1
|
Middonti E, Astanina E, Vallariello E, Hoza RM, Metovic J, Spadi R, Cristiano C, Papotti M, Allavena P, Novelli F, Parab S, Cappello P, Scarpa A, Lawlor R, Di Maio M, Arese M, Bussolino F. A neuroligin-2-YAP axis regulates progression of pancreatic intraepithelial neoplasia. EMBO Rep 2024; 25:1886-1908. [PMID: 38413734 PMCID: PMC11014856 DOI: 10.1038/s44319-024-00104-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a tumor with a dismal prognosis that arises from precursor lesions called pancreatic intraepithelial neoplasias (PanINs). Progression from low- to high-grade PanINs is considered as tumor initiation, and a deeper understanding of this switch is needed. Here, we show that synaptic molecule neuroligin-2 (NLGN2) is expressed by pancreatic exocrine cells and plays a crucial role in the regulation of contact inhibition and epithelial polarity, which characterize the switch from low- to high-grade PanIN. NLGN2 localizes to tight junctions in acinar cells, is diffusely distributed in the cytosol in low-grade PanINs and is lost in high-grade PanINs and in a high percentage of advanced PDACs. Mechanistically, NLGN2 is necessary for the formation of the PALS1/PATJ complex, which in turn induces contact inhibition by reducing YAP function. Our results provide novel insights into NLGN2 functions outside the nervous system and can be used to model PanIN progression.
Collapse
Affiliation(s)
- Emanuele Middonti
- Department of Oncology, University of Torino, 10043, Orbassano, Italy.
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy.
| | - Elena Astanina
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - Edoardo Vallariello
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - Roxana Maria Hoza
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - Jasna Metovic
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
| | - Rosella Spadi
- SC Oncologia Medica, Città della Salute e della Scienza di Torino, 10126, Torino, Italy
| | - Carmen Cristiano
- SC Oncologia Medica, Città della Salute e della Scienza di Torino, 10126, Torino, Italy
| | - Mauro Papotti
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Division of Pathology at Città della Salute e della Scienza di Torino, 10126, Torino, Italy
| | - Paola Allavena
- IRCCS, Humanitas Clinical and Research Center, 20089, Rozzano, Italy
| | - Francesco Novelli
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126, Torino, Italy
- Laboratory of Tumor Immunology, Center for Experimental Research and Medical Studies, Città della Salute e della Scienza di Torino, 10126, Torino, Italy
- Molecular Biotechnology Center, University of Torino, 10125, Torino, Italy
| | - Sushant Parab
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - Paola Cappello
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126, Torino, Italy
- Laboratory of Tumor Immunology, Center for Experimental Research and Medical Studies, Città della Salute e della Scienza di Torino, 10126, Torino, Italy
- Molecular Biotechnology Center, University of Torino, 10125, Torino, Italy
| | - Aldo Scarpa
- Applied Research Center (ARC-NET), University of Verona, 37134, Verona, Italy
- Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Rita Lawlor
- Applied Research Center (ARC-NET), University of Verona, 37134, Verona, Italy
- Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Medical Oncology, Ordine Mauriziano Hospital, 10128, Torino, Italy
| | - Marco Arese
- Department of Oncology, University of Torino, 10043, Orbassano, Italy
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy
| | - Federico Bussolino
- Department of Oncology, University of Torino, 10043, Orbassano, Italy.
- Candiolo Cancer Institute-IRCCS-FPO, 10060, Candiolo, Italy.
| |
Collapse
|
2
|
Bergaggio E, Tai WT, Aroldi A, Mecca C, Landoni E, Nüesch M, Mota I, Metovic J, Molinaro L, Ma L, Alvarado D, Ambrogio C, Voena C, Blasco RB, Li T, Klein D, Irvine DJ, Papotti M, Savoldo B, Dotti G, Chiarle R. ALK inhibitors increase ALK expression and sensitize neuroblastoma cells to ALK.CAR-T cells. Cancer Cell 2023; 41:2100-2116.e10. [PMID: 38039964 PMCID: PMC10793157 DOI: 10.1016/j.ccell.2023.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/05/2023] [Accepted: 11/06/2023] [Indexed: 12/03/2023]
Abstract
Selection of the best tumor antigen is critical for the therapeutic success of chimeric antigen receptor (CAR) T cells in hematologic malignancies and solid tumors. The anaplastic lymphoma kinase (ALK) receptor is expressed by most neuroblastomas while virtually absent in most normal tissues. ALK is an oncogenic driver in neuroblastoma and ALK inhibitors show promising clinical activity. Here, we describe the development of ALK.CAR-T cells that show potent efficacy in monotherapy against neuroblastoma with high ALK expression without toxicity. For neuroblastoma with low ALK expression, combination with ALK inhibitors specifically potentiates ALK.CAR-T cells but not GD2.CAR-T cells. Mechanistically, ALK inhibitors impair tumor growth and upregulate the expression of ALK, thereby facilitating the activity of ALK.CAR-T cells against neuroblastoma. Thus, while neither ALK inhibitors nor ALK.CAR-T cells will likely be sufficient as monotherapy in neuroblastoma with low ALK density, their combination specifically enhances therapeutic efficacy.
Collapse
Affiliation(s)
- Elisa Bergaggio
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Wei-Tien Tai
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Andrea Aroldi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Carmen Mecca
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Elisa Landoni
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Manuel Nüesch
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Ines Mota
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA; Department of Radiation Oncology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Jasna Metovic
- Department of Oncology, University of Torino, 10126 Torino, Italy
| | - Luca Molinaro
- Department of Medical Science, University of Torino, 10126 Torino, Italy
| | - Leyuan Ma
- Koch Institute and MIT, Cambridge, MA 02139, USA
| | | | - Chiara Ambrogio
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy
| | - Claudia Voena
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy
| | - Rafael B Blasco
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Tongqing Li
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Daryl Klein
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT 06520, USA
| | | | - Mauro Papotti
- Department of Oncology, University of Torino, 10126 Torino, Italy
| | - Barbara Savoldo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gianpietro Dotti
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Roberto Chiarle
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA; Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
| |
Collapse
|
3
|
Castellano I, Gallo F, Durelli P, Monge T, Fadda M, Metovic J, Cassoni P, Borella F, Raucci C, Menischetti M, Beano A, Migliaretti G, Finocchiaro C. Impact of Caloric Restriction in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: A Prospective Case Control Study. Nutrients 2023; 15:4677. [PMID: 37960330 PMCID: PMC10648206 DOI: 10.3390/nu15214677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Background and aims: It is well established that caloric restriction (CR) may influence metabolic and hormonal factors involved in cancer development and progression. Recently, several studies have demonstrated that CR may have a favorable impact on the response to systemic therapy in breast cancer (BC) patients. However, there is a lack of data regarding the influence of CR during neoadjuvant chemotherapy (NACT). Our study's primary aim was to evaluate CR's impact on BC patients undergoing NACT. Secondly, we investigated the nutritional efficacy and safety of this intervention. Methods: We performed a prospective, case-control study in two breast units. A diet group consisting of 39 patients undergoing NACT and CR was enrolled in our study at the same time. CR consisted of a 30% reduction in caloric intake, which increased to 50% on the days before, during, and after the administration of chemotherapy. A control group of 60 patients that underwent the same treatment approach only followed the general dietary recommendations for BC according to WCRF guidelines. The diet group was monitored during the study for both dietary adequacy and weight trends. Results: CR combined with NACT showed a statistically significant therapeutic response in tumor size (OR 2.94, IC 1.07-8.01, p = 0.009) and lymph node status (OR 3.22, IC 1.22-8.56, p = 0.001) compared to NACT alone, even after the adjustment for all biological parameters. Our data also showed the efficacy and safety of this intervention in both anthropometric and biochemical analyses. Conclusions: Patients who adhered to CR showed a better response to NACT, both in the breast and in the axillary lymph nodes, compared to the patients in the control group. Furthermore, the CR diet combined with NACT showed good tolerance and safety.
