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Castellana C, Eusebi LH, Dajti E, Iascone V, Vestito A, Fusaroli P, Fuccio L, D’Errico A, Zagari RM. Autoimmune Atrophic Gastritis: A Clinical Review. Cancers (Basel) 2024; 16:1310. [PMID: 38610988 PMCID: PMC11010983 DOI: 10.3390/cancers16071310] [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: 02/16/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa due to anti-parietal cell antibodies. This review provides a comprehensive and up-to-date overview of autoimmune atrophic gastritis, reporting recent evidence on epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG has been estimated at between 0.3% and 2.7% in the general population. The diagnosis of AAG is based on a combination of the serologic profile and the histological examination of gastric biopsies. Patients with AAG are often asymptomatic but can also have dyspeptic or reflux symptoms. The atrophy of the oxyntic mucosa leads to iron and vitamin B12 malabsorption, which may result in anemia and neurological affections. Autoimmune atrophic gastritis is associated with an increased risk of type I neuroendocrine tumors (NETs) and gastric cancer, with an incidence rate of 2.8% and 0.5% per person/year, respectively. Management is directed to reinstate vitamins and iron and to prevent malignancies with endoscopic surveillance. In conclusion, atrophic autoimmune gastritis is an infrequent condition, often asymptomatic and misdiagnosed, that requires an early diagnosis for appropriate vitamin supplementation and endoscopic follow-up for the early diagnosis of NETs and gastric cancer.
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Affiliation(s)
- Chiara Castellana
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastroenterology Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Leonardo Henry Eusebi
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastroenterology Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Elton Dajti
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
| | - Veronica Iascone
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastro-Esophageal Organic Diseases Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Amanda Vestito
- Gastroenterology Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Pietro Fusaroli
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastroenterology Unit, Hospital of Imola, 40026 Imola, Italy
| | - Lorenzo Fuccio
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastroenterology Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Antonietta D’Errico
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Pathology Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Rocco Maurizio Zagari
- Department of Medical Sciences and Surgery, University of Bologna, 40138 Bologna, Italy; (C.C.); (L.H.E.); (E.D.); (V.I.); (L.F.); (A.D.)
- Gastro-Esophageal Organic Diseases Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Sisi M, Vitale G, Fusaroli M, Riefolo M, Giunchi V, D’Errico A, Ardizzoni A, Raschi E, Gelsomino F. Capmatinib-Induced Liver Injury as Emerging Toxicity of MET Inhibitors in Patients With NSCLC Pretreated With Immune Checkpoint Inhibitors. JTO Clin Res Rep 2023; 4:100563. [PMID: 37745898 PMCID: PMC10511802 DOI: 10.1016/j.jtocrr.2023.100563] [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: 06/20/2023] [Revised: 07/31/2023] [Accepted: 08/12/2023] [Indexed: 09/26/2023] Open
Abstract
Safety data on MET inhibitors in patients with advanced NSCLC harboring MET exon 14 mutation and treated with frontline immune checkpoint inhibitors (ICIs) are still limited. Here, we describe clinical characteristics, liver biopsy features, and management of liver injury of two patients with a diagnosis of MET exon 14-mutant NSCLC receiving capmatinib after ICI failure. On the basis of histologic findings and exclusion of other potential causes, a diagnosis of drug-induced liver injury (DILI) associated with portal fibrosis was made in both cases. The use of hepatoprotective drugs, in addition to oral ursodeoxycholic acid, resulted in liver blood tests normalization. To provide a global safety perspective, we queried the Food and Drug Administration Adverse Event Reporting System and detected a robust disproportionality signal. Out of the 918 total reports with capmatinib from the Food and Drug Administration Adverse Event Reporting System database, DILI was recorded in 43 cases (4.7%), mostly serious (93.0%) with hospitalization and death recorded in 25.6% and 16.3% of the cases, respectively. The median time to onset was 42 days, with discontinuation and positive dechallenge documented in 41.9% and 39.5% of the cases, respectively. Anti-programmed cell death protein-1 agents were coreported in 11 DILI cases. Only two cases of DILI out of 105 reports were found for tepotinib. Our data support a potential association between capmatinib and DILI in patients who have also been previously exposed to immunotherapy. Considering the potential implications for sequence strategy and timing of ICI and MET inhibitor, further investigation is warranted.
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Affiliation(s)
- Monia Sisi
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giovanni Vitale
- Internal Medicine Unit for the Treatment of Severe Organ Failure, Istituto di Ricovero e Cura a Carattere (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michele Fusaroli
- Pharmacology Unit, DIMEC, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Mattia Riefolo
- Department of Pathology, Istituto di Ricovero e Cura a Carattere (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valentina Giunchi
- Pharmacology Unit, DIMEC, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Antonietta D’Errico
- Department of Pathology, Istituto di Ricovero e Cura a Carattere (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Ardizzoni
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emanuel Raschi
- Pharmacology Unit, DIMEC, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesco Gelsomino
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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3
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Vetrone L, Mei R, Bianchi L, Giunchi F, Farolfi A, Castellucci P, Droghetti M, Presutti M, Degiovanni A, Schiavina R, Brunocilla E, D’Errico A, Fanti S. Histology and PSMA Expression on Immunohistochemistry in High-Risk Prostate Cancer Patients: Comparison with 68Ga-PSMA PET/CT Features in Primary Staging. Cancers (Basel) 2023; 15:cancers15061716. [PMID: 36980602 PMCID: PMC10046634 DOI: 10.3390/cancers15061716] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023] Open
Abstract
PSMA-PET/CT is a suitable replacement for conventional imaging in the primary staging of PCa. The aim of this retrospective study was to assess the correlation between parameters discovered by PSMA PET/CT in primary staging and either prostate histopathology (pT) findings or PSMA-IHC expression in a cohort of biopsy-proven high-risk PCa candidates for surgery. Clinical information (age, iPSA-value, and grading group) and PSMA-PET/CT parameters (SUVmax, PSMA tumor volume [PSMA-TV], and total lesion [PSMA-TL]) were compared with pT (including histologic pattern, Gleason grade, and lymphovascular invasion [LVI]) and PSMA-IHC features, including visual quantification (VS) with a four-tiered score (0 = negative, 1+ = weak, 2+ = moderate, 3+ = strong), growth pattern (infiltrative vs expansive), and visual pattern (cytoplasmic vs membranous). In total, 44 patients were enrolled, with a median age of 67 (IQR 57-77); the median iPSA was 9.4 ng/dL (IQR 12.5-6.0). One patient (3%) was grading group (GG) 3, 27/44 (61%) were GG4, and 16/44 (36%) were GG5. PSMA-PET/CT detection rate for the presence of primary prostate cancer was 100%. Fused/poorly formed Gleason grade 4 features were predominant (22/44–50%); a cribriform pattern was present in 18/44 (41%) and acinar in 4/44 (9%). We found that lower PSMA-TVs were mostly related to acinar, while higher PSMA-TVs correlated with a higher probability to have a cribriform pattern (p-value 0.04). LVI was present in 21/44(48%) patients. We found that higher PSMA-TV and PSMA-TL are predictive of LVI p-value 0.002 and p-value 0.01, respectively. There was no correlation between PET-parameters and perineural invasion (PNI), probably because this was present in almost all the patients. Moreover, patients with high PSMA-TL values displayed the highest PSMA-IHC expression (VS3+) with a membranous pattern. In conclusion, PSMA-TV and PSMA-TL are predictors of a cribriform pattern and LVI. These conditions are mostly related to higher aggressiveness and worse outcomes.
