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Del M, Illac C, Morisseau M, Angeles MA, Ducassou A, Betrian S, Bataillon G, Ferron G, Chantalat E, Gabiache E, Martinez A. Intraepithelial tumor-infiltrating lymphocytes shape loco-regional PET/CT spread of locally advanced cervical cancer. Int J Gynecol Cancer 2024; 34:490-496. [PMID: 38471676 DOI: 10.1136/ijgc-2023-004677] [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] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Data suggest an association between positron emission tomography/CT (PET/CT) metabolic metrics and tumor microenvironment in several malignancies, and a potential role of PET/CT to monitor response to immunotherapy. OBJECTIVE To evaluate the correlation between tumor loco-regional extension and tumor-infiltrating lymphocyte infiltration in locally advanced cervical cancer prior to concurrent chemo-radiotherapy.The secondary objective was to assess the association between tumor-infiltrating lymphocytes and PET/CT metabolic metrics. METHODS Patients with locally advanced cervical cancer and negative para-aortic extensions on PET/CT were included. Two senior nuclear medicine physicians specializing in gynecologic oncology reviewed all PET/CT exams, and extracted tumor maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis, as well as pelvic lymph node involvement. One senior gynecologic oncology pathologist assessed intraepithelial tumor-infiltrating lymphocytes and stromal tumor-infiltrating lymphocytes. Intraepithelial tumor-infiltrating lymphocytes were categorized following previous studies as <1% and >1%. The cut-off for stromal tumor-infiltrating lymphocytes was chosen empirically: intermediate <60% and high >60%. RESULTS 86 patients were included. Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with tumor metabolic metrics. Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with maximum standard uptake value (p=0.16), or metabolic tumor volume (p=0.19). Tumors with <1% intraepithelial tumor-infiltrating lymphocytes score were associated with a higher MRI tumor size (≥ median) (63.3% vs 39.3%, p=0.04). Patients with pelvic lymph node uptake were significantly more frequent in patients with high stromal tumor-infiltrating lymphocytes score (≥60%) (61.5% vs 31.7%, p=0.009). CONCLUSIONS Poor or absent intraepithelial tumor-infiltrating lymphocytes were associated with more advanced disease at diagnosis and larger tumor size. Tumor-infiltrating lymphocytes were not associated with tumor metabolic activity. Intraepithelial and stroma tumor-infiltrating lymphocytes are not redundant and should be assessed separately. Further work is needed to evaluate the association between tumor metabolic profile and immune populations, including different T-cell subtypes for patient selection for immunotherapy strategies.
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Affiliation(s)
- Mathilde Del
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Claire Illac
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Mathilde Morisseau
- Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Anne Ducassou
- Radiation Oncology and Brachytherapy Department, Institut Universitaire du Cancer de Toulouse - Oncopole, Institut Claudius Regaud, Toulouse, France
| | - Sarah Betrian
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Guillaume Bataillon
- Department of Anatomopathology, Toulouse University Cancer Institute, Toulouse, France
| | - Gwenael Ferron
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
- Team 19, ONCOSARC - Oncogenesis of Sarcomas, Cancer Research Center of Toulouse (CRCT) - INSERM UMR 1037, Toulouse, France
| | - Elodie Chantalat
- Department of Surgical Oncology, University Hospital Centre Toulouse IUC Oncopole CHU Division, Toulouse, France
| | - Erwan Gabiache
- Department of Nuclear Medicine, Cancer University Institute Toulouse Oncopole, Toulouse, France
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
- Team 1, Tumor Immunology and Immunotherapy, Cancer Research Center of Toulouse (CRCT) - INSERM UMR 1037, Toulouse, France
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Wang Z, Zhang H, Lin F, Zhang R, Ma H, Shi Y, Yang P, Zhang K, Zhao F, Mao N, Xie H. Intra- and Peritumoral Radiomics of Contrast-Enhanced Mammography Predicts Axillary Lymph Node Metastasis in Patients With Breast Cancer: A Multicenter Study. Acad Radiol 2023; 30 Suppl 2:S133-S142. [PMID: 37088646 DOI: 10.1016/j.acra.2023.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 04/25/2023]
Abstract
RATIONALE AND OBJECTIVES This multicenter study aimed to explore the feasibility of radiomics based on intra- and peritumoral regions on preoperative breast cancer contrast-enhanced mammography (CEM) to predict axillary lymph node (ALN) metastasis. MATERIALS AND METHODS A total of 809 patients with preoperative breast cancer CEM images from two centers were retrospectively recruited. Least absolute shrinkage and selection operator (LASSO) regression was used to select radiomics features extracted from CEM images in regions of the tumor and peritumoral area of five and ten mm as well as construct radiomics signature. A nomogram, including the optimal radiomics signature and clinicopathological factors, was then constructed. Nomogram performance was evaluated using AUC and compared with breast radiologists directly. RESULTS In the internal testing set, AUCs of peritumoral signatures decreased when the peritumoral area increased and signaturetumor + 10mm demonstrated the best performance with an AUC of 0.712. The nomogram incorporating signaturetumor + 10mm, tumor diameter, progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and CEM-reported lymph node status yielded maximum AUCs of 0.753 and 0.732 in internal and external testing sets, respectively. Moreover, the nomogram outperformed radiologists and improved diagnostic performance of radiologists. CONCLUSION The nomogram based on CEM intra- and peritumoral regions may provide a noninvasive auxiliary tool to guide treatment strategy of ALN metastasis in breast cancer.
