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Puccio S, Azzarello G, Maffeis V, Laurino L, Mairani E, Conte F, Tessari N, Cazzador D, Zanoletti E, Politi D, Emanuelli E, Spinato G, Ausoni S. Tumor Budding, p53, and DNA Mismatch Repair Markers in Sinonasal Intestinal-Type Adenocarcinoma: A Retrospective Study Supports the Adverse Prognostic Impact of Tumor Budding. Cancers (Basel) 2024; 16:1895. [PMID: 38791973 PMCID: PMC11120584 DOI: 10.3390/cancers16101895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/02/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Sinonasal intestinal-type adenocarcinoma (ITAC) is a very rare, closely occupational-related tumor with strong histological similarities to colorectal cancer (CRC). In the latter, tumor budding (TB) is widely recognized as a negative prognostic parameter. The aim of this study was to evaluate the prognostic role of TB in ITAC and to correlate it with other established or emerging biomarkers of the disease, such as p53 and deficient DNA mismatch repair (MMR) system status/microsatellite instability (MSI). We retrospectively analyzed 32 consecutive specimens of patients with ITAC diagnosis treated in two institutions in Northern Italy. We reviewed surgical specimens for TB evaluation (low-intermediate/high); p53 expression and MMR proteins were evaluated via immunohistochemistry. Results were retrospectively stratified using clinical data and patients' outcomes. According to bud counts, patients were stratified into two groups: intermediate/high budding (>4 TB) and low budding (≤4 TB). Patients with high TB (>4) have an increased risk of recurrence and death compared to those with low TB, with a median survival of 13 and 54 months, respectively. On multivariate analysis, considering TB, therapy, and stage as covariates, TB emerged as an independent prognostic factor net of the stage of disease or type of therapy received. No impact of p53 status as a biomarker of prognosis was observed and no alterations regarding MMR proteins were identified. The results of the present work provide further significant evidence on the prognostic role of TB in ITAC and underline the need for larger multicenter studies to implement the use of TB in clinical practice.
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Affiliation(s)
- Sebastiano Puccio
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Giuseppe Azzarello
- Department of Oncology, Local Health Unit 3 Serenissima, Via don Giacobbe Sartor 4, 30035 Venice, Italy;
| | - Valeria Maffeis
- Anatomia Patologica, Azienda Ospedaliera Universitaria Integrata Verona (AOVR), Ospedale Borgo Trento, Piazzale Aristide Stefani, 1, 37126 Verona, Italy;
- Department of Pathology, Local Health Unit 2 Marca Trevigiana, Piazzale dell’Ospedale 1, 31100 Treviso, Italy;
| | - Licia Laurino
- Department of Pathology, Local Health Unit 3 Serenissima, Via Paccagnella 11, 30174 Venice, Italy;
| | - Edoardo Mairani
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Federica Conte
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Nicola Tessari
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Diego Cazzador
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Doriano Politi
- Department of Otorhinolaryngology, Local Health Unit 3 Serenissima, Via Paccagnella, 11, 30174 Venice, Italy;
| | - Enzo Emanuelli
- Department of Pathology, Local Health Unit 2 Marca Trevigiana, Piazzale dell’Ospedale 1, 31100 Treviso, Italy;
| | - Giacomo Spinato
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neuroscience, “Azienda Ospedale Università di Padova” University of Padova, via Giustiniani, 2, 35122 Padova, Italy; (S.P.); (E.M.); (N.T.); (D.C.); (E.Z.)
| | - Simonetta Ausoni
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi 58b, 35121 Padova, Italy
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Unal B, Celik MY, Gedik EO, Bassorgun CI, Elpek GO. Tumor budding as a potential prognostic marker in determining the behavior of primary liver cancers. World J Hepatol 2023; 15:775-785. [PMID: 37397937 PMCID: PMC10308291 DOI: 10.4254/wjh.v15.i6.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 06/25/2023] Open
Abstract
Hepatocellular (HCC) and intrahepatic cholangiocarcinoma (ICC), the most common primary tumors of the liver, are among the most important causes of cancer deaths worldwide. Because patients with primary liver tumors are frequently diagnosed at an advanced stage and have high mortality, many efforts have been made to identify new markers to determine their behavior and treatment, similar to those in other solid organ tumors. Recently, morphological assessment of tumor budding (TB) has been revealed as a promising prognostic finding to predict tumor behavior and survival across several different tumor types. Currently, the TB score in colorectal cancer has been revealed as an important parameter in pathology report protocols to determine the course of the disease. Regarding the liver, despite enormous data showing that many mechanisms involved in TB are associated with tumor behavior in both HCC and ICC, studies focusing on the role of TB in predicting the behavior and prognosis of these tumors have started to be investigated very recently. The purpose of this review is to present data about TB in primary tumors of the liver, pointing out the potential role of this parameter in determining the course of the disease, and emphasize the need to increase the number of further studies focusing on the evaluation of this parameter with an overview of the mechanisms involved in TB.