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Affiliation(s)
- Luigia Vetrone
- Nuclear Medicine, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
- Correspondence: (L.V.); (F.G.)
| | - Riccardo Mei
- Nuclear Medicine, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Francesca Giunchi
- Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
- Correspondence: (L.V.); (F.G.)
| | - Andrea Farolfi
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Paolo Castellucci
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Matteo Droghetti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Massimiliano Presutti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Alessio Degiovanni
- Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Antonietta D’Errico
- Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, 40138 Bologna, Italy
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Orsini A, Mastracci L, Bozzarelli I, Ferrari A, Isidori F, Fiocca R, Lugaresi M, D’Errico A, Malvi D, Cataldi-Stagetti E, Spaggiari P, Tomezzoli A, Albarello L, Ristimäki A, Bottiglieri L, Krishnadath KK, Rosati R, Fumagalli Romario U, De Manzoni G, Räsänen J, Martinelli G, Mattioli S, Bonora E. Correlations between Molecular Alterations, Histopathological Characteristics, and Poor Prognosis in Esophageal Adenocarcinoma. Cancers (Basel) 2023; 15:cancers15051408. [PMID: 36900206 PMCID: PMC10000513 DOI: 10.3390/cancers15051408] [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: 01/14/2023] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Esophageal adenocarcinoma (EAC) is a severe malignancy with increasing incidence, poorly understood pathogenesis, and low survival rates. We sequenced 164 EAC samples of naïve patients (without chemo-radiotherapy) with high coverage using next-generation sequencing technologies. A total of 337 variants were identified across the whole cohort, with TP53 as the most frequently altered gene (67.27%). Missense mutations in TP53 correlated with worse cancer-specific survival (log-rank p = 0.001). In seven cases, we found disruptive mutations in HNF1alpha associated with other gene alterations. Moreover, we detected gene fusions through massive parallel sequencing of RNA, indicating that it is not a rare event in EAC. In conclusion, we report that a specific type of TP53 mutation (missense changes) negatively affected cancer-specific survival in EAC. HNF1alpha was identified as a new EAC-mutated gene.
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Affiliation(s)
- Arianna Orsini
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Luca Mastracci
- Unit of Anatomic Pathology, Ospedale Policlinico San Martino IRCCS, 16125 Genova, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16125 Genova, Italy
| | - Isotta Bozzarelli
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Anna Ferrari
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
| | - Federica Isidori
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Roberto Fiocca
- Unit of Anatomic Pathology, Ospedale Policlinico San Martino IRCCS, 16125 Genova, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16125 Genova, Italy
| | - Marialuisa Lugaresi
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
- Division of Thoracic Surgery, Maria Cecilia Hospital, GVM Care & Research Group, Cotignola, 48022 Ravenna, Italy
| | - Antonietta D’Errico
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Deborah Malvi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Erica Cataldi-Stagetti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Paola Spaggiari
- Unit of Anatomic Pathology, Humanitas University, 20089 Milan, Italy
| | - Anna Tomezzoli
- Unit of Anatomic Pathology, Azienda Ospedaliera di Verona, 37122 Verona, Italy
| | - Luca Albarello
- Pathology Unit, San Raffaele Scientific Institute, 20135 Milan, Italy
| | - Ari Ristimäki
- Department of Pathology, HUSLAB and HUS Diagnostic Center, University of Helsinki, 00170 Helsinki, Finland
- Helsinki University Hospital, 00170 Helsinki, Finland
| | - Luca Bottiglieri
- Unit of Anatomic Pathology, Istituto Europeo di Oncologia, 20122 Milan, Italy
| | - Kausilia K. Krishnadath
- Laboratory of Experimental Medicine and Pediatrics (LEMP), Department of Gastroenterology and Hepatology, University Hospital Antwerp, 2650 Antwerp, Belgium
| | - Riccardo Rosati
- Department of Gastrointestinal Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, 20135 Milan, Italy
| | | | - Giovanni De Manzoni
- Department of Surgery, General and Upper G.I. Surgery Division, University of Verona, 37126 Verona, Italy
| | - Jari Räsänen
- Department of General Thoracic and Esophageal Surgery, Helsinki University Hospital, 00170 Helsinki, Finland
| | - Giovanni Martinelli
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
| | - Sandro Mattioli
- Division of Thoracic Surgery, Maria Cecilia Hospital, GVM Care & Research Group, Cotignola, 48022 Ravenna, Italy
| | - Elena Bonora
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-0512094761
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Chessa F, Schiavina R, Bianchi L, Piazza P, Presutti M, Droghetti M, Massari F, Mollica V, Ardizzoni A, Gaudiano C, Corcioni B, Fiorentino M, Pugliese M, Tamburini S, Mottaran A, Giunchi F, D’Errico A, Golfieri R, Vasuri F, Beretta C, Di Fresco S, Pultrone C, Dababneh H, Brunocilla E. The impact of a multidisciplinary team on treatment of patients with bladder cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00598-5] [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: 02/12/2023]
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Cuicchi D, Gabrielli L, Tardio ML, Rossini G, D’Errico A, Viale P, Lazzarotto T, Poggioli G. Virological and histological evaluation of intestinal samples in COVID-19 patients. World J Gastroenterol 2022; 28:6282-6293. [PMID: 36504555 PMCID: PMC9730443 DOI: 10.3748/wjg.v28.i44.6282] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/30/2022] [Accepted: 11/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen responsible for pandemic coronavirus disease 2019 (COVID-19). It is a highly contagious virus which primarily affects the respiratory tract, nevertheless, the lungs are not the only target organs of the virus. The intestinal tract could represent an additional tropism site for SARS-CoV-2. Several observations have collectively suggested that enteric infections can occur in COVID-19 patients. However, the detection of viral RNA in gastrointestinal (GI) tissue samples has not been adequately investigated and results are conflicting.
AIM To detect the presence of SARS-CoV-2 RNA in intestinal mucosa samples and to evaluate histological features.
METHODS The COVID-19 patients hospitalized at an Italian tertiary hospital from April 2020 to March 2021 were evaluated for enrollment in an observational, monocentric trial. The study population was composed of two groups of adult patients. In the first group (biopsy group, 30 patients), patients were eligible for inclusion if they had mild to moderate disease and if they agreed to have a rectal biopsy; in the second group (surgical specimen group, 6 patients), patients were eligible for inclusion if they underwent intestinal resection during index hospitalization. Fifty-nine intestinal mucosal samples were analyzed.
