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Noor F, Saleem MH, Chen JT, Javed MR, Al-Megrin WA, Aslam S. Integrative bioinformatics approaches to map key biological markers and therapeutic drugs in Extramammary Paget's disease of the scrotum. PLoS One 2021; 16:e0254678. [PMID: 34292991 PMCID: PMC8297842 DOI: 10.1371/journal.pone.0254678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022] Open
Abstract
Extramammary Paget’s disease (EMPD) is an intra-epidermal adenocarcinoma. Till now, the mechanisms underlying the pathogenesis of scrotal EMPD is poorly known. This present study aims to explore the knowledge of molecular mechanism of scrotal EMPD by identifying the hub genes and candidate drugs using integrated bioinformatics approaches. Firstly, the microarray datasets (GSE117285) were downloaded from the GEO database and then analyzed using GEO2R in order to obtain differentially expressed genes (DEGs). Moreover, hub genes were identified on the basis of their degree of connectivity using Cytohubba plugin of cytoscape tool. Finally, GEPIA and DGIdb were used for the survival analysis and selection of therapeutic candidates, respectively. A total of 786 DEGs were identified, of which 10 genes were considered as hub genes on the basis of the highest degree of connectivity. After the survival analysis of ten hub genes, a total of 5 genes were found to be altered in EMPD patients. Furthermore, 14 drugs of CHEK1, CCNA2, and CDK1 were found to have therapeutic potential against EMPD. This study updates the information and yields a new perspective in the context of understanding the pathogenesis of EMPD. In future, hub genes and candidate drugs might be capable of improving the personalized detection and therapies for EMPD.
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Affiliation(s)
- Fatima Noor
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | | | - Jen-Tsung Chen
- Department of Life Sciences, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Muhammad Rizwan Javed
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Wafa Abdullah Al-Megrin
- Biology Department, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sidra Aslam
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
- * E-mail:
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Cassol OS, Pastorello J, Oliveira BD, Lenhardt LH, Montagna S, Pietrobelli VL. Perianal Paget's disease. Journal of Coloproctology 2021; 39:262-4. [DOI: 10.1016/j.jcol.2019.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AbstractPaget's disease most commonly affects the breast. Extramammary involvement is rare, and the most commonly affected sites are the vulva, anus, perianal region, and axilla. The disease may progress to invasive adenocarcinoma or synchronous cancers. Due to the lack of distinctive features and nonspecific presenting symptoms, Paget's disease may be misdiagnosed as other conditions, thus delaying the correct diagnosis. We report a case of extramammary Paget's disease in the perianal region that initially presented as an irregular, circumferential, scaling lesion with eczematous eruptions. Immunology and immunohistochemistry confirmed the diagnosis. Although surgery is the standard treatment, the patient opted for pelvic radiotherapy associated with radiosensitizing chemotherapy.
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Carton I, Lebreton M, Tesson C, Henno S, Lavoué V, Levêque J, Nyangoh-Timoh K. Paget's disease of the vulva: A challenge for the gynaecologist. J Gynecol Obstet Hum Reprod 2020; 50:101896. [PMID: 32828871 DOI: 10.1016/j.jogoh.2020.101896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 01/09/2023]
Abstract
Paget's disease of the vulva is a rare form of extramammary Paget's disease mainly affecting postmenopausal women. Its pathophysiology remains largely unknown. Up to fairly recently, the only treatment for this disease was surgery, often mutilating the vulva, with significant psychosexual repercussions without the assurance of complete therapeutic efficacy. New therapeutic approaches -topical treatments, radiotherapy or chemotherapy- have emerged in recent years but lack consensual guidelines. We present a literature review of the recent results published in this field.