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Affiliation(s)
- Betul Unal
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | | | - Elif Ocak Gedik
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | | | - Gulsum Ozlem Elpek
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
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Veuger J, Kuipers NC, Willems SM, Halmos GB. Tumor Markers and Their Prognostic Value in Sinonasal ITAC/Non-ITAC. Cancers (Basel) 2023; 15:3201. [PMID: 37370810 DOI: 10.3390/cancers15123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
One of the rare tumor entities present in the nose and paranasal sinuses is sinonasal (non-) intestinal-type adenocarcinoma (ITAC/non-ITAC). Currently, surgery with postoperative radiotherapy is the cornerstone of the treatment of these tumors. Systemic treatment is usually applied in a palliative setting. The prognosis of these tumors is very diverse. Biomarkers that may have prognostic value in these rare malignancies could help clinicians in decision-making. A systematic search of the literature was performed using the PubMed database. All studies investigating the prognostic significance of biomarkers in paranasal sinus ITAC/non-ITAC were retrieved. The findings were categorized within the hallmarks of cancer, to gain an understanding of the functions of possible prognostic biomarkers in the development of ITAC/non-ITAC. There were twenty-one studies reporting on twenty-one possible biomarkers included in the review. The expression of Mucin antigen sialosyl-Tn, C-erbB-2 oncoprotein, TIMP3 methylation, TP53, VEGF, ANXA2, MUC1 and the mucinous histological subtype were found to have a significant negative effect on survival. None of the biomarkers were found to have a positive effect on prognosis. The hallmarks 'activating invasion and metastasis' and 'sustaining proliferative signaling' seem to play the largest role in sinonasal (non-)ITAC. It could be concluded that there are multiple biomarkers foreboding a negative prognosis for ITAC/non-ITAC patients.
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Affiliation(s)
- Julius Veuger
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Nona C Kuipers
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
- Department of Surgery, St. Antonius Hospital, 3543 AZ Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Groningen, University of Groningen, 9723 GZ Groningen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
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Meerwein CM, Brada MD, Soyka MB, Holzmann D, Rupp NJ. Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter. Head Neck Pathol 2022; 16:670-678. [PMID: 35015192 PMCID: PMC9424375 DOI: 10.1007/s12105-022-01410-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022]
Abstract
Since sinonasal intestinal-type adenocarcinomas (ITAC) show resemblance to colorectal adenocarcinomas, we aimed to investigate novel prognostic factors of outcome, with particular focus on the role of tumor budding (TB). Retrospective clinico-pathological single-institution study on consecutive ITAC patients between 1996 and 2020. Histopathological parameters including conventional subtypes and TB features (low, intermediate, high) were evaluated with the aid of pancytokeratin (AE1/AE3) immunohistochemical staining. Parameters were correlated to clinical data and outcome. A total of 31 ITAC patients were included. Overall, 19/31 patients (61.3%) presented with stage III/IV disease. Presence of lymph node or distant metastases was rare (1/31 patient, 3.2%). Treatment protocols consisted of tumor resection in 30/31 patients (96.8%) and primary radiochemotherapy in 1/31 patient (3.2%). Adjuvant radiation therapy was conducted in 20/30 surgically treated patients (66.7%). The 3- and 5-year overall survival (OS) was 83.9% and 78.3% and the 3- and 5-years disease-specific survival (DSS) 83.7% % and 78.5%, respectively. The presence of intermediate/high TB (defined as ≥ 5 buds) was associated with both, worse DSS (log rank p = 0.03) and OS (log rank p = 0.006). No patient with low TB revealed progressive disease or died of the disease. No association between TB and tumor stage or conventional tumor subtype was found. Tumor budding seems to be an independent prognostic factor of worse outcome in ITAC.
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Affiliation(s)
- Christian M. Meerwein
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Muriel D. Brada
- Department of Molecular Pathology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Michael B. Soyka
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Niels J. Rupp
- Department of Molecular Pathology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland ,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Huang EI, Lu A, Tsai YT, Wang TC, Chuang HC, Chen WC, Chen PT. Decreasing recurrence and increasing survival rates in patients of ethmoid or sphenoid intestinal-type adenocarcinomas: Systematic review and meta-analysis with 1126 cases. Medicine (Baltimore) 2021; 100:e27341. [PMID: 34622832 PMCID: PMC8500565 DOI: 10.1097/md.0000000000027341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Ethmoid or sphenoid intestinal-type adenocarcinomas (ITACs) form a distinct subtype of sinonasal adenocarcinomas that occur less than 1 case/100,000/yr. They have obvious exposure relationship to hardwood or leather dusts, infrequent metastasis, but a relatively high local-recurrence rate. They locate at sinuses close to vital structures listed as high-risk areas in surgeries. Even in expert hands, a craniofacial resection is associated with non-negligible mortality and morbidity. Management of these tumors, first or recurrent, needs to weigh these consequences versus the survival, regional-recurrence, and distant-recurrence rates. Due to the rareness of ethmoid or sphenoid ITACs, accurate overall survival and local- or regional-recurrence rates across diverse treatments are unclear. The aim of this study is to report the overall statistics of this cancer and the relationship between enrollment year versus age, recurrence, and survival. METHODS Systemic review and meta-analysis with 1126 cases across various treatments in the literature. RESULTS Here, we show that patients of ethmoid or sphenoid ITACs had overall local-, regional-, and distant-recurrence rates of 32.2%, 2.2%, and 10.3%, respectively, with a 5-year overall survival rate of 66.2%. The results present a significant correlation between age, local-recurrent rate, or overall survival rate versus enrollment year. CONCLUSION This suggests that recent patients of ethmoid or sphenoid ITACs may present at an older mean age, have a lower local-recurrence rate, and have a better 5-year survival rate than before. There was a shifting trend of treating ethmoid ITACs from external approach to endoscopic resection. Clinicians may want to weigh mortality and morbidity rates of external surgeries and these data to share or decide a solution.
