas located?. 1 B. What does the pancreas do? . 2 C. What is cancer and how does it affect the pancreas? .....................2 D. How common is pancreatic cancer and who is at risk?. .3 E. Is pancreatic cancer hereditary? .....................................3 F. What are the symptoms of pancreatic cancer? ..........................4 G. How is pancreatic cancer diagnosed?. 7 H. What are the types of cancer found in the pancreas? .....................9 II. Treatment A. Treatment of Pancreatic Cancer. 11 1. What are the treatment options?. 11 2. How does a patient decide on treatment? ..........................12 3. What factors affect prognosis and recovery?. .12 D. Surgery. 13 1. When is surgery a treatment?. 13 2. What other procedures are done?. .16 E. Radiation therapy . 19 1. What is radiation therapy? ......................................19 2. When is radiation therapy given?. 19 3. What happens at my first appointment? . 20 F. Chemotherapy ..................................................21 1. What is chemotherapy? ........................................21 2. How does chemotherapy work? ..................................21 3. When is chemotherapy given? ...................................21 G. -
Endocrine Tumors of the Pancreas
Friday, November 4, 2005 8:30 - 10:30 a. m. Pancreatic Tumors, Session 2 Chairman: R. Jensen, Bethesda, MD, USA 9:00 - 9:30 a. m. Working Group Session Pathology and Genetics Group leaders: J.–Y. Scoazec, Lyon, France Questions to be answered: 12 Medicine and Clinical Pathology Group leader: K. Öberg, Uppsala, Sweden Questions to be answered: 17 Surgery Group leader: B. Niederle, Vienna, Austria Questions to be answered: 11 Imaging Group leaders: S. Pauwels, Brussels, Belgium; D.J. Kwekkeboom, Rotterdam, The Netherlands Questions to be answered: 4 Color Codes Pathology and Genetics Medicine and Clinical Pathology Surgery Imaging ENETS Guidelines Neuroendocrinology 2004;80:394–424 Endocrine Tumors of the Pancreas - gastrinoma Epidemiology The incidence of clinically detected tumours has been reported to be 4-12 per million inhabitants, which is much lower than what is reported from autopsy series (about 1%) (5,13). Clinicopathological staging (12, 14, 15) Well-differentiated tumours are the large majority of which the two largest fractions are insulinomas (about 40% of cases) and non-functioning tumours (30-35%). When confined to the pancreas, non-angioinvasive, <2 cm in size, with <2 mitoses per 10 high power field (HPF) and <2% Ki-67 proliferation index are classified as of benign behaviour (WHO group 1) and, with the notable exception of insulinomas, are non-functioning. Tumours confined to the pancreas but > 2 cm in size, with angioinvasion and /or perineural space invasion, or >2mitoses >2cm in size, >2 mitoses per 20 HPF or >2% Ki-67 proliferation index, either non-functioning or functioning (gastrinoma, insulinoma, glucagonoma, somastatinoma or with ectopic syndromes, such as Cushing’s syndrome (ectopic ACTH syndrome), hypercaliemia (PTHrpoma) or acromegaly (GHRHoma)) still belong to the (WHO group 1) but are classified as tumours with uncertain behaviour. -
Coping with Stomach Cancer
COPING WITH STOMACH CANCER 800-813-HOPE (4673) [email protected] www.cancercare.org A diagnosis of stomach cancer can leave you and your loved ones feeling uncertain, anxious and overwhelmed. There are important treatment decisions to make, emotional concerns to manage, and insurance and financial paperwork to organize, among other practical concerns. It is helpful to keep in mind that there are many sources of information and support for people coping with stomach cancer. By learning about this diagnosis and its treatment options, communicating with your health care team, and surrounding yourself with a support network, you will be better able to manage your stomach cancer and experience a better quality of life. UNDERSTANDING YOUR THE IMPORTANCE OF DIAGNOSIS AND COMMUNICATING WITH YOUR TREATMENT PLAN HEALTH CARE TEAM Stomach cancer occurs when the Because stomach cancer is a complex cells found in the stomach begin to condition with complex treatment change and grow uncontrollably, options, good communication between forming a tumor (also called you and your health care team is key. a nodule), which can be either Your oncologist, nurses, and other cancerous or benign. The main members of your health care team types of stomach cancer are work together to treat your stomach adenocarcinoma, lymphoma, cancer. Since medical appointments carcinoid tumor and gastrointestinal are the main time you will interact stromal tumor (GIST). with your team, being as prepared as possible for these visits is important. There are a wide range of It will help ensure that you understand treatments for stomach cancer, your diagnosis and treatment, get including surgery, targeted therapy, answers to your questions, and feel chemotherapy and radiation therapy. -
FDG PET/CT in Pancreatic and Hepatobiliary Carcinomas Value to Patient Management and Patient Outcomes
FDG PET/CT in Pancreatic and Hepatobiliary Carcinomas Value to Patient Management and Patient Outcomes Ujas Parikh, MAa, Charles Marcus, MDa, Rutuparna Sarangi, MAa, Mehdi Taghipour, MDa, Rathan M. Subramaniam, MD, PhD, MPHa,b,c,* KEYWORDS 18F-FDG PET/CT Pancreatic cancer Hepatocellular carcinoma KEY POINTS Fludeoxyglucose F 18 (18F-FDG) PET/CT has not been shown to offer additional benefit in the initial diagnosis of pancreatic cancer, but studies show benefit of 18F-FDG PET/CT in staging, particularly in the detection of distant metastasis, and in patient prognosis. There is good evidence for 18F-FDG PET and 18F-FDG PET/CT in the staging and prognosis of both cholangiocarcinoma and gallbladder cancer. 18F-FDG PET/CT has shown promise in the staging of liver malignancies by detecting extrahepatic metastasis. There is good evidence supporting the ability of PET/CT in predicting prognosis in patients with hepatocellular carcinoma (HCC). Evidence is evolving for the role of 18F-FDG PET/CT in predicting prognosis and survival in patients with colorectal liver metastasis (CRLM). INTRODUCTION the time of diagnosis, only 20% of tumors are curative with resection.2 Invasive ductal adenocar- Pancreatic cancer is the tenth most common cinoma is the most common pancreatic malig- malignancy and fourth most common cause of nancy, accounting for more than 80% of cancer deaths in the United States, with a lifetime 1 pancreatic cancers. Other less common malig- risk of 1.5%. It was estimated that 46,420 people nancies include neuroendocrine tumors and were expected to be diagnosed with pancreatic exocrine acinar cell neoplasms.3,4 Although smok- cancer in the United States in 2014.