Mesonephric-like adenocarcinoma (MLA) of the uterine corpus is a rare but distinct malignant tumor of the female genital tract, demonstrating a characteristic morphology and unique immunohistochemical profiles and molecular alterations. We conducted immunohistochemical staining (IHC) to make precise differential diagnoses of uterine MLAs from common histological subtypes of endometrial carcinomas. We collected 25 uterine MLAs and performed IHC for GATA3, TTF1, CD10, ER, PR, p16, p53, and HER2. Seventeen cases (68.0%) showed at least moderate nuclear GATA3 immunoreactivity in ≥25% of tumor cells. Most cases expressed TTF1 (17/21, 81.0%) and CD10 (luminal; 17/21, 81.0%). Heterogeneous TTF1 expression was noted in 12 cases. An inverse pattern of GATA3 and TTF1 staining was observed in eight cases (32.0%). Three cases (12.0%) showed moderate-to-strong ER expression in ≥25% of tumor cells, and two cases (8.0%) showed moderate-to-strong PR expression in ≥5% of tumor cells. These hormone receptor-positive MLAs varied in intensity and proportion of GATA3 staining. None of the 25 cases exhibited either diffuse and strong p16 expression or aberrant p53 expression. Five cases (20.0%) showed equivocal HER2 immunoreactivity (score 2+), but HER2 FISH confirmed that none of them exhibited HER2 gene amplification. In summary, a small subset of uterine MLAs displayed atypical IHC results: focal but strong expression of ER or PR, the complete absence of GATA3 immunoreactivity, the concurrent expression of mesonephric and hormone receptors, and the inverse pattern of GATA3 and TTF1 staining. These unusual immunophenotypes may complicate the differential diagnosis of MLA. Moreover, pathologists should be encouraged to interpret the IHC results cautiously.

Background:A decrease in the number of tissue eosinophils is known to reflect the malignancy potential of neoplastic lesions and even prognosis. Increased levels of the chemokines CCL11 and CCL24 in serum and tissue are also known to have diagnostic value as serum tumor markers or prognostic factors. The aim of this study was to evaluate the correlation between the degree of tissue eosinophilia and the expression of these chemokines in the glandular and stromal cells of colorectal neoplastic lesions ranging from benign to malignant tumors.Methods:We counted the number of infiltrating eosinophils in neoplastic lesion tissue and we evaluated the expression of CCL11 and CCL24 in glandular cells and stromal cells by immunohistochemical staining.Results:The results showed that the number of eosinophils decreased significantly and the expression of CCL11 and CCL24 in glandular cells decreased with tumor progression, whereas the stromal expression of CCL11 and CCL24 appeared to increase.Conclusions:The discrepancy in CCL11 and CCL24 expression between glandular cells and stromal cells might shed light on how colorectal cancer evades the immune system, which would enable further development of immunotherapies that target these chemokines. Further research on eosinophil biology and the expression pattern of chemokines in tumor cells is needed.

BackgroundA meta-analysis and systematic review of randomized controlled trials to compare the oropharyngeal leak pressure (OLP) and clinical performance of LMA ProSeal™ (Teleflex® Inc., Wayne, PA, USA) and i-gel® (Intersurgical Ltd, Wokingham, UK) in adults undergoing general anesthesia.MethodsSearches of MEDLINE®, EMBASE®, CENTRAL, KoreaMed and Google Scholar® were performed. The primary objective was to compare OLP; secondary objectives included comparison of clinical performance and complications.ResultsFourteen RCTs were included. OLP was significantly higher with LMA ProSeal™ than with i-gel® (mean difference [MD] −2.95 cmH2O; 95% confidence interval [CI] −4.30, −1.60). The i-gel® had shorter device insertion time (MD −3.01 s; 95% CI −5.80, −0.21), and lower incidences of blood on device after removal (risk ratio [RR] 0.32; 95% CI 0.18, 0.56) and sore throat (RR 0.56; 95% CI 0.35, 0.89) than LMA ProSeal™.ConclusionLMA ProSeal™ provides superior airway sealing compared to i-gel®.