RESULTS Viral RNA was not detectable in any of the rectal biopsies performed (0/53). Histological examination showed no enterocyte damage, but slight edema of the lamina propria with mild inflammatory lymphoplasmacytic infiltration. There was no difference in inflammatory infiltrates in patients with and without GI symptoms. SARS-CoV-2 RNA was detected in fecal samples in 6 cases out of 14 cases examined (42.9%). In the surgical specimen group, all patients underwent emergency intestinal resection. Viral RNA was detected in 2 surgical specimens of the 6 examined, both of which were from patients with active neoplastic disease. Histological examination also pointed out abundant macrophages, granulocytes and plasma cells infiltrating the muscular layer and adipose tissue, and focal vasculitis.
CONCLUSION Mild-moderate COVID-19 may not be associated with rectal infection by the virus. More comprehensive autopsies or surgical specimens are needed to provide histological evidence of intestinal infection.
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Affiliation(s)
- Dajana Cuicchi
- Department of Medical and Surgical Sciences, Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Liliana Gabrielli
- Department of Experimental, Diagnostic and Specialty Medicine, Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Maria Lucia Tardio
- Department of Experimental, Diagnostic and Specialty Medicine, Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Giada Rossini
- Department of Experimental, Diagnostic and Specialty Medicine, Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Antonietta D’Errico
- Department of Experimental, Diagnostic and Specialty Medicine, Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Pierluigi Viale
- Department for Integrated Infectious Risk Management, Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
- Infectious Diseases Unit, Department for Integrated Infectious Risk Management, University of Bologna, Bologna 40138, Italy
| | - Tiziana Lazzarotto
- Department of Experimental, Diagnostic and Specialty Medicine, Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna 40138, Italy
| | - Gilberto Poggioli
- Department of Medical and Surgical Sciences, Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna 40138, Italy
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7
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Filitto G, Coppola F, Curti N, Giampieri E, Dall’Olio D, Merlotti A, Cattabriga A, Cocozza MA, Taninokuchi Tomassoni M, Remondini D, Pierotti L, Strigari L, Cuicchi D, Guido A, Rihawi K, D’Errico A, Di Fabio F, Poggioli G, Morganti AG, Ricciardiello L, Golfieri R, Castellani G. Automated Prediction of the Response to Neoadjuvant Chemoradiotherapy in Patients Affected by Rectal Cancer. Cancers (Basel) 2022; 14:cancers14092231. [PMID: 35565360 PMCID: PMC9100060 DOI: 10.3390/cancers14092231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Colorectal cancer is the second most malignant tumor per number of deaths after lung cancer and the third per number of new cases after breast and lung cancer. The correct and rapid identification (i.e., segmentation of the cancer regions) is a fundamental task for correct patient diagnosis. In this study, we propose a novel automated pipeline for the segmentation of MRI scans of patients with LARC in order to predict the response to nCRT using radiomic features. This study involved the retrospective analysis of T2-weighted MRI scans of 43 patients affected by LARC. The segmentation of tumor areas was on par or better than the state-of-the-art results, but required smaller sample sizes. The analysis of radiomic features allowed us to predict the TRG score, which agreed with the state-of-the-art results. Abstract Background: Rectal cancer is a malignant neoplasm of the large intestine resulting from the uncontrolled proliferation of the rectal tract. Predicting the pathologic response of neoadjuvant chemoradiotherapy at an MRI primary staging scan in patients affected by locally advanced rectal cancer (LARC) could lead to significant improvement in the survival and quality of life of the patients. In this study, the possibility of automatizing this estimation from a primary staging MRI scan, using a fully automated artificial intelligence-based model for the segmentation and consequent characterization of the tumor areas using radiomic features was evaluated. The TRG score was used to evaluate the clinical outcome. Methods: Forty-three patients under treatment in the IRCCS Sant’Orsola-Malpighi Polyclinic were retrospectively selected for the study; a U-Net model was trained for the automated segmentation of the tumor areas; the radiomic features were collected and used to predict the tumor regression grade (TRG) score. Results: The segmentation of tumor areas outperformed the state-of-the-art results in terms of the Dice score coefficient or was comparable to them but with the advantage of considering mucinous cases. Analysis of the radiomic features extracted from the lesion areas allowed us to predict the TRG score, with the results agreeing with the state-of-the-art results. Conclusions: The results obtained regarding TRG prediction using the proposed fully automated pipeline prove its possible usage as a viable decision support system for radiologists in clinical practice.
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Affiliation(s)
- Giuseppe Filitto
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (G.F.); (G.C.)
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
- SIRM Foundation, Italian Society of Medical and Interventional Radiology, 40138 Bologna, Italy
| | - Nico Curti
- eDIMES Lab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
- INFN Bologna, 40127 Bologna, Italy;
- Correspondence: (N.C.); (E.G.)
| | - Enrico Giampieri
- eDIMES Lab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
- Correspondence: (N.C.); (E.G.)
| | - Daniele Dall’Olio
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Alessandra Merlotti
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Arrigo Cattabriga
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Makoto Taninokuchi Tomassoni
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Daniel Remondini
- INFN Bologna, 40127 Bologna, Italy;
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Luisa Pierotti
- Sant’Orsola-Malpighi Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Lidia Strigari
- Department of Medical Physics, Sant’Orsola-Malpighi Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologn, 40138 Bologna, Italy;
| | - Dajana Cuicchi
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Alessandra Guido
- Department of Radiation Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Karim Rihawi
- Division of Medical Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (K.R.); (F.D.F.)
| | - Antonietta D’Errico
- Pathology Unit, Department of Specialized, Experimental and Diagnostic Medicine, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Francesca Di Fabio
- Division of Medical Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (K.R.); (F.D.F.)
| | - Gilberto Poggioli
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Alessio Giuseppe Morganti
- Department of Radiation Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Luigi Ricciardiello
- Department of Medical and Surgical Science, University of Bologna, 40138 Bologna, Italy;
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Gastone Castellani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (G.F.); (G.C.)
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8
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Malvi D, Vasuri F, Maloberti T, Sanza V, De Leo A, Fornelli A, Masetti M, Benini C, Lombardi R, Offi MF, Di Marco M, Ravaioli M, Fiorino S, Franceschi E, Brandes AA, Jovine E, D’Errico A, Tallini G, de Biase D. Molecular Characterization of Pancreatic Ductal Adenocarcinoma Using a Next-Generation Sequencing Custom-Designed Multigene Panel. Diagnostics (Basel) 2022; 12:diagnostics12051058. [PMID: 35626213 PMCID: PMC9139796 DOI: 10.3390/diagnostics12051058] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 02/05/2023] Open
Abstract
Despite the efforts made in the management of PDAC, the 5-year relative survival rate of pancreatic ductal adenocarcinoma (PDAC) still remains very low (10%). To date, precision oncology is far from being ready to be applied in cases of PDAC, although studies exploring the molecular and genetic alterations have been conducted, and the genomic landscape of PDAC has been characterized. This study aimed to apply a next-generation sequencing (NGS) laboratory-developed multigene panel to PDAC samples to find molecular alterations that could be associated with histopathological features and clinical outcomes. A total of 68 PDACs were characterized by using a laboratory-developed multigene NGS panel. KRAS and TP53 mutations were the more frequent alterations in 75.0% and 44.6% of cases, respectively. In the majority (58.7%) of specimens, more than one mutation was detected, mainly in KRAS and TP53 genes. KRAS mutation was significantly associated with a shorter time in tumor recurrence compared with KRAS wild-type tumors. Intriguingly, KRAS wild-type cases had a better short-term prognosis despite the lymph node status. In conclusion, our work highlights that the combination of KRAS mutation with the age of the patient and the lymph node status may help in predicting the outcome in PDAC patients.
