Rectal Cancer Following Neoadjuvant Radiochemotherapy

The prognosis of patients with rectal cancer is generally assessed using the TNM staging system, which stages lymph node involvement according to the absolute number of involved lymph nodes. Positive lymph nodes affect the prognosis of patients. Some research has indicated that the survival of patients with positive lymph nodes is much poorer. The 7th AJCC staging system divide patients with rectal cancer into four stages (N1a, N1b, N2a, N2b) which is more accurate than the 6th staging system, suggesting patients with more positive lymph nodes have unfavorable prognosis.

TNM staging system suggests more than 12 lymph node harvest is the premise of accurate N stage. However, adequate lymph nodes could be harvested in only approximate 1/3 patients of rectal cancer. Moreover, most of the patients with positive lymph nodes receive neoadjuvant radiotherapy which will reduce the number of lymph nodes harvest. It is difficult for the patients who have received preoperative radiotherapy to get adequate lymph nodes. The reduction of lymph node harvest may decrease patients’ prognosis and may not be reflected in TNM staging system. It affects prognosis value of N stage for these patients. Some researchers are searching for a more effective indicator to evaluate the situation of lymph nodes.

The lymph node ratio (LNR), the number of metastatic lymph nodes divided by the total number of examined nodes, might be a suitable staging system. LNR doesn’t depend on the absolute number of positive lymph nodes. It treats the ratio of positive lymph node as the indicator of lymph node metastasis. Although it has many drawbacks such as different cutoff values and inconsistent pathological evaluation, researchers focus on it as a valuable prognosis indicator.

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EGFR-Signaling and Autophagy: How they Fit in the Cancer Landscape

Key consequence of an overachieving Epidermal Growth Factor Receptor (EGFR)- signaling in cancer  forcefulness and poor prognosis is very much perceived. In accordance, EGFR is either enhanced or changed in greater part of the malignancies of epithelial beginning, and thusly has been perceived as a primary focus for anticancer treatment.

However, in spite of introductory clinical adequacy of the anti-EGFR treatment in tumor treatment, long term endeavor to quiet the growth boosting impacts of EGFR-dependent signaling meets resistance in malignancy cells. Quite, impacts of EGFR enactment are pleotropic. Additionally, under conditions of anti-EGFR treatment in malignancy cells, criticism initiation of the expert survival motioning by enactment of other development variable receptors can happen. However, a basic part of autophagy in the resistance against anti-EGFR treatment is quick developing. Intresetingly, EGFR controls autophagy in a context-dependent way.

Besides, EGFR deregulated tumors exhibit differential reliance upon autophagy for their survival and development. Additionally, restraining EGFR-signaling advances autophagy. These interesting contemplations are confounded further by discoveries that EGFR manages autophagy in kinase-dependent or independent way. Hence, for effective clinical tumor treatment utilizing anti-EGFR regimen, it is important that we understand molecular details of the nexus between the EGFR-Signaling and autophagy.

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Small Cell Carcinoma of the Rectum, A Systematic Literature Review and Case Series

Small cell carcinomas (SmCC) are malignancies that derive from neuroendocrine cells. The World Health Organisation (WHO) in 2010 classified SmCC as a subgroup of neuroendocrine carcinoma (NEC) which accounts for approximately 0.6 percent of all colorectal cancers. NEC has two histologic subgroups, namely large cell carcinoma (LCC) and small cell carcinoma (SmCC). LCC can be difficult to distinguish from poorly differentiated adenocarcinoma.

Despite the fact that the gastrointestinal tract (GI) has the largest number of neuroendocrine cells in the body it is unusual for such malignancies to occur here. First described in 1952, nearly 650 cases of gastrointestinal SmCC have been reported in the literature until 2007. The oesophagus is the commonest site of incidence of GI SmCC (53%) followed by the colon (13%), stomach (11%), gallbladder (8.4%) and rectum (7.3%). The aggressive neoplastic nature of SmCC is characterised by rapid growth, high mitotic proliferation rate (>20 mitotic figures per 10 high-power fields [HPF] or a Ki-67 index >20%), early dissemination and poor prognosis.

SmCC of the rectum is an extrapulmonary small cell carcinoma (EPSmCC) entity, which morphologically resembles pulmonary small cell carcinoma (PSmCC). SmCC was originally thought to derive from amine-precursor uptake and decarboxylase cells (APUD). However, the pluripotent stem cell, with its potential for variable differentiation, is now the most widely accepted theory [6-9]. Although it is important to rule out a PSmCC as the primary tumour the treatment paradigm for EPSmCC is extrapolated form the platinum based therapy used to treat PSmCC .

