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- Fehr, Andre, et al.
(författare)
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Mucoepidermoid carcinoma of the salivary glands revisited with special reference to histologic grading and CRTC1/3-MAML2 genotyping.
- 2021
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Ingår i: Virchows Archiv : an international journal of pathology. - : Springer Science and Business Media LLC. - 1432-2307. ; 479, s. 975-985
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Tidskriftsartikel (refereegranskat)abstract
- Mucoepidermoid carcinoma (MEC) is the most common carcinoma of the salivary glands. Here, we have used two large patient cohorts with MECs comprising 551 tumors to study clinical, histological, and molecular predictors of survival. One cohort (n=167), with known CRCT1/3-MAML2 fusion status, was derived from the Hamburg Reference Centre (HRC; graded with the AFIP and Brandwein systems) and the other (n=384) was derived from the population-based Cancer Registry of North Rhine-Westphalia (LKR-NRW; graded with the AFIP system). The reliability of both the AFIP and Brandwein grading systems was excellent (n=155). The weighted kappa for inter-rater agreement was 0.81 (95% CI 0.65-0.97) and 0.83 (95% CI 0.71-0.96) for the AFIP and Brandwein systems, respectively. The 5-year relative survival was 79.7% (95% CI 73.2-86.2%). Although the Brandwein system resulted in a higher rate of G3-MECs, survival in G3-tumors (AFIP or Brandwein grading) was markedly worse than in G1/G2-tumors. Survival in>T2 tumors was markedly worse than in those with lower T-stage. Also, fusion-negative MECs had a worse 5-year progression-free survival. The frequency of fusion-positive MECs in the HRC cohort was 78.4%, of which the majority (86.7%) was G1/G2-tumors. In conclusion, the AFIP and Brandwein systems are useful in estimating prognosis and to guide therapy for G3-MECs. However, their significance regarding young age (≤30years) and location-dependent heterogeneity of in particular G2-tumors is more questionable. We conclude that CRTC1/3-MAML2 testing is a useful adjunct to histologic scoring of MECs and for pinpointing tumors with poor prognosis with higher precision, thus avoiding overtreatment.
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| 2. |
- Hausner, Vera Helene, et al.
(författare)
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Impacts of climate change and climate extremes on Arctic livelihoods and communities
- 2021. - 1
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Ingår i: Amap arctic climate update 2021. - Tromsö : Arctic Monitoring and Assessment Programme (AMAP). - 9788279712015 ; , s. 107-143
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Key findings:• Climate change is impacting the subsistence harvestbased livelihoods of many small Arctic communities, affecting the quality or supply of traditional food and drinking water, including availability of species to be harvested, and altering transportation access.• Rain-on-snow, extreme snowfall, and variable freezethaw cycles have resulted in severe impacts for reindeer herders. In 2020, multiple snowstorms combined with a late spring thaw resulted in high newborn calf mortality and, together with other social stresses related to Covid-19, created severe crises for reindeer herders in Fennoscandia.• Commercial fisheries are expanding in Arctic shelf ecosystems with warmer oceans and less sea ice. This could benefit local economies and job creation, but may also challenge traditional livelihoods and culture and impact vulnerable Arctic ecosystems. Large uncertainties are associated with the effects of ocean acidification, which could potentially counteract increased commercial fishing opportunities. Commercial fishing is currently prohibited by international agreement in the Central Arctic Ocean.• Warmer water is enabling a northward expansion of salmon farming in the ice-free European Arctic. The aquaculture industry brings employment opportunities and positive ripple effects for local economies, but also has environmental and societal costs that need to be considered in marine spatial planning and regulatory measures.• Arctic cruise tourism is increasing and is attracted to the wildlife associated with the marginal ice zone. Although increased cruise tourism brings the potential for local economic development, adverse local impacts have been reported, including impacts on culture, local hunting and fishing, crowding, and revenue largely benefitting foreign-based individuals and corporations.• Permafrost thaw, flooding, and coastal erosion are causing damage to buildings, roads, and other infrastructure, and pose serious financial and health risks to Arctic residents.• Wildfire occurrence near populated regions in North America and Sweden, and throughout Siberia, in the past five years has resulted in significant economic loss from property damage as well as physical and mental health impacts.• Fishing, cruise tourism, and increased oil and gas operations near the marginal ice zone could increase demand on search and rescue operations and may represent a considerable risk for vulnerable ecosystems. The extent of ice cover is important for determining the fate of an Arctic oil spill and research indicates longer term and more severe ecological impacts from oil spills in the Arctic than in other regions.• Understanding and studying integrated socio-ecological systems, including cumulative and cascading impacts, is important not only in terms of research, but also in terms of risk mitigation, hazard response, climate adaptation,
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