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Affiliation(s)
- I Carton
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France
| | - M Lebreton
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France
| | - C Tesson
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France
| | - S Henno
- Department of Pathological Anatomy and Cytology, CHU Pontchaillou, Rennes, France
| | - V Lavoué
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France
| | - J Levêque
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France.
| | - K Nyangoh-Timoh
- Department of Obstetrics, Gynecology and Human Reproduction, CHU Anne De Bretagne, Rennes, France
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Giordano PG, Meneu Díaz JC, Aguilera Molina YY, Del Olmo López R, Tabodada Mostajo N. Perianal Paget's disease: A rare disorder masking an underlying anorectal carcinoma. Gastroenterol Hepatol 2020; 43:322-323. [PMID: 32278503 DOI: 10.1016/j.gastrohep.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/20/2019] [Accepted: 12/09/2019] [Indexed: 06/11/2023]
Affiliation(s)
- Pietro Giovanni Giordano
- Servicio de Cirugía General y AP. Digestivo, Cirugía Robótica, Hospital Ruber Juan Bravo, Madrid, España.
| | - Juan Carlos Meneu Díaz
- Servicio de Cirugía General y AP. Digestivo, Cirugía Robótica, Hospital Ruber Juan Bravo, Madrid, España
| | | | - Rubén Del Olmo López
- Servicio de Cirugía General y AP. Digestivo, Cirugía Robótica, Hospital Ruber Juan Bravo, Madrid, España
| | - Nestor Tabodada Mostajo
- Servicio de Cirugía General y AP. Digestivo, Cirugía Robótica, Hospital Ruber Juan Bravo, Madrid, España
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Liao X, Liu X, Fan X, Lai J, Zhang D. Perianal Paget's disease: a clinicopathological and immunohistochemical study of 13 cases. Diagn Pathol 2020; 15:29. [PMID: 32209119 PMCID: PMC7093992 DOI: 10.1186/s13000-020-00952-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/19/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Perianal Paget's disease (PPD) is rare and mostly described in clinical literature as case reports or small series. METHODS We investigated the clinicopathologic and immunohistochemical features of PPD in a total of 13 cases retrieved from multiple academic institutions. RESULTS The median age at diagnosis was 75 (range 50-86) years. Males were predominant with a male to female ratio of 2.25:1. Four (30.8%) cases were classified as primary PPD due to lack of synchronous or metachronous underlying malignancies, while nine (69.2%) were classified as secondary PPD with concurrent invasive adenocarcinoma (n = 8) or tubular adenoma with high-grade dysplasia (n = 1). Immunohistochemically, there is no differential expression of CK7 or CK20 in Paget's cells between primary and secondary PPD; however, GCDFP-15 was only positive in primary PPD (3/3 vs. 0/6, P = 0.012), while CDX2 was only positive in secondary PPD (0/3 vs. 7/7, P = 0.008), suggesting different cell origin. All patients received local surgical resection with or without adjuvant therapy. After a median follow-up of 47 months, one patient with secondary PPD (7.7%) died of disease progression from underlying adenocarcinoma. CONCLUSIONS PPD occurs in elderly patients with male predominance and is frequently associated with underlying malignancies. Differential expression of CDX2 and GCDFP-15 may help distinguishing primary vs. secondary PPD, which is important for management as the presence of an underlying malignancy impacts clinical course and prognosis. Surgical excision remains the major treatment strategy for PPD. Long-term follow-up is required to monitor the disease recurrence and metastasis.
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Affiliation(s)
- Xiaoyan Liao
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Xiuli Liu
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Xuemo Fan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jinping Lai
- Department of Pathology and Laboratory of Medicine, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA
| | - Dongwei Zhang
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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Migda M, Migda MS, Migda B, Mlosek RK, Maleńczyk M. The utility of high-frequency ultrasonography in preoperative assessment of vulvar Paget's disease - a case report. J Ultrason 2020; 19:311-313. [PMID: 32021714 PMCID: PMC6988460 DOI: 10.15557/jou.2019.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 11/25/2022] Open
Abstract
Paget’s disease of the vulva is a rare skin cancer accounting for less than 1% of all vulvar neoplasias. Surgery is the first treatment of choice. Unfortunately, it is insufficient in many cases, which require further treatment, and the risk of recurrence is high. We present a case of an 85-year-old woman who underwent surgery due to Paget’s disease of the vulva. A preoperative skin imaging using a high-frequency 48 MHz mechanical probe was used to assess the lesion margins. Typical high-frequency ultrasonographic features of vulvar Paget’s disease were identified and analyzed. This is the first report of high-frequency ultrasonography imaging of vulvar Paget’s disease.
