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Warren H, Rautio A, Marandino L, Pyrgidis N, Tzelves L, Roussel E, Muselaers S, Erdem S, Palumbo C, Amparore D, Wu Z, Ciccarese C, Diana P, Borregales L, Pavan N, Pecoraro A, Caliò A, Klatte T, Carbonara U, Marchioni M, Bertolo R, Campi R, Tran MG. Diagnostic Biopsy for Small Renal Tumours: A Survey of Current European Practice. EUR UROL SUPPL 2024; 62:54-60. [PMID: 38585205 PMCID: PMC10998268 DOI: 10.1016/j.euros.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 04/09/2024] Open
Abstract
Background and objective Renal tumour biopsy (RTB) can help in risk stratification of renal tumours with implications for management, but its utilisation varies. Our objective was to report current practice patterns, experiences, and perceptions of RTB and research gaps regarding RTB for small renal masses (SRMs). Methods Two web-based surveys, one for health care providers (HCPs) and one for patients, were distributed via the European Association of Urology Young Academic Urologist Renal Cancer Working Group and the European Society of Residents in Urology in January 2023. Key findings and limitations The HCP survey received 210 responses (response rate 51%) and the patient survey 54 responses (response rate 59%). A minority of HCPs offer RTB to >50% of patients (14%), while 48% offer it in <10% of cases. Most HCPs reported that RTB influences (61.5%) or sometimes influences (37.1%) management decisions. Patients were more likely to favour active treatment if RTB showed high-grade cancer and less likely to favour active treatment for benign histology. HCPs identified situations in which they would not favour RTB, such as cystic tumours and challenging anatomic locations. RTB availability (67%) and concerns about delays to treatment (43%) were barriers to offering RTB. Priority research gaps include a trial demonstrating that RTB leads to better clinical outcomes, and better evidence that benign/indolent tumours do not require active treatment. Conclusions and clinical implications Utilisation of RTB for SRMs in Europe is low, even though both HCPs and patients reported that RTB results can affect disease management. Improving timely access to RTB and generating evidence on outcomes associated with RTB use are priorities for the kidney cancer community. Patient summary A biopsy of a kidney mass can help patients and doctors make decisions on treatment, but our survey found that many patients in Europe are not offered this option. Better access to biopsy services is needed, as well as more research on what happens to patients after biopsy.
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Affiliation(s)
- Hannah Warren
- Division of Surgery and Interventional Sciences, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK
| | - Aleksandra Rautio
- North Estonia Medical Centre, Clinic of General and Oncourology, Tallinn, Estonia
| | | | - Nikolaos Pyrgidis
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | | | - Eduard Roussel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Stijn Muselaers
- Department of Urology, Radboudumc, Nijmegen, The Netherlands
| | - Selcuk Erdem
- Department of Urology, Istanbul University, Istanbul, Turkey
| | - Carlotta Palumbo
- Department of Urology, University of Eastern Piedmont, Vercelli, Italy
| | | | - Zhenjie Wu
- Department of Urology, Changhai Hospital Naval Medical University, Shanghai, China
| | - Chiara Ciccarese
- Department of Medical Oncology, Fondaziona Policlionico Universatario A. Gemelli IRCCS, Rome, Italy
| | - Pietro Diana
- Department of Urology, Fundació Puigvert, Barcelona, Spain
| | - Leonardo Borregales
- Columbia University Division of Urology, Mount Sinai Medical Centre, Miami, FL, USA
| | - Nicola Pavan
- University of Palmero and University of Trieste, Palmero, Italy
| | - Angela Pecoraro
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Anna Caliò
- Department of Pathology, University of Verona, Verona, Italy
| | - Tobias Klatte
- Department of Urology, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Umberto Carbonara
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, G. D’Annunzio University of Chieti, Chieti, Italy
| | | | - Riccardo Campi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Maxine G.B. Tran
- Division of Surgery and Interventional Sciences, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK
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Montanaro F, Bertolo R, Costantino S, De Maria N, Veccia A, Migliorini F, Caliò A, Brunelli M, Montemezzi S, Cerruto MA, Antonelli A. Robot-assisted excision of hemangioma of the right renal vein. Urol Case Rep 2024; 53:102651. [PMID: 38229734 PMCID: PMC10788791 DOI: 10.1016/j.eucr.2024.102651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024] Open
Abstract
Hemangiomas, benign vascular masses, occasionally occur in the kidneys, presenting as rare, small, unilateral, and solitary growths. Venous hemangiomas, a renal subtype, are atypical. While clinically nonspecific, they are typically asymptomatic and may be incidentally discovered during unrelated clinical workups. Diagnosing renal hemangioma preoperatively is challenging due to rarity, lacking standard radiographic criteria, and poor differentiation from aggressive renal neoplasms on contrast-enhanced imaging. These tumors commonly follow a benign course, with no documented recurrence. This video article showcases the robot-assisted excision of a renal vein hemangioma, addressing the expertise needed in managing this uncommon condition robotically.
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Affiliation(s)
- Francesca Montanaro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Riccardo Bertolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Sonia Costantino
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Nicola De Maria
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Alessandro Veccia
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Filippo Migliorini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Stefania Montemezzi
- Department of Pathology and Diagnostics, Radiology Unit, University of Verona, Verona, Italy
| | - Maria Angela Cerruto
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
| | - Alessandro Antonelli
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy
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3
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Wu Z, Chen H, Chen Q, Ge S, Yu N, Campi R, Gómez Rivas J, Autorino R, Rouprêt M, Psutka SP, Mehrazin R, Porpiglia F, Bensalah K, Black PC, Mir MC, Minervini A, Djaladat H, Margulis V, Bertolo R, Caliò A, Carbonara U, Amparore D, Borregales LD, Ciccarese C, Diana P, Erdem S, Marandino L, Marchioni M, Muselaers CHJ, Palumbo C, Pavan N, Pecoraro A, Roussel E, Warren H, Pandolfo SD, Chen R, Zhou W, Zhai W, He M, Li Y, Han B, Wan J, Zeng X, Yan J, Fu Y, Ji C, Fan X, Zhang G, Zhao C, Jing T, Wang A, Feng C, Zhao H, Sun D, Wang L, Tai S, Zhang C, Chen S, Liu Y, Xu Z, Wang H, Gao J, Wang F, Cheng J, Miao H, Rao Q, Wang J, Xu N, Wang G, Liang C, Liu Z, Xia D, Jiang J, Zu X, Chen M, Guo H, Qin W, Wang Z, Xue W, Shi B, Zhou X, Wang S, Zheng J, Ge J, Feng X, Li M, Chen C, Qu L, Wang L. Prognostic Significance of Grade Discrepancy Between Primary Tumor and Venous Thrombus in Nonmetastatic Clear-cell Renal Cell Carcinoma: Analysis of the REMEMBER Registry and Implications for Adjuvant Therapy. Eur Urol Oncol 2024; 7:112-121. [PMID: 37468393 DOI: 10.1016/j.euo.2023.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Further stratification of the risk of recurrence of clear-cell renal cell carcinoma (ccRCC) with venous tumor thrombus (VTT) will facilitate selection of candidates for adjuvant therapy. OBJECTIVE To assess the impact of tumor grade discrepancy (GD) between the primary tumor (PT) and VTT in nonmetastatic ccRCC on disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). DESIGN, SETTING, AND PARTICIPANTS This was a retrospective analysis of a multi-institutional nationwide data set for patients with pT3N0M0 ccRCC who underwent radical nephrectomy and thrombectomy. OUTCOMES MEASUREMENTS AND STATISTICAL ANALYSIS Pathology slides were centrally reviewed. GD, a bidirectional variable (upgrading or downgrading), was numerically defined as the VTT grade minus the PT grade. Multivariable models were built to predict DFS, OS, and CSS. RESULTS AND LIMITATIONS We analyzed data for 604 patients with median follow-up of 42 mo (excluding events). Tumor GD between VTT and PT was observed for 47% (285/604) of the patients and was an independent risk factor with incremental value in predicting the outcomes of interest (all p < 0.05). Incorporation of tumor GD significantly improved the performance of the ECOG-ACRIN 2805 (ASSURE) model. A GD-based model (PT grade, GD, pT stage, PT sarcomatoid features, fat invasion, and VTT consistency) had a c index of 0.72 for DFS. The hazard ratios were 8.0 for GD = +2 (p < 0.001), 1.9 for GD = +1 (p < 0.001), 0.57 for GD = -1 (p = 0.001), and 0.22 for GD = -2 (p = 0.003) versus GD = 0 as the reference. According to model-converted risk scores, DFS, OS, and CSS significantly differed between subgroups with low, intermediate, and high risk (all p < 0.001). CONCLUSIONS Routine reporting of VTT upgrading or downgrading in relation to the PT and use of our GD-based nomograms can facilitate more informed treatment decisions by tailoring strategies to an individual patient's risk of progression. PATIENT SUMMARY We developed a tool to improve patient counseling and guide decision-making on other therapies in addition to surgery for patients with the clear-cell type of kidney cancer and tumor invasion of a vein.
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Affiliation(s)
- Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China; European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands.
| | - Hui Chen
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Silun Ge
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Nengwang Yu
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Riccardo Campi
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | - Morgan Rouprêt
- Department of Urology, GRC No. 5, Predictive ONCO-URO, Hospital Pitié-Salpêtrière, AP-HP, Sorbonne University, Paris, France
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | - Peter C Black
- Department of Urologic Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Maria C Mir
- Department of Urology; Hospital Universitario La Ribera; Valencia, Spain
| | - Andrea Minervini
- Departments of Urology and Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Hooman Djaladat
- Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Riccardo Bertolo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Unit, San Carlo di Nancy Hospital, Rome, Italy
| | - Anna Caliò
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Umberto Carbonara
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Daniele Amparore
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Leonardo D Borregales
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY, USA
| | - Chiara Ciccarese
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pietro Diana
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Selcuk Erdem
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urologic Oncology, Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Laura Marandino
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Marchioni
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Medical, Oral and Biotechnological Sciences, Urology Unit, University G. d'Annunzio, Chieti, Italy
| | - Constantijn H J Muselaers
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlotta Palumbo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Nicola Pavan
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Clinic, Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Angela Pecoraro
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Eduard Roussel
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Hannah Warren
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Surgery and Interventional Science, University College London, London, UK
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Rui Chen
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Wei Zhai
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Miaoxia He
- Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yaoming Li
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Bo Han
- Department of Pathology, Qilu Hospital, Shandong University, Jinan, China
| | - Jie Wan
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junan Yan
- Department of Urology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yao Fu
- Department of Pathology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Changwei Ji
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Fan
- Department of Pathology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guangyuan Zhang
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Cheng Zhao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Taile Jing
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Anbang Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Chenchen Feng
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongwei Zhao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Di Sun
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Liang Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cheng Zhang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaohao Chen
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yixun Liu
- Department of Urology, Anhui Provincial Hospital/The First Hospital of the University of Science and Technology of China, Hefei, China
| | - Zhipeng Xu
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Haifeng Wang
- Department of Urology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Jinli Gao
- Department of Pathology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Fubo Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Jiwen Cheng
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - He Miao
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qiu Rao
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Jianning Wang
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Ning Xu
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiyu Liu
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dan Xia
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Jiang
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Ming Chen
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhe Wang
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Xue
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Xiaojun Zhou
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhua Zheng
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingping Ge
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Feng
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Minming Li
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Cheng Chen
- Department of Medical Oncology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Le Qu
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Linhui Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
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4
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Brunelli M, Gobbo S, Malpeli G, Sirgiovanni G, Caserta C, Munari E, Francesconi S, Caliò A, Martignoni G, Cimadamore A, Veccia A, Antonelli A, Tucci M, Pierconti F, Hattab IM, Eccher A, Ascani S, Milella M, Buffoni L, Cheng L, Bracarda S. TROP-2, NECTIN-4 and predictive biomarkers in sarcomatoid and rhabdoid bladder urothelial carcinoma. Pathologica 2024; 116:55-61. [PMID: 38482675 PMCID: PMC10938277 DOI: 10.32074/1591-951x-937] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/22/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction The surface protein TROP-2/TACSTD2 and the cell adhesion protein NECTIN-4/NECTIN4 are responsible for the efficacy of anticancer therapies based on antibody-drug conjugates (ADC) targeting intracellular microtubules. In contrast with common histologic subtypes of bladder urothelial carcinoma (BUC), little is known of TROP-2 and NECTIN-4 expression in sarcomatoid and rhabdoid BUC. Aims In this study, we aimed to analyze TROP-2 and NECTIN-4 expression and additional predictive biomarkers by immunohistochemistry and fluorescence in situ hybridization (FISH) on 35 undifferentiated BUC (28 sarcomatoid and 7 rhabdoid). Wide genomic investigation was also performed on 411 BUC cases of the PanCancer Atlas, focusing on genes related to the microtubule pathways. Results Seven of 35 (20%) undifferentiated BUC showed expression of TROP-2. NECTIN-4 was expressed in 10 cases (29%). Seven cases (20%) co-expressed TROP-2 and NECTIN-4. HER-2 FISH was amplified in 5 cases (14%) while HER-2 immunoexpression was observed in 14 cases (40%). PD-L1 scored positive for combined proportion score (CPS) in 66% of cases and for tumor proportion score (TPS) in 51% of cases. Pan-NTRK1-2/3 was elevated in 9 cases (26%) and FGFR-2/3 was broken in 7 of 35 cases (20%). Of 28 sarcomatoid BUC, 9 (32%) were negative for all (TROP-2, NECTIN-4, PD-L1, HER-2, FGFR and pan-NTRK) biomarkers and 3 (11%) expressed all five biomarkers. Among cases with rhabdoid dedifferentiation, 1 of 7 (14%) showed activation of all biomarkers, whereas 2 of 7 (28%) showed none. The mRNA analysis identified microtubule-related genes and pathways suitable for combined ADC treatments in BUC. Conclusion Sarcomatoid and rhabdoid BUC do harbor positive expression of the ADC targets TROP-2 or NECTIN-4 in a relatively modest subset of cases, whereas the majority do not. Different combinations of other positive biomarkers may help the choice of medical therapies. Overall, these findings have important clinical implications for targeted therapy for BUC.
