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Biswas S, Manekar S, Bakshi SR. A Case Study on PPM1D and 9 Other Shared Germline Alterations in a Family. Asian Pac J Cancer Prev 2023; 24:2129-2134. [PMID: 37378944 PMCID: PMC10505862 DOI: 10.31557/apjcp.2023.24.6.2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The use of high-throughput genotyping techniques has enabled us to identify the rare germline genetic variants with different pathogenicity and penetrance, and understand their role in cancer predisposition. We report here a familial cancer case, a study from Western Indian. METHODS NGS-WES was carried out in a lung cancer patient who has a family history of multiple cancers across generations, including tongue, lung, brain, cervical, urothelial, and esophageal cancer. The results were validated by data mining from available data bases. I-TASSER, RasMol and PyMol were used for protein structure modelling. RESULTS The sequencing by NGS-WES revealed PPM1D c.1654C>T (p.Arg552Ter) mutation in hotspot region exon 6 leading to sudden protein truncation and loss of the C-terminal, due to the substitution of C>T. This mutation was classified as a variant of uncertain significance (VUS), due to limited data on lung cancer, The three unaffected siblings of proband did not show any pathogenic variants and comparative analysis of the four siblings indicate 9 shared genetic variants, classified as benign as per ClinVar. CONCLUSION PPM1D constitutional genetic alterations are rare and uncommon in different ethnic populations. This gene encodes a phosphatase playing role in regulating the P53 tumor suppressor pathway and DNA damage response. Genetic alterations in the PPM1D gene maybe linked to history of gliomas, breast cancer, and ovarian cancer onset in the proband's family. .
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Affiliation(s)
- Shristi Biswas
- Institute of Science, Nirma University, Ahmadabad, Gujarat India.
| | - Swati Manekar
- Institute of Technology, Nirma University, Gujarat India.
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Kaissarian NM, Meyer D, Kimchi-Sarfaty C. Synonymous Variants: Necessary Nuance in our Understanding of Cancer Drivers and Treatment Outcomes. J Natl Cancer Inst 2022; 114:1072-1094. [PMID: 35477782 PMCID: PMC9360466 DOI: 10.1093/jnci/djac090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/24/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Once called "silent mutations" and assumed to have no effect on protein structure and function, synonymous variants are now recognized to be drivers for some cancers. There have been significant advances in our understanding of the numerous mechanisms by which synonymous single nucleotide variants (sSNVs) can affect protein structure and function by affecting pre-mRNA splicing, mRNA expression, stability, folding, miRNA binding, translation kinetics, and co-translational folding. This review highlights the need for considering sSNVs in cancer biology to gain a better understanding of the genetic determinants of human cancers and to improve their diagnosis and treatment. We surveyed the literature for reports of sSNVs in cancer and found numerous studies on the consequences of sSNVs on gene function with supporting in vitro evidence. We also found reports of sSNVs that have statistically significant associations with specific cancer types but for which in vitro studies are lacking to support the reported associations. Additionally, we found reports of germline and somatic sSNVs that were observed in numerous clinical studies and for which in silico analysis predicts possible effects on gene function. We provide a review of these investigations and discuss necessary future studies to elucidate the mechanisms by which sSNVs disrupt protein function and are play a role in tumorigeneses, cancer progression, and treatment efficacy. As splicing dysregulation is one of the most well recognized mechanisms by which sSNVs impact protein function, we also include our own in silico analysis for predicting which sSNVs may disrupt pre-mRNA splicing.