Collapse
Affiliation(s)
- Isabella Castellano
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Francesco Gallo
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Paola Durelli
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Taira Monge
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Maurizio Fadda
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Jasna Metovic
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Fulvio Borella
- Gynecology and Obstetrics 1U, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy;
| | - Carlo Raucci
- Oncology Unity, Cottolengo Hospital, 10152 Turin, Italy
| | | | - Alessandra Beano
- Medical Breast Oncology Unit, Department of Oncology, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy
| | - Giuseppe Migliaretti
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Concetta Finocchiaro
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| |
Collapse
|
4
|
Metovic J, Cabutti F, Osella-Abate S, Orlando G, Tampieri C, Napoli F, Maletta F, Daniele L, Volante M, Papotti M. Clinical and Pathological Features and Gene Expression Profiles of Clinically Aggressive Papillary Thyroid Carcinomas. Endocr Pathol 2023; 34:298-310. [PMID: 37208504 PMCID: PMC10511602 DOI: 10.1007/s12022-023-09769-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/21/2023]
Abstract
Papillary thyroid carcinoma (PTC) is considered an indolent neoplasm but it may demonstrate aggressive behavior. We aimed to identify clinical and pathological characteristics and molecular signatures associated with aggressive forms of PTCs. We selected 43 aggressive PTC cases based on the presence of metastases at the time of diagnosis, the development of distant metastasis during follow-up, and/or biochemical recurrence, and 43 PTC patients that were disease-free upon follow-up, matching them according to age, sex, pT, and pN parameters. Twenty-four pairs (a total of 48 cases) and 6 normal thyroid tissues were studied using targeted mRNA screening of cancer-associated genes employing NanoString nCounter® technology. In general, aggressive PTCs showed distinctive clinical and morphological features. Among adverse prognostic parameters, the presence of necrosis and an increased mitotic index were associated with shorter disease-free and overall survivals. Other parameters associated with shorter disease-free or overall survivals include a lack of tumor capsule, the presence of vascular invasion, tumor-infiltrating lymphocytes, fibrosclerotic changes, age > 55 years, and a high pTN stage. Various pathways were differentially regulated in non-aggressive as compared to aggressive PTC, including the DNA damage repair, the MAPK, and the RAS pathways. In particular, the hedgehog pathway was differentially de-regulated in aggressive PTC as compared to non-aggressive PTC cases, being WNT10A and GLI3 genes significantly up- and down-regulated in aggressive PTC and GSK3B up-regulated in non-aggressive PTC cases. In conclusion, our study revealed specific molecular signatures and morphological features in aggressive PTC that may be useful to predict more aggressive behavior in a subset of PTC patients. These findings may be useful when developing novel, tailored treatment options for these patients.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Città Della Salute E Della Scienza Hospital, Pathology Unit, Turin, Italy
| | - Francesco Cabutti
- Department of Medical Sciences, University of Turin, Città Della Salute E Della Scienza Hospital, Pathology Unit, Turin, Italy
| | | | - Giulia Orlando
- Department of Oncology, University of Turin, Città Della Salute E Della Scienza Hospital, Pathology Unit, Turin, Italy
| | - Cristian Tampieri
- Department of Medical Sciences, University of Turin, Città Della Salute E Della Scienza Hospital, Pathology Unit, Turin, Italy
| | - Francesca Napoli
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Francesca Maletta
- Pathology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Marco Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, University of Turin, Città Della Salute E Della Scienza Hospital, Pathology Unit, Turin, Italy
| |
Collapse
|
5
|
Metovic J, Sapino A, Castellano I. Reply to: Neuroendocrine neoplasms of the breast: diagnostic confusion and future perspectives. Virchows Arch 2023; 482:931-932. [PMID: 36670280 DOI: 10.1007/s00428-023-03494-w] [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] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/21/2023]
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - Anna Sapino
- Pathology Division, FPO-IRCCS, Candiolo Cancer Institute, Candiolo, Italy
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy.
| |
Collapse
|
6
|
Ferrari L, Metovic J, Pulcinelli D, Lombardi A, Rullo D, Papola F, Ventura L. pH evaluation of storage fluids and ancient DNA extraction from wet specimens in pathology museums. J Biol Res 2022. [DOI: 10.4081/jbr.2022.10820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pathology museums host ancient samples obtained during autopsies and generally used for educational purposes in the past. Such collections consist of dry and wet specimens showing diseases that no longer exist or with their natural course unmodified by modern therapies.1,2 In wet specimens, the preservation of macroscopic features due to the storage fluid has a great historical and paleopathological interest. Unfortunately, both original fixatives and storage fluids strongly influence tissue antigens and nucleic acids preservation.3 [...]
Collapse
|
7
|
Metovic J, La Salvia A, Rapa I, Napoli F, Birocco N, Pia Bizzi M, Garcia-Carbonero R, Ciuffreda L, Scagliotti G, Papotti M, Volante M. Molecular Subtypes of Extra-pulmonary Neuroendocrine Carcinomas Identified by the Expression of Neuroendocrine Lineage-Specific Transcription Factors. Endocr Pathol 2022; 33:388-399. [PMID: 35608806 PMCID: PMC9420091 DOI: 10.1007/s12022-022-09722-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 12/17/2022]
Abstract
Extra-pulmonary neuroendocrine carcinomas (EPNEC) represent a group of rare and heterogenous neoplasms with adverse clinical outcome. Their molecular profile is largely unexplored. Our aim was to investigate if the major transcriptional drivers recently described in high-grade pulmonary neuroendocrine carcinomas characterize distinct molecular and clinical subgroups of EPNEC. Gene expression of ASCL1, NEUROD1, DLL3, NOTCH1, INSM1, MYCL1, POU2F3, and YAP1 was investigated in a series of 54 EPNEC (including 10 cases with mixed components analyzed separately) and in a group of 48 pulmonary large cell neuroendocrine carcinomas (P-LCNEC). Unsupervised hierarchical cluster analysis classified the whole series into four major clusters. P-LCNEC were classified into two major clusters, the first ASCL1/DLL3/INSM1-high and the second (including four EPNEC) ASCL1/DLL3-low but INSM1-high. The remaining EPNEC cases were sub-classified into two other clusters. The first showed INSM1-high and alternative ASCL1/DLL3 or NEUROD1 high expression. The second was characterized mainly by MYCL1 and YAP1 overexpression. In the ten cases with mixed histology, ASCL1, DLL3, INSM1, and NEUROD1 genes were significantly upregulated in the neuroendocrine component. Higher gene-expression levels of NOTCH1 and INSM1 were associated with lower pT stage and negative nodal status. Low INSM1 gene expression was associated with shorter overall survival in the entire case series (p = 0.0017) and with a trend towards significance in EPNEC, only (p = 0.06). In conclusion, our results show that EPNEC possess distinct neuroendocrine-lineage-specific transcriptional profiles; moreover, low INSM1 gene expression represents a novel potential unfavorable prognostic marker in high-grade NECs including those in extra-pulmonary location.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin; Pathology Unit at Città della Salute e della Scienza Hospital, via Santena 7, Turin, Italy
| | - Anna La Salvia
- Division of Medical Oncology, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - Ida Rapa
- Department of Oncology, University of Turin; Pathology Unit at San Luigi Hospital, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Francesca Napoli
- Department of Oncology, University of Turin; Pathology Unit at San Luigi Hospital, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Nadia Birocco
- Medical Oncology Unit, Città Della Salute e Della Scienza Hospital, Turin, Italy
| | - Maria Pia Bizzi
- Medical Oncology Unit, San Luigi Hospital, Orbassano, Turin, Italy
| | | | - Libero Ciuffreda
- Medical Oncology Unit, Città Della Salute e Della Scienza Hospital, Turin, Italy
| | - Giorgio Scagliotti
- Department of Oncology, University of Turin; Medical Oncology Unit at San Luigi Hospital, Orbassano, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin; Pathology Unit at Città della Salute e della Scienza Hospital, via Santena 7, Turin, Italy
| | - Marco Volante
- Department of Oncology, University of Turin; Pathology Unit at San Luigi Hospital, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
| |
Collapse
|
8
|
Metovic J, Napoli F, Osella-Abate S, Bertero L, Tampieri C, Orlando G, Bianchi M, Carli D, Fagioli F, Volante M, Papotti M. Overexpression of INSM1, NOTCH1, NEUROD1, and YAP1 genes is associated with adverse clinical outcome in pediatric neuroblastoma. Virchows Arch 2022; 481:925-933. [PMID: 36121500 PMCID: PMC9734219 DOI: 10.1007/s00428-022-03406-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/12/2022] [Accepted: 08/27/2022] [Indexed: 01/22/2023]
Abstract
Pediatric neuroblastoma is responsible for approximately 8-10% of pediatric tumors, and it is one of the leading causes of tumor-related deaths in children. Although significant progress has been made in the characterization of neuroblastoma in recent years, the mechanisms influencing the prognosis of neuroblastoma patients remain largely unknown. Our aim was to investigate if the major neuroendocrine-associated transcriptional drivers, including ASCL1, NEUROD1, DLL3, NOTCH1, INSM1, MYCL1, POU2F3 and YAP1 are correlated with specific clinical and pathological characteristics. We selected a retrospective series of 46 primary pediatric neuroblastoma, composed of 30 treatment-naïve and 16 post-chemotherapy cases. Gene expression levels were explored by means of quantitative real-time PCR. An increased expression of NOTCH1 (p = 0.005), NEUROD1 (p = 0.0059), and YAP1 (p = 0.0008) was found in stage IV tumors, while the highest levels of MYCL1 and ASCL1 were seen in stages IVS and III, respectively (p = 0.0182 and p = 0.0134). A higher level of NOTCH1 (p = 0.0079) and YAP1 (p = 0.0026) was found in cases with differentiating morphology, while high mitosis-karyorrhexis index cases demonstrated significantly lower levels of POU2F3 (p = 0.0277). High expression of NOTCH1 (p = 0.008), NEUROD1 (p = 0.026), INSM1 (p = 0.010), and YAP1 (p = 0.005) together with stage IV (p = 0.043) was associated with shorter disease-free survival. In summary, our data indicate that the assessment of gene expression levels of neuroendocrine-lineage transcription factors might help to identify neuroblastoma patients with the risk of relapse.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Orbassano, Turin, Italy
| | - Francesca Napoli
- Department of Oncology, University of Turin, Orbassano, Turin, Italy
| | | | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Giulia Orlando
- Department of Oncology, University of Turin, Orbassano, Turin, Italy
| | - Maurizio Bianchi
- Pediatric Onco-hemathology Unit, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Diana Carli
