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Qureshi M, Thapa B, Muruganandan S. A Narrative Review-Management of Malignant Pleural Effusion Related to Malignant Pleural Mesothelioma. Heart Lung Circ 2023; 32:587-595. [PMID: 36925448 DOI: 10.1016/j.hlc.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 03/17/2023]
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive, almost universally fatal cancer with limited therapeutic options. Despite efforts, a real breakthrough in treatment and outcomes has been elusive. Pleural effusion with significant breathlessness and pain is the most typical presentation of individuals with MPM. Although thoracentesis provides relief of breathlessness, most such pleural effusions recur rapidly, and a definitive procedure is often required to prevent a recurrence. Unfortunately, the optimal treatment modality for individuals with recurrent MPM-related effusion is unclear, and considerable variation exists in practice. In addition, non-expandable lung is common in pleural effusions due to MPM and makes effective palliation of symptoms more difficult. This review delves into the latest advances in the available management options (both surgical and non-surgical) for dealing with pleural effusion and non-expandable lung related to MPM. We discuss factors that determine the choice of definitive procedures that need to be tailored to the individual patient.
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Affiliation(s)
- Maryum Qureshi
- Department of Thoracic Surgery, Northern Hospital, Melbourne, Vic, Australia.
| | - Bibhusal Thapa
- Department of Thoracic Surgery, Northern Hospital, Melbourne, Vic, Australia
| | - Sanjeevan Muruganandan
- Department of Respiratory Medicine, Northern Hospital, Melbourne, Vic, Australia; School of Medicine, Health Sciences, Dentistry, University of Melbourne, Vic, Australia
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2
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Thapa B, Wolter PT, Sturtevant BR, Foster JR, Townsend PA. Linking frass and insect phenology to optimize annual forest defoliation estimation. MethodsX 2023; 10:102075. [PMID: 36875342 PMCID: PMC9978851 DOI: 10.1016/j.mex.2023.102075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
It is often logistically impractical to measure forest defoliation events in the field due to seasonal variability in larval feeding phenology (e.g., start, peak, and end) in any given year. As such, field data collections are either incomplete or at coarse temporal resolutions, both of which result in inaccurate estimation of annual defoliation (frass or foliage loss). Using Choristoneura pinus F. and Lymantria dispar dispar L., we present a novel approach that leverages a weather-driven insect simulation model (BioSIM) and defoliation field data. Our approach includes optimization of a weighting parameter (w) for each instar and imputation of defoliation. Results show a negative skew in this weighting parameter, where the second to last instar in a season exhibits the maximum consumption and provides better estimates of annual frass and foliage biomass loss where sampling data gaps exist. Respective cross-validation RMSE (and normalized RMSE) results for C. pinus and L. dispar dispar are 77.53 kg·ha-1 (0.16) and 38.24 kg·ha-1 (0.02) for frass and 74.85 kg·ha-1 (0.10) and 47.77 kg·ha-1 (0.02) for foliage biomass loss imputation. Our method provides better estimates for ecosystem studies that leverage remote sensing data to scale defoliation rates from the field to broader landscapes and regions.•Utilize fine temporal resolution insect life cycle data derived from weather-driven insect simulation model (BioSIM) to bridge critical gaps in coarse temporal resolution defoliation field data.•Fitting distributions to optimize the instar weighting parameter (w) and impute frass and foliage biomass loss based on a cumulative density function (CDF).•Enables accurate estimation of annual defoliation impacts on ecosystems across multiple insect taxa that exhibit distinct but seasonally variable feeding phenology.
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Affiliation(s)
- B Thapa
- Department of Natural Resource Ecology & Management, Iowa State University, Ames, IA 50011, USA
| | - P T Wolter
- Department of Natural Resource Ecology & Management, Iowa State University, Ames, IA 50011, USA
| | - B R Sturtevant
- Institute for Applied Ecosystem Studies, Northern Research Station, USDA Forest Service, Rhinelander, WI 54501, USA
| | - J R Foster
- Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, VT 05405, USA
| | - P A Townsend
- Department of Forest and Wildlife Ecology, University of Wisconsin-Madison, 1630 Linden Drive, Madison, WI 53706, USA
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Biermann O, Wingfield T, Thapa B, Babajide O, Zeinali Z, Torres I, Abdalla SM, Galea S. Use of big data on the social determinants of TB to find the "missing millions". Int J Tuberc Lung Dis 2022; 26:1194-1196. [PMID: 36447326 PMCID: PMC9728948 DOI: 10.5588/ijtld.22.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/09/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- O Biermann
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - T Wingfield
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden, Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - B Thapa
- Department of Health Services, Policy and Practice, Brown University, Providence, RI, USA
| | - O Babajide
- Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
| | - Z Zeinali
- Rockefeller Foundation, Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, MA, USA
| | - I Torres
- Fundación Octaedro, Quito, Ecuador
| | - S M Abdalla
- Boston University School of Public Health, Boston, MA, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
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Qureshi M, Thapa B, Kok HK, Burrows DA. Intralobar lung sequestration: a collaborative approach to an uncommon problem. ANZ J Surg 2022; 93:1090-1092. [PMID: 36300691 DOI: 10.1111/ans.18121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/19/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Maryum Qureshi
- Department of Thoracic Surgery Northern Hospital Epping Victoria Australia
| | - Bibhusal Thapa
- Department of Thoracic Surgery Northern Hospital Epping Victoria Australia
| | - Hong Kuan Kok
- Department of Radiology Northern Hospital Epping Victoria Australia
| | - David A. Burrows
- Department of Radiology Northern Hospital Epping Victoria Australia
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Abstract
The burden of respiratory and upper-gastrointestinal diseases especially affects low- and middle-income countries. Five billion people lack access to safe, timely, and affordable surgical care, including thoracic surgical care. Minimally invasive thoracic surgery (MITS) has been shown to reduce complications, shorten hospital lengths of stay, and minimize health care costs, thereby enabling patients to pay less out-of-pocket and/or limit time away from work and families. Experiences with MITS exist but are limited in low- and middle-income countries; professional societies, academic institutions, policymakers, and industry can facilitate scale-up of MITS by increasing financing, expanding surgical training, and optimizing surgical supply chains.
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Affiliation(s)
- Yihan Lin
- Division of Cardiothoracic Surgery, C-31012631 E. 17th Avenue, Aurora, CO 80045, USA
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Bibhusal Thapa
- Thoracic Surgery Unit, Division of Surgery, Northern Health, Epping, Victoria, Australia
| | - Ranjan Sapkota
- Department of Cardio-Thoracic and Vascular Surgery, Manmohan Cardio-Thoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal
| | - John D Mitchell
- Division of Cardiothoracic Surgery, C-31012631 E. 17th Avenue, Aurora, CO 80045, USA.
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Jha N, Thapa B, Pathak SB, Pandey A, Pokhrel S, Shankar PR, Bhandary S, Mudvari A, Dangal G. A Point Prevalence Study of the Use of Antibiotics in Six Tertiary Care Hospitals in the Kathmandu Valley, Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:351-358. [PMID: 37042379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Point prevalence survey (PPS) on antibiotic use developed by the WHO has already been used in many hospitals globally. Objective To obtain information on antibiotic prescribtion using point prevalence survey methodology in six private hospitals in the Kathmandu valley. Method This descriptive cross-sectional study was completed during 20th July to 28th July 2021 using point prevalence survey methodology. The study was conducted among inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data was presented as frequencies and percentages. Result Maximum number of patients were above 60 years [34 (18.7%)]. Number of male and female participants were equal [91 (50%)]. Only one antibiotic was used in 81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum, and wound swabs were the common samples for culture. Cultures were positive for 17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic. Drug and therapeutics, infection control committee and pharmacovigilance activities were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6 (50%) and microbiological services was present in all hospitals. Antibiotic formulary and antibiotic guideline were present in 4/6 sites and facilities to audit or review surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%) study sites. Conclusion Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the commonly isolated organisms. Not all parameters for infrastructure, policy and practice and monitoring and feedback were present at the study sites. KEY WORDS.
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Affiliation(s)
- N Jha
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - B Thapa
- Department of Emergency Medicine, Kirtipur Hospital, Kirtipur, Nepal
| | - S B Pathak
- Department of Intensive Care Unit and Critical care, Nepal Mediciti Hospital, Sainbu, Bhaisepati, Nepal
| | - A Pandey
- Department of General Surgery, Madhyapur Hospital, Bhaktapur, Nepal
| | - S Pokhrel
- Department of Emergency Medicine, Nidan Hospital, Lalitpur, Pulchowk, Nepal
| | - P R Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - S Bhandary
- Department of Community Health Sciences and School of Public Health, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal
| | - A Mudvari
- Department of Clinical Pharmacology, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - G Dangal
- Kathmandu Model Hospital, Kathmandu, Nepal
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Thapa B, Sharma S, Shrestha A, Maharjan R, Jha N, Bajracharya S, Shrestha S, Neupane T, Sapkota BP, Koju RP, Oli N. Human Resources for Cardiovascular Disease Management in Nepal: A National Need Assessment. Kathmandu Univ Med J (KUMJ) 2022; 19:3-10. [PMID: 35526131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background Human resources are the mainstay of the healthcare system. Higher numbers of health workers have better healthcare coverage and outcomes. Availability of trained human resources to address the exponential rise in cardiovascular disease in Nepal is a national concern. Objective To assess the need of human resources for cardiovascular disease management in Nepal. Method We conducted an exploratory sequential mixed-method study. We developed a task force and organized a national workshop to engage stakeholders and collect feedback on the research process. We did a desk review and conducted 24 key informant interviews. We did thematic analysis from the codes generated. Result There is no clear definition and required estimation of health workers for cardiovascular disease management. There is a shortage of health workers with 8.9 doctors, 20.8 nurses, 0.05 cardiologist/cardiac surgeon, 4.2 pharmacist, 10.2 laboratory technicians per 10,000 population. There is a comprehensive human resource plan but it does not provide details of human resources for cardiovascular disease management. There is a lack of public private collaboration for human resource management. However, there is production of human resources for cardiovascular disease management through pre-service specialized courses and inservice training. Conclusion A clear definition and estimation of health workers with stringent human resource plan for cardiovascular disease management is essential. The government can still address these gaps by establishing a well-equipped central health workforce unit and expanding collaboration with private sectors.
