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Jung M, Rose M, Knuechel R, Loeffler C, Muti H, Kather JN, Gaisa NT. Characterisation of tumour-immune phenotypes and PD-L1 positivity in squamous bladder cancer. BMC Cancer 2023; 23:113. [PMID: 36726072 PMCID: PMC9890720 DOI: 10.1186/s12885-023-10576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
AIMS Immune checkpoint inhibitor (ICI) therapy has become a viable treatment strategy in bladder cancer. However, treatment responses vary, and improved biomarkers are needed. Crucially, the characteristics of immune cells remain understudied especially in squamous differentiated bladder cancer (sq-BLCA). Here, we quantitatively analysed the tumour-immune phenotypes of sq-BLCA and correlated them with PD-L1 expression and FGFR3 mutation status. METHODS Tissue microarrays (TMA) of n = 68 non-schistosomiasis associated pure squamous cell carcinoma (SCC) and n = 46 mixed urothelial carcinoma with squamous differentiation (MIX) were subjected to immunohistochemistry for CD3, CD4, CD8, CD56, CD68, CD79A, CD163, Ki67, perforin and chloroacetate esterase staining. Quantitative image evaluation was performed via digital image analysis. RESULTS Immune infiltration was generally higher in stroma than in tumour regions. B-cells (CD79A) were almost exclusively found in stromal areas (sTILs), T-lymphocytes and macrophages were also present in tumour cell areas (iTILs), while natural killer cells (CD56) were nearly missing in any area. Tumour-immune phenotype distribution differed depending on the immune cell subset, however, hot tumour-immune phenotypes (high density of immune cells in tumour areas) were frequently found for CD8 + T-cells (33%), especially perforin + lymphocytes (52.2%), and CD68 + macrophages (37.6%). Perforin + CD8 lymphocytes predicted improved overall survival in sq-BLCA while high PD-L1 expression (CPS ≥ 10) was significantly associated with higher CD3 + , CD8 + and CD163 + immune cell density and high Ki67 (density) of tumour cells. Furthermore, PD-L1 expression was positively associated with CD3 + /CD4 + , CD3 + /CD8 + and CD68 + /CD163 + hot tumour-immune phenotypes. FGFR3 mutation status was inversely associated with CD8 + , perforin + and CD79A + lymphocyte density. CONCLUSIONS Computer-based image analysis is an efficient tool to analyse immune topographies in squamous bladder cancer. Hot tumour-immune phenotypes with strong PD-L1 expression might pose a promising subgroup for clinically successful ICI therapy in squamous bladder cancer and warrant further investigation.
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Affiliation(s)
- Max Jung
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany ,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
| | - Michael Rose
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany ,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
| | - Ruth Knuechel
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany ,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
| | - Chiara Loeffler
- grid.412301.50000 0000 8653 1507Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany ,grid.4488.00000 0001 2111 7257Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Hannah Muti
- grid.412301.50000 0000 8653 1507Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany ,grid.4488.00000 0001 2111 7257Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jakob Nikolas Kather
- grid.412301.50000 0000 8653 1507Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany ,grid.4488.00000 0001 2111 7257Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Nadine T. Gaisa
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany ,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
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Kather JN, Heij LR, Grabsch HI, Loeffler C, Echle A, Muti HS, Krause J, Niehues JM, Sommer KAJ, Bankhead P, Kooreman LFS, Schulte JJ, Cipriani NA, Buelow RD, Boor P, Ortiz-Brüchle N, Hanby AM, Speirs V, Kochanny S, Patnaik A, Srisuwananukorn A, Brenner H, Hoffmeister M, van den Brandt PA, Jäger D, Trautwein C, Pearson AT, Luedde T. Author Correction: Pan-cancer image-based detection of clinically actionable genetic alterations. Nat Cancer 2020; 1:1129. [PMID: 35122072 DOI: 10.1038/s43018-020-00149-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jakob Nikolas Kather
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
- German Cancer Consortium (DKTK), Heidelberg, Germany.
- Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
| | - Lara R Heij
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Heike I Grabsch
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
- Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Chiara Loeffler
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Amelie Echle
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Hannah Sophie Muti
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Jeremias Krause
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Jan M Niehues
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Kai A J Sommer
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Peter Bankhead
- MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Loes F S Kooreman
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jefree J Schulte
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Nicole A Cipriani
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Roman D Buelow
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Peter Boor
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Andrew M Hanby
- Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Valerie Speirs
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sara Kochanny
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Akash Patnaik
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | | | - Hermann Brenner
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Piet A van den Brandt
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Dirk Jäger
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Trautwein
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Tom Luedde
- Division of Gastroenterology, Hepatology and Gastrointestinal Oncology, University Hospital RWTH Aachen, Aachen, Germany.
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Duesseldorf, Germany.
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Lazzerini K, Gutierrez-Quintana R, José-López R, McConnell F, Gonçalves R, McMurrough J, De Decker S, Muir C, Priestnall SL, Mari L, Stabile F, De Risio L, Loeffler C, Tauro A, Rusbridge C, Rodenas S, Añor S, de la Fuente C, Fischer A, Bruehschwein A, Penderis J, Guevar J. Clinical Features, Imaging Characteristics, and Long-term Outcome of Dogs with Cranial Meningocele or Meningoencephalocele. J Vet Intern Med 2017; 31:505-512. [PMID: 28247440 PMCID: PMC5354015 DOI: 10.1111/jvim.14638] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/27/2016] [Accepted: 11/21/2016] [Indexed: 11/28/2022] Open
Abstract
Background The term meningoencephalocele (MEC) describes a herniation of cerebral tissue and meninges through a defect in the cranium, whereas a meningocele (MC) is a herniation of the meninges alone. Hypothesis/Objectives To describe the clinical features, magnetic resonance imaging (MRI) characteristics, and outcomes of dogs with cranial MC and MEC. Animals Twenty‐two client‐owned dogs diagnosed with cranial MC or MEC. Methods Multicentric retrospective descriptive study. Clinical records of 13 institutions were reviewed. Signalment, clinical history, neurologic findings and MRI characteristics as well as treatment and outcome were recorded and evaluated. Results Most affected dogs were presented at a young age (median, 6.5 months; range, 1 month – 8 years). The most common presenting complaints were seizures and behavioral abnormalities. Intranasal MEC was more common than parietal MC. Magnetic resonance imaging identified meningeal enhancement of the protruded tissue in 77% of the cases. Porencephaly was seen in all cases with parietal MC. Cerebrospinal fluid (CSF) analysis identified mild abnormalities in 4 of 11 cases. Surgery was not performed in any affected dog. Seventeen patients were treated medically, and seizures were adequately controlled with anti‐epileptic drugs in 10 dogs. Dogs with intranasal MEC and mild neurologic signs had a fair prognosis with medical treatment. Conclusion and clinical importance Although uncommon, MC and MEC should be considered as a differential diagnosis in young dogs presenting with seizures or alterations in behavior. Medical treatment is a valid option with a fair prognosis when the neurologic signs are mild.
