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Pittaro A, Crivelli F, Orlando G, Napoli F, Zambelli V, Guerrera F, Sobrero S, Volante M, Righi L, Papotti M. Pulmonary Low Malignant Potential Adenocarcinoma: A Validation of the Proposed Criteria for This Novel Subtype. Am J Surg Pathol 2024; 48:204-211. [PMID: 37981865 DOI: 10.1097/pas.0000000000002151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Adenocarcinoma (ADC) is the most common histologic type of lung cancer, including in situ (lepidic), minimally invasive, and invasive forms. While the former 2 types are associated with a favorable outcome, the latter includes tumors with variable behavior, often tumor stage-related. A recent study proposed strict morphologic criteria defining a new subgroup of resected stage I invasive ADC (16% of cases) with favorable outcomes (100% disease-specific survival), named "ADC of low malignant potential (LMP-ADC)." The following criteria were met: ≤3 cm size, nonmucinous histotype, ≥15% lepidic growth, and the absence of the following: high-grade patterns, >1 mitosis/2 mm 2 , necrosis, and vascular/pleural invasion. The aim of the present study was to validate the performance of such criteria to identify LMP-ADC in a series of 274 stage IA resected lung ADCs from a single institution. Thirty-four tumors (12.4%) met the proposed criteria for LMP-ADC, as confirmed by additional stains for mitotic figures, Ki67 index, and elastic fibers (helpful to assess alveolar wall invasion). Minor differences between the lepidic and invasive components were observed regarding cell atypia and proliferation. p53 was normally expressed by invasive tumor cells. Mutations occurred in known lung cancer genes (mostly KRAS and EGFR). Five patients (14.7%) developed disease progression and 2 of them (5.9%) died of the disease. In our series, the disease-specific survival was 94.1%. In conclusion, in resected invasive lung ADC, a subgroup presenting low-grade morphologic features and associated with favorable prognosis does exist. Morphologic criteria for LMP-ADC supported by ancillary techniques represent a valid tool to better define this novel subgroup and to refine the stratification of invasive lung ADC, possibly suggesting modified follow-up protocols, based on the observed indolent behavior in most cases.
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Affiliation(s)
| | | | | | | | | | | | | | - Marco Volante
- Department of Oncology, University of Torino
- Pathology, San Luigi Hospital, University of Turin, Orbassano, Torino, Italy
| | - Luisella Righi
- Department of Oncology, University of Torino
- Pathology, San Luigi Hospital, University of Turin, Orbassano, Torino, Italy
| | - Mauro Papotti
- Divisions of Pathology
- Department of Oncology, University of Torino
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2
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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Lyberis P, Nicosia S, Pittaro A, Papotti M, Ruffini E. IgG4-infiltrate in post-intubation tracheal stenosis: a call to interventional pulmonologist and thoracic surgeons. Minerva Surg 2023; 78:503-509. [PMID: 37166947 DOI: 10.23736/s2724-5691.23.09920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Since December 2019, Sars-CoV2 infection has become a pandemic health emergency. The most severe manifestation of COVID-19 is acute respiratory distress syndrome requiring intensive care unit admission and mechanical ventilation. The most serious, although rare, complication of prolonged MV is post-intubation tracheal stenosis. We hypothesized that, in addition to recognized risk factors in COVID-19 patients, additional factors may promote airways injury. METHODS We analyzed data from 13 patients with PITS referred to our Thoracic Surgery Department from 2020 to 2022 divided in two groups: 8 ex-COVID-19 patients (in MV for ARDS during Sars-Cov2 positivity) and 5 non-COVID-19 patients (in MV for other reasons). Computer-tomography and bronchoscopy were performed to confirm diagnosis of PITS. Surgical treatment including tracheal resection and end-to-end anastomosis was performed in all patients. Tracheal samples were histologically analyzed to define the existence of any difference between the two groups. RESULTS The presence of total immunoglobulin G (IgG) and immunoglobulin G4 (IgG4) were tested. IgG infiltrate was present in both groups. IgG4-infiltrate was significantly represented in the tracheal sample of ex-COVID-19 patients and absent in the non-COVID-19 cohort of patients. CONCLUSIONS It is suggested that COVID-19 patients have almost double the risk of developing tracheal injuries. This work supports the idea of a major predisposition for such injuries in COVID-19 patients due to a possible immune-mediated mechanism leading to aberrant and fibrotic wound healing following a trigger insult (in this case MV with oro-tracheal tube). In the near future an increasing incidence of PITS is expected. Interventional pulmonologist and thoracic surgeons might be called to deal with this possibility. Clarification of the physiopathology of PITS is needed to prevent excessive tracheal scarring following prolonged endotracheal intubation and recurrence after endoscopic and/or surgical treatment. Careful prevention, early detection and effective management of this life-threatening condition are warranted.
