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Lobo J, Canete-Portillo S, Pena MDCR, McKenney JK, Aron M, Massicano F, Wilk BM, Gajapathy M, Brown DM, Baydar DE, Matoso A, Rioux-Leclerq N, Pan CC, Tretiakova MS, Trpkov K, Williamson SR, Rais-Bahrami S, Mackinnon AC, Harada S, Worthey EA, Magi-Galluzzi C. Molecular Characterization of Juxtaglomerular Cell Tumors: Evidence of Alterations in MAPK-RAS Pathway. Mod Pathol 2024; 37:100492. [PMID: 38614322 DOI: 10.1016/j.modpat.2024.100492] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/18/2024] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
Juxtaglomerular cell tumor (JGCT) is a rare neoplasm, part of the family of mesenchymal tumors of the kidney. Although the pathophysiological and clinical correlates of JGCT are well known, as these tumors are an important cause of early-onset arterial hypertension refractory to medical treatment, their molecular background is unknown, with only few small studies investigating their karyotype. Herein we describe a multi-institutional cohort of JGCTs diagnosed by experienced genitourinary pathologists, evaluating clinical presentation and outcome, morphologic diversity, and, importantly, the molecular features. Ten JGCTs were collected from 9 institutions, studied by immunohistochemistry, and submitted to whole exome sequencing. Our findings highlight the morphologic heterogeneity of JGCT, which can mimic several kidney tumor entities. Three cases showed concerning histologic features, but the patient course was unremarkable, which suggests that morphologic evaluation alone cannot reliably predict the clinical behavior. Gain-of-function variants in RAS GTPases were detected in JGCTs, with no evidence of additional recurrent genomic alterations. In conclusion, we present the largest series of JGCT characterized by whole exome sequencing, highlighting the putative role of the MAPK-RAS pathway.
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Affiliation(s)
- João Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto; Cancer Biology and Epigenetics Group, IPO Porto Research Center (GEBC CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center Raquel Seruca (P.CCC) and RISE@CI-IPOP (Health Research Network), Porto, Portugal; Department of Pathology and Molecular Immunology, ICBAS - School of Medicine and Biomedical Sciences, Porto, Portugal
| | - Sofia Canete-Portillo
- Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | | | - Jesse K McKenney
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Manju Aron
- Department of Pathology and Laboratory Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Felipe Massicano
- Department of Genetics, Center for Computational Genomics and Data Science, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Brandon M Wilk
- Department of Genetics, Center for Computational Genomics and Data Science, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Manavalan Gajapathy
- Department of Genetics, Center for Computational Genomics and Data Science, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Donna M Brown
- Department of Genetics, Center for Computational Genomics and Data Science, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Dilek E Baydar
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Andres Matoso
- Departments of Pathology, Urology, Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Chin-Chen Pan
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Maria S Tretiakova
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
| | - Sean R Williamson
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Soroush Rais-Bahrami
- Department of Urology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama; Department of Radiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Alexander C Mackinnon
- Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Shuko Harada
- Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Elizabeth A Worthey
- Department of Genetics, Center for Computational Genomics and Data Science, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama
| | - Cristina Magi-Galluzzi
- Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Albama.
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Harada S, Mackinnon AC. Navigating Next-Generation Sequencing Laboratory Developed Tests: A Critical Look at Proficiency Testing, US Food and Drug Administration Regulations, and Clinical Laboratory Performance. Arch Pathol Lab Med 2024; 148:136-138. [PMID: 37934951 DOI: 10.5858/arpa.2023-0477-ed] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/09/2023]
Affiliation(s)
- Shuko Harada
- From the Department of Pathology, The University of Alabama, Birmingham
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3
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Aron M, Chandrashekar DS, Canete-Portillo S, Brimo F, Williamson SR, Osunkoya AO, Raspollini MR, Kunju LP, Varambally S, Mackinnon AC, Harada S, Netto GJ. Nested and Large Nested Subtypes of Urothelial Carcinoma of the Upper Urinary Tract: A Multi-institutional Study. Mod Pathol 2023; 36:100333. [PMID: 37717923 DOI: 10.1016/j.modpat.2023.100333] [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: 07/03/2023] [Revised: 08/27/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Nested urothelial carcinoma (NUC) and large nested urothelial carcinoma (LNUC) of the upper urinary tract are exceedingly rare. This has contributed to the paucity of information regarding their clinicopathological and molecular characteristics. To address this knowledge gap, we explored the largest cohort to date of these rare tumors, comprising resection specimens of 10 LNUC and 7 NUC, from 7 participating institutions. Clinicopathological data were retrieved and documented. Whole exome sequencing and RNA sequencing were performed on the Illumina NovaSeq 6000 sequencer. The data generated were analyzed using the genome analysis toolkit pipeline. Somatic mutations were annotated using funcotator tool to identify pathogenic/likely pathogenic variants. Tumor mutational burden was calculated using python-based "pyTMB" tool. Microsatellite instability analysis was done using MSIsensor2 and the Idylla platform. Differential expression analysis of genes in LNUC and NUC along with mRNA expression-based molecular subtyping was performed by analyzing expression pattern of markers used in The Cancer Genome Atlas subclassification of bladder carcinoma. Both tumor types were more common in older males, were unifocal, and occurred more commonly mixed with minor components of predominantly conventional urothelial carcinoma. Overlying low-grade papillary urothelial carcinoma was significantly more common in LNUC (P = .034). On follow-up (LNUC: median, 10 months; range, 3-84 months; NUC: median, 9 months; range, 2-48 months), LNUC had better clinical outcomes (P = .031). Pathogenic mutations in FGFR3 and PIK3CA were significantly more common in LNUC (P = .049 and P = .044, respectively), with the latter present exclusively in LNUC. Seventy-five percent of the cases showed tumor mutational burden of <10, and all cases were microsatellite-stable. FGFR3 mutations were also more common in low-stage tumors. This study expands on the clinicopathological spectrum of NUC and LNUC of the upper urinary tract and is the first to comprehensively analyze the molecular profile of these tumors, highlighting pathogenic genetic alterations of potential therapeutic and prognostic value.
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Affiliation(s)
- Manju Aron
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Sofia Canete-Portillo
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Fadi Brimo
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | | | - Adeboye O Osunkoya
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia; Department of Urology, Emory University School of Medicine, Atlanta, Georgia
| | | | - Lakshmi P Kunju
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | | | - Alexander C Mackinnon
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama.
| | - George J Netto
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama.
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Anderson SA, Harbi D, Oramas Mogrovejo D, Floyd AD, Eltoum IE, Fatima H, Rosenblum F, Lora Gonzalez M, Lin D, Mackinnon AC, Siegal GP, Winokur T, Yalniz C, Huo L, Harada S, Huang X. PD-L1 (22C3) Expression Correlates with Clinical and Molecular Features of Lung Adenocarcinomas in Cytological Samples. Acta Cytol 2023; 67:507-518. [PMID: 37494911 DOI: 10.1159/000532036] [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: 05/18/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION PD-L1 expression is the most widely used predictive marker for immune checkpoint inhibitor (ICI) therapy in patients with lung adenocarcinoma. However, the current understanding of the association between PD-L1 expression and treatment response is suboptimal. A significant percentage of patients have only a cytological specimen available for clinical management. Therefore, it is relevant to examine the impact of molecular features on PD-L1 expression in cytological samples and how it might correlate with a therapeutic response. METHODS We evaluated patients diagnosed with adenocarcinoma of the lung who had both in-house targeted next-generation sequencing analysis and paired PD-L1 (22C3) immunohistochemical staining performed on the same cell blocks. We explored the association between molecular features and PD-L1 expression. In patients who underwent ICIs therapy, we assessed how a specific gene mutation impacted a therapeutic response. RESULTS 145 patients with lung adenocarcinoma were included in this study. PD-L1-high expression was found to be more common in pleural fluid than in other sample sites. Regional lymph node samples showed a higher proportion of PD-L1-high expression (29%) compared with lung samples (6%). The predictive value of PD-L1 expression was retained in cytological samples. Mutations in KRAS were also associated with a PD-L1-high expression. However, tumors with TP53 or KRAS mutations showed a lower therapy response rate regardless of the PD-L1 expression. CONCLUSION Cytological samples maintain a predictive value for PD-L1 expression in patients with lung adenocarcinoma as regards the benefit of ICI treatment. Specific molecular alterations additionally impact PD-L1 expression and its predictive value.