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Affiliation(s)
- Nayiri M Kaissarian
- Hemostasis Branch, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation & Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Douglas Meyer
- Hemostasis Branch, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation & Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Chava Kimchi-Sarfaty
- Hemostasis Branch, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation & Research, US Food and Drug Administration, Silver Spring, MD, USA
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Rashid FA, Bhat GH, Khan MS, Tabassum S, Bhat MH. Variations in MAP kinase gladiators and risk of differentiated thyroid carcinoma. Mol Clin Oncol 2022; 16:45. [PMID: 35003743 PMCID: PMC8739702 DOI: 10.3892/mco.2021.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/27/2021] [Indexed: 12/02/2022] Open
Abstract
Thyroid carcinoma (TC) accounts for ~2.1% of newly diagnosed cancer cases. Mutations in KRAS, HRAS, NRAS and BRAF are primary participants in the development and progression of various types of malignancy, including differentiated TC (DTC). Therefore, the present prospective cohort study aimed to screen patients with DTC for variations in RAS gene family and BRAF gene. Exon 1 and 2 of KRAS, HRAS, NRAS and exon 15 of BRAF gene were screened for hotspot mutations in 72 thyroid tumor and adjacent normal tissue samples using di-deoxy Sanger sequencing. HRAS T81C mutation was found in 21% (15 of 72) of DTC tissue samples, therefore this mutation was investigated in blood samples from patients with DTC and controls as a genetic polymorphism. In addition, HRAS T81C genotypes were determined in 180 patients with DTC and 220 healthy controls by performing restriction fragment length polymorphism. BRAFV600E mutation was confined to classical variant of papillary thyoid cancer (CPTC; 44.4%) and was significantly associated with multifocality and lymph node (LN) metastasis. No mutation was found in exons 1 and 2 of KRAS and NRAS and exon 2 of HRAS genes, however, mutation was detected in exon 1 of HRAS gene (codon 27) at nucleotide position 81 in 21% (15 of 72) of DTC tumor tissue samples. Furthermore, HRAS T81C single nucleotide polymorphism was significantly associated with the risk of DTC with variant genotypes more frequently detected in cases compared with controls (P≤0.05). Moreover, frequency of variant genotypes (TC+CC) was significantly higher among DTC cases with no history of smoking, males, greater age, multifocality and LN metatasis compared with healthy controls (P<0.05). BRAFV600E mutation was primarily present in CPTC and associated with an aggressive tumor phenotype but mutations in RAS gene family were not present in patients with DTC. HRAS T81C polymorphism may be involved in the etiopathogenesis of DTC in a Pakistani cohort. Furthermore, testing for the BRAFV600E mutation may be useful for selecting initial therapy and follow-up monitoring.
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Affiliation(s)
- Faiza A Rashid
- Department of Biological Sciences, International Islamic University, Islamabad 1243, Pakistan
| | - Ghulam Hassan Bhat
- Department of Biochemistry, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
| | - Mosin S Khan
- Department of Biochemistry, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
| | - Sobia Tabassum
- Department of Biological Sciences, International Islamic University, Islamabad 1243, Pakistan
| | - Mohammad Hayat Bhat
- Department of Endocrinology, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
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Butt E, Alyami S, Nageeti T, Saeed M, AlQuthami K, Bouazzaoui A, Athar M, Abduljaleel Z, Al-Allaf F, Taher M. Mutation profiling of anaplastic ependymoma grade III by Ion Proton next generation DNA sequencing. F1000Res 2019; 8:613. [PMID: 32612806 PMCID: PMC7317822 DOI: 10.12688/f1000research.18721.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Ependymomas are glial tumors derived from differentiated ependymal cells. In contrast to other types of brain tumors, histological grading is not a good prognostic marker for these tumors. In order to determine genomic changes in an anaplastic ependymoma, we analyzed its mutation patterns by next generation sequencing (NGS). Methods: Tumor DNA was sequenced using an Ion PI v3 chip on Ion Proton instrument and the data were analyzed by Ion Reporter 5.6. Results: NGS analysis identified 19 variants, of which four were previously reported missense variants; c.395G>A in IDH1, c.1173A>G in PIK3CA, c.1416A>T in KDR and c.215C>G in TP53. The frequencies of the three missense mutations ( PIK3CA c.1173A>G, KDR c.1416A>T, TP53, c.215C>G) were high, suggesting that these are germline variants, whereas the IDH1 variant frequency was low (4.81%). However, based on its FATHMM score of 0.94, only the IDH1 variant is pathogenic; other variants TP53, PIK3CA and KDR had FATHMM scores of 0.22, 0.56 and 0.07, respectively. Eight synonymous mutations were found in FGFR3, PDGFRA, EGFR, RET, HRAS, FLT3, APC and SMAD4 genes. The mutation in FLT3 p.(Val592Val) was the only novel variant found. Additionally, two known intronic variants in KDR were found and intronic variants were also found in ERBB4 and PIK3CA. A known splice site mutation at an acceptor site in FLT3, a 3'-UTR variant in the CSF1R gene and a 5'_UTR variant in the SMARCB1 gene were also identified. The p-values were below 0.00001 for all variants and the average coverage for all variants was around 2000x. Conclusions: In this grade III ependymoma, one novel synonymous mutation and one deleterious missense mutation is reported. Many of the variants reported here have not been detected in ependymal tumors by NGS analysis previously and we therefore report these variants in brain tissue for the first time.