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Affiliation(s)
- Paraskevas Lyberis
- Department of Thoracic Surgery, Città della Salute e della Scienza, University Hospital, Turin, Italy -
| | - Samanta Nicosia
- Department of Thoracic Surgery, Città della Salute e della Scienza, University Hospital, Turin, Italy
| | - Alessandra Pittaro
- Department of Pathological Anatomy, Città della Salute e della Scienza, University Hospital, Turin, Italy
| | - Mauro Papotti
- Department of Pathological Anatomy, Città della Salute e della Scienza, University Hospital, Turin, Italy
| | - Enrico Ruffini
- Department of Thoracic Surgery, Città della Salute e della Scienza, University Hospital, Turin, Italy
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Bitetto G, Lopez G, Ronchi D, Pittaro A, Melzi V, Peverelli E, Cribiù FM, Comi GP, Mantovani G, Di Fonzo A. SCARB1 downregulation in adrenal insufficiency with Allgrove syndrome. Orphanet J Rare Dis 2023; 18:152. [PMID: 37331934 DOI: 10.1186/s13023-023-02763-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/04/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Allgrove disease is a rare genetic syndrome characterized by adrenal insufficiency, alacrimia, achalasia and complex neurological involvement. Allgrove disease is due to recessive mutations in the AAAS gene, which encodes for the nucleoporin Aladin, implicated in the nucleocytoplasmic transport. The adrenal insufficiency has been suggested to rely on adrenal gland-ACTH resistance. However, the link between the molecular pathology affecting the nucleoporin Aladin and the glucocorticoid deficiency is still unknown. RESULTS By analyzing postmortem patient's adrenal gland, we identified a downregulation of Aladin transcript and protein. We found a downregulation of Scavenger receptor class B-1 (SCARB1), a key component of the steroidogenic pathway, and SCARB1 regulatory miRNAs (mir125a, mir455) in patient's tissues. With the hypothesis of an impairment in the nucleocytoplasmic transport of the SCARB1 transcription enhancer cyclic AMP-dependent protein kinase (PKA), we detected a reduction of nuclear Phospho-PKA and a cytoplasmic mislocalization in patient's samples. CONCLUSIONS These results shed a light on the possible mechanisms linking ACTH resistance, SCARB1 impairment, and defective nucleocytoplasmic transport.
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Affiliation(s)
- Giacomo Bitetto
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Dario Ronchi
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Alessandra Pittaro
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Valentina Melzi
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Erika Peverelli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fulvia Milena Cribiù
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giacomo P Comi
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Giovanna Mantovani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessio Di Fonzo
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
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Manganaro L, Bianco S, Bironzo P, Cipollini F, Colombi D, Corà D, Corti G, Doronzo G, Errico L, Falco P, Gandolfi L, Guerrera F, Monica V, Novello S, Papotti M, Parab S, Pittaro A, Primo L, Righi L, Sabbatini G, Sandri A, Vattakunnel S, Bussolino F, Scagliotti GV. Consensus clustering methodology to improve molecular stratification of non-small cell lung cancer. Sci Rep 2023; 13:7759. [PMID: 37173325 PMCID: PMC10182023 DOI: 10.1038/s41598-023-33954-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Recent advances in machine learning research, combined with the reduced sequencing costs enabled by modern next-generation sequencing, paved the way to the implementation of precision medicine through routine multi-omics molecular profiling of tumours. Thus, there is an emerging need of reliable models exploiting such data to retrieve clinically useful information. Here, we introduce an original consensus clustering approach, overcoming the intrinsic instability of common clustering methods based on molecular data. This approach is applied to the case of non-small cell lung cancer (NSCLC), integrating data of an ongoing clinical study (PROMOLE) with those made available by The Cancer Genome Atlas, to define a molecular-based stratification of the patients beyond, but still preserving, histological subtyping. The resulting subgroups are biologically characterized by well-defined mutational and gene-expression profiles and are significantly related to disease-free survival (DFS). Interestingly, it was observed that (1) cluster B, characterized by a short DFS, is enriched in KEAP1 and SKP2 mutations, that makes it an ideal candidate for further studies with inhibitors, and (2) over- and under-representation of inflammation and immune systems pathways in squamous-cell carcinomas subgroups could be potentially exploited to stratify patients treated with immunotherapy.