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Affiliation(s)
- Matteo Brunelli
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Stefano Gobbo
- Department of Translational Medicine, University of Ferrara, Italy
| | - Giorgio Malpeli
- Department of Human Sciences for the Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Grazia Sirgiovanni
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
| | - Claudia Caserta
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
| | - Enrico Munari
- Department of Molecular and Translational Medicine, University of Brescia, Italy
| | | | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Guido Martignoni
- Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - Isabelle Malak Hattab
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center and the Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Albino Eccher
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, Italy
| | - Stefano Ascani
- Unit of Pathology, S. Maria di Terni Hospital, University of Perugia, Terni, Italy
| | - Michele Milella
- Section of Oncology, University of Verona - School of Medicine, Verona University Hospital Trust, Italy
| | - Lucio Buffoni
- Medical Oncology, Humanitas Gradenigo, Torino, Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center and the Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Sergio Bracarda
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
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Caliò A, Amparore D, Roussel E, Bertolo R, Erdem S, Marchioni M, Pavan N, Campi R. The World Health Organization 2022 Classification of renal tumors: key updates for urologists. Minerva Urol Nephrol 2023; 75:766-769. [PMID: 38126288 DOI: 10.23736/s2724-6051.23.05434-4] [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: 12/23/2023]
Affiliation(s)
- Anna Caliò
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy -
| | - Daniele Amparore
- School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Eduard Roussel
- Department of Urology, University Hospitals of Leuven, Leuven, Belgium
| | | | - Selçuk Erdem
- Division of Urologic Oncology, Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, G. D'Annunzio Chieti-Pescara University, Chieti, Italy
- Department of Urology, SS Annunziata Hospital, G. D'Annunzio Chieti-Pescara University, Chieti, Italy
| | - Nicola Pavan
- Unit of Urology, Department of Surgical, Oncological and Oral Sciences, P. Giaccone University Hospital, Palermo, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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6
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Sposito M, Scaglione IM, Eccher S, Pasqualin L, Avancini A, Colato C, Rosina P, Simbolo M, Caliò A, Scarpa A, Milella M, Pilotto S, Belluomini L. Exceptional Response in BRAF p.V600E-Mutant Enteric-Type Adenocarcinoma of the Lung With Cutaneous Spread: A Case Report. JTO Clin Res Rep 2023; 4:100597. [PMID: 38124787 PMCID: PMC10730365 DOI: 10.1016/j.jtocrr.2023.100597] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/28/2023] [Indexed: 12/23/2023] Open
Abstract
Background Enteric-type adenocarcinoma of the lung (lung-ETAC) is a rare form of lung cancer with histologic similarities to colorectal cancer, with aggressive behavior and unfavorable prognosis. Case Presentation An 81-year-old man presented with discolored skin lesions on the chest and abdomen. After comprehensive evaluation, including skin biopsy and molecular profiling, the patient was diagnosed with having lung-ETAC with a BRAF p.V600E mutation. Treatment with dabrafenib and trametinib initially resulted in positive results, with improvement in skin lesions and overall clinical condition. Nevertheless, approximately 6 months after, the disease had progression with new skin lesions reappearing. Conclusions We reported a unique case of a patient with BRAF p.V600E-mutant lung-ETAC with metastatic skin lesions achieving complete cutaneous response after targeted treatment with dabrafenib and trametinib, highlighting the potential for targeted therapy in patients with lung-ETAC harboring a BRAF p.V600E mutation.
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Affiliation(s)
- Marco Sposito
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Ilaria Mariangela Scaglione
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Serena Eccher
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Luca Pasqualin
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Alice Avancini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Colato
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Paolo Rosina
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Michele Simbolo
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Anna Caliò
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
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7
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Caliò A, Marletta S, Settanni G, Rizzo M, Gobbo S, Pedron S, Stefanizzi L, Munari E, Brunelli M, Marcolini L, Pesci A, Fratoni S, Pierconti F, Raspollini MR, Marchetti A, Doglioni C, Amin MB, Porta C, Martignoni G. mTOR eosinophilic renal cell carcinoma: a distinctive tumor characterized by mTOR mutation, loss of chromosome 1, cathepsin-K expression, and response to target therapy. Virchows Arch 2023; 483:821-833. [PMID: 37938323 PMCID: PMC10700445 DOI: 10.1007/s00428-023-03688-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
In the spectrum of oncocytic renal neoplasms, a subset of tumors with high-grade-appearing histologic features harboring pathogenic mutations in mammalian target of rapamycin (mTOR) and hitherto clinical indolent behavior has been described. Three cases (2F,1 M) with histologically documented metastases (lymph node, skull, and liver) were retrieved and extensively investigated by immunohistochemistry, FISH, and next-generation sequencing. Tumors were composed of eosinophilic cells with prominent nucleoli (G3 by ISUP/WHO) arranged in solid to nested architecture. Additionally, there were larger cells with perinuclear cytoplasmic shrinkage and sparse basophilic Nissl-like granules, superficially resembling the so-called spider cells of cardiac rhabdomyomas. The renal tumors, including the skull and liver metastases, showed immunoexpression PAX8, CK8-18, and cathepsin-K, and negativity for vimentin. NGS identified mTOR genetic alterations in the three cases, including the skull and liver metastases. One patient was then treated with Everolimus (mTOR inhibitors) with clinical response (metastatic tumor shrinkage). We present a distinct renal tumor characterized by high-grade eosinophilic cells, cathepsin-K immunohistochemical expression, and harboring mTOR gene mutations demonstrating a malignant potential and showing responsiveness to mTOR inhibitors.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Giulio Settanni
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Mimma Rizzo
- Division of Medical Oncology, A.O.U. Consorziale Policlinico Di Bari, Bari, Italy
| | - Stefano Gobbo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Serena Pedron
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | | | - Enrico Munari
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Lisa Marcolini
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Anna Pesci
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Stefano Fratoni
- Division of Anatomic Pathology, S. Eugenio Hospital, Rome, Italy
| | - Francesco Pierconti
- Division of Anatomic Pathology and Histology, Foundation "A. Gemelli" University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Rosaria Raspollini
- Histopathology and Molecular Diagnostics, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Antonio Marchetti
- Division of Anatomic Pathology and Histology, Ospedale Clinicizzato "SS. Annunziata" Università Di Chieti, Chieti, Italy
| | | | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science, Memphis, TN, USA
- Department of Urology, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Camillo Porta
- Interdisciplinary Department of Medicine, University of Bari "A. Moro, Bari, Italy
| | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy.
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy.
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8
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Cimadamore A, Rescigno P, Conteduca V, Caliò A, Allegritti M, Calò V, Montagnani I, Lucianò R, Patruno M, Bracarda S. SIUrO best practice recommendations to optimize BRCA 1/2 gene testing from DNA extracted from bone biopsy in mCRPC patients (BRCA Optimal Bone Biopsy Procedure: BOP). Virchows Arch 2023; 483:579-589. [PMID: 37794204 DOI: 10.1007/s00428-023-03660-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/27/2023] [Revised: 08/11/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
The main guidelines and recommendations for the implementation of the BRCA1/2 somatic test do not focus on the clinical application of predictive testing on bone metastases, a frequent condition in metastatic prostate cancer, by analyzing the critical issues encountered by laboratory practice. Our goal is to produce a document (protocol) deriving from a multidisciplinary team approach to obtain high quality nucleic acids from biopsy of bone metastases. This document aims to compose an operational check-list of three phases: the pre-analytical phase concerns tumor cellularity, tissue processing, sample preservation (blood/FFPE), fixation and staining, but above all the decalcification process, the most critical phase because of its key role in allowing the extraction of somatic DNA with a good yield and high quality. The analytical phase involves the preparation of the libraries that can be analyzed in various NGS genetic sequencing platforms and with various bioinformatics software for the interpretation of sequence variants. Finally, the post-analytical phase that allows to report the variants of the BRCA1/2 genes in a clear and usable way to the clinician who will use these data to manage cancer therapy with PARP Inhibitors.
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Affiliation(s)
- Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medicine (DAME), University of Udine, Via Palladio 8, 33100, Udine, Italy.
| | - Pasquale Rescigno
- Translational and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
- Candiolo Cancer Institute, FPO-IRCCS, 10060, Candiolo, Italy
| | - Vincenza Conteduca
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences - Policlinico Riuniti, University of Foggia, 71122, Foggia, Italy
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Massimiliano Allegritti
- Interventional radiology Unit, Azienda ospedaliera Santa Maria Terni, Viale Tristano di Joannuccio, 05100, Terni, Italy
| | - Valentina Calò
- Central Laboratory of Advanced Diagnosis and Biomedical Research, (CLADIBIOR) Policlinico Paolo Giaccone Hospital, University of Palermo, 90127, Palermo, Italy
| | - Ilaria Montagnani
- Pathology Unit, USL Toscana Centro - Ospedale San Giuseppe, Empoli, Italy
| | - Roberta Lucianò
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Margherita Patruno
- Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II,", Bari, Italy
| | - Sergio Bracarda
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera Santa Maria, Viale Tristano di Joannuccio, 05100, Terni, Italy
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9
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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10
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Caliò A, Barreca A, Marletta S, Achenza MIS, Alessi M, Angelico R, Apicella L, Argiolas D, Bossini N, Carrano R, Carriero C, Castellano G, Comai G, Di Bella C, D’Ignoto F, Gallico A, Gastaldon F, Merlotti G, Paloschi V, Panarese A, Parodi A, Perna F, Picciotto D, Regalia A, Rossini M, Russo E, Salerno MP, Toti L, Tulissi P, Vischini G, Zaza G, Eccher A. Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy). Pathologica 2023; 115:199-204. [PMID: 37314869 PMCID: PMC10688244 DOI: 10.32074/1591-951x-858] [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: 02/27/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023] Open
Abstract
A meeting entitled Renal BIopsy for Kidney Transplantation Therapy (ReBIrth) took place on May 31st, 2022 in Bologna, Italy. The meeting drew together nephrologists, surgeons, and pathologists and recognized as experts in the field of kidney transplantation in Italy. In this paper, we present our experience working with kidney transplants in the current era of immunosuppression therapy. The primary aim is to report the histopathological characteristics of failed kidney allografts after a consensus of experts reviewed the cases on a wholeslide imaging digital platform. Regardless of the cases discussed, digital pathology was reliable in identifying all the morphological and immunohistochemical features required to improve the correct use of immunosuppressive therapy to prevent graft failure and optimize patient management.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Antonella Barreca
- Pathology Unit, “Città della Salute e della Scienza di Torino” University Hospital, Turin, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Marianna Alessi
- Department of Medicine, Nephrology, University of Padova, Padova, Italy
| | - Roberta Angelico
- Department of Surgical Sciences, HPB and Transplant Unit, University of Rome Tor Vergata, Roma Italy
| | - Luca Apicella
- Division of Nephrology, Dialysis and Renal Transplantation, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Davide Argiolas
- Renal Transplant Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Nicola Bossini
- Division of Nephrology and Dialysis, ASST Spedali Civili, Brescia, Italy
| | - Rosa Carrano
- UOSD Nefrologia e Trapianto Renale, Dipartimento di Chirurgia Generale e Chirurgie Specialistiche dei Trapianti di Rene, Nefrologia, Cure Intensive e del Dolore, Azienda Ospedaliera Universitaria Federico II, Napoli, Italy
| | | | - Giuseppe Castellano
- Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giorgia Comai
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Caterina Di Bella
- Kidney and Pancreas Transplantation Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | | | - Agnese Gallico
- Division of Nephrology and Dialysis, ASST Spedali Civili, Brescia, Italy
| | - Fiorella Gastaldon
- Unità Operativa Complessa di Nefrologia, Dialisi e Trapianto Renale, AULSS8 Berica, Ospedale San Bortolo, Vicenza, Italy
| | - Guido Merlotti
- Nephrology and Kidney Transplantation Unit, Department of Translational Medicine, University of Piemonte Orientale (UPO), “Maggiore della Carità” University Hospital, Novara, Italy
| | - Vera Paloschi
- Transplant Medicine Unit, Department of Internal Medicine, IRCCS San Raffaele Hospital, Milano, Italy
| | - Alessandra Panarese
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, L’Aquila, Italy
| | - Angelica Parodi
- Unit of Nephrology Dialysis and Transplantation, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Perna
- Fondazione Policlinico A. Gemelli – UOS Trapianti di Rene, Roma, Italy
| | - Daniela Picciotto
- Unit of Nephrology Dialysis and Transplantation, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Regalia
- Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Rossini
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Enrico Russo
- General Surgery and Kidney Transplantation Unit, “OO.RR. San Giovanni di Dio e Ruggi d’Aragona” University Hospital, Salerno, Italy
| | | | - Luca Toti
- Transplant and HPB Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
| | - Patrizia Tulissi
- Unità complessa di Nefrologia, Dialisi e Trapianto, Udine, Italy
| | - Gisella Vischini
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gianluigi Zaza
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Albino Eccher
- Department of Diagnostic and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
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11
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Distante A, Marandino L, Bertolo R, Ingels A, Pavan N, Pecoraro A, Marchioni M, Carbonara U, Erdem S, Amparore D, Campi R, Roussel E, Caliò A, Wu Z, Palumbo C, Borregales LD, Mulders P, Muselaers CHJ. Artificial Intelligence in Renal Cell Carcinoma Histopathology: Current Applications and Future Perspectives. Diagnostics (Basel) 2023; 13:2294. [PMID: 37443687 DOI: 10.3390/diagnostics13132294] [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: 05/31/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Renal cell carcinoma (RCC) is characterized by its diverse histopathological features, which pose possible challenges to accurate diagnosis and prognosis. A comprehensive literature review was conducted to explore recent advancements in the field of artificial intelligence (AI) in RCC pathology. The aim of this paper is to assess whether these advancements hold promise in improving the precision, efficiency, and objectivity of histopathological analysis for RCC, while also reducing costs and interobserver variability and potentially alleviating the labor and time burden experienced by pathologists. The reviewed AI-powered approaches demonstrate effective identification and classification abilities regarding several histopathological features associated with RCC, facilitating accurate diagnosis, grading, and prognosis prediction and enabling precise and reliable assessments. Nevertheless, implementing AI in renal cell carcinoma generates challenges concerning standardization, generalizability, benchmarking performance, and integration of data into clinical workflows. Developing methodologies that enable pathologists to interpret AI decisions accurately is imperative. Moreover, establishing more robust and standardized validation workflows is crucial to instill confidence in AI-powered systems' outcomes. These efforts are vital for advancing current state-of-the-art practices and enhancing patient care in the future.
