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Jairath V, Peyrin-Biroulet L, Zou G, Mosli M, Vande Casteele N, Pai RK, Valasek MA, Marchal-Bressenot A, Stitt LW, Shackelton LM, Khanna R, D'Haens GR, Sandborn WJ, Olson A, Feagan BG, Pai RK. Responsiveness of histological disease activity indices in ulcerative colitis: a post hoc analysis using data from the TOUCHSTONE randomised controlled trial. Gut 2019; 68:1162-1168. [PMID: 30076171 DOI: 10.1136/gutjnl-2018-316702] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/02/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We evaluated the reliability and responsiveness of available but incompletely validated UC histological disease activity indices using standardised rules for centralised assessment. DESIGN Disease activity was assessed in biopsies collected in a phase II placebo-controlled ozanimod trial by four blinded pathologists using the Geboes (GS) and modified Riley (MRS) scores, the Robarts Histopathology (RHI) and Nancy Histological (NHI) indices and a Visual Analogue Scale. Reliability was assessed with intraclass correlation coefficients (ICCs). Index responsiveness was evaluated by assessing longitudinal validity (Pearson correlations of changes in index scores and other disease measures), and effect size estimates (standardised effect size (SES)) using two criteria for change (treatment assignment and >2 point decrease in total Mayo Clinic score). Area under the receiver operating characteristic (AUROC) curve estimates evaluated the probability of the indices to discriminate between treatment and placebo. RESULTS Inter-rater reliability of the histological indices was substantial to almost perfect (ICC>0.61), and responsiveness was moderate to large (SES estimates>0.5); 0.81 (0.52, 1.10), 0.87 (0.58, 1.17), 0.57 (0.30, 0.84) and 0.81 (0.52, 1.09) when treatment assignment was the criterion for change and 1.05 (0.80, 1.31), 1.13 (0.87, 1.39), 0.88 (0.64, 1.12) and 1.06 (0.80, 1.31) for the change in Mayo score criterion for the GS, MRS, RHI and NHI, respectively. The indices had similar drisciminative ability based on AUROC estimates (range 0.608-0.649). CONCLUSION All four existing histological indices were similarly reliable and responsive based on this dataset.
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Affiliation(s)
- Vipul Jairath
- Robarts Clinical Trials Inc., London, Ontario, Canada
| | | | - Guangyong Zou
- Robarts Clinical Trials Inc., London, Ontario, Canada
| | - Mahmoud Mosli
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Reetesh K Pai
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mark A Valasek
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | | | - Larry W Stitt
- Robarts Clinical Trials Inc., London, Ontario, Canada
| | | | - Reena Khanna
- Robarts Clinical Trials Inc., London, Ontario, Canada
| | | | | | | | | | - Rish K Pai
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona, USA
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Dudez O, Dalstein V, Kanagaratnam L, Nasri S, Coquelet C, Fichel C, Bouland N, Lemaire E, Diebold MD, Marchal-Bressenot A, Boulagnon-Rombi C. Is the Mirror Image Method Really Useful in Tumor Tissue Bank Quality Control? Biopreserv Biobank 2019; 17:539-545. [PMID: 31233333 DOI: 10.1089/bio.2018.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Oncology research projects are highly dependent on the quality of tumor samples stored in the biobank. Microscopic control is important to ensure the quality of the frozen sample (Does the sample correspond to tumor tissue? Does the sample contain a sufficient number of tumor cells for molecular analysis?). The aim of this study was to evaluate the value of the mirror image method in quality control of colonic adenocarcinoma samples stored in a tumor bank. Microscopic concordance for the differentiation grade, malignant and normal cell percentages, necrosis, mucinous component, and ulceration was assessed on 82 colon adenocarcinoma banked samples and their paired, formalin-fixed, paraffin-embedded mirror controls. Molecular concordance for KRAS status was evaluated in 76 of these 82 cases. Morphological correspondence between frozen and mirror samples was good for the mucinous component (intraclass correlation coefficient [ICC] = 0.81), moderate for differentiation (Cohen's kappa coefficient [k] = 0.67), fair for malignant cells (ICC = 0.44), and poor for ulceration (k = 0.08), normal tissue (ICC = 0.36), and necrosis (ICC = 0.13) percentages. Molecular correspondence for KRAS status was almost perfect (95% correspondence, k = 0.88) between frozen and mirror samples. In conclusion, the mirror sample method is not a good alternative for microscopic and molecular control of frozen colonic adenocarcinoma samples.
