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Guo Z, Yang Z, Li D, Tang J, Xu J, Shen H, Yuan Y. Colorectal cancer with invasive micropapillary components (IMPCs) shows high lymph node metastasis and a poor prognosis: A retrospective clinical study. Medicine (Baltimore) 2020; 99:e20238. [PMID: 32481300 PMCID: PMC7249862 DOI: 10.1097/md.0000000000020238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTS The present study aimed to identify the clinicopathological characteristics of colorectal cancer (CRC) with invasive micropapillary components (IMPCs) and the relationship between different amounts of micropapillary components and lymph node metastasis. METHODS A cohort of 363 patients with CRC who underwent surgical treatment in the Second Affiliated Hospital of Zhejiang University School of Medicine between January 2013 and December 2016 were retrospectively reviewed. We compared the clinicopathological characteristics, including survival outcomes and immunohistochemical profiles (EMA, MUC1, MLH1, MSH2, MSH6, and PMS2), between CRC with IMPCs and those with conventional adenocarcinoma (named non-IMPCs in this study). Logistic regression was used to identify the association between IMPCs and lymph node invasion. A multivariate analysis was performed using the Cox proportional hazard model to evaluate significant survival predictors. RESULTS Among 363 patients, 76 cases had IMPCs, including 22 cases with a lower proportion of IMPCs (≤5%, IMPCs-L) and 54 cases with a higher proportion (>5%, IMPCs-H). Compared to the non-IMPC group, the IMPC group (including both IMPC-L and IMPC-H) had a lower degree of tumor differentiation (P = .000), a higher N-classification (P = .000), more venous invasion (P = .019), more perineural invasion (P = .025) and a later tumor node metastasis (TNM) stage (P = .000). Only tumor differentiation (P = .031) and tumor size (P = .022) were different between IMPCs-L and IMPCs-H. EMA/MUC1 enhanced the characteristic inside-out staining pattern of IMPCs, whereas non-IMPCs showed luminal staining patterns. The percentage of mismatch repair deficiency (dMMR) in the non-IMPC group was much higher than that in the IMPC group (14.7% vs 4.7%). The overall survival time of patients with IMPCs was significantly less than that of patients with non-IMPCs (P = .002), then that of IMPCs-H was lower than that of IMPCs-L (P = .030). Logistic regression revealed that patients with IMPCs were associated with lymph metastasis, regardless of the proportion of IMPCs. Multivariate analysis demonstrated both IMPCs-L and IMPCs-H as negative prognostic factors. CONCLUSIONS IMPCs are significantly associated with lymph node metastasis and poor outcome, and even a minor component (≤5%) may render significant information and should therefore be part of the pathology report.
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Affiliation(s)
- Zeying Guo
- Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine
- Department of Medical Oncology, Zhuji People's Hospital of Zhejiang Province, Zhuji
| | - Ziru Yang
- Department of Radiation Oncology, the Lihuili Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Dan Li
- Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, the Second Affiliated Hospital of Zhejiang University School of Medicine
| | - Jinlong Tang
- Department of Pathology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Jinghong Xu
- Department of Pathology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Hong Shen
- Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Ying Yuan
- Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, the Second Affiliated Hospital of Zhejiang University School of Medicine
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Patel N, Vyas M, Celli R, Jain D, Zhang X. Adverse Histologic Features in Colorectal Nonpedunculated Malignant Polyps With Nodal Metastasis. Am J Surg Pathol 2020; 44:241-246. [PMID: 31498179 DOI: 10.1097/pas.0000000000001369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Tumor differentiation, lymphovascular invasion, margin status, polyp shape, and size are important parameters of malignant polyps (pT1) indicating possible node metastasis, which justifies a surgery. However, the size, margin, and lymphovascular invasion are often unknown or difficult to assess in a piecemeal polypectomy from a nonpedunculated malignant polyp. The aim of the study was to identify adverse histologic features in nonpedunculated malignant polyps associated with an increased risk of nodal metastasis, which may warrant a colectomy procedure. A total of 24 node-positive and 18 node-negative nonpedunculated malignant polyps and their corresponding subsequent resection specimens from 2005 to 2018 were reviewed. Cases with node metastasis were more often positive for high-grade tumor budding (70.8% vs. 16.7%; P=0.0005), poorly differentiated clusters (54.2% vs. 22.2%; P=0.0369), and both high-grade tumor budding and poorly differentiated clusters (45.8% vs. 11.1%; P=0.0160) compared with controls without nodal metastasis. High-grade tumor budding, poorly differentiated clusters, and combined high-grade tumor budding and poorly differentiated clusters increased the risk of nodal metastasis, with odds ratio of 12.1, 4.1, and 14.3, respectively. Furthermore, nodal metastasis could be seen in subsequent colectomy specimen even in completely excised malignant polyps with adverse histologic features. Our findings indicate that high-grade tumor budding and poorly differentiated clusters are important adverse histologic risk features in predicting lymph node metastatic potential. These histologic features should be reported and it may warrant a colectomy when they are present.