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Affiliation(s)
- B Thapa
- Department of Nursing, Tribhuvan University, Institute of Medicine, Nepalgunj Nursing Campus, Banke, Nepal. and Fellow, TREIN Nepal, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Sharma
- Fellow, TREIN Nepal, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. Department of Nursing, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal. and Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - A Shrestha
- Department of Public Health and Community Programs, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA. and Institute for Implementation Science and Health, Kathmandu, Nepal
| | - R Maharjan
- Fellow, TREIN Nepal, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. and Department of Nursing and Midwifery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. Kathmandu, Nepal
| | - N Jha
- Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Bajracharya
- Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Shrestha
- Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - T Neupane
- Nepal Health Research Council, Kathmandu, Nepal
| | - B P Sapkota
- Health Coordination Division, Ministry of Health and Population, Kathmandu Nepal. and CIH-LMU Center for International Health, University Hospital, LMU Munich, Germany
| | - R P Koju
- Dean, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre. and Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre
| | - N Oli
- Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
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Gupta K, Thapa B, Gupta S, Sharma S. Lung Function Tests in Hairdressers of Gangtok: A Cross-Sectional Study. Indian J Occup Environ Med 2022; 26:91-94. [PMID: 35991197 PMCID: PMC9384880 DOI: 10.4103/ijoem.ijoem_264_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 01/09/2023] Open
Abstract
Background Hairdressers undergo extensive and prolonged exposure to a variety of chemical substances present in the air in their salons. Although in low concentrations, the various products used for hair care are harmful as most of these products generate chemical aerosols during different procedures. These aerosols which have irritant or sensitizing effects on respiratory mucosa have been found to enter into the airways. Aim The aim of this study is to assess the impairment of lung function in hairdressers in Gangtok. Method This is a cross-sectional, comparative study conducted on 50 hairdressers and 50 age- and sex-matched non-hairdresser comparison group. The sampling technique used was simple random sampling. Permission from Institutional Ethical Committee was obtained before beginning the study. A standard questionnaire was used to record the respiratory symptoms. The pulmonary function parameters of the subjects were measured using portable spirometer HELIOS 720. Results All the parameters were decreased in hairdressers and almost all the differences were statistically significant. FEV1 (P = 0.023) and FEV1/FVC ratio (P < 0.05) were reduced significantly. FEF25-75% and PEFR were also significantly reduced (P < 0.05 in both parameters). FVC was also reduced in hairdressers, but it was not statistically significant (P = 0.342). Conclusion Hairdressers undergo exposure to different chemicals in their workplace and carry the risk of decreased pulmonary function.
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Affiliation(s)
- K. Gupta
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
| | - B. Thapa
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India,Address for correspondence: Dr. B. Thapa, Department of Physiology, Sikkim Manipal Institute of Medical Sciences, 5th Mile, Tadong, Gangtok, Sikkim, India. E-mail:
| | - S. Gupta
- Sikkim Manipal College of Physiotherapy, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
| | - S. Sharma
- Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India
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Vaidya N, Sapkota P, Chaurasia S, Thapa B, Bhandari N, Bhattarai I. Diagnostic Accuracy of Drop Hydrogen Peroxide Test as a Novel Bedside Diagnostic Test to Differentiate Transudative and Exudative Pleural Effusion Against Light's Criteria. Kathmandu Univ Med J (KUMJ) 2022; 20:93-96. [PMID: 36273299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Diagnostic evaluation of pleural fluid according to Light's criteria to differentiate between exudative and transudative fluid takes 1 or 2 working days. For rapid clinical management, especially in critically ill patients, a simpler bedside diagnostic test can be done which has similar diagnostic accuracy as that of Light's Criteria. Objective To determine the diagnostic accuracy of Drop Hydrogen Peroxide test to differentiate exudative and transudative pleural effusion in comparison to Light's criteria. Method A concurrent validity test was performed using a convenient sampling technique including patients presenting to the Department of Internal Medicine from January to September 2021, who had pleural effusion. Two milliliters of tapped pleural fluid of patients who underwent aseptic thoracocentesis was collected in a test tube to which one to two drops of 20% hydrogen peroxide was added. Presence of bubbles suggested an exudative type of fluid. Rest of the tapped pleural fluid was sent to the laboratory for further evaluation by Light's criteria, which was compared with the results by Drop Hydrogen Peroxide Test. Result There were 83 patients who had pleural effusion, of them a total of 43 patients had transudative pleural effusion while 40 patients had exudative pleural effusion based on Light's criteria and 37 patients had transudative pleural effusion while 46 patients had exudative pleural effusion based on drop hydrogen peroxide test. Conclusion The drop hydrogen peroxide test allows cost effective and prompt evaluation of the type of pleural effusion is exudative or transudative, thereby making it a convenient diagnostic bedside test.
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Affiliation(s)
- N Vaidya
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - P Sapkota
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Chaurasia
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Thapa
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - N Bhandari
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - I Bhattarai
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Joshi H, Ram M, Limbu N, Rai DP, Thapa B, Labar K, Laref A, Thapa RK, Shankar A. Author Correction: Modulation of optical absorption in m-Fe 1-xRu xS 2 and exploring stability in new m-RuS 2. Sci Rep 2021; 11:16022. [PMID: 34341477 PMCID: PMC8329053 DOI: 10.1038/s41598-021-95557-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- H Joshi
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India. .,Department of Physics, St. Josephs College, North Point, Darjeeling, 734103, India.
| | - M Ram
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - N Limbu
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - D P Rai
- Physical Science Research Centre, Pachhunga University College, Aizawl, Mizoram, 796001, India
| | - B Thapa
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - K Labar
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - A Laref
- Physics Department, Faculty of Science, King Saudi University, Riyad, Saudi Arabia
| | - R K Thapa
- Department of Physics, Mizoram University, Aizawl, 796009, India
| | - A Shankar
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India.
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Khadka P, Thapa B, Sapkota R, Sharma A, Sayami P. An Audit of the Outcomes of Thymic Surgery. J Coll Physicians Surg Pak 2021; 31:602-604. [PMID: 34027880 DOI: 10.29271/jcpsp.2021.05.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/28/2020] [Indexed: 11/11/2022]
Abstract
Most pathology of the thymus gland warrant its surgical removal; and this requires significant expertise and adequate medical set-up. This study aimed to audit the results of thymectomies performed in a specialised tertiary level centre in a resource-poor country. The outcomes of open and minimally invasive video-assisted thoracoscopic surgery (VATS) thymectomies were also compared. Out of 58 patients operated at Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal between October 2012 and January 2019, 33 patients underwent open thymectomy and 25 had VATS thymectomy. We conducted a retrospective search to look at operative time, blood loss and length of postoperative hospitalisation. The open surgery group was followed for an average of 32 months, and the VATS cohort for 38 months. No significant differences were found in mean operative times and overall survival between groups. In selected cases, thymectomy via VATS is safer and comparable to open thymectomy in terms of operative safety and oncological completeness. Key Words: Thymus, VATS, Thymectomy, Outcome.
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Affiliation(s)
- Pralaya Khadka
- Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
| | - Bibhusal Thapa
- Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
| | - Ranjan Sapkota
- Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
| | - Aakriti Sharma
- Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
| | - Prakash Sayami
- Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
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12
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Joshi H, Ram M, Limbu N, Rai DP, Thapa B, Labar K, Laref A, Thapa RK, Shankar A. Modulation of optical absorption in m-Fe 1-xRu xS 2 and exploring stability in new m-RuS 2. Sci Rep 2021; 11:6601. [PMID: 33758358 PMCID: PMC7987963 DOI: 10.1038/s41598-021-86181-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 03/08/2021] [Indexed: 12/03/2022] Open
Abstract
A first-principle computational method has been used to investigate the effects of Ru dopants on the electronic and optical absorption properties of marcasite FeS2. In addition, we have also revealed a new marcasite phase in RuS2, unlike most studied pyrite structures. The new phase has fulfilled all the necessary criteria of structural stability and its practical existence. The transition pressure of 8 GPa drives the structural change from pyrite to orthorhombic phase in RuS2. From the thermodynamical calculation, we have reported the stability of new-phase under various ranges of applied pressure and temperature. Further, from the results of phonon dispersion calculated at Zero Point Energy, pyrite structure exhibits ground state stability and the marcasite phase has all modes of frequencies positive. The newly proposed phase is a semiconductor with a band gap comparable to its pyrite counterpart but vary in optical absorption by around 106 cm-1. The various Ru doped structures have also shown similar optical absorption spectra in the same order of magnitude. We have used crystal field theory to explain high optical absorption which is due to the involvement of different electronic states in formation of electronic and optical band gaps. Lӧwdin charge analysis is used over the customarily Mulliken charges to predict 89% of covalence in the compound. Our results indicate the importance of new phase to enhance the efficiency of photovoltaic materials for practical applications.
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Affiliation(s)
- H Joshi
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India.
- Department of Physics, St. Josephs College, North Point, Darjeeling, 734103, India.
| | - M Ram
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - N Limbu
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - D P Rai
- Physical Science Research Centre, Pachhunga University College, Aizawl, Mizoram, 796001, India
| | - B Thapa
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - K Labar
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India
| | - A Laref
- Physics Department, Faculty of Science, King Saudi University, Riyad, Saudi Arabia
| | - R K Thapa
- Department of Physics, Mizoram University, Aizawl, 796009, India
| | - A Shankar
- Condensed Matter Theory Research Lab, Kurseong College, Darjeeling, 734203, India.
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Thapa B, Patra P, Puri S, Neupane K, Shankar A. Tailoring energy band gap and optical absorption of Cd doped MnTe2. Chem Phys 2021. [DOI: 10.1016/j.chemphys.2020.111059] [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: 11/27/2022]
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14
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Chia PL, Parakh S, Russell P, Gan HK, Asadi K, Gebski V, Murone C, Walkiewicz M, Liu Z, Thapa B, Scott FE, Scott AM, John T. Expression of EGFR and conformational forms of EGFR in malignant pleural mesothelioma and its impact on survival. Lung Cancer 2020; 153:35-41. [PMID: 33453471 DOI: 10.1016/j.lungcan.2020.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 01/24/2023]
Abstract
AIM Conformational forms of the epidermal growth factor receptor (EGFR) are pro-tumorigenic. The prevalence and impact of conformational forms of EGFR in malignant mesothelioma (MM) is unknown. We investigated expression of EGFR and conformational forms of EGFR by immunohistochemistry using EGFR-targeting monoclonal antibodies (mAb). In addition, EGFR gene amplification was investigated by fluorescent in-situ hybridization (FISH). Findings were correlated with survival. METHODS Patients treated between 1988 and 2014 were identified from the thoracic surgery database of the Austin Hospital, Melbourne, Australia. Tissue microarrays (TMAs) were constructed, subjected to wild type (wt) EGFR IHC staining and FISH analysis. Conformational and mutation forms of EGFR were detected by IHC using mAb806, and LMH-151 which detects EGFRVIII. `H-scores` were derived and EGFR expression correlated with survival by Kaplan-Meier and log rank analysis. RESULTS WtEGFR expression was seen in 93 % (299/321) of cases with overexpression (defined as an H-score ≥200) seen in more than half of cases (64 %). EGFR overexpression in MM was seen more commonly in the epithelioid subtype. EGFR overexpression was not associated with true EGFR amplification, although multiple copies were appreciated in samples with polysomy. EGFR expression did not correlate with survival. A conformational form of EGFR associated with EGFR dysregulation was found in 8.2 % of cases, and patients with these tumors had a trend towards a poorer outcome. No cases of the EGFRVIII mutation were identified. CONCLUSION MM consistently demonstrated high expression of EGFR, with a subset of tumors showing conformational EGFR forms consistent with EGFR dysregulation, but withoutEGFR amplification or EGFR VIII mutation. wtEGFR expression did not influence survival. The impact of EGFR conformation on survival warrants further investigation.