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Affiliation(s)
- Oriane Dudez
- Pathology Department, Academic Hospital, Reims, France
| | - Véronique Dalstein
- Pathology Department, Academic Hospital, Reims, France.,Champagne Ardenne Cancers' Molecular Genetic Platform, Reims, France.,Inserm UMR-S 903, Université de Reims Champagne Ardenne, Reims, France
| | | | - Saviz Nasri
- Champagne Ardenne Biobank, Academic Hospital, Reims, France
| | | | | | - Nicole Bouland
- Pathology Department, Medicine University, Reims, France
| | - Emeric Lemaire
- Pathology Department, Academic Hospital, Reims, France.,Inserm UMR-S 903, Université de Reims Champagne Ardenne, Reims, France
| | - Marie-Danièle Diebold
- Pathology Department, Academic Hospital, Reims, France.,Champagne Ardenne Biobank, Academic Hospital, Reims, France.,Pathology Department, Medicine University, Reims, France
| | - Aude Marchal-Bressenot
- Pathology Department, Academic Hospital, Reims, France.,Pathology Department, Medicine University, Reims, France
| | - Camille Boulagnon-Rombi
- Pathology Department, Academic Hospital, Reims, France.,Pathology Department, Medicine University, Reims, France.,UMR CNRS 7369, Reims University, Reims, France
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Marchal-Bressenot A, Salleron J, Boulagnon-Rombi C, Bastien C, Cahn V, Cadiot G, Diebold MD, Danese S, Reinisch W, Schreiber S, Travis S, Peyrin-Biroulet L. Development and validation of the Nancy histological index for UC. Gut 2017; 66:43-49. [PMID: 26464414 DOI: 10.1136/gutjnl-2015-310187] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/31/2015] [Accepted: 09/22/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We developed a validated index for assessing histological disease activity in UC and established its responsiveness. METHODS Two hundred biopsies were scored. The outcome was the Global Visual Evaluation (GVE). Eight histological features were tested. The Nancy index was developed by multiple linear regression and bootstrap process to create an index that best matched the GVE. Goodness of fit was assessed by the adjusted R squared (adjusted R2). The second step was the validation of the index: 100 biopsies were scored for the Nancy index by three pathologists from different centres. Inter-reader reliability was evaluated for each reader. The relationship between the change of the Nancy index and the Geboes index was assessed to assess the responsiveness. RESULTS After backward selection with bootstrap validation, 3/8 items were selected: ulceration (adjusted R2=0.55), acute inflammatory infiltrate (adjusted R2=0.88) and chronic inflammatory infiltrate (adjusted R2=0.79). The Nancy index is defined by a 5-level classification ranging from grade 0 (absence of significant histological disease activity) to grade 4 (severely active disease). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.88 (95% CI 0.82 to 0.92) and the index had good inter-reader reliability (ICC=0.86 (0.81 to 0.99)). The correlation between the Nancy index and the Geboes score or the GVE was very good. The index had a good responsiveness with a high correlation between changes in the Geboes score and changes in the Nancy index (0.910 (0.813 to 0.955)). CONCLUSIONS A three descriptor histological index has been validated for use in clinical practice and clinical trials.
