Evidence map›Paper›PMID 39192803›Full record

ArticleHistopathology2025

Medullary carcinomas of the nonampullary small intestine: association with coeliac disease, mismatch repair deficiency, PD-L1 expression, and favourable prognosis.

Alessandro Vanoli, Federica Grillo, Giuseppe De Lisi, Camilla Guerini, Giovanni Arpa, Catherine Klersy, Matteo Fassan, Paola Parente, Luca Mastracci, Elena Biletta and 9 more

Abstract read
In one paragraph

Article in Histopathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Alessandro VanoliDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0002-2976-7032
Federica GrilloIRCCS Ospedale Policlinico San Martino, Genoa, Italy.ORCID https://orcid.org/0000-0001-6477-3182
Giuseppe De LisiDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.
Camilla GueriniDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.
Giovanni ArpaDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0001-7226-381X
Catherine KlersyBiostatistics and Clinical Trial Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.ORCID https://orcid.org/0000-0003-0314-8548
Matteo FassanDepartment of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy.ORCID https://orcid.org/0000-0001-6515-5482
Paola ParenteUnit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.ORCID https://orcid.org/0000-0003-0591-6723
Luca MastracciIRCCS Ospedale Policlinico San Martino, Genoa, Italy.ORCID https://orcid.org/0000-0003-0193-5281
Elena BilettaUnit of Pathology, Department of Surgery ASL BI, Nuovo Ospedale degli Infermi, Ponderano, Italy.ORCID https://orcid.org/0009-0009-0093-7315
Gabriella NesiPathology Section, Department of Health Sciences, University of Florence, Florence, Italy.
Maria C MacciomeiPathology Unit, San Camillo-Forlanini Hospital, Rome, Italy.ORCID https://orcid.org/0000-0002-4199-5636
Marco V LentiDepartment of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0002-6654-4911
Erica QuaquariniMedical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.ORCID https://orcid.org/0000-0001-9099-5352
Anna M ChiaravalliDepartment of Oncology, Ospedale di Circolo, ASST-Sette Laghi, Varese, Italy.ORCID https://orcid.org/0000-0002-3924-2117
Daniela FurlanDepartment of Oncology, Ospedale di Circolo, ASST-Sette Laghi, Varese, Italy.ORCID https://orcid.org/0000-0002-5958-5379
Stefano La RosaDepartment of Oncology, Ospedale di Circolo, ASST-Sette Laghi, Varese, Italy.ORCID https://orcid.org/0000-0003-1941-2403
Marco PaulliDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.
Antonio Di SabatinoDepartment of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0002-0302-8645

Funding

Department of Molecular Medicine of the University of PaviaDipartimenti di Eccellenza (2018-2022)Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Policlinico San Matteo, Pavia, ItalyItalian Ministry of Education, University and Research (MIUR)Italian Ministry of Health
6 · The paper itself

Abstract

aimGastrointestinal medullary carcinoma is a rare histologic subtype of adenocarcinoma. As nonampullary small bowel medullary carcinomas (SB-MCs) are poorly characterized, we aimed to analyse their clinicopathologic and immunohistochemical features and to compare them with nonmedullary small bowel adenocarcinomas (NM-SBAs). METHODS AND

resultsSurgically resected SBAs collected through the Small Bowel Cancer Italian Consortium were classified as SB-MCs (carcinomas with ≥50% of tumour fulfilling the typical histologic criteria of MC) or NM-SBAs. Immunohistochemistry for cytokeratin (CK)7, CK20, CDX2, programmed death-ligand 1 (PD-L1) and mismatch repair proteins was performed in both SB-MCs and NM-SBAs. SB-MCs were also tested for CK8/18, synaptophysin, SMARCB1, SMARCA2, SMARCA4, and ARID1A and for Epstein-Barr virus (EBV)-encoded RNAs by in-situ hybridization. MLH1 promoter methylation status was evaluated in MLH1-deficient cases. Eleven SB-MCs and 149 NM-SBAs were identified. One (9%) SB-MC was EBV-positive, while 10 (91%) harboured mismatch repair deficiency (dMMR). MLH1 promoter hypermethylation was found in all eight dMMR SB-MCs tested. Switch/sucrose nonfermentable deficiency was seen in two (18%) SB-MCs, both with isolated loss of ARID1A. Compared with NM-SBAs, SB-MCs exhibited an association with coeliac disease (P < 0.001), higher rates of dMMR (P < 0.001), and PD-L1 positivity by both tumour proportion score and combined positive score (P < 0.001 for both), and a lower rate of CK20 expression (P = 0.024). Survival analysis revealed a better prognosis of SB-MC patients compared to NM-SBA cases (P = 0.02).

conclusionSB-MCs represent a distinct histologic subtype, with peculiar features compared to NM-SBAs, including association with coeliac disease, dMMR, PD-L1 expression, and better prognosis.

Indexed as

B7-H1 AntigenBiomarkers, TumorCarcinoma, MedullaryCeliac DiseaseIntestinal NeoplasmsAdenocarcinomaAdultAgedAged, 80 and overBrain NeoplasmsColorectal NeoplasmsDNA Mismatch RepairFemaleHumansImmunohistochemistryIntestine, SmallB7-H1 AntigenBiomarkers, TumorCD274 protein, humanARID1AEpstein–Barr virusimmune‐mediated disordersmicrosatellite instabilitysmall bowel adenocarcinoma

Identifiers

PMID39192803
PMCPMC11649516

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.