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Affiliation(s)
- L Manganaro
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - S Bianco
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - P Bironzo
- Medical Oncology Division at San Luigi Hospital, Department of Oncology, University of Torino, Orbassano (TO), Italy
| | - F Cipollini
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - D Colombi
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - D Corà
- Department of Translational Medicine, Piemonte Orientale University, Novara, Italy
- Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Novara, Italy
| | - G Corti
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - G Doronzo
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - L Errico
- Division of Thoracic Surgery at AOU San Luigi, Department of Oncology, University of Torino, Orbassano (TO), Italy
| | - P Falco
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - L Gandolfi
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - F Guerrera
- Division of Thoracic Surgery at AOU Città della Salute e della Scienza, Department of Surgical Sciences, University of Torino, Torino, Italy
| | - V Monica
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - S Novello
- Medical Oncology Division at San Luigi Hospital, Department of Oncology, University of Torino, Orbassano (TO), Italy
| | - M Papotti
- Pathology Division at AOU Città della Salute e della Scienza, Department of Oncology, University of Torino, Torino, Italy
| | - S Parab
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - A Pittaro
- Pathology Division at AOU Città della Salute e della Scienza, Department of Oncology, University of Torino, Torino, Italy
| | - L Primo
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - L Righi
- Pathology Division at AOU San Luigi, Department of Oncology, University of Torino, Orbassano (TO), Italy
| | - G Sabbatini
- aizoOn Technology Consulting S.R.L, Torino, Italy
| | - A Sandri
- Division of Thoracic Surgery at AOU San Luigi, Department of Oncology, University of Torino, Orbassano (TO), Italy
| | | | - F Bussolino
- Department of Oncology, University of Torino, 10060, Candiolo, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - G V Scagliotti
- Medical Oncology Division at San Luigi Hospital, Department of Oncology, University of Torino, Orbassano (TO), Italy.
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Borella F, Bertero L, Di Giovanni F, Witel G, Orlando G, Ricci AA, Pittaro A, Castellano I, Cassoni P. COVID-19 and Breast Cancer: Analysis of Surgical Management of a Large Referral Center during the 2020-2021 Pandemic Period. Curr Oncol 2023; 30:4767-4778. [PMID: 37232817 DOI: 10.3390/curroncol30050359] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/03/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Coronavirus disease-19 (COVID-19) has spread worldwide since December 2019 and was officially declared a pandemic in March 2020. Due to the rapid transmission and the high fatality rate, drastic emergency restrictions were issued, with a negative impact on routine clinical activities. In particular, in Italy, many authors have reported a reduction in the number of breast cancer diagnoses and critical problems in the management of patients who accessed the breast units during the dramatic first months of the pandemic. Our study aims to analyze the global impact of COVID-19 in the two years of the pandemic (2020-2021) on the surgical management of breast cancer by comparing them with the previous two years. METHODS In our retrospective study, we analyzed all cases of breast cancer diagnosed and surgically treated at the breast unit of "Città della Salute e della Scienza" in Turin, Italy, making a comparison between the 2018-2019 pre-pandemic period and the 2020-2021 pandemic period. RESULTS We included in our analysis 1331 breast cancer cases surgically treated from January 2018 to December 2021. A total of 726 patients were treated in the pre-pandemic years and 605 in the pandemic period (-121 cases, 9%). No significant differences were observed regarding diagnosis (screening vs. no screening) and timing between radiological diagnosis and surgery for both in situ and invasive tumors. There were no variations in the breast surgical approach (mastectomy vs. conservative surgery), while a reduction in axillary dissection compared to the sentinel lymph node in the pandemic period was observed (p-value < 0.001). Regarding the biological characteristics of breast cancers, we observed a greater number of grades 2-3 (p-value = 0.007), pT stage 3-4 breast cancer surgically treated without previous neoadjuvant chemotherapy (p-value = 0.03), and a reduction in luminal B tumors (p-value = 0.007). CONCLUSIONS Overall, we report a limited reduction in surgical activity for breast cancer treatment considering the entire pandemic period (2020-2021). These results suggest a prompt resumption of surgical activity similar to the pre-pandemic period.