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Affiliation(s)
- Deborah Malvi
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.M.); (F.V.); (A.D.)
| | - Francesco Vasuri
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.M.); (F.V.); (A.D.)
| | - Thais Maloberti
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna-Molecular Diagnostic Unit, Azienda USL di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (G.T.)
- Division of Molecular Pathology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Viviana Sanza
- Division of Molecular Pathology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Antonio De Leo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna-Molecular Diagnostic Unit, Azienda USL di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (G.T.)
- Division of Molecular Pathology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Adele Fornelli
- Anatomic Pathology Unit, Azienda USL, Maggiore Hospital, 40133 Bologna, Italy;
| | - Michele Masetti
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy; (M.M.); (C.B.); (R.L.); (M.F.O.); (E.J.)
| | - Claudia Benini
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy; (M.M.); (C.B.); (R.L.); (M.F.O.); (E.J.)
| | - Raffaele Lombardi
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy; (M.M.); (C.B.); (R.L.); (M.F.O.); (E.J.)
| | - Maria Fortuna Offi
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy; (M.M.); (C.B.); (R.L.); (M.F.O.); (E.J.)
| | - Mariacristina Di Marco
- Division of Medical Oncology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, 40138 Bologna, Italy
| | - Matteo Ravaioli
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Sirio Fiorino
- Internal Medicine Unit, Budrio Hospital, Budrio (Bologna), Azienda USL di Bologna, 40054 Bologna, Italy;
| | - Enrico Franceschi
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (E.F.); (A.A.B.)
| | - Alba A. Brandes
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (E.F.); (A.A.B.)
| | - Elio Jovine
- Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Maggiore Hospital, 40133 Bologna, Italy; (M.M.); (C.B.); (R.L.); (M.F.O.); (E.J.)
| | - Antonietta D’Errico
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.M.); (F.V.); (A.D.)
| | - Giovanni Tallini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna-Molecular Diagnostic Unit, Azienda USL di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (G.T.)
- Division of Molecular Pathology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Dario de Biase
- Department of Pharmacy and Biotechnology (FaBiT), University of Bologna, 40138 Bologna, Italy
- Correspondence:
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9
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Bolognesi F, Fazio N, Boriani F, Fabbri VP, Gravina D, Pedrini FA, Zini N, Greco M, Paolucci M, Re MC, Asioli S, Foschini MP, D’Errico A, Baldini N, Marchetti C. Validation of a Cleanroom Compliant Sonication-Based Decellularization Technique: A New Concept in Nerve Allograft Production. Int J Mol Sci 2022; 23:ijms23031530. [PMID: 35163474 PMCID: PMC8836166 DOI: 10.3390/ijms23031530] [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: 12/31/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 12/10/2022] Open
Abstract
Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. If the direct suture of a lesion is not possible, i.e., nerve gap > 2 cm, it is necessary to use grafts. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable functional deficit and further morbidity. An alternative to autografting is represented by the acellular nerve allograft (ANA), which avoids disadvantages of autograft harvesting and fresh allograft rejection. In this research, the authors intend to transfer to human nerves a novel technique, previously implemented in animal models, to decellularize nerves. The new method is based on soaking the nerve tissues in decellularizing solutions while associating ultrasounds and freeze-thaw cycles. It is performed without interrupting the sterility chain, so that the new graft may not require post-production γ-ray irradiation, which is suspected to affect the structural and functional quality of tissues. The new method is rapid, safe, and inexpensive if compared with available commercial ANAs. Histology and immunohistochemistry have been adopted to evaluate the new decellularized nerves. The study shows that the new method can be applied to human nerve samples, obtaining similar, and, sometimes better, results compared with the chosen control method, the Hudson technique.
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Affiliation(s)
- Federico Bolognesi
- Oral and Maxillofacial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
- Correspondence: ; Tel.: +39-333-689-4116
| | - Nicola Fazio
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (N.F.); (D.G.); (M.G.)
| | - Filippo Boriani
- Department of Plastic Surgery and Microsurgery, University of Cagliari, 09124 Cagliari, Italy;
| | - Viscardo Paolo Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
- Unit of Anatomic Pathology, Department of Oncology, Bellaria “Carlo Alberto Pizzardi” Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Davide Gravina
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (N.F.); (D.G.); (M.G.)
| | - Francesca Alice Pedrini
- Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy;
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy
| | - Nicoletta Zini
- Unit of Bologna, CNR-National Research Council of Italy, Institute of Molecular Genetics “Luigi Luca Cavalli–Sforza”, Via di Barbiano 1/10, 40136 Bologna, Italy;
- IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Michelina Greco
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (N.F.); (D.G.); (M.G.)
| | - Michela Paolucci
- Microbiology Section of the Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.P.); (M.C.R.)
| | - Maria Carla Re
- Microbiology Section of the Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.P.); (M.C.R.)
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
- Unit of Anatomic Pathology, Department of Oncology, Bellaria “Carlo Alberto Pizzardi” Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
- Unit of Anatomic Pathology, Department of Oncology, Bellaria “Carlo Alberto Pizzardi” Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Antonietta D’Errico
- Pathology Unit, Department of Specialized, Experimental and Diagnostic Medicine, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy;
| | - Nicola Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (N.F.); (D.G.); (M.G.)
| | - Claudio Marchetti
- Oral and Maxillofacial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy; (V.P.F.); (S.A.); (M.P.F.); (N.B.)