- Pediatric Onco-hemathology Unit, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Franca Fagioli
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Marco Volante
- Department of Oncology, University of Turin, Orbassano, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, University of Turin, Orbassano, Turin, Italy
| |
Collapse
|
9
|
Metovic J, Cascardi E, Uccella S, Maragliano R, Querzoli G, Osella-Abate S, Pittaro A, La Rosa S, Bogina G, Cassoni P, Marchiò C, Sapino A, Castellano I, Papotti M. Neuroendocrine neoplasms of the breast: diagnostic agreement and impact on outcome. Virchows Arch 2022; 481:839-846. [PMID: 36243799 PMCID: PMC9734208 DOI: 10.1007/s00428-022-03426-0] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 01/25/2023]
Abstract
The classification of breast neuroendocrine neoplasms (Br-NENs) was modified many times over the years and is still a matter of discussion. In the present study, we aimed to evaluate the diagnostic reproducibility and impact on patient outcomes of the most recent WHO 2019 edition of breast tumor classification, namely, for neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). This multicentric observational study included 287 breast neoplasms with NE differentiation. The cases were blindly classified by three independent groups of dedicated breast and/or endocrine pathologists following the 2019 guidelines. Diagnostic concordance and clinical impact were assessed. We observed only a moderate overall diagnostic agreement across the three centers (Cohen's kappa 0.4532) in distinguishing NET from solid papillary carcinomas (SPCs) and no special type carcinomas (NST) with NE differentiation. Br-NENs were diagnosed in 122/287 (42.5%) cases, subclassified as 11 NET G1 (3.8%), 84 NET G2 (29.3%), and 27 NEC (9.4%), the latter group consisting of 26 large-cell and 1 small-cell NECs. The remaining 165/287 (57.5%) cases were labeled as non-NEN, including SPC, mucinous, NST, and mixed NE carcinomas. While NET and non-NEN cases had a comparable outcome, the diagnosis of NECs showed negative impact on disease-free interval compared to NETs and non-NENs (p = 0.0109). In conclusion, the current diagnostic classification of Br-NENs needs further adjustments regarding morphological and immunohistochemical criteria to increase the diagnostic reproducibility among pathologists. Our data suggest that, apart from high-grade small- and large-cell NECs, Br-NENs behave like non-NEN breast carcinomas and should be managed similarly.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - Eliano Cascardi
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy
| | - Silvia Uccella
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Roberta Maragliano
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giulia Querzoli
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Alessandra Pittaro
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Stefano La Rosa
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giuseppe Bogina
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Caterina Marchiò
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Anna Sapino
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| |
Collapse
|
10
|
Abstract
According to the 2019 WHO classification of breast tumors, neuroendocrine neoplasms (NENs) are classified into well-differentiated NE tumors (NET) and poorly differentiated NE carcinomas (NEC), while other breast cancers (BCs) of special and no special type with neuroendocrine (NE) features are not incorporated in this scheme anymore. We aimed to assess whether INSM1, a novel NE marker, could have a role in breast NEN subtyping. We selected 63 BCs operated from 2003 to 2018, classified as BCs with NE features, with available clinico-pathological data. Following 2019 WHO criteria, this cohort was reclassified into 37 NETs/NECs, the remaining 26 tumors representing solid-papillary (7), mucinous (7), and mixed type (12) carcinomas with NE differentiation. Chromogranin A (CGA) and synaptophysin (SYN) immunostains were reviewed, and INSM1 was tested by immunohistochemistry. Thirty CGA- and SYN-negative no special type BCs served as negative control. INSM1 was expressed in 52/63 cases of the whole cohort (82.54%). INSM1 positive and negative cases had no significantly different clinico-pathological characteristics. INSM1 expression was not significantly different between the newly reclassified NET/NEC group and other BCs with NE features. No immunoexpression was observed in control BCs. The sensitivity and specificity of INSM1 for the NE phenotype was 82.5% and 100%, respectively, compared to 61.9% and 100% for CGA, and 95.2 and 100% for SYN. In conclusion, INSM1 is as accurate as traditional NE biomarkers to identify NE differentiation in BC. In analogy to standard NE markers, INSM1 could not distinguish NET and NEC from the other BC histotypes with NE differentiation.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy.
| | - Eleonora Marinelli
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, 10060, Candiolo, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| |
Collapse
|
11
|
Pelosi G, Bianchi F, Dama E, Metovic J, Barella M, Sonzogni A, Albini A, Papotti M, Gong Y, Vijayvergia N. A Subset of Large Cell Neuroendocrine Carcinomas in the Gastroenteropancreatic Tract May Evolve from Pre-existing Well-Differentiated Neuroendocrine Tumors. Endocr Pathol 2021; 32:396-407. [PMID: 33433886 DOI: 10.1007/s12022-020-09659-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Accepted: 12/16/2020] [Indexed: 02/06/2023]
Abstract
In the gastro-entero-pancreatic (GEP) tract, neuroendocrine neoplasms (NENs) include well differentiated neuroendocrine tumors (NETs) and high-grade NE carcinomas (NECs), which are thought to make up separate and mutually exclusive tumor entities. Little is known, however, as to whether there may be any pathogenetic link between them. Clustering analysis of a 10-gene panel generated from a previously reported next-generation sequencing analysis on 48 GEP-NENs with clinical annotations was used in the study. Unsupervised cluster analysis showed three histology-independent clusters, namely, C1, C2, and C3, which accounted for 44% of patients but the entire array of mutations. All but two NECs fell into the clusters, yet with different prevalence rates (p < 0.0001). A model was devised according to which NETs were likely to evolve into NECs upon progression of C3 into C1 and C2, despite different morphology. The median Ki-67 labeling index was 5% in C3 showing better prognosis and 50% in C1 and C2 experiencing worse prognosis, with an impressive intra-tumor heterogeneity of diversely proliferating tumor areas. This study suggests that a subset of large cell NECs in the gastroenteropancreatic tract may evolve from pre-existing well-differentiated NETs.
Collapse
Affiliation(s)
- Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy.
| | - Fabrizio Bianchi
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Elisa Dama
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Marco Barella
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Adriana Albini
- Laboratory of Vascular Biology and Angiogenesis, IRCCS MultiMedica, Milan, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Yulan Gong
- Department of Pathology, Fox Chase Cancer Centre, Philadelphia, PA, USA
| | - Namrata Vijayvergia
- Department of Medical Oncology, Fox Chase Cancer Centre, Philadelphia, PA, USA
| |
Collapse
|
12
|
Abstract
Ectopic adrenal rests are a rare condition which can be found in various sites, generally in the retroperitoneum or pelvis along the path of gonadal descent. Their real prevalence is unknown. Males are more commonly affected, at least in the pediatric age. Adrenal rests are usually clinically silent and incidentally found in surgical samples, mostly in the pediatric population, and rarely in adults. With the aim of increasing knowledge and estimating the prevalence of ectopic adrenocortical tissue in the adult population, 44 adrenal rests in the urogenital tract of 40 adults are described. These represent approximately 0.07% of the total number of urogenital and gynecological surgeries performed in the 22 considered years. Adrenal rests were identified in the spermatic cord (10 males) and in paraovarian, parasalpingeal, or infundibulopelvic ligament locations (30 females). All but one was incidental findings. One case regarded an adrenocortical carcinoma arisen in adrenal rests. A literature review of adrenal ectopia in the urogenital tract of adults identified 57 reported cases from 53 patients, with similar clinicopathological features as those of our series, with the exception of a lower incidence of parasalpingeal locations. Despite their limited clinical implications, awareness of ectopic adrenal rests is essential also in adults for at least two reasons: (a) to correctly identify sources of adrenocortical hormone production in case of adrenal insufficiency or hormonal imbalance and (b) to avoid misinterpretations in the diagnostic workup of renal cell carcinoma, adrenocortical tumors, and rare gonadal neoplasms, including Sertoli/Leydig cell tumors.
Collapse
Affiliation(s)
- Enrico Costantino Falco
- Pathology Unit, Department of Medical Sciences, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
| | | | - Jasna Metovic
- Pathology Unit, Department of Oncology, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
| | - Enrico Bollito
- Pathology Unit, San Luigi Hospital, Orbassano, Turin, Italy
| | | | - Marco Volante
- Pathology Unit, Department of Oncology at San Luigi Hospital, University of Turin, Orbassano, Turin, Italy.
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
| |
Collapse
|
13
|
Bergaggio E, Tai WT, Aroldi A, Mota I, Alvarado D, Landoni E, Metovic J, Nüesch M, Blasco-Patiño R, Papotti M, Dotti G, Chiarle R. Abstract 1544: Generation of ALK CAR-T cells for neuroblastoma therapy. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Neuroblastoma (NB) is the most deadly cancer in children with dismal survival in high-risk patients. The majority of NB express the full length anaplastic lymphoma kinase (ALK) receptor, that typically acts as driver oncogene together with MYCN. In contrast to ALK-driven lung cancer or lymphoma, targeted therapies with ALK tyrosine kinase inhibitors (TKIs), despite encouraging, induce only partial responses in NB. Therefore, additional tools to improve NB treatment are strongly needed. To specifically target NB cells, we developed a series of ALK chimeric antigen receptor (CAR) T constructs from antibodies that recognize both human and mouse ALK. Murine ALK CAR-T cells are able to control the growth of ALK+ leukemia and NB in syngeneic tumor models without detectable toxicity. From the leading candidate, we generated fully humanized ALK CAR-T cells that showed potent in vitro killing activity against a large panel of human NB lines, with activity comparable to GD2 CAR-T cells that are currently in clinical trials for NB patients. Remarkably, ALK CAR-T treatment synergized in vivo with the ALK inhibitor lorlatinib. Mechanistically, lorlatinib not only reduced tumor growth, but enhanced ALK expression on the surface of tumor cells, thereby facilitating ALK CAR-T targeting. Combination of ALK CAR-T cells with lorlatinib resulted in enhanced killing of NB cells and cure or markedly increased survival in mouse models of human metastatic NB even with low ALK expression. These findings support the clinical development of ALK CAR-T cells for NB therapy.