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Affiliation(s)
- Fulvio Borella
- Obstetrics and Gynecology Unit 1, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Fabrizia Di Giovanni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Gianluca Witel
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Orlando
- Pathology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Alessia Andrea Ricci
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Alessandra Pittaro
- Pathology Unit, Città della Salute e della Scienza University Hospital, 10126 Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
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7
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Metovic J, Cascardi E, Uccella S, Maragliano R, Querzoli G, Osella-Abate S, Pittaro A, La Rosa S, Bogina G, Cassoni P, Marchiò C, Sapino A, Castellano I, Papotti M. Neuroendocrine neoplasms of the breast: diagnostic agreement and impact on outcome. Virchows Arch 2022; 481:839-846. [PMID: 36243799 PMCID: PMC9734208 DOI: 10.1007/s00428-022-03426-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 01/25/2023]
Abstract
The classification of breast neuroendocrine neoplasms (Br-NENs) was modified many times over the years and is still a matter of discussion. In the present study, we aimed to evaluate the diagnostic reproducibility and impact on patient outcomes of the most recent WHO 2019 edition of breast tumor classification, namely, for neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). This multicentric observational study included 287 breast neoplasms with NE differentiation. The cases were blindly classified by three independent groups of dedicated breast and/or endocrine pathologists following the 2019 guidelines. Diagnostic concordance and clinical impact were assessed. We observed only a moderate overall diagnostic agreement across the three centers (Cohen's kappa 0.4532) in distinguishing NET from solid papillary carcinomas (SPCs) and no special type carcinomas (NST) with NE differentiation. Br-NENs were diagnosed in 122/287 (42.5%) cases, subclassified as 11 NET G1 (3.8%), 84 NET G2 (29.3%), and 27 NEC (9.4%), the latter group consisting of 26 large-cell and 1 small-cell NECs. The remaining 165/287 (57.5%) cases were labeled as non-NEN, including SPC, mucinous, NST, and mixed NE carcinomas. While NET and non-NEN cases had a comparable outcome, the diagnosis of NECs showed negative impact on disease-free interval compared to NETs and non-NENs (p = 0.0109). In conclusion, the current diagnostic classification of Br-NENs needs further adjustments regarding morphological and immunohistochemical criteria to increase the diagnostic reproducibility among pathologists. Our data suggest that, apart from high-grade small- and large-cell NECs, Br-NENs behave like non-NEN breast carcinomas and should be managed similarly.
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Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - Eliano Cascardi
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy
| | - Silvia Uccella
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Roberta Maragliano
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giulia Querzoli
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Alessandra Pittaro
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Stefano La Rosa
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giuseppe Bogina
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Caterina Marchiò
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Anna Sapino
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
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8
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Bitonto V, Ruggiero MR, Pittaro A, Castellano I, Bussone R, Broche LM, Lurie DJ, Aime S, Baroni S, Geninatti Crich S. Low-Field NMR Relaxometry for Intraoperative Tumour Margin Assessment in Breast-Conserving Surgery. Cancers (Basel) 2021; 13:cancers13164141. [PMID: 34439294 PMCID: PMC8392401 DOI: 10.3390/cancers13164141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Breast cancer is the most diagnosed cancer for women, and clear surgical margins in breast-conserving surgery (BCS) are essential for preventing recurrence. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new tool for intraoperative margin assessment was evaluated. The technique allows the determination of the tissue proton relaxation rates as a function of the applied magnetic field on small tissue samples excised from surgical specimens, at the margins of tumour resection, prior to histopathological analysis. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved. The discriminating ability shown by the relaxometric assay relies mainly on the difference of fat/water content between healthy and tumour cells. The information obtained has the potential to support the surgeon in real-time margin assessment during BCS. Abstract As conserving surgery is routinely applied for the treatment of early-stage breast cancer, the need for new technology to improve intraoperative margin assessment has become increasingly important. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new diagnostic tool was evaluated. The technique allows the determination of the tissue proton relaxation rates (R1), as a function of the applied magnetic field, which are affected by the changes in the composition of the mammary gland tissue occurring during the development of neoplasia. The study involved 104 small tissue samples obtained from surgical specimens destined for histopathology. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved by using two quantifiers, namely (i) the slope of the line joining the R1 values measured at 0.02 and 1 MHz and (ii) the sum of the R1 values measured at 0.39 and 1 MHz. The method is fast, and it does not rely on the expertise of a pathologist or cytologist. The obtained results suggest that a simplified, low-cost, automated instrument might compete well with the currently available tools in margin assessment.