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Affiliation(s)
- Puey Ling Chia
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Sagun Parakh
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Prudence Russell
- Faculty of Medicine, University of Melbourne, Melbourne, Australia; Department of Pathology, St Vincent's, Melbourne, Australia
| | - Hui K Gan
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Khashayer Asadi
- Department of Pathology, Austin Health, Melbourne, Australia
| | - Val Gebski
- NHMRC Clinical Trials Centre, Sydney, Australia
| | - Carmel Murone
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia
| | | | - Zhanqi Liu
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Bibhusal Thapa
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia
| | - Fiona E Scott
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Andrew M Scott
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia; Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.
| | - Thomas John
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
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15
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Arulananda S, O'Brien M, Evangelista M, Harris TJ, Steinohrt NS, Jenkins LJ, Walkiewicz M, O'Donoghue RJJ, Poh AR, Thapa B, Williams DS, Leong T, Mariadason JM, Li X, Cebon J, Lee EF, John T, Fairlie WD. BCL-XL is an actionable target for treatment of malignant pleural mesothelioma. Cell Death Discov 2020; 6:114. [PMID: 33298868 PMCID: PMC7603509 DOI: 10.1038/s41420-020-00348-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/23/2020] [Accepted: 09/20/2020] [Indexed: 12/29/2022] Open
Abstract
Despite having one of the lowest survival rates of all cancers, there have been no new approved treatments for malignant pleural mesothelioma (MPM) in over a decade. Standard-of-care treatment relies on Cisplatin plus Pemetrexed chemotherapy. Here, we tested a suite of BH3-mimetic drugs targeting BCL-2 pro-survival proteins of the intrinsic apoptotic pathway. We found BCL-XL is the dominant pro-survival protein in a panel of cell lines in vitro, though potent, synergistic cell killing occurred with MCL-1 co-targeting. This correlates with high-level expression of BCL-XL and MCL-1 in cell lines and a large cohort of patient tumour samples. BCL-XL inhibition combined with Cisplatin also enhanced cell killing. In vivo BCL-XL inhibition was as effective as Cisplatin, and the combination enhanced tumour growth control and survival. Genetic ablation of MCL-1 also enhanced the effects of BCL-XL inhibitors, in vivo. Combined, these data provide a compelling rationale for the clinical investigation of BH3-mimetics targeting BCL-XL in MPM.
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Affiliation(s)
- Surein Arulananda
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - Megan O'Brien
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Marco Evangelista
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Tiffany J Harris
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Nikita S Steinohrt
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Laura J Jenkins
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Marzena Walkiewicz
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Robert J J O'Donoghue
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, VIC, Australia
| | - Ashleigh R Poh
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - David S Williams
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.,Department of Pathology, Austin Health, Heidelberg, VIC, Australia
| | - Trishe Leong
- Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.,Department of Pathology, Austin Health, Heidelberg, VIC, Australia
| | - John M Mariadason
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Bundoora, VIC, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - Erinna F Lee
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia.
| | - Thomas John
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia. .,Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - W D Fairlie
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia.
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16
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Chia PL, Russell P, Asadi K, Thapa B, Gebski V, Murone C, Walkiewicz M, Eriksson U, Scott AM, John T. Analysis of angiogenic and stromal biomarkers in a large malignant mesothelioma cohort. Lung Cancer 2020; 150:1-8. [PMID: 33035778 DOI: 10.1016/j.lungcan.2020.09.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/08/2020] [Revised: 09/04/2020] [Accepted: 09/25/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Malignant mesothelioma (MM) is an aggressive malignancy of the pleura and other mesothelial membranes. Agents targeting vascular endothelial growth factor (VEGF) such as bevacizumab; and multi-kinase inhibitors such as nintedanib [angiokinase inhibitor of VEGF, platelet-derived growth factor (PDGF) receptor and fibroblast growth factor receptor (FGFR)] have recently demonstrated efficacy in MM. METHODS Tissue microarrays (TMAs) were created from formalin-fixed, paraffin-embedded tissue samples obtained from 326 patients with MM who were treated surgically. PDGF-CC, FGFR-1, VEGF and CD31 expression were analysed by immunohistochemical (IHC) staining. The H-score method assigned a score of 0-300 to each sample, based on the percentage of cells stained at different intensities. CD31 was evaluated via Chalkley's method to evaluate microvessel density. We evaluated the association between expression of the biomarkers, clinicopathological factors and outcomes, in patients with MM. RESULTS CD31 high (≥5) was seen in only 31/302 (10.3%) irrespective of histology. PDGF-CC high (≥150) was seen in 203 /310 (65%) of all samples. VEGF high (≥80) was seen in 219/322 (68%) of all MM with 143/209 (68%) of epithelioid histology. FGFR-1 high (≥40) was seen in 127/310 (41%) of all MM. There was no association of VEGF and FGFR-1 IHC with survival nor differences between histological subtypes. There was a non-significant trend towards poorer survival in epithelioid tumours with increased PDGF-CC expression (OS 18.5 vs 13.2 months; HR 0.7928; 95% CI 0.5958 to 1.055, P = 0.1110). High CD31 score was associated with significantly poorer survival (OS 12 vs 8.6 months; HR 0.48; 95% CI 0.2873 to 0.7941, P = 0.0044). Of the 31 patients with high CD31 scores; 23/31 (74%) were also high for PDGF-CC and 20/31 (64%) with high VEGF scores. CD31 was found to be an independent prognostic factor in multivariate analysis (HR 1.540; 95% CI 1.018 to 2.330; p = 0.041). CONCLUSIONS High CD31 was an independent poor prognostic factor and high PDGF-CC expression was associated with poor survival in MM. Abrogating these pathways may have prognostic implications.
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Affiliation(s)
- Puey Ling Chia
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia.
| | - Prudence Russell
- Department of Pathology, St Vincent's Hospital, Melbourne, Australia
| | - Khashi Asadi
- Department of Pathology, Austin Hospital, Melbourne, Australia
| | - Bibhusal Thapa
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Val Gebski
- Australia National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Carmel Murone
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia
| | | | - Ulf Eriksson
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Andrew M Scott
- Olivia-Newton John Cancer Research Institute, Melbourne, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia; Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - Thomas John
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia-Newton John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Australia
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17
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Leal JL, Peters G, Szaumkessel M, Leong T, Asadi K, Rivalland G, Do H, Senko C, Mitchell PL, Quing CZ, Dobrovic A, Thapa B, John T. NTRK and ALK rearrangements in malignant pleural mesothelioma, pulmonary neuroendocrine tumours and non-small cell lung cancer. Lung Cancer 2020; 146:154-159. [PMID: 32540558 DOI: 10.1016/j.lungcan.2020.05.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Gene rearrangements involving NTRK1, NTRK2, NTRK3, ROS1 and ALK have been identified in many types of cancer, including non-small cell lung cancer (NSCLC). Data in malignant pleural mesothelioma (MPM), lung neuroendocrine tumors (NETs) and small-cell lung cancer (SCLC) are lacking. Given the activity of NTRK, ROS-1 and ALK inhibitors in tumors harboring gene fusions, we sought to explore such rearrangements in these less common tumors in addition to NSCLC. METHODS Archival tumor tissue from patients with MPM, lung NETs, SCLC and NSCLC were used to create tissue microarrays. Immunohistochemistry (IHC) was performed using a cocktail of antibodies against TRK, ROS1 and ALK. IHC positive samples underwent RNA sequencing using the ArcherDX FusionPlex CTL diagnostic assay. Clinical data were obtained through retrospective chart review. RESULTS We performed IHC on 1116 samples: 335 MPMs, 522 NSCLCs, 105 SCLCs and 154 lung NETs. There were 23 IHC positive cases (2.1%) including eight MPMs (2.4%), eight NETs (5.2%), five SCLC (4.8%) and two NSCLC (0.4%). The following fusions were detected: one MPM with an NTRK ex10-TPM3 ex8, another MPM with an ALK ex20-EML4ex13, one lung intermediate-grade NET (atypical carcinoid) with an ALK ex20-EML4 ex6/intron6, and two NSCLCs with an ALK ex20-EML4 ex6/intron6 rearrangement. None of the patients received targeted treatment. CONCLUSIONS To our knowledge, we report for the first time NTRK and ALK rearrangements in a small subset of MPM. An ALK rearrangement was also detected in lung intermediate-grade NET (or atypical carcinoid). Our data suggest that IHC could be a useful screening test in such patients to ensure that all therapeutic strategies including targeted therapy are utilized.
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Affiliation(s)
- Jose Luis Leal
- Department of Medical Oncology, Austin Health, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Geoffrey Peters
- ANU Medical School, Australian National University, Australian Capital Territory, Australia; Department of Medical Oncology, The Canberra Hospital, Australian Capital Territory, Australia
| | - Marcin Szaumkessel
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
| | - Trishe Leong
- Department of Anatomical Pathology, Austin Health, Heidelberg, Victoria, Australia; Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Khashayar Asadi
- Department of Anatomical Pathology, Austin Health, Heidelberg, Victoria, Australia
| | - Gareth Rivalland
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
| | - Hongdo Do
- Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Clare Senko
- Department of Medical Oncology, Austin Health, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia
| | - Paul L Mitchell
- Department of Medical Oncology, Austin Health, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia
| | - Chai Zi Quing
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia; University of Melbourne Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia; Department of Cardiothoracic Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - Thomas John
- Department of Medical Oncology, Austin Health, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.
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18
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Abstract
Mucocele of the native esophagus is a rare complication after esophageal bypass surgery for various indications. Esophageal mucoceles rarely get infected, forming a ‘pyocele’ which becomes symptomatic. Various approaches have been utilized in the management of such pyoceles. We report a similar patient managed successfully in our center utilizing a thoracoscopic deroofing and partial excision of the pyocele.
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Affiliation(s)
- Ranjan Sapkota
- Department of Cardio-Thoracic and Vascular Surgery, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal
| | - Bibhusal Thapa
- Department of Cardio-Thoracic and Vascular Surgery, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal
| | - Prakash Sayami
- Department of Cardio-Thoracic and Vascular Surgery, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal
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19
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Busacca S, Brannan L, Nakas A, Sharkey A, Riganti C, Waller D, Richards C, Salaroglio I, Milosevic V, Wells-Jordan P, Dawson A, Sheaff M, LeQuesne J, Gaba A, Hastings R, Martinson L, Lo JL, Bajaj A, Boutros P, John T, Thapa B, Wilson G, Shaw J, Swanton C, Dudbridge F, Hollox E, Fennell DA. Abstract 2908: Mesothelioma phylogeny reveal MTAP as a solitary clonal deletion, exposing vulnerability to the PRMT5 perturbagen, quinacrine. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Malignant Pleural Mesothelioma (MPM) remains an incurable cancer that is caused by asbestos, and for which there is a paucity of effective therapy. Stratified medicine for MPM is in its infancy. We hypothesized that deciphering the phylogenetic architecture of mesothelioma would yield a census of recurrent clonal homozygous copy number losses as potential therapeutic vulnerabilities.
Methods and Results: We prospectively enrolled 125 patients with MPM undergoing radical pleurectomy decortication, into the MEDUSA (Mesothelioma Evolution: DrUgging Somatic Alterations) study. Multi-region whole exome sequencing was conducted on 106 tumours from 20 patients (Medusa20 cohort). Up to 5 consistent regions were sampled: apex, pericardium, anterior/ posterior costophrenic angles, and the oblique fissure. For each patient, matching whole blood DNA was also whole exome sequenced to allow identification of tumour- specific somatic variations. Somatic copy number alterations (SCNAs) in each tumour region were called using SEQUENZA. We inferred phylogeny for each patient’s tumour using the SCNA calls by maximum parsimony (TUMULT), which revealed branched evolution in all MPMs. The total number of SCNAs ranged from 78 to 380 across the cohort with biphasic MPMs exhibiting a significantly larger total and clonal SCNA burden compared to epithelioid MPMs (p=0.024) . Only 9p21 which harbours CDKNA and methylthioadenosine phosphorylase (MTAP), exhibited clonal homozygous loss in 3 patients (15%). Clonal heterozygous loss was seen in 2 patients (10%). A further 5 patients showed with evidence of parallel evolution involving MTAP loss in distant MPM regions (25%), with one patient's MPM having late homozygous deletion in a single branch (5%). MTAP loss was validated by array based SCNA analysis and was found to be negatively prognostic in an independent cohort. Protein arginine methyltransferase 5 (PRMT5) has been recently identified as a vulnerability in MTAP deleted cancer. We found that siRNA silencing of PRMT5, caused MTAP selective loss of clonogenicity with proliferative arrest. Utilizing the connectivity map, quinacrine was validated as a PRMT5 perturbagen, which suppressed c-jun-dependent PRMT5 expression without inhibiting its methyltransferase activity. Quinacrine phenocopied PRMT5 siRNA, reducing global symmetrical arginine dimethylation of histone H4 (H4R3me2S). Finally, exogenous wild-type PRMT5 rescued quinacrine-mediated cell arrest in MTAP-negative cells, an effect not seen using the PMRT5 E444Q methyltransferase dead mutant.