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Affiliation(s)
- Sarah A Anderson
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Djamel Harbi
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Diana Oramas Mogrovejo
- Department of Laboratory Medicine and Pathology, The University of Minnesota, Minneapolis, Minnesota, USA
| | - Antoinette D Floyd
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Isam-Eldin Eltoum
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Huma Fatima
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Frida Rosenblum
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manuel Lora Gonzalez
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Diana Lin
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alexander C Mackinnon
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas Winokur
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ceren Yalniz
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lei Huo
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Xiao Huang
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Mejbel HA, Harada S, Stevens TM, Huang X, Netto GJ, Mackinnon AC, Al Diffalha S. Spindle Cell Sarcoma of the Uterus Harboring MEIS1::NCOA1 Fusion Gene and Mimicking Endometrial Stromal Sarcoma. Int J Surg Pathol 2023; 31:227-232. [PMID: 35477326 DOI: 10.1177/10668969221098081] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
MEIS1::NCOA1/2 sarcomas are a newly recognized group of exceedingly rare low-grade spindle cell sarcomas that often involve the genitourinary and gynecologic tracts. Due to its deceptively low-grade morphology and the non-specific immunoprofile, these neoplasms may pose a diagnostic challenge by histologically mimicking other entities such as endometrial stromal sarcoma, smooth muscle tumor, or uterine perivascular epithelioid cell tumor (PEComa). Histologically, MEIS1::NCOA1/2 sarcomas typically show spindle cell proliferation with hyperchromatic nuclei and a generalized cytologic uniformity, arranged in short fascicles and exhibiting alternating zones of hypo- and hypercellularity. Among the previously reported cases, molecular analysis revealed the MEIS1::NCOA2 fusion as the most commonly detected fusion gene, whereas the MEIS1::NCOA1 fusion gene has been reported in only a single case that involved kidney. Herein we report the first case of uterine sarcoma harboring the MEIS1::NCOA1 fusion gene that was initially misclassified as low-grade endometrial stromal sarcoma, demonstrating its clinicopathologic features, and highlighting the essential role of molecular pathology to arrive at the accurate diagnosis that may alter disease classification and inform therapy.
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Affiliation(s)
- Haider A Mejbel
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shuko Harada
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Todd M Stevens
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xiao Huang
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA
| | - George J Netto
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alexander C Mackinnon
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sameer Al Diffalha
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
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6
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Suster DI, Mejbel H, Mackinnon AC, Suster S. Desmoplastic Adamantinoma-like Thymic Carcinoma: Clinicopathologic, Immunohistochemical, and Molecular Study of 5 Cases. Am J Surg Pathol 2022; 46:1722-1731. [PMID: 35993584 DOI: 10.1097/pas.0000000000001947] [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: 11/26/2022]
Abstract
Five cases of a heretofore unreported rare variant of thymic carcinoma characterized by a striking resemblance to adamantinoma of the mandible are described. The tumors occurred in 4 women and 1 man aged 58 to 76 years (mean: 67.8 y); they arose in the anterior mediastinum and measured from 5.3 to 12.0 cm in greatest diameter (mean: 8.9 cm). Presenting symptoms included chest pain, shortness of breath, and in 2 patients, pleural effusion. One tumor was asymptomatic and discovered incidentally. Histologically, the tumors were extensively desmoplastic, and the cellular proliferation was characterized by multiple islands of squamous epithelium with striking peripheral palisading of nuclei and central areas containing clear cells resembling a stellate reticulum. Areas of preexisting spindle cell thymoma were identified in 2 cases; these areas gradually merged with the higher-grade component of the lesion. Cystic changes were noted in 3 cases. Immunohistochemical studies in 3 cases showed the tumor cells were positive for cytokeratins, p40 and p63, and all showed a high proliferation rate (>50% nuclear positivity) with Ki-67. Next-generation sequencing was performed in 2 cases that showed amplification of the AKT1 gene (copy numbers 6 and 13). Clinical follow-up in 3 patients showed recurrence and metastasis after 1 and 2 years; 1 patient passed away 2 years after diagnosis due to the tumor. Desmoplastic adamantinoma-like thymic carcinoma represents an unusual histologic variant of thymic carcinoma that needs to be distinguished from metastases from similar tumors to the mediastinum.
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Affiliation(s)
- David I Suster
- Department of Pathology, Rutgers University New Jersey Medical School, Newark, NJ
| | - Haider Mejbel
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Saul Suster
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
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Hanbazazh M, Morlote D, Mackinnon AC, Harada S. Utility of Single-Gene Testing in Cancer Specimens. Clin Lab Med 2022; 42:385-394. [DOI: 10.1016/j.cll.2022.05.001] [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: 11/29/2022]
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Harada S, Mackinnon AC. New Approaches and Strategies for Proficiency Testing for Next-Generation Sequencing-Based Oncology Assays. Am J Clin Pathol 2022; 157:478-479. [PMID: 34871347 DOI: 10.1093/ajcp/aqab175] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Shuko Harada
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
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Suster D, Ronen S, Mackinnon AC, Suster S. Immature Chondroid Choristoma: Clinicopathologic, Immunohistochemical, and Molecular Study of an Unusual Benign Skin Tumor. Am J Dermatopathol 2022; 44:148-151. [PMID: 34291748 DOI: 10.1097/dad.0000000000002013] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT An unusual benign skin tumor is reported occurring in a 68-year-old woman with no significant medical history. The lesion presented as a small skin nodule in the neck. Histologic examination showed a well-circumscribed superficial dermal nodule composed of a solid proliferation of large, round cells with abundant eosinophilic cytoplasm and small centrally placed nuclei displaying a vaguely chondroid appearance. Immunohistochemical studies showed strong positivity of the tumor cells for S100 protein and vimentin and negative staining for SOX10, melanoma cocktail, HMB45, Melan-A, cytokeratin AE1/AE3, inhibin, desmin, smooth muscle actin, CD68, CD164, and neuron specific enolase. Next-generation sequencing using a panel of 50 actionable genes commonly encountered in human neoplasia did not reveal the presence of any mutations. Owing to the remarkable similarity of the lesion to immature cartilage, we consider this to be a benign tumor, most likely resulting from an embryologic defect. We propose the term immature chondroid choristoma to designate this lesion.
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Affiliation(s)
- David Suster
- Department of Pathology, Rutgers University Hospital, New Jersey Medical School, Newark, NJ
| | - Shira Ronen
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Saul Suster
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
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10
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Harada S, Caliò A, Janowski KM, Morlote D, Rodriguez Pena MD, Canete-Portillo S, Harbi D, DeFrank G, Magi-Galluzzi C, Netto GJ, Martignoni G, Mackinnon AC. Diagnostic utility of one-stop fusion gene panel to detect TFE3/TFEB gene rearrangement and amplification in renal cell carcinomas. Mod Pathol 2021; 34:2055-2063. [PMID: 34148064 DOI: 10.1038/s41379-021-00858-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022]
Abstract
MiT family translocation renal cell carcinoma (MiT-RCC) harbors translocations involving the TFE3 or TFEB genes. RCC with TFEB amplification is also identified and is associated with a more aggressive clinical course. Accurate diagnosis of MiT-RCC is crucial for patient management. In this study, we evaluated the performance of the Archer FusionPlex assay for detection of MiT-RCC with TFE3 or TFEB translocations and TFEB amplifications. RNA was extracted from 49 RCC FFPE tissue samples with known TFE3/TFEB status (26 TFE3 FISH positive, 12 TFEB FISH positive, 4 TFEB amplified (1 case both split and amplified), and 8 FISH negative) using the Covaris extraction kit. Target enriched cDNA libraries were prepared using the Archer FusionPlex kit and sequenced on the Illumina NextSeq 550. We demonstrate that the age of the specimen, quality of RNA, and sequencing metrics are important for fusion detection. Fusions were identified in 20 of 21 cases less than 2 years old, and TFE3/TFEB rearrangements were detected in all cases with Fusion QC ≥ 100. The assay identified intrachromosomal inversions in two cases (TFE3-RBM10 and NONO-TFE3), usually difficult to identify by FISH assays. TFEB mRNA expression and the TFEB/TFE3 mRNA expression ratio were significantly higher in RCCs with TFEB fusion and TFEB gene amplification compared to tumors without TFEB fusion or amplification. A cutoff TFEB/TFE3 ratio of 0.5 resulted in 97.3% concordance to FISH results with no false negatives. Our study demonstrates that the FusionPlex assay successfully identifies TFE3 and TFEB fusions including intrachromosomal inversions. Age of the specimen and certain sequencing metrics are important for successful fusion detection. Furthermore, mRNA expression levels may be used for predicting cases harboring TFEB amplification, thereby streamlining testing. This assay enables accurate molecular detection of multiple subtypes of MiT-RCCs in a convenient workflow.
