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Giraud J, Chalopin D, Ramel E, Boyer T, Zouine A, Derieppe MA, Larmonier N, Adotevi O, Le Bail B, Blanc JF, Laurent C, Chiche L, Derive M, Nikolski M, Saleh M. THBS1 + myeloid cells expand in SLD hepatocellular carcinoma and contribute to immunosuppression and unfavorable prognosis through TREM1. Cell Rep 2024; 43:113773. [PMID: 38350444 DOI: 10.1016/j.celrep.2024.113773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/05/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is an inflammation-associated cancer arising from viral or non-viral etiologies including steatotic liver diseases (SLDs). Expansion of immunosuppressive myeloid cells is a hallmark of inflammation and cancer, but their heterogeneity in HCC is not fully resolved and might underlie immunotherapy resistance. Here, we present a high-resolution atlas of innate immune cells from patients with HCC that unravels an SLD-associated contexture characterized by influx of inflammatory and immunosuppressive myeloid cells, including a discrete population of THBS1+ regulatory myeloid (Mreg) cells expressing monocyte- and neutrophil-affiliated genes. THBS1+ Mreg cells expand in SLD-associated HCC, populate fibrotic lesions, and are associated with poor prognosis. THBS1+ Mreg cells are CD163+ but distinguished from macrophages by high expression of triggering receptor expressed on myeloid cells 1 (TREM1), which contributes to their immunosuppressive activity and promotes HCC tumor growth in vivo. Our data support myeloid subset-targeted immunotherapies to treat HCC.
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Affiliation(s)
- Julie Giraud
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Domitille Chalopin
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France; University of Bordeaux, CNRS, IBGC, UMR 5095, 33000 Bordeaux, France
| | - Eloïse Ramel
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Thomas Boyer
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Atika Zouine
- Bordeaux University, CNRS UMS3427, INSERM US05, Flow Cytometry Facility, TransBioMed Core, 33000 Bordeaux, France
| | | | - Nicolas Larmonier
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Olivier Adotevi
- Université Bourgogne Franche-Comté, INSERM, UMR1098, 25000 Besançon, France
| | - Brigitte Le Bail
- Bordeaux University Hospital, Division of Pathology, Pellegrin Hospital, 33000 Bordeaux, France
| | - Jean-Frédéric Blanc
- University of Bordeaux Hospital, Division of Gastrohepatology and Oncology, Haut Leveque Hospital, 33604 Pessac, France
| | - Christophe Laurent
- University of Bordeaux Hospital, Division of Gastrohepatology and Oncology, Haut Leveque Hospital, 33604 Pessac, France
| | - Laurence Chiche
- University of Bordeaux Hospital, Division of Gastrohepatology and Oncology, Haut Leveque Hospital, 33604 Pessac, France
| | | | - Macha Nikolski
- University of Bordeaux, CNRS, IBGC, UMR 5095, 33000 Bordeaux, France
| | - Maya Saleh
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France; Institut National de la Recherche Scientifique (INRS), Armand Frappier Health & Biotechnology (AFSB) Research Center, Laval, QC H7V 1B7, Canada.
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Di Tommaso S, Dourthe C, Dupuy JW, Dugot-Senant N, Cappellen D, Cazier H, Paradis V, Blanc JF, Le Bail B, Balabaud C, Bioulac-Sage P, Saltel F, Raymond AA. Spatial characterisation of β-catenin-mutated hepatocellular adenoma subtypes by proteomic profiling of the tumour rim. JHEP Rep 2024; 6:100913. [PMID: 38304236 PMCID: PMC10831953 DOI: 10.1016/j.jhepr.2023.100913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 02/03/2024] Open
Abstract
Background & Aims Hepatocellular adenomas (HCAs) are rare, benign, liver tumours classified at the clinicopathological, genetic, and proteomic levels. The β-catenin-activated (b-HCA) subtypes harbour several mutation types in the β-catenin gene (CTNNB1) associated with different risks of malignant transformation or bleeding. Glutamine synthetase is a surrogate marker of β-catenin pathway activation associated with the risk of malignant transformation. Recently, we revealed an overexpression of glutamine synthetase in the rims of exon 3 S45-mutated b-HCA and exon 7/8-mutated b-HCA compared with the rest of the tumour. A difference in vascularisation was found in this rim shown by diffuse CD34 staining only at the tumour centre. Here, we aimed to characterise this tumour heterogeneity to better understand its physiopathological involvement. Methods Using mass spectrometry imaging, genetic, and proteomic analyses combined with laser capture microdissection, we compared the tumour centre with the tumour rim and with adjacent non-tumoural tissue. Results The tumour rim harboured the same mutation as the tumour centre, meaning both parts belong to the same tumour. Mass spectrometry imaging showed different spectral profiles between the rim and the tumour centre. Proteomic profiling revealed the significant differential expression of 40 proteins at the rim compared with the tumour centre. The majority of these proteins were associated with metabolism, with an expression profile comparable with a normal perivenous hepatocyte expression profile. Conclusions The difference in phenotype between the tumour centres and tumour rims of exon 3 S45-mutated b-HCA and exon 7/8-mutated b-HCA does not depend on CTNNB1 mutational status. In a context of sinusoidal arterial pathology, tumour heterogeneity at the rim harbours perivenous characteristics and could be caused by a functional peripheral venous drainage. Impact and implications Tumour heterogeneity was revealed in β-catenin-mutated hepatocellular adenomas (b-HCAs) via the differential expression of glutamine synthase at tumour rims. The combination of several spatial approaches (mass spectrometry imaging, genetic, and proteomic analyses) after laser capture microdissection allowed identification of a potential role for peripheral venous drainage underlying this difference. Through this study, we were able to illustrate that beyond a mutational context, many factors can downstream regulate gene expression and contribute to different clinicopathological phenotypes. We believe that the combinations of spatial analyses that we used could be inspiring for all researchers wanting to access heterogeneity information of liver tumours.
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Affiliation(s)
- Sylvaine Di Tommaso
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | - Cyril Dourthe
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | | | | | - David Cappellen
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Bordeaux University Hospital Center, Tumor Bank and Tumor Biology Laboratory, Pessac, France
| | - Hélène Cazier
- Pathology Department, Henri Mondor AP-HP Hospital, Créteil, France
| | - Valérie Paradis
- Pathology Department, Henri Mondor AP-HP Hospital, Créteil, France
| | - Jean-Frédéric Blanc
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Department of Hepatology and Oncology, Bordeaux University Hospital, INSERM CIC 1401, Bordeaux, France
| | - Brigitte Le Bail
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
| | - Charles Balabaud
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
| | - Paulette Bioulac-Sage
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
| | - Frédéric Saltel
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | - Anne-Aurélie Raymond
- Université Bordeaux, Inserm UMR1312 BoRdeaux Institute of onCology (BRIC), Bordeaux, France
- Oncoprot Platform, TBM-Core US 005, Bordeaux, France
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Costentin C, Audureau E, Park YN, Langella S, Vibert E, Laurent A, Cauchy F, Scatton O, Chirica M, Rhaiem R, Boleslawski E, di Tommaso L, Ferrero A, Yano H, Akiba J, Donadon M, Nebbia M, Detry O, Honoré P, Di Martino M, Schwarz L, Barbier L, Nault JC, Rhee H, Lim C, Brustia R, Paradis V, Guettier C, Le Bail B, Okumura S, Blanc JF, Calderaro J. ERS: A simple scoring system to predict early recurrence after surgical resection for hepatocellular carcinoma. Liver Int 2023; 43:2538-2547. [PMID: 37577984 DOI: 10.1111/liv.15683] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 06/20/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Surgical resection (SR) is a potentially curative treatment of hepatocellular carcinoma (HCC) hampered by high rates of recurrence. New drugs are tested in the adjuvant setting, but standardised risk stratification tools of HCC recurrence are lacking. OBJECTIVES To develop and validate a simple scoring system to predict 2-year recurrence after SR for HCC. METHODS 2359 treatment-naïve patients who underwent SR for HCC in 17 centres in Europe and Asia between 2004 and 2017 were divided into a development (DS; n = 1558) and validation set (VS; n = 801) by random sampling of participating centres. The Early Recurrence Score (ERS) was generated using variables associated with 2-year recurrence in the DS and validated in the VS. RESULTS Variables associated with 2-year recurrence in the DS were (with associated points) alpha-fetoprotein (<10 ng/mL:0; 10-100: 2; >100: 3), size of largest nodule (≥40 mm: 1), multifocality (yes: 2), satellite nodules (yes: 2), vascular invasion (yes: 1) and surgical margin (positive R1: 2). The sum of points provided a score ranging from 0 to 11, allowing stratification into four levels of 2-year recurrence risk (Wolbers' C-indices 66.8% DS and 68.4% VS), with excellent calibration according to risk categories. Wolber's and Harrell's C-indices apparent values were systematically higher for ERS when compared to Early Recurrence After Surgery for Liver tumour post-operative model to predict time to early recurrence or recurrence-free survival. CONCLUSIONS ERS is a user-friendly staging system identifying four levels of early recurrence risk after SR and a robust tool to design personalised surveillance strategies and adjuvant therapy trials.
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Affiliation(s)
- Charlotte Costentin
- Grenoble Alpes University, Institute for Advanced Biosciences, Research Center UGA/Inserm U 1209/CNRS 5309, Gastroenterology, Hepatology and GI Oncology Department, Digidune, Grenoble Alpes University Hospital, La Tronche, France
| | - Etienne Audureau
- Service de Santé Publique, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, and Université Paris-Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA7376, UPEC, Créteil, France
| | - Young Nyun Park
- Department of Pathology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Serena Langella
- Department of General and Oncological Surgery, Ospedale Mauriziano "Umberto I", Turin, Italy
| | - Eric Vibert
- Centre hépato-biliaire, Assistance Publique Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - Alexis Laurent
- Service de Chirurgie Digestive, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Créteil, France
| | - François Cauchy
- Service de Chirurgie Hepato-Bilio-Pancréatique et Transplantation Hépatique, Hôpital Beaujon, AP-HP et Université de Paris, Clichy, France
| | - Olivier Scatton
- Service de Chirurgie Digestive, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié Salpétrière, Paris, France
| | - Mircea Chirica
- Service de Chirurgie Digestive, CHU Grenoble-Alpes, Grenoble, France
| | - Rami Rhaiem
- Service de Chirurgie Digestive, CHU de Reims, Reims, France
| | - Emmanuel Boleslawski
- Univ. Lille, INSERM U1189, CHU Lille, Service de Chirurgie Digestive et Transplantations, Lille, France
| | - Luca di Tommaso
- Unit of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Alessandro Ferrero
- Department of General and Oncological Surgery, Ospedale Mauriziano "Umberto I", Turin, Italy
| | - Hirohisa Yano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Matteo Donadon
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - Martina Nebbia
- Department of Surgery, Colon and Rectal Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Olivier Detry
- Department of Abdominal Surgery and Transplantation, Centre Hospitalier Universitaire de Liege, University of Liege, Liege, Belgium
| | - Pierre Honoré
- Department of Abdominal Surgery and Transplantation, Centre Hospitalier Universitaire de Liege, University of Liege, Liege, Belgium
| | - Marcello Di Martino
- Department of Surgery, HPB Unit, University Hospital La Princesa, Madrid, Spain
| | - Lilian Schwarz
- Service de Chirurgie Digestive, CHU de Rouen, Rouen, France
| | - Louise Barbier
- Service de Chirurgie Digestive, CHU de Tours, Tours, France
| | - Jean-Charles Nault
- Liver Unit, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Bobigny, France
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, team « Functional Genomics of Solid Tumors », Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France
| | - Hyungjin Rhee
- Department of Radiology, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chetana Lim
- Service de Chirurgie Digestive, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié Salpétrière, Paris, France
| | - Raffaele Brustia
- Service de Chirurgie Digestive, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Créteil, France
| | - Valérie Paradis
- Service d'Anatomie et de Cytologie Pathologique, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Université de Paris, Clichy, France
| | - Catherine Guettier
- Service d'Anatomie et de Cytologie Pathologique, Assistance Publique Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Brigitte Le Bail
- Service de Pathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Shinya Okumura
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jean-Frédéric Blanc
- Service Hépato-Gastroentérologie et Oncologie Digestive, Centre Médico-Chirurgical Magellan, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Julien Calderaro
- Département de Pathologie, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Créteil, France
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4
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Marichez A, Chauveau B, Bail BL, Chiche L. Isolated IgG4-related cholecystitis mimicking an advanced gallbladder cancer: Don't fall into the trap. Dig Liver Dis 2023; 55:1297-1298. [PMID: 37316364 DOI: 10.1016/j.dld.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Arthur Marichez
- Department of Hepato-Bilio-Pancreatic Surgery and Liver Transplantation, Haut Leveque Hospital, Bordeaux University Hospital, France; INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France.
| | - Bertrand Chauveau
- Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux 33000, France; CNRS UMR 5164, University of Bordeaux, ImmunoConcEpT, 146 Rue Léo Saignat, Bordeaux 33000, France
| | - Brigitte Le Bail
- INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France; Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux 33000, France
| | - Laurence Chiche
- Department of Hepato-Bilio-Pancreatic Surgery and Liver Transplantation, Haut Leveque Hospital, Bordeaux University Hospital, France; INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France
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5
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Boursier J, Roux M, Costentin C, Chaigneau J, Fournier-Poizat C, Trylesinski A, Canivet CM, Michalak S, Le Bail B, Paradis V, Bedossa P, Sturm N, de Ledinghen V, Newsome PN. Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests. Nat Commun 2023; 14:5219. [PMID: 37633932 PMCID: PMC10460420 DOI: 10.1038/s41467-023-40328-4] [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: 01/12/2023] [Accepted: 07/24/2023] [Indexed: 08/28/2023] Open
Abstract
Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only -2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.