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Malignant Transformation in Potentially Malignant Lesions

Breast Cancer is the most frequent cancer among the women now a day. It is most reported cancer globally. By far Breast cancer is the most spotted cancer among women. Globally, more than 20% enhancement in breast cancer since 2008 with a newly diagnosed cases of 1.7 million in 2012; and there are 6.3 million women alive with breast cancer with 14% increase in mortality rate in preceding 5 years.

In Asia, mostly breast cancer occursin women in their forties. In Africa it is also usually around 48 years in which two third cases are premenopausal whereas in Europe majority cases happens in postmenopausal stage. Normal human women breast consists of milk producing lobules, tiny ducts that carry milk from lobule to the nipple and stroma which contains fatty tissues and connective tissues surrounding ducts, lobules, blood vessel and lymphatic vessels. Breast cancer is an assemblage of very diverse group of diseases. The Basis of classification of breast cancer was started with histological features, then based on estrogen receptor(ER) expression and later according to presence of Human Epithelial Growth Factor receptor (HER2).

Breast cancer in specifically begin in lobules (lobular cancer) or ducts (ductal cancer). Keeping in mind the metastatic capability, breast cancer can either be in situ/non invasive or invasive. in situ breast cancer can have different origin and grouped accordingly as Ductal carcinoma in situ (DCIS) or Lobular carcinoma in situ (LCIS). DCIs are the most common type of in situ carcinoma while LCIS can be termed as pre cancer. There is some other in situ type of breast cancer having characteristics of both ductal and lobular carcinomas and have an unknown origin.

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Epidemiology of Thyroglossal Duct Cysts in an Eastern Caribbean Nation

Cystic lesions of the neck include branchial cleft cysts, thyroglossal duct cysts, lymphangioma, dermoid cysts, epidermoid cysts, infections/inflammatory masses, cystic lesions of the thyroid, thymic cysts, laryngoceles, ranulas, cystic lesions of salivary glands, cystic metastatic lymph nodes, neurogenic tumours, rare vascular lesions and cervical bronchogenic cysts. The thyroglossal duct cyst accounts for 70% of all congenital neck masses.

The thyroid gland descends from the base of the tongue at the level of the foramen caecum into the anterior neck through the thyroglossal duct. This duct usually undergoes involution but in seven percent of patients it remains patent. The ducts have an epithelial lining which - in the presence of infection or inflammation produces excess secretions that cause ductal dilatation and cyst formation. The patient may seek medical attention for cosmetic concerns regarding an asymptomatic cyst or when the cyst becomes symptomatic.

In this small case series, the statistics reported in the age groups less than fifty years compared favorably to international statistics. Ahura et al. and Fischer et al. also reported a greater percentage of patients over fifty years that developed cysts. No particular reason was found to account for this.

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Small Cell Carcinoma of the Rectum, A Systematic Literature Review and Case Series

Small cell carcinomas (SmCC) are malignancies that derive from neuroendocrine cells. The World Health Organisation (WHO) in 2010 classified SmCC as a subgroup of neuroendocrine carcinoma (NEC) which accounts for approximately 0.6 percent of all colorectal cancers. NEC has two histologic subgroups, namely large cell carcinoma (LCC) and small cell carcinoma (SmCC). LCC can be difficult to distinguish from poorly differentiated adenocarcinoma.

Despite the fact that the gastrointestinal tract (GI) has the largest number of neuroendocrine cells in the body it is unusual for such malignancies to occur here. First described in 1952, nearly 650 cases of gastrointestinal SmCC have been reported in the literature until 2007. The oesophagus is the commonest site of incidence of GI SmCC (53%) followed by the colon (13%), stomach (11%), gallbladder (8.4%) and rectum (7.3%). The aggressive neoplastic nature of SmCC is characterised by rapid growth, high mitotic proliferation rate (>20 mitotic figures per 10 high-power fields [HPF] or a Ki-67 index >20%), early dissemination and poor prognosis.

SmCC of the rectum is an extrapulmonary small cell carcinoma (EPSmCC) entity, which morphologically resembles pulmonary small cell carcinoma (PSmCC). SmCC was originally thought to derive from amine-precursor uptake and decarboxylase cells (APUD). However, the pluripotent stem cell, with its potential for variable differentiation, is now the most widely accepted theory.

Malignant Transformation in Potentially Malignant Lesions

Early detection and prompt treatment of precancers as well as early detection of any malignancy in these precancers is of equal importance for the successful reduction of morbidity and mortality rates of oral cancers. An inexpensive, noninvasive, and accessible diagnostic methodology to detect the malignant conversion of oral premalignant lesions is required.

Early detection and prompt treatment of precancers as well as early detection of any malignancy in these precancers is of equal importance for the successful reduction of morbidity and mortality rates of oral cancers. An inexpensive, noninvasive, and accessible diagnostic methodology to detect the malignant conversion of oral premalignant lesions is required.

The goal of a cancer-screening program is to detect tumors at a stage early enough that treatment is likely to be successful.

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