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Affiliation(s)
- Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Karen M Janowski
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Diana Morlote
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Sofia Canete-Portillo
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Djamel Harbi
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gina DeFrank
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - George J Netto
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Alexander C Mackinnon
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Tsongalis GJ, Al Turkmani MR, Suriawinata M, Babcock MJ, Mitchell K, Ding Y, Scicchitano L, Tira A, Buckingham L, Atkinson S, Lax A, Aisner DL, Davies KD, Wood HN, O’Neill SS, Levine EA, Sequeira J, Harada S, DeFrank G, Paluri R, Tan BA, Colabella H, Snead C, Cruz-Correa M, Ramirez V, Rojas A, Huang H, Mackinnon AC, Garcia FU, Cavone SM, Elfahal M, Abel G, Vasef MA, Judd A, Linder MW, Alkhateeb K, Skinner WL, Boccia R, Patel K. Comparison of Tissue Molecular Biomarker Testing Turnaround Times and Concordance Between Standard of Care and the Biocartis Idylla Platform in Patients With Colorectal Cancer. Am J Clin Pathol 2020; 154:266-276. [PMID: 32525522 PMCID: PMC10893851 DOI: 10.1093/ajcp/aqaa044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Management of colorectal cancer warrants mutational analysis of KRAS/NRAS when considering anti-epidermal growth factor receptor therapy and BRAF testing for prognostic stratification. In this multicenter study, we compared a fully integrated, cartridge-based system to standard-of-care assays used by participating laboratories. METHODS Twenty laboratories enrolled 874 colorectal cancer cases between November 2017 and December 2018. Testing was performed on the Idylla automated system (Biocartis) using the KRAS and NRAS-BRAF cartridges (research use only) and results compared with in-house standard-of-care testing methods. RESULTS There were sufficient data on 780 cases to measure turnaround time compared with standard assays. In-house polymerase chain reaction (PCR) had an average testing turnaround time of 5.6 days, send-out PCR of 22.5 days, in-house Sanger sequencing of 14.7 days, send-out Sanger of 17.8 days, in-house next-generation sequencing (NGS) of 12.5 days, and send-out NGS of 20.0 days. Standard testing had an average turnaround time of 11 days. Idylla average time to results was 4.9 days with a range of 0.4 to 13.5 days. CONCLUSIONS The described cartridge-based system offers rapid and reliable testing of clinically actionable mutation in colorectal cancer specimens directly from formalin-fixed, paraffin-embedded tissue sections. Its simplicity and ease of use compared with other molecular techniques make it suitable for routine clinical laboratory testing.
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Affiliation(s)
- Gregory J Tsongalis
- Clinical Genomics and Advanced Technology (CGAT) Laboratory, Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Health System, Lebanon, NH
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - M Rabie Al Turkmani
- Clinical Genomics and Advanced Technology (CGAT) Laboratory, Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Health System, Lebanon, NH
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Michael Suriawinata
- Clinical Genomics and Advanced Technology (CGAT) Laboratory, Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Health System, Lebanon, NH
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Michael J Babcock
- Bioinformatics & Molecular Pathology, Dahl-Chase Diagnostic Services & Pathology Associates, Bangor, ME
| | - Kristi Mitchell
- Bioinformatics & Molecular Pathology, Dahl-Chase Diagnostic Services & Pathology Associates, Bangor, ME
| | - Yi Ding
- Diagnostic Medicine Institute, Geisinger Medical Center, Danville, PA
| | - Lisa Scicchitano
- Diagnostic Medicine Institute, Geisinger Medical Center, Danville, PA
| | - Adrian Tira
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Lela Buckingham
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Sara Atkinson
- Department of Cytology, Cone Health Moses Cone Hospital, Greensboro, NC
| | - Amy Lax
- Department of Cytology, Cone Health Moses Cone Hospital, Greensboro, NC
| | - Dara L Aisner
- Colorado Molecular Correlates Laboratory (CMOCO), Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora
| | - Kurtis D Davies
- Colorado Molecular Correlates Laboratory (CMOCO), Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora
| | - Holly N Wood
- Colorado Molecular Correlates Laboratory (CMOCO), Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora
| | - Stacey S O’Neill
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Edward A Levine
- Division of Surgical Oncology, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC
| | - Judy Sequeira
- Department of Pathology and Laboratory Medicine, Comprehensive Care and Research Center, Cancer Treatment Centers of America Atlanta, Newnan, GA
| | - Shuko Harada
- Molecular Diagnostics Laboratory, Department of Pathology, University of Alabama Birmingham School of Medicine, Birmingham
| | - Gina DeFrank
- Molecular Diagnostics Laboratory, Department of Pathology, University of Alabama Birmingham School of Medicine, Birmingham
| | - Ravikumar Paluri
- Department of Medicine, Division of Hematology/Oncology, University of Alabama Birmingham School of Medicine, Birmingham
| | - Bradford A Tan
- Department of Pathology and Laboratory Medicine, Comprehensive Care and Research Center, Cancer Treatment Centers of America Chicago, Zion, IL
| | - Heather Colabella
- Department of Pathology and Laboratory Medicine, Comprehensive Care and Research Center, Cancer Treatment Centers of America Chicago, Zion, IL
| | | | - Marcia Cruz-Correa
- Pan American Center for Oncology Trials, Oncologic Hospital, Puerto Rico Medical Center, Rio Piedras, Puerto Rico
| | - Virginia Ramirez
- Pan American Center for Oncology Trials, Oncologic Hospital, Puerto Rico Medical Center, Rio Piedras, Puerto Rico
| | - Arnaldo Rojas
- Pan American Center for Oncology Trials, Oncologic Hospital, Puerto Rico Medical Center, Rio Piedras, Puerto Rico
| | - Huiya Huang
- Department of Pathology, Medical College of Wisconsin, Milwaukee
| | | | - Fernando U Garcia
- Department of Pathology and Laboratory Medicine, Comprehensive Care and Research Center, Cancer Treatment Centers of America Philadelphia, Philadelphia, PA
| | - Sharon M Cavone
- Department of Pathology and Laboratory Medicine, Comprehensive Care and Research Center, Cancer Treatment Centers of America Philadelphia, Philadelphia, PA
| | - Mutasim Elfahal
- Department of Pathology and Laboratory Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA
| | - Gyorgy Abel
- Department of Pathology and Laboratory Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA
| | - Mohammad A Vasef
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque
| | - Andrew Judd
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque
| | - Mark W Linder
- Department of Pathology and Laboratory Medicine, University of Louisville Hospital, Louisville, KY
| | - Khaled Alkhateeb
- Department of Pathology and Laboratory Medicine, University of Louisville Hospital, Louisville, KY
| | | | - Ralph Boccia
- The Center for Cancer and Blood Disorders, Bethesda, MD
| | - Kashyap Patel
- Carolina Blood and Cancer Care Associates, PA, Rock Hill, SC
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12
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Hong W, Khampang P, Kerschner AR, Mackinnon AC, Yan K, Simpson PM, Kerschner JE. Antibiotic modulation of mucins in otitis media; should this change our approach to watchful waiting? Int J Pediatr Otorhinolaryngol 2019; 125:134-140. [PMID: 31302575 PMCID: PMC6742428 DOI: 10.1016/j.ijporl.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/05/2019] [Accepted: 07/02/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Gel-forming mucins (GFMs) play important roles in otitis media (OM) pathogenesis. Increased mucin expression is activated by pathogens and proinflammatory cytokines. Bacterial biofilms influence inflammation and resolution of OM and may contribute to prolonged mucin production. The influence of specific pathogens on mucin expression and development of chronic OM with effusion (OME) remains an area of significant knowledge deficit. OBJECTIVES To assess the relationship between GFM expression, specific pathogens, middle ear mucosal (MEM) changes, biofilm formation, and antibiotic utilization. METHODS Mixed gender chinchillas were inoculated with nontypeable Haemophilus influenzae (NTHi) strain 86028NP or Streptococcus pneumoniae (SP) strain TIGR4 via transbulla injection. Antibiotic was administered on day 3-5 post inoculation. GFM expression was measured by quantitative PCR. Biofilm formation was identified and middle ear histologic changes were measured. RESULTS SP infection resulted in higher incidence of biofilm and ME effusion compared with NTHi infection. However, NTHi persisted in the ME longer than SP with no substantive bacterial clearance detected on day 10 compared with complete bacterial clearance on day 10 for 50-60% of the SP-infected chinchillas. Both infections increased MEM inflammatory cell infiltration and thickening. NTHi upregulated the Muc5AC, Muc5B and Muc19 expression on day 10 (p = 0.0004, 0.003, and 0.002 respectively). SP-induced GFM upregulations were trended toward significant. In both NTHi and SP infections, the degree of GFM upregulation had a direct relationship to increased MEM hypertrophy, inflammatory cell infiltration and biofilm formation. Antibiotic treatment reduced the incidence of ME effusion and biofilm, limited the MEM changes and reversed the GFM upregulation. In NTHi infection, the rate of returning to baseline level of GFMs in treated chinchillas was quicker than those without treatment. CONCLUSIONS In an animal model of OM, GFM genes are upregulated in conjunction with MEM hypertrophy and biofilm formation. This upregulation is less robust and more quickly ameliorated to a significant degree in the NTHi infection with appropriate antibiotic therapy. These findings contribute to the understanding of pathogen specific influences on mucin expression during OM pathogenesis and provide new data which may have implications in clinical approach for OM treatment.
