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  1. Article: Pancreatic non-functioning neuroendocrine tumor: a new entity genetically related to Lynch syndrome.

    Serracant Barrera, Anna / Serra Pla, Sheila / Blázquez Maña, Carmen María / Salas, Rubén Carrera / García Monforte, Neus / Bejarano González, Natalia / Romaguera Monzonis, Andreu / Andreu Navarro, Francisco Javier / Bella Cueto, Maria Rosa / Borobia, Francisco G

    Journal of gastrointestinal oncology

    2017  Volume 8, Issue 5, Page(s) E73–E79

    Abstract: Some pancreatic neuroendocrine tumors (P-NETs) are associated with hereditary syndromes. An association between Lynch syndrome (LS) and P-NETs has been suggested, however it has not been confirmed to date. We describe the first case associating LS and P- ... ...

    Abstract Some pancreatic neuroendocrine tumors (P-NETs) are associated with hereditary syndromes. An association between Lynch syndrome (LS) and P-NETs has been suggested, however it has not been confirmed to date. We describe the first case associating LS and P-NETs. Here we report a 65-year-old woman who in the past 20 years presented two colorectal carcinomas (CRC) endometrial carcinoma (EC), infiltrating ductal breast carcinoma, small intestine adenocarcinoma, two non-functioning P-NETs and sebomatricoma. With the exception of one P-NET, all these conditions were associated with LS, as confirmed by immunohistochemistry (IHC) and polymerase chain reaction (PCR). LS is caused by a mutation of a mismatch repair (MMR) gene which leads to a loss of expression of its protein. CRC is the most common tumor, followed by EC. Pancreatic tumors have also been associated with LS. Diagnosis of LS is based on clinical criteria (Amsterdam II and Bethesda) and genetic study (MMR gene mutation). The association between LS and our patient's tumors was confirmed by IHC (loss of expression of proteins MLH1 and its dimer PMS2) and the detection of microsatellite instability (MSI) using PCR.
    Language English
    Publishing date 2017-11-24
    Publishing country China
    Document type Case Reports
    ZDB-ID 2594644-4
    ISSN 2219-679X ; 2078-6891
    ISSN (online) 2219-679X
    ISSN 2078-6891
    DOI 10.21037/jgo.2017.07.02
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study.

    Groen, Emma J / Hudecek, Jan / Mulder, Lennart / van Seijen, Maartje / Almekinders, Mathilde M / Alexov, Stoyan / Kovács, Anikó / Ryska, Ales / Varga, Zsuzsanna / Andreu Navarro, Francisco-Javier / Bianchi, Simonetta / Vreuls, Willem / Balslev, Eva / Boot, Max V / Kulka, Janina / Chmielik, Ewa / Barbé, Ellis / de Rooij, Mathilda J / Vos, Winand /
    Farkas, Andrea / Leeuwis-Fedorovich, Natalja E / Regitnig, Peter / Westenend, Pieter J / Kooreman, Loes F S / Quinn, Cecily / Floris, Giuseppe / Cserni, Gábor / van Diest, Paul J / Lips, Esther H / Schaapveld, Michael / Wesseling, Jelle

    Breast cancer research and treatment

    2020  Volume 183, Issue 3, Page(s) 759–770

    Abstract: Purpose: For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and ... ...

    Abstract Purpose: For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsilateral invasive breast cancer (iIBC) risk.
    Methods: Using a case-cohort design, reliability was assessed in a population-based, nationwide cohort of 2767 women with screen-detected DCIS diagnosed between 1993 and 2004, treated by breast-conserving surgery with/without radiotherapy (BCS ± RT) using Krippendorff's alpha (KA) and Gwet's AC2 (GAC2). Thirty-eight raters scored histopathological DCIS features including grade (2-tiered and 3-tiered), growth pattern, mitotic activity, periductal fibrosis, and lymphocytic infiltrate in 342 women. Using majority opinion-based scores for each feature, their association with subsequent iIBC risk was assessed using Cox regression.
    Results: Interrater reliability of grade using various classifications was fair to moderate, and only substantial for grade 1 versus 2 + 3 when using GAC2 (0.78). Reliability for growth pattern (KA 0.44, GAC2 0.78), calcifications (KA 0.49, GAC2 0.70) and necrosis (KA 0.47, GAC2 0.70) was moderate using KA and substantial using GAC2; for (type of) periductal fibrosis and lymphocytic infiltrate fair to moderate estimates were found and for mitotic activity reliability was substantial using GAC2 (0.70). Only in patients treated with BCS-RT, high mitotic activity was associated with a higher iIBC risk in univariable analysis (Hazard Ratio (HR) 2.53, 95% Confidence Interval (95% CI) 1.05-6.11); grade 3 versus 1 + 2 (HR 2.64, 95% CI 1.35-5.14) and a cribriform/solid versus flat epithelial atypia/clinging/(micro)papillary growth pattern (HR 3.70, 95% CI 1.34-10.23) were independently associated with a higher iIBC risk.
    Conclusions: Using majority opinion-based scores, DCIS grade, growth pattern, and mitotic activity are associated with iIBC risk in patients treated with BCS-RT, but interrater variability is substantial. Semi-quantitative grading, incorporating and separately evaluating nuclear pleomorphism, growth pattern, and mitotic activity, may improve the reliability and prognostic value of these features.
    MeSH term(s) Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Intraductal, Noninfiltrating/surgery ; Female ; Humans ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Prognosis ; Reproducibility of Results
    Language English
    Publishing date 2020-07-30
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 604563-7
    ISSN 1573-7217 ; 0167-6806
    ISSN (online) 1573-7217
    ISSN 0167-6806
    DOI 10.1007/s10549-020-05816-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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