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Affiliation(s)
- Michał Migda
- Clinical Unit of Obstetrics, Women's Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Torun, Poland.,Civis Vita Medical Center Torun, Poland
| | | | - Bartosz Migda
- Department of Diagnostic Imaging, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland
| | - Robert Krzysztof Mlosek
- Department of Diagnostic Imaging, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland
| | - Marek Maleńczyk
- Clinical Unit of Obstetrics, Women's Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Torun, Poland
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Abstract
RATIONAL Perianal Paget's disease (PPD) is a very rare intraepithelial adenocarcinoma. Very few cases of PPD have been reported till date, so the treatment remains controversial and more experience is needed. PATIENT CONCERNS A 73-year-old female was admitted to several hospitals with diagnosed as "perianal eczema" in perianal lesion. After a variety of treatments, the patient's condition did not improve. DIAGNOSES Abdominopelvic computed tomography and rectal magnetic resonance imaging showed thickening of the soft tissue around the anus, with significant enhancement. Histologic examination revealed the state of Paget's cells. INTERVENTIONS Laparoscopic Extralevator Abdominoperineal Excision (ELAPE) surgery was performed at our department. OUTCOMES The patient recovered well. After 10 months, a check-up revealed that her perianal area was disease-free. LESSONS The aim of this report was to present the characteristics of PPD in order to improve its diagnosis and treatment. Laparoscopic ELAPE is a successful therapy.
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Affiliation(s)
- Dong Zeng
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University
| | - Jianghong Chen
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, P.R. China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University
| | - Junke Li
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, P.R. China
| | - Hongyu Wu
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, P.R. China
| | - Dan Ma
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, P.R. China
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Guo H, Qi RQ, Sheng J, Liu C, Ma H, Wang HX, Li JH, Gao XH, Wan YS, Chen HD. MiR-155, a potential serum marker of extramammary Paget's disease. BMC Cancer 2018; 18:1078. [PMID: 30458743 PMCID: PMC6247506 DOI: 10.1186/s12885-018-4994-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/24/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extramammary Paget's disease (EMPD), a rare skin malignancy with non-specific manifestations, is often misdiagnosed as eczema of scrotum or tinea cruris. Although the diagnosis of EMPD could be confirmed by biopsy, it can be delayed as patients are reluctant to receive invasive operations. Herein, we investigated the serum miRNA expressions of EMPD patients and compared to that of the eczema of scrotum or tinea cruris patients as well as health volunteers for potential diagnostic markers for EMPD. METHODS Altogether 45 subjects including 16 patients diagnosed with EMPD, 12 patients diagnosed with eczema of scrotum or tinea cruris and 17 healthy volunteers were enrolled in this study. Serum from all of subjects were collected to identify miRNAs (by miRNA array global normalization, RT-PCR validation, and receiver operating characteristic curve analysis) that could be potential diagnostic markers for EMPD. RESULTS The miRNA array analyses revealed that the expressions of 37 miRNAs from the EMPD patients were different (change ≥4-fold) from health volunteers. Among these miRNAs, the expression of miR-155 was significantly increased (p < 0.01) in the EMPD patients as compared with that of the health volunteers and the eczema of scrotum or the tinea cruris patients (no difference between these two control groups). In addition, receiver operating characteristic (ROC) curve analysis showed that diagnostic capacities (defined as the area under curve of ROC) of miR-155 are 0.85 (as compared with health volunteers group) and 0.81 (as compared with the eczema of scrotum or the tinea cruris patients group), respectively. CONCLUSION The serum miRNA expression of gene miR-155 in the EMPD patients was differentiated from that of other subjects warranting further validation of miR-155 as a diagnostic marker of EMPD.