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Affiliation(s)
- Valeria Bitonto
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Maria Rosaria Ruggiero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Alessandra Pittaro
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | | | - Lionel M. Broche
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - David J. Lurie
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - Silvio Aime
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- IRCCS SDN, Via E. Gianturco 113, 80143 Napoli, Italy
| | - Simona Baroni
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- Correspondence:
| | - Simonetta Geninatti Crich
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
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9
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Bitetto G, Ronchi D, Bonato S, Pittaro A, Compagnoni GM, Bordoni A, Salani S, Frattini E, Lopez G, Cribiù FM, Corti S, Comi GP, Bresolin N, Di Fonzo A. Loss of the nucleoporin Aladin in central nervous system and fibroblasts of Allgrove Syndrome. Hum Mol Genet 2020; 28:3921-3927. [PMID: 31600784 DOI: 10.1093/hmg/ddz236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/04/2019] [Accepted: 09/07/2019] [Indexed: 11/12/2022] Open
Abstract
Allgrove syndrome (AS) is a rare disease with broad neurological involvement. Neurodegeneration can affect spinal motor neurons, Purkinje cells, striatal neurons and the autonomic system. The mechanisms that lead to neuronal loss are still unclear. Recessive mutations in the AAAS gene affect the encoded protein Aladin, which would normally localize to the cytoplasmic face of the nuclear membrane as part of the nuclear pore complex (NPC). While the NPC is known to be a key factor for nucleocytoplasmic transport, the precise role of Aladin has not been elucidated yet. Here, we explored the consequences of the homozygous AAAS mutation c.464G>A (p.R155H) in central nervous system tissues and fibroblasts of a novel AS patient presenting motor neuron disease, cerebellar ataxia and autonomic dysfunction. Neuropathological analyses showed severe loss of motor neurons and Purkinje cells, with significant reduction in the perinuclear expression of Aladin. A reduced amount of protein was detected in the nuclear membrane fraction of the patient's brain. RNA analysis revealed a significant reduction of the transcript AAAS-1, while the AAAS-2 transcript was upregulated in fibroblasts. To our knowledge, this is the first study to demonstrate the effects of AAAS mutations in the human central nervous system.
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Affiliation(s)
- Giacomo Bitetto
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Dario Ronchi
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Sara Bonato
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandra Pittaro
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Giacomo Monzio Compagnoni
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andreina Bordoni
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Sabrina Salani
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emanuele Frattini
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Fulvia Milena Cribiù
- Division of Pathology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Stefania Corti
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giacomo P Comi
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Nereo Bresolin
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessio Di Fonzo
- Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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10
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Affiliation(s)
- Alessandra Pittaro
- 1 Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elisabetta Iofrida
- 1 Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Fusco
- 1 Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,2 University of Milan, Milan, Italy
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11
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Duregon E, Bertero L, Pittaro A, Soffietti R, Rudà R, Trevisan M, Papotti M, Ventura L, Senetta R, Cassoni P. Ki-67 proliferation index but not mitotic thresholds integrates the molecular prognostic stratification of lower grade gliomas. Oncotarget 2018; 7:21190-8. [PMID: 27049832 PMCID: PMC5008278 DOI: 10.18632/oncotarget.8498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 02/28/2016] [Accepted: 03/26/2016] [Indexed: 01/07/2023] Open
Abstract
Despite several molecular signatures for “lower grade diffuse gliomas” (LGG) have been identified, WHO grade still remains a cornerstone of treatment guidelines. Mitotic count bears a crucial role in its definition, although limited by the poor reproducibility of standard Hematoxylin & Eosin (H&E) evaluation. Phospho-histone-H3 (PHH3) and Ki-67 have been proposed as alternative assays of cellular proliferation. Therefore in the present series of 141 LGG, the molecular characterization (namely IDH status, 1p/19q co-deletion and MGMT promoter methylation) was integrated with the tumor “proliferative trait” (conventional H&E or PHH3-guided mitotic count and Ki-67 index) in term of prognosis definition. Exclusively high PHH3 and Ki-67 values were predictor of poor prognosis (log rank test, P = 0.0281 for PHH3 and P = 0.032 for Ki-67), unlike standard mitotic count. Based on Cox proportional hazard regression analyses, among all clinical (age), pathological (PHH3 and Ki-67) and molecular variables (IDH, 1p/19q codeletion and MGMT methylation) with a prognostic relevance at univariate survival analysis, only IDH expression (P = 0.001) and Ki-67 proliferation index (P = 0.027) proved to be independent prognostic factors. In addition, stratifying by IDH expression status, high Ki-67 retained its prognostic relevance uniquely in the IDH negative patient (P = 0.029) doubling their risk of death (hazard ratio = 2.27). Overall, PHH3 immunostaining is the sole reliable method with a prognostic value to highlight mitotic figures in LGG. Ki-67 proliferation index exceeds PHH3 mitotic count as a predictor of patient's prognosis, and should be integrated with molecular markers in a comprehensive grading system for LGG.