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Affiliation(s)
- Jérôme Boursier
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France.
| | - Marine Roux
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - Charlotte Costentin
- Univ. Grenoble Alpes, Clinique Universitaire d'Hépato-gastroentérologie, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes; Institute for Advanced Biosciences, CNRS UMR 5309-INSERM U1209, Grenoble, France
| | - Julien Chaigneau
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | | | | | - Clémence M Canivet
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - Sophie Michalak
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
- Pathology Department, Angers University Hospital, Angers, France
| | - Brigitte Le Bail
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
- Bordeaux Institute of Oncology, BRIC UMR U1312, INSERM, Université de Bordeaux, Bordeaux, France
| | - Valérie Paradis
- Department of Pathology, Physiology and Imaging, Beaujon Hospital Paris Diderot University, Paris, France
| | - Pierre Bedossa
- Department of Pathology, Physiology and Imaging, Beaujon Hospital Paris Diderot University, Paris, France
- Liverpat, Paris, France
| | - Nathalie Sturm
- Pathology Department, CHU Grenoble Alpes, Grenoble, France
| | - Victor de Ledinghen
- Bordeaux Institute of Oncology, BRIC UMR U1312, INSERM, Université de Bordeaux, Bordeaux, France
- Hepatology Unit, Haut Leveque hospital, Bordeaux University Hospital, Bordeaux, France
| | - Philip N Newsome
- National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Centre for Liver & Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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6
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Gest C, Sena S, Dif L, Neaud V, Loesch R, Dugot-Senant N, Paysan L, Piquet L, Robbe T, Allain N, Dembele D, Guettier C, Bioulac-Sage P, Rullier A, Le Bail B, Grosset CF, Saltel F, Lagrée V, Colnot S, Moreau V. Antagonism between wild-type and mutant β-catenin controls hepatoblastoma differentiation via fascin-1. JHEP Rep 2023; 5:100691. [PMID: 37153687 PMCID: PMC10159820 DOI: 10.1016/j.jhepr.2023.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 05/10/2023] Open
Abstract
Background & Aims β-catenin is a well-known effector of the Wnt pathway, and a key player in cadherin-mediated cell adhesion. Oncogenic mutations of β-catenin are very frequent in paediatric liver primary tumours. Those mutations are mostly heterozygous, which allows the co-expression of wild-type (WT) and mutated β-catenins in tumour cells. We investigated the interplay between WT and mutated β-catenins in liver tumour cells, and searched for new actors of the β-catenin pathway. Methods Using an RNAi strategy in β-catenin-mutated hepatoblastoma (HB) cells, we dissociated the structural and transcriptional activities of β-catenin, which are carried mainly by WT and mutated proteins, respectively. Their impact was characterised using transcriptomic and functional analyses. We studied mice that develop liver tumours upon activation of β-catenin in hepatocytes (APCKO and β-cateninΔexon3 mice). We used transcriptomic data from mouse and human HB specimens, and used immunohistochemistry to analyse samples. Results We highlighted an antagonistic role of WT and mutated β-catenins with regard to hepatocyte differentiation, as attested by alterations in the expression of hepatocyte markers and the formation of bile canaliculi. We characterised fascin-1 as a transcriptional target of mutated β-catenin involved in tumour cell differentiation. Using mouse models, we found that fascin-1 is highly expressed in undifferentiated tumours. Finally, we found that fascin-1 is a specific marker of primitive cells including embryonal and blastemal cells in human HBs. Conclusions Fascin-1 expression is linked to a loss of differentiation and polarity of hepatocytes. We present fascin-1 as a previously unrecognised factor in the modulation of hepatocyte differentiation associated with β-catenin pathway alteration in the liver, and as a new potential target in HB. Impact and implications The FSCN1 gene, encoding fascin-1, was reported to be a metastasis-related gene in various cancers. Herein, we uncover its expression in poor-prognosis hepatoblastomas, a paediatric liver cancer. We show that fascin-1 expression is driven by the mutated beta-catenin in liver tumour cells. We provide new insights on the impact of fascin-1 expression on tumour cell differentiation. We highlight fascin-1 as a marker of immature cells in mouse and human hepatoblastomas.
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Affiliation(s)
- Caroline Gest
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Sandra Sena
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Lydia Dif
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Véronique Neaud
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Robin Loesch
- INSERM, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers (CRC), Paris, France
| | | | - Lisa Paysan
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Léo Piquet
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Terezinha Robbe
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Nathalie Allain
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Doulaye Dembele
- IGBMC, CNRS UMR 7104 – INSERM U 1258 – Université de Strasbourg, Illkirch, France
| | - Catherine Guettier
- Department of Pathology, Bicêtre University Hospital, University of Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Anne Rullier
- Department of Pathology, University Bordeaux Hospital, Bordeaux, France
| | - Brigitte Le Bail
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
- Department of Pathology, University Bordeaux Hospital, Bordeaux, France
| | | | - Frédéric Saltel
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Valérie Lagrée
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Sabine Colnot
- INSERM, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers (CRC), Paris, France
| | - Violaine Moreau
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
- Corresponding author. Address: 146 Rue Léo Saignat, F-33076, Bordeaux, France. Tel.: +33-5-57-57-12-72.
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Gigante E, Hobeika C, Le Bail B, Paradis V, Tougeron D, Lequoy M, Bouattour M, Blanc JF, Ganne-Carrié N, Tran H, Hollande C, Allaire M, Amaddeo G, Regnault H, Vigneron P, Ronot M, Elkrief L, Verset G, Trepo E, Zaanan A, Ziol M, Ningarhari M, Calderaro J, Edeline J, Nault JC. Systemic Treatments with Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy in Patients with Unresectable or Metastatic Hepatocholangiocarcinoma. Liver Cancer 2022; 11:460-473. [PMID: 36158591 PMCID: PMC9485952 DOI: 10.1159/000525488] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/22/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUNDS AND AIMS Even if no systemic treatment is currently validated for unresectable hepatocellular-cholangiocarcinoma (cHCC-CCA), tyrosine kinase inhibitors (TKIs) and platinum-based chemotherapy are frequently used in clinical practice. Our study aims to describe the effectiveness of first-line systemic treatments in patients with cHCC-CCA. PATIENTS AND METHODS Patients with histological diagnosis of unresectable or metastatic cHCC-CCA confirmed by a centralized review (WHO classification 2019) and who received systemic treatment from 2009 to 2020 were included retrospectively in 11 centers. The outcomes of patients with cHCC-CCA were compared with patients with hepatocellular carcinoma (HCC) treated by sorafenib (n = 117) and with intrahepatic cholangiocarcinoma (iCCA, n = 94) treated mainly by platinum-based chemotherapy using a frailty Cox model. The efficacy of TKIs and platinum-based chemotherapies in patients with cHCC-CCA was assessed using a doubly robust estimator. RESULTS A total of 83 patients with cHCC-CCA were included and were predominantly male (72%) with underlying cirrhosis (55%). 67% of patients had extrahepatic metastases and 31% macrovascular tumor invasion. cHCC-CCAs were more often developed on cirrhosis (55.4%) than iCCA (26.6%) but less frequently than HCC (80.2%) (p < 0.001). Both HCC (36.8% and cHCC-CCA (66.2%) had less frequent extrahepatic metastases than iCCA (81%) (p < 0.001). Unadjusted overall survival (OS) was better in iCCA (13 months) compared to cHCC-CCA (12 months) and HCC (11 months) (p = 0.130). In multivariable analysis, after adjustment by a Cox frailty model, patients with cHCC-CCA had the same survival as HCC and iCCA (HR = 0.67, 95% CI: 0.37-1.22, p = 0.189 and HR = 0.66, 95% CI: 0.43-1.02, p = 0.064, respectively). ALBI score (HR = 2.15; 95% CI: 1.23-3.76; p = 0.009), ascites (HR = 3.45, 95% CI: 1.31-9.03, p = 0.013), and tobacco use (HR = 2.29, 95% CI: 1.08-4.87, p = 0.032) were independently associated with OS in patients with cHCC-CCA. Among patients with cHCC-CCA, 25 patients treated with TKI were compared with 54 patients who received platinum-based chemotherapies. Patients treated with TKI had a median OS of 8.3 months compared to 11.9 months for patients treated with platinum-based chemotherapy (p = 0.86). After a robust doubly adjustment on tumor number and size, vascular invasion, ALBI, MELD, and cirrhosis, the type of treatment did not impact OS (HR = 0.92, 95% CI: 0.27-3.15, p = 0.88) or progression-free survival (HR = 1.24, 95% CI: 0.44-3.49, p = 0.67). CONCLUSIONS First-line systemic treatments with TKIs or platinum-based chemotherapies have similar efficacy in patients with unresectable/metastatic cHCC-CCA. The ALBI score predicts OS.
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Affiliation(s)
- Elia Gigante
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France et Centre de recherche sur l'inflammation, Inserm, Université de Paris, INSERM UMR 1149, De l'inflammation au cancer, Paris, France
| | - Christian Hobeika
- Service de Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique, Hôpital de la Pitié Salpêtrière, AP-HP, Paris, France
| | - Brigitte Le Bail
- Service d'Anatomo-Pathologie, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France
| | - Valérie Paradis
- Service d'Anatomo-Pathologie, Hôpital Beaujon, AP-HP, Clichy, France et Centre de recherche sur l'inflammation, Inserm, Université de Paris, INSERM UMR 1149, De l'inflammation au cancer, Paris, France
| | - David Tougeron
- Service d'Hépato-gastroentérologie, CHU de Poitiers et Université de Poitiers, Poitiers, France
| | - Marie Lequoy
- Service d'Hépatologie, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Mohamed Bouattour
- Unité Oncologie Hépatique, Service d'Hépatologie, Hôpital Beaujon, AP-HP, Paris, France
| | - Jean-Frederic Blanc
- Service d'Hépato-gastroentérologie et d'Oncologie digestive, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac: INSERM U1053, Université de Bordeaux, Bordeaux, France
| | - Nathalie Ganne-Carrié
- Service d'Hépatologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, Paris, France,Centre de Recherche des Cordeliers, Université de Paris, INSERM UMR 1138, Paris, France
| | - Henri Tran
- Service d'Hépatologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, Paris, France,Centre de Recherche des Cordeliers, Université de Paris, INSERM UMR 1138, Paris, France
| | | | - Manon Allaire
- Service d'Hépatologie, Hôpital de la Pitié Salpêtrière, AP-HP, Paris, France
| | | | | | - Paul Vigneron
- Service d'Hépatologie, Hôpital Mondor, AP-HP, Paris, France
| | - Maxime Ronot
- Centre de recherche sur l'inflammation, Inserm, Université de Paris, INSERM UMR 1149, De l'inflammation au cancer, Paris, France,Service de Radiologie, Hôpital Beaujon, AP-HP, Paris, France
| | - Laure Elkrief
- Service d'Hépatologie HC, UMUH 1, CHRU Tours, Tours, France
| | - Gontran Verset
- Department of Gastroenterology and Digestive Oncology, Erasme Hospital, Brussels, Belgium
| | - Eric Trepo
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium
| | - Aziz Zaanan
- Service Hépato-gastro-entérologie et Oncologie digestive, Hôpital Européen Georges-Pompidou, Université de Paris, AP-HP centre, Paris, France
| | - Marianne Ziol
- Service d'Anatomo-Pathologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Massih Ningarhari
- Service des Maladies de l'appareil digestif et nutrition–Hépatologie, CHRU de Lille–Hôpital Claude Huriez, Lille, France
| | - Julien Calderaro
- Service d'Anatomo-Pathologie, Hôpital Mondor, AP-HP, Paris, France
| | - Julien Edeline
- Service d'Oncologie, Centre Eugène Marquis, Rennes, France
| | - Jean-Charles Nault
- Service d'Hépatologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, Paris, France,Centre de Recherche des Cordeliers, Université de Paris, INSERM UMR 1138, Paris, France,*Jean-Charles Nault,
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Julien C, Le Bail B, Balabaud C, Bioulac-Sage P. Risk factors for bleeding hepatocellular adenoma. Liver Int 2022; 42:947-948. [PMID: 35129283 DOI: 10.1111/liv.15184] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Céline Julien
- Department of Digestive Surgery, University Bordeaux Hospital, Bordeaux, France
| | - Brigitte Le Bail
- Department of Pathology, University Bordeaux Hospital, Bordeaux, France.,INSERM, BRIC, University Bordeaux, Bordeaux, France
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Boursier J, Canivet CM, Costentin C, Lannes A, Delamarre A, Sturm N, Le Bail B, Michalak S, Oberti F, Hilleret MN, Irles-Depé M, Fouchard I, Hermabessiere P, Barthelon J, Calès P, Cariou B, de Ledinghen V, Roux M. Impact of Type 2 Diabetes on the Accuracy of Noninvasive Tests of Liver Fibrosis With Resulting Clinical Implications. Clin Gastroenterol Hepatol 2022; 21:1243-1251.e12. [PMID: 35288342 DOI: 10.1016/j.cgh.2022.02.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Noninvasive tests (NITs) of liver fibrosis have been suggested to be less accurate in type 2 diabetes mellitus (T2DM). We aimed to compare the accuracy of 6 NITs between patients with or without T2DM, explain any differences, and adapt diagnostic algorithms for clinical practice accordingly. METHODS We included 1051 patients with nonalcoholic fatty liver disease with liver biopsy, blood fibrosis tests (Nonalcoholic Fatty Liver Disease Fibrosis Score, FIB4, Fibrotest, FibroMeter), vibration-controlled transient elastography (VCTE), and the combinatory elasto-blood test FibroMeterVCTE. The study endpoint was advanced fibrosis on liver biopsy. RESULTS NIT areas under the receiver operating characteristic curve were significantly lower in patients with T2DM, mostly because of a decrease in specificity. For FIB4, this decrease in specificity was only related to the higher age of patients with T2DM enrolled. For Fibrotest, FibroMeter, and FibroMeterVCTE, the decrease in specificity was related to age but also to higher alpha2-macroglobulin level, which is known to increase in T2DM. Sensitivity was unaffected by T2DM, but it masked a doubled raw number of false negatives because of the 2-fold higher prevalence of advanced fibrosis in that setting. The sequential algorithm FIB4-vibration-controlled transient elastography had 90.3% accuracy in patients without T2DM vs 79.0% in those with (P < .001). Algorithms using first-line specialized tests maintained a low rate of false negatives and false positives in T2DM. CONCLUSIONS The decrease in NIT accuracy observed in T2DM is partly biased by the different characteristics of the groups studied, but also linked to T2DM itself through modification of the levels of some NIT biomarkers. Specialized tests should be used first-line to diagnose advanced liver fibrosis in T2DM.