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10
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Lodato F, Larocca A, D’Errico A, Cennamo V. An unusual case of acute cholestatic hepatitis after m-RNABNT162b2 (Comirnaty) SARS-CoV-2 vaccine: Coincidence, autoimmunity or drug-related liver injury. J Hepatol 2021; 75:1254-1256. [PMID: 34256064 PMCID: PMC8272621 DOI: 10.1016/j.jhep.2021.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Francesca Lodato
- Gastroenterology and Interventional Endoscopy Unit, Azienda Unità Sanitaria Locale di Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
| | - Anna Larocca
- Gastroenterology and Interventional Endoscopy Unit, Azienda Unità Sanitaria Locale di Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | | | - Vincenzo Cennamo
- Gastroenterology and Interventional Endoscopy Unit, Azienda Unità Sanitaria Locale di Bologna Bellaria-Maggiore Hospital, Bologna, Italy
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11
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Coppola F, Mottola M, Lo Monaco S, Cattabriga A, Cocozza MA, Yuan JC, De Benedittis C, Cuicchi D, Guido A, Rojas Llimpe FL, D’Errico A, Ardizzoni A, Poggioli G, Strigari L, Morganti AG, Bazzoli F, Ricciardiello L, Golfieri R, Bevilacqua A. The Heterogeneity of Skewness in T2W-Based Radiomics Predicts the Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer. Diagnostics (Basel) 2021; 11:diagnostics11050795. [PMID: 33924854 PMCID: PMC8146691 DOI: 10.3390/diagnostics11050795] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/18/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/12/2022] Open
Abstract
Our study aimed to investigate whether radiomics on MRI sequences can differentiate responder (R) and non-responder (NR) patients based on the tumour regression grade (TRG) assigned after surgical resection in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT). Eighty-five patients undergoing primary staging with MRI were retrospectively evaluated, and 40 patients were finally selected. The ROIs were manually outlined in the tumour site on T2w sequences in the oblique-axial plane. Based on the TRG, patients were grouped as having either a complete or a partial response (TRG = (0,1), n = 15). NR patients had a minimal or poor nCRT response (TRG = (2,3), n = 25). Eighty-four local first-order radiomic features (RFs) were extracted from tumour ROIs. Only single RFs were investigated. Each feature was selected using univariate analysis guided by a one-tailed Wilcoxon rank-sum. ROC curve analysis was performed, using AUC computation and the Youden index (YI) for sensitivity and specificity. The RF measuring the heterogeneity of local skewness of T2w values from tumour ROIs differentiated Rs and NRs with a p-value ≈ 10−5; AUC = 0.90 (95%CI, 0.73–0.96); and YI = 0.68, corresponding to 80% sensitivity and 88% specificity. In conclusion, higher heterogeneity in skewness maps of the baseline tumour correlated with a greater benefit from nCRT.
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Affiliation(s)
- Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
- SIRM Foundation, Italian Society of Medical and Interventional Radiology, Via della Signora 2, 20122 Milan, Italy
| | - Margherita Mottola
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, Via Toffano 2/2, 40125 Bologna, Italy; (M.M.); (A.B.)
| | - Silvia Lo Monaco
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
- Correspondence:
| | - Arrigo Cattabriga
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
| | - Jia Cheng Yuan
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
| | - Caterina De Benedittis
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
| | - Dajana Cuicchi
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Alessandra Guido
- Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Fabiola Lorena Rojas Llimpe
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.L.R.L.); (A.A.)
| | - Antonietta D’Errico
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Andrea Ardizzoni
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.L.R.L.); (A.A.)
| | - Gilberto Poggioli
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy;
| | - Alessio Giuseppe Morganti
- Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Franco Bazzoli
- Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (F.B.); (L.R.)
| | - Luigi Ricciardiello
- Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (F.B.); (L.R.)
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (J.C.Y.); (C.D.B.); (R.G.)
| | - Alessandro Bevilacqua
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, Via Toffano 2/2, 40125 Bologna, Italy; (M.M.); (A.B.)
- Department of Computer Science and Engineering, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
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12
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Zanoni L, Mei R, Bianchi L, Giunchi F, Maltoni L, Pultrone CV, Nanni C, Bossert I, Matti A, Schiavina R, Fiorentino M, Fonti C, Lodi F, D’Errico A, Brunocilla E, Fanti S. The Role of [ 18F]Fluciclovine PET/CT in the Characterization of High-Risk Primary Prostate Cancer: Comparison with [ 11C]Choline PET/CT and Histopathological Analysis. Cancers (Basel) 2021; 13:cancers13071575. [PMID: 33805543 PMCID: PMC8037300 DOI: 10.3390/cancers13071575] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary The role of [18F]Fluciclovine Positron Emission Tomography/Computed Tomography (PET/CT) in the characterization of intra-prostatic lesions was evaluated in high-risk primary PCa patients, scheduled for radical surgery, comparing investigational [18F]Fluciclovine and conventional [11C]Choline PET/CT results with the reference standard of pathologic surgical specimen. PET visual and semi-quantitative analyses were performed: for instance, patient-based, blinded to histopathology; subsequently lesion-based, unblinded, according to a pathology reference mapping. Among 19 pts, 45 malignant and 31 benign lesions were found. The highest SUVmax matched with the lobe of the index lesion in 89% of pts and a direct correlation between [18F]Fluciclovine uptake values and pISUP was demonstrated. Overall, the lesion-based performance of PET semiquantitative parameters (SUVmax, Target to background Ratio-TBRs) with either [18F]Fluciclovine or [11C]Choline, in detecting either malignant/ISUP2-5/ISUP4-5 PCa lesions, was moderate and similar (AUCs ≥ 0.70), but still inadequate (AUCs ≤ 0.81) as standalone staging procedure. TBRs (especially with threshold higher than bone marrow) may be complementary to implement malignancy targeting. Abstract The primary aim of the study was to evaluate the role of [18F]Fluciclovine PET/CT in the characterization of intra-prostatic lesions in high-risk primary PCa patients eligible for radical prostatectomy, in comparison with conventional [11C]Choline PET/CT and validated by prostatectomy pathologic examination. Secondary aims were to determine the performance of PET semi-quantitative parameters (SUVmax; target-to-background ratios [TBRs], using abdominal aorta, bone marrow and liver as backgrounds) for malignant lesion detection (and best cut-off values) and to search predictive factors of malignancy. A six sextants prostate template was created and used by PET readers and pathologists for data comparison and validation. PET visual and semi-quantitative analyses were performed: for instance, patient-based, blinded to histopathology; subsequently lesion-based, un-blinded, according to the pathology reference template. Among 19 patients included (mean age 63 years, 89% high and 11% very-high-risk, mean PSA 9.15 ng/mL), 45 malignant and 31 benign lesions were found and 19 healthy areas were selected (n = 95). For both tracers, the location of the “blinded” prostate SUVmax matched with the lobe of the lesion with the highest pGS in 17/19 cases (89%). There was direct correlation between [18F]Fluciclovine uptake values and pISUP. Overall, lesion-based (n = 95), the performance of PET semiquantitative parameters, with either [18F]Fluciclovine or [11C]Choline, in detecting either malignant/ISUP2-5/ISUP4-5 PCa lesions, was moderate and similar (AUCs ≥ 0.70) but still inadequate (AUCs ≤ 0.81) as a standalone staging procedure. A [18F]Fluciclovine TBR-L3 ≥ 1.5 would depict a clinical significant lesion with a sensitivity and specificity of 85% and 68% respectively; whereas a SUVmax cut-off value of 4 would be able to identify a ISUP 4-5 lesion in all cases (sensitivity 100%), although with low specificity (52%). TBRs (especially with threshold significantly higher than aorta and slightly higher than bone marrow), may be complementary to implement malignancy targeting.
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Affiliation(s)
- Lucia Zanoni
- Nuclear Medicine Unit, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (C.N.); (F.L.); (S.F.)
- Correspondence: ; Tel.: +39-051-214-3959
| | - Riccardo Mei
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy; (R.M.); (M.F.)
| | - Lorenzo Bianchi
- Division of Urology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.B.); (C.V.P.); (R.S.); (E.B.)
- Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy;
| | - Francesca Giunchi
- Pathology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.G.); (A.D.)
| | - Lorenzo Maltoni
- Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy;
| | - Cristian Vincenzo Pultrone
- Division of Urology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.B.); (C.V.P.); (R.S.); (E.B.)
| | - Cristina Nanni
- Nuclear Medicine Unit, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (C.N.); (F.L.); (S.F.)
| | - Irene Bossert
- Nuclear Medicine, Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy;
| | - Antonella Matti
- Nuclear Medicine, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Ospedale Sacro Cuore-Don Calabria, 37024 Negrar di Valpolicella (VR), Italy;
| | - Riccardo Schiavina
- Division of Urology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.B.); (C.V.P.); (R.S.); (E.B.)
- Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy;
| | - Michelangelo Fiorentino
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy; (R.M.); (M.F.)
| | - Cristina Fonti
- Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy;
| | - Filippo Lodi
- Nuclear Medicine Unit, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (C.N.); (F.L.); (S.F.)
| | - Antonietta D’Errico
- Pathology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.G.); (A.D.)
| | - Eugenio Brunocilla
- Division of Urology, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.B.); (C.V.P.); (R.S.); (E.B.)
- Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy;
| | - Stefano Fanti
- Nuclear Medicine Unit, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (C.N.); (F.L.); (S.F.)
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy; (R.M.); (M.F.)
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De Lorenzo S, Tovoli F, Mazzotta A, Vasuri F, Edeline J, Malvi D, Boudjema K, Renzulli M, Jeddou H, D’Errico A, Turlin B, Cescon M, Uguen T, Granito A, Lièvre A, Brandi G. Non-Alcoholic Steatohepatitis as a Risk Factor for Intrahepatic Cholangiocarcinoma and Its Prognostic Role. Cancers (Basel) 2020; 12:cancers12113182. [PMID: 33138044 PMCID: PMC7692633 DOI: 10.3390/cancers12113182] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 09/07/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and its most aggressive form, non-alcoholic steatohepatitis (NASH), are causing a rise in the prevalence of hepatocellular carcinoma. Data about NAFLD/NASH and intrahepatic cholangiocarcinoma (iCCA) are few and contradictory, coming from population registries that do not correctly distinguish between NAFLD and NASH. We evaluated the prevalence of NAFLD and NASH in peritumoral tissue of resected iCCA (n = 180) and in needle biopsies of matched liver donors. Data of iCCA patients were subsequently analysed to compare NASH-related iCCA (Group A), iCCA arisen in a healthy liver (Group B) or in patients with classical iCCA risk factors (Group C). NASH was found in 22.5% of 129 iCCA patients without known risk factors and in 6.2% of matched controls (risk ratio 3.625, 95% confidence interval 1.723-7.626, p < 0.001), while NAFLD was equally represented in both groups. The overall survival of NASH-related iCCA was inferior to that of patients with healthy liver (38.5 vs. 48.1 months, p = 0.003) and similar to that of patients with known risk factors (31.9 months, p = 0.948), regardless of liver fibrosis. The multivariable Cox regression confirmed NASH as a prognostic factor (hazard ratio 1.773, 95% confidence interval 1.156-2.718, p = 0.009). We concluded that NASH (but not NAFLD) is a risk factor for iCCA and might affect its prognosis. Dissecting NASH from NAFLD by histology is necessary to correctly assess the actual role of these conditions. Prevention protocols for NASH patients should also consider the risk for iCCA and not only HCC. Mechanistic studies aimed to find a direct pathogenic link between NASH and iCCA could add further relevant information.
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Affiliation(s)
- Stefania De Lorenzo
- Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, 40138 Bologna, Italy;
| | - Francesco Tovoli
- Division of Internal Medicine, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, 40138 Bologna, Italy;
- Correspondence: (F.T.); (G.B.); Tel.: +39-051-214-2214 (F.T.)
| | - Alessandro Mazzotta
- Service de Chirurgie Hépatobiliaire et Digestive, Centre Hospitalier Universitaire Pontchaillou Rennes, CIC-INSERM, Université de Rennes, 35000 Rennes, France; (A.M.); (K.B.); (H.J.)
| | - Francesco Vasuri
- Pathology Unit, S. Orsola-Malpighi Bologna Authority Hospital, 40138 Bologna, Italy; (F.V.); (D.M.); (A.D.)
| | - Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, 35000 Rennes, France;
| | - Deborah Malvi
- Pathology Unit, S. Orsola-Malpighi Bologna Authority Hospital, 40138 Bologna, Italy; (F.V.); (D.M.); (A.D.)
| | - Karim Boudjema
- Service de Chirurgie Hépatobiliaire et Digestive, Centre Hospitalier Universitaire Pontchaillou Rennes, CIC-INSERM, Université de Rennes, 35000 Rennes, France; (A.M.); (K.B.); (H.J.)
| | - Matteo Renzulli
- Radiology Unit, S. Orsola-Malpighi Bologna Authority Hospital, 40138 Bologna, Italy;
| | - Heithem Jeddou
- Service de Chirurgie Hépatobiliaire et Digestive, Centre Hospitalier Universitaire Pontchaillou Rennes, CIC-INSERM, Université de Rennes, 35000 Rennes, France; (A.M.); (K.B.); (H.J.)
| | - Antonietta D’Errico
- Pathology Unit, S. Orsola-Malpighi Bologna Authority Hospital, 40138 Bologna, Italy; (F.V.); (D.M.); (A.D.)
| | - Bruno Turlin
- Service de Pathologie-Centre Hospitalier Universitaire Pontchaillou Rennes, INSERM Numecan U1241, Université de Rennes, Centre de Ressources Biologiques-BB-0033-00056, 35000 Rennes, France;
| | - Matteo Cescon
- Surgery Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Thomas Uguen
- Service de Hepatologie, Centre Hospitalier Universitaire Pontchaillou, 35000 Rennes, France;
| | - Alessandro Granito
- Division of Internal Medicine, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, 40138 Bologna, Italy;
| | - Astrid Lièvre
- Department of Gastroenterology, Centre Hospitalier Universitaire Pontchaillou, University of Rennes, Inserm U1242, Rennes, France;
| | - Giovanni Brandi
- Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, 40138 Bologna, Italy;
- Correspondence: (F.T.); (G.B.); Tel.: +39-051-214-2214 (F.T.)