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Affiliation(s)
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Riccardo Soffietti
- Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy
| | - Roberta Rudà
- Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy
| | - Morena Trevisan
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin, Turin, Italy.,CPO-Piemonte, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Laura Ventura
- Department of Statistical Sciences, University of Padua, Padova, Italy
| | - Rebecca Senetta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
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12
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Gilardi L, Vadrucci M, Pittaro A, Pennacchioli E, Rizzo S. 18 F-FDG PET/CT in aggressive angiomyxoma of the pelvis. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Gilardi L, Vadrucci M, Pittaro A, Pennacchioli E, Rizzo S. 18 F-FDG PET/CT in aggressive angiomyxoma of the pelvis. Rev Esp Med Nucl Imagen Mol 2017; 36:403-405. [DOI: 10.1016/j.remn.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
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14
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Duregon E, Senetta R, Bertero L, Bussolati B, Annaratone L, Pittaro A, Papotti M, Marchiò C, Cassoni P. Caveolin 1 expression favors tumor growth and is associated with poor survival in primary lung adenocarcinomas. Tumour Biol 2017; 39:1010428317694311. [DOI: 10.1177/1010428317694311] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite the consolidated clinico-pathological correlates of Caveolin 1 expression in non–small cell lung cancer, the available data on the role of Caveolin 1 in relation to proliferation, migration, and metastasis in lung adenocarcinoma cells is still scant. Here, we aimed to confirm whether Caveolin 1 may act as a promoter of cell growth in human lung adenocarcinoma using in vitro and in vivo models, supported by a survival analysis of Caveolin 1 expression in a series of 116 primary lung adenocarcinomas. The silencing of endogenous Caveolin 1 expression in H522 lung adenocarcinoma cells through stable shRNA transfection significantly inhibited cellular proliferation in vitro and in vivo, in a lung adenocarcinoma xenograft mouse model. The bioluminescence imaging analysis revealed that tumors derived from Caveolin 1 shRNA-transfected cells grew slower than control xenografts. However, this difference progressively diminished over time and was definitively lost after 21 days. This was consistent with a progressive Caveolin 1 re-expression, which started at day 7. The association between the restored expression of Caveolin 1 and the restart of tumor growth in vivo supports the booster role of Caveolin 1 in lung adenocarcinoma progression. To further confirm this role, Caveolin 1 expression was assessed by immunohistochemistry in a series of 116 human lung adenocarcinomas. Positive Caveolin 1 tumors accounted for 20% of cases and were associated with a significantly worse overall survival compared to Caveolin 1-negative cancers. Taken together, these data highlight that Caveolin 1 expression confers a proliferative advantage in lung adenocarcinoma cells, thus fostering increased tumor aggressiveness.