Citation Format: Elisa Bergaggio, Wei-Tien Tai, Andrea Aroldi, Ineês Mota, Diego Alvarado, Elisa Landoni, Jasna Metovic, Manuel Nüesch, Rafael Blasco-Patiño, Mauro Papotti, Gianpietro Dotti, Roberto Chiarle. Generation of ALK CAR-T cells for neuroblastoma therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1544.
Collapse
Affiliation(s)
| | | | - Andrea Aroldi
- 2Haematology Division and Bone Marrow Unit, Ospedale San Gerardo, Monza, Italy
| | | | | | - Elisa Landoni
- 4Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jasna Metovic
- 5Department of Oncology, University of Torino, Torino, Italy
| | | | | | - Mauro Papotti
- 5Department of Oncology, University of Torino, Torino, Italy
| | - Gianpietro Dotti
- 4Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | |
Collapse
|
14
|
Gambella A, Falco EC, Metovic J, Maletta F, De Angelis C, Maragliano R, Uccella S, Pacchioni D, Papotti M. Amyloid-Rich Pancreatic Neuroendocrine Tumors: a Potential Diagnostic Pitfall in Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology (EUS-FNAC). Endocr Pathol 2021; 32:318-325. [PMID: 32399832 DOI: 10.1007/s12022-020-09625-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/27/2022]
Abstract
Pancreatic neuroendocrine tumors (PanNETs) are rare neoplasms that include even rarer variants that may pose different diagnostic problems, especially in fine needle aspiration cytology (FNAC). We describe the diagnostic clues of the amyloid-rich variant of PanNETs in endoscopic ultrasound (EUS)-guided fine needle aspiration cytology (EUS-FNAC). Three cases of PanNETs with an amyloid-rich stromal component were retrieved and retrospectively reviewed. For every case, the pancreatic lesion was investigated by a EUS-FNAC procedure. The final diagnosis was supported by immunocytochemistry and Congo red staining. All cases had similar EUS-FNAC features: neoplastic cells were entrapped in an eosinophilic, homogeneous dense and amorphous matrix. The neuroendocrine nature was confirmed by immunoexpression of synaptophysin and chromogranin A, while the amorphous stroma was characterized as amyloid based on positive Congo red staining. Regarding the hormonal profile, no insulin or proinsulin reactivity was observed, but all cases were diffusely positive for amylin. The diagnosis of uncommon variants of PanNETs, such as the amyloid-rich, is challenging especially in EUS-FNAC procedures because of a unique and misleading morphology, potentially mimicking fibrotic conditions and amyloid deposition within systemic amyloidosis. In cytology specimens, the presence of amorphous material requires amyloid deposition to be considered in the differential diagnosis of pancreatic neoplasms with neuroendocrine phenotype.
Collapse
Affiliation(s)
- Alessandro Gambella
- Division of Pathology, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Francesca Maletta
- Division of Pathology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Claudio De Angelis
- Division of Gastroenterology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Roberta Maragliano
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Silvia Uccella
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Donatella Pacchioni
- Division of Pathology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy.
- Anatomia Patologica, Università di Torino, Via Santena 7, I-10126, Torino, Italy.
| |
Collapse
|
15
|
Metovic J, Bianchi F, Barella M, Papotti M, Pelosi G. SMARCA2 Deficiency While Preserving SMARCA4 and SMARCB1 in Lung Neuroendocrine Carcinomas. J Thorac Oncol 2021; 16:e32-e35. [PMID: 33896578 DOI: 10.1016/j.jtho.2021.01.1613] [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: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Fabrizio Bianchi
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Marco Barella
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Giuseppe Pelosi
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| |
Collapse
|
16
|
Metovic J, Bragoni A, Osella-Abate S, Borella F, Benedetto C, Gualano MR, Olivero E, Scaioli G, Siliquini R, Ferrando PM, Bertero L, Sapino A, Cassoni P, Castellano I. Clinical Relevance of Tubular Breast Carcinoma: Large Retrospective Study and Meta-Analysis. Front Oncol 2021; 11:653388. [PMID: 33996576 PMCID: PMC8117349 DOI: 10.3389/fonc.2021.653388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Tubular carcinoma (TC) is a low proliferative grade 1 (G1) breast cancer (BC). Despite its favorable outcome and allegedly lower aggressiveness, patients are treated like other luminal G1 BC, with radiotherapy (RT) and hormonal therapy (HT). We performed: (1) a retrospective study comparing a TC cohort and a control series of luminal G1 BC and (2) a systematic review and meta-analysis focused on TC outcome. Materials and Methods: We selected a series of 572 G1 luminal BC patients [111 TC, 350 not otherwise specified (NOS), and 111 special-type (ST) BC] with follow-up and clinico-pathological data, who underwent local excision followed by RT at Città della Salute e della Scienza Hospital, Turin. Moreover, 22 and 13 studies were included in qualitative and quantitative meta-analysis, respectively. Results: TCs were generally smaller (≤10 mm) (P < 0.001), with lower lymph node involvement (P < 0.001). TCs showed no local and/or distant recurrences, while 16 NOS and 2 ST relapsed (P = 0.036). Kaplan–Meier curves confirmed more favorable TC outcome (DFI: log-rank test P = 0.03). Meta-analysis data, including the results of our study, showed that the pooled DFI rate was 96.4 and 91.8% at 5 and 10 years, respectively. Meta-regression analyses did not show a significant influence of RT nor HT on the DFI at 10 years. Conclusions: Compared to the other G1 BCs, TCs have an excellent outcome. The meta-analysis shows that TC recurrences are infrequent, and HT and RT have limited influence on prognosis. Hence, accurate diagnosis of TC subtype is critical to ensuring a tailored treatment approach.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Alberto Bragoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simona Osella-Abate
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - Maria Rosaria Gualano
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Elena Olivero
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Giacomo Scaioli
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Pietro Maria Ferrando
- Plastic Surgery Unit, Department of General and Specialistic Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Anna Sapino
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.,Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
17
|
Metovic J, Bianchi F, Rossi G, Barella M, Sonzogni A, Harari S, Papotti M, Pelosi G. Recent advances and current controversies in lung neuroendocrine neoplasms ✰. Semin Diagn Pathol 2021; 38:90-97. [PMID: 33810912 DOI: 10.1053/j.semdp.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 11/11/2022]
Abstract
In the lung, neuroendocrine tumors (NETs), namely typical and atypical carcinoids, and neuroendocrine carcinomas (NECs), grouping small cell carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC), make up for distinct tumor entities according to epidemiological, genetic, pathologic and clinical data. The proper classification is essential in clinical practice for diagnosis, prognosis and therapy purposes. Through an extensive literature survey, three perspectives on lung NENs have been revised: i) criteria and terminology on biopsy or cytology samples of primaries or metastases; ii) carcinoids with elevated mitotic counts and/or Ki-67 proliferation rates; iii) relevance of molecular landscape to identify new tumor entities and therapeutic targets. Furthermore, a dispute about lung NEN development has been raised according to emerging molecular models. We herein provide a pathology update on practical topics in the setting of lung NENs according to the current classification (recent advances). We have also reappraised the development of these tumors by modeling risk factors and natural history of disease (recent controversies). Combining recent advances and controversies may help clarify our biological understanding of lung NENs and give practical information for the clinical decision-making process.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Fabrizio Bianchi
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giulio Rossi
- Operative Unit of Pathologic Anatomy, Azienda USL Romagna, Hospital Santa Maria delle Croci, Ravenna, Italy
| | - Marco Barella
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sergio Harari
- Department of Medical Sciences and Community Health, University of Milan, Milan, Italy; Division of Pneumology, San Giuseppe Hospital, IRCCS MultiMedica, Milan, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy.
| |
Collapse
|
18
|
Metovic J, Abate SO, Borella F, Vissio E, Bertero L, Mariscotti G, Durando M, Senetta R, Ala A, Benedetto C, Sapino A, Cassoni P, Castellano I. The lobular neoplasia enigma: management and prognosis in a long follow-up case series. World J Surg Oncol 2021; 19:80. [PMID: 33736652 PMCID: PMC7976718 DOI: 10.1186/s12957-021-02182-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many oncologists debate if lobular neoplasia (LN) is a risk factor or an obligatory precursor of more aggressive disease. This study has three aims: (i) describe the different treatment options (surgical resection vs observation), (ii) investigate the upgrade rate in surgically treated patients, and (iii) evaluate the long-term occurrences of aggressive disease in both operated and unoperated patients. METHODS A series of 122 patients with LN bioptic diagnosis and follow-up information were selected. Clinical, radiological, and pathological data were collected from medical charts. At definitive histology, either invasive or ductal carcinoma in situ was considered upgraded lesions. RESULTS Atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), and high-grade LN (HG-LN) were diagnosed in 44, 63, and 15 patients, respectively. The median follow-up was 9.5 years. Ninety-nine patients were surgically treated, while 23 underwent clinical-radiological follow-up. An upgrade was observed in 28/99 (28.3%). Age ≥ 54 years (OR 4.01, CI 1.42-11.29, p = 0.009), Breast Imaging-Reporting and Data System (BI-RADS) categories 4-5 (OR 3.76, CI 1.37-10.1, p = 0.010), and preoperatory HG-LN diagnosis (OR 8.76, 1.82-42.27, p = 0.007) were related to upgraded/aggressive disease. During follow-up, 8 patients developed an ipsilateral malignant lesion, four of whom were not initially operated (4/23, 17%). CONCLUSIONS BI-RADS categories 4-5, HG-LN diagnosis, and age ≥ 54 years were features associated with an upgrade at definitive surgery. Moreover, 17% of unoperated cases developed an aggressive disease, emphasizing that LN patients need close surveillance due to the long-term risk of breast cancer.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Simona Osella Abate
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Elena Vissio
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Giovanna Mariscotti
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Manuela Durando
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Rebecca Senetta
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Ada Ala
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Str. Prov. 142, 10060, Candiolo, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| |
Collapse
|
19
|
Uccella S, La Rosa S, Metovic J, Marchiori D, Scoazec JY, Volante M, Mete O, Papotti M. Genomics of High-Grade Neuroendocrine Neoplasms: Well-Differentiated Neuroendocrine Tumor with High-Grade Features (G3 NET) and Neuroendocrine Carcinomas (NEC) of Various Anatomic Sites. Endocr Pathol 2021; 32:192-210. [PMID: 33433884 DOI: 10.1007/s12022-020-09660-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
High-grade neuroendocrine neoplasms (HG-NENs) are clinically aggressive diseases, the classification of which has recently been redefined. They now include both poorly differentiated NENs (neuroendocrine carcinoma, NECs) and high proliferating well-differentiated NENs (called grade 3 neuroendocrine tumors, G3 NETs, in the digestive system). In the last decade, the "molecular revolution" that has affected all fields of medical oncology has also shed light in the understanding of HG NENs heterogeneity and has provided new diagnostic and therapeutic tools, useful in the management of these malignancies. Considering the kaleidoscopic aspects of HG NENs in various anatomical sites, this review systematically addresses the genomic landscape of such neoplasm throughout the more common thoracic and digestive locations, as well as it will consider other rare but not exceptional primary sites, including the skin, the head and neck, and the urogenital system. The revision of the available literature will then be oriented to understand the translational relevance of molecular data, by analyzing conceptual issues, clinicopathological correlations, and unmet needs in this field.
