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Endocrine and Neuroendocrine Tumors
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Natasha Shrikrishnapalasuriyar, P.N. Plowman, Márta Korbonits, Ashley B. Grossman
Survival depends on the stage at presentation, with an overall 5-year survival of 82% for stage 1 extending to 13% for stage IV. Tumors greater than 6 cm have a 25% chance of being malignant compared to 2% of tumors less than 4 cm. The Weiss score was created in 1984 for evaluating ACC based on nine histopathological criteria and has been used widely. A score of three histopathological features is suggestive of malignancy. In addition, the Ki-67 labeling index has been used with a cut off of 10% suggesting malignant potential.
Duodenal Neuroendocrine Tumors
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Valentina Andreasi, Stefano Partelli, Francesca Muffatti, Massimo Falconi
The patient presented in this scenario underwent upper gastrointestinal endoscopy with the finding of a 12 mm submucosal lesion on the antipancreatic surface of duodenum, at the junction between first and second part. Upper gastrointestinal endoscopy represents the gold standard in the diagnosis of duodenal neuroendocrine neoplasms, as it is the most sensitive modality to detect primary tumors located in the upper gastrointestinal tract [2]. As recommended by guidelines, the lesion was biopsied and it was assessed as a duodenal NET-G1. It is important to perform a direct tissue biopsy in order to histologically confirm duodenal neuroendocrine neoplasm diagnosis and to rule out differential diagnoses such as Brunner’s gland hyperplasia, adenomas, and adenocarcinomas [1,2]. Moreover, biopsy permits determination of Ki-67 value. It has been reported that the presence of a duodenal neuroendocrine neoplasm with Ki-67 ≥3% represents a strong predictor of tumor aggressiveness [3,5]. Therefore, the determination of Ki-67 index may influence the subsequent management between surgical or endoscopic resection [1,2].
Hereditary Breast and Ovarian Cancer
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Moreover, tests (not usually recommended as part of a routine breast cancer workup) may be conducted for ploidy and cell proliferation rate. The cells containing normal amount of DNA are described as diploid, and the cells containing abnormal amount of DNA are described as aneuploid. The rate of cancer cell division can be estimated by the S-phase fraction or a Ki-67 test. Ki-67 is a nuclear protein of 359 kDa encoded by Ki-67 gene located on the long arm of chromosome 10 (10q26.2). Ki-67 expression increases with cell growth and is required for maintaining cell proliferation, DNA metabolic process, cellular response to heat, meiosis, and organ regeneration. The cancer cells with a high S-phase fraction or Ki-67 labeling index divide more rapidly, suggesting a more aggressive cancer [21]. Further, S100A14 and S100A16 are recently identified cancer biomarkers that play a potential role in tumor progression. Higher expression levels of S100A14 and S100A16 proteins in breast cancer appear to be significantly associated with a younger age (<60 years), ER-negative status, HER2-positive status, and a poorer prognosis (Figure 30.2) [22].
Spindle cell oncocytoma of the neurohypophysis with metastasis to the sphenoparietal sinus and immunohistochemical negativity for S100 and epithelial membrane antigen (EMA)
Published in British Journal of Neurosurgery, 2023
Hanno M. Witte, Armin Riecke, Wolfgang Saeger, Carsten Hackenbroch, René Mathieu, Uwe Max Mauer, Chris Schulz
A follow-up contrast-enhanced MRI scan one year later demonstrated residual tumors that showed marked progression and required surgery, which was again performed using a transsphenoidal approach (Figure 1). Heavy intraoperative bleeding resulted in incomplete tumor resection. Resected tumor specimens were sent to a histopathology reference laboratory. Based on the immunohistochemical expression pattern, an epithelioid spindle cell oncocytoma (SCO) of the hypophysis was diagnosed. It showed B-cell lymphoma 2 (Bcl-2) expression and marked vimentin expression. The tumor was a rare subtype that was negative for S100 and EMA. The SCO showed increased proliferation and metastatic dissemination and was thus a malignant tumor. This diagnosis is supported not only by the spindle cell morphology of the tumor with abundant eosinophilic cytoplasm and relatively distinct cell membranes but also by the nuclear expression of TTF-1. This type of tumor usually shows a Ki-67 index of about 1%. In the case presented here, the Ki-67 index was 8%, which is consistent with a rapid clinical course and metastatic dissemination (Figure 2a–d). Whereas SCOs are usually S100-positive, our case showed S100 negativity.
Molecular markers for cervical cancer screening
Published in Expert Review of Proteomics, 2021
Coşkun Güzel, Jenny van Sten-van’t Hoff, Inge M.C.M. de Kok, Natalia I. Govorukhina, Alexander Boychenko, Theo M. Luider, Rainer Bischoff
As one of the major challenges in cervical cancer screening programs is to discriminate productive infections with hrHPV (those that produce viral particles but carry a low risk of transformation) from transforming infections (those that carry a high risk of transformation leading to cervical cancer), it is amenable that proteins that are implicated in regulating cell division and DNA replication may be candidates to make this discrimination. p16ink4a (referred to as p16 in this article) is a tumor suppressor and cell cycle regulatory protein that inhibits CDK 4 and 6, thereby suppressing cellular proliferation. Integration of viral genes coding for the oncoproteins E6 and E7 into the host genome leads to enhanced expression and cellular accumulation of p16 in epithelial cells of CIN2+ lesions undergoing transformation [102]. Ki-67 is a marker of proliferating cells routinely used in diagnostic settings. It is present during all phases of the cell cycle and is often increased in cervical lesions [103]. IHC staining for p16 and Ki-67 is used to discriminate lesions with a high short-term risk of transformation from those with a low risk [101].
Clinical Evaluation of P21 Activated Kinase 1 (PAK1) Activation in Gliomas and Its Effect on Cell Proliferation
Published in Cancer Investigation, 2021
Akkanapally Venu, Balasubramanian Archana, Rahul Kanumuri, Veena Kumari Vuttaradhi, Lawrence D’Cruze, Sowmiya Murugan, Krishnamurthy Ganesh, Duvuru Prathiba, Mayya Alexandrovna Dymova, Suresh Kumar Rayala, Ganesh Venkatraman
Ki-67 is a proliferation marker used for pathological investigation of cell proliferation and cancer cell growth (6). The expression of Ki-67 is directly related to the clinical stage of cancers, which is higher in malignant tumor tissues in contrast to the normal ones (35). In our study, we observed the Ki-67 LI for 101 clinical samples which was varied in different grades of gliomas with the highest expression seen in grade-IV cancers. Here, the mean LI was noticed to be 3.483 ± 8.4159, 2.593 ± 1.8864, 21.417 ± 19.2989 and 31.74 ± 17.0028 for grade-I, grade-II, grade-III and grade-IV gliomas, respectively (Figure 2 and Table 2). The statistical analysis data executed by employing ANOVA revealed a strong statistical significance between different grades of gliomas with a p value of 0.000. The multiple comparisons of the mean expression of Ki-67 LI with the different grades of gliomas portrayed a statistically notable difference between grade-I and III, I and IV, IIand III, II and IV, and III and IV (p value <0.05) but there was not much considerable difference observed between grades-I and II (p value 0.855) (Table 3).