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Affiliation(s)
| | - Rebecca Senetta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Benedetta Bussolati
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Mauro Papotti
- Department of Oncology, University of Turin, Orbassano, Italy
| | - Caterina Marchiò
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
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15
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Marchi S, Corricelli M, Trapani E, Bravi L, Pittaro A, Delle Monache S, Ferroni L, Patergnani S, Missiroli S, Goitre L, Trabalzini L, Rimessi A, Giorgi C, Zavan B, Cassoni P, Dejana E, Retta SF, Pinton P. Defective autophagy is a key feature of cerebral cavernous malformations. EMBO Mol Med 2016; 7:1403-17. [PMID: 26417067 PMCID: PMC4644374 DOI: 10.15252/emmm.201505316] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [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] [Indexed: 12/27/2022] Open
Abstract
Cerebral cavernous malformation (CCM) is a major cerebrovascular disease affecting approximately 0.3-0.5% of the population and is characterized by enlarged and leaky capillaries that predispose to seizures, focal neurological deficits, and fatal intracerebral hemorrhages. Cerebral cavernous malformation is a genetic disease that may arise sporadically or be inherited as an autosomal dominant condition with incomplete penetrance and variable expressivity. Causative loss-of-function mutations have been identified in three genes, KRIT1 (CCM1), CCM2 (MGC4607), and PDCD10 (CCM3), which occur in both sporadic and familial forms. Autophagy is a bulk degradation process that maintains intracellular homeostasis and that plays essential quality control functions within the cell. Indeed, several studies have identified the association between dysregulated autophagy and different human diseases. Here, we show that the ablation of the KRIT1 gene strongly suppresses autophagy, leading to the aberrant accumulation of the autophagy adaptor p62/SQSTM1, defective quality control systems, and increased intracellular stress. KRIT1 loss-of-function activates the mTOR-ULK1 pathway, which is a master regulator of autophagy, and treatment with mTOR inhibitors rescues some of the mole-cular and cellular phenotypes associated with CCM. Insufficient autophagy is also evident in CCM2-silenced human endothelial cells and in both cells and tissues from an endothelial-specific CCM3-knockout mouse model, as well as in human CCM lesions. Furthermore, defective autophagy is highly correlated to endothelial-to-mesenchymal transition, a crucial event that contributes to CCM progression. Taken together, our data point to a key role for defective autophagy in CCM disease pathogenesis, thus providing a novel framework for the development of new pharmacological strategies to prevent or reverse adverse clinical outcomes of CCM lesions.
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Affiliation(s)
- Saverio Marchi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Mariangela Corricelli
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Eliana Trapani
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Luca Bravi
- IFOM FIRC Institute of Molecular Oncology, Milano, Italy
| | | | - Simona Delle Monache
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | - Letizia Ferroni
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Simone Patergnani
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Sonia Missiroli
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Luca Goitre
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Lorenza Trabalzini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Alessandro Rimessi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Carlotta Giorgi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Barbara Zavan
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Torino, Torino, Italy
| | | | | | - Paolo Pinton
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
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16
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Senetta R, Mellai M, Manini C, Castellano I, Bertero L, Pittaro A, Schiffer D, Boldorini R, Cassoni P. Mesenchymal/radioresistant traits in granular astrocytomas: evidence from a combined clinical and molecular approach. Histopathology 2016; 69:329-37. [PMID: 26845757 DOI: 10.1111/his.12944] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/26/2016] [Accepted: 01/31/2016] [Indexed: 01/18/2023]
Abstract
AIMS Granular-cell astrocytomas (GCAs) are morphologically characterized by a prominent component of granular periodic acid-Schiff-positive cells, and show increased aggressiveness as compared with 'ordinary' astrocytomas. The aim of this study was to investigate, in a small series of three GCAs, the expression of mesenchymal/radioresistance-associated biomarkers [such as chitinase-3-like protein 1 (YKL-40), hepatocyte growth factor receptor (c-Met), and caveolin 1 (Cav1)] that could contribute to the poor outcome associated with this glioma subgroup. METHODS AND RESULTS Our results show that GCAs, according to the new molecular glioma classifications, consistently show a prognostically negative molecular trait (IDH1wt-ATRX noloss-1p/19q nocodeletion). Furthermore, GCAs significantly differed from a control series of 33 'conventional' astrocytomas, because of diffuse and strong immunohistochemical coexpression of YKL-40, c-Met, and Cav1. CONCLUSIONS Our findings show that specific morphological traits, such as a granular-cell component, could represent useful features in guiding the search for prognostic and predictive biomarkers that could eventually be therapy-targetable (e.g. Met inhibitors aimed at reducing radioresistance).
