Dipeptidyl Peptidase 10, a Novel Prognostic Marker in Colorectal Cancer

PURPOSE: The dipeptidyl peptidase IV (DPPIV) gene family exhibits multiple functions and is involved in the pathogenesis of various diseases. It has attracted pharmaceutical interest in the areas of metabolic disorders as well as cancer. However, clinicopathologic significance of DPPIV family in colorectal cancer is not fully understood. MATERIALS AND METHODS: The clinical relevance of DPPIV and DPP10 expression was determined by immunohistochemical staining, and by assessing its clinicopathologic correlation in 383 colorectal cancer patients with known clinical outcomes. RESULTS: DPPIV was not expressed in normal colon mucosa, but it showed luminal expression in 52 of the 383 colorectal cancers (13.5%). DPPIV expression in tumors was associated with right-sided location of the colon (p=0.010) and more advanced tumor stage (p=0.045). DPP10 was expressed in normal colonic mucosa, but its expression varied in primary colorectal cancer tissues. Loss of DPP10 expression was found in 11 colorectal cancers (CRCs) (2.9%), and multivariate analysis showed that loss of DPP10 expression was an independent factor for poor patient prognosis (p=0.008). CONCLUSION: DPP10 may play a role in disease progression of colorectal cancer and loss of DPP10 expression in primary CRC is significantly associated with poor survival outcomes.ope

Treatment Response and Long Term Follow-up Results of Nonspecific Interstitial Pneumonia

The purpose of this study was to investigate the long-term clinical course of non-specific interstitial pneumonia (NSIP) and to determine which factors are associated with a response to steroid therapy and relapse. Thirty-five patients with pathologically proven NSIP were included. Clinical, radiological, and laboratory data were reviewed retrospectively. The male-to-female ratio was 7:28 (median age, 52 yr). Thirty (86%) patients responded to steroid therapy, and the median follow-up was 55.2 months (range, 15.9-102.0 months). Five patients (14%) showed sustained disease progression and three died despite treatment. In the five with sustained disease progression, NSIP was associated with various systemic conditions, and the seropositivity of fluorescent antinuclear antibody was significantly associated with a poor response to steroids (P = 0.028). The rate of relapse was 25%, but all relapsed patients improved after re-treatment. The initial dose of steroids was significantly low in the relapse group (P = 0.020). In conclusion, progression is associated with various systemic conditions in patients who show progression. A low dose of initial steroids is significantly associated with relapse.ope

Tumor budding and recurrence in submucosal invasive colorectal cancers of favorable histology: case reports of two early colorectal cancers with advanced recurrences

Complete resection of submucosal invasive colorectal cancer (SICC) showing favorable histology is regarded as curative. We report on two cases of SICC showing recurrence within 5 years despite complete resection. The first patient was a 68-year-old woman with well differentiated rectal adenocarcinoma invading the superficial submucosa, which recurred after 4.7 years. The second patient was a 53-year-old man with pT1N0 moderately differentiated colonic adenocarcinoma. He developed widespread tumor recurrence after 3.9 years. Retrospective pathologic review of the original tumors showed multiple foci of tumor budding at the invasive front. Immunohistochemical staining for D2-40 of deeper levels of the paraffin blocks showed rare foci of small lymphatic invasion. Tumor budding at the invasive front may be an important indicator for SICC aggressiveness or may reflect early lymphatic invasion. More aggressive pathologic examination and follow-up is required for patients with SICC showing tumor budding, even in the absence of unfavorable histologic findings.ope

Comparative analyses of overall survival in patients with anaplastic lymphoma kinase-positive and matched wild-type advanced nonsmall cell lung cancer.

BACKGROUND: The purpose of this study was to investigate the overall survival (OS) of patients with advanced ALK-positive nonsmall cell lung cancer (NSCLC) who were managed in the pre-ALK inhibitor era and to compare their survival with that of a matched case cohort of ALK wild-type (WT) patients. METHODS: Data from 1166 patients who had stage IIIB/IV NSCLC with nonsquamous histology were collected from the NSCLC database of Seoul National University Hospital between 2003 and 2009. ALK fluorescence in situ hybridization (FISH) was used to analyze 262 patients who either had the WT epidermal growth factor receptor (EGFR) or were nonresponders to previous EGFR tyrosine kinase inhibitor (TKI) therapy. Overall survival (OS) was compared between 3 groups: 1) ALK-positive patients, 2) EGFR mutation-positive patients, and 3) ALK-WT/EGFR-WT patients. Progression-free survival (PFS) after first-line chemotherapy and EGFR TKIs also was analyzed. RESULTS: Twenty-three patients were ALK-positive according to FISH analysis and did not receive ALK inhibitors during follow-up. The median OS for ALK-positive patients, EGFR mutation-positive patients, and WT/WT patients was 12.2 months, 29.6 months, and 19.3 months, respectively (vs EGFR mutation-positive patients, P = .001; vs WT/WT, P = .127). The PFS after first-line chemotherapy for the 3 groups was not different. However, the PFS for patients who received EGFR TKIs was shorter in ALK-positive patients compared with the other 2 groups (vs EGFR mutation-positive patients, P < .001; vs WT/WT, P < .021). CONCLUSIONS: In the pre-ALK inhibitor era, ALK-positive patients experienced the shortest survival, although it did not differ statistically from that of WT/WT patients. Although their responses to platinum-based chemotherapy were not different from comparator groups, ALK-positive patients were even more resistant to EGFR TKI treatment than WT/WT patients.ope