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Affiliation(s)
- Alfredo Distante
- Department of Urology, Catholic University of the Sacred Heart, 00168 Roma, Italy
- Department of Urology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Laura Marandino
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Riccardo Bertolo
- Department of Urology, San Carlo Di Nancy Hospital, 00165 Rome, Italy
| | - Alexandre Ingels
- Department of Urology, University Hospital Henri Mondor, APHP (Assistance Publique-Hôpitaux de Paris), 94000 Créteil, France
| | - Nicola Pavan
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo, 90133 Palermo, Italy
| | - Angela Pecoraro
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, 10043 Turin, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, 66100 Chieti, Italy
| | - Umberto Carbonara
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, 70121 Bari, Italy
| | - Selcuk Erdem
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul 34093, Turkey
| | - Daniele Amparore
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, 10043 Turin, Italy
| | - Riccardo Campi
- Urological Robotic Surgery and Renal Transplantation Unit, Careggi Hospital, University of Florence, 50121 Firenze, Italy
| | - Eduard Roussel
- Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Anna Caliò
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy
| | - Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Carlotta Palumbo
- Division of Urology, Maggiore della Carità Hospital of Novara, Department of Translational Medicine, University of Eastern Piedmont, 13100 Novara, Italy
| | - Leonardo D Borregales
- Department of Urology, Well Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Peter Mulders
- Department of Urology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Constantijn H J Muselaers
- Department of Urology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
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12
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Marletta S, Caliò A, Bogina G, Rizzo M, Brunelli M, Pedron S, Marcolini L, Stefanizzi L, Gobbo S, Princiotta A, Porta C, Pecoraro A, Antonelli A, Martignoni G. STING is a prognostic factor related to tumor necrosis, sarcomatoid dedifferentiation, and distant metastasis in clear cell renal cell carcinoma. Virchows Arch 2023:10.1007/s00428-023-03549-y. [PMID: 37120444 DOI: 10.1007/s00428-023-03549-y] [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: 12/04/2022] [Revised: 02/21/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
STING is a molecule involved in immune reactions against double-stranded DNA fragments, released in infective and neoplastic diseases, whose role in the interactions between immune and neoplastic cells in clear cell renal cell carcinoma has not been studied yet. We investigated the immunohistochemical expression of STING in a series of 146 clear-cell renal cell carcinomas and correlated it with the main pathological prognostic factors. Furthermore, tumoral inflammatory infiltrate was evaluated and studied for the subpopulations of lymphocytes. Expression of STING was observed in 36% (53/146) of the samples, more frequently in high-grade (G3-G4) tumors (48%,43/90) and recurrent/metastatic ones (75%, 24/32) than in low grade (G1-G2) and indolent neoplasms (16%, 9/55). STING staining correlated with parameters of aggressive behavior, including coagulative granular necrosis (p = 0.001), stage (p < 0.001), and development of metastases (p < 0.001). Among prognostic parameters, STING immune expression reached an independent statistical significance (p = 0.029) in multivariable analysis, along with the stage and the presence of coagulative granular necrosis. About tumor immune-environment, no significant statistical association has been demonstrated between tumor-infiltrating lymphocytes and STING. Our results provide novel insights regarding the role of STING in aggressive clear cell renal cell carcinomas, suggesting its adoption as a prognostic marker and a potentially targetable molecule for specific immunotherapies.
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Affiliation(s)
- Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Giuseppe Bogina
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Mimma Rizzo
- Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Serena Pedron
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy
| | - Lisa Marcolini
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Stefano Gobbo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | | | - Camillo Porta
- Interdisciplinary Department of Medicine, University of Bari "A. Moro,", Bari, Italy
| | - Angela Pecoraro
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
- Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy.
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy.
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13
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Warren H, Palumbo C, Caliò A, Tran MGB, Campi R. Oncocytoma on renal mass biopsy: why is surgery even performed? World J Urol 2023:10.1007/s00345-023-04402-2. [PMID: 37084134 DOI: 10.1007/s00345-023-04402-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/01/2023] [Indexed: 04/22/2023] Open
Affiliation(s)
- Hannah Warren
- Division of Surgery and Interventional Sciences, University College London, London, UK.
- Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.
| | - Carlotta Palumbo
- Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Maxine G B Tran
- Division of Surgery and Interventional Sciences, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK
| | - Riccardo Campi
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
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14
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Zampiva I, Merler S, Inzerilli N, Zacchi F, Manduca S, Pafumi S, Piacentini M, Marletta S, Cesta Incani U, Torroni L, Vesentini R, Marchetti P, Fantinel E, Zivi A, Caliò A, Brunelli M, Verlato G, Milella M. Additional biological and clinical characteristics to refine International Metastatic RCC Database Consortium (IMDC) prognostic/predictive assessment in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.705] [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: 03/15/2023] Open
Abstract
705 Background: mRCC prognostic stratification is currently based on the IMDC score. However, some patients experience outcomes markedly different from those predicted by the median outcome of their risk class. Moreover, risk scores are prognostic, rather than predictive, and developing reproducible, affordable, biology-based predictive biomarkers to tailor treatment choices in individual pts remains an unmet clinical need. Methods: A retrospective cohort of 113 mRCC pts treated at the Verona University Hospital Trust between 2013 and 2021 was explored to identify additional clinical prognostic factors for OS to complement IMDC score. Outlier pts (i.e. individual pts whose clinical outcome differed significantly from the median of the IMDC group they belonged to) were further explored to find putative molecular signatures, using FISH and IHC assays. Results: At a median follow-up of 69 months (range 18-136m), novel variables impacting on OS in addition to IMDC risk group were identified: bone, central nervous system (CNS) and pancreatic mets and high neutrophil/lymphocyte ratio (N/L) with a cut-off of 3.2. We also analyzed outliers: 3 good-risk pts with lower than expected OS, 4 poor-risk pts with longer than expected OS, and two intermediate-risk pts with long treatment response. Two putative signatures were found predictive of disease behavior: a cold signature (9p loss, poor of TILs) and a hot signature (rich in CD56+, CD15+ and CD8+ infiltrating cells). The cold and hot signatures were found in good risk pts with bad OS and poor-risk pts good OS, respectively; both intermediate-risk pts had a hot signature, consistent with their disease course. Conclusions: Additional clinical and molecular factors have been identified to possibly improve IMDC prognostic performance; multivariable models including them along with standard IMDC are being developed. Molecular analysis suggests potential signatures to be applied in routine clinical practice, whose predictive performance could be validated in prospective multicentric trials. [Table: see text]
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Affiliation(s)
- Ilaria Zampiva
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Sara Merler
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Nicola Inzerilli
- Azienda USL di Piacenza, Department of Medical Oncology, Piacenza, Italy
| | - Francesca Zacchi
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Stefano Manduca
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Sarah Pafumi
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Michela Piacentini
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy, Verona, Italy
| | - Ursula Cesta Incani
- Oncology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health University of Verona Verona Italy, Verona, Italy
| | - Roberta Vesentini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health University of Verona Verona Italy, Verona, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health University of Verona Verona Italy, Verona, Italy
| | - Emanuela Fantinel
- Oncology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Andrea Zivi
- Oncology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health University of Verona Verona Italy, Verona, Italy
| | - Michele Milella
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
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15
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Carbonara U, Amparore D, Borregales LD, Caliò A, Ciccarese C, Diana P, Erdem S, Marandino L, Marchioni M, Muselaers CH, Palumbo C, Pavan N, Pecoraro A, Roussel E, Warren H, Wu ZJ, Campi R, Bertolo R. Single-port robotic partial nephrectomy: impact on perioperative outcomes and hospital stay. Ther Adv Urol 2023; 15:17562872231172834. [PMID: 37325290 PMCID: PMC10265377 DOI: 10.1177/17562872231172834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/13/2023] [Indexed: 06/17/2023] Open
Abstract
Single-port (SP) robotic surgery is a novel technology and is at the beginning of its adoption curve in urology. The goal of this narrative review is to provide an overview of SP-robotic partial nephrectomy (PN) 4 years after the introduction of the da Vinci SP dedicated platform, focusing on perioperative outcomes, length of stay, and surgical technique. A nonsystematic review of the literature was conducted. The research included the most updated articles that referred to SP robotic PN. Since its commercial release in 2018, several institutions have reproduced robotic PN by using the SP platform, both via a transperitoneal and a retroperitoneal approach. The published SP-robotic PN series are generally based on preliminary experiences by surgeons who had previous experience with conventional multi-arms robotic platforms. The reported outcomes are encouraging. Overall, three studies reported that SP-robotic PN cases had nonsignificantly different operative time, estimated blood loss, overall complications rate, and length of stay compared to the conventional 'multi-arms' robotic PN. However, in all these series, renal masses treated by SP had overall lower complexity. Moreover, two studies underlined decreased postoperative pain as a major pro of adopting the SP system. This should reduce/avoid the need for opioids after surgery. No study compared SP-robotic versus multi-arms robotic PN in cost-effectiveness. Published experience with SP-robotic PN has reported the feasibility and safety of the approach. Preliminary results are encouraging and at least noninferior with respect to those from the multi-arms series. Prospective comparative studies with long-term oncologic and functional results are awaited to draw more definitive conclusions and better establish the more appropriate indications of SP robotics in the field of PN.