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Affiliation(s)
- Wenzhou Hong
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | - Abigail R Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA
| | | | - Ke Yan
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, USA
| | - Pippa M Simpson
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, USA
| | - Joseph E Kerschner
- Division of Pediatric Otolaryngology, Medical College of Wisconsin, USA; Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, USA.
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13
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Huang H, Springborn S, Haug K, Bartow K, Samra H, Menon S, Mackinnon AC. Evaluation, Validation, and Implementation of the Idylla System as Rapid Molecular Testing for Precision Medicine. J Mol Diagn 2019; 21:862-872. [DOI: 10.1016/j.jmoldx.2019.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/30/2019] [Accepted: 05/15/2019] [Indexed: 12/18/2022] Open
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14
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Suster D, Ronen S, Peterson JF, Mackinnon AC, Hes O, Suster S, Lin DI. MDM2 amplification and immunohistochemical expression in sarcomatoid renal cell carcinoma. Hum Pathol 2019; 87:28-36. [DOI: 10.1016/j.humpath.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 12/13/2022]
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15
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Xiong D, Wang Y, Singavi AK, Mackinnon AC, George B, You M. Immunogenomic Landscape Contributes to Hyperprogressive Disease after Anti-PD-1 Immunotherapy for Cancer. iScience 2018; 9:258-277. [PMID: 30439581 PMCID: PMC6234258 DOI: 10.1016/j.isci.2018.10.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [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: 06/29/2018] [Revised: 09/14/2018] [Accepted: 10/19/2018] [Indexed: 12/11/2022] Open
Abstract
Although PD-1-blocking immunotherapies demonstrate significant therapeutic promise, a subset of the patients could develop hyperprogressive disease (HPD) with accelerated tumor growth after anti-PD1 immunotherapy. To elucidate the underlying mechanisms, we compared the mutational and transcriptional landscapes between the pre- and post-therapy tumors of two patients developing HPD after anti-PD-1 immunotherapy. In post-therapy HPD tumors, somatic mutations were found in known cancer genes, including tumor suppressor genes such as TSC2 and VHL, along with transcriptional upregulation of oncogenic pathways, including IGF-1, ERK/MAPK, PI3K/AKT, and TGF-β. We found that post-therapy HPD tumors were less immunogenic than pre-therapy tumors, concurrent with an increased presence of ILC3 cells, a subset of innate lymphoid cells. We also developed a gene expression signature predictive of HPD. In summary, we identified the genomics and immune features associated with HPD, which may help identify patients at risk of adverse clinical outcome after anti-PD-1 immunotherapy. Mutations/expression changes occur in hyperprogressive tumors after anti-PD-1 therapy Immune cell population abundance pattern changed in the hyperprogressive tumors ILC3 cells may be enriched in the hyperprogressive tumors after anti-PD-1 therapy Post-therapy hyperprogressive tumors were less immunogenic than pre-therapy tumors
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Affiliation(s)
- Donghai Xiong
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Yian Wang
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Arun K Singavi
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Alexander C Mackinnon
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Ben George
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Ming You
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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16
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Ronen S, Agarwal M, Mackinnon AC, Cochran E. Cerebellar pleomorphic xanthoastrocytoma in a patient with neurofibromatosis type 1 – Molecular study and review of literature. Human Pathology: Case Reports 2018. [DOI: 10.1016/j.ehpc.2017.10.001] [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: 11/28/2022] Open
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17
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Hurrell SL, McGarry SD, Kaczmarowski A, Iczkowski KA, Jacobsohn K, Hohenwalter MD, Hall WA, See WA, Banerjee A, Charles DK, Nevalainen MT, Mackinnon AC, LaViolette PS. Optimized b-value selection for the discrimination of prostate cancer grades, including the cribriform pattern, using diffusion weighted imaging. J Med Imaging (Bellingham) 2017; 5:011004. [PMID: 29098169 PMCID: PMC5658575 DOI: 10.1117/1.jmi.5.1.011004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 06/15/2017] [Accepted: 09/21/2017] [Indexed: 01/21/2023] Open
Abstract
Multiparametric magnetic resonance imaging (MP-MRI), including diffusion-weighted imaging, is commonly used to diagnose prostate cancer. This radiology–pathology study correlates prostate cancer grade and morphology with common b-value combinations for calculating apparent diffusion coefficient (ADC). Thirty-nine patients undergoing radical prostatectomy were recruited for MP-MRI prior to surgery. Diffusion imaging was collected with seven b-values, and ADC was calculated. Excised prostates were sliced in the same orientation as the MRI using 3-D printed slicing jigs. Whole-mount slides were digitized and annotated by a pathologist. Annotated samples were aligned to the MRI, and ADC values were extracted from annotated peripheral zone (PZ) regions. A receiver operating characteristic (ROC) analysis was performed to determine accuracy of tissue type discrimination and optimal ADC b-value combination. ADC significantly discriminates Gleason (G) G4-5 cancer from G3 and other prostate tissue types. The optimal b-values for discriminating high from low-grade and noncancerous tissue in the PZ are 50 and 2000, followed closely by 100 to 2000 and 0 to 2000. Optimal ADC cut-offs are presented for dichotomized discrimination of tissue types according to each b-value combination. Selection of b-values affects the sensitivity and specificity of ADC for discrimination of prostate cancer.