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Affiliation(s)
- Rebecca Senetta
- Department of Medical Sciences, University of Turin, Turin, Italy.,IRCCS Candiolo, Turin, Italy
| | - Marta Mellai
- Neuro-Bio-Oncology Centre/Policlinico di Monza Foundation, Vercelli, Italy
| | - Claudia Manini
- Division of Pathology, Giovanni Bosco Hospital, Turin, Italy
| | | | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Davide Schiffer
- Neuro-Bio-Oncology Centre/Policlinico di Monza Foundation, Vercelli, Italy
| | - Renzo Boldorini
- Unit of Pathology, Department of Health Sciences, University of Eastern Piedmont 'Amedeo Avogadro', Novara, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
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17
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Duregon E, Senetta R, Pittaro A, Verdun di Cantogno L, Stella G, De Blasi P, Zorzetto M, Mantovani C, Papotti M, Cassoni P. CAVEOLIN-1 expression in brain metastasis from lung cancer predicts worse outcome and radioresistance, irrespective of tumor histotype. Oncotarget 2015; 6:29626-36. [PMID: 26315660 PMCID: PMC4745751 DOI: 10.18632/oncotarget.4988] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/16/2015] [Indexed: 02/02/2023] Open
Abstract
Brain metastases develop in one-third of patients with non-small-cell lung cancer and are associated with a dismal prognosis, irrespective of surgery or chemo-radiotherapy. Pathological markers for predicting outcomes after surgical resection and radiotherapy responsiveness are still lacking. Caveolin 1 has been associated with chemo- and radioresistance in various tumors, including non-small-cell lung cancer. Here, caveolin 1 expression was assessed in a series of 69 brain metastases from non-small-cell lung cancer and matched primary tumors to determine its role in predicting survival and radiotherapy responsiveness. Only caveolin 1 expression in brain metastasis was associated with poor prognosis and an increased risk of death (log rank test, p = 0.015). Moreover, in the younger patients (median age of <54 years), caveolin 1 expression neutralized the favorable effect of young age on survival compared with the older patients. Among the radiotherapy-treated patients, an increased risk of death was detected in the group with caveolin 1-positive brain metastasis (14 out of 22 patients, HR=6.839, 95% CI 1.849 to 25.301, Wald test p = 0.004). Overall, caveolin 1 expression in brain metastasis from non-small-cell lung cancer is independently predictive of worse outcome and radioresistance and could become an additional tool for personalized therapy in the critical subset of brain-metastatic non-small-cell lung cancer patients.
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Affiliation(s)
- Eleonora Duregon
- Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Turin, Italy
| | | | | | | | - Giulia Stella
- Laboratory of Biochemistry and Genetics, Pneumology Unit, Department of Molecular Medicine University and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Michele Zorzetto
- Laboratory of Biochemistry and Genetics, Pneumology Unit, Department of Molecular Medicine University and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Mauro Papotti
- Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Torino, Italy
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18
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Duregon E, Cassenti A, Pittaro A, Ventura L, Senetta R, Rudà R, Cassoni P. Better see to better agree: phosphohistone H3 increases interobserver agreement in mitotic count for meningioma grading and imposes new specific thresholds. Neuro Oncol 2015; 17:663-9. [PMID: 25646026 DOI: 10.1093/neuonc/nov002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 06/25/2014] [Accepted: 12/30/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mitotic count on hematoxylin and eosin (H&E)-stained slides is a crucial diagnostic criterion in meningioma grading. However, mitosis assessment on H&E slides can be impaired by technical factors and by pathologist's experience. Phosphohistone H3 (PHH3) serine-10 is a mitosis-specific antibody that has proven to facilitate mitotic count in various tumors. METHODS A series of 70 meningiomas (15 grade I, 40 grade II, 15 grade III) was used to validate PHH3 intra- and interobserver reproducibility and to identify PHH3-specific mitotic thresholds. Four pathologists with different experience in neuropathology counted mitoses on both H&E- and PHH3-stained slides. RESULTS H&E and PHH3 mitotic rates were highly correlated (Pearson's r = 0.92, P < .0001). PHH3 mitotic counts had both a good mean interobserver correlation (R(m) = 0.83) and a good intraclass correlation (0.78), higher than H&E mitotic indices (R(m) = 0.77, intraclass correlation = 0.71). After further stratification of meningiomas according to World Health Organization grade, PHH3 performed better in terms of interobserver concordance (Kendall's W = 0.761) compared with H&E (Kendall's W = 0.697). Referring to the same meningioma groups identified by World Health Organization grade as the gold standard, the volume under the receiver operator characteristic surface was 0.91, indicating a very good diagnostic ability of PHH3 scores in discriminating the 3 meningioma groups. The 2 optimal PHH3-specific cutoff values were 6.61 and 22.02. CONCLUSION PHH3 staining is a useful diagnostic complementary tool to standard H&E mitotic count, optimizing intra- and interobserver reproducibility. PHH3-specific mitotic thresholds should be adopted to avoid overgrading of meningioma when ancillary methods are employed.
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Affiliation(s)
- Eleonora Duregon
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Adele Cassenti
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Alessandra Pittaro
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Laura Ventura
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Rebecca Senetta
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Roberta Rudà
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Paola Cassoni
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
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