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Affiliation(s)
- Zhongyi Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000
| | - Haicheng Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000
| | - Fan Lin
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000; Institute of medical imaging, Binzhou Medical University, Yantai, Shandong, P. R. China, 264000
| | - Ran Zhang
- Artificial Intelligence and Clinical Innovation Institute, Huiying Medical Technology Co., Ltd, P. R. China, 100192
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000
| | - Yinghong Shi
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000
| | - Ping Yang
- Department of Pathology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai, Shandong, P. R. China, 264000
| | - Kun Zhang
- Department of Breast Surgery, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai, Shandong, P. R. China, 264000
| | - Feng Zhao
- School of Compute Science and Technology, Shandong Technology and Business University, Yantai, Shandong, People's Republic of China, 264000
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000
| | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding east road, Yantai, Shandong, P. R. China, 264000.
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Ding S, Dong X, Song X. Tumor educated platelet: the novel BioSource for cancer detection. Cancer Cell Int 2023; 23:91. [PMID: 37170255 PMCID: PMC10176761 DOI: 10.1186/s12935-023-02927-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/15/2023] [Indexed: 05/13/2023] Open
Abstract
Platelets, involved in the whole process of tumorigenesis and development, constantly absorb and enrich tumor-specific substances in the circulation during their life span, thus called "Tumor Educated Platelets" (TEPs). The alterations of platelet mRNA profiles have been identified as tumor markers due to the regulatory mechanism of post-transcriptional splicing. Small nuclear RNAs (SnRNAs), the important spliceosome components in platelets, dominate platelet RNA splicing and regulate the splicing intensity of pre-mRNA. Endogenous variation at the snRNA levels leads to widespread differences in alternative splicing, thereby driving the development and progression of neoplastic diseases. This review systematically expounds the bidirectional tumor-platelets interactions, especially the tumor induced alternative splicing in TEP, and further explores whether molecules related to alternative splicing such as snRNAs can serve as novel biomarkers for cancer diagnostics.
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Affiliation(s)
- Shanshan Ding
- Department of Clinical Laboratory, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, PR China
| | - Xiaohan Dong
- Department of Laboratory Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Xingguo Song
- Department of Clinical Laboratory, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, PR China.
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Wang H, Yu J, Shen W, Zhao H, Cui J, Gao B. The ratio of lymphocyte/red blood cells and platelets/lymphocytes are predictive biomarkers for lymph node metastasis in patients with breast cancer. Cancer Biomark 2023; 38:595-602. [PMID: 38143337 DOI: 10.3233/cbm-220260] [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] [Indexed: 12/26/2023]
Abstract
BACKGROUND Axillary lymph node metastasis (LNM) affects the progression of breast cancer. However, it is difficult to preoperatively diagnose axillary lymph node status with high sensitivity. Therefore, we hypothesized that platelets/lymphocytes ratio (PLR) and lymphocytes/ red blood cells ratio (LRR) might help in the prognosis of lymph node metastasis in T1-T2 breast cancer. METHODS 166 patients (Chang Ning Maternity & Infant Health Institute) were included in our study, and the associations of PLR and LPR with lymph node metastasis were investigated. Peripheral blood was collected one week before the surgery, and the patients were divided into different categories based on their PLR and LRR. RESULTS The incidence of LNM was significantly increased in the high PLR group (p= 0.002) compared with the low PLR group; LNM was also significantly increased in the low LRR group (p= 0.036) compared with the high LPR group. Further, our study revealed that high PLR (p< 0.001, OR = 4.397, 95% CI = 2.005-9.645), low LRR (p= 0.017, OR = 0.336, 95%CI = 0.136-0.825) and high clinical T stage (p< 0.001, OR = 3.929, 95%CI = 1.913-8.071) are independent predictors of LNM. CONCLUSIONS PLR and LRR could be identified as predictors of LNM in patients with T1/T2 breast cancer.
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Daniaux M, Gruber L, Santner W, Czech T, Knapp R. Interval breast cancer: Analysis of occurrence, subtypes and implications for breast cancer screening in a model region. Eur J Radiol 2021; 143:109905. [PMID: 34403883 DOI: 10.1016/j.ejrad.2021.109905] [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] [Received: 05/16/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE Interval breast carcinomas (IBC) constitute a subgroup of malignancies in women participating in a breast cancer screening programme, yet diagnosed outside of a screening appointment. Tyrol is an Austrian screening model region with a dedicated IBC board. We analysed IBC subtype distribution, demographic and biological parameters and implications for screening programmes. METHOD 161 patients with an IBC diagnosed from 2014 to 2017 were retrospectively analysed and grouped into true, occult, minimal-signs, and false negative (due to reading or technical error) IBCs cases by three independent readers. The influence of demographic and disease-related covariates were assessed. RESULTS The median interval from screening to diagnostic diagnosis was 12.8 months (range 1.1 to 23.9 months). Most cases were true (36.02%), occult (31.06%) and false-negative IBCs due to reading errors (29.81%). Interobserver agreement was rated as 'high' between all readers. Higher breast density was associated with true and occult IBCs. The rate of invasive subtypes was highest in true IBCs. Regardless of smaller tumour size in true and occult IBCs, doubling time was lower and ki-67 index higher in true and occult compared to false-negative IBCs. CONCLUSIONS True and occult IBCs present with a more aggressive biological phenotype and are associated with younger age and higher breast density. Additional yearly ultrasound examinations in women at risk may aid in the earlier detection.
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Affiliation(s)
- Martin Daniaux
- Department of Radiology, Medical University Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Leonhard Gruber
- Department of Radiology, Medical University Innsbruck, Anichstraße 35, Innsbruck, Austria.
| | - Wolfram Santner
- Department of Radiology, Privatklinik Hirslanden, Rigistrasse 1, Cham, Switzerland
| | - Theresa Czech
- Department of Gynaecology, Medical University Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Rudolf Knapp
- Department of Radiology, Bezirkskrankenhaus Kufstein, Endach 27, Kufstein, Austria
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