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Affiliation(s)
- Jérôme Boursier
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France.
| | - Clémence M Canivet
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
| | - Charlotte Costentin
- Hepato-Gastroenterology Department, Grenoble Alpes University Hospital, Grenoble, France; Institute for Advanced Biosciences, Research Center UGA/Inserm U 1209/CNRS 5309, University Grenoble Alpes, Grenoble, France
| | - Adrien Lannes
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
| | - Adèle Delamarre
- Hepatology Unit, Haut Leveque Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Nathalie Sturm
- Pathology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Brigitte Le Bail
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
| | - Sophie Michalak
- HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France; Pathology Department, Angers University Hospital, Angers, France
| | - Frédéric Oberti
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
| | - Marie-Noelle Hilleret
- Hepato-Gastroenterology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Marie Irles-Depé
- Hepatology Unit, Haut Leveque Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Isabelle Fouchard
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
| | - Paul Hermabessiere
- Hepatology Unit, Haut Leveque Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Justine Barthelon
- Hepato-Gastroenterology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Paul Calès
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France; HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
| | - Bertrand Cariou
- University of Nantes, Nantes University Hospital, CNRS, INSERM, Thorax Institute, F-44000 Nantes, France
| | - Victor de Ledinghen
- Hepatology Unit, Haut Leveque Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Marine Roux
- HIFIH Laboratory UPRES EA3859, SFR 4208, Angers University, Angers, France
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10
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Julien C, Le Bail B, Chiche L, Balabaud C, Bioulac-Sage P. Malignant transformation of hepatocellular adenoma. JHEP Rep 2022; 4:100430. [PMID: 35243278 PMCID: PMC8883183 DOI: 10.1016/j.jhepr.2022.100430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/18/2023] Open
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11
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Paisant A, Lemoine S, Cassinotto C, de Lédinghen V, Ronot M, Irlès-Depé M, Vilgrain V, Le Bail B, Paradis V, Canivet CM, Michalak S, Rousselet MC, Rautou PE, Lebigot J, Hunault G, Crouan A, Aubé C, Boursier J. Reliability Criteria of Two-Dimensional Shear Wave Elastography: Analysis of 4277 Measurements in 788 Patients. Clin Gastroenterol Hepatol 2022; 20:400-408.e10. [PMID: 33340779 DOI: 10.1016/j.cgh.2020.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Two-dimensional shear wave elastography (2D-SWE) is an accurate method for the non-invasive evaluation of liver fibrosis. We aimed to determine the reliability criteria and the number of necessary reliable measurements for 2D-SWE. METHODS 788 patients with chronic liver disease underwent liver biopsy and 2D-SWE examination in three centers. The 4277 2D-SWE measurements performed were 2:1 randomly divided into derivation (n = 2851) and validation (n = 1426) sets. Reliability criteria for a 2D-SWE measurement were defined in the derivation set from the intrinsic characteristics given by the device (mean liver stiffness, standard deviation, diameter of the region of interest), with further evaluation in the validation set. RESULTS In the whole population of 4277 measurements, AUROC for bridging fibrosis was 0.825 ± 0.006 and AUROC for cirrhosis was 0.880 ± 0.006. Mean stiffness and coefficient of variation (CV) were independent predictors of bridging fibrosis or cirrhosis. From these two parameters, new criteria were derived to define a reliable 2D-SWE measurement: stiffness <8.8 kPa, or stiffness between 8.8-11.9 kPa with CV <0.25, or stiffness ≥12.0 kPa with CV <0.10. In the validation set, AUROC for bridging fibrosis was 0.830 ± 0.013 in reliable measurements vs 0.667 ± 0.031 in unreliable measurements (P < .001). AUROC for cirrhosis was 0.918±0.014 vs 0.714 ± 0.027, respectively (P < .001). The best diagnostic accuracy for a 2D-SWE examination was achieved from three reliable measurements. CONCLUSIONS Reliability of a 2D-SWE measurement relies on the coefficient of variation and the liver stiffness level. A 2D-SWE examination should include three reliable measurements according to our new criteria.
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Affiliation(s)
- Anita Paisant
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France.
| | - Sylvain Lemoine
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Christophe Cassinotto
- Département de Radiologie, Hôpital Saint-Eloi Hospital, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Victor de Lédinghen
- Service d'Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Maxime Ronot
- Service de Radiologie, HUPNSV, Hôpital Beaujon, Clichy, INSERM UMR 1149, Université de Paris, Paris, France
| | - Marie Irlès-Depé
- Service d'Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Valérie Vilgrain
- Service de Radiologie, HUPNSV, Hôpital Beaujon, Clichy, INSERM UMR 1149, Université de Paris, Paris, France
| | - Brigitte Le Bail
- Service d'Anatomopathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Valérie Paradis
- Service d'Anatomopathologie, HUPNSV, Hôpital Beaujon, Clichy, France
| | - Clémence M Canivet
- Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Sophie Michalak
- Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Marie-Christine Rousselet
- Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | | | - Jérôme Lebigot
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France
| | - Gilles Hunault
- Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France
| | - Anne Crouan
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Christophe Aubé
- Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France
| | - Jérôme Boursier
- Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France
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12
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Dourthe C, Julien C, Di Tommaso S, Dupuy JW, Dugot-Senant N, Brochard A, Le Bail B, Blanc JF, Chiche L, Balabaud C, Bioulac-Sage P, Saltel F, Raymond AA. Proteomic Profiling of Hepatocellular Adenomas Paves the Way to Diagnostic and Prognostic Approaches. Hepatology 2021; 74:1595-1610. [PMID: 33754354 DOI: 10.1002/hep.31826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/26/2021] [Accepted: 03/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Through an exploratory proteomic approach based on typical hepatocellular adenomas (HCAs), we previously identified a diagnostic biomarker for a distinctive subtype of HCA with high risk of bleeding, already validated on a multicenter cohort. We hypothesized that the whole protein expression deregulation profile could deliver much more informative data for tumor characterization. Therefore, we pursued our analysis with the characterization of HCA proteomic profiles, evaluating their correspondence with the established genotype/phenotype classification and assessing whether they could provide added diagnosis and prognosis values. APPROACH AND RESULTS From a collection of 260 cases, we selected 52 typical cases of all different subgroups on which we built a reference HCA proteomics database. Combining laser microdissection and mass-spectrometry-based proteomic analysis, we compared the relative protein abundances between tumoral (T) and nontumoral (NT) liver tissues from each patient and we defined a specific proteomic profile of each of the HCA subgroups. Next, we built a matching algorithm comparing the proteomic profile extracted from a patient with our reference HCA database. Proteomic profiles allowed HCA classification and made diagnosis possible, even for complex cases with immunohistological or genomic analysis that did not lead to a formal conclusion. Despite a well-established pathomolecular classification, clinical practices have not substantially changed and the HCA management link to the assessment of the malignant transformation risk remains delicate for many surgeons. That is why we also identified and validated a proteomic profile that would directly evaluate malignant transformation risk regardless of HCA subtype. CONCLUSIONS This work proposes a proteomic-based machine learning tool, operational on fixed biopsies, that can improve diagnosis and prognosis and therefore patient management for HCAs.
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Affiliation(s)
- Cyril Dourthe
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | - Céline Julien
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Department of Digestive Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Sylvaine Di Tommaso
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | | | | | | | - Brigitte Le Bail
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - Jean-Frédéric Blanc
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Department of Hepatology and Oncology, Bordeaux University Hospital, Bordeaux, France
| | - Laurence Chiche
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Department of Digestive Surgery, Bordeaux University Hospital, Bordeaux, France
| | | | | | - Frédéric Saltel
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Oncoprot Platform, TBM-Core US 005, Bordeaux, France
| | - Anne-Aurélie Raymond
- Univ. Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France.,Oncoprot Platform, TBM-Core US 005, Bordeaux, France
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Fu C, Wai JW, Nik Mustapha NR, Irles M, Wong GLH, Mahadeva S, Shili S, Chan AWH, Merrouche W, Chan HLY, Foucher J, Le Bail B, Wong VWS, Chan WK, de Lédinghen V. Performance of Simple Fibrosis Scores in Nonobese Patients With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2020; 18:2843-2845.e2. [PMID: 31574313 DOI: 10.1016/j.cgh.2019.09.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/12/2019] [Accepted: 09/20/2019] [Indexed: 02/07/2023]
Abstract
Because only a minority of patients with nonalcoholic fatty liver disease (NAFLD) have advanced fibrosis and would eventually develop liver-related complications, current guidelines recommend initial assessment with noninvasive tests of fibrosis.1-3 Most previous studies focused on overweight and obese patients. Despite a strong association between obesity and NAFLD, 3%-30% of people with relatively normal body mass index (BMI) may still have NAFLD.4,5 Hence, this study aims to evaluate the performance of the common noninvasive tests in non-obese (BMI <25 kg/m2) and obese (BMI ≥25 kg/m2) NAFLD patients.
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Affiliation(s)
- Charmaine Fu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Janae Wentong Wai
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | | | - Marie Irles
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Sanjiv Mahadeva
- Department of Medicine, Gastroenterology and Hepatology Unit, University of Malaya, Kuala Lumpur, Malaysia
| | - Sarah Shili
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Anthony Wing-Hung Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong
| | - Wassil Merrouche
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Henry Lik-Yuen Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Juliette Foucher
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Brigitte Le Bail
- Pathology Unit, Hôpital Pellegrin, Bordeaux University Hospital, Pessac, France; INSERM U1053, Bordeaux University, Bordeaux, France
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Wah Kheong Chan
- Department of Medicine, Gastroenterology and Hepatology Unit, University of Malaya, Kuala Lumpur, Malaysia.
| | - Victor de Lédinghen
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France; INSERM U1053, Bordeaux University, Bordeaux, France.
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Del Bello A, Neau-Cransac M, Lavayssiere L, Dubois V, Congy-Jolivet N, Visentin J, Danjoux M, Le Bail B, Hervieu V, Boillot O, Antonini T, Kamar N, Dumortier J. Outcome of Liver Transplant Patients With Preformed Donor-Specific Anti-Human Leukocyte Antigen Antibodies. Liver Transpl 2020; 26:256-267. [PMID: 31612580 DOI: 10.1002/lt.25663] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/22/2019] [Indexed: 02/07/2023]
Abstract
After liver transplantation (LT), the role of preformed donor-specific anti-human leukocyte antigen antibodies (pDSAs) remains incompletely understood. We conducted a retrospective, case-control analysis to determine the impact of pDSAs after LT in 3 French transplant centers (Bordeaux, Lyon, and Toulouse). Among the 1788 LTs performed during the study period, 142 (7.9%) had at least 1 pDSA. The patient survival rate was not different between patients who received an LT with pDSAs and the matched-control group. A liver biopsy was performed 1 year after transplantation in 87 recipients. The metavir fibrosis score did not differ between both groups (1 ± 0.8 versus 0 ± 0.8; P = 0.80). However, undergoing a retransplantation (hazard ratio [HR] = 2.6, 95% confidence interval [CI], 1.02-6.77; P = 0.05) and receiving induction therapy with polyclonal antibodies (HR = 2.5; 95% CI, 1.33-4.74; P = 0.01) were associated with a higher risk of mortality. Nonetheless, high mean fluorescence intensity (MFI) donor-specific antibodies (ie, >10,000 with One Lambda assay or >5000 with Immucor assay) were associated with an increased risk of acute rejection (HR = 2.0; 95% CI, 1.12-3.49; P = 0.02). Acute antibody-mediated rejection was diagnosed in 10 patients: 8 recipients were alive 34 (1-125) months after rejection. The use of polyclonal antibodies or rituximab as an induction therapy did not reduce the risk of acute rejection, but it increased the risk of infectious complications. In conclusion, high MFI pDSAs increase the risk of graft rejection after LT, but they do not reduce medium-term and longterm patient survival. The use of a T or B cell-depleting agent did not reduce the risk of acute rejection.
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Affiliation(s)
- Arnaud Del Bello
- Department of Nephrology and Organ Transplantation, Centre Hospitalier Universitaire Toulouse-Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Martine Neau-Cransac
- Department of Nephrology and Kidney Transplantation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Laurence Lavayssiere
- Department of Nephrology and Organ Transplantation, Centre Hospitalier Universitaire Toulouse-Rangueil, Toulouse, France
| | - Valérie Dubois
- Etablissement Français du Sang Auvergne Rhône Alpes site de Lyon, Lyon, France
| | - Nicolas Congy-Jolivet
- Laboratoire d'Immunogénétique Moléculaire, Laboratoire d'Immunologie, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Jonathan Visentin
- Laboratoire d'Immunologie et Immunogénétique, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Immuno Concept, Unités Mixtes de Recherche Centre National de la Recherche Scientifique 5164, Bordeaux, France.,Université de Bordeaux, Bordeaux, France
| | - Marie Danjoux
- Département d'Anatomie et de Cytologie Pathologiques, IUCT Oncopole, Toulouse, France
| | - Brigitte Le Bail
- Département d'Anatomie et de Cytologie pathologiques, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Valérie Hervieu
- Groupement Hospitalier est Département d'Anatomie et de Cytologie Pathologiques, Hospices Civils de Lyon, Bron, France.,Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Olivier Boillot
- Université Claude Bernard Lyon 1, Villeurbanne, France.,Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Teresa Antonini
- Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, Centre Hospitalier Universitaire Toulouse-Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Jérôme Dumortier
- Université Claude Bernard Lyon 1, Villeurbanne, France.,Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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15
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Wong VWS, Irles M, Wong GLH, Shili S, Chan AWH, Merrouche W, Shu SST, Foucher J, Le Bail B, Chan WK, Chan HLY, de Ledinghen V. Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease. Gut 2019; 68:2057-2064. [PMID: 30658997 DOI: 10.1136/gutjnl-2018-317334] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/03/2018] [Accepted: 12/27/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The latest model of vibration-controlled transient elastography (VCTE) automatically selects M or XL probe according to patients' body built. We aim to test the application of a unified interpretation of VCTE results with probes appropriate for the body mass index (BMI) and hypothesise that this approach is not affected by hepatic steatosis. DESIGN We prospectively recruited 496 patients with non-alcoholic fatty liver disease who underwent VCTE by both M and XL probes within 1 week before liver biopsy. RESULTS 391 (78.8%) and 433 (87.3%) patients had reliable liver stiffness measurement (LSM) (10 successful acquisitions and IQR:median ratio ≤0.30) by M and XL probes, respectively (p<0.001). The area under the receiver operating characteristic curves was similar between the two probes (0.75-0.88 for F2-4, 0.83-0.91 for F4). When used in the same patient, LSM by XL probe was lower than that by M probe (mean difference 2.3 kPa). In contrast, patients with BMI ≥30 kg/m2 had higher LSM regardless of the probe used. When M and XL probes were used in patients with BMI <30 and ≥30 kg/m2, respectively, they yielded nearly identical median LSM at each fibrosis stage and similar diagnostic performance. Severe steatosis did not increase LSM or the rate of false-positive diagnosis by XL probe. CONCLUSION High BMI but not severe steatosis increases LSM. The same LSM cut-offs can be used without further adjustment for steatosis when M and XL probes are used according to the appropriate BMI.
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Affiliation(s)
- Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Marie Irles
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Sarah Shili
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Anthony Wing-Hung Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Wassil Merrouche
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Sally She-Ting Shu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Juliette Foucher
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France
| | - Brigitte Le Bail
- Pathology Unit, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France.,INSERM U1053, Bordeaux University, Bordeaux, France
| | - Wah Kheong Chan
- Department of Medicine, Gastroenterology and Hepatology Unit, University of Malaya, Kuala Lumpur, Malaysia
| | - Henry Lik-Yuen Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Victor de Ledinghen
- Centre d'Investigation de la Fibrose Hépatique, Bordeaux University Hospital, Pessac, France.,INSERM U1053, Bordeaux University, Bordeaux, France
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16
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Boursier J, Guillaume M, Leroy V, Irlès M, Roux M, Lannes A, Foucher J, Zuberbuhler F, Delabaudière C, Barthelon J, Michalak S, Hiriart JB, Peron JM, Gerster T, Le Bail B, Riou J, Hunault G, Merrouche W, Oberti F, Pelade L, Fouchard I, Bureau C, Calès P, de Ledinghen V. New sequential combinations of non-invasive fibrosis tests provide an accurate diagnosis of advanced fibrosis in NAFLD. J Hepatol 2019; 71:389-396. [PMID: 31102719 DOI: 10.1016/j.jhep.2019.04.020] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Advanced liver fibrosis is an important diagnostic target in non-alcoholic fatty liver disease (NAFLD) as it defines the subgroup of patients with impaired prognosis. The non-invasive diagnosis of advanced fibrosis is currently limited by the suboptimal positive predictive value and the grey zone (representing indeterminate diagnosis) of fibrosis tests. Here, we aimed to determine the best combination of non-invasive tests for the diagnosis of advanced fibrosis in NAFLD. METHODS A total of 938 patients with biopsy-proven NAFLD were randomized 2:1 into derivation and validation sets. All patients underwent liver stiffness measurement with vibration controlled transient elastography (VCTE) and blood fibrosis tests (NAFLD fibrosis score, Fibrosis-4 [FIB4], Fibrotest, Hepascore, FibroMeter). FibroMeterVCTE, which combines VCTE results and FibroMeter markers in a single test, was also calculated in all patients. RESULTS For the diagnosis of advanced fibrosis, VCTE was significantly more accurate than the blood tests (area under the receiver operating characteristic curve [AUROC]: 0.840 ± 0.013, p ≤0.005). FibroMeter was the most accurate blood test (AUROC: 0.793 ± 0.015, p ≤0.017). The combinatory test FibroMeterVCTE outperformed VCTE and blood tests (AUROC: 0.866 ± 0.012, p ≤0.005). The sequential combination of FIB4 then FibroMeterVCTE (FIB4-FMVCTE algorithm) or VCTE then FibroMeterVCTE (VCTE-FMVCTE algorithm) provided an excellent diagnostic accuracy of 90% for advanced fibrosis, with liver biopsy only required to confirm the diagnosis in 20% of cases. The FIB4-FMVCTE and VCTE-FMVCTE algorithms were significantly more accurate than the pragmatic algorithms currently proposed. CONCLUSION The sequential combination of fibrosis tests in the FIB4-FMVCTE and VCTE-FMVCTE algorithms provides a highly accurate solution for the diagnosis of advanced fibrosis in NAFLD. These algorithms should now be validated for the diagnosis of advanced liver fibrosis in diabetology or primary care settings. LAY SUMMARY The evaluation of liver fibrosis is mandatory in non-alcoholic fatty liver disease (NAFLD), as advanced fibrosis identifies the subgroup of patients with impaired prognosis. FibroMeterVCTE is a new fibrosis test combining blood markers and the result of vibration controlled transient elastography (VCTE) into a single diagnostic test. Our results show that FibroMeterVCTE outperforms other blood fibrosis tests and VCTE alone for the diagnosis of advanced fibrosis in a large multi-centric cohort of 938 patients with biopsy-proven NAFLD. Sequential algorithms using a simple blood test or VCTE as a first-line procedure, then FibroMeterVCTE as a second-line test accurately classified 90% of patients.