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Affiliation(s)
| | - Daniele Amparore
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Leonardo D. Borregales
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian, New York, NY, USA
| | - Anna Caliò
- Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Chiara Ciccarese
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Pietro Diana
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Selcuk Erdem
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Division of Urologic Oncology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Laura Marandino
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Michele Marchioni
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, SS Annunziata Hospital, ‘G. D’Annunzio’ University of Chieti, Chieti, Italy
| | - Constantijn H.J. Muselaers
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlotta Palumbo
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands; Urology Unit, Ospedale Maggiore della Carità, Novara, Italy
| | - Nicola Pavan
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Urology Clinic, Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Angela Pecoraro
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Eduard Roussel
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Hannah Warren
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Zhen-Jie Wu
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Riccardo Campi
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi University Hospital, University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Riccardo Bertolo
- Renal Cancer Working Group, Young Academic Urologists (YAU), European Association of Urology (EAU), Arnhem, The Netherlands
- Department of Urology, San Carlo Di Nancy Hospital, Rome, Italy
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16
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Cimadamore A, Caliò A, Marandino L, Marletta S, Franzese C, Schips L, Amparore D, Bertolo R, Muselaers S, Erdem S, Ingels A, Pavan N, Pecoraro A, Kara Ö, Roussel E, Carbonara U, Campi R, Marchioni M. Hot topics in renal cancer pathology: implications for clinical management. Expert Rev Anticancer Ther 2022; 22:1275-1287. [PMID: 36377655 DOI: 10.1080/14737140.2022.2145952] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The updated European Association of Urology (EAU) Guidelines issued a weak recommendation for adjuvant pembrolizumab for patients with high-risk operable clear cell Renal Cell Carcinoma (ccRCC). High risk of recurrence was defined, as per protocol-criteria, as T2 with nuclear grade 4 or sarcomatoid differentiation, T3 or higher, regional lymph node metastasis, or stage M1 with no evidence of disease. Considering the heterogeneous population included in the recommendation, it has been questioned if adjuvant pembrolizumab may lead to overtreatment of some patients as well as undertreatment of patients with worse prognosis. AREAS COVERED In this review, we discuss the issues related to the assessment of pathological features required to identify those patients harboring a high-risk tumor, highlighting the issue related to interobserver variability and discuss the currently available prognostic scoring systems in ccRCC. EXPERT OPINION PPathologist assessment of prognostic features suffers from interobserver variability which may depend on gross sampling and the pathologist's expertise. The presence of clear cell feature is not sufficient criteria by itself to define ccRCC since clear cell can be also found in other histotypes. Application of molecular biomarkers may be useful tools in the near future to help clinicians identify patients harboring tumors with worse prognosis.
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Affiliation(s)
- Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medical Area, University of UdineUdineItaly
| | - Anna Caliò
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Laura Marandino
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Carmine Franzese
- Department of Urology, Polytechnic University of Marche, Ancona, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Science, "Ss. Annunziata" Hospital Urology Unit, "G. d'Annunzio" University of Chieti and Pescara, Chieti, Italy
| | - Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Stijn Muselaers
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Selcuk Erdem
- Division of Urologic Oncology, Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alexandre Ingels
- Department of Urology, University Hospital Henri Mondor, Créteil, France
| | - Nicola Pavan
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Angela Pecoraro
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Önder Kara
- Department of Urology, Kocaeli University School of Medicine, Izmit, Turkey
| | - Eduard Roussel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Umberto Carbonara
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Science, "Ss. Annunziata" Hospital Urology Unit, "G. d'Annunzio" University of Chieti and Pescara, Chieti, Italy
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17
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Caldart A, Fiorio E, Zanelli S, Biondani P, Parolin V, Pellini F, Montemezzi S, Nottegar A, Caliò A, Zampiva I, Merler S, Mongillo M, Avesani B, Borghesani G, Giontella E, Scarpa A, Milella M. Detecting actionable PIK3CA mutations through next-generation sequencing (NGS) in hormone receptor positive (HR+)/HER2-negative advanced/metastatic breast cancer (MBC): a real-life experience. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01453-8] [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: 11/19/2022]
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18
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Munari E, Querzoli G, Brunelli M, Marconi M, Sommaggio M, Cocchi MA, Martignoni G, Netto GJ, Caliò A, Quatrini L, Mariotti FR, Luchini C, Girolami I, Eccher A, Segala D, Ciompi F, Zamboni G, Moretta L, Bogina G. Comparison of three validated PD-L1 immunohistochemical assays in urothelial carcinoma of the bladder: interchangeability and issues related to patient selection. Front Immunol 2022; 13:954910. [PMID: 35967344 PMCID: PMC9363581 DOI: 10.3389/fimmu.2022.954910] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Different programmed cell death-ligand 1 (PD-L1) assays and scoring algorithms are being used in the evaluation of PD-L1 expression for the selection of patients for immunotherapy in specific settings of advanced urothelial carcinoma (UC). In this paper, we sought to investigate three approved assays (Ventana SP142 and SP263, and Dako 22C3) in UC with emphasis on implications for patient selection for atezolizumab/pembrolizumab as the first line of treatment. Tumors from 124 patients with invasive UC of the bladder were analyzed using tissue microarrays (TMA). Serial sections were stained with SP263 and SP142 on Ventana Benchmark Ultra and with 22C3 on Dako Autostainer Link 48. Stains were evaluated independently by two observers and scored using the combined positive score (CPS) and tumor infiltrating immune cells (IC) algorithms. Differences in proportions (DP), overall percent agreement (OPA), positive percent agreement (PPA), negative percent agreement (NPA), and Cohen κ were calculated for all comparable cases. Good overall concordance in analytic performance was observed for 22C3 and SP263 with both scoring algorithms; specifically, the highest OPA was observed between 22C3 and SP263 (89.6%) when using CPS. On the other hand, SP142 consistently showed lower positivity rates with high differences in proportions (DP) compared with 22C3 and SP263 with both CPS and IC, and with a low PPA, especially when using the CPS algorithm. In conclusion, 22C3 and SP263 assays show comparable analytical performance while SP142 shows divergent staining results, with important implications for the selection of patients for both pembrolizumab and atezolizumab.
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Affiliation(s)
- Enrico Munari
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- *Correspondence: Enrico Munari, ; Lorenzo Moretta,
| | - Giulia Querzoli
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Matteo Brunelli
- Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Marcella Marconi
- Pathology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Marco A. Cocchi
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Guido Martignoni
- Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - George J. Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Anna Caliò
- Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Linda Quatrini
- Tumor Immunology Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, Italy
| | | | - Claudio Luchini
- Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | | | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Diego Segala
- Pathology Unit, ASST Spedali Civili, Brescia, Italy
| | - Francesco Ciompi
- Computational Pathology Group, Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Giuseppe Zamboni
- Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- Pathology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Lorenzo Moretta
- Tumor Immunology Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, Italy
- *Correspondence: Enrico Munari, ; Lorenzo Moretta,
| | - Giuseppe Bogina
- Pathology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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19
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Caliò A, Cheng L, Martignoni G, Zhang S, Brunelli M, Eble JN. Mixed epithelial and stromal tumours of the kidney with malignant transformation: a clinicopathological study of four cases. Pathology 2022; 54:707-720. [PMID: 35697534 DOI: 10.1016/j.pathol.2022.03.011] [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: 11/22/2021] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
Mixed epithelial and stromal tumour of the kidney is a complex benign neoplasm in which malignancy rarely arises. In this study, we report four mixed epithelial and stromal tumours in which sarcoma or carcinoma developed. In the first, a multifocal adenocarcinoma arose and areas of transition from benign to malignant epithelium were observed. Oestrogen and progesterone receptors were diffusely present in the nuclei of the spindle cell stroma of the benign component. The second was a sarcoma in which benign epithelial elements were intermixed. Outside the renal parenchyma, clusters of small benign glands surrounded by oestrogen receptor-positive benign stroma were present, supporting the diagnosis of mixed epithelial and stromal tumour. Fluorescence in situ hybridisation for SYT-SSX translocation and immunohistochemical results, specifically TLE1 -ativity, argued against primary renal synovial sarcoma. The patient died 24 months after surgery. The third tumour consisted of small blue round cells, positive for epithelial membrane antigen, BCL2, CD99, and FLI1. Throughout the tumour, the presence of benign appearing branching tubules in fibromuscular stroma, reactive for smooth muscle actin, desmin and progesterone receptor, supported the diagnosis of mixed epithelial and stromal tumour in which a small round blue cell sarcoma with EWSR1 rearrangement arose. In the fourth tumour, adenocarcinoma with papillary architecture arose in a typical mixed epithelial and stromal tumour. In summary, we present four cases of mixed epithelial and stromal tumour with malignant transformation, two showing carcinomatous and the other two with sarcomatous transformation. Identification of typical benign looking elements and the absence of SYT-SSX translocation are helpful in recognition of this entity.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Shaobo Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - John N Eble
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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20
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Munari E, Settanni G, Caliò A, Segala D, Lonardi S, Sandrini S, Vacca P, Tumino N, Marconi M, Brunelli M, Gobbo S, Netto GJ, Moretta L, Zamboni G, Martignoni G. TSC loss is a clonal event in eosinophilic solid and cystic renal cell carcinoma: a multiregional tumor sampling study. Mod Pathol 2022; 35:376-385. [PMID: 33990704 DOI: 10.1038/s41379-021-00816-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
Eosinophilic, solid and cystic (ESC) renal cell carcinoma (RCC) is characterized by a solid and cystic architecture with cells showing abundant eosinophilic cytoplasm with hobnail arrangement and a cytokeratin 7-negative/cytokeratin 20-positive immunophenotype. Recent studies have suggested that bi-allelic events affecting TSC genes might play an important role for such tumors. However, only indirect evidence of the clonal origin of TSC mutation has been gathered so far. Therefore, in this paper we aimed to perform multi-regional tumor sampling molecular analysis in four ESC RCC cases that had been completely embedded, three sporadic and one occurring in a patient with tuberous sclerosis complex (TSC). Histologically, the 4 cases showed cystic and solid architecture and cells with abundant eosinophilic cytoplasm with cytoplasmic stippling and round to oval nuclei. Immunohistochemistry showed at least focal expression of cytokeratin 20 in all tissue samples and negative cytokeratin 7, as well as diffuse positivity for S100A1 and at least focal expression of cathepsin K in three out of four cases. The sporadic cases showed the same somatic TSC1 mutations in all tissue samples analyzed, while the TSC-associated case showed the same TSC1 alteration in both normal tissue and all tumor samples analyzed, proving the germline nature of the alteration. In conclusion, our data demonstrate that clonal TSC loss is a key event in ESC RCC and support considering ESC RCC as an entity given its distinct morphologic, immunophenotypical and molecular characteristics.
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Affiliation(s)
- Enrico Munari
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Giulio Settanni
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Diego Segala
- Pathology Unit, ASST-Spedali Civili, Brescia, Italy
| | - Sara Lonardi
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Silvia Sandrini
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Paola Vacca
- Immunology Area, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Nicola Tumino
- Immunology Area, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Marcella Marconi
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Gobbo
- Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - George J Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lorenzo Moretta
- Immunology Area, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Giuseppe Zamboni
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Guido Martignoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy. .,Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
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21
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Caliò A, Marletta S, Brunelli M, Martignoni G. WHO 2022 Classification of Kidney Tumors: what is relevant? An update and future novelties for the pathologist. Pathologica 2022; 115:23-31. [PMID: 36645397 DOI: 10.32074/1591-951x-814] [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: 10/15/2022] [Accepted: 10/21/2022] [Indexed: 01/17/2023] Open
Abstract
Classification systems reflect our technical abilities in the investigation of tumors and our current theories on tumor development. Herein, by providing a historical perspective on the evolution of classifying renal tumors, we assess the current WHO classification highlighting the novelties and the implications of these changes in daily clinical practice.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera, Italy
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22
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Marletta S, Caliò A, Fioravanzo A, Cavallo E, Torresani E, Zampieri F, Gilioli E. Recurrent primary endobronchial fetal rhabdomyoma: a case report and literature review. Pathologica 2022; 113:436-441. [PMID: 34974549 PMCID: PMC8720399 DOI: 10.32074/1591-951x-197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/14/2020] [Indexed: 11/30/2022] Open
Abstract
Fetal rhabdomyoma is an extremely rare benign rhabdomyoblastic tumor with myotube-like differentiation, mainly arising on mucosal surfaces of the head and neck region of both children and young patients, almost invariably definitively treated with surgical excision. Herein the case of a male adult suffering from a recurrent fetal rhabdomyoma primary involving the bronchial structures is reported, along with a detailed literature review. This is the first fetal rhabdomyoma described to originate in such a localization; furthermore, an 11-year interval period between the first lesion and the recurrent one has never been reported.