Conclusion: MTAP deletion is a clonal homozygous event in mesothelioma, with potential as a therapeutically tractable Achilles heel, via PRMT5 silencing using a repurposed small molecule, quinacrine.
Citation Format: Sara Busacca, Lee Brannan, Apostolos Nakas, Annabel Sharkey, Chiara Riganti, David Waller, Cathy Richards, Iris Salaroglio, Vladan Milosevic, Peter Wells-Jordan, Alan Dawson, Michael Sheaff, John LeQuesne, Aarti Gaba, Robert Hastings, Luke Martinson, Jin-Li Lo, Amrita Bajaj, Paul Boutros, Tom John, Bibhusal Thapa, Gareth Wilson, Jacqui Shaw, Charles Swanton, Frank Dudbridge, Edward Hollox, Dean A. Fennell. Mesothelioma phylogeny reveal MTAP as a solitary clonal deletion, exposing vulnerability to the PRMT5 perturbagen, quinacrine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2908.
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Affiliation(s)
- Sara Busacca
- 1University of Leicester, Leicester, United Kingdom
| | - Lee Brannan
- 1University of Leicester, Leicester, United Kingdom
| | - Apostolos Nakas
- 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Annabel Sharkey
- 3Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom
| | | | - David Waller
- 5Barts and the London NHS Trust, London, United Kingdom
| | - Cathy Richards
- 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | | | | | | | - Alan Dawson
- 1University of Leicester, Leicester, United Kingdom
| | | | | | - Aarti Gaba
- 1University of Leicester, Leicester, United Kingdom
| | | | | | - Jin-Li Lo
- 1University of Leicester, Leicester, United Kingdom
| | - Amrita Bajaj
- 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Paul Boutros
- 6Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Tom John
- 7Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Bibhusal Thapa
- 7Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | | | - Jacqui Shaw
- 1University of Leicester, Leicester, United Kingdom
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20
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Fancourt T, McArthur S, Thapa B, Barnett S, Knight S, Newman M. Investigation of pathologic response in patients with pancoast tumours after treatment with trimodality therapy. Pathology 2019. [DOI: 10.1016/j.pathol.2018.12.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Kim M, Thapa B, Yap CH. Outcomes of Video-Assisted Thoracoscopic Surgery Lung Resections in a Regional Service. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.170] [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: 10/26/2022]
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22
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Sharma S, Oli N, Thapa B. Electronic health-literacy skills among nursing students. Adv Med Educ Pract 2019; 10:527-532. [PMID: 31410077 PMCID: PMC6645068 DOI: 10.2147/amep.s207353] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/15/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND The Internet has become a major source of health-related information. In order to provide better health services and health-care education to society, nurses should have acceptable electronic health (eHealth) literacy. OBJECTIVE The main aim was to measure eHealth-literacy skills among nursing students of Kathmandu Medical College Teaching Hospital, Nepal. METHODS A cross-sectional study was conducted among 152 Bachelor of Science nursing students at the hospital. Data were collected using the self-administered eHealth Literacy Scale. This is an eight-item tool that is assessed on 5-point likert scale to measure consumers' perceived skills at finding, evaluating, and applying eHealth information to health problems. Demographical and personal variables were collected to explore their relationship with eHealth literacy. RESULTS A total of 152 nursing students with mean age of 19.84±1.62 years participated in the study. While 44.7% perceived that they had average Internet skills, 65.1% found the Internet useful in helping them make decisions about their health. Nursing students had a moderate self-perceived level of eHealth literacy (median 3.69, IQR 0.87). Related factors included students' Internet skills, frequency of using the Internet for health related purposes, and self-perception of the usefulness and importance of the Internet. CONCLUSION This study represents a baseline reference for eHealth literacy among nursing students. Students have some basic necessary skills, while other skills still need to be improved. There is a need to pay attention to eHealth-literacy needs of nursing students.
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Affiliation(s)
- S Sharma
- Department of Nursing, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
- Correspondence: S Sharma Department of Nursing, Kathmandu Medical College Teaching Hospital, Clinical Science Complex, Sinamangal Road, Kathmandu 44600, NepalTel +977 984 156 2571Email
| | - N Oli
- Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
| | - B Thapa
- Department of Nursing, Nepalgunj Nursing Campus, Nepalgunj, Nepal
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23
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Thapa B, Walkeiwicz M, Rivalland G, Murone C, Asadi K, Barnett S, Knight S, Hendry S, Russell P, John T. OA08.05 Quantifying Tumour Infiltrating Lymphocytes (TILs) in Malignant Pleural Mesothelioma (MPM) -Defining the Hot, the Warm and the Cold Tumours. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Pulmonary parasitic infestations are a worldwide problem associated with significant morbidity and socioeconomic impact. They are known to have varied clinical presentations and radiological appearances. Prevention of parasite transmission and medical treatment of cases form the two pillars of control of these diseases. The role of surgery is limited to the diagnosis and definitive treatment of the minority of pulmonary parasitic afflictions, most notably hydatidosis. Despite surgery being established as the treatment of choice in pulmonary hydatid cysts (PHCs) for over half a century, variations and unresolved controversies persist regarding the best surgical technique. Complications brought on by cyst rupture, multiplicity and multi-organ involvement add complexity to treatment decisions. The development of video-assisted thoracoscopic surgery (VATS) brings the promise of reduced peri-operative morbidity but is yet to be universally accepted as a safe technique. In this review, we endeavor to discuss the common pulmonary infestations focusing on the current trends and controversies surrounding surgery for PHC.
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Affiliation(s)
- Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Victoria, Australia.,Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - Ranjan Sapkota
- Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - Michelle Kim
- Department of Cardiothoracic Surgery, Barwon Health, Geelong, Australia
| | | | - Prakash Sayami
- Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
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Lee RC, Thapa B, John T. LACES and bootstraps: the hunt for prognostic and predictive markers for adjuvant therapy in NSCLC. Transl Lung Cancer Res 2018; 7:S239-S242. [PMID: 30393612 PMCID: PMC6193923 DOI: 10.21037/tlcr.2018.09.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/03/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Rachael Chang Lee
- Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia
| | - Thomas John
- Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia
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Sharma A, Sapkota R, Thapa B, Sayami P. Operative management of pediatric empyema: a single center review. J Soc Surg Nepal 2018. [DOI: 10.3126/jssn.v21i1.24367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Empyema thoracis is an uncommon complication of childhood pneumonias but a common problem faced by a thoracic surgeon. Its management is still controversial, with a range of treatment options available and evolving gradually towards adoption of video-assisted thoracoscopic surgery (VATS) as the most commonly practiced one.
Aim: The aim of this study was to review our experience in pediatric empyema thoracis.
Methods: It was a retrospective review of the prospectively recorded data, spanning a period of 18 months in the Department of Cardio-Thoracic and Vascular Surgery in Manmohan Cardio-Thoracic Vascular and Transplant Center.
Results: A total of 40 consecutive patients, 29 males and 11 females, aged 15 years or less were operated upon for a diagnosis of empyema thoracis made based on clinical, radiological and laboratory evidence. All of them were referred patients, mostly from pediatricians. VATS was undertaken in 36 of them, the remaining four treated by open approach. Deloculation sufficed in majority (26/40; 65%) of the patients which mostly (23/26; 90%) had either acute or subacute presentation. Decortication was required in 35% (14/40) of the patients. However, all of the patients but one had a successful outcome in terms of lung expansion, sterilization of the pleural cavity and absence of recurrence. There was no operative mortality.
Conclusion: Surgical management of pediatric thoracic empyema is feasible and safe with favorable outcome. VATS is gradually becoming the more favored modality of operative management.
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Peters GD, Szaumkessel M, Leong T, Walkiewicz M, Do H, Dobrovic A, Rivalland G, Thapa B, John T. NTRK and ALK rearrangements in mesothelioma and lung carcinoid. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e20558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Hongdo Do
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | | | - Gareth Rivalland
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
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Kim M, Thapa B, Seevanayagam S. Video-assisted Thoracoscopic Surgery Diaphragmatic Plication With Mesh Repair: A Novel Technique. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.04.176] [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: 10/28/2022]
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Mauti L, Rivalland G, Klingbiel D, Kao S, Schmid S, Nowak A, Gautschi O, Hughes B, Bartnick T, Pavlakis N, Bouchaab H, O'Byrne K, Rothschild S, Russell P, Savic Prince S, Thapa B, Pless M, von Moos R, Metaxas Y, John T. Pembrolizumab (pembro) for relapsed malignant pleural mesothelioma (MPM): Outcomes in real-life setting in Australia (AUS) and Switzerland (CH). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.007] [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: 11/15/2022] Open
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Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B, Christie M, van de Vijver K, Estrada MV, Gonzalez-Ericsson PI, Sanders M, Solomon B, Solinas C, Van den Eynden GGGM, Allory Y, Preusser M, Hainfellner J, Pruneri G, Vingiani A, Demaria S, Symmans F, Nuciforo P, Comerma L, Thompson EA, Lakhani S, Kim SR, Schnitt S, Colpaert C, Sotiriou C, Scherer SJ, Ignatiadis M, Badve S, Pierce RH, Viale G, Sirtaine N, Penault-Llorca F, Sugie T, Fineberg S, Paik S, Srinivasan A, Richardson A, Wang Y, Chmielik E, Brock J, Johnson DB, Balko J, Wienert S, Bossuyt V, Michiels S, Ternes N, Burchardi N, Luen SJ, Savas P, Klauschen F, Watson PH, Nelson BH, Criscitiello C, O’Toole S, Larsimont D, de Wind R, Curigliano G, André F, Lacroix-Triki M, van de Vijver M, Rojo F, Floris G, Bedri S, Sparano J, Rimm D, Nielsen T, Kos Z, Hewitt S, Singh B, Farshid G, Loibl S, Allison KH, Tung N, Adams S, Willard-Gallo K, Horlings HM, Gandhi L, Moreira A, Hirsch F, Dieci MV, Urbanowicz M, Brcic I, Korski K, Gaire F, Koeppen H, Lo A, Giltnane J, Ziai J, Rebelatto MC, Steele KE, Zha J, Emancipator K, Juco JW, Denkert C, Reis-Filho J, Loi S, Fox SB. Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors. Adv Anat Pathol 2017; 24:311-335. [PMID: 28777143 PMCID: PMC5638696 DOI: 10.1097/pap.0000000000000161] [Citation(s) in RCA: 438] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Assessment of the immune response to tumors is growing in importance as the prognostic implications of this response are increasingly recognized, and as immunotherapies are evaluated and implemented in different tumor types. However, many different approaches can be used to assess and describe the immune response, which limits efforts at implementation as a routine clinical biomarker. In part 1 of this review, we have proposed a standardized methodology to assess tumor-infiltrating lymphocytes (TILs) in solid tumors, based on the International Immuno-Oncology Biomarkers Working Group guidelines for invasive breast carcinoma. In part 2 of this review, we discuss the available evidence for the prognostic and predictive value of TILs in common solid tumors, including carcinomas of the lung, gastrointestinal tract, genitourinary system, gynecologic system, and head and neck, as well as primary brain tumors, mesothelioma and melanoma. The particularities and different emphases in TIL assessment in different tumor types are discussed. The standardized methodology we propose can be adapted to different tumor types and may be used as a standard against which other approaches can be compared. Standardization of TIL assessment will help clinicians, researchers and pathologists to conclusively evaluate the utility of this simple biomarker in the current era of immunotherapy.