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Affiliation(s)
- Jérôme Boursier
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France.
| | - Maeva Guillaume
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Institut CARDIOMET, Fédération Hospitalo-Universitaire IMPACT, Toulouse, France
| | - Vincent Leroy
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France; INSERM U1209, Université Grenoble-Alpes, Grenoble, France
| | - Marie Irlès
- Service d'Hépatologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Marine Roux
- Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Adrien Lannes
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Juliette Foucher
- Service d'Hépatologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Floraine Zuberbuhler
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Cyrielle Delabaudière
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Justine Barthelon
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Sophie Michalak
- Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France; Département de Pathologie Tissulaire et Cellulaire, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Jean-Baptiste Hiriart
- Service d'Hépatologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Jean-Marie Peron
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Institut CARDIOMET, Fédération Hospitalo-Universitaire IMPACT, Toulouse, France
| | - Theophile Gerster
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Brigitte Le Bail
- Service d'Anatomopathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Jeremie Riou
- MINT UMR INSERM 1066, CNRS 6021, Angers University, France
| | - Gilles Hunault
- Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Wassil Merrouche
- Service d'Hépatologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Frederic Oberti
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Laurence Pelade
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Isabelle Fouchard
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Christophe Bureau
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Institut CARDIOMET, Fédération Hospitalo-Universitaire IMPACT, Toulouse, France
| | - Paul Calès
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, Angers, France
| | - Victor de Ledinghen
- Service d'Hépatologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France; INSERM U1053, Université de Bordeaux, Bordeaux, France
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17
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Bioulac-Sage P, Sempoux C, Frulio N, Le Bail B, Blanc JF, Castain C, Laurent C, Trillaud H, Chiche L, Balabaud C. Snapshot summary of diagnosis and management of hepatocellular adenoma subtypes. Clin Res Hepatol Gastroenterol 2019; 43:12-19. [PMID: 30213653 DOI: 10.1016/j.clinre.2018.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/10/2018] [Accepted: 07/20/2018] [Indexed: 02/04/2023]
Abstract
Hepatocellular adenomas (HCA) are rare benign hepatocellular tumors occurring mainly in women taking oral contraceptives with 2 major complications: severe bleeding and malignant transformation that can be avoided if nodules exceeding 5 cm are resected. This simple attitude has been challenged in the recent years with HCA in men, in young adolescent, in aged persons, and complications in hepatocellular adenomas below 5 cm. The discovery of specific mutations leading to specific phenotypes has modified the clinical spectrum of the disease. The phenotypic immune classification of HCA based on the molecular classification is being widely used in liver referral centers. The aim of this snapshot is to briefly present for each subtype the clinical, pathological, immuno-pathological criteria as well as the risk of complications and guidelines for treatment and management.
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Affiliation(s)
- Paulette Bioulac-Sage
- Inserm, UMR1053 Bordeaux research in translational oncology, BaRITOn, université de Bordeaux, 33076 Bordeaux, France; Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, 25 rue du Bugnon, CH-1011 Lausanne, Switzerland.
| | - Christine Sempoux
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, 25 rue du Bugnon, CH-1011 Lausanne, Switzerland
| | - Nora Frulio
- Department of Radiology Magellan 2, Haut-Lévêque hospital, CHU Bordeaux, 33604 Pessac, France
| | - Brigitte Le Bail
- Inserm, UMR1053 Bordeaux research in translational oncology, BaRITOn, université de Bordeaux, 33076 Bordeaux, France; Pathology Department, Pellegrin Hospital, CHU Bordeaux, F 33076 Bordeaux France
| | - Jean Frédéric Blanc
- Inserm, UMR1053 Bordeaux research in translational oncology, BaRITOn, université de Bordeaux, 33076 Bordeaux, France; Department of Hepato-Gastroenterology and Digestive Oncology, Haut-Lévêque hospital, CHU Bordeaux, 33604 Pessac, France
| | - Claire Castain
- Pathology Department, Pellegrin Hospital, CHU Bordeaux, F 33076 Bordeaux France
| | - Christophe Laurent
- Department of Digestive Surgery, Centre Médico Chirurgical Magellan, Haut-Lévêque Hospital, CHU Bordeaux, 33604 Pessac, France
| | - Hervé Trillaud
- Department of Radiology Magellan 2, Haut-Lévêque hospital, CHU Bordeaux, 33604 Pessac, France
| | - Laurence Chiche
- Department of Digestive Surgery, Centre Médico Chirurgical Magellan, Haut-Lévêque Hospital, CHU Bordeaux, 33604 Pessac, France
| | - Charles Balabaud
- Inserm, UMR1053 Bordeaux research in translational oncology, BaRITOn, université de Bordeaux, 33076 Bordeaux, France
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18
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Desjardin M, Bonhomme B, Le Bail B, Evrard S, Brouste V, Desolneux G, Fonck M, Bécouarn Y, Béchade D. Hepatotoxicities Induced by Neoadjuvant Chemotherapy in Colorectal Cancer Liver Metastases: Distinguishing the True From the False. Clin Med Insights Oncol 2019; 13:1179554918825450. [PMID: 30718969 PMCID: PMC6348554 DOI: 10.1177/1179554918825450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/25/2018] [Indexed: 02/06/2023]
Abstract
Background: Pre-operative chemotherapy for colorectal liver metastasis (CRLM) is thought to be the cause of hepatotoxicity of non-tumoural parenchyma. Studies on hepatotoxicity are contradictory. We investigated the impact of a single-line pre-operative chemotherapy on non-tumoural liver analysed by an expert hepatico-pancreatico-biliary pathologist, and the consequences on surgical outcomes. Patients and methods: Patients operated for CRLM, after a pure first-line pre-operative chemotherapy, were retrospectively included. Two comparative histopathological analyses were performed for vascular toxicity and steatohepatitis. Results: Between 2003 and 2015, 147 patients were included. Chemotherapy was based on oxaliplatin (40.1%), irinotecan (55.8%), or both (4.1%). The expert pathologist described 38.8% of vascular lesions including dilation, nodular regeneration, and peliosis. In multivariate analysis, vascular lesions correlated to male sex (P = .01), pre-operative platelets <150 g/L (P = .04), and aspartate aminotransferase to platelet ratio index (APRI) score >0.36 (P = .02). Steatohepatitis was observed in 15 patients (10.2%), more frequently after irinotecan (14.8% vs 3.4%, P = .01; odds ratio [OR] = 7.3; 95% confidence interval [CI] = [1.5-34.7]), and for patients with body mass index (BMI) >25 kg/m2 (P = .004; OR = 10.0; 95% CI = [2.1-47.5]). A total of 29 patients (19.7%) developed major complications with 2 risk factors: portal vein obstruction (PVO) and septic surgery. Reproducibility assessment of steatohepatitis and dilated lesions by 2 pathologists showed moderate agreement (Kappa score 0.53 and 0.54, respectively). Conclusions: There is a probable association between non-alcoholic steatohepatitis (NASH) and irinotecan. Oxaliplatin seems to lead to higher vascular lesions. Except in the presence of pre-existent comorbidities, liver toxicities should not restrain the use of pre-operative chemotherapy prior to parenchymal-sparing surgery.
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Affiliation(s)
| | | | - Brigitte Le Bail
- Department of Anatomopathology, University Hospital, Bordeaux, France
| | - Serge Evrard
- Digestive Tumours Unit, Institut Bergonié, Bordeaux, France
| | - Véronique Brouste
- Clinical and Epidemiological Research Unit, Institut Bergonié, Bordeaux, France
| | | | - Marianne Fonck
- Digestive Tumours Unit, Institut Bergonié, Bordeaux, France
| | - Yves Bécouarn
- Digestive Tumours Unit, Institut Bergonié, Bordeaux, France
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19
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Boursier J, Cassinotto C, Hunault G, Shili S, Lebigot J, Lapuyade B, Lannes A, Hiriart JB, Cartier V, Le Bail B, Michalak S, Mouries A, Oberti F, Chermak F, Fouchard-Hubert I, Cales P, Aube C, de Ledinghen V. Criteria to Determine Reliability of Noninvasive Assessment of Liver Fibrosis With Virtual Touch Quantification. Clin Gastroenterol Hepatol 2019; 17:164-171.e5. [PMID: 29753082 DOI: 10.1016/j.cgh.2018.04.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/20/2018] [Accepted: 04/29/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Virtual Touch Quantification (VTQ) evaluates liver fibrosis in patients with chronic liver diseases by measuring shear wave speed in the liver. We aimed to determine the reliability criteria of VTQ examination. METHODS We performed a prospective study of 1094 patients with chronic liver disease from November 2009 through October 2016 at Angers University Hospital, and between April 2010 and May 2015 at Bordeaux University Hospital, in France. All patients underwent liver biopsy analysis (reference standard), and VTQ examination was made by experienced operators on the same day, or no more than 3 months before or afterward. Advanced liver fibrosis was defined as fibrosis stage F ≥ 3 according to the scoring system of the Nonalcoholic Steatohepatitis Clinical Research Network, or fibrosis stage F ≥ 2 according to the Metavir scoring system. The diagnostic accuracy of VTQ in detection of advanced fibrosis or cirrhosis was assessed using the area under the receiver operating characteristic (AUROC) and the rate of correctly classified patients. Reliability criteria were defined from the intrinsic characteristics of VTQ examination, which were shown to influence the diagnostic accuracy. RESULTS VTQ identified patients with advanced fibrosis with an AUROC of 0.773 ± 0.014 and correctly classified 72.0% of patients using a diagnostic cut-off value of 1.37 m/s. VTQ identified patients with cirrhosis with an AUROC value of 0.839 ± 0.014 and correctly classified 78.4% of patients using a cut-off value of 1.87 m/s. The reliability of VTQ decreased with an increasing ratio of interquartile range/median (IQR/M) in patients with intermediate-high VTQ results. We defined 3 reliability categories for VTQ: unreliable (IQR/M ≥0.35 with VTQ result ≥1.37 m/s), reliable (IQR/M ≥0.35 with VTQ result <1.37 m/s or IQR/M 0.15-0.34), and very reliable (IQR/M <0.15). For advanced fibrosis, VTQ correctly classified 57.8% of patients in the unreliable group, 73.7% of patients in the reliable group, and 80.9% of patients in the very reliable group (P < .001); for cirrhosis, these values were 50.0%, 83.4%, and 92.6%, respectively (P < .001). Of the VTQ examinations made, 21.4% were unreliable, 55.0% were reliable, and 23.6% were very reliable. The skin-liver capsule distance was independently associated with an unreliable VTQ examination, which occurred in 52.7% of patients with a distance of 30 mm or more. CONCLUSIONS In a study to determine the reliability of VTQ findings, compared with results from biopsy analysis, we assigned VTQ examinations to 3 categories (unreliable, reliable, and very reliable). VTQ examinations with IQR/M ≥0.35 and ≥1.37 m/s had very low diagnostic accuracy. Our reliability criteria for liver fibrosis assessment with VTQ will help physicians to accurately evaluate the severity of chronic liver diseases and monitor their progression.
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Affiliation(s)
- Jerome Boursier
- Hepatology Department, Angers University Hospital, Angers, France; Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France.
| | - Christophe Cassinotto
- Radiology Department, Saint-Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Gilles Hunault
- Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France
| | - Sarah Shili
- Hepatology Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Jerome Lebigot
- Radiology Department, Angers University Hospital, Angers, France
| | - Bruno Lapuyade
- Radiology Department, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Adrien Lannes
- Hepatology Department, Angers University Hospital, Angers, France
| | - Jean-Baptiste Hiriart
- Hepatology Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Victoire Cartier
- Radiology Department, Angers University Hospital, Angers, France
| | - Brigitte Le Bail
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
| | - Sophie Michalak
- Pathology Department, Angers University Hospital, Angers, France
| | - Amaury Mouries
- Radiology Department, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Frederic Oberti
- Hepatology Department, Angers University Hospital, Angers, France; Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France
| | - Faiza Chermak
- Hepatology Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Isabelle Fouchard-Hubert
- Hepatology Department, Angers University Hospital, Angers, France; Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France
| | - Paul Cales
- Hepatology Department, Angers University Hospital, Angers, France; Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France
| | - Christophe Aube
- Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques Laboratory, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Bretagne Loire University, Angers, France; Radiology Department, Angers University Hospital, Angers, France
| | - Victor de Ledinghen
- Hepatology Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France; INSERM U1053, Bordeaux University, Bordeaux, France
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20
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Balabaud C, Laurent C, Le Bail B, Castain C, Possenti L, Frulio N, Chiche L, Blanc JF, Bioulac-Sage P. Unexpected discovery of small HNF1α-inactivated hepatocellular adenoma in pathological specimens from patients resected for liver tumours. Liver Int 2018; 38:1273-1279. [PMID: 29265678 DOI: 10.1111/liv.13667] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/04/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS It is rare but not uncommon to discover micro/small HNF1α-inactivated hepatocellular adenoma (H-HCA) outside the context of resected H-HCA. We aimed to review our cases of micro/small H-HCA discovered by chance on different kinds of liver resected specimens. METHODS We retrieved cases of micro/small H-HCA discovered by chance on resected specimens outside the context of H-HCA. All these nodules were liver fatty acid binding protein (LFABP)-negative contrasting with normal positivity in the surrounding non-tumoural liver, ruling out the possibility of focal steatosis or other subtypes of micro-HCAs. RESULTS We identified 19 micro/small H-HCA cases. In 16 cases they were discovered in patients who underwent surgery for benign nodules including one haemangioma, six focal nodular hyperplasia, seven inflammatory HCA (including one with b-catenin activation), one HCA, whose subtype could not be identified because of massive necrosis/hemorrhage, and one hepatocellular carcinoma. In two additional cases, patients followed up for a melanoma underwent liver surgery to remove micro nodules possibly related to a metastatic process. Finally in one case a micro nodule was seen and resected during a cholecystectomy. CONCLUSION Taken together, H-HCAs are more frequent than we initially supposed as micro and small HCAs cannot all be detected by routine ultrasound. Despite no information on the potential growth of these micro/small H-HCAs, there is no argument to stop oral contraceptives or to ask for a specific regular surveillance. The association of different subtypes of HCAs with focal nodular hyperplasia suggests they share or have common etiological factors.