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Affiliation(s)
- K Lazzerini
- Small Animal Hospital, University of Glasgow, Glasgow, UK
| | | | - R José-López
- Small Animal Hospital, University of Glasgow, Glasgow, UK
| | - F McConnell
- Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
| | - R Gonçalves
- Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
| | | | - S De Decker
- Queen Mother Hospital for Animals, Royal Veterinary College, London, UK
| | - C Muir
- Pathology and Pathogen Biology, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - S L Priestnall
- Pathology and Pathogen Biology, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - L Mari
- Animal Health Trust, Newmarket, UK
| | | | | | - C Loeffler
- Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - A Tauro
- Fitzpatrick Referrals, Eashing, Surrey, UK
| | | | - S Rodenas
- Hospital Veterinario Valencia Sur, Valencia, Spain
| | - S Añor
- Fundació Hospital Clínic Veterinari, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - C de la Fuente
- Fundació Hospital Clínic Veterinari, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - A Fischer
- Ludwig-Maximilian University Munich, Munchen, Germany
| | | | - J Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling, UK
| | - J Guevar
- Small Animal Hospital, University of Glasgow, Glasgow, UK
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Abstract
Radiation doses to adult male patients from abdominal aortogram and aorta femoral runoff examinations in a medical center were determined with the help of a dose-area product meter. The abdominal aortogram and aorta femoral runoff examination consisted of scout radiographs, fluoroscopy (to position a catheter near the area of interest), and serial films (to record the flow of contrast media). Measurements were converted to effective doses with the help of published results from Monte Carlo simulation calculations. Data from 19 male adult patients weighing 53 to 86 kg were analyzed. The resulting total effective dose had a value of 14.0 +/- 4A mSv (mean and standard deviation). The percent contribution by fluoroscopy was 18.5 +/- 9.9%. The fluoroscopy effective dose had a stronger correlation with the dose-area product (correlation coefficient of 0.97) than with duration of exposure (correlation coefficient of 0.84). Most of the radiation exposure in the observed abdominal aortogram and aorta femoral runoff examination was attributed to radiography.
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Affiliation(s)
- R Y Chu
- Radiology Service, Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA
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Lussos SA, Loeffler C. Epidural blood patch improves postdural puncture headache in a patient with benign intracranial hypertension. Reg Anesth 1993; 18:315-7. [PMID: 8268123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Benign intracranial hypertension (BIH) is a disorder of elevated resting intracranial pressure without associated intracranial abnormality. When medical therapy fails to halt visual impairments or recalcitrant headaches progress, lumbar dural puncture and cerebral spinal fluid (CSF) drainage procedures are instituted. The authors report on a patient with BIH in whom a severe postdural puncture headache (low CSF pressure syndrome) paradoxically developed after therapeutic CSF drainage. This postdural puncture headache was successfully treated with an epidural blood patch without complicating the patient's underlying BIH condition.
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Affiliation(s)
- S A Lussos
- Department of Anesthesiology, Fairfax Hospital, Falls Church, Virginia 22046
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Tytle TL, Loeffler C, Thompson WM. Transjugular intrahepatic portosystemic shunt (TIPS): a promising nonsurgical treatment for bleeding gastroesophageal varices. J Okla State Med Assoc 1993; 86:220-4. [PMID: 8315526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Transjugular intrahepatic portosystemic shunts (TIPS) is a relatively new procedure for variceal decompression and alleviation of variceal bleeding. A central connection is made transjugularly between the right hepatic vein and portal vein confluence. The shunt is then buttressed with metallic stents. Between March and August 1992, nine patients with cirrhosis and recurrent variceal hemorrhage have undergone the TIPS procedure at Oklahoma Memorial Hospital. The procedure was successfully performed in all patients. The mean initial direct portosystemic gradient of 22.4 mm Hg was reduced to 9.7 mm Hg. All patients have survived to date with no evidence of recurrent variceal hemorrhage following discharge or transfer. Initial results from our institution and internationally suggest that the TIPS procedure will become an attractive alternative to operative portosystemic shunts.
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Affiliation(s)
- T L Tytle
- Department of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma Memorial Hospital, Oklahoma City 73190
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Hofmann R, Pfab R, Loeffler C. [Statistical evaluation of andrologic-urologic consultation]. Helv Chir Acta 1984; 51:383-7. [PMID: 6568224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Fex G, Grubb A, Loeffler C, Larsson J. Isolation and partial characterization of a low molecular weight trypsin inhibitor from human urine. Biochim Biophys Acta 1981; 667:303-8. [PMID: 6163474 DOI: 10.1016/0005-2795(81)90196-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A low molecular weight glycoprotein which completely inhibited trypsin at a 1 : 1 molar ratio was isolated from human urine. It was generated from a precursor molecule which in turn derived from plasma inter-alpha-trypsin inhibitor. It had one polypeptide chain with a molecular weight of about 20 000 and a high content of half-cystine residues. Its amino-terminal amino-acid sequence was Val-Thr-Glu-Val-Thr-X-Leu-Glu-Asp-.
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