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Pancreatic Neoplasms: HELP
Articles by Michelle X. Yang
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, Michelle Yang wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Clinical Trial Imaging of pancreatic cystic lesions with confocal laser endomicroscopy: an ex vivo pilot study. 2017

Kadayifci, Abdurrahman / Atar, Mustafa / Yang, Michelle / Fernandez-Del Castillo, Carlos / Mino-Kenudson, Mari / Brugge, William R. ·Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. kadayifci@hotmail.com. · Division of Gastroenterology, University of Gaziantep, University street, 27060, Gaziantep, Turkey. kadayifci@hotmail.com. · Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. ·Surg Endosc · Pubmed #28444494.

ABSTRACT: BACKGROUND: The differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE. METHODS: Patients who underwent surgery of a PCL were enrolled. During surgery, intravenous fluorescein (2.5 ml of 10%) was injected just prior to the ligation of blood vessels supplying the pancreas. The freshly excised specimens were transected along the long axis to fully expose the luminal surface. A Gastroflex-UHD CLE probe (pCLE) was used manually to acquire images directly from the surface of cyst wall. The specimen subsequently underwent cross-sectional histology. All recorded data were analyzed by two investigators for predefined and original image findings of PCLs. RESULTS: Ten cases were recruited into the study. All patients underwent surgery because of a mucinous cyst with worrisome features or a symptomatic PCL. Imaging was successful in all patients and differently shaped papillary projections (PP) were visualized in eight patients. Pathological examination of those patients confirmed 6 cases with Intraductal Papillary Mucinous Neoplasm (IPMN) and 2 cases with Mucinous Cystic Neoplasm (MCN). In two patients with serous cystadenoma, typical vascular network was visualized in one patient, and microcystic structures in the other. Three of the IPMNs were malignant. The loss of papillary margin integrity and significant fragmentation together with irregularity was detected in malignant IPMNs by CLE. CONCLUSIONS: Pancreatic cyst epithelial wall can be visualized successfully by pCLE in ex vivo surgical specimens. Different papillary projections have been seen in all cases of IPMNs and MCNs. CLE has potential for identifying IPMN subtypes and for grading dysplasia.

2 Article Phosphatase PPM1A is a novel prognostic marker in pancreatic ductal adenocarcinoma. 2016

Fan, Jie / Yang, Michelle X / Ouyang, Qi / Fu, Deliang / Xu, Zude / Liu, Xiuping / Mino-Kenudson, Mari / Geng, Jiang / Tang, Feng. ·Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China. · Department of Pathology, University of Vermont Medical Center, Burlington, VT 05401. · Department of Pathology, Huadong Hospital; Fudan University, Shanghai 200040, China. · Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China. · Department of Pathology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China. · Department of Pathology, Massachusetts General Hospital, Boston, MA 02114. · Department of Urology, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, China. Electronic address: gengjiangsn@sina.com. · Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address: tangfeng1996@sina.com. ·Hum Pathol · Pubmed #27195906.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) harbors complex molecular alterations and remains a lethal disease. Aberrant TGF-β/Smads signaling is a well-known mechanism involved in the progression of PDACs. However, loss of Smad4 expression is reported in only ~50% of PDACs and is generally associated with worse prognosis. Investigating additional prognostic markers is warranted. PPM1A is a phosphatase that dephosphorylates TGF-β-activated Smad2/3 and inactivates the TGF-β signaling. Little is known about the clinical significance of PPM1A in PDACs and its functional relationship to Smad4. In this study, PPM1A and Smad4 immunohistochemistry was assessed in 180 R0 resected human PDACs. PPM1A was lost in 41.7% cases, whereas Smad4 was lost in 45.7% cases. The median survival rate with negative and positive PPM1A was 10.9 and 16.8 months, respectively. Loss of PPM1A was significantly associated with larger tumor size and higher stage and was an independent predictor of unfavorable outcomes. Intriguingly, the overall survival of this cohort was divided into 3 groups based on the expression pattern of PPM1A and Smad4, with the Smad4+/PPM1A+ pattern associated with favorable survival, the Smad4+/PPM1A- or Smad4-/PPM1A- pattern associated with unfavorable, and the PPM1A+/Smad4- pattern fell between these 2 groups. In 82 cases with negative Smad4, PPM1A or P-Smad2/3 expression was retained. Using a SMAD4-deficient human PDAC cell line, BxPC3, we further demonstrated that TGF-β1 treatment induced PPM1A and P-Smad2/3 expression in this cell line. PPM1A and Smad4 immunohistochemistry in surgical specimens may provide more accurate prognostic stratification for patients with PDAC.