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Affiliation(s)
- Charles Balabaud
- Inserm, UMR1053 Bordeaux Research In Translational Oncology, BaRITOn, Université de Bordeaux, Bordeaux, France
| | - Christophe Laurent
- Service de Chirurgie Digestive et Endocrinienne, Centre Médico Chirurgical Magellan, CHU Bordeaux, Pessac, France
| | - Brigitte Le Bail
- Inserm, UMR1053 Bordeaux Research In Translational Oncology, BaRITOn, Université de Bordeaux, Bordeaux, France.,Pathology Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Claire Castain
- Pathology Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Laurent Possenti
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Haut-Lévêque, CHU Bordeaux, Bordeaux, France
| | - Nora Frulio
- Department of Radiology, Haut Leveque Hospital, CHU Bordeaux, Pessac, France
| | - Laurence Chiche
- Service de Chirurgie Digestive et Endocrinienne, Centre Médico Chirurgical Magellan, CHU Bordeaux, Pessac, France
| | - Jean Frédéric Blanc
- Inserm, UMR1053 Bordeaux Research In Translational Oncology, BaRITOn, Université de Bordeaux, Bordeaux, France.,Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Haut-Lévêque, CHU Bordeaux, Bordeaux, France
| | - Paulette Bioulac-Sage
- Inserm, UMR1053 Bordeaux Research In Translational Oncology, BaRITOn, Université de Bordeaux, Bordeaux, France
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21
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Henriet E, Abou Hammoud A, Dupuy JW, Dartigues B, Ezzoukry Z, Dugot-Senant N, Leste-Lasserre T, Pallares-Lupon N, Nikolski M, Le Bail B, Blanc JF, Balabaud C, Bioulac-Sage P, Raymond AA, Saltel F. Argininosuccinate synthase 1 (ASS1): A marker of unclassified hepatocellular adenoma and high bleeding risk. Hepatology 2017. [PMID: 28646562 DOI: 10.1002/hep.29336] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
UNLABELLED Hepatocellular adenomas (HCAs) are rare benign tumors divided into three main subgroups defined by pathomolecular features, HNF1A (H-HCA), mutated β-catenin (b-HCA), and inflammatory (IHCA). In the case of unclassified HCAs (UHCAs), which are currently identified by default, a high risk of bleeding remains a clinical issue. The objective of this study was to explore UHCA proteome with the aim to identify specific biomarkers. Following dissection of the tumoral (T) and nontumoral (NT) tissue on formalin-fixed, paraffin-embedded HCA tissue sections using laser capture methodology, we performed mass spectrometry analysis to compare T and NT protein expression levels in H-HCA, IHCA, b-HCA, UHCA, and focal nodular hyperplasia. Using this methodology, we searched for proteins which are specifically deregulated in UHCA. We demonstrate that proteomic profiles allow for discriminating known HCA subtypes through identification of classical biomarkers in each HCA subgroup. We observed specific up-regulation of the arginine synthesis pathway associated with overexpression of argininosuccinate synthase (ASS1) and arginosuccinate lyase in UHCA. ASS1 immunohistochemistry identified all the UHCA, of which 64.7% presented clinical bleeding manifestations. Interestingly, we demonstrated that the significance of ASS1 was not restricted to UHCA, but also encompassed certain hemorrhagic cases in other HCA subtypes, particularly IHCA. CONCLUSION ASS1 + HCA combined with a typical hematoxylin and eosin stain aspect defined a new HCA subgroup at a high risk of bleeding. (Hepatology 2017;66:2016-2028).
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Affiliation(s)
- Elodie Henriet
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France
| | - Aya Abou Hammoud
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France
| | - Jean-William Dupuy
- Plateforme Protéome, Centre de Génomique Fonctionnelle de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Benjamin Dartigues
- Centre de Bioinformatique de Bordeaux, Centre de Génomique Fonctionnelle de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Zakaria Ezzoukry
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France
| | | | | | - Nestor Pallares-Lupon
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France
| | - Macha Nikolski
- Centre de Bioinformatique de Bordeaux, Centre de Génomique Fonctionnelle de Bordeaux, Université de Bordeaux, Bordeaux, France.,LaBRI, CNRS UMR 5800, Université de Bordeaux, Bordeaux, France
| | - Brigitte Le Bail
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France.,Service de Pathologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Jean-Frédéric Blanc
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France.,Service Hépato-Gastroentérologie et oncologie digestive, centre médico-chirurgical Magellan, Hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - Charles Balabaud
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France
| | - Paulette Bioulac-Sage
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France.,Service de Pathologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Anne-Aurélie Raymond
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France.,Oncoprot, INSERM 1053, TBM-Core US 005, Bordeaux, France
| | - Frédéric Saltel
- INSERM, UMR1053, BaRITOn Bordeaux Research in Translational Oncology, Bordeaux, France.,Oncoprot, INSERM 1053, TBM-Core US 005, Bordeaux, France
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22
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Wong VWS, Petta S, Hiriart JB, Cammà C, Wong GLH, Marra F, Vergniol J, Chan AWH, Tuttolomondo A, Merrouche W, Chan HLY, Le Bail B, Arena U, Craxì A, de Lédinghen V. Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter. J Hepatol 2017; 67:577-584. [PMID: 28506907 DOI: 10.1016/j.jhep.2017.05.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/03/2017] [Accepted: 05/01/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Controlled attenuation parameter (CAP) can be performed together with liver stiffness measurement (LSM) by transient elastography (TE) and is often used to diagnose fatty liver. We aimed to define the validity criteria of CAP. METHODS CAP was measured by the M probe prior to liver biopsy in 754 consecutive patients with different liver diseases at three centers in Europe and Hong Kong (derivation cohort, n=340; validation cohort, n=414; 101 chronic hepatitis B, 154 chronic hepatitis C, 349 non-alcoholic fatty liver disease, 37 autoimmune hepatitis, 49 cholestatic liver disease, 64 others; 277 F3-4; age 52±14; body mass index 27.2±5.3kg/m2). The primary outcome was the diagnosis of fatty liver, defined as steatosis involving ≥5% of hepatocytes. RESULTS The area under the receiver-operating characteristics curve (AUROC) for CAP diagnosis of fatty liver was 0.85 (95% CI 0.82-0.88). The interquartile range (IQR) of CAP had a negative correlation with CAP (r=-0.32, p<0.001), suggesting the IQR-to-median ratio of CAP would be an inappropriate validity parameter. In the derivation cohort, the IQR of CAP was associated with the accuracy of CAP (AUROC 0.86, 0.89 and 0.76 in patients with IQR of CAP <20 [15% of patients], 20-39 [51%], and ≥40dB/m [33%], respectively). Likewise, the AUROC of CAP in the validation cohort was 0.90 and 0.77 in patients with IQR of CAP <40 and ≥40dB/m, respectively (p=0.004). The accuracy of CAP in detecting grade 2 and 3 steatosis was lower among patients with body mass index ≥30kg/m2 and F3-4 fibrosis. CONCLUSIONS The validity of CAP for the diagnosis of fatty liver is lower if the IQR of CAP is ≥40dB/m. Lay summary: Controlled attenuation parameter (CAP) is measured by transient elastography (TE) for the detection of fatty liver. In this large study, using liver biopsy as a reference, we show that the variability of CAP measurements based on its interquartile range can reflect the accuracy of fatty liver diagnosis. In contrast, other clinical factors such as adiposity and liver enzyme levels do not affect the performance of CAP.
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Affiliation(s)
- Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
| | - Salvatore Petta
- Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
| | - Jean-Baptiste Hiriart
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Calogero Cammà
- Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Fabio Marra
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Florence, Italy
| | - Julien Vergniol
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Anthony Wing-Hung Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong
| | - Antonino Tuttolomondo
- Sezione di Medicina Interna e Cardioangiologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
| | - Wassil Merrouche
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Henry Lik-Yuen Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Brigitte Le Bail
- INSERM U1053, Bordeaux University, Bordeaux, France; Service de Pathologie, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Umberto Arena
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Florence, Italy
| | - Antonio Craxì
- Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
| | - Victor de Lédinghen
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, France; INSERM U1053, Bordeaux University, Bordeaux, France.
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23
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Indersie E, Lesjean S, Hooks KB, Sagliocco F, Ernault T, Cairo S, Merched-Sauvage M, Rullier A, Le Bail B, Taque S, Grotzer M, Branchereau S, Guettier C, Fabre M, Brugières L, Hagedorn M, Buendia MA, Grosset CF. MicroRNA therapy inhibits hepatoblastoma growth in vivo by targeting β-catenin and Wnt signaling. Hepatol Commun 2017; 1:168-183. [PMID: 29404451 PMCID: PMC5721429 DOI: 10.1002/hep4.1029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/24/2017] [Accepted: 02/27/2017] [Indexed: 01/03/2023] Open
Abstract
Hepatoblastoma (HBL) is the most common pediatric liver cancer. In this malignant neoplasm, beta-catenin protein accumulates and increases Wnt signaling due to recurrent activating mutations in the catenin-beta 1 (CTNNB1) gene. Therefore, beta-catenin is a key therapeutic target in HBL. However, controlling beta-catenin production with therapeutic molecules has been challenging. New biological studies could provide alternative therapeutic solutions for the treatment of HBL, especially for advanced tumors and metastatic disease. In this study, we identified microRNAs (miRNAs) that target beta-catenin and block HBL cell proliferation in vitro and tumor growth in vivo. Using our dual-fluorescence-FunREG system, we screened a library of 1,712 miRNA mimics and selected candidates inhibiting CTNNB1 expression through interaction with its untranslated regions. After validating the regulatory effect of nine miRNAs on beta-catenin in HBL cells, we measured their expression in patient samples. Let-7i-3p, miR-449b-3p, miR-624-5p, and miR-885-5p were decreased in tumors compared to normal livers. Moreover, they inhibited HBL cell growth and Wnt signaling activity in vitro partly through beta-catenin down-regulation. Additionally, miR-624-5p induced cell senescence in vitro, blocked experimental HBL growth in vivo, and directly targeted the beta-catenin 3'-untranslated region. Conclusion: Our results shed light on how beta-catenin-regulating miRNAs control HBL progression through Wnt signaling inactivation. In particular, miR-624-5p may constitute a promising candidate for miRNA replacement therapy for HBL patients. (Hepatology Communications 2017;1:168-183).
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Affiliation(s)
- Emilie Indersie
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Sarah Lesjean
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Katarzyna B Hooks
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Francis Sagliocco
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Tony Ernault
- INSERM, UMR 1193, Paul-Brousse Hospital, Hepatobiliary Centre F-94800 Villejuif France.,Univ. Paris Saclay F-94800 Villejuif France
| | - Stefano Cairo
- XenTechEvry France.,Laboratory for Technologies of Advanced Therapies, Department of Morphology, Surgery and Experimental Medicine University of Ferrara Italy
| | | | | | | | | | - Michael Grotzer
- SIOPEL (International Childhood Liver Tumours Strategy Group) Liver Tumor and Tissue Banking Program University Children's Hospital Zürich Switzerland
| | | | | | | | | | - Martin Hagedorn
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Marie-Annick Buendia
- INSERM, UMR 1193, Paul-Brousse Hospital, Hepatobiliary Centre F-94800 Villejuif France.,Univ. Paris Saclay F-94800 Villejuif France
| | - Christophe F Grosset
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
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24
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Nault JC, Couchy G, Balabaud C, Morcrette G, Caruso S, Blanc JF, Bacq Y, Calderaro J, Paradis V, Ramos J, Scoazec JY, Gnemmi V, Sturm N, Guettier C, Fabre M, Savier E, Chiche L, Labrune P, Selves J, Wendum D, Pilati C, Laurent A, De Muret A, Le Bail B, Rebouissou S, Imbeaud S, Bioulac-Sage P, Letouzé E, Zucman-Rossi J. Molecular Classification of Hepatocellular Adenoma Associates With Risk Factors, Bleeding, and Malignant Transformation. Gastroenterology 2017; 152:880-894.e6. [PMID: 27939373 DOI: 10.1053/j.gastro.2016.11.042] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/17/2016] [Accepted: 11/21/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Hepatocellular adenomas (HCAs) are benign liver tumors that can be assigned to molecular subtypes based on inactivating mutations in hepatocyte nuclear factor 1A, activating mutations in β-catenin, or activation of inflammatory signaling pathways. We aimed to update the classification system for HCA and associate the subtypes with disease risk factors and complications. METHODS We analyzed expression levels of 20 genes and sequenced exon regions of 8 genes (HNF1A, IL6ST, CTNNB1, FRK, STAT3, GNAS, JAK1, and TERT) in 607 samples of 533 HCAs from 411 patients, collected from 28 centers mainly in France from 2000 and 2014. We performed gene expression profile, RNA sequence, whole-exome and genome sequence, and immunohistochemical analyses of select samples. Molecular data were associated with risk factors, histopathology, bleeding, and malignant transformation. RESULTS Symptomatic bleeding occurred in 14% of the patients (85% of cases were female, median age, 38 years); 7% of the nodules were borderline between HCA and hepatocellular carcinoma, and 3% of patients developed hepatocellular carcinoma from HCA. Based on molecular features, we classified HCA into 8 subgroups. One new subgroup, composed of previously unclassified HCA, represented 4% of HCAs overall and was associated with obesity and bleeding. These tumors were characterized by activation of sonic hedgehog signaling, due to focal deletions that fuse the promoter of INHBE with GLI1. Analysis of genetic heterogeneity among multiple HCAs, from different patients, revealed a molecular subtype field effect; multiple tumors had different mutations that deregulated similar pathways. Specific molecular subtypes of HCA associated with various HCA risk factors, including imbalances in estrogen or androgen hormones. Specific molecular subgroup of HCA with β-catenin and sonic hedgehog activation associated with malignant transformation and bleeding, respectively. CONCLUSIONS Using sequencing and gene expression analyses, we identified a subgroup of HCA characterized by fusion of the INHBE and GLI1 genes and activation of sonic hedgehog pathway. Molecular subtypes of HCAs associated with different patients' risk factors for HCA, disease progression, and pathology features of tumors. This classification system might be used to select treatment strategies for patients with HCA.