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Affiliation(s)
- Sarah L Hurrell
- Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, United States
| | - Sean D McGarry
- Medical College of Wisconsin, Department of Biophysics, Milwaukee, Wisconsin, United States
| | - Amy Kaczmarowski
- Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, United States
| | - Kenneth A Iczkowski
- Medical College of Wisconsin, Department of Pathology, Milwaukee, Wisconsin, United States.,Medical College of Wisconsin, Department of Urology, Milwaukee, Wisconsin, United States
| | - Kenneth Jacobsohn
- Medical College of Wisconsin, Department of Urology, Milwaukee, Wisconsin, United States
| | - Mark D Hohenwalter
- Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, United States
| | - William A Hall
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, Wisconsin, United States
| | - William A See
- Medical College of Wisconsin, Department of Urology, Milwaukee, Wisconsin, United States
| | - Anjishnu Banerjee
- Medical College of Wisconsin, Department of Biostatistics, Milwaukee, Wisconsin, United States
| | - David K Charles
- Medical College of Wisconsin, Department of Urology, Milwaukee, Wisconsin, United States
| | - Marja T Nevalainen
- Medical College of Wisconsin, Department of Pathology, Milwaukee, Wisconsin, United States.,Medical College of Wisconsin, Department of Pharmacology and Toxicology, Milwaukee, Wisconsin, United States
| | - Alexander C Mackinnon
- Medical College of Wisconsin, Department of Pathology, Milwaukee, Wisconsin, United States
| | - Peter S LaViolette
- Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, United States.,Medical College of Wisconsin, Department of Biomedical Engineering, Milwaukee, Wisconsin, United States
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18
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Murray IR, Gonzalez ZN, Baily J, Dobie R, Wallace RJ, Mackinnon AC, Smith JR, Greenhalgh SN, Thompson AI, Conroy KP, Griggs DW, Ruminski PG, Gray GA, Singh M, Campbell MA, Kendall TJ, Dai J, Li Y, Iredale JP, Simpson H, Huard J, Péault B, Henderson NC. αv integrins on mesenchymal cells regulate skeletal and cardiac muscle fibrosis. Nat Commun 2017; 8:1118. [PMID: 29061963 PMCID: PMC5653645 DOI: 10.1038/s41467-017-01097-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/17/2017] [Indexed: 01/21/2023] Open
Abstract
Mesenchymal cells expressing platelet-derived growth factor receptor beta (PDGFRβ) are known to be important in fibrosis of organs such as the liver and kidney. Here we show that PDGFRβ+ cells contribute to skeletal muscle and cardiac fibrosis via a mechanism that depends on αv integrins. Mice in which αv integrin is depleted in PDGFRβ+ cells are protected from cardiotoxin and laceration-induced skeletal muscle fibrosis and angiotensin II-induced cardiac fibrosis. In addition, a small-molecule inhibitor of αv integrins attenuates fibrosis, even when pre-established, in both skeletal and cardiac muscle, and improves skeletal muscle function. αv integrin blockade also reduces TGFβ activation in primary human skeletal muscle and cardiac PDGFRβ+ cells, suggesting that αv integrin inhibitors may be effective for the treatment and prevention of a broad range of muscle fibroses.
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Affiliation(s)
- I R Murray
- Department of Trauma and Orthopaedics, University of Edinburgh, Chancellors Building, Little France Campus, Edinburgh, EH16 4TJ, UK
- BHF Centre for Vascular Regeneration & MRC Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - Z N Gonzalez
- BHF Centre for Vascular Regeneration & MRC Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - J Baily
- BHF Centre for Vascular Regeneration & MRC Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - R Dobie
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - R J Wallace
- Department of Trauma and Orthopaedics, University of Edinburgh, Chancellors Building, Little France Campus, Edinburgh, EH16 4TJ, UK
| | - A C Mackinnon
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - J R Smith
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - S N Greenhalgh
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - A I Thompson
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - K P Conroy
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - D W Griggs
- Center for World Health and Medicine, Saint Louis University, Edward A. Doisy Research Center, St. Louis, MO 63104, USA
| | - P G Ruminski
- Center for World Health and Medicine, Saint Louis University, Edward A. Doisy Research Center, St. Louis, MO 63104, USA
| | - G A Gray
- BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - M Singh
- Center for World Health and Medicine, Saint Louis University, Edward A. Doisy Research Center, St. Louis, MO 63104, USA
| | - M A Campbell
- Center for World Health and Medicine, Saint Louis University, Edward A. Doisy Research Center, St. Louis, MO 63104, USA
| | - T J Kendall
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - J Dai
- Department of Pediatric Surgery, University of Texas McGovern Medical School, TX, 77030, USA
- Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine (IMM), The University of Texas Health Science Center at Houston (UT Health), TX, 77030, USA
| | - Y Li
- Department of Pediatric Surgery, University of Texas McGovern Medical School, TX, 77030, USA
- Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine (IMM), The University of Texas Health Science Center at Houston (UT Health), TX, 77030, USA
| | - J P Iredale
- University of Bristol, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - H Simpson
- Department of Trauma and Orthopaedics, University of Edinburgh, Chancellors Building, Little France Campus, Edinburgh, EH16 4TJ, UK
| | - J Huard
- Steadman Philippon Research Institute, Vail, CO 81657, USA
- Department of Orthopaedic Surgery, University of Texas, Medical School at Houston, Houston, TX 77030, USA
| | - B Péault
- BHF Centre for Vascular Regeneration & MRC Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, UK.
- Orthopaedic Hospital Research Center and Broad Stem Cell Research Center, University of California, Los Angeles, CA 90024, USA.
| | - N C Henderson
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK.
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19
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Raychaudhuri R, Riese MJ, Bylow K, Burfeind J, Mackinnon AC, Tolat PP, Iczkowski KA, Kilari D. Immune Check Point Inhibition in Sarcomatoid Renal Cell Carcinoma: A New Treatment Paradigm. Clin Genitourin Cancer 2017. [DOI: 10.1016/j.clgc.2017.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Batdorf BH, Kroft SH, Hosking PR, Harrington AM, Mackinnon AC, Olteanu H. Evaluation of CD43 expression in non-hematopoietic malignancies. Ann Diagn Pathol 2017; 29:23-27. [PMID: 28807337 DOI: 10.1016/j.anndiagpath.2017.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES CD43 is normally expressed only on the surface of leukocytes, and is considered a sensitive and specific marker for hematologic malignancies. As such, it may have diagnostic utility in confirming hematolymphoid lineage in cases that are negative for CD45. Aberrant CD43 expression has been described in non-hematopoietic tumors, although literature data on this topic is variable and sometimes contradictory. To clarify and expand on existing literature findings, we evaluated CD43 expression by immunohistochemistry (IHC) in a large cohort (307) of non-hematopoietic neoplasms, including poorly differentiated malignancies. METHODS 17 tissue microarrays and sections from 19 individual cases were stained with CD43 (clone DF-T1) monoclonal antibody. The proportion of positive cells, stain localization (nuclear, cytoplasmic or membranous), and intensity (compared to internal leukocyte controls) were recorded in all cases. RESULTS There were 98/307 (32%) positive cases, that showed focal weak nuclear staining in 1-25% of cells, including 23/25 (92%) pancreatic ductal adenocarcinomas; 31/34 (91%) breast invasive ductal carcinomas; 13/15 (87%) papillary thyroid carcinomas; 3/4 (75%) follicular thyroid carcinomas; 6/15 (40%) renal cell carcinomas; 9/28 (32%) lung adenocarcinomas; 1/13 (8%) lung squamous cell carcinomas (SCCs); 2/8 (25%) prostate adenocarcinomas; 8/62 (13%) colon adenocarcinomas; and 2/21 (10%) neuroendocrine neoplasms. None of the positive cases demonstrated strong, membranous CD43 expression comparable to that seen in background mature lymphocytes or segmented neutrophils. Negative cases included 11 cervical SCCs, 12 cervical adenocarcinomas, 19 urothelial carcinomas, 10 lung small cell carcinomas, 11 sarcomas, and 19 poorly differentiated carcinomas from various tissue sites. CONCLUSIONS In our cohort, most non-hematopoietic neoplasms are negative for CD43 expression, with a subset showing focal, weak nuclear positivity. This data indicates that uniform and strong membranous staining appears to be specific to hematopoietic neoplasms.
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Affiliation(s)
- Bjorn H Batdorf
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Steven H Kroft
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Paul R Hosking
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | | | - Horatiu Olteanu
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States.
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21
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Pratt SD, Xuei X, Mackinnon AC, Nilius AM, Hensey-Rudloff DM, Zhong P, Katz L. Development of a Coupled VanA/VanX Assay: Screening for Inhibitors of Glycopeptide Resistance. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/108705719700200409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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]
Abstract
Resistance in Enterococcus faecium to the glycopeptide antibiotics vancomycin and teicoplanin is encoded by five genes: vanR, vanS, vanH, vanA, and vanX.1 The mechanism of resistance involves replacement of the dipeptide D-Ala-D-Ala, destined for the peptidoglycan layer with the depsipeptide D-Ala-D-lactate. This alteration lowers the binding affinity of vancomycin for the bacterial cell wall by a factor of 1000. The functions of VanA and VanX are the ligation of D-Ala and D-lactate, and the hydrolysis of D-Ala-D-Ala, respectively. We report here the overexpression of both genes as well as the D-Ala-D-Ala ligase (Ddl) from Enterococcus faecium, development of a coupled assay and several inhibitors obtained by high-throughput screening (HTS). All genes were expressed in E. coli by translational coupling to kdsB, the CMP-KDO synthetase gene, under control of a modified lac promoter. The coupled VanA/VanX assay employs colorimetric detection of inorganic phosphate (Pi) released in the VanA ligation reaction, with the VanX dipeptidase activity providing the D-Ala substrate for VanA. A secondary VanX assay uses cadmium-ninhydrin calorimetric detection of free amino acid released by the dipeptidase activity of the enzyme on D-Ala-D-Ala. We have also developed an assay using Ddl ligase. Over 250,000 compounds have been screened to date using the coupled assay.
