Pathological assessment of endoscopic resections of the gastrointestinal tract: a comprehensive clinicopathologic review

Kumarasinghe, M. Priyanthi; Bourke, Michael J.; Brown, Ian; Draganov, Peter V.; McLeod, Duncan; Streutker, Catherine; Raftopoulos, Spiro; Ushiku, Tetsuo; Lauwers, Gregory Y.

doi:10.1038/s41379-019-0443-1

Cited by 38 publications

(63 citation statements)

References 105 publications

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“…The significant regional difference is the main epidemiological characteristic of ESCA ( 27 ). There are two main subtypes in ESCA, called ESCC and EAC, respectively ( 27 , 28 ). ESCC is mainly in the East Asian population, whereas EAC mainly occurs in Western countries ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

m6A Reader HNRNPA2B1 Promotes Esophageal Cancer Progression via Up-Regulation of ACLY and ACC1

Guo

Wang

et al. 2020

Front. Oncol.

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N6-methyladenosine (m 6 A) modification is the most abundant modification on eukaryotic RNA. In recent years, lots of studies have reported that m 6 A modification and m 6 A RNA methylation regulators were involved in cancer progression. However, the m 6 A level and its regulators in esophageal cancer (ESCA) remain poorly understood. In this study, we analyzed the expression of m 6 A regulators using The Cancer Genome Atlas data and found 14 of 19 m 6 A regulators are significantly increased in ESCA samples. Then we performed a univariate Cox regression analysis and LASSO (least absolute shrinkage and selection operator) Cox regression model to investigate the prognostic role of m 6 A regulators in ESCA, and the results indicated that a two-gene prognostic signature including ALKBH5 and HNRNPA2B1 could predict overall survival of ESCA patients. Moreover, HNRNPA2B1 is higher expressed in high-risk scores subtype of ESCA, indicating that HNRNPA2B1 may be involved in ESCA development. Subsequently, we confirmed that the level of m 6 A and HNRNPA2B1 was significantly increased in ESCA. We also found that HNRNPA2B1 expression positively correlated with tumor diameter and lymphatic metastasis of ESCA. Moreover, functional study showed that knockdown of HNRNPA2B1 inhibited the proliferation, migration, and invasion of ESCA. Mechanistically, we found that knockdown of HNRNPA2B1 inhibited the expression of de novo fatty acid synthetic enzymes, ACLY and ACC1, and subsequently suppressed cellular lipid accumulation. In conclusion, our study provides critical clues to understand the role of m 6 A and its regulators in ESCA. Moreover, HNRNPA2B1 functions as an oncogenic factor in promoting ESCA progression via up-regulation of fatty acid synthesis enzymes ACLY and ACC1, and it may be a promising prognostic biomarker and therapeutic target for human ESCA.

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Section: Discussionmentioning

confidence: 99%

m6A Reader HNRNPA2B1 Promotes Esophageal Cancer Progression via Up-Regulation of ACLY and ACC1

Guo

Wang

et al. 2020

Front. Oncol.

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“…Adenoma is the primary precursor lesion of CRC and can be removed by colonoscopic resection to avoid the carcinogenesis progress. Laterally spreading tumors (LSTs) are known for primary precursor lesion of CRC (4,5). LSTs are at least 10 mm in size and are characterized by horizontally extending growth patterns (6).…”

Section: Page 4/24mentioning

confidence: 99%

WITHDRAWN: Fecal Enterotoxigenic Bacteroides fragilis-Peptostreptococcus stomatis-Parvimonas micra Biomarker for Noninvasive Diagnosis and Prognosis of Colorectal Laterally Spreading Tumor