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Affiliation(s)
- Jean-Charles Nault
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France; Liver Unit, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France
| | - Gabrielle Couchy
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Charles Balabaud
- Université Bordeaux, Bordeaux Research in Translational Oncology, Bordeaux, France
| | - Guillaume Morcrette
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Stefano Caruso
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Jean-Frederic Blanc
- Université Bordeaux, Bordeaux Research in Translational Oncology, Bordeaux, France; Service Hépato-Gastroentérologie et Oncologie Digestive, Centre Medico-Chirurgical Magellan, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Yannick Bacq
- Service d'Hépatogastroentérologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Julien Calderaro
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France; Service d'Anatomopathologie, Hôpital Henri Mondor, Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Valérie Paradis
- Service d'Anatomopathologie, Hôpital Beaujon, Clichy, France
| | - Jeanne Ramos
- Service d'Anatomopathologie, Gui de Chauliac, Montpellier, France
| | - Jean-Yves Scoazec
- Service d'Anatomopathologie, Institut Gustave Roussy, Villejuif, France
| | - Viviane Gnemmi
- Institut de Pathologie, Centre Hospitalier Régional Universitaire de Lille, UMR-S 1124, Jean-Pierre Aubert Research Center, Lille, France
| | - Nathalie Sturm
- Service d'Anatomopathologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Catherine Guettier
- Service d'Anatomopathologie, Hôpitaux Paul Brousse et Bicêtre, Le Kremlin Bicêtre, Institut National de la Santé et de la Recherche Médicale U1193 Université Paris-Sud, Orsay, France
| | - Monique Fabre
- Service d'Anatomopathologie, Hôptal Necker-Enfants Malades, Paris, France
| | - Eric Savier
- Service de Chirurgie Hépato-Bilio-Pancréatique, Centre Hospitalier Universitaire, Pitié Salpétrière, Université Pierre et Marie Curie, Paris, France
| | - Laurence Chiche
- Service de Chirurgie Digestive, Centre Medico-Chirurgical Magellan, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Philippe Labrune
- Assistance Hôpitaux Publique de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Antoine Béclère, Centre de Référence des Maladies Héréditaires du Métabolisme Hépatique, Clamart, and Université Paris-Sud, and Institut National de la Santé et de la Recherche Médicale U 1169, Orsay, France
| | - Janick Selves
- Département d'Anatomopathologie, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | - Dominique Wendum
- Service d'Anatomie Pathologique, Assistance Hôpitaux Publique de Paris Hôpital St Antoine, Sorbonne Universités, Université Pierre et Marie Curie 06, Paris, France
| | - Camilla Pilati
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Alexis Laurent
- Service de Chirurgie Digestive, Hôpital Henri Mondor, Créteil, Institut National de la Santé et de la Recherche Médicale U955, Créteil, France
| | - Anne De Muret
- Service d'anatomopathologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Brigitte Le Bail
- Université Bordeaux, Bordeaux Research in Translational Oncology, Bordeaux, France; Service de Pathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Sandra Rebouissou
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Sandrine Imbeaud
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | | | - Paulette Bioulac-Sage
- Université Bordeaux, Bordeaux Research in Translational Oncology, Bordeaux, France; Service de Pathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Eric Letouzé
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Jessica Zucman-Rossi
- Unité Mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Université Paris Descartes, Université Paris Diderot, Paris, France; Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Département d'Oncologie, Paris, France.
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25
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Neven B, Pérot P, Bruneau J, Pasquet M, Ramirez M, Diana JS, Luzi S, Corre-Catelin N, Chardot C, Moshous D, Leclerc Mercier S, Mahlaoui N, Aladjidi N, Le Bail B, Lecuit M, Bodemer C, Molina TJ, Blanche S, Eloit M. Cutaneous and Visceral Chronic Granulomatous Disease Triggered by a Rubella Virus Vaccine Strain in Children With Primary Immunodeficiencies. Clin Infect Dis 2016; 64:83-86. [PMID: 27810866 DOI: 10.1093/cid/ciw675] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/22/2016] [Indexed: 11/12/2022] Open
Abstract
Persistence of rubella live vaccine has been associated with chronic skin granuloma in 3 children with primary immunodeficiency. We describe 6 additional children with these findings, including 1 with visceral extension to the spleen.
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Affiliation(s)
- Bénédicte Neven
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Paediatric Haemato-Immunology Unit.,National Reference Centre for Primary Immune Deficiencies
| | - Philippe Pérot
- Biology of Infection Unit, Laboratory of Pathogen Discovery, Inserm U1117.,Biomics, Centre d'Innovation et de Recherche Technologique
| | | | - Marlene Pasquet
- Hematology and Immunology Pediatric Department, CHU Toulouse, Center of Research in Cancerology of Toulouse, Team 16, Institut Universitaire du Cancer de Toulouse-Oncopole
| | - Marie Ramirez
- Biology of Infection Unit, Laboratory of Pathogen Discovery, Inserm U1117
| | - Jean-Sébastien Diana
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Paediatric Haemato-Immunology Unit
| | | | - Nicole Corre-Catelin
- Investigation Clinique et Accès aux Ressources Biologiques, Institut Pasteur, Paris
| | | | - Despina Moshous
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Paediatric Haemato-Immunology Unit.,National Reference Centre for Primary Immune Deficiencies
| | | | - Nizar Mahlaoui
- Paediatric Haemato-Immunology Unit.,National Reference Centre for Primary Immune Deficiencies
| | - Nathalie Aladjidi
- Pediatric Oncology Hematology Unit/CEREVANCE/CIC 1401, Inserm Centre d'Investigation Clinique Plurithématique, University Hospital of Bordeaux, Pediatric Hospital
| | - Brigitte Le Bail
- Department of Pathology, Hôpital des Enfants-Hôpital Pellegrin, Bordeaux, France
| | - Marc Lecuit
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Department of Infectious Diseases, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris.,National Reference Centre for Primary Immune Deficiencies.,Biology of Infection Unit, Laboratory of Pathogen Discovery, Inserm U1117
| | | | - Thierry Jo Molina
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Department of Pathology
| | - Stéphane Blanche
- Sorbonne Paris Cité, Paris Descartes University, Institut Imagine.,Paediatric Haemato-Immunology Unit.,National Reference Centre for Primary Immune Deficiencies
| | - Marc Eloit
- Biology of Infection Unit, Laboratory of Pathogen Discovery, Inserm U1117
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26
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Desclaux A, Receveur MC, Lechot A, Le Bail B, Malvy D. Swelling of the nose and upper lip in a young patient from the Comoro islands. Travel Med Infect Dis 2016; 15:84-85. [PMID: 27697613 DOI: 10.1016/j.tmaid.2016.06.012] [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: 02/29/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Arnaud Desclaux
- Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France.
| | - Marie-Catherine Receveur
- Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Amandine Lechot
- ORL et chirurgie cervico-faciale, Clinique Thiers, 330, Avenue Thiers, 33100 Bordeaux, France
| | - Brigitte Le Bail
- Service de Pathologie, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Denis Malvy
- Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
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27
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Boursier J, Vergniol J, Guillet A, Hiriart JB, Lannes A, Le Bail B, Michalak S, Chermak F, Bertrais S, Foucher J, Oberti F, Charbonnier M, Fouchard-Hubert I, Rousselet MC, Calès P, de Lédinghen V. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol 2016; 65:570-8. [PMID: 27151181 DOI: 10.1016/j.jhep.2016.04.023] [Citation(s) in RCA: 248] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/09/2016] [Accepted: 04/23/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS NAFLD is highly prevalent but only a small subset of patients develop advanced liver fibrosis with impaired liver-related prognosis. We aimed to compare blood fibrosis tests and liver stiffness measurement (LSM) by FibroScan for the diagnosis of liver fibrosis and the evaluation of prognosis in NAFLD. METHODS Diagnostic accuracy was evaluated in a cross-sectional study including 452 NAFLD patients with liver biopsy (NASH-CRN fibrosis stage), LSM, and eight blood fibrosis tests (BARD, NAFLD fibrosis score, FibroMeter(NAFLD), aspartate aminotransferase to platelet ratio index (APRI), FIB4, FibroTest, Hepascore, FibroMeter(V2G)). Prognostic accuracy was evaluated in a longitudinal study including 360 NAFLD patients. RESULTS LSM and FibroMeter(V2G) were the two best-performing tests in the cross-sectional study: AUROCs for advanced fibrosis (F3/4) were, respectively, 0.831±0.019 and 0.817±0.020 (p⩽0.041 vs. other tests); rates of patients with ⩾90% negative/positive predictive values for F3/4 were 56.4% and 46.7% (p<0.001 vs. other tests); Obuchowski indexes were 0.834±0.014 and 0.798±0.016 (p⩽0.036 vs. other tests). Two fibrosis classifications were developed to precisely estimate the histological fibrosis stage from LSM or FibroMeter(V2G) results without liver biopsy (diagnostic accuracy, respectively: 80.8% vs. 77.4%, p=0.190). Kaplan-Meier curves in the longitudinal study showed that both classifications categorised NAFLD patients into subgroups with significantly different prognoses (p<0.001): the higher was the class of the fibrosis classification, the worse was the prognosis. CONCLUSIONS LSM and FibroMeter(V2G) were the most accurate of nine evaluated tests for the non-invasive diagnosis of liver fibrosis in NAFLD. LSM and FibroMeter(V2G) fibrosis classifications help physicians estimate both fibrosis stage and patient prognosis in clinical practice. LAY SUMMARY The amount of liver fibrosis is the main determinant of the liver-related prognosis in patients with non-alcoholic fatty liver disease (NAFLD). We evaluated eight blood tests and FibroScan in a cross-sectional diagnostic study and found that FibroScan and the blood test FibroMeter(V2G) were the two most accurate tests for the non-invasive evaluation of liver fibrosis in NAFLD. A longitudinal prognostic study showed these two tests initially developed for the diagnosis are also prognostic markers as they allow for the stratification of NAFLD patients in several subgroups with significantly different prognosis.
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Affiliation(s)
- Jérôme Boursier
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France; HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France.
| | - Julien Vergniol
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Anne Guillet
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France
| | - Jean-Baptiste Hiriart
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Adrien Lannes
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France
| | - Brigitte Le Bail
- Service de Pathologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Sophie Michalak
- Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalier Universitaire, Angers, France
| | - Faiza Chermak
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | | | - Juliette Foucher
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Frédéric Oberti
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France; HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France
| | - Maude Charbonnier
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Isabelle Fouchard-Hubert
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France; HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France
| | - Marie-Christine Rousselet
- HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France; Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalier Universitaire, Angers, France
| | - Paul Calès
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France; HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France
| | - Victor de Lédinghen
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France; INSERM U1053, Université Bordeaux, Bordeaux, France
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28
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Cassinotto C, Boursier J, de Lédinghen V, Lebigot J, Lapuyade B, Cales P, Hiriart JB, Michalak S, Bail BL, Cartier V, Mouries A, Oberti F, Fouchard-Hubert I, Vergniol J, Aubé C. Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 2016; 63:1817-27. [PMID: 26659452 DOI: 10.1002/hep.28394] [Citation(s) in RCA: 328] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/19/2015] [Accepted: 12/10/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (P = 0.004). Clinical factors related to obesity such as body mass index ≥ 30 kg/m(2) , waist circumference ≥102 cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R = 0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD did not affect LSM results in multivariate analysis. The cutoff values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. CONCLUSION Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. (Hepatology 2016;63:1817-1827).
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Affiliation(s)
- Christophe Cassinotto
- Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France.,INSERM U1053, University of Bordeaux, Bordeaux, France
| | - Jérome Boursier
- Department of Hepatology, University Hospital of Angers, France.,Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France
| | - Victor de Lédinghen
- INSERM U1053, University of Bordeaux, Bordeaux, France.,Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Jérome Lebigot
- Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France.,Department of Radiology, University Hospital of Angers, France
| | - Bruno Lapuyade
- Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Paul Cales
- Department of Hepatology, University Hospital of Angers, France.,Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France
| | - Jean-Baptiste Hiriart
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Sophie Michalak
- Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France.,Department of Pathology, University Hospital of Angers, France
| | - Brigitte Le Bail
- INSERM U1053, University of Bordeaux, Bordeaux, France.,Department of Pathology, Hôpital Pellegrin, University Hospital of Bordeaux, Bordeaux, France
| | - Victoire Cartier
- Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France.,Department of Radiology, University Hospital of Angers, France
| | - Amaury Mouries
- Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Frédéric Oberti
- Department of Hepatology, University Hospital of Angers, France.,Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France
| | | | - Julien Vergniol
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Christophe Aubé
- Laboratory HIFIH, UPRES 3859, LUNAM University, Angers, France.,Department of Radiology, University Hospital of Angers, France
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29
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de Lédinghen V, Wong GLH, Vergniol J, Chan HLY, Hiriart JB, Chan AWH, Chermak F, Choi PCL, Foucher J, Chan CKM, Merrouche W, Chim AML, Le Bail B, Wong VWS. Controlled attenuation parameter for the diagnosis of steatosis in non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2016; 31:848-55. [PMID: 26514665 DOI: 10.1111/jgh.13219] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/12/2015] [Accepted: 10/18/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Controlled attenuation parameter (CAP) evaluated with transient elastography (FibroScan) is a recent method for non-invasive assessment of steatosis. Its usefulness in non-alcoholic fatty liver disease (NAFLD) is unknown. We prospectively investigated the performance of CAP for the diagnosis of steatosis in NAFLD, factors associated with discordances between CAP and steatosis grades, and relationships between CAP and clinical or biological parameters. METHODS All CAP examinations performed in NAFLD patients with a liver biopsy performed within 1 week of CAP measurement were included. Liver biopsies were assessed for activity and fibrosis stage, NAFLD activity score, and steatosis graded as follows: S0, steatosis < 5%; S1, 5-33%; S2, 34-66%; S3, >66%. RESULTS Two hundred sixty-one patients (59% male, age 56 years) from two ethnic groups were included. No patient had steatosis < 5%. The area under the receiver-operating characteristics curve of CAP for steatosis ≥S2 and S3 was 0.80 and 0.66, respectively. At a cut-off value of 310 dB/m, the sensitivity, specificity, and positive and negative predictive values for ≥S2 steatosis were 79%, 71%, 86%, and 71%, respectively. Discordance of at least one grade between CAP and steatosis was observed in 81 patients. By multivariate analysis, only steatosis S2S3 was associated with no discordance. By multivariate analysis, only BMI ≥ 30 kg/m(2) was significantly associated with CAP > 310 dB/m. CONCLUSION The association of CAP with steatosis, especially in patients with non-alcoholic steatohepatitis, and with elevated BMI could be useful for the diagnosis and follow-up of NAFLD patients.