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Affiliation(s)
- Shona Hendry
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory/Breast International Group, Institut Jules Bordet, Brussels, Belgium
- Department of Pathology and TCRU, GZA, Antwerp, Belgium
| | - Thomas Gevaert
- Department of Development and Regeneration, Laboratory of Experimental Urology, KU Leuven, Leuven, Belgium
- Department of Pathology, AZ Klina, Brasschaat, Belgium
| | - Prudence A. Russell
- Department of Anatomical Pathology, St Vincent’s Hospital Melbourne, Fitzroy, Australia
- Department of Pathology, University of Melbourne, Parkville, Australia
| | - Tom John
- Department of Medical Oncology, Austin Health, Heidelberg, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- School of Cancer Medicine, La Trobe University, Bundoora, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- Department of Medicine, University of Melbourne, Parkville, Australia
| | - Michael Christie
- Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
| | - Koen van de Vijver
- Divisions of Diagnostic Oncology & Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - M. Valeria Estrada
- Department of Pathology, School of Medicine, University of California, San Diego, USA
| | | | - Melinda Sanders
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - Benjamin Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Cinzia Solinas
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Gert GGM Van den Eynden
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Department of Pathology, GZA Ziekenhuizen, Antwerp, Belgium
| | - Yves Allory
- Université Paris-Est, Créteil, France
- INSERM, UMR 955, Créteil, France
- Département de pathologie, APHP, Hôpital Henri-Mondor, Créteil, France
| | - Matthias Preusser
- Department of Medicine, Clinical Division of Oncology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Johannes Hainfellner
- Institute of Neurology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Giancarlo Pruneri
- European Institute of Oncology, Milan, Italy
- University of Milan, School of Medicine, Milan, Italy
| | - Andrea Vingiani
- European Institute of Oncology, Milan, Italy
- University of Milan, School of Medicine, Milan, Italy
| | - Sandra Demaria
- New York University Medical School, New York, USA
- Perlmutter Cancer Center, New York, USA
| | - Fraser Symmans
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Laura Comerma
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | - Sunil Lakhani
- Centre for Clinical Research and School of Medicine, The University of Queensland, Brisbane, Australia
- Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Seong-Rim Kim
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Stuart Schnitt
- Cancer Research Institute and Department of Pathology, Beth Israel Deaconess Cancer Center, Boston, USA
- Harvard Medical School, Boston, USA
| | - Cecile Colpaert
- Department of Pathology, GZA Ziekenhuizen, Sint-Augustinus, Wilrijk, Belgium
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan J. Scherer
- Academic Medical Innovation, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - Michail Ignatiadis
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sunil Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, USA
| | - Robert H. Pierce
- Cancer Immunotherapy Trials Network, Central Laboratory and Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Nicolas Sirtaine
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Frederique Penault-Llorca
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France
- University of Auvergne UMR1240, Clermont-Ferrand, France
| | - Tomohagu Sugie
- Department of Surgery, Kansai Medical School, Hirakata, Japan
| | - Susan Fineberg
- Montefiore Medical Center, Bronx, New York, USA
- The Albert Einstein College of Medicine, Bronx, New York, USA
| | - Soonmyung Paik
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
- Severance Biomedical Science Institute and Department of Medical Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ashok Srinivasan
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Andrea Richardson
- Harvard Medical School, Boston, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, USA
- Department of Cancer Biology, Dana Farber Cancer Institute, Boston, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, USA
- Warren Alpert Medical School of Brown University, Providence, USA
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center, Gliwice, Poland
- Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jane Brock
- Harvard Medical School, Boston, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, USA
| | - Douglas B. Johnson
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA
- Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Justin Balko
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA
- Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Stephan Wienert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
- VMscope GmbH, Berlin, Germany
| | - Veerle Bossuyt
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Stefan Michiels
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | - Nils Ternes
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | | | - Stephen J. Luen
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Peter Savas
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Peter H. Watson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Brad H. Nelson
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
- Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sandra O’Toole
- The Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, Australia
- Australian Clinical Labs, Bella Vista, Australia
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Roland de Wind
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Fabrice André
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris Sud, Kremlin-Bicêtre, France
| | - Magali Lacroix-Triki
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Mark van de Vijver
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Federico Rojo
- Pathology Department, IIS-Fundacion Jimenez Diaz, UAM, Madrid, Spain
| | - Giuseppe Floris
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Shahinaz Bedri
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Joseph Sparano
- Department of Oncology, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, USA
| | - David Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Torsten Nielsen
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Zuzana Kos
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Stephen Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baljit Singh
- Department of Pathology, New York University Langone Medical Centre, New York, USA
| | - Gelareh Farshid
- Directorate of Surgical Pathology, SA Pathology, Adelaide, Australia
- Discipline of Medicine, Adelaide University, Adelaide, Australia
| | | | | | - Nadine Tung
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, USA
| | - Sylvia Adams
- New York University Medical School, New York, USA
- Perlmutter Cancer Center, New York, USA
| | - Karen Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Hugo M. Horlings
- Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Leena Gandhi
- Perlmutter Cancer Center, New York, USA
- Dana-Farber Cancer Institute, Boston, USA
| | - Andre Moreira
- Pulmonary Pathology, New York University Center for Biospecimen Research and Development, New York University, New York, USA
| | - Fred Hirsch
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Maria Urbanowicz
- European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - Iva Brcic
- Institute of Pathology, Medical University of Graz, Austria
| | - Konstanty Korski
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Fabien Gaire
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Hartmut Koeppen
- Research Pathology, Genentech Inc., South San Francisco, USA
| | - Amy Lo
- Research Pathology, Genentech Inc., South San Francisco, USA
- Department of Pathology, Stanford University, Palo Alto, USA
| | | | - James Ziai
- Research Pathology, Genentech Inc., South San Francisco, USA
| | | | | | - Jiping Zha
- Translational Sciences, MedImmune, Gaithersberg, USA
| | | | | | - Carsten Denkert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jorge Reis-Filho
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Sherene Loi
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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Thapa B, Powell J, Yi J, McGee J, Landis J, Rein L, Kim S, Shrestha S, Karmacharya B. Adolescent Health Risk and Behavior Survey: A School Based Survey in Central Nepal. Kathmandu Univ Med J (KUMJ) 2017; 15:301-307. [PMID: 30580346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background A comprehensive study of adolescent health risk specific to the Dhulikhel catchment area has not been performed. Objective This survey assesses trends in demographics, nutrition, hygiene and related infrastructure, causes of injury, violence, mental health, substance abuse, and menstrual hygiene. Method A 40 question survey was adapted from the Center for Disease Control (CDC) Youth Risk Behavior Surveillance System, translated into the Nepali language, and administered to 1200 students in eight different schools in central Nepal. Descriptive statistics were used to summarize the data. Result The data has identified nutrition, infrastructure, mental health, and menstrual hygiene as areas for improvement. The number of adolescents who reported going hungry some, most, or all of the time (30.5%, 25.8%, 13.9%) reveals a need for better food access. Approximately 44.5 % of students had no access to soap and water at school. Students who endorse dissatisfaction with themselves was 6.5% and those with suicidal ideation or attempt was 11.8% of the surveyed population. A significantly greater percentage of students who reported suicidal ideation also reported engaging in behaviors related to physical violence, substance abuse, being dissatisfaction with themselves, insomnia due to anxiety, and loneliness. Of the female students, 40.1% reported missing school at least once in the last three months due to their period. Conclusion This data shows a need for better food access, improved infrastructure in schools in central Nepal, and the need to address the prevalence of mental health issues through program interventions.
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Affiliation(s)
- B Thapa
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - J Powell
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - J Yi
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - J McGee
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - J Landis
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - L Rein
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - S Kim
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - S Shrestha
- Department of Community Programs, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre
| | - B Karmacharya
- Department of Community Programs, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre
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Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B, Christie M, van de Vijver K, Estrada MV, Gonzalez-Ericsson PI, Sanders M, Solomon B, Solinas C, Van den Eynden GGGM, Allory Y, Preusser M, Hainfellner J, Pruneri G, Vingiani A, Demaria S, Symmans F, Nuciforo P, Comerma L, Thompson EA, Lakhani S, Kim SR, Schnitt S, Colpaert C, Sotiriou C, Scherer SJ, Ignatiadis M, Badve S, Pierce RH, Viale G, Sirtaine N, Penault-Llorca F, Sugie T, Fineberg S, Paik S, Srinivasan A, Richardson A, Wang Y, Chmielik E, Brock J, Johnson DB, Balko J, Wienert S, Bossuyt V, Michiels S, Ternes N, Burchardi N, Luen SJ, Savas P, Klauschen F, Watson PH, Nelson BH, Criscitiello C, O’Toole S, Larsimont D, de Wind R, Curigliano G, André F, Lacroix-Triki M, van de Vijver M, Rojo F, Floris G, Bedri S, Sparano J, Rimm D, Nielsen T, Kos Z, Hewitt S, Singh B, Farshid G, Loibl S, Allison KH, Tung N, Adams S, Willard-Gallo K, Horlings HM, Gandhi L, Moreira A, Hirsch F, Dieci MV, Urbanowicz M, Brcic I, Korski K, Gaire F, Koeppen H, Lo A, Giltnane J, Ziai J, Rebelatto MC, Steele KE, Zha J, Emancipator K, Juco JW, Denkert C, Reis-Filho J, Loi S, Fox SB. Assessing Tumor-infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method From the International Immunooncology Biomarkers Working Group: Part 1: Assessing the Host Immune Response, TILs in Invasive Breast Carcinoma and Ductal Carcinoma In Situ, Metastatic Tumor Deposits and Areas for Further Research. Adv Anat Pathol 2017; 24:235-251. [PMID: 28777142 PMCID: PMC5564448 DOI: 10.1097/pap.0000000000000162] [Citation(s) in RCA: 423] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Assessment of tumor-infiltrating lymphocytes (TILs) in histopathologic specimens can provide important prognostic information in diverse solid tumor types, and may also be of value in predicting response to treatments. However, implementation as a routine clinical biomarker has not yet been achieved. As successful use of immune checkpoint inhibitors and other forms of immunotherapy become a clinical reality, the need for widely applicable, accessible, and reliable immunooncology biomarkers is clear. In part 1 of this review we briefly discuss the host immune response to tumors and different approaches to TIL assessment. We propose a standardized methodology to assess TILs in solid tumors on hematoxylin and eosin sections, in both primary and metastatic settings, based on the International Immuno-Oncology Biomarker Working Group guidelines for TIL assessment in invasive breast carcinoma. A review of the literature regarding the value of TIL assessment in different solid tumor types follows in part 2. The method we propose is reproducible, affordable, easily applied, and has demonstrated prognostic and predictive significance in invasive breast carcinoma. This standardized methodology may be used as a reference against which other methods are compared, and should be evaluated for clinical validity and utility. Standardization of TIL assessment will help to improve consistency and reproducibility in this field, enrich both the quality and quantity of comparable evidence, and help to thoroughly evaluate the utility of TILs assessment in this era of immunotherapy.