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Affiliation(s)
- Ejaz Butt
- Histopathology Division, Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
- Histopathology Department, Amna Inayat Medical College, Sheikhupura, Punjab, Pakistan
| | - Sabra Alyami
- Department of Medical Genetics, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Tahani Nageeti
- Department of Radiation Oncology, King Abdullah Medical City, Makkah, Makkah, Saudi Arabia
| | - Muhammad Saeed
- Faculty of Medicine, Umm-Al-Qura University and Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
| | - Khalid AlQuthami
- Department of Laboratory Medicine and Blood Bank, Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
| | - Abdellatif Bouazzaoui
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Mohammad Athar
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Zainularifeen Abduljaleel
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Faisal Al-Allaf
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Mohiuddin Taher
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
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Butt E, Alyami S, Nageeti T, Saeed M, AlQuthami K, Bouazzaoui A, Athar M, Abduljaleel Z, Al-Allaf F, Taher M. Mutation profiling of anaplastic ependymoma grade III by Ion Proton next generation DNA sequencing. F1000Res 2019; 8:613. [PMID: 32612806 PMCID: PMC7317822 DOI: 10.12688/f1000research.18721.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 03/30/2024] Open
Abstract
Background: Ependymomas are glial tumors derived from differentiated ependymal cells. In contrast to other types of brain tumors, histological grading is not a good prognostic marker for these tumors. In order to determine genomic changes in an anaplastic ependymoma, we analyzed its mutation patterns by next generation sequencing (NGS). Methods: Tumor DNA was sequenced using an Ion PI v3 chip on Ion Proton instrument and the data were analyzed by Ion Reporter 5.6. Results: NGS analysis identified 19 variants, of which four were previously reported missense variants; c.395G>A in IDH1, c.1173A>G in PIK3CA, c.1416A>T in KDR and c.215C>G in TP53. The frequencies of the three missense mutations ( PIK3CA c.1173A>G, KDR c.1416A>T, TP53, c.215C>G) were high, suggesting that these are germline variants, whereas the IDH1 variant frequency was low (4.81%). However, based on its FATHMM score of 0.94, only the IDH1 variant is pathogenic; other variants TP53, PIK3CA and KDR had FATHMM scores of 0.22, 0.56 and 0.07, respectively. Eight synonymous mutations were found in FGFR3, PDGFRA, EGFR, RET, HRAS, FLT3, APC and SMAD4 genes. The mutation in FLT3 p.(Val592Val) was the only novel variant found. Additionally, two known intronic variants in KDR were found and intronic variants were also found in ERBB4 and PIK3CA. A known splice site mutation at an acceptor site in FLT3, a 3'-UTR variant in the CSF1R gene and a 5'_UTR variant in the SMARCB1 gene were also identified. The p-values were below 0.00001 for all variants and the average coverage for all variants was around 2000x. Conclusions: In this grade III ependymoma, one novel synonymous mutation and one deleterious missense mutation is reported. Many of the variants reported here have not been detected in ependymal tumors by NGS analysis previously and we therefore report these variants in brain tissue for the first time.
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Affiliation(s)
- Ejaz Butt
- Histopathology Division, Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
- Histopathology Department, Amna Inayat Medical College, Sheikhupura, Punjab, Pakistan
| | - Sabra Alyami
- Department of Medical Genetics, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Tahani Nageeti
- Department of Radiation Oncology, King Abdullah Medical City, Makkah, Makkah, Saudi Arabia
| | - Muhammad Saeed
- Faculty of Medicine, Umm-Al-Qura University and Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
| | - Khalid AlQuthami
- Department of Laboratory Medicine and Blood Bank, Al-Noor Specialty Hospital, Makkah, Makkah, Saudi Arabia
| | - Abdellatif Bouazzaoui
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Mohammad Athar
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Zainularifeen Abduljaleel
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Faisal Al-Allaf
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Mohiuddin Taher
- Department of Medical Genetics and Science and Technology Unit, Umm-Al-Qura University, Makkah, Makkah, Saudi Arabia
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Fu W, Zhuo Z, Hua RX, Fu K, Jia W, Zhu J, Zhang J, Cheng J, Zhou H, Xia H, He J, Liu G. Association of KRAS and NRAS gene polymorphisms with Wilms tumor risk: a four-center case-control study. Aging (Albany NY) 2019; 11:1551-1563. [PMID: 30860980 PMCID: PMC6428095 DOI: 10.18632/aging.101855] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
Wilms tumor is a type of pediatric solid tumor that arises partly due to somatic and germline mutations. Single-nucleotide polymorphisms (SNPs) in the RAS gene reportedly modify the risk for several types of human malignancies. We conducted a multicenter study to investigate whether RAS gene variants predispose individuals to Wilms tumor. Four SNPs in RAS were genotyped in 355 Wilms tumor cases and 1070 controls. The SNPs included rs12587 G>T, rs7973450 A>G and rs7312175 G>A in KRAS, and rs2273267 A>T in NRAS. Individuals harboring the rs12587 GT genotype were more likely to develop Wilms tumor than those carrying the GG genotype (adjusted odds ratio [OR]=1.30, 95% confidence interval [CI]=1.004-1.68, P=0.046). However, the other three SNPs seemed not to influence the risk for Wilms tumor. Compared to individuals without a risk genotype, those harboring one to three KRAS risk genotypes had an adjusted OR of 1.28 for developing Wilms tumor (95% CI=1.002-1.64, P=0.048). Stratification analysis revealed that rs12587 GT/TT was associated with Wilms tumor risk in children >18 months old (adjusted OR=1.39, 95% CI=1.02-1.89, P=0.037). Our findings indicate that the rs12587 G>T polymorphism in KRAS is associated with increased Wilms tumor susceptibility.