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Affiliation(s)
- Steven D. Pratt
- Pharmaceutical Products Division, Abbott Laboratories, Abbott Park, IL 60064
| | - Xiaoling Xuei
- Pharmaceutical Products Division, Abbott Laboratories, Abbott Park, IL 60064
| | | | - Angela M. Nilius
- Pharmaceutical Products Division, Abbott Laboratories, Abbott Park, IL 60064
| | | | - Ping Zhong
- Pharmaceutical Products Division, Abbott Laboratories, Abbott Park, IL 60064
| | - Leonard Katz
- Pharmaceutical Products Division, Abbott Laboratories, Abbott Park, IL 60064
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22
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Lasowski M, Stemm M, Charlson JA, Bedi M, Mackinnon AC. High SPARC expression in treated sarcomas may correlate with decreased overall survival. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e22529] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Bergom C, Hauser AD, Rymaszewski A, Gonyo P, Prokop JW, Jennings BC, Lawton AJ, Frei A, Lorimer EL, Aguilera-Barrantes I, Mackinnon AC, Noon K, Fierke CA, Williams CL. The tumor-suppressive small GTPase DiRas1 binds the noncanonical guanine nucleotide exchange factor SmgGDS and antagonizes SmgGDS interactions with oncogenic small GTPases. J Biol Chem 2016; 291:10948. [PMID: 27197236 DOI: 10.1074/jbc.a115.696831] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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24
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Tsai S, Ritch PS, Erickson B, George B, Johnston FM, Mackinnon AC, Evans DB, Christians KK. Rapid immunohistochemical analysis of pancreatic cytology from endoscopic ultrasound-guided fine-needle aspirates: A prospective clinical trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.400] [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: 11/20/2022] Open
Abstract
400 Background: Acquisition of pancreatic cancer (PC) tissue specimens from endoscopic ultrasound-guided fine needle aspirates (EUS-FNA) is crucial to investigational pancreatic cancer trials seeking to utilize molecular profile directed therapy. Methods: In an ongoing prospective clinical trial we have utilized molecular profiling of EUS-FNA specimens from patients with resectable and borderline resectable pancreatic cancers. Cytologic specimens were evaluated for six biomarkers to guide the choice of neoadjuvant therapy: secreted protein acid rich in cysteine (SPARC), thymidylate synthase (TYMS), ribonucleotide reductase M1 (RRM1), human equilibrative nucleoside transporter 1 (ENT1), excision repair cross-complementing 1 (ERCC), and topoisomerase 1 (TOPO). Final immunohistochemical (IHC) interpretation was scored by a single pathologist using both staining intensity and percent immunochemically reactive cells. Results: The trial has enrolled 99 patients to date; 47 (47%) resectable patients and 52 (52%) borderline resectable patients. No patient experienced a EUS-FNA related complication. IHC profiling was reported in a median of 5 business days (IQR:3). Of the 99 patient samples, 73 (74%) had adequate cellularity for IHC profiling and this was not affected by stage of disease (n = 35, resectable; n = 38 borderline resectable; p = 0.82). Analysis of SPARC expression was limited to specimens with adequate stromal cells for analysis (n = 50, 51%). Among the 73 patients with adequate tissue for profiling, expression profiling was interpreted to be favorable for the following therapeutic agents: nab-paclitaxel, (SPARC, n = 35, 48%), 5-fluorouracil (TYMS, n = 68, 93%), gemcitabine (RRM1, n = 34, 47%; ENT1, n = 38, 52%), platinum agents (ERCC, n = 30, 41%), and irinotecan (TOPO, n = 62, 85%). Conclusions: The use of EUS-FNA specimens for molecular diagnostics is feasible and IHC analysis was possible in 74% of patient specimens, with preservation of stromal components in over 50%. Further refinement of molecular techniques may expand the breadth of analysis which may be performed, to include quantitative polymerase chain reaction and genetic sequencing Clinical trial information: NCIT01726582.
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Affiliation(s)
- Susan Tsai
- Medical College of Wisconsin, Milwaukee, WI
| | - Paul S. Ritch
- Froedtert Hospital and Medical College of Wisconsin, Milwaukee, WI
| | | | - Ben George
- Medical College of Wisconsin, Milwaukee, WI
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Bergom C, Hauser AD, Rymaszewski A, Gonyo P, Prokop JW, Jennings BC, Lawton AJ, Frei A, Lorimer EL, Aguilera-Barrantes I, Mackinnon AC, Noon K, Fierke CA, Williams CL. The Tumor-suppressive Small GTPase DiRas1 Binds the Noncanonical Guanine Nucleotide Exchange Factor SmgGDS and Antagonizes SmgGDS Interactions with Oncogenic Small GTPases. J Biol Chem 2016; 291:6534-45. [PMID: 26814130 DOI: 10.1074/jbc.m115.696831] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Indexed: 11/06/2022] Open
Abstract
The small GTPase DiRas1 has tumor-suppressive activities, unlike the oncogenic properties more common to small GTPases such as K-Ras and RhoA. Although DiRas1 has been found to be a tumor suppressor in gliomas and esophageal squamous cell carcinomas, the mechanisms by which it inhibits malignant phenotypes have not been fully determined. In this study, we demonstrate that DiRas1 binds to SmgGDS, a protein that promotes the activation of several oncogenic GTPases. In silico docking studies predict that DiRas1 binds to SmgGDS in a manner similar to other small GTPases. SmgGDS is a guanine nucleotide exchange factor for RhoA, but we report here that SmgGDS does not mediate GDP/GTP exchange on DiRas1. Intriguingly, DiRas1 acts similarly to a dominant-negative small GTPase, binding to SmgGDS and inhibiting SmgGDS binding to other small GTPases, including K-Ras4B, RhoA, and Rap1A. DiRas1 is expressed in normal breast tissue, but its expression is decreased in most breast cancers, similar to its family member DiRas3 (ARHI). DiRas1 inhibits RhoA- and SmgGDS-mediated NF-κB transcriptional activity in HEK293T cells. We also report that DiRas1 suppresses basal NF-κB activation in breast cancer and glioblastoma cell lines. Taken together, our data support a model in which DiRas1 expression inhibits malignant features of cancers in part by nonproductively binding to SmgGDS and inhibiting the binding of other small GTPases to SmgGDS.
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Affiliation(s)
- Carmen Bergom
- From the Cancer Center, the Departments of Radiation Oncology,
| | - Andrew D Hauser
- From the Cancer Center, the Departments of Radiation Oncology, Pharmacology and Toxicology, and the Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, New York 10016, and
| | | | - Patrick Gonyo
- From the Cancer Center, Pharmacology and Toxicology, and
| | | | | | - Alexis J Lawton
- the Department of Chemistry, Biochemistry Undergraduate Program, and
| | - Anne Frei
- From the Cancer Center, the Departments of Radiation Oncology
| | | | | | | | - Kathleen Noon
- the Mass Spectroscopy Facility for Proteomics, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Carol A Fierke
- the Department of Chemistry, Department of Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109
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Xia S, Huang CC, Le M, Dittmar R, Du M, Yuan T, Guo Y, Wang Y, Wang X, Tsai S, Suster S, Mackinnon AC, Wang L. Genomic variations in plasma cell free DNA differentiate early stage lung cancers from normal controls. Lung Cancer 2015; 90:78-84. [DOI: 10.1016/j.lungcan.2015.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 06/23/2015] [Accepted: 07/02/2015] [Indexed: 12/15/2022]
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Hauser AD, Bergom C, Schuld NJ, Chen X, Lorimer EL, Huang J, Mackinnon AC, Williams CL. The SmgGDS splice variant SmgGDS-558 is a key promoter of tumor growth and RhoA signaling in breast cancer. Mol Cancer Res 2013; 12:130-42. [PMID: 24197117 DOI: 10.1158/1541-7786.mcr-13-0362] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED Breast cancer malignancy is promoted by the small GTPases RhoA and RhoC. SmgGDS is a guanine nucleotide exchange factor that activates RhoA and RhoC in vitro. We previously reported that two splice variants of SmgGDS, SmgGDS-607, and SmgGDS-558, have different characteristics in binding and transport of small GTPases. To define the role of SmgGDS in breast cancer, we tested the expression of SmgGDS in breast tumors, and the role of each splice variant in proliferation, tumor growth, Rho activation, and NF-κB transcriptional activity in breast cancer cells. We show upregulated SmgGDS protein expression in breast cancer samples compared with normal breast tissue. In addition, Kaplan-Meier survival curves indicated that patients with high SmgGDS expression in their tumors had worse clinical outcomes. Knockdown of SmgGDS-558, but not SmgGDS-607, in breast cancer cells decreased proliferation, in vivo tumor growth, and RhoA activity. Furthermore, we found that SmgGDS promoted a Rho-dependent activation of the transcription factor NF-κB, which provides a potential mechanism to define how SmgGDS-mediated activation of RhoA promotes breast cancer. This study demonstrates that elevated SmgGDS expression in breast tumors correlates with poor survival, and that SmgGDS-558 plays a functional role in breast cancer malignancy. Taken together, these findings define SmgGDS-558 as a unique promoter of RhoA and NF-κB activity and a novel therapeutic target in breast cancer. IMPLICATIONS This study defines a new mechanism to regulate the activities of RhoA and NF-κB in breast cancer cells, and identifies SmgGDS-558 as a novel promoter of breast cancer malignancy.