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Affiliation(s)
- Shona Hendry
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory/Breast International Group, Institut Jules Bordet, Brussels, Belgium,Department of Pathology and TCRU, GZA, Antwerp, Belgium
| | - Thomas Gevaert
- Department of Development and Regeneration, Laboratory of Experimental Urology, KU Leuven, Leuven, Belgium,Department of Pathology, AZ Klina, Brasschaat, Belgium
| | - Prudence A. Russell
- Department of Anatomical Pathology, St Vincent’s Hospital Melbourne, Fitzroy, Australia,Department of Pathology, University of Melbourne, Parkville, Australia
| | - Tom John
- Department of Medical Oncology, Austin Health, Heidelberg, Australia,Olivia Newton-John Cancer Research Institute, Heidelberg, Australia,School of Cancer Medicine, La Trobe University, Bundoora, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Michael Christie
- Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
| | - Koen van de Vijver
- Divisions of Diagnostic Oncology & Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - M. Valeria Estrada
- Department of Pathology, School of Medicine, University of California, San Diego, USA
| | | | - Melinda Sanders
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - Benjamin Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Cinzia Solinas
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Gert GGM Van den Eynden
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium,Department of Pathology, GZA Ziekenhuizen, Antwerp, Belgium
| | - Yves Allory
- Université Paris-Est, Créteil, France,INSERM, UMR 955, Créteil, France,Département de pathologie, APHP, Hôpital Henri-Mondor, Créteil, France
| | - Matthias Preusser
- Department of Medicine, Clinical Division of Oncology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Johannes Hainfellner
- Institute of Neurology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Giancarlo Pruneri
- European Institute of Oncology, Milan, Italy,University of Milan, School of Medicine, Milan, Italy
| | - Andrea Vingiani
- European Institute of Oncology, Milan, Italy,University of Milan, School of Medicine, Milan, Italy
| | - Sandra Demaria
- New York University Medical School, New York, USA,Perlmutter Cancer Center, New York, USA
| | - Fraser Symmans
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Laura Comerma
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | - Sunil Lakhani
- Centre for Clinical Research and School of Medicine, The University of Queensland, Brisbane, Australia,Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Seong-Rim Kim
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Stuart Schnitt
- Cancer Research Institute and Department of Pathology, Beth Israel Deaconess Cancer Center, Boston, USA,Harvard Medical School, Boston, USA
| | - Cecile Colpaert
- Department of Pathology, GZA Ziekenhuizen, Sint-Augustinus, Wilrijk, Belgium
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan J. Scherer
- Academic Medical Innovation, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - Michail Ignatiadis
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sunil Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, USA
| | - Robert H. Pierce
- Cancer Immunotherapy Trials Network, Central Laboratory and Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Nicolas Sirtaine
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Frederique Penault-Llorca
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France,University of Auvergne UMR1240, Clermont-Ferrand, France
| | - Tomohagu Sugie
- Department of Surgery, Kansai Medical School, Hirakata, Japan
| | - Susan Fineberg
- Montefiore Medical Center, Bronx, New York, USA,The Albert Einstein College of Medicine, Bronx, New York, USA
| | - Soonmyung Paik
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania,Severance Biomedical Science Institute and Department of Medical Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ashok Srinivasan
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Andrea Richardson
- Harvard Medical School, Boston, USA,Department of Pathology, Brigham and Women’s Hospital, Boston, USA,Department of Cancer Biology, Dana Farber Cancer Institute, Boston, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, USA,Warren Alpert Medical School of Brown University, Providence, USA
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center, Gliwice, Poland,Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jane Brock
- Harvard Medical School, Boston, USA,Department of Pathology, Brigham and Women’s Hospital, Boston, USA
| | - Douglas B. Johnson
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA,Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Justin Balko
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA,Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Stephan Wienert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany,VMscope GmbH, Berlin, Germany
| | - Veerle Bossuyt
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Stefan Michiels
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | - Nils Ternes
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | | | - Stephen J. Luen
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Peter Savas
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Peter H. Watson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada,Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Brad H. Nelson
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada,Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada,Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sandra O’Toole
- The Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, Australia,Australian Clinical Labs, Bella Vista, Australia
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Roland de Wind
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Fabrice André
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France,Faculté de Médecine, Université Paris Sud, Kremlin-Bicêtre, France
| | - Magali Lacroix-Triki
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Mark van de Vijver
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Federico Rojo
- Pathology Department, IIS-Fundacion Jimenez Diaz, UAM, Madrid, Spain
| | - Giuseppe Floris
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Shahinaz Bedri
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Joseph Sparano
- Department of Oncology, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, USA
| | - David Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Torsten Nielsen
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Zuzana Kos
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Stephen Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baljit Singh
- Department of Pathology, New York University Langone Medical Centre, New York, USA
| | - Gelareh Farshid
- Directorate of Surgical Pathology, SA Pathology, Adelaide, Australia,Discipline of Medicine, Adelaide University, Adelaide, Australia
| | | | | | - Nadine Tung
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, USA
| | - Sylvia Adams
- New York University Medical School, New York, USA,Perlmutter Cancer Center, New York, USA
| | - Karen Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Hugo M. Horlings
- Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Leena Gandhi
- Perlmutter Cancer Center, New York, USA,Dana-Farber Cancer Institute, Boston, USA
| | - Andre Moreira
- Pulmonary Pathology, New York University Center for Biospecimen Research and Development, New York University, New York, USA
| | - Fred Hirsch
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Maria Urbanowicz
- European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - Iva Brcic
- Institute of Pathology, Medical University of Graz, Austria
| | - Konstanty Korski
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Fabien Gaire
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Hartmut Koeppen
- Research Pathology, Genentech Inc., South San Francisco, USA
| | - Amy Lo
- Research Pathology, Genentech Inc., South San Francisco, USA,Department of Pathology, Stanford University, Palo Alto, USA
| | | | - James Ziai
- Research Pathology, Genentech Inc., South San Francisco, USA
| | | | | | - Jiping Zha
- Translational Sciences, MedImmune, Gaithersberg, USA
| | | | | | - Carsten Denkert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jorge Reis-Filho
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Sherene Loi
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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Thapa B, Walkiewicz M, Rivalland G, Murone C, Asadi K, Barnett S, Knight S, Watkins N, Russell PA, John T. Immune microenvironment in mesothelioma: Looking beyond PD-L1. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8515 Background: Studies using immune checkpoint inhibitors in mesothelioma (MM) have shown promise. Differences in response to PD-L1 and PD-1 inhibitors (10% vs 25%) have been reported. Also, expression of PD-L1 alone appears to be a limited predictor. As the roles of the multiple check point receptors and their ligands become defined, an understanding of their expression and interplay in the mm tumour microenvironment, which could affect suitability for checkpoint inhibition therapy, has become necessary. Methods: Tissue microarrays were constructed and stained with PD-L2, LAG3 and TIM3 antibodies. Tumour infiltrating lymphocytes (TILs) were assessed in the stroma and expressed as a % of stromal area within invasive tumour. These data were combined with PD-L1 expression, CD4+ and CD8+ infiltration in the same cohort reported previously. To quantify the immunosuppressive milieu, we combined our assessment of PD-L1, PD-L2 and TIM3 expression to derive an “Immune checkpoint score (ICS)” and explored its correlation with the tumour microenvironment and clinicopathological covariates. We are also exploring its predictive value in an independent cohort of mm patients who have received anti-PD-1 treatment. Results: Amongst 329 patients evaluated, PD-L1 was positive (+) in 41.7% and PD-L2+ in 24.5%. TIM3+ lymphocytes were found in 99.4% but LAG3+ lymphocytes in only 0.2%. 28/173 (16%) of PD-L1- patients were PD-L2+ and 31/136 (22%) PD-L1 and PD-L2 negative patients had high infiltration with TIM3+ lymphocytes. High ICS was associated with non-epithelioid histology, increased TILs and poorer survival. On multivariate analysis, high TILs, non-epithelioid histology and poor physiological status remained significantly associated with poorer survival. Data on the predictive role of ICS score will also be reported. Conclusions: While co-expression of PD-L1, PD-L2 and TIM3 can occur, their expression is mutually exclusive in a large proportion of patients. The expression of PD-L2 may explain differences in responses seen between PD-1 compared to PD-L1 inhibitors. A comprehensive assessment of these multiple immunosuppressive pathways may be necessary to truly gauge the immunosuppressive environment and tailor immunotherapy for individual cases.
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Affiliation(s)
- Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | | | - Gareth Rivalland
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | - Carmel Murone
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Khashayar Asadi
- Department of Anatomical Pathology, Austin Health, Heidelberg, Australia
| | | | | | - Neil Watkins
- Garvan Institute of Medical Research, Sydney, Australia
| | | | - Thomas John
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
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Rivalland G, Kao SCH, Pavlakis N, Hughes BGM, Thapa B, Pal A, Walkiewicz M, Zimet AS, White S, O'Byrne K, Mitchell P, John T. Outcomes of anti-PD-1 therapy in mesothelioma and correlation with PD-L1 expression. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8514] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8514 Background: Early phase trials of anti-programmed death 1 (PD-1) antibodies have demonstrated important responses in malignant mesothelioma (MM). Expression of the ligand, PD-L1, is a potential biomarker for PD-1 directed therapy use and is expressed in a significant proportion of MM. We present results for a cohort treated with PD-1 inhibitory antibodies and assessed for PD-L1 expression. Methods: Patients (pts) with unresectable pleural or peritoneal mm treated with anti-PD-1 antibodies were included. Data was collected retrospectively. Radiological response was assessed using RECIST 1.1. Overall survival (OS) and progression-free survival (PFS) were evaluated. PD-L1 expression was assessed with IHC clone E1L3N (Cell Signaling Technology). PD-L1 positivity was defined as membranous expression on tumour cells: > 5% for PD-L1+ and > 50% for PD-L1hi. Results: Forty-six pts were treated between July 2015 and January 2017. Median age was 66.5 years, ECOG PS was 0/1 in 3/46 (7%) and 35/46 (76%) respectively. Most were male (83%), and 43/46 (93%) had ≥1 prior therapy, with a median of 2 (range 0 - 5). The predominant histology was epithelioid (n = 32/46; 70%). Pembrolizumab was used in 45/46 and BGB-A317 (a PD-L1 antibody) in 1 pt. Of the 46 pts, the overall response rate (ORR) was 15% (7 PR) with 15/46 (33%) achieving stable disease, giving a DCR of 44%. Progression was seen in 24/46 (52%). Median OS for the entire cohort was 8.0 months (95% CI: 2.3 – 11.9). Median duration of response was not yet reached (range 1.5 -19.8). PD-L1 testing was performed in 14 samples, with PD-L1+ in 5 (36%) and PD-L1hi in 4 (29%). The ORR was 40% (2 PR, 3 SD) with PD-L1+, 50% (2 PR, 2 SD) with PD-L1hi and 22% (2/9 patients) with negative expression. PFS and OS were greater with both PD-L1+ (PFS HR: 0.26, 95% CI 0.05 – 1.32, p = 0.10) and PD-L1hi(PFS HR: 0.17, 95% CI 0.02 – 1.47, p = 0.11). PD-L1+ positivity remained a borderline predictor of improved survival on multivariate analysis (p = 0.06). Complete PD-L1 analysis will be presented at the meeting. Conclusions: PD-1 targeted therapy demonstrated a clinically significant response rate in this cohort of mm patients. Initial analysis suggests PD-L1 expression is correlated with improved response and survival.