Collapse
Affiliation(s)
- Silvia Uccella
- Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Stefano La Rosa
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jasna Metovic
- Department of Oncology, University of Turin, Torino, Italy
| | - Deborah Marchiori
- Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Jean-Yves Scoazec
- Department of Pathology, Gustave Roussy Cancer Campus, Paris, France
| | - Marco Volante
- Department of Oncology, University of Turin, Torino, Italy
| | - Ozgur Mete
- Department of Pathology, University Health Network, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mauro Papotti
- Department of Oncology, University of Turin, Torino, Italy
| |
Collapse
|
20
|
Righi L, Righi A, Vatrano S, Rapa I, Listì A, Metovic J, Rocca M, Salone M, Giovenali P, Sidoni A, Tabbò F, Dei Tos AP, Volante M, Papotti M. Primary lung adenocarcinoma in three adolescent patients affected by bone sarcomas. Virchows Arch 2021; 478:1125-1134. [PMID: 33420836 DOI: 10.1007/s00428-020-02990-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 01/28/2023]
Abstract
Pediatric primary lung carcinomas are extremely rare. Apart from known associations with congenital adenomatoid malformations, cases of primary lung adenocarcinomas after prolonged treatments of pediatric malignancy have been reported. We describe the morphological and molecular features of three cases of lung adenocarcinoma developed in adolescents aged 8 to 17 years during progression of their bone osteosarcoma or Ewing sarcomas. The morphological features overlapped those of adult lung adenocarcinoma including in situ, minimally invasive, and invasive forms. EGFR gene mutations were found in all three cases by targeted next-generation sequencing. The two patients with Ewing sarcoma had no progression of their lung cancer and no further progression of the metastatic bone tumor after additional chemo- and radio-therapy. Conversely, the osteosarcoma patient refused further treatments after thoracic surgery for metastatic osteosarcoma and locally advanced adenocarcinoma and died 2 years later of widespread distant metastases. Our results indicate that primary lung cancer might originate in pediatric patients during prolonged adjuvant therapies for primary bone neoplasm, and this possibility should be considered in the presence of suspected lung disease progression to correctly monitor the primary tumor evolution and define the appropriate therapeutic strategy at each time point. If appropriately treated, second primary lung cancer may not affect the patients' prognosis. The pathogenetic mechanisms of these rare lung adenocarcinomas are not clear, but the presence of EGFR mutations in all three cases indicates an oncogene addiction of the lung tumor, rather than a direct cancerogenic effect of the sarcoma-related treatment.
Collapse
Affiliation(s)
- Luisella Righi
- Department of Oncology, University of Turin, Turin, Italy
| | - Alberto Righi
- Division of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Simona Vatrano
- Department of Oncology, University of Turin, Turin, Italy
- Department of Pathology, Cannizzaro Hospital, Catania, Italy
| | - Ida Rapa
- Department of Oncology, University of Turin, Turin, Italy
| | - Angela Listì
- Department of Oncology, University of Turin, Turin, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Michele Rocca
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Mariacristina Salone
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Paolo Giovenali
- Divisions of Pathology, Policlinico Hospital and University of Perugia, Perugia, Italy
| | - Angelo Sidoni
- Divisions of Pathology, Policlinico Hospital and University of Perugia, Perugia, Italy
| | - Fabrizio Tabbò
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Marco Volante
- Department of Oncology, University of Turin, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| |
Collapse
|
21
|
Poli R, Scatolini M, Grosso E, Maletta F, Gallo M, Liscia D, Nelva A, Cesario F, Forte G, Metovic J, Volante M, Arvat E, Papotti M. Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations. Endocrine 2021; 71:216-224. [PMID: 32743766 DOI: 10.1007/s12020-020-02438-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/01/2020] [Accepted: 07/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Struma ovarii (SO) is a highly specialized ovarian teratoma, consisting of thyroid tissue. Rarely, carcinomas histologically identical to their thyroid counterparts may occur, and are comprehensively defined as malignant struma ovarii (MSO). Their optimal management is controversial, and the molecular profile of the malignant counterpart in the ovary is incompletely known. In this study, the clinicopathological and molecular features of six MSO from different Italian Institutions were analysed, to explore genetic profiles of potential therapeutic interest. METHODS The histopathological features and immunoprofile (according to the known markers Galectin-3, HBME1, cytokeratin 19 and CD56) were reviewed. In addition, all cases underwent genetic analysis with a next-generation sequencing (NGS) hot spot cancer panel detecting mutations in 50 genes involved in cancerogenesis. RET/PTC rearrangements and TERT promoter alterations were also evaluated. RESULTS Papillary carcinoma in all similar to its thyroid counterpart was found in five of six cases, including classical (two tumors) and follicular variant (three tumors) types. The last case was a poorly differentiated carcinoma. An activating gene mutation, was detected in five of six cases, including two NRAS, two BRAF, and one JAK3 oncogene mutations. No alterations were found in the other panel genes, nor in TERT promoter, or in RET chromosomal regions. CONCLUSIONS MSO is a rare condition. Papillary carcinoma is the predominant malignant type, sharing both histomorphological and molecular features of its thyroid counterpart. Interestingly, the single case of poorly differentiated carcinoma displayed a JAK3 mutation. The presence of such driving mutation could be of potential interest in guiding postoperative treatment.
Collapse
Affiliation(s)
- Roberta Poli
- Division of Internal Medicine, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy.
| | - Maria Scatolini
- Molecular Oncology Laboratory, Fondazione "Edo ed Elvo Tempia Valenta", via dei Ponderanesi 2, Ponderano, 13875, Biella, Italy
| | - Enrico Grosso
- Molecular Oncology Laboratory, Fondazione "Edo ed Elvo Tempia Valenta", via dei Ponderanesi 2, Ponderano, 13875, Biella, Italy
| | - Francesca Maletta
- Pathology Unit, AOU Città della Salute e della Scienza Hospital, via Santena 7, 10126, Turin, Italy
| | - Marco Gallo
- Oncological Endocrinology, AOU Città della Salute e della Scienza di Torino Hospital, via Genova 3, 10126, Turin, Italy
| | - Daniele Liscia
- Pathology Unit, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy
| | - Anna Nelva
- Endocrinology and Diabetology Unit, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy
| | - Flora Cesario
- Division of Endocrinology, Diabetes and Metabolism, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Giuseppe Forte
- Pathology Unit, Santa Croce e Carle Hospital, via M Coppino 26, 12100, Cuneo, Italy
| | - Jasna Metovic
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| | - Marco Volante
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| | - Emanuela Arvat
- Oncological Endocrinology, Department of Medical Sciences, University of Turin, via Genova 3, 10126, Turin, Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| |
Collapse
|
22
|
Rapa I, Votta A, Giorcelli J, Izzo S, Rigutto A, Metovic J, Napoli F, Volante M. Proposal of a Panel of Genes Identified by miRNA Profiling as Candidate Prognostic Biomarkers in Lung Carcinoids. Neuroendocrinology 2021; 111:115-122. [PMID: 32040954 DOI: 10.1159/000506401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/09/2020] [Indexed: 11/19/2022]
Abstract
AIM To validate the prognostic role of a panel of genes previously uncovered by our group to be specific targets of miRNAs differentially expressed in lung carcinoids with aggressive pathological features. METHODS Four genes, namely, cyclic AMP response element binding protein-1 (CREBP1), activin A receptor type 2B (ACVR2B), LIM homeobox 2 (LHX2), and Krüppel-like factor 12 (KLF12), were identified in a previous study by our group using in silico analysis to be regulated by 3 miRNAs (miR-409-3p, miR-409-5p, and miR-431-5p) that were shown to be downregulated in aggressive lung carcinoids. These genes were analyzed using real-time PCR in a cohort of 102 lung carcinoids. Fifty high-grade lung carcinomas served as control group. Their expression was correlated with the expression of miR-409-3p, miR-409-5p, and miR-431-5p and with clinical pathological parameters and disease-free survival. RESULTS The expression of all but CREBP1 gene was significantly different between lung carcinoids and high-grade neuroendocrine carcinomas. ACVR2B and LHX2 were significantly inversely correlated with miR-409-3p and miR-409-5p. High levels of ACVR2B and LHX2 were significantly associated with atypical histotype, high tumor grade, and higher proliferation Ki-67 index (all p < 0.05). Low levels of KLF12 were significantly associated with the presence of necrosis and positive nodal status (all p < 0.05). Finally, low KLF12 expression was associated with shorter disease-free survival in lung carcinoids as a whole and in atypical carcinoids, only (all p < 0.001). CONCLUSIONS ACVR2B, LHX2, and KFL12 are novel potential biomarkers associated with aggressive features in lung carcinoids.