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Affiliation(s)
- Andrew D Hauser
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226.
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Tsai S, Ritch PS, Erickson B, Kelly TR, Quebbeman E, Evans DB, Mackinnon AC, Christians KK. Phase II clinical trial of biomarker-directed therapy for localized pancreatic cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.tps4147] [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: 11/20/2022] Open
Abstract
TPS4147 Background: Several candidate biomarkers exist for the common chemotherapeutic agents used to treat pancreatic cancer (PC) (Table). The predictive value of these markers in the treatment of PC has not been established. This is the first prospective clinical trial utilizing biomarker-directed therapy for localized pancreatic cancer. Methods: Patients with localized pancreatic cancer undergo endoscopic ultrasound-guided fine needle aspiration (FNA) for confirmation of diagnosis and immunohistochemical profiling . Six biomarkers (STREET profile) were selected based on their relevance to accepted pancreatic chemotherapy regimens (table). The treatment algorithm selected for each individual patient is based on the clinical stage of resectability (resectable/borderline resectable) and the STREET profile results. Neoadjuvant therapy is followed by restaging (CT and serum Ca19-9) and in the absence of disease progression, patients undergo surgery. Post-surgical (adjuvant) therapy is determined by the STREET profile of the resected specimen. The primary endpoint is an increase in the rate of surgical resection 20% compared with historical controls treated with best available neoadjuvant therapy which was not biomarker-directed. Secondary endpoints include assessment of overall and progression-free survival, comparative STREET profiling of pre- and post-treatment specimens, and changes in radiographic response. Eligbility Criteria: Patients with resectable or borderline resectable pancreatic cancer undergo endoscopic ultrasound-guided fine needle aspiration (FNA) for confirmation of diagnosis and immunohistochemical profiling. Enrollment: 26 of planned 100 patients have been enrolled. Clinical trial information: NCT01726582. [Table: see text]
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Affiliation(s)
- Susan Tsai
- Medical College of Wisconsin, Milwaukee, WI
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Abstract
Bar code–based tracking solutions, long present in clinical pathology laboratories, have recently made an appearance in anatomic pathology (AP) laboratories. Tracking of AP “assets” (specimens, blocks, slides) can enhance laboratory efficiency, promote patient safety, and improve patient care. Routing of excess clinical material into research laboratories and biorepositories are other avenues that can benefit from tracking of AP assets. Implementing tracking is not as simple as installing software and turning it on. Not all tracking solutions are alike. Careful analysis of laboratory workflow is needed before implementing tracking to assure that this solution will meet the needs of the laboratory. Such analysis will likely uncover practices that may need to be modified before a tracking system can be deployed. Costs that go beyond simply that of purchasing software will be incurred and need to be considered in the budgeting process. Finally, people, not technology, are the key to assuring quality. Tracking will require significant changes in workflow and an overall change in the culture of the laboratory. Preparation, training, buy-in, and accountability of the people involved are crucial to the success of this process. This article reviews the benefits, available technology, underlying principles, and implementation of tracking solutions for the AP and research laboratory.
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Affiliation(s)
- Liron Pantanowitz
- From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Pantanowitz); the Department of Pathology, Medical College of Wisconsin, Milwaukee (Dr Mackinnon); and the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Sinard)
| | - Alexander C. Mackinnon
- From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Pantanowitz); the Department of Pathology, Medical College of Wisconsin, Milwaukee (Dr Mackinnon); and the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Sinard)
| | - John H. Sinard
- From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Pantanowitz); the Department of Pathology, Medical College of Wisconsin, Milwaukee (Dr Mackinnon); and the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Sinard)
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Mackinnon AC, Wang YL, Sahota A, Yeung CC, Weck KE. Certification in molecular pathology in the United States: an update from the Association for Molecular Pathology Training and Education Committee. J Mol Diagn 2012; 14:541-9. [PMID: 22925695 DOI: 10.1016/j.jmoldx.2012.05.004] [Citation(s) in RCA: 3] [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] [Received: 11/16/2011] [Revised: 04/03/2012] [Accepted: 05/08/2012] [Indexed: 11/30/2022] Open
Abstract
The past 25 years have witnessed the field of molecular pathology evolving from an imprecisely defined discipline to a firmly established medical subspecialty that plays an essential role in patient care. During this time, the training, certification, and licensure requirements for directing and performing testing in a molecular pathology or molecular diagnostics laboratory have become better defined. The purpose of this document is to describe the various board certifications available to individuals seeking certification in molecular diagnostics at the level of laboratory director, supervisor, or technologist. Several national organizations offer certification in molecular pathology or molecular diagnostics for doctoral-level clinical scientists to function as the director of a molecular diagnostics laboratory. Furthermore, 12 states and Puerto Rico require licensing of medical technologists, including those working in molecular diagnostic laboratories. The information provided here updates a 2002 document by the Training and Education Committee of the Association for Molecular Pathology and has been expanded to include certification and licensing requirements for laboratory technologists.
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Affiliation(s)
- Alexander C Mackinnon
- Association for Molecular Pathology Training and Education Committee, Bethesda, Maryland, USA.
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Budzik JM, Hosseini M, Mackinnon AC, Taxy JB. Disseminated Nocardia farcinica: literature review and fatal outcome in an immunocompetent patient. Surg Infect (Larchmt) 2012; 13:163-70. [PMID: 22612440 DOI: 10.1089/sur.2011.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nocardia farcinica is a gram-positive, partially acid-fast, methenamine silver-positive aerobic actinomycete. Nocardia spp. are opportunistic pathogens, and N. farcinica is the least common species of clinical importance. METHODS Review of the recent literature and description of a immunocompetent patient with no known risk factors who contracted fatal N. farcinica sepsis. RESULTS Positive pre-mortem and post-mortem cultures from the lung and synovium correlated with acute bronchopneumonia and synovitis at autopsy. Colonies of filamentous bacteria, which were not apparent in conventional hematoxylin and eosin-stained sections, were observed with gram and methenamine silver stains, but acid-fast stains were negative. A literature review revealed that disseminated N. farcinica often is associated with an underlying malignant tumor or autoimmune disease (88% of patients). Chemotherapy or corticosteroid treatments are additional risk factors. CONCLUSIONS Trimethoprim-sulfamethoxazole typically is the first-line therapy for N. farcinica; treatment with amikacin and imipenem-cilastatin is used less often (7% of patients). Despite aggressive therapy, we observed that the death rate (39%) associated with N. farcinica in recent publications was eight percentage points higher than reported in a review from 2000.