Indicators and Qualitative Assessment of Lung Cancer Management by Health Insurance Review and Assessment Service (HIRA) of Korea in 2015

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.ope

Metastatic endobronchial adenocarcinoma from the uterine cervix verified by human papillomavirus genotyping

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A Case of Adenocarcinomatous Transformation of a Sacrococcygeal Teratoma in an Adult

Sacrococcygeal teratoma (SCT) is an unusual tumor in adults. The incidence of malignant transformation of this tumor increases when its excision is delayed beyond 1 month of age. We report an uncommon case of adenocarcinoma arising within the colonic mucosa of a mature teratoma of the sacrococcyx in a 44-year-old male. The patient received surgical resection for a sacrococcygeal mass in a local hospital and was diagnosed with adenocarcinoma arising from SCT. He was referred to our hospital for further treatment and received chemotherapy as adjuvant treatment. After 4.5 years, the coccygeal mass recurred on follow-up imaging workup, and surgical resection was performed. On pathologic work-up, residual disease at the resection margin was identified microscopically. Pathologic diagnosis was a primary adenocarcinoma arising from the colonic mucosa within a mature teratoma. The patient received adjuvant-chemotherapy and radiotherapy and has been followed up.ope

A low grade fibromyxoid sarcoma originating from the masseter muscle: a case report

INTRODUCTION: Low grade fibromyxoid sarcoma is a distinctive variant of fibrosarcoma. We recently experienced a rare case of low grade fibromyxoid sarcoma arising in the masseter muscle. CASE PRESENTATION: A 63-year-old Korean woman with a large growing mass in her right parotid gland area for 1 year visited our clinic. Complete removal of the tumor was achieved by parotidectomy with facial nerve preservation. The tumor measured over 4cm with pathologic findings compatible with low grade fibromyxoid sarcoma. CONCLUSIONS: Low grade fibromyxoid sarcoma is an extremely rare tumor, and report of the present case is noteworthy since it represents a rare localization of low grade fibromyxoid sarcoma in the head and neck. Close follow up on a long-term basis is considered necessary because of its high potential to metastasize.ope

Sclerosing Pneumocytoma with a Wax-and-Wane Pattern of Growth: A Case Report on Computed Tomography and Magnetic Resonance Imaging Findings and a Literature Review

Sclerosing pneumocytoma (SP) of the lung is a rare benign neoplasm. Here, we describe an unusual presentation of SP with a wax-and-wane pattern of growth in a 47-year-old woman. Tumor diameter decreased over a 3-year follow-up period and then increased on serial follow-up computed tomography scans. The mass showed high signal intensity on both T1- and T2-weighted chest magnetic resonance imaging (MRI) and early enhancement with a plateau on dynamic MRI. We speculate that intratumoral bleeding and resorption processes accounted for the changes in tumor size.ope

Clinical follow-up of conjunctival malignant melanoma

PURPOSE: To investigate the clinical features and course of conjunctival malignant melanoma in Korea. METHODS: The medical records of 15 patients, 5 males and 10 females, diagnosed with conjunctival malignant melanoma who had been treated at Severance Hospital from May 1991 to March 2004 were reviewed retrospectively. The clinical parameters of the patients, tumors, and treatment were analyzed for their relation to outcome measures. RESULTS: The mean age at the time of diagnosis was 53.4 years (s). In all cases, the disease was unilateral and all patients had experienced at least one recurrence. Local lymph node metastasis was found in 3 patients (20%) and the mean time to metastasis was 3.5 years. Systemic metastasis was found in 6 patients (40%) and the mean time to metastasis was 9.3 years. There were 5 cases of tumor-related death (33.3%), 4 of which were attributed to systemic metastasis. The Kaplan-Meier estimates of cumulative survival rate were 90% at 30 months and 56.6% at 70 months. CONCLUSIONS: Although conjunctival malignant melanoma is a rare disease, it is life-threatening and complete tumor excision at an early stage is mandatory, as is additional therapy to prevent local recurrence and systemic metastasis.ope