Shen

et al. 2020

Preprint

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BackgroudUp to now, non-invasive prediction of laterally spreading tumor (LST) and adenoma recurrence after LST resection is inevitable. The purpose of this study was to identify a microbiome signature with a high predictive effect on LSTs and a microbiome with a high predictive effect on adenoma recurrence after LSTs colectomy.MethodsWe performed 16S rRNA sequencing in mucosal samples with 5 healthy controls (HC), 8 colorectal adenoma (CRA) patients and 11 LST patients. The differentiating microbiota in fecal samples was quantified by qPCR in 475 cases including 113 HC, 208 CRA patients, 109 LST patients and 45 colorectal cancer (CRC) patients. We applied linear discriminant analysis effect size analysis to identify taxa differentially abundant between cases and controls. ROC curve was used to evaluate the diagnostic value of bacterial candidates. Pairwise comparison of AUCs was performed using the Delong's test. Mantel-Haenszel hazard models were used to determine the effects of microbiota composition on recurrence free survival. ResultsLST microbial dysbiosis was characterized by relative high abundance of the genus Bacteroides-Streptococcus and the species enterotoxigenic Bacteroides fragilis (ETBF)-Peptostreptococcus stomatis (P. stomatis)-Parvimonas micra (P. micra). The abundance of ETBF, P. stomatis and P. micra were steadily increasing in LST and CRC groups. P.stomatis behaved stronger value on diagnosis of LST than the other two bacteria (AUC 0.887, 95%CI 0.842-0.931). The combination of P.stomatis, P.micra and ETBF (AUC 0.922, 95%CI 0.887-0.958) revealed strongest diagnostic power with 88.7% sensitivity and 81.4% specificity. ETBF, P. stomatis and P. micra were related to the malignant LST (PP. stomatis=0.0015, PP. micra =0.0255, PETBF =0.0169) and the abundance of IL-6. The relative high-abundance of P. stomatis were related to the adenoma recurrence after LST resection (HR = 3.88, P = 0.008). ConclusionsFecal microbiome signature (ETBF-P. stomatis-P. micra) can diagnose LSTs with high accuracy. ETBF, P. stomatis and P. micra were related to the malignant LST and P.stomatis exhibited a high predictive effect on the adenoma recurrence after endoscopic resection of LSTs. The signature bacteria of LST may provide a noninvasive alternative to early detect LST and predict the adenoma recurrence risk after resections.

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“…Therefore, similarly to the reporting of large surgical specimens, a systematic approach for handling and diagnosing ER specimens is recommended to appropriately evaluate all important pathological risk factors and the margin status. 89,90 Currently, in leading tertiary centres, endoscopic resection and surgery are complementary and not competitive. However, in some cases, further adjuvant therapies such as salvage surgery or chemotherapy and radiotherapy are required and dependent upon the incident risk of nodal metastasis, which is determined based on pathological assessment.…”

Section: Management Of Barrett's-related Neoplasia H G D a N D E A R mentioning

confidence: 99%

The modern management of Barrett’s oesophagus and related neoplasia: role of pathology

et al. 2020

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Modern management of Barrett’s oesophagus and related neoplasia essentially focuses upon surveillance to detect early low‐risk neoplastic lesions and offering organ‐preserving advanced endoscopic therapies, while traditional surgical treatments of oesophagectomy and lymph node clearance with or without chemoradiation are preserved only for high‐risk and advanced carcinomas. With this evolution towards figless invasive therapy, the choice of therapy hinges upon the pathological assessment for risk stratifying patients into those with low risk for nodal metastasis who can continue with less invasive endoscopic therapies and others with high risk for nodal metastasis for which surgery or other forms of treatment are indicated. Detection and confirmation of neoplasia in the first instance depends upon endoscopic and pathological assessment. Endoscopic examination and biopsy sampling should be performed according to the recommended protocols, and endoscopic biopsy interpretation should be performed applying standard criteria using appropriate ancillary studies by histopathologists experienced in the pathology of Barrett’s disease. Endoscopic resections (ERs) are both diagnostic and curative and should be performed by clinicians who are skilled with advanced endoscopic techniques. Proper preparation and handling of ERs are essential to assess histological parameters that dictate the curative nature of the procedure. Those parameters are adequacy of resection and risk of lymph node metastasis. The risk of lymph node metastasis is determined by depth invasion and presence of poor differentiation and lymphovascular invasion. Those adenocarcinomas with invasion up to muscularis mucosae (pT1a) and those with superficial submucosal invasion (pT1b) up to 500 µ with no poor differentiation and lymphovascular invasion and negative margins may be considered cured by endoscopic resections.

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Pathological assessment of endoscopic resections of the gastrointestinal tract: a comprehensive clinicopathologic review

Cited by 38 publications

References 105 publications

m6A Reader HNRNPA2B1 Promotes Esophageal Cancer Progression via Up-Regulation of ACLY and ACC1

m6A Reader HNRNPA2B1 Promotes Esophageal Cancer Progression via Up-Regulation of ACLY and ACC1

WITHDRAWN: Fecal Enterotoxigenic Bacteroides fragilis-Peptostreptococcus stomatis-Parvimonas micra Biomarker for Noninvasive Diagnosis and Prognosis of Colorectal Laterally Spreading Tumor

The modern management of Barrett’s oesophagus and related neoplasia: role of pathology

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