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Affiliation(s)
- Aude Marchal-Bressenot
- Department of Pathology, University of Reims et Champagne-Ardenne, Reims, France.,Inserm U954, Genetic Nutrition and Exposure to Environmental Risks (NGERE), University of Lorraine, Vandoeuvre- lès-Nancy, France
| | - Julia Salleron
- Department of Biostatistics, Institute de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | | | - Claire Bastien
- Department of Pathology, University Hospital of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Virginie Cahn
- Department of Pathology, Centre Hospitalier Sud Francilien, Corbeil Essonnes, France
| | - Guillaume Cadiot
- Department of Hepato-Gastroenterology, University Hospital of Reims et Champagne-Ardenne, Reims, France
| | | | - Silvio Danese
- Humanitas Clinical and Research Center and Humanitas University, Rozzano, Milan,Italy
| | - Walter Reinisch
- Department of Gastroenterology, IBD Center, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Stefan Schreiber
- Department Medicine I, University-Hospital Schleswig-Holstein, Kiel, Germany
| | - Simon Travis
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK
| | - Laurent Peyrin-Biroulet
- Inserm U954, Genetic Nutrition and Exposure to Environmental Risks (NGERE), University of Lorraine, Vandoeuvre- lès-Nancy, France.,Department of Hepato-Gastroenterology, University Hospital of Lorraine, Vandoeuvre-lès-Nancy, France
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Bison A, Marchal-Bressenot A, Li Z, Elamouri I, Feigerlova E, Peng L, Houlgatte R, Beck B, Pourié G, Alberto JM, Umoret R, Conroy G, Bronowicki JP, Guéant JL, Guéant-Rodriguez RM. Foetal programming by methyl donor deficiency produces steato-hepatitis in rats exposed to high fat diet. Sci Rep 2016; 6:37207. [PMID: 27853271 PMCID: PMC5112564 DOI: 10.1038/srep37207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 03/09/2016] [Accepted: 10/13/2016] [Indexed: 01/04/2023] Open
Abstract
Non-alcoholic steatohepatitis (NASH) is a manifestation of metabolic syndrome, which emerges as a major public health problem. Deficiency in methyl donors (folate and vitamin B12) during gestation and lactation is frequent in humans and produces foetal programming effects of metabolic syndrome, with small birth weight and liver steatosis at day 21 (d21), in rat pups. We investigated the effects of fetal programming on liver of rats born from deficient mothers (iMDD) and subsequently subjected to normal diet after d21 and high fat diet (HF) after d50. We observed increased abdominal fat, ASAT/ALAT ratio and angiotensin blood level, but no histological liver abnormality in d50 iMDD rats. In contrast, d185 iMDD/HF animals had hallmarks of steato-hepatitis, with increased markers of inflammation and fibrosis (caspase1, cleaved IL-1β, α1(I) and α2(I) collagens and α-SMA), insulin resistance (HOMA-IR and Glut 2) and expression of genes involved in stellate cell stimulation and remodelling and key genes triggering NASH pathomechanisms (transforming growth factor beta super family, angiotensin and angiotensin receptor type 1). Our data showed a foetal programming effect of MDD on liver inflammation and fibrosis, which suggests investigating whether MDD during pregnancy is a risk factor of NASH in populations subsequently exposed to HF diet.
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Affiliation(s)
- Anaïs Bison
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Aude Marchal-Bressenot
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Zhen Li
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Ilef Elamouri
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Eva Feigerlova
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Lu Peng
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Remi Houlgatte
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Bernard Beck
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Gregory Pourié
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Marc Alberto
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Remy Umoret
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Guillaume Conroy
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Pierre Bronowicki
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Louis Guéant
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Rosa-Maria Guéant-Rodriguez
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
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5
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Marchal-Bressenot A, Scherl A, Salleron J, Peyrin-Biroulet L. A practical guide to assess the Nancy histological index for UC. Gut 2016; 65:1919-1920. [PMID: 27566129 PMCID: PMC5099187 DOI: 10.1136/gutjnl-2016-312722] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/04/2016] [Accepted: 08/07/2016] [Indexed: 02/07/2023]
Affiliation(s)
| | - Alexis Scherl
- Department of Pathology, Genentech, Inc, South San Francisco, California, USA
| | - Julia Salleron
- Department of biostatistics, Institute de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Laurent Peyrin-Biroulet
- Inserm U954, University of Lorraine, Vandoeuvre-lès-Nancy, France,Department of Hepato-Gastroenterology, Nancy University of Hospital, Vandoeuvre-lès-Nancy, France
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