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Affiliation(s)
- Natalie Patel
- Department of Pathology, Yale School of Medicine, New Haven, CT
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Colonic Manifestations and Complications Are Relatively Under-Reported in Systemic Sclerosis: A Systematic Review. Am J Gastroenterol 2019; 114:1847-1856. [PMID: 31805016 DOI: 10.14309/ajg.0000000000000397] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Although systemic sclerosis (SSc) is known to affect the gastrointestinal (GI) tract, most of the literature focuses on esophageal, small intestinal, or anorectal manifestations. There have been no reviews focused on large bowel SSc complications in over 30 years. The aim of this study is to perform a systematic review of colonic manifestations and complications of SSc. METHODS An experienced librarian conducted a search of databases, including English and Spanish articles. The search used keywords including "systemic sclerosis," "scleroderma," and "colon." A systematic review was performed using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Case reports/series were screened for validity by adapting from criteria published elsewhere. RESULTS Of 1,890 articles, 74 met selection criteria. Fifty-nine of the 77 articles were case reports/series. The most common article topics on colonic SSc complications were constipation/dysmotility (15), colonic volvulus (8), inflammatory bowel disease (7), microscopic colitis (6), megacolon (6), and telangiectasia (6). Colonic manifestations constituted 24% of articles on GI complications of SSc. There were a total of 85 cases (84% women, with a median age of onset of colon complication of 52 years). Limited cutaneous SSc phenotype (65.6%) was more common than diffuse (26.2%). Patients frequently had poor outcomes with high mortality related to colonic complications (27%). Recent studies explore contemporary topics such as the microbiome in SSc and prucalopride for chronic constipation in SSc. DISCUSSION Colonic complications comprise a large proportion of the published reports on GI symptoms afflicting patients with SSc and require raised diagnostic suspicion and deliberate action to avoid potentially serious complications including death.
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Vyas M, Patel N, Celli R, Wajapeyee N, Jain D, Zhang X. Glucose Metabolic Reprogramming and Cell Proliferation Arrest in Colorectal Micropapillary Carcinoma. Gastroenterology Res 2019; 12:128-134. [PMID: 31236153 PMCID: PMC6575135 DOI: 10.14740/gr1145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/30/2019] [Indexed: 12/24/2022] Open
Abstract
Background Micropapillary carcinoma (MPC) has been reported as an aggressive variant of colorectal carcinoma (CRC) associated with frequent lymphovascular invasion and poor outcome. Altered glycogen metabolism by metabolic reprogramming plays a critical role for cancer cell growth and survival. We aimed to investigate glucose metabolic reprogramming in colorectal MPC. Methods Immmunostains for Ki-67 and glucose transporter 1 (GLUT1) were performed on 10 colorectal MPCs. Real-time PCR analysis of expressions of GLUT1 and glycogen metabolizing enzymes: glycogen synthase (GYS1) and glycogen phosphorylase (PYGL) was performed on cultured monolayer and three-dimensional (3D) spheroid HCT116 colon cancer cells. Results GLUT1 was strongly expressed in MPC as compared to adjacent conventional glandular component, and was also significantly increased expression in 3D spheroids. Upregulation of GYS1 and PYGL was markedly increased in 3D spheroids. The proliferation rate (Ki-67) of MPC was significantly lower compared to conventional glandular component. The 3D spheroids showed increased cell cycle arrest. Our results demonstrate altered glycogen metabolism in colorectal MPC. Conclusion The reprogramming of glycogen metabolism in MPC provides a source of energy contributing to tumor cell survival in a low proliferation state. Targeting glucose-regulated metabolism may warrant consideration as possible MPC therapies.
