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Carcinosarcoma of the pancreas: comprehensive clinicopathological and molecular characterization.

胰腺癌肉瘤: 综合临床病理和分子特征。

  • 影响因子:2.92
  • DOI:10.1016/j.hpb.2020.01.017
  • 作者列表:"Li J","Wei T","Zhang J","Wei S","Chen Q","Chen BW","Zhou Y","Wen L","Qin H","Bai X","Liang T
  • 发表时间:2020-02-17
Abstract

BACKGROUND:Carcinosarcoma of pancreas is a rare subtype of pancreatic cancer. The aim of this study was to comprehensively elaborate the clinicopathological and molecular features of this rare malignancy. METHODS:Patients who were diagnosed with carcinosarcoma of the pancreas were retrospectively identified from pathology database of a single institution between 2012 and 2018. RESULTS:A total of nine patients were identified. Pathological examination of tumor tissues from included patients showed coexisting carcinomatous and sarcomatous components. These two components were distinguished by mutually exclusive expression of cytokeratin and vimentin. The sarcomatous tissue exhibited more extensive proliferation, as revealed by Ki67 staining, and necrosis compared with the carcinomatous counterpart. Genomic analysis of tumor tissues for two patients demonstrated hotspot mutation at KRAS and TP53. Carcinomatous and sarcomatous components were separately obtained via laser captured microdissection in one patient, and mutations of driving genes were highly concordant between them. Besides, immunostaining of frequently-altered tumor suppressor genes for these two components suggested consistent expression patterns. The median overall survival for six patients with adequate follow-up was 14 months. CONCLUSION:Carcinosarcoma of the pancreas represent a rare malignancy with distinct histological characteristics. Genomic and molecular analysis suggested monoclonal origin of carcinomatous and sarcomatous components.

摘要

背景: 胰腺癌肉瘤是一种罕见的胰腺癌亚型。本研究的目的是全面阐述这种罕见恶性肿瘤的临床病理和分子特征。 方法: 从 2018 和 2012年单个机构的病理学数据库中回顾性地鉴定诊断为胰腺癌肉瘤的患者。 结果: 共确定 9 例患者。对纳入患者的肿瘤组织进行病理检查,发现癌和肉瘤成分并存。这两种成分通过细胞角蛋白和波形蛋白的互斥表达来区分。与癌对体相比,肉瘤组织表现出更广泛的增殖和坏死,如 Ki67 染色所示。2 例患者肿瘤组织的基因组分析显示 KRAS 和 tp53 存在热点突变。1 例患者通过激光捕获显微切割分别获得癌瘤和肉瘤成分,驱动基因突变高度一致。此外,这两个组分频繁改变的肿瘤抑制基因的免疫染色提示一致的表达模式。经过充分随访的 6 例患者的中位总生存期为 14 个月。 结论: 胰腺癌肉瘤是一种罕见的恶性肿瘤,具有独特的组织学特征。基因组和分子分析提示癌性和肉瘤成分的单克隆起源。

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DOI:10.1080/09553002.2020.1721609
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影响因子:2.69
发表时间:2020-01-18
DOI:10.1016/j.bbrc.2020.01.048
作者列表:["Li Y","Wang Z","Jin J","Zhu SX","He GQ","Li SH","Wang J","Cai Y"]

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影响因子:2.46
发表时间:2020-01-01
DOI:10.1097/COC.0000000000000609
作者列表:["Appelt AL","Andersen RF","Lindebjerg J","Jakobsen A"]

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