Introduction:Mucoepidermoid carcinoma (MEC) of the breast is an exceptionally rare salivary gland-type malignancy with uncertain prognostic behaviour. This study compared the clinicopathologic characteristics, treatment patterns, and survival outcomes of MEC and invasive ductal carcinoma not otherwise specified (IDC-NOS) using Surveillance, Epidemiology, and End Results (SEER) data. Material and methods:A retrospective cohort analysis of SEER data (1975-2022) identified cases with MEC (n = 42) and IDC-NOS (n = 50,881). Demographic, clinicopathologic, and treatment variables were compared using χ2 and one-way analysis of variance tests. Overall survival (OS) and disease-specific survival (DSS) were analysed with Kaplan-Meier and Cox proportional hazards models. Results:Mucoepidermoid carcinoma cases were older (≥ 70 years: 91.0% vs. 31.1%; p < 0.001) and predominantly White. Compared with IDC-NOS, MEC exhibited lower HER2 positivity (0.0% vs. 31.4%), oestrogen receptor/progesterone receptor expression (31.0% and 0.0% vs. 60.1% and 52.3%), and distant metastasis (0.0% vs. 20.1%) (all p < 0.001). Mucoepidermoid carcinoma cases were less likely to undergo surgery (85.7%) or receive systemic therapy (40.5%, p < 0.05). Only five deaths (OS) and three (DSS) occurred among MEC cases. Kaplan-Meier curves showed similar early survival, but MEC survival plateaued after 120 months, whereas IDC-NOS declined steadily. Multivariable Cox analysis revealed higher all-cause mortality for IDC-NOS (adjusted hazard ratios [HR] = 3.80, 95% CI: 1.18-12.22), with no significant difference in cancer-specific mortality (HR = 2.32, 95% CI: 0.71-7.58). Conclusions:Mucoepidermoid carcinoma exhibits distinct clinicopathologic features, limited metastatic potential, and favourable long-term survival despite frequent triple negativity. Its indolent course supports conservative management for low-grade cases, warranting further molecular and prognostic studies.
Introduction:Fibroblast growth factor receptor (FGFR) signalling is implicated in breast cancer (BC) progression, but little is known about FGFR status as the disease develops. We evaluated FGFR1-4 expression changes in primary tumours (PT) and matched lymph node metastases (LNM) in the context of BC phenotype and circulating tumour cell (CTC) burden. Material and methods:Fibroblast growth factor receptor 1-4, oestrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2) and Ki-67 were assessed immunohistochemically in paired PT and LNM. Circulating tumour cells were quantified by imaging flow cytometry in 67 BC patients and correlated with BC phenotype and FGFR status. Results:Switch of the BC subtype between PT and LNM was observed in 3/23 cases (13.0%). In contrast, discordance in FGFR expression occurred in 11/22 (50.0%), 5/22 (22.7%), 12/22 (54.5%), and 5/21 (23.8%) cases for FGFR1, FGFR2, FGFR3, and FGFR4, respectively; in most discordant cases, the difference reflected increased expression in LNM. Circulating tumour cells were detected in 22/67 patients (32.8%), with a median burden of 5.7 CTCs per 1 million peripheral blood mononuclear cells (interquartile ranges: 3.0-17.8). Circulating tumour cell presence was not associated with lymph node (LN) status (p = 0.806). Circulating tumour cell presence was more frequent in cases with FGFR1 discordance than in FGFR1-concordant tumours (63.6% vs. 9.1%; p = 0.024). Circulating tumour cell burden correlated inversely with FGFR1 level in LNM (Spearman's ρ = -0.49, p = 0.021). A shift in the FGFR1 status was noted exclusively in HER2-negative tumours. Conclusions:The observed association between CTCs and FGFR1 status conversion, but not LN involvement in the context of disease progression, may reflect a previously unrecognised biological feature of FGFR1- positive cells, most likely restricted to HER2-negative breast cancer.