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Affiliation(s)
- Monika Vyas
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Natalie Patel
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Romulo Celli
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Narendra Wajapeyee
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Dhanpat Jain
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Xuchen Zhang
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
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Ciocalteu A, Gheonea DI, Saftoiu A, Streba L, Dragoescu NA, Tenea-Cojan TS. Current strategies for malignant pedunculated colorectal polyps. World J Gastrointest Oncol 2018; 10:465-475. [PMID: 30595800 PMCID: PMC6304302 DOI: 10.4251/wjgo.v10.i12.465] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 02/05/2023] Open
Abstract
Despite significant advances in imaging techniques, the incidence of colorectal cancer has been increasing in recent years, with many cases still being diagnosed in advanced stages. Early detection and accurate staging remain the main factors that lead to a decrease in the cost and invasiveness of the curative techniques, significantly improving the outcome. However, the diagnosis of pedunculated early colorectal malignancy remains a current challenge. Data on the management of pedunculated cancer precursors, apart from data on nonpolypoid lesions, are still limited. An adequate technique for complete resection, which provides the best long-term outcome, is mandatory for curative intent. In this context, a discussion regarding the diagnosis of malignancy of pedunculated polyps, separate from non-pedunculated variants, is necessary. The purpose of this review is to provide a critical review of the most recent literature reporting the different features of malignant pedunculated colorectal polyps, including diagnosis and management strategies.
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Affiliation(s)
- Adriana Ciocalteu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Dan Ionut Gheonea
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Adrian Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Liliana Streba
- Department of Oncology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Nicoleta Alice Dragoescu
- Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Tiberiu Stefanita Tenea-Cojan
- Department of General Surgery, C.F. Clinical Hospital, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
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Gonzalez RS, Huh WJ, Cates JM, Washington K, Beauchamp RD, Coffey RJ, Shi C. Micropapillary colorectal carcinoma: clinical, pathological and molecular properties, including evidence of epithelial-mesenchymal transition. Histopathology 2017; 70:223-231. [PMID: 27560620 PMCID: PMC5921077 DOI: 10.1111/his.13068] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/24/2016] [Indexed: 02/03/2023]
Abstract
AIMS Colorectal carcinoma (CRC) with micropapillary (MP) features has only been described recently and is still being characterized. METHODS AND RESULTS We reviewed the clinicopathological and molecular features of 42 CRC with MP features. Twenty-nine cases were also evaluated for immunohistochemical evidence of epithelial-mesenchymal transition (EMT). The extent of MP features within our cohort ranged from 5% (13 cases) to 100% (one case). Twenty-seven cases featured prominent cribriforming with dirty necrosis in the non-MP component; nine displayed mucinous features. Twenty-four of 29 cases (83%) demonstrated evidence of EMT. Thirty-six cases (86%) showed advanced T-category (pT3 or pT4), 31 (74%) had lymph node metastases and 23 (55%) had distant metastases. Median overall follow-up was 36 months. Seventeen patients (40%) died of disease, with median survival of 23 months. Mutations were seen in 17 of 31 tested cases (55%), including 11 KRAS mutations and four BRAF V600E mutations. Microsatellite instability testing was performed on 21 cases; all were microsatellite-stable. Compared to a cohort of 972 conventional CRC, MP CRC was more likely to present as stage IV disease (P < 0.001), but patients with MP CRC showed no significant differences in overall survival after adjusting for stage. CONCLUSIONS Micropapillary features in CRC portend a high likelihood of advanced local disease and distant metastases. MP CRC is often associated with a cribriform pattern elsewhere in the tumour and cystic nodal metastases with prominent necrosis. They also show frequent mutations in KRAS and BRAF. Immunohistochemical evidence of EMT is common in MP CRC.
