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Mashup Score: 10
Aims Pre-surgical risk classification tools for prostate cancer have shown better patient stratification with the addition of cribriform pattern 4 (CC) and intraductal prostatic carcinoma (IDC) identified in biopsies. Here, we analyse the additional prognostic impact of CC/IDC observed in prostatectomies using Cancer of Prostate Risk Assessment post-surgical (CAPRA-S) stratification. Methods A retrospective cohort of treatment-naïve radical prostatectomy specimens from three North American academic institutions (2010–2018) was assessed for the presence of CC/IDC. Patients were classified, after calculating the CAPRA-S scores, into low-risk (0–2), intermediate-risk (3–5) and high-risk (6–12) groups. Kaplan-Meier curves were created to estimate biochemical recurrence (BCR)-free survival. Prognostic performance was examined using Harrell’s concordance index, and the effects of CC/IDC within each risk group were evaluated using the Cox proportional hazards models. Results Our cohort includ
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Mashup Score: 22Spatial resolution of renal amyloid deposits through MALDI-MSI: a combined digital and molecular approach to monoclonal gammopathies - 2 day(s) ago
Aims Identification and characterisation of monoclonal gammopathies of renal significance (MGRS) is critical for therapeutic purposes. Amyloidosis represents one of the most common forms of MGRS, and renal biopsy remains the gold standard for their classification, although mass spectrometry has shown greater sensitivity in this area. Methods In the present study, a new in situ proteomic technique, matrix-assisted laser desorption/ionisation mass spectrometry imaging (MALDI-MSI), is investigated as an alternative to conventional laser capture microdissection MS for the characterisation of amyloids. MALDI-MSI was performed on 16 cases (3 lambda light chain amyloidosis (AL), 3 AL kappa, 3 serum amyloid A amyloidosis (SAA), 2 lambda light chain deposition disease (LCDD), 2 challenging amyloid cases and 3 controls). Analysis began with regions of interest labelled by the pathologist, and then automatic segmentation was performed. Results MALDI-MSI correctly identified and typed cases with k
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▶️ MALDI-MSI renal amyloidosis ▶️ 16 cases amyloidosis ▶️ high sensitivity /specificity in identifying and typing known amyloid '▶️ restricted fingerprint' for amyloid detection composed of apolipoprotein E, serum amyloid protein, and apolipoprotein A1 https://t.co/WTPb1aIbSB https://t.co/3NCAqEbEHQ
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Mashup Score: 2Best practice for LDL-cholesterol: when and how to calculate - 2 day(s) ago
The lipid profile is important in the risk assessment for cardiovascular disease. The lipid profile includes total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides (TGs) and low-density lipoprotein (LDL)-cholesterol (LDL-C). LDL-C has traditionally been calculated using the Friedewald equation (invalid with TGs greater than 4.5 mmol/L and is based on the assumption that the ratio of TG to cholesterol in very- low-density lipoprotein (VLDL) is 5 when measured in mg /dL). LDL-C can be quantified with a reference method, beta-quantification involving ultracentrifugation and this is unsuitable for routine use. Direct measurement of LDL-C was expected to provide a solution with high TGs. However, this has some challenges because of a lack of standardisation between the reagents and assays from different manufacturers as well as the additional costs. Furthermore, mild hypertriglyceridaemia also distorts direct LDL-C measurements. With the limitations of the Friedewald e
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Mashup Score: 11Emerging and under-recognised patterns of colorectal carcinoma morphologies: a comprehensive review - 3 day(s) ago
While the overwhelming majority of colorectal carcinomas (CRC) are diagnosed as adenocarcinoma not otherwise specified, there are numerous under-recognised morphologic patterns of CRC. These patterns are recognised by the WHO, appear in reporting manuals for the American Joint Committee of Cancer, and/or are listed on synoptic reports, while many other variants have either fallen out of favour or are emerging as future bona fide patterns. Herein, we discuss 13 variants: serrated adenocarcinoma, micropapillary adenocarcinoma, medullary carcinoma, neuroendocrine carcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, adenosquamous carcinoma, adenoma-like adenocarcinoma, lymphoglandular complex-like CRC, carcinoma with sarcomatoid components, cribriform-comedo-type adenocarcinoma, undifferentiated carcinoma and low-grade tubuloglandular adenocarcinoma. The purpose of this review is to scrutinise these variants by assessing their clinical characteristics, morphologic cues, as well
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Mashup Score: 13Enteroblastic gastric cancer subtype holds therapeutic clues - 4 day(s) ago
In this issue of the Journal of Clinical Pathology , Pu and colleagues from the Nanjing University Medical School, China, report that NTRK gene alterations were enriched in gastric carcinoma with hepatoid or enteroblastic differentiation but not, as in the colon, dMMR-type gastric carcinomas.1 The study analysed 51 cases of EBV (Epstein-Barr virus)-associated gastric carcinomas, 94 cases of dMMR gastric carcinomas, 90 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation and 256 cases of conventional gastric carcinomas. All four tumours with NTRK gene alterations were identified in gastric carcinoma with hepatoid or enteroblastic differentiation. Among these four cases, two were associated with fusion ( NTRK2-SMCHD1 fusion and TPM3-NTRK1 ) and two with amplification ( NTRK1 and NTRK3 ). The role of NTRK amplification is unclear, but emerging evidence suggests that these genetic alterations may also be targetable.2 The study adds to the growing literature that g
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Mashup Score: 57Utility of an infectious and tropical disease histopathology diagnostic review service - 4 day(s) ago
Aim To assess the utility of a London-based infectious and tropical disease histopathology diagnostic review service. Methods The original and specialist review histopathology reports of 457 samples from over 3 years of referrals were compared retrospectively. Results Overall 329 (72.0%) showed no significant difference; 34 (7.4%) showed a non-clinically significant difference; and 94 (20.6%) showed a clinically significant difference. Of the 94 clinically significant discrepancies, 46 (48.9%) were incorrectly suspected infections; 19 (20.2%) were missed infections; 8 (8.5%) were different infections; and in 20 (21.3%), the specialist review yielded more specific identification of an organism or a more correct assessment of its viability. Conclusions A review of histopathology cases by an infectious disease (ID) histopathology referral centre has yielded a 20.6% clinically significant error rate. Measures to improve training in ID histopathology in the UK are discussed.