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Affiliation(s)
- Hao Guo
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Rui-Qun Qi
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Jie Sheng
- Department of Anesthesiology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Chang Liu
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - Hang Ma
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - He-Xiao Wang
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Jiu-Hong Li
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Xing-Hua Gao
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Yin-Sheng Wan
- Department of Physiology, Providence College, Providence, RI, 02918, USA
| | - Hong-Duo Chen
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China.
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Abstract
The skin and subcutaneous tissues are inevitably imaged as part of most body MRI studies. Incidental or even symptomatic skin lesions may, therefore, be detected and present a diagnostic challenge for the radiologist. We aim to provide a comprehensive review, with illustrative examples, of the skin abnormalities encountered on body MRI studies in our busy academic radiology department.
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Affiliation(s)
- David Becker-Weidman
- Great Lakes Medical Imaging, 199 Park Club Lane #300, Williamsville, NY, 14221, USA.
| | | | - Koenraad J Mortele
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02115, USA
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Yoshida Y, Goto H, Tsutsumi R, Yamamoto O. Use of an Anal Retractor Device for Excision in Patients with Perianal Extramammary Paget's Disease. Indian J Dermatol 2018; 63:435-437. [PMID: 30210173 PMCID: PMC6124241 DOI: 10.4103/ijd.ijd_251_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yuichi Yoshida
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, Yonago, Japan. E-mail:
| | - Hiroyuki Goto
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, Yonago, Japan. E-mail:
| | - Reiko Tsutsumi
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, Yonago, Japan. E-mail:
| | - Osamu Yamamoto
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, Yonago, Japan. E-mail:
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Ebrom P, Parizh D, Hajdu CH, Gadangi P. Paget's disease of the anus masking a mixed adenoneuroendocrine tumour of the rectum. BMJ Case Rep 2017; 2017:bcr-2016-218717. [PMID: 28196824 DOI: 10.1136/bcr-2016-218717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A man aged 83 years with vague perirectal symptoms had a delayed diagnosis of Paget's disease of the anus. A lack of thorough digital rectal examination failed to diagnose a mixed adenonueroendocrine tumour of the rectum in a timely matter.
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Affiliation(s)
- Pierson Ebrom
- Department of General Surgery, NYU Lutheran, Brooklyn, New York, USA
| | - David Parizh
- Department of General Surgery, NYU Lutheran, Brooklyn, New York, USA
| | - Cristina H Hajdu
- Department of Pathology, NYU Langone Medical Center, Brooklyn, New York, USA
| | - Pratap Gadangi
- Department of General Surgery, NYU Lutheran, Brooklyn, New York, USA
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Chumbalkar V, Jennings TA, Ainechi S, Lee EC, Lee H. Extramammary Paget's Disease of Anal Canal Associated With Rectal Adenoma Without Invasive Carcinoma. Gastroenterology Res 2016; 9:99-102. [PMID: 28058078 PMCID: PMC5191897 DOI: 10.14740/gr727e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 01/27/2023] Open
Abstract
Extramammary Paget's disease (EMPD) is a rare disease which is found in apocrine-rich locations such as anogenital region, axilla and rarely in other sites. Perianal EMPD is often reported as the involvement of perianal skin, but involvement of anal mucosa is very rare. Based on pathogenesis and association with either synchronous or metachronous malignancy, EMPD can be divided into primary and secondary types. Treatment approach for these two types of Paget's disease and their prognosis is different, thus it is important to make the distinction. Secondary type of Paget's disease is almost always described in association with invasive malignancy. While secondary Paget's disease arising in association with ductal carcinoma in situ of the breast is common, secondary EMPD associated with precursor lesion of the rectum without invasion is exceedingly rare. We report a very rare case of secondary Paget's disease of the anal canal in association with rectal tubular adenoma (precursor lesion) without malignancy.
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Affiliation(s)
- Vaibhav Chumbalkar
- Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
| | - Timothy A Jennings
- Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
| | - Sanaz Ainechi
- Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
| | - Edward C Lee
- General Surgery, Albany Medical College, Albany, NY, USA
| | - Hwajeong Lee
- Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
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