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Affiliation(s)
- Raul S. Gonzalez
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY
| | - Won Jae Huh
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Justin M.M. Cates
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Kay Washington
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - R. Daniel Beauchamp
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN
| | - Robert J. Coffey
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Chanjuan Shi
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN
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Reversed polarity of the glandular epithelial cells in micropapillary carcinoma of the large intestine and the EMA/MUC1 immunostain. Pathology 2016; 46:527-32. [PMID: 25158820 DOI: 10.1097/pat.0000000000000144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Micropapillary carcinoma of the colon and rectum is associated with an adverse prognosis. This tumour type displays reverse polarity of the tumour cells and is stated to be characterised by an inside-out epithelial membrane antigen (EMA)/MUC1 staining. Nine cases of primary colorectal carcinoma and one omental metastasis were studied by means of immunohistochemistry, using antibodies to detect EMA, MUC1, MUC2, MUC3, MUC5AC, MUC6, CD10, CA125, carcinoembryonic antigen (CEA). The inside-out pattern staining with EMA/MUC1 ranged from diffuse circumferential through focal and partial to negative, but in some cases CEA, MUC3 and CD10 also showed this pattern staining, sometimes more clearly than did EMA or MUC1. The reverse polarity of colorectal micropapillary carcinomas is sometimes better visualised by immunostains other than EMA/MUC1.
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Miyaoka Y, Fujiwara A, Kotani S, Tsukano K, Ogawa S, Yamanouchi S, Kusunoki R, Fujishiro H, Kohge N, Yamamoto T, Amano Y. Primary micropapillary carcinoma of the colon with submucosal invasion: A case report. Endosc Int Open 2016; 4:E744-7. [PMID: 27556088 PMCID: PMC4993887 DOI: 10.1055/s-0042-106721] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/11/2016] [Indexed: 12/27/2022] Open
Abstract
We present a case of invasive micropapillary carcinoma (IMPC) of the colon treated by endoscopic resection following magnifying endoscopy. A 47-year-old woman visited our hospital for follow-up of a positive fecal occult blood test. Colonoscopy revealed a semi-pedunculated reddish polyp, the surface of which showed gentle irregularity, and mild tension in the sigmoid colon. Magnifying colonoscopy with narrow band imaging revealed an irregular surface pattern with heterogeneity in vascular diameter and distribution. Magnifying endoscopic findings using crystal violet staining showed an irregular pit pattern with an expansion of stromal areas. Endoscopic resection of the sigmoid colon tumor was performed, and the histology of the resected specimen primarily revealed a micropapillary component with a small moderately differentiated adenocarcinoma component that massively invaded into the submucosal layer, accompanied by lymphatic invasion, although the tumor was very small (7 mm in diameter, smaller than any in previous reports). Laparoscopy-assisted sigmoidectomy and regional lymph node resection were performed; neither cancer nor lymph node metastases were present. This is the first report of a case with early-stage colonic IMPC observed with magnifying colonoscopy.
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Affiliation(s)
- Youichi Miyaoka
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan ,Corresponding author Yoichi Miyaoka, MD, PhD Division of Endoscopy, Shimane Prefectural Central Hospital4-1-1 Himebara, Izumo 693-8555, ShimaneJapan+81-0853-22-5111+81-0853-21-2197
| | - Aya Fujiwara
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Kotani
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Kosuke Tsukano
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Sayaka Ogawa
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Yamanouchi
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Ryusaku Kusunoki
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Hirofumi Fujishiro
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Naruaki Kohge
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tomohiko Yamamoto
- Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan
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Barresi V, Branca G, Vitarelli E, Tuccari G. Micropapillary pattern and poorly differentiated clusters represent the same biological phenomenon in colorectal cancer: a proposal for a change in terminology. Am J Clin Pathol 2014; 142:375-83. [PMID: 25125629 DOI: 10.1309/ajcpfea7ka0sbbna] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Colorectal carcinomas (CRCs) with a micropapillary pattern and those showing high counts of poorly differentiated clusters (PDCs) are characterized by a higher probability to develop nodal metastases and have a worse prognosis. In light of the morphologic similarity to the micropapillary component, we aimed to verify whether PDCs also display an inverted secretory pattern. METHODS The immunohistochemical expression of MUC1 and E-cadherin was assessed in a cohort of CRCs with PDCs and compared with that observed in CRCs without PDCs. RESULTS PDCs in our cases always displayed an inverted MUC1 pattern. In addition, we found abnormal (lost or cytoplasmic) expression of E-cadherin in PDCs. CONCLUSIONS The altered expression of MUC1 and E-cadherin may account for the aggressive behavior and higher metastatic potential of CRCs with high PDC counts and indicate an epithelial-mesenchymal transition. Our findings suggest that regardless of the morphologic aspect, PDCs and the micropapillary component may reflect the same biological phenomenon in CRCs. Thus, we wonder whether the micropapillary areas should be considered a variant of CRCs or more objectively counted as PDCs to predict prognosis. We also believe that the term PDC better describes the biological phenomena underlying this peculiar morphologic aspect in comparison with the misnomer micropapillary.