Introduction:Although computed tomography (CT)-based assessment of body composition has demonstrated that the prognostic value in oncological patients of traditional single-slice manual segmentation is limited by variability and time constraints. This study aims to evaluate the prognostic significance of artificial intelligence (AI)-driven, fully automated volumetric body composition analysis in patients with colorectal liver metastases (CRLM). Material and methods:Clinical and imaging data were collected from 177 patients with CRLM (105 males and 72 females) with a mean age of 59.72 ±12.19 years. Contrast- enhanced CT scans performed within six weeks of partial hepatectomy were processed using a custom AI-driven segmentation pipeline. Segmentation accuracy was assessed using the Dice coefficient. A Cox proportional- hazards model was employed to analyse the relationship between body composition parameters and overall survival. Results:The segmentation model achieved a median Dice coefficient above 0.99. The final survival model identified nine significant predictors of overall survival, including muscle segment volume percentage, mean Hounsfield units (HU) of the muscle segment, maximum tumour size (cm), sex, presence of multiple metastases (≥ 2), extrahepatic disease, prior chemotherapy before liver resection, non-alcoholic steatohepatitis, and histopathological treatment response > 50%. A higher muscle volume percentage was associated with improved survival (HR = 0.69, p < 0.05), while increased mean HU in muscle segment related to a higher hazard of death (HR = 1.36, p < 0.05). Conclusions:Automated skeletal muscle measurements revealed significant associations with survival, emphasising their role in outcome prediction and underscoring the need for further validation in larger, multi-institutional cohorts.
Introduction:Triple-negative breast cancer (TNBC) is an aggressive subtype with poor prognosis and limited therapeutic options. Fangchinoline, a bisbenzylisoquinoline alkaloid, has demonstrated anticancer activity; however, its molecular mechanism in TNBC remains unclear. This study aimed to investigate the anticancer effects of fangchinoline and explore its potential molecular mechanisms in TNBC. Material and methods:An integrated in vitro and in silico approach was employed. Molecular docking and molecular dynamics simulations were conducted to evaluate the interaction of fangchinoline with TGF-β1 and mTOR proteins. Cytotoxicity was assessed in murine 4T1 TNBC-cells.Flow cytometry was used to analyse cell cycle distribution, apoptosis, and protein expression related to the PI3K/Akt/mTOR pathway and p53. Results:Fangchinoline demonstrated strong binding affinity toward TGF-β1 and exhibited selective cytotoxicity against 4T1 cells (IC50 = 25.95 µM). Treatment induced apoptosis and mild G2/M phase arrest. In addition, changes in the expression of PI3K, Akt, mTOR, and p53 proteins were observed. These findings suggest that fangchinoline may suppress cell proliferation and promote apoptosis, possibly through modulation of the PI3K/Akt/mTOR signalling pathway; however, this interpretation is based on protein expression data without phosphorylation analysis or functional validation. Conclusions:Fangchinoline exhibits potential anticancer activity against TNBC-cells by inducing apoptosis and affecting key survival-related pathways. Further studies are required to confirm its molecular mechanisms and therapeutic potential.
Appendiceal mucinous neoplasms are rare tumours whose terminology, staging and management remain difficult to align with conventional colorectal cancer paradigms. Low-grade appendiceal mucinous neoplasm (LAMN) is well established, whereas high-grade appendiceal mucinous neoplasm (HAMN) remains less clearly defined in clinical practice. This review summarises current evidence on the classification, pathological distinction, clinical behaviour, prognosis and management of LAMN and HAMN. Both entities share a non-infiltrative growth pattern, but HAMN is distinguished by high-grade cytologic atypia and a greater association with high-grade peritoneal disease once dissemination occurs. In appendix-confined, non- perforated disease, HAMN seems to behave more like LAMN than invasive adenocarcinoma, so high-grade cytology alone should not be taken as an indication for routine right hemicolectomy. When perforation, extra-appendiceal mucin or peritoneal involvement is present, management should be escalated to specialist multidisciplinary assessment, with surveillance and consideration of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy tailored to disease extent. Management should therefore integrate histology with disease extent, perforation status, peritoneal cellularity and dissemination pattern rather than rely on the cytologic grade alone.
