BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance...BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance so that it is difficult to differentiate between primary ICA and liver metastasis of GBC,which sometimes becomes a point of discussion in clinical practice.Although these cancers demonstrate significant differences in their mutational landscape,several reports demonstrated shared genomic alteration in paired primary and metastatic site aids in distinguishing metastatic recurrence from second primary cancers.CASE SUMMARY We present a 73-year-old female patient who underwent curative resection for GBC harboring epidermal growth factor receptor 2(ERBB2)activating mutation on next-generation sequencing(NGS)-based genomic testing.One year later,a hepatic lesion was observed on follow-up imaging and she underwent surgical resection for a pathological diagnosis.The histological findings of the hepatic lesion were similar to those of the primary lesion.Additionally,using NGS panel testing,the hepatic lesion was found to have ERBB2 activating mutation,which is the identical mutation detected in the sequencing result of the primary site.ERBB2 activating mutation occurs more frequently in GBC than ICA and ECA.Therefore,in the present case,we think this molecular finding potentiated the diagnosis of the liver mass toward a metastatic recurrence.Additionally,this patient underwent HER2-targeted treatment with lapatinib in combination with capecitabin and obtained clinical benefit.CONCLUSION This case illustrated NGS panel usefulness in distinguishing GBC recurrence from second primary cancer and HER2-targeted agent efficacy on ERBB2 mutated GBC.展开更多
After more than one hundred fifty years of the publication of On the Origin of Species by Darwin, scientists are still arguing on the relative importance of mutation and natural selection, on the driving force of orga...After more than one hundred fifty years of the publication of On the Origin of Species by Darwin, scientists are still arguing on the relative importance of mutation and natural selection, on the driving force of organismal evolution, on microevo- lution and macroevolution, etc. Such periodically repeated debates appeared to have introduced more chaos than musings. What happened and why？ Have we really considered our views, opinions and arguments under the big picture of evolution before pos- ing the questions？ Or are we talking past each other？ We do need some reflections. While we believe that the current evolutionary theory is doing fine, perhaps a refinement or re-encapsulation of its knowledge framework can help promote a better understanding of the evolutionary science as a whole and blow offthe mist over the big picture [Current Zoology 61 （1）： 217-220, 2015 ].展开更多
文摘BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance so that it is difficult to differentiate between primary ICA and liver metastasis of GBC,which sometimes becomes a point of discussion in clinical practice.Although these cancers demonstrate significant differences in their mutational landscape,several reports demonstrated shared genomic alteration in paired primary and metastatic site aids in distinguishing metastatic recurrence from second primary cancers.CASE SUMMARY We present a 73-year-old female patient who underwent curative resection for GBC harboring epidermal growth factor receptor 2(ERBB2)activating mutation on next-generation sequencing(NGS)-based genomic testing.One year later,a hepatic lesion was observed on follow-up imaging and she underwent surgical resection for a pathological diagnosis.The histological findings of the hepatic lesion were similar to those of the primary lesion.Additionally,using NGS panel testing,the hepatic lesion was found to have ERBB2 activating mutation,which is the identical mutation detected in the sequencing result of the primary site.ERBB2 activating mutation occurs more frequently in GBC than ICA and ECA.Therefore,in the present case,we think this molecular finding potentiated the diagnosis of the liver mass toward a metastatic recurrence.Additionally,this patient underwent HER2-targeted treatment with lapatinib in combination with capecitabin and obtained clinical benefit.CONCLUSION This case illustrated NGS panel usefulness in distinguishing GBC recurrence from second primary cancer and HER2-targeted agent efficacy on ERBB2 mutated GBC.
文摘After more than one hundred fifty years of the publication of On the Origin of Species by Darwin, scientists are still arguing on the relative importance of mutation and natural selection, on the driving force of organismal evolution, on microevo- lution and macroevolution, etc. Such periodically repeated debates appeared to have introduced more chaos than musings. What happened and why？ Have we really considered our views, opinions and arguments under the big picture of evolution before pos- ing the questions？ Or are we talking past each other？ We do need some reflections. While we believe that the current evolutionary theory is doing fine, perhaps a refinement or re-encapsulation of its knowledge framework can help promote a better understanding of the evolutionary science as a whole and blow offthe mist over the big picture [Current Zoology 61 （1）： 217-220, 2015 ].