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Mashup Score: 13Enteroblastic gastric cancer subtype holds therapeutic clues - 5 day(s) ago
In this issue of the Journal of Clinical Pathology , Pu and colleagues from the Nanjing University Medical School, China, report that NTRK gene alterations were enriched in gastric carcinoma with hepatoid or enteroblastic differentiation but not, as in the colon, dMMR-type gastric carcinomas.1 The study analysed 51 cases of EBV (Epstein-Barr virus)-associated gastric carcinomas, 94 cases of dMMR gastric carcinomas, 90 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation and 256 cases of conventional gastric carcinomas. All four tumours with NTRK gene alterations were identified in gastric carcinoma with hepatoid or enteroblastic differentiation. Among these four cases, two were associated with fusion ( NTRK2-SMCHD1 fusion and TPM3-NTRK1 ) and two with amplification ( NTRK1 and NTRK3 ). The role of NTRK amplification is unclear, but emerging evidence suggests that these genetic alterations may also be targetable.2 The study adds to the growing literature that g
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Mashup Score: 17Risk assessment in pT1 colorectal cancer - 5 day(s) ago
Colorectal cancer (CRC) is a common malignancy worldwide and tumour stage is closely related to clinical outcome. A small but significant proportion of submucosal-invasive (ie, pT1) CRC are associated with regional lymph node metastases (LNM) and a worse prognosis. The likelihood of LNM in pT1 CRC needs to be balanced against the operative risk and costs of surgical resection when determining the best patient management. A wide range of histopathological and clinical factors may affect LNM risk in this setting. This script provides a comprehensive overview of the tumour and patient-associated features that have been linked to LNM risk in pT1 CRC. Some of the features are well established within the literature and are included in published guidelines, while others are novel and emerging in nature. Odds ratios for LNM that are associated with key predictive features are provided where appropriate, and published models developed as an aid to the calculation of LNM risk are discussed.
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Mashup Score: 9
Adenomyosis has long been referred to as the ‘elusive’ condition in gynaecology.1 Clinical diagnosis is complicated by symptoms shared with other gynaecological pathologies. Despite being a common part of preoperative workup, ultrasound and MRI lack both sensitivity and specificity.2 Histological assessment of the uterus, while viewed as gold standard, has an inter-pathologist variation as wide as 10–88%.3 The literature reports multiple reasons for this. Diagnosis predominantly relates to the distance of endometrial glands and stroma from the deepest point of the endomyometrial junction. The extent of invasion required for diagnosis, however, is still a matter of debate,4 with no consensus between pathology services. Furthermore, the spread of adenomyosis …
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Mashup Score: 19
Telomere maintenance and elongation allows cells to gain replicative immortality and evade cellular senescence during cancer development. While most cancers use telomerase to maintain telomere lengths, a subset of cancers engage the alternative lengthening of telomeres (ALT) pathway for telomere maintenance. ALT is present in 5%–10% of all cancers, although the prevalence is dramatically higher in certain cancer types, including complex karyotype sarcomas, isocitrate dehydrogenase-mutant astrocytoma (WHO grade II–IV), pancreatic neuroendocrine tumours, neuroblastoma and chromophobe hepatocellular carcinomas. ALT is maintained through a homology-directed DNA repair mechanism. Resembling break-induced replication, this aberrant process results in dramatic cell-to-cell telomere length heterogeneity, widespread chromosomal instability and chronic replication stress. Additionally, ALT-positive cancers frequently harbour inactivating mutations in either chromatin remodelling proteins ( ATRX
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Prostate carcinoma: Cribriform pattern 4 (CC) and intraductal carcinoma (IDC) to the CAPRA-S tool. A tweetorial https://t.co/yFd3q55U1h