[Clinicopathological characterization and autopsybased classification of the Cancer of Unknown Primary origin (CUP) syndrome]
- PMID: 31225530
[Clinicopathological characterization and autopsybased classification of the Cancer of Unknown Primary origin (CUP) syndrome]
Abstract
Cancer of Unknown Primary origin (CUP) is characterized by metastatic tumor spread without identifiable primary tumor. CUP cohort was selected from 6966 autopsy cases (2001-2014). Type-1 ("clinical") CUPs: primary site was not found clinically but identified by autopsy. Type-2 ("clinicopathological") CUPs: no primary site either clinically or by autopsy. Type-3 ("pathological") CUPs: no tumor was suspected clinically whereas autopsy revealed metastatic spread from unidentifiable source. 2160 malignant tumors were found including 80 CUPs (type-1/2/3: 42/29/9). Cumulative incidence declined with time (3.70%; 2001-2007: 4.51%; 2008-2014: 3.19%) due to decreasing incidence of type-1 and -3 CUPs. CUPs were mostly adenocarcinomas and type-1 CUPs usually originate from the lung or pancreas. As a conclusion, type-2 and -3 CUPs may originate from microscopic-sized metastasizing primary tumors. Based on the above classification, improvement of clinical diagnostics may contribute to decreased incidence of type-1 CUPs and transfer of type-3 CUPs into type-2 category.
Az ismeretlen kiindulású malignus daganat (Cancer of Unknown Primary origin; CUP) jellemzõje a célzott és kiterjedt keresés ellenére sem azonosítható primer tumor. Intézetünk 6966 boncesetébõl (2001–2014) kiválogattuk a CUP-szindrómának megfelelõeket. 1-es típusú („klinikai”) CUP: klinikailag keresett, de csak boncolás során megtalált primer tumor. 2-es típusú („klinikopatológiai”) CUP: a klinikailag keresett primert boncolás sem azonosította. 3-as típusú („patológiai”) CUP: a boncolás klinikailag nem ismert daganatos betegséget talált, ismeretlen primer hellyel. 2160 malignus tumorból 80 CUP-ot találtunk (1/2/3 típus: 42/29/9). Összesített incidenciájuk 3,70% volt, idõbeli csökkenéssel (2001–2007: 4,51%; 2008–2014: 3,19%), ami az 1-es és 3-as típusú CUP-ok csökkenésébõl adódott. A CUP szövettanilag leggyakrabban adenokarcinóma volt, boncolással azonosított leggyakoribb forrása a tüdõ és a hasnyálmirigy. A klinikopatológiai és patológiai CUP-szindrómákat mikroszkopikus, de metasztatizáló primer tumorok okozhatják. A klinikai diagnosztika javulása e típusok összgyakoriságát nem, de a klinikai CUP-esetek számát csökkentheti, valamint a patológiai típus klinikopatológiai CUP-ként történõ felismerését segítheti.
Keywords: autopsy; unknown primary tumors.
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