Division of Anatomic Pathology, Rochester, MN Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: John C. Cheville, MD, 200 First Street, Southwest Rochester, MN 55905 (e-mail: [email protected]).
Molecular classification of high-grade serous ovarian cancer (HGSOC) using transcriptional profiling has proven to be complex and difficult to validate across studies. We determined gene expression profiles of 174 well-annotated HGSOCs and demonstrate prognostic significance of the prespecified TCGA Network gene signatures. Furthermore, we confirm the presence of four HGSOC transcriptional subtypes using a de novo classification. Survival differed statistically significantly between de novo subtypes (log rank, P = .006) and was the best for the immunoreactive-like subtype, but statistically significantly worse for the proliferative- or mesenchymal-like subtypes (adjusted hazard ratio = 1.89, 95% confidence interval = 1.18 to 3.02, P = .008, and adjusted hazard ratio = 2.45, 95% confidence interval = 1.43 to 4.18, P = .001, respectively). More prognostic information was provided by the de novo than the TCGA classification (Likelihood Ratio tests, P = .003 and P = .04, respectively). All statistical tests were two-sided. These findings were replicated in an external data set of 185 HGSOCs and confirm the presence of four prognostically relevant molecular subtypes that have the potential to guide therapy decisions.
To describe visualization of gastrointestinal neural ganglia by endoscopic ultrasound (EUS).We retrospectively identified patients in whom neural ganglia were visualized during EUS and the diagnosis of ganglion confirmed by EUS guided fine needle aspiration (FNA) cytology.Ten patients were identified. Celiac ganglia were visualized in nine, and a perirectal ganglion was visualized in one. Ganglia appeared as discrete hypoechoic structures, often with associated hypoechoic threads that may represent neural rami. Aspiration of ganglia yielded scant material and caused transient pain. Ganglia were best visualized with linear array echoendoscopes. Celiac ganglia (but not the perirectal ganglion) were retrospectively identified on computed tomography scans.Gastrointestinal neural ganglia can be imaged by EUS and their identity confirmed by EUS FNA.
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