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Affiliation(s)
- Gareth Rivalland
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | | | - Nick Pavlakis
- Northern Cancer Institute, University of Sydney, Sydney, Australia
| | | | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Abhijit Pal
- Royal Prince Alfred Hospital, Sydney, Australia
| | | | | | - Shane White
- Joint Austin-Ludwig Oncology Unit, Austin Health, Melbourne, Australia
| | - Ken O'Byrne
- Princess Alexandra Hospital and Queensland University of Technology, Brisbane, Australia
| | | | - Thomas John
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
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Thapa B, Salcedo A, Lin X, Walkiewicz M, Murone C, Ameratunga M, Asadi K, Deb S, Barnett SA, Knight S, Mitchell P, Watkins DN, Boutros PC, John T. The Immune Microenvironment, Genome-wide Copy Number Aberrations, and Survival in Mesothelioma. J Thorac Oncol 2017; 12:850-859. [DOI: 10.1016/j.jtho.2017.02.013] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/19/2016] [Accepted: 02/12/2017] [Indexed: 02/07/2023]
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John T, Russell PA, Thapa B. Is Mesothelioma in China Rare or Misdiagnosed? J Thorac Oncol 2017; 12:607-609. [DOI: 10.1016/j.jtho.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 10/19/2022]
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Thapa B, Walkeiwicz M, Murone C, Ameratunga M, Asadi K, Deb S, Barnett S, Knight S, Lin X, Salcedo A, Mitchell P, Boutros P, Watkins N, John T. P3.03-004 Genome-Wide Copy Number Aberrations in Mesothelioma and Its Correlation with Tumor Microenvironment including PD-L1 Expression. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1903] [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: 10/20/2022]
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Thapa B, Shrestha K. Factors Influencing Brain Drain among Nepalese Nurses. Kathmandu Univ Med J (KUMJ) 2017; 15:35-39. [PMID: 29446360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Background Brain drain means migration of technically skilled people from one country to another country. Migration of health workers including nurses are the result of interplay of many push and pull factors. Push factors are those conditions that influence the nurses' decision to leave their own country. Conversely, pull factors are those conditions in a given country that attract nurses, influencing their movement to that country. Objective The objective of this study was to identify push and pull factors of brain drain among the Nepalese nurses. Method Descriptive cross sectional study was done among 228 Nepalese nurses working in five different countries in 2016 by using quota sampling technique. A self administered questionnaire consisting of structured four-point Likert scale was designed to collect information on push and pull factors of brain drain. Descriptive and inferential statistics were computed using SPSS version 16. Result Many of brain drained nurses had ranked very important push factor was personal ambition (72.8%) and very important pull factor was better job and career opportunity (77.2%). Majority of nurses working in Nepal had ranked very important push factor was lack of job and career opportunity (86.0%) and pull factor was better job and career opportunity (85.1%). All push and pull factors were significantly associated with brain drain. Conclusion Most of the Nepalese nurses were forced to go abroad due to personal ambition, followed by low salary, and lack of job and career opportunity. Nurse migration out of Nepal is likely to persist and even increase if underlying factors aren't properly resolved.
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Affiliation(s)
- B Thapa
- Department of Nursing, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - K Shrestha
- Department of Nursing, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Thapa B. Mediastinoscopy: safety and utility Cervical mediastinoscopy: assessing mediastinal lymphadenopathy at Manmohan Cardio-thoracic Vascular and Transplant center. J Soc Surg Nepal 2016. [DOI: 10.3126/jssn.v19i2.24542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Mediastinoscopy is considered essential in staging of lung cancer and evaluation of mediastinal lymphadenopathy and masses. This facility has only recently been available at our center. We review our initial experience and analyse its safety and utility in our setting.
Methods: Retrospective analysis of data of all patients who underwent cervical mediastinoscopy at Manmohan Cardio-thoracic Vascular and Transplant Center (MCVTC) was done. Demographic, clinical and perioperative data were recorded. Concordance of pre and post-operative diagnosis was studied.
Results: Between January 2012 and April 2014, 24 patients underwent mediastinoscopy. The age ranged from 28-75 years (mean = 43.12 ± 15.14). Females outnumbered males (M: F = 3:5). Mediastinoscopy was done for staging of lung cancer in six patients and for assessment of mediastinal lymphadenopathy in 18 patients. One patient had a minor preoperative bleeding. One patient developed surgical site infection. The post-operative stay ranged from 1-4 days (mean = 2.15 ± 0.75). Concordance of pre and postoperative diagnosis was seen in 14 (58%) patients. Amongst the five patients pre-operatively thought to have tubercular mediastinal lymphadenopathy; Tuberculosis was confirmed in only three. Only one of six patients in whom mediastinoscopy was done as a staging procedure in lung cancer was found to have malignant spread in the sampled nodes.
Conclusion: Mediastinoscopy is safe and efficacious in diagnosing mediastinal lymphadenopathy. It should be routinely considered in staging of NSCLC and evaluation of enlarged mediastinal nodes.
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Thapa B, Walkiewicz M, Murone C, Asadi K, Deb S, Barnett S, Knight S, Mitchell P, Liew D, Watkins DN, John T. Calretinin but not caveolin-1 correlates with tumour histology and survival in malignant mesothelioma. Pathology 2016; 48:660-665. [PMID: 27780599 DOI: 10.1016/j.pathol.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/14/2016] [Accepted: 08/18/2016] [Indexed: 12/28/2022]
Abstract
Malignant mesothelioma (MM) continues to be a disease with poor prognosis and limited treatment options. Calretinin and caveolin-1 expression by tumour in MM have recently been described to be associated with tumour histology, differentiation and consequently survival. In a large, well annotated cohort, we studied both of these biomarkers and explored their association with clinicopathological parameters and survival. A retrospective search of patients with MM who underwent surgery at the Austin Hospital in Melbourne, Australia, was conducted. Clinical history and outcome data were retrieved from patient records. Tissue microarrays (TMAs) were constructed and stained for calretinin and caveolin-1. 'H scores' were derived, taking intensity and distribution of staining, and the cohort was dichotomised using median values for both markers. In the 329 patients evaluated, median age was 67 years. Males outnumbered females by 5:1. Epithelioid histology 202/319 (62.9%) was the most common, followed by biphasic 72/319 (21.8%) and sarcomatoid 45/319 (13.6%); histology could not be confirmed in 10 patients. Calretinin expression was detected in 246 of the 324 (76%) evaluable patients and high expression was associated with epithelioid histology (p < 0.0001). Caveolin-1 was expressed in 298 (94%) of 317 evaluable patients which was much higher compared to its expression in a cohort of lung adenocarcinomas (8/58, 13.7%). However, no association with histology was found (p = 0.409). When taken as a continuous variable, calretinin expression was found to be an independent predictor of survival, alongside histology, neutrophil-lymphocyte ratio, weight loss and stage. No prognostic value was demonstrable for caveolin-1 expression and calretinin/caveolin-1 ratio. There was no relationship between calretinin and caveolin-1 expression. In MM, increased calretinin expression is associated with epithelioid histology and better survival. Caveolin-1 is a sensitive MM marker and is expressed in a high proportion of cases but lacks association with histology and survival.
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Affiliation(s)
- Bibhusal Thapa
- Department of Medicine, University of Melbourne, Vic, Australia; Olivia Newton John Cancer Research Institute, Vic, Australia
| | | | - Carmel Murone
- Olivia Newton John Cancer Research Institute, Vic, Australia; Department of Pathology, Austin Health, Vic, Australia
| | | | - Siddhartha Deb
- Olivia Newton John Cancer Research Institute, Vic, Australia; Anatpath, Gardenvale, Vic, Australia
| | - Stephen Barnett
- Department of Thoracic Surgery, Austin Hospital, Melbourne, Vic, Australia
| | - Simon Knight
- Department of Thoracic Surgery, Austin Hospital, Melbourne, Vic, Australia
| | - Paul Mitchell
- Department of Medical Oncology, Austin Health, Olivia-Newton John Cancer and Wellness Centre, Vic, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, Monash University, Vic, Australia
| | | | - Thomas John
- Olivia Newton John Cancer Research Institute, Vic, Australia; Department of Medical Oncology, Austin Health, Olivia-Newton John Cancer and Wellness Centre, Vic, Australia; School of Cancer Medicine, La Trobe University, Vic, Australia.
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Thapa B, Walkiewicz M, Murone C, Ameratunga M, Asadi K, Deb S, Lin X, Salcedo A, Barnett S, Knight S, Mitchell P, Boutros PC, Watkins N, John T. Correlation of PD-L1 expression with immune cell infiltrates, genome-wide copy number aberrations and survival in mesothelioma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Melbourne, Australia
| | | | - Carmel Murone
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | | | - Khashayar Asadi
- Department of Anatomical Pathology, Austin Health, Heidelberg, Australia
| | | | - Xihui Lin
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Adriana Salcedo
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | | | | | - Paul C Boutros
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | - Thomas John
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
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Karki L, Thapa B, Sah MK. Hyponatremia in Patients with Community Acquired Pneumonia. JNMA J Nepal Med Assoc 2016; 54:67-71. [PMID: 27935926] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Community acquired pneumonia is one the frequent cause of hospital admissions. Whereas, hyponatremia is a common electrolyte abnormality in hospitalized patients and has been shown to be associated with considerable morbidity and mortality. We aim to studyt the association of hyponatremia with community acquired pneumonia in terms of morbidity and mortality. METHODS A prospective observational hospital based study was conducted in a hospital for a year. All patients with a diagnosis of community acquired pneumonia and admitted in medicine ward, were included. Patients with diarrhea, known Chronic Kidney Disease, Heart Failure, Cirrhosis of Liver, Malignancy, taking diuretics, chemical pneumonitis, interstitial pneumonias and other debilitating disease were excluded. RESULTS Among the 72 cases of CAP, 61% were females and 39% were males. The mean age of patients was 51.3 years, 22 (30.55%) patients had severe CAP. A total of 7 cases expired with an overall mortality of 13.7%. The mortality risk increased with increasing CURB-65 score; CURB-65 score 0, 0%; CURB-65 score 1, 0%; CURB-65 score 2, 0%; CURB-65 score 3, 10%; CURB-65 score 4, 33%; CURB-65 score 5, 100%. i.e higher the CURB-65 score, higher the death rate of CAP patients (p<0.05). Hyponatremia was a common occurrence at hospital admission with an incidence of 36.11%. Hyponatremia at hospital admission was also associated with a longer length of hospital stay in cured CAP patients. The mean length of hospital stay was 4.3 days. CONCLUSIONS High CURB-65 scores and lower values of serum sodium at admission in patients of CAP are associated with adverse outcomes both in terms of mortality and longer length of hospital stay. CURB-65 score should be incorporated into assessment of CAP and sodium of the patients during admission.
