Objective To evaluate the capability of 64 multidetector CT in the differentiation between mucinous and nonmucinous gastric cancer. Methods From June 2006 to June 2007, 68 patients diagnosed as gastric cancer (18 mucinous and 50 nonmucinous cancer) underwent preoperative scan with a 64-slice helical CT scanner at West China Hospital. The CT images were analyzed retrospectively on tumor location (proximal/distal stomach), diameter of tumor, appearance of thickened gastric wall, contrast enhancement pattern (layered/nonlayered), degree of enhancement and serosal invasion. Results The primarily thickened layer (94% of patients) was the low attenuation middle layer in mucinous cancer and the rate was 72% with high attenuating inner layer or entire layer in nonmucinous cancer. The most common contrast enhancement pattern and degree was layered (83% of patients) and non-enhanced (89% of patients) in mucinous cancer and nonlayered (76% of patients) with enhanced (60%of patients) in nonmucinous cancer. The more common serosal invasion was shown in mucinous cancer than in nonmucinous cancer （89% vs 64%）. These findings were statistically significant (P＜0.05). Tumor location and size of gastric cancer were not correlated with operative pathologic classification. Conclusion Sixty-four multidetector CT is effective in distinguishing mucinous from nonmucinous gastric cancer, predominantly on the basis of thickened and layered gastric wall, enhancement pattern of low-attenuating middle layer.
ObjectiveTo summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma (PMBC), and to retrospectively analyze the prognosis and the prognostic factors. MethodsNinety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively. Results① Clinicopathological characteristics:These patients accounted for 1.48% (94/6 330) of all breast cancer patients who treated in our hospital during the same period. They were all female,with a median age of 45 years old (29-85 years)and median duration of 90 d (5-2920 d). A proportion of 63.83% (60/94) of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% (58/68) tumors were in T1-T2 staging, and 82.80% (77/93) tumors were node-negative. A proportion of 1.05% (1/95) tumors had metastasized at diagnosis. A proportion of 92.54% (62/67) tumors were in Ⅰ-Ⅱ staging, 84.34% (70/83) tumors were estrogen receptor (ER) positive, 74.70% (62/83) were progesterone receptor (PR) positive, and 20.25% (16/79) were human epidermal growth factor receptor 2 (HER-2/neu) positive. A proportion of 6.32% (6/95) of tumors had breast-conserving surgery. ② Preoperative diagnosis:The detection rate of malignance were 60.87% (14/23), 83.33% (40/48), and 100% (18/18), respectively for patients who were examined with mammography, ultrasonography, and mammography+ultrasonography, and there was significant difference between the three groups (P=0.006). ③ Prognosis and prognostic factors:The follow-up rate was 80.85% (76/94). Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year and ten-year overall survival rate (OS) were 98.50%, both five-year and ten-year disease-free survival rate (DFS) were 95.80%. There was no lymph node involvement in patients of T1 phase, and no recurrence, metastasis or death occurred during the follow-up. The univariate analysis showed that the disease course, T staging, TNM staging, and HER-2/neu status were statistically significant prognostic factors for DFS situation (P<0.050). ConclusionsCases in this group displayed indolent behavior and favorable prognosis which are similar to western populations. The disease course, T staging, TNM staging, and HER-2/neu status appear to be significant predictors of worse prognosis. The combination of mammography and ultrasonography could largely improve the diagnostic accuracy, and breast-conserving therapy may be recommended for patients with no contraindications.
ObjectiveTo summarize the research progress of colorectal mucinous adenocarcinoma.MethodThe articles about colorectal mucinous adenocarcinoma in recent years were reviewed.ResultsThe colorectal mucinous adenocarcinoma was a pathological subtype of colorectal cancer, which had unique clinicopathologic characteristics, relatively low incidence, and poor prognosis. The current studies suggested that the BRAF mutation, microsatellite instability, CpG island methylation, and mucin expression were related to the occurrence and development of colorectal mucinous adenocarcinoma, but its molecular mechanism was still unclear. The colorectal mucinous adenocarcinoma was more common in the proximal colon and female patients. The multiple metastases, extrahepatic and peritoneal metastases were also common. The preoperative MRI examination was very valuable. The main treatment was surgery, and the multidisciplinary discussions were still needed to determine the best treatment for patients in the advanced stage. Compared with other types of colorectal adenocarcinoma, patients with colorectal mucinous adenocarcinoma had a poor prognosis.ConclusionsAlthough we have a certain understanding of colorectal mucinous adenocarcinoma, the study results are limited due to the small sample size of many related articles and the lack of prospective randomized controlled studies. Therefore, more studies are needed in the future to improve the cognition of colorectal mucinous adenocarcinoma. Future research should focus on the molecular mechanism and treatment of colorectal mucinous adenocarcinoma.
ObjectiveTo investigate the relationship between primary pulmonary mucinous adenocarcinoma (PPMA) mass type and pneumonia type and the difference of malignant degree, and to analyze the role of clinical manifestations and CT features in the diagnosis of this disease. MethodsThe clinical data of PPMA patients admitted in the First Affiliated Hospital of Xiamen University from May 2011 to March 2022 were retrospectively analyzed. According to CT features, they were divided into a mass type group and a pneumonia type group. The clinical manifestations, CT features and the relationship between Ki-67 index and the degree of malignancy between the two groups were analyzed and compared, and the diagnostic ability of PPMA was enhanced. ResultsA total of 57 PPMA patients were enrolled. There were 17 males and 40 females, with an average age of 53.82±10.65 years, and 28 (49%) patients had reversed hato-like sign. There were statistically significant differences between the two groups in the maximum diameter of tumor, boundary condition and pleural indentation sign (P<0.05). There was no significant difference between the two groups in Ki-67% index and its high and low value-added groups (P>0.05). ConclusionThere is no significant difference in the degree of malignancy between the two types of PPMA, which supports that the pneumonia type is only the manifestation of the disease progression of the lump type. PPMA is more common in elderly women and often occurs in both lower lungs. The clinical manifestations are mainly cough and white mucinous sputum. CT scans can show various manifestations, among which the reversed hato-like sign is expected to become an important imaging feature. Combined with high solid fraction, pleural indentation sign, and vacuole sign, it can play a significant auxiliary role in its diagnosis.