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Affiliation(s)
- Stefano Marletta
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Adele Fioravanzo
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Enrico Cavallo
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Evelin Torresani
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Federica Zampieri
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Eliana Gilioli
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
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23
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Caliò A, Brunelli M, Marletta S, Zamboni G, Bonetti F, Pea M, Martignoni G. Epithelioid angiomyolipoma: a pathological entity discovered in Verona with the endorsement of Doctor Rosai. Pathologica 2021; 113:307-315. [PMID: 34837089 PMCID: PMC8720413 DOI: 10.32074/1591-951x-335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022] Open
Abstract
In this manuscript, we summarize the main features of angiomyolipoma highlighting the recognition of epithelioid angiomyolipoma and the discovery of immunohistochemical expression of HMB45 in a group of tumors that now are referred to as as PEComas. In this scenario, Dr. Rosai believed in our intuition, demonstrating his intellectual honesty and motivated us with his experience (“when a tumor seems malignant it is malignant”) and enthusiasm for the new entities (“in Verona, you use HMB45 instead of H&E”). He really pushed the improvement of the knowledge in this field.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Giuseppe Zamboni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy.,Department of Pathology, Sacro Cuore Hospital, Negrar, Italy
| | - Franco Bonetti
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Maurizio Pea
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy
| | - Guido Martignoni
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera, Italy
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24
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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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25
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Belluomini L, Riva ST, Simbolo M, Nocini R, Trestini I, Avancini A, Tregnago D, Ferrara MG, Caldart A, Dodi A, Caliò A, Bria E, Scarpa A, Milella M, Menis J, Pilotto S. Anticipating EGFR Targeting in Early Stages of Lung Cancer: Leave No Stone Unturned. Cells 2021; 10:2685. [PMID: 34685665 PMCID: PMC8535007 DOI: 10.3390/cells10102685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The current treatment landscape of early stage lung cancer is rapidly evolving, particularly in EGFR mutant non-small cell lung cancer (NSCLC), where target therapy is moving to early stages. In the current review, we collected the available data exploring the impact of EGFR targeting in both neoadjuvant and adjuvant settings, underlying lights and shadows and discussing the existing open issues. Methods: We performed a comprehensive search using PubMed and the proceedings of major international meetings to identify neoadjuvant/adjuvant trials with EGFR tyrosine kinase inhibitors (TKIs) in NSCLC. Results: Limited data are available so far about the activity/efficacy of neoadjuvant TKIs in EGFR mutant NSCLC, with only modest downstaging and pathological complete response rates reported. Differently, the ADAURA trial already proposed osimertinib as a potential new standard of care in resected NSCLC harboring an activating EGFR mutation. Conclusion: Anticipating targeted therapy to early stage EGFR mutant NSCLC presents great opportunities but also meaningful challenges in the current therapeutic/diagnostic pathway of lung cancer care. Appropriate endpoint(s) selection for clinical trials, disease progression management, patients' and treatment selection, as well as need to address the feasibility of molecular profiling anticipation, represent crucial issues to face before innovation can move to early stages.
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Affiliation(s)
- Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Silvia Teresa Riva
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Michele Simbolo
- Section of Pathology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (M.S.); (A.C.); (A.S.)
| | - Riccardo Nocini
- Otolaryngology—Head and Neck Surgery Department, University of Verona Hospital Trust, 37126 Verona, Italy;
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Alice Avancini
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Miriam Grazia Ferrara
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy; (M.G.F.); (E.B.)
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00100 Rome, Italy
| | - Alberto Caldart
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Alessandra Dodi
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Anna Caliò
- Section of Pathology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (M.S.); (A.C.); (A.S.)
| | - Emilio Bria
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy; (M.G.F.); (E.B.)
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00100 Rome, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (M.S.); (A.C.); (A.S.)
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Jessica Menis
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy; (L.B.); (S.T.R.); (I.T.); (A.A.); (D.T.); (A.C.); (A.D.); (M.M.); (J.M.)
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Pasello G, Menis J, Pilotto S, Frega S, Belluomini L, Pezzuto F, Caliò A, Sepulcri M, Cernusco NLV, Schiavon M, Infante MV, Damin M, Micheletto C, Del Bianco P, Giovannetti R, Bonanno L, Fantoni U, Guarneri V, Calabrese F, Rea F, Milella M, Conte P. How the COVID-19 Pandemic Impacted on Integrated Care Pathways for Lung Cancer: The Parallel Experience of a COVID-Spared and a COVID-Dedicated Center. Front Oncol 2021; 11:669786. [PMID: 34262861 PMCID: PMC8273534 DOI: 10.3389/fonc.2021.669786] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The COVID-19 pandemic has proved to be a historic challenge for healthcare systems, particularly with regard to cancer patients. So far, very limited data have been presented on the impact on integrated care pathways (ICPs). Methods We reviewed the ICPs of lung cancer patients who accessed the Veneto Institute of Oncology (IOV)/University Hospital of Padua (Center 1) and the University Hospital of Verona (Center 2) before and after the COVID-19 pandemic, through sixteen indicators chosen by the members of a multidisciplinary team (MDT). Results Two window periods (March and April 2019 and 2020) were chosen for comparison. Endoscopic diagnostic procedures and major resections for early stage NSCLC patients increased at Center 1, where a priority pathway with dedicated personnel was established for cancer patients. A slight decrease was observed at Center 2 which became part of the COVID unit. Personnel shortage and different processing methods of tumor samples determined a slightly longer time for diagnostic pathway completion at both Centers. Personnel protection strategies led to a MDT reshape on a web basis and to a significant selection of cases to be discussed in both Centers. The optimization of patient access to healthcare units reduced first outpatient oncological visits, patient enrollment in clinical trials, and end-of-life cancer systemic treatments; finally, a higher proportion of hypofractionation was delivered as a radiotherapy approach for early stage and locally advanced NSCLC. Conclusions Based on the experience of the two Centers, we identified the key steps in ICP that were impacted by the COVID-19 pandemic so as to proactively put in place a robust service provision of thoracic oncology.
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Affiliation(s)
- Giulia Pasello
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Jessica Menis
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Stefano Frega
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Federica Pezzuto
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Matteo Sepulcri
- Radiation Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Nunzia Luna Valentina Cernusco
- Radiation Oncology Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Marco Schiavon
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Maurizio Valentino Infante
- Cardiovascular and Thoracic Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Marco Damin
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Claudio Micheletto
- Cardiovascular and Thoracic Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Paola Del Bianco
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Riccardo Giovannetti
- Cardiovascular and Thoracic Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Laura Bonanno
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Umberto Fantoni
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Valentina Guarneri
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fiorella Calabrese
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Federico Rea
- University of Padova, Medical School, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - PierFranco Conte
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
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Zito Marino F, Brunelli M, Rossi G, Calabrese G, Caliò A, Nardiello P, Martignoni G, Squire JA, Cheng L, Massi D, Franco R. Multitarget fluorescence in situ hybridization diagnostic applications in solid and hematological tumors. Expert Rev Mol Diagn 2021; 21:161-173. [PMID: 33593207 DOI: 10.1080/14737159.2021.1887733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Multitarget FISH (mFISH) is a technique allowing for simultaneous detection of multiple targets sequences on the same slide through the choice of spectrally distinct fluorophore labels. The mFISH could represent a useful tool in the field of precision oncology.Areas covered: This review discusses the potential applications of mFISH technology in the molecular diagnosis of different solid and hematological tumors, including non-small cell lung cancers, melanomas, renal cell carcinomas, bladder carcinomas, germ cell tumors, and multiple myeloma, as commonly required in the clinical practice.Expert Opinion: In this emerging era of the tailored therapies and newer histo-molecular classifications, there are increasing numbers of predictive and diagnostic biomarkers required for effective clinical care. The mFISH approach may have several applications in the common clinical practice, improving the molecular diagnosis in terms of time, cost and preservation of biomaterial for tumors with a limited amount of tumor available. The mFISH provides several advantages compared to other high-throughput technologies; however, it requires high level of expertise required to interpret complex results.
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Affiliation(s)
- Federica Zito Marino
- Department of Mental and Physic Health and Preventive Medicine, Pathology Unit, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Verona, Italy
| | - Giulio Rossi
- Pathology Unit, Ospedale Santa Maria Delle Croci, Ravenna, Italy
| | | | - Anna Caliò
- Department of Pathology, University of Verona, Verona, Italy
| | - Pamela Nardiello
- Section of Pathology, Department of Health Sciences, University of Florence Florence, Italy
| | - Guido Martignoni
- Pathology Unit, Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Jeremy A Squire
- Departments of Genetics, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence Florence, Italy
| | - Renato Franco
- Department of Mental and Physic Health and Preventive Medicine, Pathology Unit, University of Campania Luigi Vanvitelli, Napoli, Italy
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Akgul M, Williamson SR, Ertoy D, Argani P, Gupta S, Caliò A, Reuter V, Tickoo S, Al-Ahmadie HA, Netto GJ, Hes O, Hirsch MS, Delahunt B, Mehra R, Skala S, Osunkoya AO, Harik L, Rao P, Sangoi AR, Nourieh M, Zynger DL, Smith SC, Nazeer T, Gumuskaya B, Kulac I, Khani F, Tretiakova MS, Vakar-Lopez F, Barkan G, Molinié V, Verkarre V, Rao Q, Kis L, Panizo A, Farzaneh T, Magers MJ, Sanfrancesco J, Perrino C, Gondim D, Araneta R, So JS, Ro JY, Wasco M, Hameed O, Lopez-Beltran A, Samaratunga H, Wobker SE, Melamed J, Cheng L, Idrees MT. Diagnostic approach in TFE3-rearranged renal cell carcinoma: a multi-institutional international survey. J Clin Pathol 2021; 74:291-299. [PMID: 33514585 DOI: 10.1136/jclinpath-2020-207372] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022]
Abstract
Transcription factor E3-rearranged renal cell carcinoma (TFE3-RCC) has heterogenous morphologic and immunohistochemical (IHC) features.131 pathologists with genitourinary expertise were invited in an online survey containing 23 questions assessing their experience on TFE3-RCC diagnostic work-up.Fifty (38%) participants completed the survey. 46 of 50 participants reported multiple patterns, most commonly papillary pattern (almost always 9/46, 19.5%; frequently 29/46, 63%). Large epithelioid cells with abundant cytoplasm were the most encountered cytologic feature, with either clear (almost always 10/50, 20%; frequently 34/50, 68%) or eosinophilic (almost always 4/49, 8%; frequently 28/49, 57%) cytology. Strong (3+) or diffuse (>75% of tumour cells) nuclear TFE3 IHC expression was considered diagnostic by 13/46 (28%) and 12/47 (26%) participants, respectively. Main TFE3 IHC issues were the low specificity (16/42, 38%), unreliable staining performance (15/42, 36%) and background staining (12/42, 29%). Most preferred IHC assays other than TFE3, cathepsin K and pancytokeratin were melan A (44/50, 88%), HMB45 (43/50, 86%), carbonic anhydrase IX (41/50, 82%) and CK7 (32/50, 64%). Cut-off for positive TFE3 fluorescent in situ hybridisation (FISH) was preferably 10% (9/50, 18%), although significant variation in cut-off values was present. 23/48 (48%) participants required TFE3 FISH testing to confirm TFE3-RCC regardless of the histomorphologic and IHC assessment. 28/50 (56%) participants would request additional molecular studies other than FISH assay in selected cases, whereas 3/50 participants use additional molecular cases in all cases when TFE3-RCC is in the differential.Optimal diagnostic approach on TFE3-RCC is impacted by IHC and/or FISH assay preferences as well as their conflicting interpretation methods.