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Affiliation(s)
- L Karki
- Department of Internal Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - B Thapa
- Department of Internal Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
| | - M K Sah
- Department of Internal Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
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Pokhrel RH, Aung MS, Thapa B, Chaudhary R, Mishra SK, Kawaguchiya M, Urushibara N, Kobayashi N. Detection of ST772 Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (Bengal Bay clone) and ST22 S. aureus isolates with a genetic variant of elastin binding protein in Nepal. New Microbes New Infect 2016; 11:20-7. [PMID: 27014464 PMCID: PMC4789347 DOI: 10.1016/j.nmni.2016.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/03/2016] [Accepted: 02/03/2016] [Indexed: 11/25/2022] Open
Abstract
Genetic characteristics were analysed for recent clinical isolates of methicillin-resistant and -susceptible Staphylococcus aureus (MRSA and MSSA respectively) in Kathmandu, Nepal. MRSA isolates harbouring Panton-Valentine leukocidin (PVL) genes were classified into ST1, ST22 and ST88 with SCCmec-IV and ST772 with SCCmec-V (Bengal Bay clone), while PVL-positive MSSA into ST22, ST30 and ST772. ST22 isolates (PVL-positive MRSA and MSSA, PVL-negative MRSA) possessed a variant of elastin binding protein gene (ebpS) with an internal deletion of 180 bp, which was similar to that reported for ST121 S. aureus previously outside Nepal. Phylogenetic analysis indicated that the ebpS variant in ST22 might have occurred independently of ST121 strains. This is the first report of ST772 PVL-positive MRSA in Nepal and detection of the deletion variant of ebpS in ST22 S. aureus.
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Affiliation(s)
- R H Pokhrel
- Genesis Laboratory and Research, Tribhuvan University, Kathmandu, Nepal
| | - M S Aung
- Sapporo Medical University, Sapporo, Japan
| | - B Thapa
- Genesis Laboratory and Research, Tribhuvan University, Kathmandu, Nepal
| | - R Chaudhary
- Nepal Army Institute of Health Sciences, Tribhuvan University, Kathmandu, Nepal
| | - S K Mishra
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Prasad BM, Satyanarayana S, Chadha SS, Das A, Thapa B, Mohanty S, Pandurangan S, Babu ER, Tonsing J, Sachdeva KS. Experience of active tuberculosis case finding in nearly 5 million households in India. Public Health Action 2016; 6:15-8. [PMID: 27051605 DOI: 10.5588/pha.15.0035] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/26/2015] [Indexed: 11/10/2022] Open
Abstract
In India, to increase tuberculosis (TB) case detection under the National Tuberculosis Programme, active case finding (ACF) was implemented by the Global Fund-supported Project Axshya, among high-risk groups in 300 districts. Between April 2013 and December 2014, 4.9 million households covering ~20 million people were visited. Of 350 047 presumptive pulmonary TB cases (cough of ⩾2 weeks) identified, 187 586 (54%) underwent sputum smear examination and 14 447 (8%) were found to be smear-positive. ACF resulted in the detection of a large number of persons with presumptive pulmonary TB and smear-positive TB. Ensuring sputum examination of all those with presumptive TB was a major challenge.
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Affiliation(s)
- B M Prasad
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | | | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - B Thapa
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - S Pandurangan
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - E R Babu
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - K S Sachdeva
- Central Tuberculosis Division, Ministry of Health & Family Welfare, Government of India, New Delhi, India
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Do H, Cameron D, Molania R, Thapa B, Rivalland G, Mitchell PL, Murone C, John T, Papenfuss A, Dobrovic A. Digital PCR of Genomic Rearrangements for Monitoring Circulating Tumour DNA. Adv Exp Med Biol 2016; 924:139-146. [PMID: 27753035 DOI: 10.1007/978-3-319-42044-8_27] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Identifying circulating tumour DNA (ctDNA) for monitoring of cancer therapy is dependent on the development of readily designed, sensitive cancer-specific DNA markers. Genomic rearrangements that are present in the vast majority of cancers provide such markers.Tumour DNA isolated from two fresh-frozen lung tumours underwent whole genome sequencing. Genomic rearrangements were detected using a new computational algorithm, GRIDSS. Four genomic rearrangements from each tumour were chosen for further study using rearrangement-specific primers. Six of the eight rearrangements tested were identified as tumour-specific, the remaining two were present in the germline. ctDNA was quantified using digital PCR for the tumour genomic rearrangements in patient blood. Interestingly, one of the patients had no detectable ctDNA either prior to or post surgery although the rearrangements were readily detectable in the tumour DNA.This study demonstrates the feasibility of using digital PCR based on genomic rearrangements for the monitoring of minimal residual disease. In addition, whole genome sequencing provided further information enabling therapeutic choices including the identification of a cryptic EGFR exon 19 deletion in one patient and the identification of a high somatic mutation load in the other patient. This approach can be used as a model for all cancers with rearranged genomes.
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Affiliation(s)
- Hongdo Do
- Translational Genomics and Epigenomics Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3084, Australia. .,Department of Pathology, University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Daniel Cameron
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ramyar Molania
- Translational Genomics and Epigenomics Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, VIC, 3084, Australia.,Department of Medicine, University of Melbourne, Heidelberg, VIC, 3084, Australia
| | - Bibhusal Thapa
- Department of Medicine, University of Melbourne, Heidelberg, VIC, 3084, Australia.,Medical Oncology, Olivia Newton-John Cancer Research Institute, Austin Health, Heidelberg, VIC, 3084, Australia
| | - Gareth Rivalland
- Medical Oncology, Olivia Newton-John Cancer Research Institute, Austin Health, Heidelberg, VIC, 3084, Australia
| | - Paul L Mitchell
- Medical Oncology, Olivia Newton-John Cancer Research Institute, Austin Health, Heidelberg, VIC, 3084, Australia
| | - Carmel Murone
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Thomas John
- School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3084, Australia.,Medical Oncology, Olivia Newton-John Cancer Research Institute, Austin Health, Heidelberg, VIC, 3084, Australia
| | - Anthony Papenfuss
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Alexander Dobrovic
- Translational Genomics and Epigenomics Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3084, Australia. .,Department of Pathology, University of Melbourne, Parkville, VIC, 3010, Australia.
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Thapa B, Chadha SS, Das A, Mohanty S, Tonsing J. High and equitable tuberculosis awareness coverage in the community-driven Axshya TB control project in India. Public Health Action 2015; 5:70-3. [PMID: 26400604 DOI: 10.5588/pha.14.0105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/01/2015] [Indexed: 11/10/2022] Open
Abstract
Data from surveys on knowledge, attitudes and practice (KAP) on tuberculosis (TB) conducted under the Axshya project at two time points (baseline 2010-2011 and mid-line 2012-2013) were analysed for changes in coverage and equity of TB awareness after project interventions. Overall coverage increased from 84% at baseline to 88% at midline (5% increase, P < 0.05). In comparison to baseline results, coverage at the midline survey had significantly increased, from 81% to 87% among the rural population, from 81% to 86% among women, from 73% to 85% in the ⩾55 years age group, from 71% to 80% among illiterates and from 73% to 81% in the south zone (P < 0.05). The equity gap among the different study groups (settlement, sex, age, education and zones) decreased from 6-23% at baseline to 3-11% during the midline survey. The maximum decline was observed for type of settlement (rural vs. urban), from 10% to 3% (P < 0.05). This community-driven TB control project has achieved high and equitable coverage of TB awareness, offering valuable lessons for the global community.
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Affiliation(s)
- B Thapa
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
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Parajuli S, Thapa B. Microbiology of Urinary Tract Infection and the Status of Urinary Isolates in Pregnant Women. Med J Shree Birendra Hosp 2015. [DOI: 10.3126/mjsbh.v13i2.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Urinary tract infection (UTI) is one of the most frequently encountered problems owing to significant number of patients needing hospitalization during pregnancy. The incidence of UTI in pregnant women is reported to be high up to 7-8%.Methods: This is a prospective study conducted in Valley Maternity Hospital during a period of 6 months (Jan 2011 to June 2011). 520 MSU (Mid stream urine samples) from pregnant women clinically suspected of urine infection were evaluated by urine dipstick analysis, microscopic and culture method. The isolates were identified and antibiotic sensitivity pattern was determined by standard protocol.Results: The majority of the patients were in-between the age group of 20-30years- 338cases (65%) and these patients usually presented in the first trimester of pregnancy- 317cases (60.96%). Out of the 520 clinically suspected UTI cases, 232 (44.61%) was culture positive. Out of the culture positive cases; Escherichia coli (E.coli) was the most common accounting for a total of 144cases (80%). Nitrofurantoin was found to be the most effective drug against the gram negative (Gm-ve) bacteria. Similarly, Ampicillin, Amoxycillin and Cloxacillin were found to be effective agent against gram positive (Gm+ve) bacteria.Conclusions: Screening for bacteriuria is recommended among all pregnant women at the first prenatal visit and in the subsequent trimesters of pregnancy. Prompt treatment of symptomatic UTI and asymptomatic bacteriuria is required in pregnant women to avoid complications like preterm birth, low birth weight and increased perinatal mortality.
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Thapa B, Singh Y, Sayami P, Shrestha UK, Sapkota R, Sayami G. Breast cancer in young women from a low risk population in Nepal. Asian Pac J Cancer Prev 2014; 14:5095-9. [PMID: 24175782 DOI: 10.7314/apjcp.2013.14.9.5095] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. MATERIALS AND METHODS Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. RESULTS Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was 34.6 ± 5.0 years among younger patients compared to 54.1 ± 9.9 for those ≥ 40 years. The mean age at menarche was also significantly lower (13.5 ± 1.5 vs 14.2 ± 1.5 years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women (5.0 ± 2.5 vs 4.5 ± 2.4 cm, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, p ≤ 0.05). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/ or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). CONCLUSIONS Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.
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Affiliation(s)
- Bibhusal Thapa
- Departments of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal E-mail :
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Shrestha A, Pradhan S, Tuladhar AS, Pradhan S, Yadav B, Acharya R, Pathak R, Thapa B. Normal fetal nasal bone length at 14 to 28 weeks of gestation. Nepal Med Coll J 2014; 16:152-155. [PMID: 26930735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The fetal nasal bone length (FNBL) is a recent sonographic marker included in second trimester genetic sonography which varies with race and ethnicity. The importance of measuring FNBL is in the prenatal diagnosis of Down's syndrome (DS), the most common chromosomal abnormality. Nasal bone hypoplasia or absence is one of the frequent features of DS. Different studies conducted in different parts of the world have established FNBL in different races. But, reference values for normal fetal nasal bone length are yet to be established for Nepalese population. So, the aim of this study was to determine normal FNBL in second trimester. Objective was to create normal reference values for fetal nasal bone in Nepalese population. A cross sectional study was carried out on 150 second trimester pregnancy cases referred for antenatal ultrasound to Department of Radiology at Nepal Medical College and Teaching Hospital between May 2014 and July 2014. Cases included all the clinically normal second trimester pregnancy in which fetal nasal bone could be visualized in midsagittal plane. Table demonstrating normal FNBL corresponding to weeks of gestation was generated using IBM SPSS Statistics Version 20. There was linear increase in mean FNBL with gestational age. Minimum mean FNBL was 2.93 mm at 14 weeks and maximum was 7.89 mm at 27 weeks. Age of patients ranged from 17 to 35 years. Normal FNBL values in Nepalese population corroborates with those published in Western literature but with variation. Hence, reference values for local population become more relevant for antenatal ultrasound practices in Nepal.
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