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Cima L, Nacchia F, Ghimenton C, Valotto G, Boschiero L, Gobbo S, Zaza G, Neil D, Mescoli C, Vanzo F, D’Errico A, Ghimenton C, Rugge M, Casartelli-Liviero M, Brunelli M, Novelli L, Eccher A. Histopathology and Long-Term Outcome of Kidneys Transplanted From Donors With Severe Acute Kidney Injury. Prog Transplant 2019; 29:36-42. [DOI: 10.1177/1526924818817054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background: Acute kidney injury is a treatable entity although difficult to recognize without diagnostic biopsy. We investigated the potential association between clinically defined deceased donors and acute kidney injury with preimplantation histological findings and recipient outcomes. Methods: Kidney biopsies from donors were classified using the Acute Kidney Injury Network criteria and assessed for percentage glomerulosclerosis, tubular atrophy, interstitial fibrosis, and vascular narrowing with the Remuzzi score and for acute tubular necrosis. Differences in incidence rates of delayed graft function (DGF) and cumulative rejection episodes were compared between recipients transplanted with normal and 3 levels of acute kidney injury using the analysis of variance with Bonferroni correction ( P = .0012). Results: Sixteen out of 335 donors showed a severe acute kidney injury level 3 with a median serum creatinine of 458 µmol/L. Fourteen (88%) had 0-3 Remuzzi score and were used for single kidney transplantation and 2 (12%) were used for dual kidney transplantation (score: 4-6). Recipients who received a kidney from a donor with level 3 acute kidney injury had a higher percentage of DGF (47%) without statistical significance ( P = .008). The rate of cumulative rejection (45%) at 2 years was not significantly increased ( P = .09). Conclusions: Recipients receiving level 3 acute kidney injury kidneys, selected with Remuzzi histopathological score and acute tubular necrosis assessment, had a greater incidence of DGF but a similar long-term cumulative rejection compared to no injury and level 1 and level 2 acute kidney injury donors. The application of the histopathological examination allowed expansion of the kidney donor pool.
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Affiliation(s)
- Luca Cima
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Francesco Nacchia
- Department of Surgical Sciences, Kidney Transplant Center, University and Hospital Trust of Verona, Verona, Italy
| | - Claudio Ghimenton
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Giovanni Valotto
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Luigino Boschiero
- Department of Surgical Sciences, Kidney Transplant Center, University and Hospital Trust of Verona, Verona, Italy
| | - Stefano Gobbo
- Pathology Unit, Pederzoli Hospital of Peschiera Del Garda, Verona, Italy
| | - Gianluigi Zaza
- Department of Medicine, Renal Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Desley Neil
- Department of Histopathology, Pathology Unit, Queen Elizabeth Hospital Birmingham, England
| | - Claudia Mescoli
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University and Hospital Trust of Padua, Padua, Italy
| | - Francesca Vanzo
- Arsenàl, Veneto’s Research Center for eHealth Innovation, Veneto, Italy
| | - Antonietta D’Errico
- Department of Specialised, Experimental and Diagnostic Medicine, Pathology Unit, Sant’Orsola-Malpighi University Hospital, Bologna, Italy
| | | | - Massimo Rugge
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University and Hospital Trust of Padua, Padua, Italy
| | - Marilena Casartelli-Liviero
- Department of Surgical Sciences, Neurosurgery and Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Luca Novelli
- Pathology Unit, Carreggi University Hospital, Firenze, Italy
| | - Albino Eccher
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
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15
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De Giorgi V, Gori A, Greco A, Savarese I, Alfaioli B, Grazzini M, Rossari S, Papi F, Scarfi F, Janowska A, D’Errico A, Salvati L, Covarelli P, Gandini S. Sun-Protection Behavior, Pubertal Development and Menarche: Factors Influencing the Melanocytic Nevi Development—The Results of an Observational Study of 1,512 Children. J Invest Dermatol 2018; 138:2144-2151. [DOI: 10.1016/j.jid.2018.02.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/05/2018] [Accepted: 02/10/2018] [Indexed: 11/29/2022]
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16
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Serra C, Rizzello F, Pratico’ C, Felicani C, Fiorini E, Brugnera R, Mazzotta E, Giunchi F, Fiorentino M, D’Errico A, Morselli-Labate AM, Mastroroberto M, Campieri M, Poggioli G, Gionchetti P. Real-time elastography for the detection of fibrotic and inflammatory tissue in patients with stricturing Crohn's disease. J Ultrasound 2017; 20:273-284. [PMID: 29204231 PMCID: PMC5698189 DOI: 10.1007/s40477-017-0265-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/28/2017] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The distinction between active inflammation and fibrosis of the bowel wall is essential for therapeutic decisions in stricturing Crohn's disease. We aimed to assess whether real-time elastography (RTE) with strain ratio measurement could be useful in differentiating fibrotic from inflamed bowel strictures and to evaluate the possible relationship between US techniques and the histology of the stenotic bowel wall. MATERIALS AND METHODS Bowel ultrasonography (including RTE, color-Doppler and CEUS examination) was prospectively evaluated in 26 patients with symptomatic stricturing Crohn's disease, before surgery. RTE was adopted to evaluate bowel stiffness: five loops of 20 RTE frames were recorded for each stenotic segment and the mean strain ratio (MSR) was obtained. Histology scoring systems both for inflammation and fibrosis were established for surgical specimens. RESULTS No significant correlation was found between MSR and fibrosis score (P = 0.877). Color-Doppler score was significantly related to gut wall and submucosal thicknesses (P = 0.006 and P = 0.032, respectively). There was no significant correlation between the number of vessels counted at histology and color-Doppler and CEUS examinations (P = 0.170 and P = 0.302, respectively). CONCLUSION MSR detection was not able to distinguish fibrotic from inflammatory tissue in our selected population. This result could be influenced by the presence of the superimposed inflammation. Larger cohort of patients, further analysis with shear wave elastography, and validated histopathology classification systems for fibrosis and inflammation are necessary to assess if intestinal fibrosis could be reliably detected on the basis of bowel elastic properties.
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Affiliation(s)
- Carla Serra
- Department of Organ Failure and Transplantation, Ultrasound Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Fernando Rizzello
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Chiara Pratico’
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Cristina Felicani
- Department of Organ Failure and Transplantation, Ultrasound Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Erica Fiorini
- Department of Organ Failure and Transplantation, Ultrasound Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ramona Brugnera
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Elena Mazzotta
- Department of Organ Failure and Transplantation, Ultrasound Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Francesca Giunchi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), “F. Addarii” Institute of Oncology and Transplant Pathology, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), “F. Addarii” Institute of Oncology and Transplant Pathology, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Antonietta D’Errico
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), “F. Addarii” Institute of Oncology and Transplant Pathology, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Antonio Maria Morselli-Labate
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Marianna Mastroroberto
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Massimo Campieri
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Gilberto Poggioli
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Paolo Gionchetti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
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Mastrolorenzo A, D’Errico A, Pierotti P, Vannucchi M, Giannini S, Fossi F. Pleomorphic cutaneous xanthomas disclosing homozygous familial hypercholesterolemia. World J Dermatol 2017; 6:59-65. [DOI: 10.5314/wjd.v6.i4.59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 08/30/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
Homoxygous Familial Hypercholesterolemia is characterized by a presence of several types of cutaneous xanthomas with an abnormal lipid profile. Some of these could be pathognomonic. Although these could be initially interpreted as isolated and localized benign disorders and offered surgical treatment, it has become increasingly clear that they could be a part of a systemic pathology. Here we describe a case of this rare disorder in a 19 years old non-obese young man who presented multiple, intertriginous, tuberous and tendinous xanthomas and had an associated abnormal lipid profile with elevated low-density lipoprotein cholesterol levels. A detailed history with clinical assessment in the differential diagnosis and laboratory investigations led to a precise diagnosis.