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Affiliation(s)
- Ethan I. Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ang Lu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ting-Chung Wang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Huei-Chieh Chuang
- Department of Pathology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wen-Cheng Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ping-Tsung Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Meng Z, Zhu S, Liu N, Tian J. miR-362-3p suppresses sinonasal squamous cell carcinoma progression via directly targeting pituitary tumor-transforming gene 1. J Recept Signal Transduct Res 2020; 42:43-51. [PMID: 33148101 DOI: 10.1080/10799893.2020.1839766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sinonasal squamous cell carcinoma (SNSCC) is a main subtype of sinonasal malignancy with unclear pathogenesis. microRNAs (miRNAs) are involved in SNSCC progression. Nevertheless, the role and mechanism of miR-362-3p in SNSCC development are unclear. METHODS The SNSCC tissues (n = 23) and normal sinonasal samples (n = 13) were harvested. SNSCC cell line RPMI-2650 cells were transfected using Lipofectamine 3000. miR-362-3p and pituitary tumor-transforming gene 1 (PTTG1) were determined by quantitative reverse transcription polymerase chain reaction and western blot. Cell proliferation was analyzed via Cell Counting Kit-8 and 5-ethynyl-2'-deoxyuridine assays. Cell migration and invasion was assessed using wound healing assay and transwell assay. Epithelial-mesenchymal transition (EMT)-associated protein (E-cadherin, N-cadherin and Vimentin) levels were measured via western blot. The binding relationship was analyzed via bioinformatic analysis and dual-luciferase reporter assay. RESULTS miR-362-3p abundance was decreased in SNSCC samples. miR-362-3p addition constrained cell proliferation, migration, invasion and EMT, but miR-362-3p knockdown played an opposite effect. PTTG1 was targeted and negatively modulated by miR-362-3p. PTTG1 abundance was elevated in SNSCC samples. PTTG1 overexpression mitigated miR-362-3p-modulated suppression of cell proliferation, migration, invasion and EMT in SNSCC cells. CONCLUSION miR-362-3p repressed cell proliferation, migration, invasion and EMT in SNSCC via targeting PTTG1.
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Affiliation(s)
- Zhaolun Meng
- Department of E. N. T, Qingdao Jiaozhou Center Hospital, Qingdao, Shandong, China
| | - Shu Zhu
- Department of E. N. T, Qingdao Jiaozhou Center Hospital, Qingdao, Shandong, China
| | - Na Liu
- Department of E. N. T, Qingdao Jiaozhou Center Hospital, Qingdao, Shandong, China
| | - Jie Tian
- Department of Otolaryngology, Zibo Center Hospital, Zibo, Shandong, China
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Abstract
Tumour budding is an emerging prognostic biomarker in colorectal cancer (CRC) and other solid cancers. Tumour buds are usually defined as isolated single cancer cells or clusters of up to four cancer cells located at the invasive tumour front. The prognostic value of tumour budding is now supported by a large body of evidence, whereas the utility of this phenotype as a predictive biomarker remains under investigation. The application of tumour budding indices in clinical practice requires a standardized scoring system that can be tailored to specific tumour types and clinical scenarios. In the context of CRC, tumour budding can be assessed according to the method agreed at the International Tumour Budding Consensus Conference (ITBCC) in 2016. Using the ITBCC scoring system, tumour budding is an independent predictor of lymph node metastasis in patients with pT1 CRC and of unfavourable survival in patients with stage II colon cancer. Regardless of the clinical scenario or tumour type, the assertion that 'the more tumour buds, the worse the clinical outcome' applies. In this Review, we provide an overview of tumour budding in solid cancers, highlighting the molecular and biological aspects of this phenomenon, including its associations with epithelial-mesenchymal transition and features of the tumour microenvironment. We also describe the available evidence demonstrating the value of tumour budding as a biomarker across various solid cancers.
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