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Affiliation(s)
- Jonathan M Budzik
- Department of Pathology, Pritzker School of Medicine, Chicago, Illinois, USA
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Bock JM, Wrege K, Johnston N, Mackinnon AC, Williams CL. Abstract 2143: Smg-GDS regulates cellular proliferation in squamous cell carcinomas of the head and neck. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-2143] [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: 11/16/2022]
Abstract
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) is a major worldwide source of morbidity and mortality, with over 26,000 estimated new cases and 6,000 deaths from pharyngeal and laryngeal cancer in 2011 in the the United States alone. SCCHN is an aggressive disease which is characterized by local invasion and lymphatic and distant metastasis. Ras and Rho family GTPases are known to regulate tumor cell proliferation in numerous human cancers including SCCHN. SmgGDS, an unusual guanine nucleotide exchange factor, has previously been shown in other systems to activate these small GTPases and directly regulate cellular proliferation through control of small GTPase prenylation and cellular localization. Little is known about the role of SmgGDS in the progression of SCCHN. These studies were begun to characterize the expression of SmgGDS in SCCHN and assess the role that SmgGDS plays in SCCHN proliferation. SCCHN tumor tissue microarray analysis demonstrated increased SmgGDS expression in tumor tissue from various head and neck sites compared to normal tissues, with evidence for higher SmgGDS expression at the pushing tumor boarders in invasive cancers. Significantly increased amounts of SmgGDS protein and RNA expression were also noted in head and neck tumor cell lines compared to cultured normal head and neck tissue cell lines. To assess the function of Smg-GDS expression in SCCHN, UM-SCC-1 cells were transfected with siRNA directed toward the 60.7 and 55.8 kD SmgGDS isoforms, with significant decreases in S-phase distribution for all treatments. Blocking both 60.7 and 55.8 kD SmgGDS isoforms with siRNA induced an 89% decrease in S-phase distribution as determined by Click-iT Edu cell cycle proliferation assay. These studies confirm an active role for SmgGDS protein function in the promotion of cancer cell proliferation in SCCHN, and provide the basis for further investigations into the role of small GTPases in head and neck neoplasia.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2143. doi:1538-7445.AM2012-2143
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Affiliation(s)
| | - Kay Wrege
- 1Medical College of Wisconsin, Milwaukee, WI
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Mackinnon AC, Tretiakova M, Henderson L, Mehta RG, Yan BC, Joseph L, Krausz T, Husain AN, Reid ME, Salgia R. Paxillin expression and amplification in early lung lesions of high-risk patients, lung adenocarcinoma and metastatic disease. J Clin Pathol 2010; 64:16-24. [PMID: 21045234 PMCID: PMC3002839 DOI: 10.1136/jcp.2010.075853] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Paxillin is a modular protein that localises to cell adhesion sites where it facilitates bidirectional communication between the intracellular actin cytoskeleton and the extracellular matrix. These complex and dynamic interactions are essential for cell adhesion, cell migration and cell survival. The authors have previously demonstrated that paxillin is overexpressed in lung cancer tissues and identified somatic paxillin mutations in 9% of lung cancers. A murine in vivo xenograft model of the most common paxillin mutation (A127T) showed increased cell proliferation and invasive tumour growth, establishing an important role for paxillin in the development of lung cancer. Methods The authors analysed 279 bronchoscopy-aided biopsy specimens from 92 high-risk patients. Adenocarcinoma with bronchioloalveolar features and pure bronchioloalveolar carcinoma (BAC) were analysed with fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC). Results Paxillin is overexpressed in premalignant areas of hyperplasia, squamous metaplasia and goblet cell metaplasia, as well as dysplastic lesions and carcinoma in high-risk patients. Concordance between increased paxillin gene copy number and paxillin overexpression was observed in cases of adenocarcinoma eusomic for chromosome 12. Conclusions Paxillin overexpression occurs during the earliest stages of lung cancer development. FISH and IHC analysis of lung adenocarcinoma suggests that relatively small-scale genomic rearrangements of chromosome 12 are associated with paxillin overexpression in lung adenocarcinoma.
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Affiliation(s)
- Alexander C Mackinnon
- Department of Pathology, University of Chicago Medical Center, Chicago, Illinois 60637, USA.
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Gao Z, Kim GH, Mackinnon AC, Flagg AE, Bassett B, Earley JU, Svensson EC. Ets1 is required for proper migration and differentiation of the cardiac neural crest. Development 2010; 137:1543-51. [PMID: 20356956 DOI: 10.1242/dev.047696] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Defects in cardiac neural crest lead to congenital heart disease through failure of cardiac outflow tract and ventricular septation. In this report, we demonstrate a previously unappreciated role for the transcription factor Ets1 in the regulation of cardiac neural crest development. When bred onto a C57BL/6 genetic background, Ets1(-/-) mice have a nearly complete perinatal lethality. Histologic examination of Ets1(-/-) embryos revealed a membranous ventricular septal defect and an abnormal nodule of cartilage within the heart. Lineage-tracing experiments in Ets1(-/-) mice demonstrated that cells of the neural crest lineage form this cartilage nodule and do not complete their migration to the proximal aspects of the outflow tract endocardial cushions, resulting in the failure of membranous interventricular septum formation. Given previous studies demonstrating that the MEK/ERK pathway directly regulates Ets1 activity, we cultured embryonic hearts in the presence of the MEK inhibitor U0126 and found that U0126 induced intra-cardiac cartilage formation, suggesting the involvement of a MEK/ERK/Ets1 pathway in blocking chondrocyte differentiation of cardiac neural crest. Taken together, these results demonstrate that Ets1 is required to direct the proper migration and differentiation of cardiac neural crest in the formation of the interventricular septum, and therefore could play a role in the etiology of human congenital heart disease.
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Affiliation(s)
- Zhiguang Gao
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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Abstract
PURPOSE Lung cancer is the leading cause of cancer deaths in the developed world. Small cell lung cancer (SCLC) has the worst prognosis due to the emergence of resistance to chemotherapy. This article will review recent work that has defined mechanisms of chemo-resistance focusing on the role of integrins. RESULTS SCLC is surrounded by an extensive stroma of extracellular matrix (ECM) and high levels of expression correlate with poor prognosis. ECM protects SCLC cells against chemotherapy-induced cell death by activating beta1 integrins leading to activation of phosphoinositide-3-OH kinase (PI3-kinase), which prevents etoposide-induced caspase-3 activation and subsequent apoptosis. Engagement of ECM prevents etoposide and radiation induced G2/M cell cycle arrest in SCLC cells by blocking the up-regulation of p21Cip1/WAF1 and p27Kip1 and the down-regulation of cyclins E, A and B. These effects are abrogated by pharmacological and genetic inhibition of PI3-kinase signalling. CONCLUSIONS Thus, ECM via beta1 integrin-mediated PI3-kinase activation allows SCLC cells to survive treatment induced cell cycle arrest and apoptosis with persistent DNA damage, providing a model to account for the emergence of acquired drug resistance. Novel therapeutic strategies may therefore be directed at inhibiting integrin-mediated cell survival signals improving response rates and cure in this devastating cancer.
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Affiliation(s)
- P S Hodkinson
- Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Hodkinson PS, Elliott T, Wong WS, Rintoul RC, Mackinnon AC, Haslett C, Sethi T. ECM overrides DNA damage-induced cell cycle arrest and apoptosis in small-cell lung cancer cells through β1 integrin-dependent activation of PI3-kinase. Cell Death Differ 2006; 13:1776-88. [PMID: 16410797 DOI: 10.1038/sj.cdd.4401849] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The emergence of resistance to chemotherapy remains a principle problem in the treatment of small-cell lung cancer (SCLC). We demonstrate that extracellular matrix (ECM) activates phosphatidyl inositol 3-kinase (PI3-kinase) signaling in SCLC cells and prevents etoposide-induced caspase-3 activation and subsequent apoptosis in a beta1 integrin/PI3-kinase-dependent manner. Crucially we show that etoposide and radiation induce G2/M cell cycle arrest in SCLC cells prior to apoptosis and that ECM prevents this by overriding the upregulation of p21(Cip1/WAF1) and p27(Kip1) and the downregulation of cyclins E, A and B. These effects are abrogated by pharmacological and genetic inhibition of PI3-kinase signaling. Importantly we show that chemoprotection is not mediated by altered SCLC cell proliferation or DNA repair. Thus, ECM via beta1 integrin-mediated PI3-kinase activation overrides treatment-induced cell cycle arrest and apoptosis, allowing SCLC cells to survive with persistent DNA damage, providing a model to account for the emergence of acquired drug resistance.
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Affiliation(s)
- P S Hodkinson
- MRC Centre for Inflammation Research, Queen's Institute of Medical Research, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK
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