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Affiliation(s)
- Valeria Barresi
- From the Department of Human Pathology "Gaetano Barresi," University of Messina, Messina, Italy.
| | - Giovanni Branca
- From the Department of Human Pathology "Gaetano Barresi," University of Messina, Messina, Italy
| | - Enrica Vitarelli
- From the Department of Human Pathology "Gaetano Barresi," University of Messina, Messina, Italy
| | - Giovanni Tuccari
- From the Department of Human Pathology "Gaetano Barresi," University of Messina, Messina, Italy
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Guzińska-Ustymowicz K, Niewiarowska K, Pryczynicz A. Invasive micropapillary carcinoma: A distinct type of adenocarcinomas in the gastrointestinal tract. World J Gastroenterol 2014; 20:4597-4606. [PMID: 24782612 PMCID: PMC4000496 DOI: 10.3748/wjg.v20.i16.4597] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 03/19/2014] [Indexed: 02/06/2023] Open
Abstract
Invasive micropapillary carcinoma (IMPC) is a rare histological type of tumor, first described in invasive ductal breast cancer, than in malignancies in other organs such as lungs, urinary bladder, ovaries or salivary glands. Recent literature data shows that this histological lesion has also been found in cancers of the gastrointestinal system. The micropapillary components are clusters of neoplastic cells that closely adhere to each other and are located in distinct empty spaces. Moreover, clusters of neoplastic cells do not have a fibrous-vascular core. The IMPC cells show reverse polarity resulting in typical ‘’inside-out’’ structures that determines secretary properties, disturbs adhesion and conditions grade of malignancy in gastrointestinal (GI) tract. Invasive micropapillary carcinoma in this location is associated with metastases to local lymph nodes and lymphovascular invasion. IMPC can be a prognostic factor for patients with cancers of the stomach, pancreas and with colorectal cancer since it is related with disease-free and overall survival. The purpose of this review is to present the characterization of invasive micropapillary carcinoma in colon, rectum, stomach and others site of GI tract, and to determine the immunohistological indentification of IMPC in those localization.
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Invasive micropapillary carcinoma of the ascending colon--a report of a case. Int Surg 2011; 96:82-6. [PMID: 21675626 DOI: 10.9738/1355.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Micropapillary carcinoma (MC) has been recently recognized to be a rare but distinctive variant of adenocarcinoma. At present, only a limited number of colorectal MC cases have been reported. We present a case of MC of the ascending colon with distant metastasis. A 61-year-old female patient was hospitalized with a complaint of abdominal pain. A diagnostic work-up revealed cancer of the ascending colon with multiple lung metastases. The patient underwent a right hemicolectomy with lymph node dissection. A peritoneal nodule was observed in the abdominal cavity during surgery, and this nodule was also resected. The pathologic findings of the colon tumor revealed components of conventional tubular adenocarcinoma and micropapillary carcinoma. Lymph nodes and a peritoneal nodule revealed tubular adenocarcinoma. MC is a rare disease but has high malignant potential. In the present case the tumor was small in size, but the patient had a peritoneal and multiple lung metastases.
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Primary micropapillary carcinoma of the colon: a case report and literature review. Clin J Gastroenterol 2011; 4:99-103. [DOI: 10.1007/s12328-011-0211-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
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