Collapse
Affiliation(s)
- Ida Rapa
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Arianna Votta
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Jessica Giorcelli
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Stefania Izzo
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Angelica Rigutto
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Francesca Napoli
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Marco Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy,
| |
Collapse
|
23
|
Metovic J, Barella M, Harari S, Pattini L, Albini A, Sonzogni A, Veronesi G, Papotti M, Pelosi G. Clinical implications of lung neuroendocrine neoplasm classification. Expert Rev Anticancer Ther 2020; 21:377-387. [PMID: 33306420 DOI: 10.1080/14737140.2021.1862654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Neuroendocrine neoplasms of the lung (Lung NENs) encompass NE tumors (NETs), which are in turn split into typical and atypical carcinoids, and NE carcinomas (NECs), which group together small-cell carcinoma and large-cell NE carcinoma. This classification is the current basis for orienting the daily practice of these patients, with diagnostic, prognostic, and predictive inferences. AREAS COVERED The clinical implications of lung NEN classification are addressed according to three converging perspectives, which were dissected through an extensive literature overview: (1) how to put intratumor heterogeneity into the context of the current classification; (2) how to contextualize immunohistochemistry markers to improve diagnosis, prognosis, and therapy prediction; and (3) how to use immuno-oncology strategies for life-threatening NECs, which still account for 90% or more of lung NENs. EXPERT OPINION We provide practical insights to account for intratumor heterogeneity, practice the choice of immunohistochemistry markers, and emphasize once again the added value of immuno-oncology in the setting of personalized medicine of lung NENs.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Marco Barella
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Sergio Harari
- Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.,Division of Pneumology, San Giuseppe Hospital, IRCCS MultiMedica, Milan, Italy
| | - Linda Pattini
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
| | - Adriana Albini
- Laboratory of Vascular Biology and Angiogenesis, IRCCS MultiMedica, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Giulia Veronesi
- Division of Thoracic Surgery, San Raffaele Scientific Institute - IRCCS, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Giuseppe Pelosi
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
24
|
Poli R, Scatolini M, Grosso E, Maletta F, Gallo M, Liscia D, Nelva A, Cesario F, Forte G, Metovic J, Volante M, Arvat E, Papotti M. Correction to: Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations. Endocrine 2020; 70:661. [PMID: 33025560 DOI: 10.1007/s12020-020-02514-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/25/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Collapse
Affiliation(s)
- Roberta Poli
- Division of Internal Medicine, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy.
| | - Maria Scatolini
- Molecular Oncology Laboratory, Fondazione "Edo ed Elvo Tempia Valenta", via dei Ponderanesi 2, Ponderano, 13875, Biella, Italy
| | - Enrico Grosso
- Molecular Oncology Laboratory, Fondazione "Edo ed Elvo Tempia Valenta", via dei Ponderanesi 2, Ponderano, 13875, Biella, Italy
| | - Francesca Maletta
- Pathology Unit, AOU Città della Salute e della Scienza Hospital, via Santena 7, 10126, Turin, Italy
| | - Marco Gallo
- Oncological Endocrinology, AOU Città della Salute e della Scienza di Torino Hospital, via Genova 3, 10126, Turin, Italy
| | - Daniele Liscia
- Pathology Unit, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy
| | - Anna Nelva
- Endocrinology and Diabetology Unit, Ospedale degli Infermi, via dei Ponderanesi 2 Ponderano, 13875, Biella, Italy
| | - Flora Cesario
- Division of Endocrinology, Diabetes and Metabolism, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Giuseppe Forte
- Pathology Unit, Santa Croce e Carle Hospital, via M Coppino 26, 12100, Cuneo, Italy
| | - Jasna Metovic
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| | - Marco Volante
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| | - Emanuela Arvat
- Oncological Endocrinology, Department of Medical Sciences, University of Turin, via Genova 3, 10126, Turin, Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin, via Santena 7, 10126, Turin, Italy
| |
Collapse
|
25
|
Metovic J, Vignale C, Annaratone L, Osella-Abate S, Maletta F, Rapa I, Cabutti F, Patriarca S, Gallo M, Nikiforov YE, Volante M, Papotti M. The Oncocytic Variant of Poorly Differentiated Thyroid Carcinoma Shows a Specific Immune-Related Gene Expression Profile. J Clin Endocrinol Metab 2020; 105:5906602. [PMID: 32936917 DOI: 10.1210/clinem/dgaa655] [Citation(s) in RCA: 7] [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: 02/21/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Poorly differentiated thyroid cancer (PDTC) is a rare, follicular cell-derived neoplasm with an unfavorable prognosis. The oncocytic variant of PDTC may be associated with even more adverse outcome than classical PDTC cases, but its specific molecular features are largely unknown. Our aim was to explore the immune-related gene expression profile of oncocytic and classical PDTC, in correlation with clinical and pathological characteristics (including programmed death ligand 1 [PD-L1] expression) and outcome, and in comparison with a control group of well-differentiated follicular carcinomas (WDFCs), including conventional follicular carcinomas (FTCs) and Hürthle cell carcinomas (HCCs). METHODS A retrospective series of 48 PDTCs and 24 WDFCs was analyzed by means of NanoString technology employing the nCounter PanCancer Immune Profiling panel. Gene expression data were validated using quantitative real-time polymerase chain reaction. RESULTS Oncocytic PDTCs showed a specific immune-related gene expression profile, with higher expression of LAIR2, CD274, DEFB1, IRAK1, CAMP, LCN2, LY96, and APOE, and lower expression of NOD1, as compared to conventional PDTCs. This molecular signature was associated with increased intratumoral lymphocytic infiltration, PD-L1 expression, and adverse outcome. Three of these genes, CD274, DEFB1, and IRAK1, as well as PD-L1 expression, were also the hallmarks of HCCs as compared to FTCs. By contrast, the panel of genes differentially regulated in PDTCs as compared to WDFCs was unrelated to the oncocytic phenotype. CONCLUSIONS Our results revealed a distinctive immune-related gene expression profile of oncocytic PDTC and confirmed a more aggressive outcome in this cancer subtype. These findings may provide guidance when exploring novel immunotherapeutic options for oncocytic PDTC patients.
Collapse
MESH Headings
- Adenocarcinoma, Follicular/genetics
- Adenocarcinoma, Follicular/immunology
- Adenocarcinoma, Follicular/mortality
- Adenocarcinoma, Follicular/pathology
- Adenoma, Oxyphilic/genetics
- Adenoma, Oxyphilic/immunology
- Adenoma, Oxyphilic/mortality
- Adenoma, Oxyphilic/pathology
- Adult
- Aged
- Aged, 80 and over
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunity/genetics
- Male
- Microarray Analysis
- Middle Aged
- Oxyphil Cells/metabolism
- Oxyphil Cells/pathology
- Retrospective Studies
- Thyroid Neoplasms/genetics
- Thyroid Neoplasms/immunology
- Thyroid Neoplasms/mortality
- Thyroid Neoplasms/pathology
- Transcriptome
- Tumor Escape/genetics
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit of Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Chiara Vignale
- Department of Oncology, Pathology Unit of Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Francesca Maletta
- Department of Oncology, Pathology Unit of Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ida Rapa
- Department of Oncology, Pathology Unit of San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Cabutti
- Department of Oncology, Pathology Unit of Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Silvia Patriarca
- Piedmont Cancer Registry-CRPT, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gallo
- Department of Medical Sciences, Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Yuri E Nikiforov
- Department of Pathology, Division of Molecular Genomic Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marco Volante
- Department of Oncology, Pathology Unit of San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, Pathology Unit of Città della Salute e della Scienza, University of Turin, Turin, Italy
| |
Collapse
|
26
|
Salvi M, Molinaro L, Metovic J, Patrono D, Romagnoli R, Papotti M, Molinari F. Fully automated quantitative assessment of hepatic steatosis in liver transplants. Comput Biol Med 2020; 123:103836. [PMID: 32658781 DOI: 10.1016/j.compbiomed.2020.103836] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The presence of macro- and microvesicular steatosis is one of the major risk factors for liver transplantation. An accurate assessment of the steatosis percentage is crucial for determining liver graft transplantability, which is currently based on the pathologists' visual evaluations on liver histology specimens. METHOD The aim of this study was to develop and validate a fully automated algorithm, called HEPASS (HEPatic Adaptive Steatosis Segmentation), for both micro- and macro-steatosis detection in digital liver histological images. The proposed method employs a hybrid deep learning framework, combining the accuracy of an adaptive threshold with the semantic segmentation of a deep convolutional neural network. Starting from all white regions, the HEPASS algorithm was able to detect lipid droplets and classify them into micro- or macrosteatosis. RESULTS The proposed method was developed and tested on 385 hematoxylin and eosin (H&E) stained images coming from 77 liver donors. Automated results were compared with manual annotations and nine state-of-the-art techniques designed for steatosis segmentation. In the TEST set, the algorithm was characterized by 97.27% accuracy in steatosis quantification (average error 1.07%, maximum average error 5.62%) and outperformed all the compared methods. CONCLUSIONS To the best of our knowledge, the proposed algorithm is the first fully automated algorithm for the assessment of both micro- and macrosteatosis in H&E stained liver tissue images. Being very fast (average computational time 0.72 s), this algorithm paves the way for automated, quantitative and real-time liver graft assessments.