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Affiliation(s)
- Wen Fu
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
- Equal contribution
| | - Zhenjian Zhuo
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Equal contribution
| | - Rui-Xi Hua
- Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China
- Equal contribution
| | - Kai Fu
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Wei Jia
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Jinhong Zhu
- Department of Clinical Laboratory, Molecular Epidemiology Laboratory, Harbin Medical University Cancer Hospital, Harbin 150040, Heilongjiang, China
| | - Jiao Zhang
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jiwen Cheng
- Department of Pediatric Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China
| | - Haixia Zhou
- Department of Hematology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Huimin Xia
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Guochang Liu
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
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Zbytek B, Peacock DL, Seagroves TN, Slominski A. Putative role of HIF transcriptional activity in melanocytes and melanoma biology. DERMATO-ENDOCRINOLOGY 2014; 5:239-51. [PMID: 24194964 PMCID: PMC3772912 DOI: 10.4161/derm.22678] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 10/23/2012] [Accepted: 10/26/2012] [Indexed: 12/30/2022]
Abstract
Hypoxia-inducible factor-1α (HIF-1α) is a highly oxygen sensitive bHLH protein that is part of the heterodimeric HIF-1 transcription factor. Under hypoxic stress, HIF-1 activity is induced to control expression of multiple downstream target genes, including vascular endothelial growth factor (VEGF). The normal epidermis exists in a constant mild hypoxic microenvironment and constitutively expresses HIF-1α and HIF-2α. Expression of HIF-1α and/or HIF-2α has been suggested to correlate with the increased malignant potential of melanocytes, therefore, failures of melanoma therapies may be partially linked to high HIF activity. Notably, melanomas that have the V600E BRAF mutation exhibit increased HIF-1α expression. We have utilized a bioinformatics approach to identify putative hypoxia response elements (HREs) in a set of genes known to participate in the process of melanogenesis (includingTRPM1, SLC45A2, HRAS, C-KIT, PMEL and CRH). While some of the mechanistic links between these genes and the HIF pathway have been previously explored, others await further investigation. Although agents targeting HIF activity have been proposed as novel treatment modalities for melanoma, there are currently no clinical trials in progress to test their efficacy in melanoma.
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Affiliation(s)
- Blazej Zbytek
- Department of Pathology and Laboratory Medicine; Center for Adult Cancer Research; University of Tennessee Health Science Center; Memphis, TN USA
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Tomei S, Wang E, Delogu LG, Marincola FM, Bedognetti D. Non-BRAF-targeted therapy, immunotherapy, and combination therapy for melanoma. Expert Opin Biol Ther 2014; 14:663-86. [DOI: 10.1517/14712598.2014.890586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Lawrie CH, Larrea E, Larrinaga G, Goicoechea I, Arestin M, Fernandez-Mercado M, Hes O, Cáceres F, Manterola L, López JI. Targeted next-generation sequencing and non-coding RNA expression analysis of clear cell papillary renal cell carcinoma suggests distinct pathological mechanisms from other renal tumour subtypes. J Pathol 2013; 232:32-42. [DOI: 10.1002/path.4296] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/23/2013] [Accepted: 10/15/2013] [Indexed: 12/15/2022]
Affiliation(s)
- Charles H Lawrie
- Oncology Area; Biodonostia Research Institute; San Sebastian Spain
- Nuffield Department of Clinical Laboratory Sciences; University of Oxford; UK
- IKERBASQUE; Basque Foundation for Science; Bilbao Spain
| | - Erika Larrea
- Oncology Area; Biodonostia Research Institute; San Sebastian Spain
| | - Gorka Larrinaga
- Nursing School; University of the Basque Country (UPV/EHU); Leioa Bizkaia Spain
| | - Ibai Goicoechea
- Oncology Area; Biodonostia Research Institute; San Sebastian Spain
| | - María Arestin
- Oncology Area; Biodonostia Research Institute; San Sebastian Spain
| | | | - Ondrej Hes
- Department of Pathology; Charles University Hospital; Plzen Czech Republic
| | - Francisco Cáceres
- Department of Urology; Cruces University Hospital; Barakaldo Bizkaia Spain
| | - Lorea Manterola
- Oncology Area; Biodonostia Research Institute; San Sebastian Spain
| | - José I López
- Department of Pathology, Cruces University Hospital, BioCruces Research Institute; University of the Basque Country (UPV/EHU); Barakaldo Bizkaia Spain
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