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Affiliation(s)
- Victor de Lédinghen
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.,INSERM U1053, Bordeaux University, Bordeaux, France
| | - Grace Lai-Hung Wong
- State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Julien Vergniol
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Henry Lik-Yuen Chan
- State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Jean-Baptiste Hiriart
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Anthony Wing-Hung Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Faiza Chermak
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Paul Cheung-Lung Choi
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Juliette Foucher
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Carmen Ka-Man Chan
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.,INSERM U1053, Bordeaux University, Bordeaux, France
| | - Wassil Merrouche
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Angel Mei-Ling Chim
- Investigation Center of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.,INSERM U1053, Bordeaux University, Bordeaux, France
| | - Brigitte Le Bail
- INSERM U1053, Bordeaux University, Bordeaux, France.,Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Wai-Sun Wong
- State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
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30
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Neau-Cransac M, Le Bail B, Guidicelli G, Visentin J, Moreau K, Quinart A, Boueilh A, Laurent C, Taupin JL. Evolution of serum and intra-graft donor-specific anti-HLA antibodies in a patient with two consecutive liver transplantations. Transpl Immunol 2015; 33:58-62. [DOI: 10.1016/j.trim.2015.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/07/2015] [Accepted: 08/17/2015] [Indexed: 01/30/2023]
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31
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Rogier J, Roullet S, Cornélis F, Biais M, Quinart A, Revel P, Bioulac-Sage P, Le Bail B. Noninvasive assessment of macrovesicular liver steatosis in cadaveric donors based on computed tomography liver-to-spleen attenuation ratio. Liver Transpl 2015; 21:690-5. [PMID: 25761371 DOI: 10.1002/lt.24105] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 01/13/2015] [Accepted: 02/17/2015] [Indexed: 12/17/2022]
Abstract
Fatty liver disease, including liver steatosis, is a major health problem worldwide. In liver transplantation, macrovesicular steatosis in donor livers is a major cause of graft failure and remains difficult to assess. On one hand, several imaging modalities can be used for the assessment of liver fat, but liver biopsy, which is still considered the gold standard, may be difficult to perform in this context. On the other hand, computed tomography (CT) is commonly used by teams managing cadaveric donors to assess donors and to minimize the risk of complications in recipients. The purpose of our study was to validate the use of CT as a semiquantitative method for assessing macrovesicular steatosis in cadaveric donors with liver biopsy as a reference standard. A total of 109 consecutive cadaveric donors were included between October 2009 and May 2011. Brain death was diagnosed according to French legislation. Liver biopsy and then CT were performed on the same day to determine the degree of macrovesicular steatosis. All liver biopsies and CT scans were analyzed in a double-blinded fashion by a senior pathologist and a senior radiologist, respectively. For CT, we used the liver-to-spleen (L/S) attenuation ratio, which is a validated method for determining 30% or greater steatosis in living liver donors. Fourteen of 109 biopsies exhibited macrovesicular steatosis > 30% upon histologic analysis. A receiver operating characteristic curve was generated for the L/S ratio to identify its ability to predict significant steatosis, which was defined as >30%. A cutoff value of 0.9 for the CT L/S ratio provided a sensitivity of 79% and a specificity of 97% to detect significant steatosis.
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Affiliation(s)
- Julien Rogier
- Emergency Intensive Care Unit, Pellegrin Hospital, University Hospital, Bordeaux, France
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32
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Le Bail B. [Pathology of gallbladder and extrahepatic bile ducts. Introduction]. Ann Pathol 2014; 34:258-65; quiz 269-78. [PMID: 25132435 DOI: 10.1016/j.annpat.2014.06.008] [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: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Brigitte Le Bail
- Service de pathologie, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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33
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Le Bail B. [Pathology of gallbladder and extrahepatic bile ducts. Case 8. Intraductal papillary neoplasm of extrahepatic bile duct without invasive carcinoma (WHO 2010), with high-grade intraepithelial neoplasia/carcinoma in situ (pTisNx, TNM 7th edition): "Dysplastic degenerated biliary papillomatosis, but non-invasive"]. Ann Pathol 2014; 34:324-33. [PMID: 25132444 DOI: 10.1016/j.annpat.2014.06.011] [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: 06/13/2014] [Accepted: 06/13/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Brigitte Le Bail
- Service de pathologie, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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34
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Le Bail B. [Pathology of gallbladder and extrahepatic bile ducts. Case 1. Alcalculous gangrenous cholecystitis]. Ann Pathol 2014; 34:271-8. [PMID: 25132438 DOI: 10.1016/j.annpat.2014.06.006] [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] [Received: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 12/07/2022]
Affiliation(s)
- Brigitte Le Bail
- Service de pathologie, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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35
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Le Bail B. Pathologie de la vésicule biliaire et des voies biliaires extra-hépatiques. Réponses au pré-test. Ann Pathol 2014. [DOI: 10.1016/j.annpat.2014.06.005] [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: 10/25/2022]
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Castain C, Sempoux C, Brunt EM, Causse O, Heitzmann A, Hernandez-Prera JC, Le Bail B, Schirmacher P, Thung SN, Balabaud C, Bioulac-Sage P. Coexistence of inflammatory hepatocellular adenomas with HNF1α-inactivated adenomas: is there an association? Histopathology 2014; 64:890-5. [DOI: 10.1111/his.12326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/13/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Claire Castain
- Service de Pathologie; Hôpital Pellegrin; CHU Bordeaux; Bordeaux France
- Inserm U1053; Université Bordeaux Segalen; Bordeaux France
| | - Christine Sempoux
- Service d'Anatomie Pathologique; Cliniques universitaires Saint Luc; Université catholique de Louvain; Brussels Belgium
| | - Elizabeth M Brunt
- Department of Pathology and Immunology; Washington University School of Medicine; St Louis MO USA
| | - Olivier Causse
- Service d'hépato-gastroentérologie; CHR d'Orléans; Hôpital de la Source; Orléans France
| | - Anne Heitzmann
- Service d'anatomie et cytologie pathologiques; CHR d'Orléans; Hôpital de la Source; Orléans France
| | | | - Brigitte Le Bail
- Service de Pathologie; Hôpital Pellegrin; CHU Bordeaux; Bordeaux France
- Inserm U1053; Université Bordeaux Segalen; Bordeaux France
| | | | - Swan N Thung
- Department of Pathology; Mount Sinai School of Medicine; New York NY USA
| | | | - Paulette Bioulac-Sage
- Service de Pathologie; Hôpital Pellegrin; CHU Bordeaux; Bordeaux France
- Inserm U1053; Université Bordeaux Segalen; Bordeaux France
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Affiliation(s)
- Loic Raffray
- Travel Clinics and Tropical Diseases Unit, University Hospital Center of Bordeaux, Bordeaux, France
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Cassinotto C, Lapuyade B, Aït-Ali A, Vergniol J, Gaye D, Foucher J, Bailacq-Auder C, Chermak F, Le Bail B, de Lédinghen V. Liver fibrosis: noninvasive assessment with acoustic radiation force impulse elastography--comparison with FibroScan M and XL probes and FibroTest in patients with chronic liver disease. Radiology 2013; 269:283-92. [PMID: 23630312 DOI: 10.1148/radiol.13122208] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To compare the diagnostic performance of acoustic radiation force impulse (ARFI) elastography with that of FibroScan M and XL probes and FibroTest in the staging of fibrosis in patients with chronic liver disease. MATERIALS AND METHODS This study received ethics approval, and all participants provided written informed consent. A total of 321 consecutive patients with chronic liver disease who underwent liver biopsy were prospectively enrolled from April 2010 to May 2012. Liver disease was caused by viral hepatitis (n = 136), alcoholic or nonalcoholic steatohepatitis disorders (n = 113), or some other disease (n = 72). In each patient, liver stiffness was evaluated with ARFI elastography, M and XL probes, and FibroTest within 1 month before liver biopsy. Histologic staging of liver fibrosis served as the reference standard. RESULTS Liver stiffness measurement failure rates were 11.2% with the M probe (36 of 321 patients), 2.3% with the XL probe (six of 260 patients), and 0% with ARFI elastography (0 of 321 patients). Unreliable results with ARFI elastography were more frequent in obese patients (those with a body mass index of 30 kg/m(2) or more) (42 of 86 patients [48.8%] vs 34 of 235 patients [14.5%], P < .0001). No significant difference was found between ARFI elastography and the M probe in the diagnosis of cirrhosis (area under under the receiver operating characteristic curve [Az], 0.88 vs 0.91; P = .12) or severe fibrosis (Az, 0.85 vs 0.89; P = .15); however, the M probe demonstrated better results in the diagnosis of moderate fibrosis (Az, 0.81 vs 0.88; P = .008). No significant difference was found between ARFI elastography and the XL probe in the diagnosis of moderate fibrosis, severe fibrosis, or cirrhosis. The diagnostic performance of ARFI elastography improved when it was applied in nonobese patients (Az of ARFI for cirrhosis and severe fibrosis = 0.92 and 0.91, respectively, in nonobese patients [P = .0002] and 0.63 and 0.63, respectively, in obese patients [P < .0001]). CONCLUSION ARFI elastography is reliable in the assessment of liver fibrosis in patients with chronic liver disease, especially nonobese patients.
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Affiliation(s)
- Christophe Cassinotto
- Service de Radiologie and Service d'hépato-gastro-entérologie, Centre d'investigation de la fibrose hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1, Avenue de Magellan, 33604 Pessac, France; Service d'anatomo-pathologie, Hôpital Pellegrin, Centre Universitaire de Bordeaux, Bordeaux, France
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Balabaud C, Al-Rabih WR, Chen PJ, Evason K, Ferrell L, Hernandez-Prera JC, Huang SF, Longerich T, Park YN, Quaglia A, Schirmacher P, Sempoux C, Thung SN, Torbenson M, Wee A, Yeh MM, Yeh SH, Le Bail B, Zucman-Rossi J, Bioulac-Sage P. Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification. Int J Hepatol 2013; 2013:268625. [PMID: 23691331 PMCID: PMC3654480 DOI: 10.1155/2013/268625] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/25/2012] [Indexed: 12/14/2022] Open
Abstract
Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are benign hepatocellular tumors. The risk of bleeding and malignant transformation of HCA are strong arguments to differentiate HCA from FNH. Despite great progress that has been made in the differential radiological diagnosis of the 2 types of nodules, liver biopsy is sometimes necessary to separate the 2 entities. Identification of HCA subtypes using immunohistochemical techniques, namely, HNF1A-inactivated HCA (35-40%), inflammatory HCA (IHCA), and beta-catenin-mutated inflammatory HCA (b-IHCA) (50-55%), beta-catenin-activated HCA (5-10%), and unclassified HCA (10%) has greatly improved the diagnostic accuracy of benign hepatocellular nodules. If HCA malignant transformation occurs in all HCA subgroups, the risk is by far the highest in the β -catenin-mutated subgroups (b-HCA, b-IHCA). In the coming decade the management of HCA will be more dependent on the identification of HCA subtypes, particularly for smaller nodules (<5 cm) in terms of imaging, follow-up, and resection.
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Affiliation(s)
- Charles Balabaud
- Inserm U1053, Université Bordeaux Segalen, 33076 Bordeaux Cedex, France
| | | | - Pei-Jer Chen
- National Taiwan University College of Medicine, Taipei, Taiwan
- National Taiwan University Hospital, Taipei, Taiwan
| | - Kimberley Evason
- Department of Pathology, University of California, San Francisco, CA 94143-0102, USA
| | - Linda Ferrell
- Department of Pathology, University of California, San Francisco, CA 94143-0102, USA
| | | | - Shiu-Feng Huang
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Thomas Longerich
- Institute of Pathology, University Hospital, 69120 Heidelberg, Germany
| | - Young Nyun Park
- Department of Pathology, Yonsei University College of Medicine, P.O. Box 8044, Seoul, Republic of Korea
| | - Alberto Quaglia
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Peter Schirmacher
- Institute of Pathology, University Hospital, 69120 Heidelberg, Germany
| | - Christine Sempoux
- Service d'Anatomie Pathologique, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Swan N. Thung
- Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Michael Torbenson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aileen Wee
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, National University Health System, Singapore 119074
| | - Matthew M. Yeh
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Shiou-Hwei Yeh
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Brigitte Le Bail
- Inserm U1053, Université Bordeaux Segalen, 33076 Bordeaux Cedex, France
- Pathology Department, Hôpital Pellegrin, CHU Bordeaux, 33076 Bordeaux Cedex, France
| | - Jessica Zucman-Rossi
- Inserm, UMR-674, Génomique Fonctionnelle des Tumeurs Solides, IUH, 75010 Paris, France
- Université Paris Descartes, Labex Immunooncology, Sorbonne Paris Cité, Faculté de Médecine, 75005 Paris, France
| | - Paulette Bioulac-Sage
- Inserm U1053, Université Bordeaux Segalen, 33076 Bordeaux Cedex, France
- Pathology Department, Hôpital Pellegrin, CHU Bordeaux, 33076 Bordeaux Cedex, France
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Gonzalez C, de Ledinghen V, Vergniol J, Foucher J, Le Bail B, Carlier S, Maury E, Gin H, Rigalleau V. Hepatic Steatosis, Carbohydrate Intake, and Food Quotient in Patients with NAFLD. Int J Endocrinol 2013; 2013:428542. [PMID: 23737773 PMCID: PMC3659479 DOI: 10.1155/2013/428542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 04/12/2013] [Indexed: 01/13/2023] Open
Abstract
Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×% calories from carbohydrates/100) + (0.70×% calories from lipids/100) + (0.81×% calories from proteins/100). The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5% ± 25.5 [10-90], correlated with their energy intake (1993 ± 597 kcal/d, r = 0.41, P < 0.05) and food quotient (0.85 ± 0.02, r = 0.42, P < 0.05), which remained significant with both variables by a multivariate regression analysis (r = 0.51, P < 0.05). For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863 ± 503 versus others: 2382 ± 733 kcal/d, P < 0.05), and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories.
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Affiliation(s)
- Concepcion Gonzalez
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Victor de Ledinghen
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Julien Vergniol
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Juliette Foucher
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | | | - Sabrina Carlier
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Elisa Maury
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Henri Gin
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
| | - Vincent Rigalleau
- Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France
- INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, 33000 Bordeaux, France
- *Vincent Rigalleau:
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Yi P, Higa A, Taouji S, Bexiga MG, Marza E, Arma D, Castain C, Le Bail B, Simpson JC, Rosenbaum J, Balabaud C, Bioulac-Sage P, Blanc JF, Chevet E. Sorafenib-Mediated Targeting of the AAA+ ATPase p97/VCP Leads to Disruption of the Secretory Pathway, Endoplasmic Reticulum Stress, and Hepatocellular Cancer Cell Death. Mol Cancer Ther 2012; 11:2610-20. [DOI: 10.1158/1535-7163.mct-12-0516] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jeannot E, Lacape G, Gin H, Couchy G, Saric J, Laumonier H, Le Bail B, Bioulac-Sage P, Balabaud C, Zucman-Rossi J. Double heterozygous germline HNF1A mutations in a patient with liver adenomatosis. Diabetes Care 2012; 35:e35. [PMID: 22517943 PMCID: PMC3329811 DOI: 10.2337/dc12-0030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | - Geneviève Lacape
- Molecular Biology Laboratory, Haut Lévêque Hospital, CHU-Bordeaux, Bordeaux, France; the
| | - Henri Gin
- Department of Diabetology, Haut Lévêque Hospital, CHU-Bordeaux, Bordeaux, France; the
| | | | - Jean Saric
- Department of Digestive Surgery, Saint André Hospital, CHU-Bordeaux, Bordeaux, France; the
| | - Hervé Laumonier
- Department of Radiology, CHU-Bordeaux, Bordeaux, France; the
| | - Brigitte Le Bail
- Department of Pathology, Pellegrin Hospital, CHU-Bordeaux, Bordeaux, France; and
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de Lédinghen V, Wong VWS, Vergniol J, Wong GLH, Foucher J, Chu SHT, Le Bail B, Choi PCL, Chermak F, Yiu KKL, Merrouche W, Chan HLY. Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan®. J Hepatol 2012; 56:833-9. [PMID: 22173167 DOI: 10.1016/j.jhep.2011.10.017] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Revised: 10/15/2011] [Accepted: 10/17/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30 kg/m(2). A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. METHODS Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan®. RESULTS A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m(2). By univariate analysis, only BMI >30 kg/m(2) was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. CONCLUSIONS Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
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Affiliation(s)
- Victor de Lédinghen
- Centre d'Investigation de la Fibrose Hépatique, Centre Hospitalier Universitaire (CHU) de Bordeaux, Hôpital Haut-Lévêque, France.