Collapse
Affiliation(s)
- Massimo Salvi
- Politobiomed Lab, Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.
| | - Luca Molinaro
- Division of Pathology, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Jasna Metovic
- Division of Pathology, Department of Oncology, University of Turin, Turin, Italy
| | - Damiano Patrono
- General Surgery 2U, Liver Transplant Center, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplant Center, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Mauro Papotti
- Division of Pathology, Department of Oncology, University of Turin, Turin, Italy
| | - Filippo Molinari
- Politobiomed Lab, Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| |
Collapse
|
27
|
Natoli G, Metovic J, Taraglio S, Miraglia S, Misischi F, Delsedime L. A rare case of metastatic testicular adult granulosa cell tumor. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15506 Background: Adult granulosa cell tumour (AGCT) is a rare disease that develops in the testis, composed of sex cord cells, accounting for less than 0.5% of all sex cord-stromal neoplasias (WHO 2016). To our knowledge, 48 cases of AGCT of the testis have been published up to date reporting follow-up (Table 1). Infrequently, these tumors can metastasize, usually to retroperitoneal lymph nodes, but also liver, lungs and bones. Methods: In 2015 a 60-year-old Caucasian male with unilateral, painless slowly growing mass underwent to orchioectomy. A diagnosis of malignant ADTC was rendered. After 19 months metestatic spread to lung was hystologically confirmed. After cytotoxic treatment a compassionate use of pazopanib was sterted and the was in complete response today. Results: The patient is still on pazopanib treatment with complete response that is well tolerated and has improved quality of life 55 months after the initial AGCT diagnosis. Conclusions: Our case report could offer an important source of information for clinicians who are currently facing this rare entity. In summary in case of tumor larger than 4-5 cm adjuvant treatment may be considered and, more importantly, systemic treatments, including pazopanib, could be suggested as a treatment apporach to a metastatic AGCT patient. In the future, other reports containg long-term follow up will be of vital importance to understand the best management of patient with AGCT.
Collapse
Affiliation(s)
| | - Jasna Metovic
- Department of Oncology, University of Torino, Torino, Italy
| | | | | | | | - Luisa Delsedime
- Division of Pathology, Città della Salute Hospital, Torino, Italy
| |
Collapse
|
28
|
Metovic J, Annaratone L, Linari A, Osella-Abate S, Musuraca C, Veneziano F, Vignale C, Bertero L, Cassoni P, Ratto N, Comandone A, Grignani G, Piana R, Papotti M. Prognostic role of PD-L1 and immune-related gene expression profiles in giant cell tumors of bone. Cancer Immunol Immunother 2020; 69:1905-1916. [PMID: 32377818 DOI: 10.1007/s00262-020-02594-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
Giant cell tumor of bone (GCTB) is a locally aggressive and rarely metastatic tumor, with a relatively unpredictable clinical course. A retrospective series of 46 GCTB and a control group of 24 aneurysmal bone cysts (ABC) were selected with the aim of investigating the PD-L1 expression levels and immune-related gene expression profile, in correlation with clinicopathological features. PD-L1 and Ki67 were immunohistochemically tested in each case. Furthermore, comprehensive molecular analyses were carried out using NanoString technology and nCounter PanCancer Immune Profiling Panel, and the gene expression results were correlated with clinicopathological characteristics. PD-L1 expression was observed in 13/46 (28.3%) GCTB (and in 1/24, 4.2%, control ABC, only) and associated with a shorter disease free interval according to univariate analysis. Moreover, in PD-L1-positive lesions, three genes (CD27, CD6 and IL10) were significantly upregulated (p < 0.01), while two were downregulated (LCK and TLR8, showing borderline significance, p = 0.06). Interestingly, these genes can be related to maturation and immune tolerance of bone tissue microenvironment, suggesting a more immature/anergic phenotype of giant cell tumors. Our findings suggest that PD-L1 immunoreactivity may help to select GCTB patients with a higher risk of recurrence who could potentially benefit from immune checkpoint blockade.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Turin, Italy
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | | | | | | | | | - Chiara Vignale
- Department of Oncology, University of Turin, Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Nicola Ratto
- Division of Orthopedics, Città della Salute e della Scienza di Torino Hospital, Turin, Italy
| | - Alessandro Comandone
- Division of Medical Oncology, Humanitas Gradenigo Hospital, Turin, Italy
- ASL Città di Torino, Turin, Italy
| | | | - Raimondo Piana
- Division of Orthopedics, Città della Salute e della Scienza di Torino Hospital, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy.
- Anatomia Patologica, Città della Salute e della Scienza Hospital, University of Turin, Via Santena 7, 10126, Turin, Italy.
| |
Collapse
|
29
|
Maletta F, Falco EC, Gambella A, Metovic J, Papotti M. Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: From Echography to Genetic Profile. TOHOKU J EXP MED 2020; 252:209-218. [PMID: 33087681 DOI: 10.1620/tjem.252.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In thyroid pathology, the great variety of types and the wide range of aggressiveness of thyroid cancers complicate both diagnosis and management. In 2016, a subset of noninvasive encapsulated follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid tumor with papillary-like nuclear features (NIFTP) to reduce overtreatment of this low-risk tumor that follows a benign course after surgery. Starting from a paradigmatic clinical case, in this short review, we will summarize the ultrasonography, cytological, histological and molecular features of this new entity. In the preoperative settings, the recognition of some peculiar elements may only suggest the possibility of a NIFTP, thus favoring a less aggressive surgical approach. However, the diagnosis of NIFTP can only be made after complete resection of the lesion by detecting well-defined inclusion and exclusion histopathological criteria. Since NIFTP is not 'malignant,' surgery may be considered curative with no further treatment or surveillance needed. NIFTP-related issues, including nodule size, multifocality, oncocytic changes, heterogeneous incidence across different geographical areas and its occurrence in the pediatric age, will be discussed.
Collapse
Affiliation(s)
- Francesca Maletta
- Pathology Unit, Department of Laboratory Medicine, AOU Città della Salute e della Scienza di Torino
| | | | | | - Jasna Metovic
- Pathology Unit, Department of Oncology, University of Turin
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin
| |
Collapse
|
30
|
Marchiò C, Da Cruz Paula A, Gularte-Merida R, Basili T, Brandes A, da Silva EM, Silveira C, Ferrando L, Metovic J, Maletta F, Annaratone L, Pareja F, Rubin BP, Hoschar AP, De Rosa G, La Rosa S, Bongiovanni M, Purgina B, Piana S, Volante M, Weigelt B, Reis-Filho JS, Papotti M. PAX8-GLIS3 gene fusion is a pathognomonic genetic alteration of hyalinizing trabecular tumors of the thyroid. Mod Pathol 2019; 32:1734-1743. [PMID: 31273314 PMCID: PMC7442035 DOI: 10.1038/s41379-019-0313-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 04/13/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 12/28/2022]
Abstract
The hyalinizing trabecular adenoma/tumor is a rare and poorly characterized follicular-derived thyroid neoplasm recently shown to harbor recurrent PAX8-GLIS1 or PAX8-GLIS3 gene fusions. Here we sought to define the repertoire of genetic alterations of hyalinizing trabecular tumors, and whether PAX8-GLIS3 fusions are pathognomonic for hyalinizing trabecular tumors. A discovery series of eight hyalinizing trabecular tumors was subjected to RNA-sequencing (n = 8), whole-exome sequencing (n = 3) or targeted massively parallel sequencing (n = 5). No recurrent somatic mutations or copy number alterations were identified in hyalinizing trabecular tumor, whereas RNA-sequencing revealed the presence of a recurrent genetic rearrangement involving PAX8 (2q14.1) and GLIS3 (9p24.2) genes in all cases. In this in-frame fusion gene, which comprised exons 1-2 of PAX8 and exons 3-11 of GLIS3, GLIS3 is likely placed under the regulation of PAX8. Reverse transcription RT-PCR and/or fluorescence in situ hybridization analyses of a validation series of 26 hyalinizing trabecular tumors revealed that the PAX8-GLIS3 gene fusion was present in all hyalinizing trabecular tumors (100%). No GLIS1 rearrangements were identified. Conversely, no PAX8-GLIS3 gene fusions were detected in a cohort of 237 control thyroid neoplasms, including 15 trabecular thyroid lesions highly resembling hyalinizing trabecular tumor from a morphological standpoint, as well as trabecular/solid follicular adenomas, solid/trabecular variants of papillary carcinoma, and Hurthle cell adenomas or carcinomas. Our data provide evidence to suggest that the PAX8-GLIS3 fusion is pathognomonic for hyalinizing trabecular tumors, and that the presence of the PAX8-GLIS3 fusion in thyroid neoplasms may be used as an ancillary marker for the diagnosis of hyalinizing trabecular tumor, thereby avoiding overtreatment in case of misdiagnoses with apparently similar malignant tumors.