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Affiliation(s)
- Mahmut Akgul
- Pathology, Albany Medical Center, Albany, New York, USA
| | - Sean R Williamson
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dilek Ertoy
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Pedram Argani
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sounak Gupta
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anna Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Veneto, Italy
| | - Victor Reuter
- Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Satish Tickoo
- Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - George J Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ondrej Hes
- Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic.,Medical Teaching School, University Hospital, Charles University, Plzen, Czech Republic
| | - Michelle S Hirsch
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Brett Delahunt
- Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington South, New Zealand
| | - Rohit Mehra
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephanie Skala
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Adeboye O Osunkoya
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lara Harik
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Priya Rao
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ankur R Sangoi
- Department of Pathology, El Camino Hospital, Mountain View, California, USA
| | - Maya Nourieh
- Department of Pathology, Institut Curie, Paris, France
| | - Debra L Zynger
- Department of Pathology, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Steven Cristopher Smith
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Tipu Nazeer
- Pathology, Albany Medical Center, Albany, New York, USA
| | - Berrak Gumuskaya
- Department of Pathology, Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Ibrahim Kulac
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Francesca Khani
- Department of Pathology, Cornell University Joan and Sanford I Weill Medical College, New York City, New York, USA
| | - Maria S Tretiakova
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Funda Vakar-Lopez
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Guliz Barkan
- Department of Pathology, Loyola University Health System, Maywood, Illinois, USA
| | - Vincent Molinié
- Pathology, University Hospital Center of Martinique, Fort-de-France, Martinique
| | - Virginie Verkarre
- Department of Pathology, Hôpital Européen Georges Pompidou Anatomie Pathologie, Paris, Île-de-France, France
| | - Qiu Rao
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Lorand Kis
- Department of Pathology, Karolinska Institute, Stockholm, Sweden
| | - Angel Panizo
- Department of Pathology, Complejo Hospitalario de Navarra Servicio de Cardiologia, Pamplona, Navarra, Spain
| | - Ted Farzaneh
- Department of Pathology, Univer Irvine Healthcare, Orange County, California, USA
| | - Martin J Magers
- IHA Pathology and Laboratory Medicine, Ann Arbor, Michigan, USA
| | - Joseph Sanfrancesco
- Department of Pathology, Charleston Area Medical Center, Charleston, South Carolina, USA
| | - Carmen Perrino
- Department of Pathology, Mount Auburn Hospital, Cambridge, Massachusetts, USA
| | - Dibson Gondim
- Department of Pathology, University of Louisville, Louisville, Kentucky, USA
| | - Ronald Araneta
- Department of Pathology, Hartford Hospital, Hartford, Connecticut, USA
| | - Jeffrey S So
- Department of Pathology, St Luke's Hospital, Manila, Philippines
| | - Jae Y Ro
- Department of Pathology, Houston Methodist Hospital, Houston, Texas, USA
| | - Matthew Wasco
- Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan, USA
| | - Omar Hameed
- Forward Pathology Solutions, Vanderbilt University, Kansas City, Montana, USA
| | - Antonio Lopez-Beltran
- Department of Pathology and Surgery, Cordoba University Medical School, Cordoba, Spain
| | | | - Sara E Wobker
- Department of Pathology, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Jonathan Melamed
- Department of Pathology, New York University Langone Medical Center, New York City, New York, USA
| | - Liang Cheng
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Muhammad T Idrees
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Belluomini L, Caliò A, Giovannetti R, Motton M, Mazzarotto R, Micheletto C, Infante MV, Scarpa A, Milella M, Pilotto S. Molecular predictors of EGFR-mutant NSCLC transformation into LCNEC after frontline osimertinib: digging under the surface. ESMO Open 2021; 6:100028. [PMID: 33465742 PMCID: PMC7814107 DOI: 10.1016/j.esmoop.2020.100028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- L Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - A Caliò
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - R Giovannetti
- Thoracic Surgery Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - M Motton
- Radiology Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - R Mazzarotto
- Section of Radiotherapy, Department of Surgery and Oncology, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - C Micheletto
- Pulmonary Unit, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - M V Infante
- Thoracic Surgery Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - A Scarpa
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - M Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - S Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
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30
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Caliò A, Brunelli M, Gobbo S, Pedron S, Segala D, Argani P, Martignoni G. Stimulator of interferon genes (STING) immunohistochemical expression in the spectrum of perivascular epithelioid cell (PEC) lesions of the kidney. Pathology 2021; 53:579-585. [PMID: 33461798 DOI: 10.1016/j.pathol.2020.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/20/2020] [Indexed: 01/13/2023]
Abstract
Angiomyolipoma is the prototype of renal perivascular epithelioid cell (PEC) lesions whose pathogenesis is determined by mutations affecting TSC genes, with eventual deregulation of the mTOR pathway. It is well known that mTOR complex protein is involved in autophagy, and recently the role of STING in this process has been demonstrated. Based on this background, we sought to investigate STING immunohistochemical expression in a series of PEC lesions of the kidney. Fifty classic angiomyolipomas, 14 epithelioid angiomyolipomas/pure epithelioid PEComas, two angiomyolipomas with epithelial cysts (AMLEC), and two intraglomerular PEC lesions were collected. Immunostaining for STING was carried out in all cases and FISH analysis using dual colour break apart TFE3 and TFEB probes was performed in all pure epithelioid PEComas and AMLEC. Control cases including 20 normal adult kidneys, five fetal kidneys, and 30 MiT family translocation renal cell carcinomas (the main differential diagnosis with epithelioid angiomyolipoma/pure epithelioid PEComa) were also immunohistochemically stained with STING. Strong and diffuse cytoplasmic expression of STING was observed in 100% of classic angiomyolipomas, AMLEC, and intraglomerular lesions, and in 79% (11/14) of epithelioid angiomyolipomas/pure epithelioid PEComas. TFE3 gene rearrangement was demonstrated in two epithelioid angiomyolipomas/pure epithelioid PEComas, both completely negative for STING. None of the MiT family translocation renal cell carcinomas expressed STING. In conclusion, we demonstrate the expression of STING in almost all PEC lesions of the kidney. This result provides novel insights into the possible role of autophagy in PEC lesions of the kidney. Moreover, this finding may be useful for diagnostic purposes, particularly in distinguishing epithelioid angiomyolipoma/pure epithelioid PEComa from MiT family translocation renal cell carcinoma and detecting intraglomerular PEC lesions.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Stefano Gobbo
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Serena Pedron
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Diego Segala
- Department of Molecular and Translational Medicine, Section of Pathology, University-Spedali Civili of Brescia, Italy
| | - Pedram Argani
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, 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, Verona, Italy.
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Zampieri N, Frigo I, Caliò A, Camoglio FS. Histology and immunohistochemical evaluation of phimotic prepuce: The role of steroid therapy. Andrologia 2021; 53:e13967. [PMID: 33415759 DOI: 10.1111/and.13967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 11/30/2022] Open
Abstract
Phimosis is one of the most frequent andrological diseases in paediatric age. Steroids are useful to treat phimosis. Through a retrospective study of histological and immunohistochemical analysis, we evaluated the effectiveness of topical steroid treatment in patients undergoing circumcision. Cases of patients treated for phimosis were selected during the two-year study period. All patients underwent circumcision and were divided into four groups: groups A (religiously circumcised patients), B (phimotic patients not undergoing steroid treatment), C (phimotic patients who do not respond to cortisone treatment) and D (hypospadic patients undergoing urethroplasty). An histological evaluation of the degree of fibrosis and an immunohistochemical evaluation of collagen IV and tenascin were carried out. Study results demonstrate that the grade of fibrosis is age-related. On histological and immunohistochemical evaluation, fibrosis was found to be lower in patients receiving steroids; higher degrees of fibrosis were found in older patients (p < .05). Different degrees of fibrosis have also been found in hypospadic patients. We can conclude that study results correlated with the clinical history of the patients. The success rate of medical therapy seems to be age-related.
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Affiliation(s)
- Nicola Zampieri
- Pediatric surgical Unit, Woman and Child Hospital, University of Verona, Verona, Italy
| | - Irene Frigo
- Pediatric surgical Unit, Woman and Child Hospital, University of Verona, Verona, Italy
| | - Anna Caliò
- Department of Pathology, G.B. Rossi Hospital, University of Verona, Verona, Italy
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Brunelli M, Tafuri A, Cima L, Cerruto MA, Milella M, Zivi A, Buti S, Bersanelli M, Fornarini G, Vellone VG, Rebuzzi SE, Procopio G, Verzoni E, Bracarda S, Sabbatini R, Baldessari C, Eccher A, Passalacqua R, Perrucci B, Giganti MO, Donini M, Panni S, Tucci M, Prati V, Ortega C, Caliò A, Alongi F, Munari E, Pappagallo G, Iacovelli R, Mosca A, Porta C, Martignoni G, Antonelli A. MDM2 gene amplification as selection tool for innovative targeted approaches in PD-L1 positive or negative muscle-invasive urothelial bladder carcinoma. J Clin Pathol 2020; 75:39-44. [PMID: 33144356 DOI: 10.1136/jclinpath-2020-207089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/04/2022]
Abstract
AIMS According to The Cancer Genome Atlas (TCGA), around 9% of bladder carcinomas usually show abnormalities of the murine double minute 2 (MDM2) gene, but a few studies have been investigated them. We profiled MDM2 gene amplification in a series of urothelial carcinomas (UC) considering the molecular subtypes and expression of programmed death ligand 1 (PD-L1). METHODS 117 patients with muscle-invasive UC (pT2-3) without (N0) or with (N+) lymph-node metastases were revised. Only cases with availability of in toto specimens and follow-up were studied. Tissue microarray was built. p53, ER, RB1, GATA-3, CK20, CK5/6, CD44 and PD-L1 (clone sp263) immunoexpression was evaluated. Fluorescent in situ hybridisation was assessed by using the HER-2/neu, FGFR-3, CDKN2A and MDM2 probes. True (ratio 12q/CEP12 >2) MDM2 gene amplification was distinguished from polyploidy/gains (ratio <2, absolute copy number of MDM-2 >2). MDM2 and PD-L1 values were correlated to the TCGA molecular phenotypes. Statistical analysis was performed. RESULTS 6/50 (12%) cases (5 N0 and 1 N+) were amplified for MDM2 without matching to molecular phenotypes. Of 50, 14 (37%) cases expressed PD-L1 at 1% cut-off; 3/50 (9%) at >50% cut-off; of these, 2 cases on side of neoplasia among inflammatory cells. Only one out of six (17%) cases amplified for MDM2 showed expression (>50% cut-off) of PD-L1. MDM2 amplification was independent to all documented profiles (k test=0.3) and was prevalent in recurrent UC. CONCLUSION MDM2 amplification has been seen in both PD-L1 positive and negative muscle-invasive bladder UC independently from the TCGA molecular phenotypes. MDM2 and PD-L1 might be assessed in order to predict a better response to combo/single targeted therapies.
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Affiliation(s)
- Matteo Brunelli
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy .,Department of Diagnostics and Public Health, FISH Lab, University and Hospital Trust of Verona, Verona, Italy
| | - Alessandro Tafuri
- Division of Urology, University and Hospital Trust of Verona, Verona, Italy
| | - Luca Cima
- Department of Clinical Services, Pathology Unit, Santa Chiara Hospital, Trento, Italy
| | | | - Michele Milella
- Division of Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - Andrea Zivi
- Division of Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - Sebastiano Buti
- Division of Oncology, University and Hospital Trust of Parma, Parma, Italy
| | - Melissa Bersanelli
- Division of Oncology, University and Hospital Trust of Parma, Parma, Italy
| | | | | | | | - Giuseppe Procopio
- Division of Oncology, IRCCS Foundation, Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Elena Verzoni
- Division of Oncology, IRCCS Foundation, Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | | | - Roberto Sabbatini
- Department of Oncology, Hematology & Respiratory Diseases, Division of Oncology, University of Modena & Reggio Emilia, Modena, Modena & Reggio Emilia, Italy
| | - Cinzia Baldessari
- Department of Oncology, Hematology & Respiratory Diseases, Division of Oncology, University of Modena & Reggio Emilia, Modena, Modena & Reggio Emilia, Italy
| | - Albino Eccher
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | | | - Bruno Perrucci
- Division of Oncology, Hospital Trust of Cremona, Cremona, Italy
| | | | | | - Stefano Panni
- Division of Oncology, Hospital Trust of Cremona, Cremona, Italy
| | - Marcello Tucci
- Division of Oncology, Cardinal Massaia Hospital, Asti, Italy
| | - Veronica Prati
- Division of Oncology, Institute for Cancer Research and Treatment, Asl Cn2 Alba-Brà, Alba-Brà, Italy
| | - Cinzia Ortega
- Division of Oncology, Institute for Cancer Research and Treatment, Asl Cn2 Alba-Brà, Alba-Brà, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Filippo Alongi
- Division of Radiotherapy, Ospedale SacroCuore di Negrar di Valpolicella, Negrar, Italy
| | - Enrico Munari
- Division of Pathology, Ospedale SacroCuore di Negrar di Valpolicella, Negrar, Italy
| | | | | | | | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari 'A.Moro', Bari, Italy.,Division of Medical Oncology, Policlinico Consorziale di Bari, Bari, Italy
| | - Guido Martignoni
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy.,Pathology Unit, Pederzoli Hospital, Italy
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Sartori G, Belluomini L, Trovato R, Minari R, Caliò A, Ugel S, Milella M, Pilotto S. HER2 Aberrations in NSCLC: So Close Yet So Far. JCO Precis Oncol 2020; 4:1049-1051. [DOI: 10.1200/po.20.00195] [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
Affiliation(s)
- Giulia Sartori
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Lorenzo Belluomini
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Rosalinda Trovato
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Roberta Minari
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Anna Caliò
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Stefano Ugel
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Michele Milella
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
| | - Sara Pilotto
- Giulia Sartori, MD and Lorenzo Belluomini, MD, Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Rosalinda Trovato, PhD, Immunology Section, Department of Medicine, Verona University Hospital, Verona, Italy; Roberta Minari, PhD, Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Anna Caliò, MD, PhD, Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of
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Marletta S, Cavallo E, Ammendola S, Stefanizzi L, Mastrosimini MG, D'Onofrio M, Brunelli M, Caliò A, Pecori S, Dalbeni A, Ruzzenente A, Capelli P. Multifocal Hepatic Angiosarcoma with Atypical Presentation: Case Report and Literature Review. J Gastrointest Cancer 2020; 52:771-775. [PMID: 32894473 PMCID: PMC8131285 DOI: 10.1007/s12029-020-00504-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Stefano Marletta
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy.
| | - Enrico Cavallo
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Serena Ammendola
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Lavinia Stefanizzi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Maria Gaia Mastrosimini
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Mirko D'Onofrio
- Department of Diagnostics and Public Health, Section of Department of Radiology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, P.le L.A. Scuro n. 10, 37134, Verona, Italy
| | - Sara Pecori
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Andrea Dalbeni
- Department of Medicine, Section of General Medicine and Hypertension Unit & Liver Unit, University of Verona, Verona, Italy
| | - Andrea Ruzzenente
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Paola Capelli
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
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Ohashi R, Martignoni G, Hartmann A, Caliò A, Segala D, Stöhr C, Wach S, Erlmeier F, Weichert W, Autenrieth M, Schraml P, Rupp NJ, Ohe C, Otsuki Y, Kawasaki T, Kobayashi H, Kobayashi K, Miyazaki T, Shibuya H, Usuda H, Umezu H, Fujishima F, Furusato B, Osakabe M, Sugai T, Kuroda N, Tsuzuki T, Nagashima Y, Ajioka Y, Moch H. Correction to: Multi-institutional re-evaluation of prognostic factors in chromophobe renal cell carcinoma: proposal of a novel two-tiered grading scheme. Virchows Arch 2020; 476:419-422. [PMID: 32157467 DOI: 10.1007/s00428-020-02786-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The legends of Figs. 1 and 3 in the published original version of the above article are incorrect.