Background/Aim: We investigated differences in the clinicopathological and molecular characteristics between gastric-type mucinous carcinoma (GMC) and usualtype endocervical adenocarcinoma (UEA). Patients and Methods: We collected the clinicopathological information and performed targeted genomic sequencing analysis. Results: GMCs exhibited significantly deeper invasion depth, larger horizontal spread, more advanced stage, more frequent distant metastasis, and more frequent parametrial and vaginal extension. Disease-free survival time of GMC patients was significantly shorter than that of UEA patients. GMCs displayed mutant p53 immunostaining pattern, whereas UEAs exhibited p16 block positivity. GMCs harbored mutations in KRAS, TP53, NF1, CDKN2A, STK11, and ARID1A. One GMC exhibited MDM2 amplification. In contrast, UEAs harbored mutations in HRAS, PIK3CA, and BRCA2. Two UEAs were found to have novel TP53 mutations. Conclusion: GMC is associated with more aggressive behavior than UEA. Distinctive p53 and p16 immunostaining patterns enable differential diagnosis. GMC and UEA exhibit genetic heterogeneity with potentially actionable molecular alterations. Cervical cancer is the fourth most common gynecological malignancy and the fourth leading cause of cancer-related death in women worldwide (1, 2), although cervicovaginal cytology screening decreased the incidence rate of cervical cancer and its associated mortality rate. Adenocarcinoma of the uterine cervix is relatively less common than squamous cell carcinoma and accounts for approximately 10-20% of all cervical cancers (3, 4). However, despite the declined incidence of cervical cancer, the proportion of endocervical adenocarcinoma has increased (4-6). The International Endocervical Adenocarcinoma Criteria and Classification (IECC) is a recent system to classify endocervical adenocarcinoma into human papillomavirus (HPV)-associated adenocarcinoma (HPVA) and non-HPV-associated adenocarcinoma (NHPVA) categories based on morphological features (7). Identification of high-risk HPV, notable mitotic activity, and numerous apoptotic bodies across the glandular lumina allowed diagnosing HPVAs. The HPVAs were further divided into usual type, mucinous type (intestinal type, signet ring cell type, and not otherwise specified), villoglandular type, and invasive stratified mucin-producing carcinoma (invasive stratified mucin-producing intraepithelial lesion), depending on their cytoplasmic mucin component and nuclear characteristics. Meanwhile, NHPVAs include gastric-type mucinous carcinoma (GMC), mesonephric carcinoma, serous carcinoma, clear cell carcinoma, and endometrioid adenocarcinoma. Among these carcinomas, GMC, which is the second most common subtype of endocervical adenocarcinoma, is included in the 2014 World Health Organization (WHO) Classification of Tumours of Female Reproductive Organs (1). Although the incidence of 627 This article is freely accessible online.

Background/Aim: Sphingosine kinase 1 (SPHK1) is up-regulated in many different cancers and plays a crucial role in tumor development and progression. However, the prognostic value of SPHK1 in colorectal cancer (CRC) remains unclear. Materials and Methods: The expression of SPHK1 in CRC cell lines and 328 CRC tissue samples was examined. It was also investigated whether SPHK1 expression is associated with clinicopathological characteristics and outcomes in patients with CRC. Results: HCT 116 and HT-29 cells expressed significantly higher SPHK1 levels than did CCD 841 CoTr. On immunohistochemistry, SPHK1 expression was significantly higher in CRC tissue than in normal colonic mucosal tissue, with 34.1% of CRC patients exhibiting high SPHK1 expression. High SPHK1 expression in CRC was significantly associated with higher histological grade, deeper invasion depth, lymphatic invasion, vascular invasion, and development of distant metastasis, and was shown to be an independent predictor of distant metastasis. Furthermore, patients with high SPHK1 expression had significantly lower overall survival rates than those with low expression. Conclusion: High SPHK1 expression was significantly associated with aggressive CRC behavior and worse overall survival, and was an independent predictor of distant metastasis. SPHK1 may thus be a potential prognostic biomarker and therapeutic target in CRC patients.