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Castéra L, Sebastiani G, Le Bail B, de Lédinghen V, Couzigou P, Alberti A. Prospective comparison of two algorithms combining non-invasive methods for staging liver fibrosis in chronic hepatitis C. J Hepatol 2010; 52:191-8. [PMID: 20006397 DOI: 10.1016/j.jhep.2009.11.008] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 08/06/2009] [Accepted: 09/01/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Non-invasive assessment of liver fibrosis is a challenging area. Several methods have been proposed in patients with chronic hepatitis C (CHC) but their performance may be improved when they are combined as suggested by recently proposed algorithms using either transient elastography (TE) and Fibrotest (FT) (Castera) or AST-to-Platelet Ratio Index (APRI) and FT (SAFE biopsy). The aim of this prospective study was to compare the performance of these two algorithms for diagnosing significant fibrosis and cirrhosis in 302 CHC patients. METHODS All patients underwent TE, FT and APRI the same day as liver biopsy, taken as reference standard. RESULTS Significant fibrosis (Metavir F>or=2) was present in 76% of patients and cirrhosis (F4) in 25%. TE failure was observed in eight cases (2.6%). For significant fibrosis, Castera algorithm saved 23% more liver biopsies (71.9% vs. 48.3%, respectively; p<0.0001) than SAFE biopsy but its accuracy was significantly lower (87.7% vs. 97.0%, respectively; p<0.0001). Regarding cirrhosis, accuracy of Castera algorithm was significantly higher than that of SAFE biopsy (95.7% vs. 88.7%, respectively; p<0.0001). The number of saved liver biopsies did not differ between the two algorithms (78.8% vs. 74.8%; p=NS). CONCLUSIONS Both algorithms are effective for non-invasive staging of liver fibrosis in chronic hepatitis C. Although the number of liver biopsies avoided does not differ between algorithms for diagnosing cirrhosis, it is significantly higher with Castera algorithm than SAFE biopsy for significant fibrosis.
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Affiliation(s)
- Laurent Castéra
- Service d'Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire (C.H.U.) de Bordeaux, Pessac, France.
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Wong VWS, Vergniol J, Wong GLH, Foucher J, Chan HLY, Le Bail B, Choi PCL, Kowo M, Chan AWH, Merrouche W, Sung JJY, de Lédinghen V. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010; 51:454-62. [PMID: 20101745 DOI: 10.1002/hep.23312] [Citation(s) in RCA: 876] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in affluent countries. Accurate noninvasive tests for liver injury are urgently needed. The aim of this study was to evaluate the accuracy of transient elastography for the diagnosis of fibrosis and cirrhosis in patients with NAFLD and to study factors associated with discordance between transient elastography and histology. Two hundred forty-six consecutive patients from two ethnic groups had successful liver stiffness measurement and satisfactory liver biopsy specimens. The area under the receiver-operating characteristics curve (AUROC) of transient elastography for F3 or higher and F4 disease was 0.93 and 0.95, respectively, and was significantly higher than that of the aspartate aminotransferase-to-alanine aminotransferase ratio, aspartate aminotransferase-to-platelet ratio index, FIB-4, BARD, and NAFLD fibrosis scores (AUROC ranged from 0.62 to 0.81, P < 0.05 for all comparisons). At a cutoff value of 7.9 kPa, the sensitivity, specificity, and positive and negative predictive values for F3 or greater disease were 91%, 75%, 52%, and 97%, respectively. Liver stiffness was not affected by hepatic steatosis, necroinflammation, or body mass index. Discordance of at least two stages between transient elastography and histology was observed in 33 (13.4%) patients. By multivariate analysis, liver biopsy length less than 20 mm and F0-2 disease were associated with discordance. CONCLUSION Transient elastography is accurate in most NAFLD patients. Unsatisfactory liver biopsy specimens rather than transient elastography technique account for most cases of discordance. With high negative predictive value and modest positive predictive value, transient elastography is useful as a screening test to exclude advanced fibrosis. Liver biopsy may be considered in NAFLD patients with liver stiffness of at least 7.9 kPa.
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Affiliation(s)
- Vincent Wai-Sun Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
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Köhler MO, Mougenot C, Quesson B, Enholm J, Le Bail B, Laurent C, Moonen CTW, Ehnholm GJ. Volumetric HIFU ablation under 3D guidance of rapid MRI thermometry. Med Phys 2009; 36:3521-35. [PMID: 19746786 DOI: 10.1118/1.3152112] [Citation(s) in RCA: 226] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A volumetric sonication method is proposed that produces volume ablations by steering the focal point along a predetermined trajectory consisting of multiple concentric outward-moving circles. This method was tested in vivo on pig thigh muscle (32 ablations in nine animals). Trajectory diameters were 4, 12, and 16 mm with sonication duration depending on the trajectory size and ranging from 20 to 73 s. Despite the larger trajectories requiring more energy to reach necrosis within the desired volume, the ablated volume per unit applied energy increased with trajectory size, indicating improved treatment efficiency for larger trajectories. The higher amounts of energy required for the larger trajectories also increased the risk of off-focus heating, especially along the beam axis in the near field. To avoid related adverse effects, rapid volumetric multiplane MR thermometry was introduced for simultaneous monitoring of the temperature and thermal dose evolution along the beam axis and in the near field, as well as in the target region with a total coverage of six slices acquired every 3 s. An excellent correlation was observed between the thermal dose and both the nonperfused (R=0.929 for the diameter and R=0.964 for the length) and oedematous (R=0.913 for the diameter and R=0.939 for the length) volumes as seen in contrast-enhanced T1-weighted difference images and T2-weighted postsonication images, respectively. Histology confirmed the presence of a homogeneous necrosis inside the heated volumes. These results show that volumetric high-intensity focused ultrasound (HIFU) sonication allows for efficiently creating large thermal lesions while reducing treatment duration and also that the rapid multiplane MR thermometry improves the safety of the therapeutic procedure by monitoring temperature evolution both inside as well as outside the targeted volume.
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Bioulac-Sage P, Laumonier H, Couchy G, Le Bail B, Sa Cunha A, Rullier A, Laurent C, Blanc JF, Cubel G, Trillaud H, Zucman-Rossi J, Balabaud C, Saric J. Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience. Hepatology 2009; 50:481-9. [PMID: 19585623 DOI: 10.1002/hep.22995] [Citation(s) in RCA: 282] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED We took advantage of the reported genotype/phenotype classification to analyze our surgical series of hepatocellular adenoma (HCA). The series without specific known etiologies included 128 cases (116 women). The number of nodules varies from single, <5, and >or=5 in 78, 38, and 12 cases, respectively. The resection was complete in 95 cases. We identified 46 HNF1alpha-inactivated HCAs (44 women), 63 inflammatory HCAs (IHCA, 53 women) of which nine were also beta-catenin-activated, and seven beta-catenin-activated HCAs (all women); six additional cases had no known phenotypic marker and six others could not be phenotypically analyzed. Twenty-three of 128 HCAs showed bleeding. No differences were observed in solitary or multiple tumors in terms of hemorrhagic manifestations between groups. In contrast, differences were observed between the two main groups. Steatosis (tumor), microadenomas (resected specimen), and additional benign nodules were more frequently observed in HNF1alpha-inactivated HCAs (P < 0.01) than in IHCAs. Body mass index > 25, peliosis (tumor), and steatosis in background liver were more frequent in IHCA (P < 0.01). After complete resection, new HCAs in the centimetric range were more frequently found during follow-up (>1 year) in HNF1alpha-inactivated HCA. After incomplete resection (HCA left in nonresected liver), the majority of HCA remained stable in the two main groups and even sometimes regressed. Six patients of 128 developed hepatocellular carcinoma (HCC) (all were beta-catenin-activated, whether inflammatory or not). CONCLUSION There were noticeable clinical differences between HNF1alpha-inactivated HCA and IHCA; there was no increased risk of bleeding or HCC related to the number of HCAs; beta-catenin-activated HCAs are at higher risk of HCC. As a consequence, we believe that management of HCA needs to be adapted to the phenotype of these tumors.
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Affiliation(s)
- Paulette Bioulac-Sage
- Service d'Anatomie Pathologique, Hôpital Pellegrin, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France.
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Lucidarme D, Foucher J, Le Bail B, Vergniol J, Castera L, Duburque C, Forzy G, Filoche B, Couzigou P, de Lédinghen V. Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis C. Hepatology 2009; 49:1083-9. [PMID: 19140221 DOI: 10.1002/hep.22748] [Citation(s) in RCA: 184] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
UNLABELLED The purpose of this study was to assess the influence of success rate and interquartile range on the accuracy of transient elastography for the diagnostic of fibrosis in hepatitis C virus infection. Two-hundred fifty-four consecutive patients had liver stiffness measurements and liver biopsy of at least 15 mm. Discordances of at least two stages between transient elastography and histological assessment were observed in 28 cases (11%). Factors of discordance were assessed by comparing the 28 misclassified cases with the 226 others. In multivariate analysis, fibrosis stage (F0-F2 versus F3-F4) and the ratio interquartile range/median value of liver stiffness measurement (IQR/M) were associated with discordances (P <or= 0.05). The most significantly discriminant cutoff value was 0.21. For IQR/M < 0.21 versus IQR/M >or= 0.21, discordances of at least two stages of fibrosis were respectively observed in 10 of 135 cases (7.4%) versus 18 of 119 cases (15.1%) (P <or= 0.05). In patients with IQR/M >or= 0.21 versus IQR/M < 0.21, for the diagnosis of liver fibrosis F >or= 2, F >or= 3, F = 4, areas under the receiver operating characteristic curve (AUROCs) were 0.80 (95% confidence interval [CI], 0.73-0.89) versus 0.81 (95% CI, 0.70-0.90), (P = NS); 0.80 (95% CI, 0.72-0.88) versus 0.89 (95% CI, 0.83-0.95) (P = 0.04); and 0.86 (95% CI, 0.77-0.94) versus 0.95 (95% CI, 0.92-0.99) (P = NS). No association was found between success rate and discordance. CONCLUSION IQR/M is a factor of overestimation of liver fibrosis, and the most discriminant cutoff value is 0.21. Success rate is not a factor of accuracy for the diagnosis of hepatic fibrosis.
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Affiliation(s)
- Damien Lucidarme
- Groupe Hospitalier de l'Institut Catholique de Lille, Hôpital saint Philibert, Service de Pathologie Digestive, Lomme, France.
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Loko MA, Castera L, Dabis F, Le Bail B, Winnock M, Coureau G, Bioulac-Sage P, de Ledinghen V, Neau D. Validation and comparison of simple noninvasive indexes for predicting liver fibrosis in HIV-HCV-coinfected patients: ANRS CO3 Aquitaine cohort. Am J Gastroenterol 2008; 103:1973-80. [PMID: 18796094 DOI: 10.1111/j.1572-0241.2008.01954.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although an increasing number of noninvasive fibrosis markers are available in HCV-monoinfected patients, data on the performance of these tests in HIV-HCV-coinfected patients are lacking. OBJECTIVE To assess the diagnostic performance for predicting hepatic fibrosis stage of four simple and inexpensive noninvasive indexes (FIB-4, APRI, Forns, and platelet count) in HIV-HCV-coinfected patients. METHODS Two hundred consecutive HIV-HCV-coinfected patients from the ANRS-CO3 Aquitaine cohort who underwent liver biopsy were studied. Fibrosis stage was assessed according to Metavir scoring system by a single pathologist unaware of the data of the patients. Diagnostic performances were assessed by measuring the areas under the receiver operating characteristic curves (AUROC) and the percentage of patients correctly identified (PCI). RESULTS For predicting significant fibrosis (F > or = 2), APRI, Forns index, and FIB-4 had AUROCS of 0.77, 0.75, and 0.79, with 39%, 25%, and 70% of PCI, respectively. For predicting severe fibrosis (F > or = 3), FIB-4 had AUROC of 0.77 with 56% of PCI. For predicting cirrhosis (F4), FIB-4, APRI, and platelet count had AUROCs of 0.80, 0.79, and 0.78, with 59%, 60%, and 76% of PCI, respectively. Overall, diagnostic performances of the different indexes did not differ significantly for both significant fibrosis and cirrhosis. CONCLUSION The use of these noninvasive indexes could save liver biopsies in up to 56-76% of cases for the prediction of severe fibrosis-cirrhosis. However, given the high percentage of misclassified cases for significant fibrosis, such indexes do not appear currently suitable for use in clinical practice in HIV-HCV-coinfected patients.
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Seror O, Lepetit-Coiffé M, Le Bail B, de Senneville BD, Trillaud H, Moonen C, Quesson B. Real time monitoring of radiofrequency ablation based on MR thermometry and thermal dose in the pig liver in vivo. Eur Radiol 2007; 18:408-16. [PMID: 17899103 DOI: 10.1007/s00330-007-0761-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [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: 04/11/2007] [Revised: 08/03/2007] [Accepted: 08/27/2007] [Indexed: 02/02/2023]
Abstract
To evaluate the feasibility and accuracy of MR thermometry based on the thermal dose (TD) concept for monitoring radiofrequency (RF) ablations, 13 RF ablations in pig livers were performed under continuous MR thermometry at 1.5 T with a filtered clinical RF device. Respiratory gated fast gradient echo images were acquired simultaneously to RF deposition for providing MR temperature maps with the proton resonant frequency technique. Residual motion, signal to noise ratio (SNR) and standard deviation (SD) of MR temperature images were quantitatively analyzed to detect and reject artifacted images in the time series. SD of temperature measurement remained under 2 degrees C. Macroscopic analysis of liver ablations showed a white zone (Wz) surrounded by a red zone (Rz). A detailed histological analysis confirmed the ongoing nature of the coagulation necrosis in both Wz and Rz. Average differences (+/-SD) between macroscopic size measurements of Wz and Rz and TD predictions of ablation zones were 4.1 (+/-1.93) mm and -0.71 (+/-2.47) mm, respectively. Correlation values between TD and Wz and TD and Rz were 0.97 and 0.99, respectively. MR thermometry monitoring based on TD is an accurate method to delineate the size of the ablation zone during the RF procedure and provides a clinical endpoint.
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Affiliation(s)
- Olivier Seror
- Imagerie Moléculaire et Fonctionnelle: de la physiologie à la thérapie, ERT CNRS/Université Victor Segalen Bordeaux 2, 33000 Bordeaux, France.
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