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Affiliation(s)
- Riuko Ohashi
- Histopathology Core Facility, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.,Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland.,Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Guido Martignoni
- Department of Diagnostic and Public Health, University of Verona, Piazzale Ludovico Antonio Scuro 10, 37134, Verona, Italy.,Department of Pathology, Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse 8-10, 91054, Erlangen, Germany
| | - Anna Caliò
- Department of Diagnostic and Public Health, University of Verona, Piazzale Ludovico Antonio Scuro 10, 37134, Verona, Italy
| | - Diego Segala
- Department of Pathology, Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Christine Stöhr
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse 8-10, 91054, Erlangen, Germany
| | - Sven Wach
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich Alexander-University Erlangen-Nürnberg, Krankenhausstrasse 12, 91054, Erlangen, Germany
| | - Franziska Erlmeier
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse 8-10, 91054, Erlangen, Germany.,Institute of Pathology, Technical University Munich, Trogerstrasse 18, 81675, Munich, Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich, Trogerstrasse 18, 81675, Munich, Germany
| | - Michael Autenrieth
- Department of Urology, Technical University Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Peter Schraml
- Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Chisato Ohe
- Department of Pathology and Laboratory Medicine, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, 573-1010, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, 430-8558, Japan
| | - Takashi Kawasaki
- Department of Pathology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata, 951-8566, Japan
| | - Hiroshi Kobayashi
- Department of Pathology, Tachikawa General Hospital, 1-24 Asahioka, Nagaoka, 940-8621, Japan
| | - Kazuhiro Kobayashi
- Department of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Tatsuhiko Miyazaki
- Department of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroyuki Shibuya
- Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Hiroyuki Usuda
- Department of Diagnostic Pathology, Nagaoka Red Cross Hospital, 2-297-1 Sensyu, Nagaoka, 940-2085, Japan
| | - Hajime Umezu
- Division of Pathology, Niigata University Medical & Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Fumiyoshi Fujishima
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Bungo Furusato
- Cancer Genomics Unit, Clinical Genomics Center, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Mitsumasa Osakabe
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, 2-1-1, Idai-dori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, 2-1-1, Idai-dori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, 1-4-63-11 hadaminamimachi, Kochi, Kochi, 780-8562, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yoichi Ajioka
- Histopathology Core Facility, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.,Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland.
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Pilotto S, Vita E, Sperduti I, Noia VPD, Grizzi G, D’Argento E, Simbolo M, Vicentini C, Caliò A, Mafficini A, Carbognin L, Corbo V, Gkountakos A, Santo A, Brunelli M, Martini M, Scarpa A, Milella M, Tortora G, Bria E. Exploring resistance to nivolumab [NIV] applying an Immune Genomic Signature (IGS) in advanced pretreated NSCLC [PRINCiPe study]. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.106] [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: 11/12/2022] Open
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Pilotto S, Di Noia V, Sperduti I, Grizzi G, D'Argento E, Simbolo M, Vicentini C, Caliò A, Mafficini A, Carbognin L, Corbo V, Gkountakos A, Vita E, Santo A, Brunelli M, Martini M, Scarpa A, Milella M, Tortora G, Bria E. P2.04-51 A 6-Gene Immune Genomic Signature (IGS) Predicts Resistance to Nivolumab [NIV] in Advanced Pretreated NSCLC: Results of PRINCiPe Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1556] [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: 11/25/2022]
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Paolino G, Girolami I, Bernasconi R, Beccari S, Marchioni D, Molteni G, De Robertis R, Ghimenton C, Caliò A, Brunelli M, Eccher A. From fine-needle aspiration cytology to fluorescent in-situ hybridization in an unusual case of pharyngeal synovial sarcoma. Diagn Cytopathol 2019; 47:1067-1071. [PMID: 31293093 DOI: 10.1002/dc.24274] [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: 04/18/2019] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 11/12/2022]
Abstract
Synovial sarcoma arising in the pharynx is a rare entity, with very few cases described in literature, mainly as surgical-oriented case reports. We report the case of a healthy 20-year old man who presented with a painless right neck mass, clinically suspicious for a thyroid nodule. Ultrasound scan and fine-needle aspiration cytology failed to provide a definitive result, although suggesting a mesenchymal proliferation, in accordance with magnetic resonance imaging findings. Therefore, the lesion was removed with a minimally invasive surgical intervention. Definitive histologic and immunohistochemical examination of the surgical specimen revealed a biphasic synovial sarcoma, further validated by the detection of SS18 gene rearrangement on fluorescent in-situ hybridization examination. Although rarely, synovial sarcoma may arise in the pharynx. Radiological, cytological, histological and molecular findings are needed along each step of the diagnostic process.
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Affiliation(s)
- Gaetano Paolino
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Ilaria Girolami
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Riccardo Bernasconi
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Serena Beccari
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Daniele Marchioni
- Department of Otorhinolaringology and Head & Neck Surgery, Integrated University Hospital of Verona, Verona, Italy
| | - Gabriele Molteni
- Department of Otorhinolaringology and Head & Neck Surgery, Integrated University Hospital of Verona, Verona, Italy
| | - Riccardo De Robertis
- Radiology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Claudio Ghimenton
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
| | - Anna Caliò
- Pathology Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Pathology Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Albino Eccher
- Pathology Unit, Department of Pathology and Diagnostics, Integrated University Hospital of Verona, Verona, Italy
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Caliò A, Brunelli M, Segala D, Pedron S, Doglioni C, Argani P, Martignoni G. VEGFA amplification/increased gene copy number and VEGFA mRNA expression in renal cell carcinoma with TFEB gene alterations. Mod Pathol 2019; 32:258-268. [PMID: 30206412 DOI: 10.1038/s41379-018-0128-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/21/2018] [Accepted: 07/28/2018] [Indexed: 12/20/2022]
Abstract
Amplification of vascular endothelial growth factor A (VEGFA) has been recently reported in TFEB-amplified renal cell carcinomas regardless the level of TFEB amplification. We sought to determine VEGFA amplification by fluorescent in situ hybridization (FISH) and VEGFA mRNA expression by in situ hybridization (RNAscope 2.5) in a series of 10 renal cell carcinomas with TFEB gene alterations, either amplification and/or rearrangement (t(6;11) renal cell carcinoma). TFEB gene rearrangement was demonstrated in eight cases, whereas the remaining two cases showed a high level of TFEB (> 10 copies of fluorescent signals) gene amplification without evidence of rearrangement. Among the eight t(6;11) renal cell carcinomas (TFEB-rearranged cases), one case displayed a high level of TFEB gene amplification and two showed increased TFEB gene copy number (3-4 copies of fluorescent signals). Those three cases behaved aggressively. By FISH, VEGFA was amplified in all three cases with TFEB amplification and increased VEGFA gene copy number was observed in the two aggressive cases t(6;11) renal cell carcinomas with an overlapping increased number of TFEB fluorescent signals. Overall, VEGFA mRNA expression was observed in 8 of 10 cases (80%); of these 8 cases, 3 cases showed high-level TFEB amplification, one case showed TFEB rearrangement with increased TFEB gene copy number, whereas four showed TFEB gene rearrangement without increased copy number. In summary, VEGFA amplification/increased gene copy number and VEGFA mRNA expression occur in TFEB-amplified renal cell carcinoma, but also in a subset of t(6;11) renal cell carcinoma demonstrating aggressive behavior, and in unamplified conventional t(6;11) renal cell carcinoma suggesting VEGFA as potential therapeutic target in these neoplasms even in the absence of TFEB amplification. We finally propose that all the renal tumors showing morphological characteristics suggesting t(6;11) renal cell carcinoma and all unclassified renal cell carcinomas, either high grade or low grade, should immunohistochemically be evaluated for cathepsin K and/or Melan-A and if one of them is positive, tested for TFEB gene alteration and VEGFA gene amplification.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Diego Segala
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Serena Pedron
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | | | - Pedram Argani
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, 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, Verona, Italy.
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Munari E, Zamboni G, Sighele G, Marconi M, Sommaggio M, Lunardi G, Rossi G, Cavazza A, Moretta F, Gilioli E, Caliò A, Netto GJ, Hoque MO, Martignoni G, Brunelli M, Vacca P, Moretta L, Bogina G. Expression of programmed cell death ligand 1 in non-small cell lung cancer: Comparison between cytologic smears, core biopsies, and whole sections using the SP263 assay. Cancer Cytopathol 2018; 127:52-61. [PMID: 30500997 DOI: 10.1002/cncy.22083] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 08/01/2018] [Revised: 10/13/2018] [Accepted: 10/18/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Evaluation of programmed cell death ligand 1 (PD-L1) expression can be made on both resection specimens and diagnostic biopsies; however, more than 30% of patients with advanced non-small cell lung cancer (NSCLC) do not have adequate histologic material to perform PD-L1 assays and require additional biopsies. In addition, in our practice, more than 16% of cases have cytological smears as the only available material. Our aim was to validate the PD-L1 immunocytochemistry assay on cytological smears and compare its accuracy with the results obtained from tissue cores and whole tumor sections using the clinically relevant cutoff of 50%. METHOD We compared the PD-L1 staining results of cytological smears to those from tissue cores or whole sections in 50 and 53 NSCLC cases, respectively, using the SP263 assay after scanning hematoxylin and eosin slides. RESULTS We found an overall agreement of 90.6% between cytological smears and whole sections; specifically, we found absolute concordance between smears with PD-L1 expressed in <10% and ≥50% of cells and whole sections with PD-L1 expressed in <50% and ≥50% of cells, respectively. In addition, slightly lower diagnostic accuracy was found for the cytological smears in comparison with the tissue cores, but the difference was not statistically significant. We found excellent intraobserver and good interobserver agreement in the evaluation of PD-L1 on smears. CONCLUSION Immunocytochemistry on cytological smears is a reliable method for determination of PD-L1 at the 50% cutoff when positive cells are <10% or ≥50%; for cases showing PD-L1 expression in 10% to 49% of cells, additional tissue sampling may be necessary.