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Affiliation(s)
- Antonio Mastrolorenzo
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Public Hospital Piero Palagi, Florence 50125, Italy
| | - Antonietta D’Errico
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Public Hospital Piero Palagi, Florence 50125, Italy
| | - Piera Pierotti
- Azienda Sanitaria di Firenze, Department of Infectious Diseases, Ospedale SM Annunziata, Florence 50012, Italy
| | - Margherita Vannucchi
- Histopathology and Molecular Diagnostics Institute, Careggi University Hospital, Florence 50134, Italy
| | - Stefano Giannini
- Diabetes and Metabolic Disease Agency, Careggi University Hospital, Florence 50134, Italy
| | - Fiammetta Fossi
- SODc of Transfusion Medicine and Cell Therapy, Careggi University Hospital, Florence 50134, Italy
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Giunchi F, Jordahl K, Bollito E, Colecchia M, Patriarca C, D’Errico A, Vasuri F, Malvi D, Fornari A, Bonetti LR, Corti B, Papotti M, DeGiuli P, Loda M, Montironi R, Fiorentino M, Rider JR. Interpathologist concordance in the histological diagnosis of focal prostatic atrophy lesions, acute and chronic prostatitis, PIN, and prostate cancer. Virchows Arch 2017; 470:711-715. [DOI: 10.1007/s00428-017-2123-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/13/2017] [Accepted: 04/05/2017] [Indexed: 11/30/2022]
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Van Gossum A, Pironi L, Messing B, Moreno C, Colecchia A, D’Errico A, Demetter P, De Gos F, Cazals-Halem D, Joly F. Transient Elastography (FibroScan) Is Not Correlated With Liver Fibrosis but With Cholestasis in Patients With Long-Term Home Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2014; 39:719-24. [DOI: 10.1177/0148607114538057] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/29/2014] [Indexed: 12/19/2022]
Affiliation(s)
- André Van Gossum
- Department of Gastroenterology and Pathology, Hôpital Erasme, Brussels, Belgium
| | - Loris Pironi
- Department of Gastroenterology and Pathology, St Orsola-Malpighi Hospital, Bologna, Italy
| | - Bernard Messing
- Department of Gastroenterology and Pathology, Hôpital Beaujon, Paris, France
| | - Christophe Moreno
- Department of Gastroenterology and Pathology, Hôpital Erasme, Brussels, Belgium
| | - Antonio Colecchia
- Department of Gastroenterology and Pathology, St Orsola-Malpighi Hospital, Bologna, Italy
| | - Antonietta D’Errico
- Department of Gastroenterology and Pathology, St Orsola-Malpighi Hospital, Bologna, Italy
| | - Pieter Demetter
- Department of Gastroenterology and Pathology, Hôpital Erasme, Brussels, Belgium
| | - Françoise De Gos
- Department of Gastroenterology and Pathology, Hôpital Beaujon, Paris, France
| | | | - Francisca Joly
- Department of Gastroenterology and Pathology, Hôpital Beaujon, Paris, France
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Marangoni A, Cavallini C, Foschi C, Nardini P, Aldini R, D’Errico A, Rosini F, Cevenini R. P1.005 Evaluation of Cytokines and Matrix Metalloproteinases Genes Expression in Genital Organs After Vaginal Exposure to Chlamydia Muridarum. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0226] [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: 11/03/2022]
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Passarini B, Balestri R, D’Errico A, Pinna AD, Infusino SD. Lack of recurrence of malignant atrophic papulosis of Degos in multivisceral transplant: Insights into possible pathogenesis? J Am Acad Dermatol 2011; 65:e49-e50. [DOI: 10.1016/j.jaad.2010.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 12/09/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
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Pironi L, Colecchia A, Guidetti M, Belluzzi A, D’Errico A. Fish oil-based emulsion for the treatment of parenteral nutrition associated liver disease in an adult patient. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.eclnm.2010.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fixa B, Komárková O, Krejsek K, Bures J, Nozicka Z, Giorcelli W, Rodi M, Camisasca G, Martinotti RG, Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D, Northfield TC, Vorobjova T, Vassiljev V, Kisand K, Wadström T, Uibo R, Zotz RB, Xu SG, Recklinghausen GV, Meusers P, Goebell H, Rhee KH, Youn HS, Paik SK, Lee WK, Cho MJ, Park CK, Li Y, Hu P, Du G, Wong Z, Hazell SL, Mitchell HM, Korwin JDD, Remot P, Hartemann P, Catelle A, Conroy MC, Schmitt J, Stolte M, Wellens E, Bethke B, Ritter M, Eidt H, Zanten SVV, Best L, Bezanson G, Marrie T, Poniewierka E, Gosciniak G, Matysiak-Budnik T, Quatrini M, Boni F, Baldassarri AR, Vecchi AD, Castelnovo C, Viganò E, Tenconi L, Bianchi PA, Carlucci A, Ferrini G, Bianco I, Larcinese G, Sciascio AD, Fly GF, Hauge T, Persson J, Coelho LGV, Teixeira MM, Passos MCF, Givisiez CB, Santos CMFR, Rodrigues CJS, Chausson Y, Castro LP, Hyvärinen H, Seppälä K, Kivilaakso E, Kosunen T, Gormse M, Pilotto A, Vianello F, Tornaboni D, Dotto P, Battaglia G, Binda F, Mario FD, Donisi PM, Pasini M, Benve-nuti ME, Stracca-Pansa V, Pasquino M, Jablonowski H, Szelényi H, Hengels KJ, Strohmeyer G, Banatvala N, Mayo K, Megraud F, Jennings R, Deeks JJ, Feldman RA, Bulighin G, Ederie A, Pilati S, Franzin G, Zamboni G, Maran M, Musola R, Tobin A, Hackman RC, McDonald GB, Fatela N, Cristino JM, Monteiro L, Ramalho F, Saragoça A, Salgado MJ, Moura MCD, Pretolani S, Gasbarrini G, Bonvicini F, Baraldini M, Tonelli E, Gatto MRA, Ghironzi GC, égraud FM, Bouchard S, Lubcvzumiska-Kowalska W, Knapik Z, Meenan J, Goggins M, Shahi C, Keeling PWN, Keane C, Weir DG, Vaira D, Miglioli M, Mulè P, Holten J, Menegati M, Biasco G, Vergura M, Nannetti A, Barbara L, Boschini A, Begnini M, Menegatti M, Ghira C, D’Errico A, Evans DG, Asnicar MA, Evans DJ, Graham DY, Lee CH, Coschieri M, Fosse T, Paul MCS, Michiels JR, Delmont JP, Péroux JL, Pradier C, Rampai P, Pazzi P, Merighi A, Gamberini S, Scarliarini R, Bicochi R, Libanore M, Bisi G, Gulllini S. Epidemiology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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