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Affiliation(s)
- Enrico Munari
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giuseppe Zamboni
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giorgia Sighele
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Marcella Marconi
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Marco Sommaggio
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Gianluigi Lunardi
- Department of Oncology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giulio Rossi
- Department of Pathology, AUSL della Romagna, Ravenna, Italy
| | - Alberto Cavazza
- Department of Pathology, Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy
| | - Francesca Moretta
- Department of Laboratory Medicine, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Eliana Gilioli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - George J Netto
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Mohammad O Hoque
- Department of Otolaryngology, Urology, Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Guido Martignoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paola Vacca
- Immunology Research Area, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Lorenzo Moretta
- Immunology Research Area, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Giuseppe Bogina
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
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42
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Munari E, Caliò A, Brunelli M, Martignoni G. Predicting progression in T1 non-muscle-invasive bladder cancer: back to histology. BJU Int 2018; 122:914-915. [PMID: 30460787 DOI: 10.1111/bju.14465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Enrico Munari
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, VR, Italy
| | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Guido Martignoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera del Garda, VR, Italy
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Pilotto S, Grizzi G, Sperduti I, Simbolo M, Vicentini C, Caliò A, Caccese M, Mafficini A, Carbognin L, Corbo V, Gkountakos A, Santo A, Infante M, Brunelli M, Scarpa A, Tortora G, Bria E. P2.04-12 A Genomic Signature [JAK2, JAK3, PIAS4, PTPN2, STAT3, IFNAR2] Predicts Baseline Resistance to Nivolumab in Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1236] [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: 11/25/2022]
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44
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Pilotto S, Grizzi G, Sperduti I, Simbolo M, Vicentini C, Caliò A, Caccese M, Mafficini A, Carbognin L, Corbo V, Gkountakos A, Santo A, Infante M, Brunelli M, Scarpa A, Tortora G, Bria E. Preliminary results of PRINCiPe (predictors of resistance to immunotherapy with nivolumab [NIV]) study in advanced pretreated non-small cell lung cancer (APNSCLC), investigating the role of an immune genomic signature (IGS) including JAK2, JAK3, PIAS4, PTPN2, STAT3, IFNAR2 alterations. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.039] [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: 11/14/2022] Open
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45
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Montemezzi S, Camera L, Giri MG, Pozzetto A, Caliò A, Meliadò G, Caumo F, Cavedon C. Is there a correlation between 3T multiparametric MRI and molecular subtypes of breast cancer? Eur J Radiol 2018; 108:120-127. [PMID: 30396643 DOI: 10.1016/j.ejrad.2018.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/20/2018] [Accepted: 09/18/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To test whether 3 T multiparametric magnetic resonance imaging (mMRI) provides information related to molecular subtypes of breast cancer. METHODS Women with mammographic or US findings of breast lesions (BI-RADS 4-5) underwent 3 T mMRI (DCE, DWI and MR spectroscopy). The histological type of breast cancer was assessed. Estrogen-receptor (ER), progesterone-receptor (PgR), Ki-67 status and HER-2 expression, assessed by immunohistochemistry (IHC), defined four molecular subtypes: Luminal-A, Luminal-B, HER2-enriched and triple-negative. Non-parametric tests (Kruskal-Wallis, k-sample equality of medians, and Mann-Whitney), logistic regression or ANOVA, and a multivariate analysis were performed to investigate correlations between the four molecular subtypes and mMRI (lesion volume, margins or distribution, enhancement pattern, ADC, type of kinetic curve, and total choline (tCho) signal-to-noise-ratio (SNR)). A ROC analysis was finally performed to test the diagnostic power of a multivariate logistic regression model. RESULTS 433 patients (453 lesions) were considered. Volume was smaller in Luminal-B and larger in triple-negative tumours compared to the other subtypes combined. Margins were significantly correlated to Luminal-A and Luminal-B. The type of curve was significantly correlated to Luminal-A. ADC values were higher in Luminal-A. tCho SNR was higher in triple-negative tumours. The ROC analysis showed that the area under the curve (AUC) significantly improved when multiple MRI features were used compared to individual parameters. CONCLUSIONS A significant correlation was found between some MRI features and molecular subtypes of breast tumours. A multiparametric approach improved the diagnostic power of MRI. However, further research is needed in order to predict the molecular subtype on the sole basis of mMRI.
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Affiliation(s)
- Stefania Montemezzi
- Department of Pathology and Diagnostics - Radiology Unit, University Hospital of Verona, Verona, Italy.
| | - Lucia Camera
- Department of Pathology and Diagnostics - Radiology Unit, University Hospital of Verona, Verona, Italy
| | - Maria Grazia Giri
- Department of Pathology and Diagnostics - Medical Physics Unit, University Hospital of Verona, Verona, Italy
| | - Alice Pozzetto
- Department of Pathology and Diagnostics - Radiology Unit, University Hospital of Verona, Verona, Italy
| | - Anna Caliò
- Department of Pathology and Diagnostics - Pathology Unit, University Hospital of Verona, Verona, Italy
| | - Gabriele Meliadò
- Department of Pathology and Diagnostics - Medical Physics Unit, University Hospital of Verona, Verona, Italy
| | - Francesca Caumo
- Radiology Department, Istituto Oncologico Veneto, Padova, Italy
| | - Carlo Cavedon
- Department of Pathology and Diagnostics - Medical Physics Unit, University Hospital of Verona, Verona, Italy
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46
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Carbognin L, Simbolo M, Vicentini C, Sperduti I, Caliò A, Schettini F, Dieci MV, Griguolo G, Pilotto S, Nortilli R, Pollini GP, Arpino G, Guarneri V, De Placido S, Conte PF, Manfrin E, Brunelli M, Scarpa A, Tortora G, Bria E. Next-generation targeted sequencing (NGTS) investigating CDK4 as a prognostic driver in pure invasive lobular breast carcinoma (ILC): Preliminary results in early-stage patients (pts) stratified according to a validated clinico-pathological model. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Affiliation(s)
| | - Michele Simbolo
- Department of Diagnostics and Public Health, Section of Anatomical Pathology and ARC-Net Research Centre, University and Hospital Trust of Verona, Verona, Italy
| | - Caterina Vicentini
- Department of Diagnostics and Public Health, Section of Anatomical Pathology and ARC-Net Research Centre, University and Hospital Trust of Verona, Verona, Italy
| | - Isabella Sperduti
- Bio-Statistics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Anna Caliò
- Department of Pathology, AOUI, Verona, Verona, Italy
| | | | | | | | | | | | | | - Grazia Arpino
- Clinical Medicine and Surgery Department, University of Naples Federico II, Naples, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Medical Oncology 2, Instituto Oncologico Veneto IRCCS, Padova, Italy
| | | | - Pier Franco Conte
- University of Padova and Istituto Oncologico Veneto IRCSS, Padova, Italy
| | | | - Matteo Brunelli
- Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (AOUI) and University of Verona, Verona, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Anatomical Pathology and ARC-Net Research Centre, University and Hospital Trust of Verona, Verona, Italy
| | - Giampaolo Tortora
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Emilio Bria
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Caliò A, Brunelli M, Segala D, Pedron S, Tardanico R, Remo A, Gobbo S, Meneghelli E, Doglioni C, Hes O, Zampini C, Argani P, Martignoni G. t(6;11) renal cell carcinoma: a study of seven cases including two with aggressive behavior, and utility of CD68 (PG-M1) in the differential diagnosis with pure epithelioid PEComa/epithelioid angiomyolipoma. Mod Pathol 2018; 31:474-487. [PMID: 29052596 DOI: 10.1038/modpathol.2017.144] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/10/2017] [Accepted: 09/11/2017] [Indexed: 01/21/2023]
Abstract
Renal cell carcinomas with t(6;11) chromosome translocation involving the TFEB gene are indolent neoplasms which often occur in young patients. In this study, we report seven cases of renal cell carcinoma with TFEB rearrangement, two of whom had histologically proven metastasis. Patients (4F, 3M) ranged in age from 19 to 55 years (mean 37). One patient developed paratracheal and pleural metastases 24 months after surgery and died of disease after 46 months; another one recurred with neoplastic nodules in the perinephric fat and pelvic soft tissue. Histologically, either cytological or architectural appearance was peculiar in each case whereas one tumor displayed the typical biphasic morphology. By immunohistochemistry, all tumors labelled for cathepsin K, Melan-A and CD68 (KP1 clone). HMB45 and PAX8 staining were detected in six of seven tumors. All tumors were negative for CD68 (PG-M1 clone), CKAE1-AE3, CK7, CAIX, and AMACR. Seven pure epithelioid PEComa/epithelioid angiomyolipomas, used as control, were positive for cathepsin K, melanocytic markers, and CD68 (PG-M1 and KP1) and negative for PAX8. Fluorescence in situ hybridization results showed the presence of TFEB gene translocation in all t(6;11) renal cell carcinomas with a high frequency of split TFEB fluorescent signals (mean 74%). In the primary and metastatic samples of the two aggressive tumors, increased gene copy number was observed (3-5 fluorescent signals per neoplastic nuclei) with a concomitant increased number of CEP6. Review of the literature revealed older age and larger tumor size as correlating with aggressive behavior in these neoplasms. In conclusion, we present the clinical, morphological and molecular features of seven t(6;11) renal cell carcinomas, two with histologically demonstrated metastasis. We report the high frequency of split signals by FISH in tumors with t(6;11) chromosomal rearrangement and the occurrence of TFEB gene copy number gains in the aggressive cases, analyzing either the primary or metastatic tumor. Finally, we demonstrate the usefulness of CD68 (PG-M1) immunohistochemical staining in distinguishing t(6;11) renal cell carcinoma from pure epithelioid PEComa/epithelioid angiomyolipoma.
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Affiliation(s)
- Anna Caliò
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Diego Segala
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Serena Pedron
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | | | - Andrea Remo
- Department of Pathology, Hospital 'Mater Salutis', Legnago, Italy
| | - Stefano Gobbo
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Emanuela Meneghelli
- Department of Life and Reproduction Sciences, Clinical Biochemistry Laboratory, University of Verona, Verona, Italy
| | | | - Ondrej Hes
- Department of Pathology, Charles University Hospital Plzen, Plzen, Czech Republic
| | - Claudia Zampini
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Pedram Argani
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, 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
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48
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Posenato I, Caliò A, Segala D, Sgroi S, Polara A, Brunelli M, Martignoni G. Primary seminal vesicle carcinoma. The usefulness of PAX8 immunohistochemical expression for the differential diagnosis. Hum Pathol 2017; 69:123-128. [DOI: 10.1016/j.humpath.2017.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 05/01/2017] [Indexed: 01/15/2023]
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49
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Carbognin L, Brunelli M, Manfrin E, Caliò A, Sperduti I, Dieci M, Griguolo G, Guarneri V, Nortilli R, Pilotto S, Fiorio E, Parolin V, Orvieto E, Pellini F, Pollini G, Conte P, Scarpa A, Tortora G, Bria E. ESR1, Ph-mTOR, CDK4/6 and PD-L1 expression as prognostic (and potentially druggable) drivers for pure invasive lobular breast carcinoma (ILC): Preliminary results of prognostic outliers according to a clinical-pathological model. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.054] [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: 11/13/2022] Open
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50
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Caliò A, Lever V, Rossi A, Gilioli E, Brunelli M, Dubini A, Tomassetti S, Piciucchi S, Nottegar A, Rossi G, Kambouchner M, Cancellieri A, Barbareschi M, Pelosi G, Doglioni C, Cavazza A, Carella R, Graziano P, Murer B, Poletti V, Chilosi M. Increased frequency of bronchiolar histotypes in lung carcinomas associated with idiopathic pulmonary fibrosis. Histopathology 2017; 71:725-735. [PMID: 28556957 DOI: 10.1111/his.13269] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 04/02/2017] [Accepted: 05/26/2017] [Indexed: 12/31/2022]
Abstract
AIMS The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well known, but the significance of this association is poorly understood. Bronchiolar honeycomb cysts have been proposed as possible precursors for the development of carcinoma, but limited evidence in support of this hypothesis is available. The aim of this study was to investigate this hypothesis analysing a series of carcinomas arising in IPF by immunohistochemistry. METHODS AND RESULTS Thirty-three lung carcinomas arising in patients with IPF were analysed with a panel of immunohistochemical markers. The antibodies included those against pneumocyte markers [thyroid transcription factor 1 (TTF1), napsin-A, and surfactant protein A], the goblet cell marker mucin 5AC, markers of basal/squamous cell differentiation [cytokeratin (CK) 5/6 and ΔN-p63], and markers related to enteric differentiation (CDX2, mucin 2, CK20, and villin). A series of 100 consecutive lung adenocarcinomas arising in smokers without IPF were investigated as controls. All carcinomas arising in IPF patients were peripherally located on imaging analysis. The diagnoses were: eight squamous cell carcinomas, 20 adenocarcinomas, three small-cell carcinomas (including one composite small-cell carcinoma and adenocarcinoma), and two large-cell carcinomas. Among adenocarcinomas, a 'pneumocyte' profile (TTF1/napsin-A/SPA1-triple-positive) was observed in seven of 20 (35% versus 84% in non-IPF controls, P = 0.0001). The remaining 13 adenocarcinomas (65%) showed rare histotypes: four invasive mucinous adenocarcinomas (20% in IPF patients versus 1% in non-IPF controls, P = 0.002), seven tumours (35%) that were characterized by variable expression of markers of enteric differentiation, and two tumours (10%) that showed a peculiar basaloid component. CONCLUSIONS The immunohistochemical characterization of carcinomas arising in IPF patients shows striking divergence from that in non-IPF smokers. The prevalence of rare entities showing bronchiole-related markers is in line with the hypothesis that these tumours arise from transformed small airways in honeycomb lung areas where abnormal bronchiolar proliferation takes place.
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Affiliation(s)
- Anna Caliò
- Department of Pathology AOUI, University of Verona, Verona, Italy
| | - Veronica Lever
- Department of Pathology AOUI, University of Verona, Verona, Italy
| | - Andrea Rossi
- Department of Pneumology AOUI, University of Verona, Verona, Italy
| | - Eliana Gilioli
- Department of Pathology AOUI, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology AOUI, University of Verona, Verona, Italy
| | | | | | | | - Alessia Nottegar
- Department of Pathology AOUI, University of Verona, Verona, Italy
| | - Giulio Rossi
- Operative Unit of Pathology, Azienda USL Valle d'Aosta, Aosta, Italy
| | | | | | | | | | | | - Alberto Cavazza
- Department of Pathology, Arcispedale S. Maria Nuova/I.R.C.C.S., Reggio Emilia, Italy
| | | | - Paolo Graziano
- Department of Pathology, San Giovanni Rotondo Hospital, San Giovanni Rotondo, Italy
| | - Bruno Murer
- Department of Pathology, Mestre Hospital, Mestre, Italy
| | | | - Marco Chilosi
- Department of Pathology AOUI, University of Verona, Verona, Italy.,Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
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