Collapse
Affiliation(s)
- Caterina Marchiò
- Pathology Division, Candiolo Cancer Institute, FPO – IRCCS, Candiolo, Italy,Department of Medical Sciences, University of Turin, Torino, Italy
| | - Arnaud Da Cruz Paula
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rodrigo Gularte-Merida
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thais Basili
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alissa Brandes
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edaise M. da Silva
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Catarina Silveira
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Ferrando
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy
| | - Francesca Maletta
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy
| | - Laura Annaratone
- Pathology Division, Candiolo Cancer Institute, FPO – IRCCS, Candiolo, Italy,Department of Medical Sciences, University of Turin, Torino, Italy
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brian P. Rubin
- Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Stefano La Rosa
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Massimo Bongiovanni
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Bibianna Purgina
- Department of Pathology and Laboratory Medicine, Ottawa Hospital, Ontario, Canada
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Italy
| | - Marco Volante
- San Luigi Gonzaga Hospital and Department of Oncology, University of Turin, Orbassano, Italy
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mauro Papotti
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy.
| |
Collapse
|
31
|
Tabbò F, Annaratone L, Nocifora A, Vignale C, Carnio S, Metovic J, Veneziano F, Scodes S, Russo A, Franchina T, Sini C, Coco S, Garlatti P, Vieri S, Adamo V, Boccardo S, Grossi F, Cappuzzo F, Papotti M, Righi L, Passiglia F, Novello S. P1.04-45 Immune-Oncology Gene Expression Profiles Allow Lung Cancer Patients’ Stratification and Identification of Responders to Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.948] [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]
|
32
|
Altinay S, Metovic J, Massa F, Gatti G, Cassoni P, Scagliotti GV, Volante M, Papotti M. Spread through air spaces (STAS) is a predictor of poor outcome in atypical carcinoids of the lung. Virchows Arch 2019; 475:325-334. [PMID: 31201506 DOI: 10.1007/s00428-019-02596-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/12/2019] [Revised: 04/19/2019] [Accepted: 06/03/2019] [Indexed: 11/25/2022]
Abstract
Spread through air spaces (STAS) have been recently recognized as a prognostic factor for adenocarcinoma and squamous cell carcinoma of the lung. Pulmonary neuroendocrine neoplasms (NENs) include tumors with different morphology and a heterogeneous clinical behavior. Among atypical carcinoids (ACs), new prognostic factors able to refine prognosis are needed. In the present study, a retrospective series of 91 surgically resected ACs was investigated, in parallel with 191 control cases of typical carcinoids (TCs) and of high-grade small- and large-cell neuroendocrine carcinomas, to assess the presence and potential prognostic role of STAS. STAS was defined by the presence of neoplastic nests or single cells in air spaces beyond the tumor edge. Clinicopathological parameters and survival were correlated by univariate and multivariate analyses. STAS was identified in 48% of ACs (44/91) compared to 20.5% of TCs and 71-88% of high-grade large- and small-cell carcinomas in the control group. In the carcinoid group, presence of STAS was significantly correlated with unfavorable parameters, such as high tumor stage, positive nodal status, high Ki-67 index, presence of angioinvasion, and with adverse disease outcome, shorter overall survival, and time to progression. In conclusion, the presence of STAS is an additional relevant adverse prognostic factor in pulmonary AC that currently has the most unpredictable outcome and the most controversial treatment strategy.
Collapse
Affiliation(s)
- Serdar Altinay
- Division of Pathology, University of Health Sciences, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Jasna Metovic
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy
| | - Federica Massa
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy
| | - Gaia Gatti
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy
| | - Paola Cassoni
- Pathology Division of the Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giorgio Vittorio Scagliotti
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy
| | - Marco Volante
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy.
| | - Mauro Papotti
- Pathology Division of the Department of Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, 10043, Torino, Italy
| |
Collapse
|
33
|
Metovic J, Righi L, Delsedime L, Volante M, Papotti M. Role of Immunocytochemistry in the Cytological Diagnosis of Pulmonary Tumors. Acta Cytol 2019; 64:16-29. [PMID: 30878997 DOI: 10.1159/000496030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/04/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022]
Abstract
Pulmonary cytology is a challenging diagnostic tool, and it is usually evaluated considering medical history and radiological findings in order to reach an accurate diagnosis. Since the majority of lung cancer patients have an advanced stage at diagnosis, a cytological specimen is frequently the only material available for diagnosis and further prognostic/predictive marker determination. Several types of specimens can be obtained from the respiratory system (including sputum, bronchoalveolar lavage, bronchial brushing, fine needle aspiration, and pleural fluid) with different technical preclinical management protocols and different diagnostic yields. Immunocytochemistry (ICC) has a pivotal role in the determination of diagnostic, prognostic, and predictive markers. Therefore, limited cytology samples are to be used with a cell-sparing approach, to allow both diagnostic ICC evaluation as well as predictive marker assessment by ICC or specific molecular assays. In this review, we describe the most common ICC markers used for the diagnosis and prognostic/predictive characterization of thoracic tumors in different cytological specimens.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Luisella Righi
- Department of Oncology, San Luigi Hospital, University of Turin, Turin, Italy
| | - Luisa Delsedime
- Department of Oncology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Marco Volante
- Department of Oncology, San Luigi Hospital, University of Turin, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, Città della Salute e della Scienza, University of Turin, Turin, Italy,
| |
Collapse
|
34
|
Metovic J, Gallino C, Zanon E, Bussone R, Russo R, Vissio E, Annaratone L, Conti L, Papotti M, Cassoni P, Castellano I. Eccrine spiradenoma of the nipple: Case report, differential diagnosis and literature review. Histol Histopathol 2019; 34:909-915. [PMID: 30806477 DOI: 10.14670/hh-18-094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Eccrine spiradenoma is a rare lesion originating from eccrine sweat glands, with only few cases reported in breast tissue: we here describe for the first time, an eccrine spiradenoma arising in the nipple. An 84 year-old woman with a lesion enlarging her right nipple, showing ulcerations and eczema-like changes of the covering skin, was admitted to our hospital. Surgical excision of the central quadrant with nipple-areola complex was performed, followed by histopathological evaluation which revealed an adenoma with predominantly basaloid epithelial cells. The lesion was composed of tightly packed small and large groups of cells, arranged in diffuse alveolar/pseudorosette formations. The small cells expressed p63 and calponin, while a positive expression of CK7 and CD117 was detected in large cells. After careful and detailed examination, excluding various similar entities, a diagnosis of eccrine spiradenoma has been rendered. Although extremely rare, eccrine spiradenoma should be taken into account in the differential diagnosis of subcutaneous primary breast tumors.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Chiara Gallino
- Breast Unit, Department of Radiology, Cottolengo Hospital, Turin, Italy
| | - Eugenio Zanon
- Breast Unit, Department of Radiology, Cottolengo Hospital, Turin, Italy
| | - Riccardo Bussone
- Breast Unit, Department of Surgery, Cottolengo Hospital, Turin, Italy
| | - Roberto Russo
- Department of Public Health Sciences and Pediatrics, University of Turin, Cottolengo Hospital, Turin, Italy
| | - Elena Vissio
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Conti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | |
Collapse
|
35
|
Roxas RBS, Bernardo MCF, Jacoba AP, Lim-Dy J, Alvarado AC, Metovic J, Annaratone L, Papotti M. Primary Thymic Signet Ring Cell Adenocarcinoma: A Currently Unrecognized Variant. Int J Surg Pathol 2018; 27:315-321. [DOI: 10.1177/1066896918803673] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe the first case of primary thymic adenocarcinoma with signet ring cell features. The patient was a 39-year-old Filipino male who presented with a huge anterior mediastinal mass extending to the left supraclavicular fossa, which underwent an incisional biopsy. Extensive clinicoradiological work-up showed no evidence of any primary tumor in other organs, and radiological imaging confirmed a primary tumor location in the thymic area. He later developed bilateral pleural and pericardial effusions and eventually died of his tumor. The biopsy contained a neoplastic growth of solid nests made of cells with prominent signet ring features in sclerotic stroma. Immunohistochemically, the tumor cells were reactive for cytokeratin 7, carcinoembryonic antigen, and CD5 and negative for cytokeratin 20, TTF1, napsin A, α-fetoprotein, PAX-8, CD-117, CA19-9, CA-125, CDX2, p63, and CD99. No genetic alterations of ALK, RET, and ROS1 were found, nor was any ALK or ROS1 immunostaining detected, as known to occur in a fraction of primary pulmonary adenocarcinomas. Morphologically, this thymic tumor resembled signet ring cell adenocarcinomas of other locations, including, stomach, pancreas, and lung, but CD5 immunoreactivity strongly supported the clinical and radiological evidence of a primary thymic origin. In the English literature, only 58 cases of primary thymic adenocarcinoma are on record and this is the first report of a signet ring cell variant, which further broadens the morphological spectrum of thymic adenocarcinoma subtypes.
Collapse
Affiliation(s)
| | | | | | - Janet Lim-Dy
- Quirino Memorial Medical Center, Manila, Philippines
| | | | | | | | | |
Collapse
|
36
|
Rangel N, Fortunati N, Osella-Abate S, Annaratone L, Isella C, Catalano MG, Rinella L, Metovic J, Boldorini R, Balmativola D, Ferrando P, Marano F, Cassoni P, Sapino A, Castellano I. FOXA1 and AR in invasive breast cancer: new findings on their co-expression and impact on prognosis in ER-positive patients. BMC Cancer 2018; 18:703. [PMID: 29970021 PMCID: PMC6029370 DOI: 10.1186/s12885-018-4624-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background The role of forkhead-box A1 (FOXA1) and Androgen receptor (AR) in breast cancer (BC) has been extensively studied. However, the prognostic role of their co-expression in Estrogen receptor positive (ER+) BC has not been investigated so far. The aim of the present study was thus to assess the co-expression (protein and mRNA) of FOXA1 and AR in BC patients, in order to evaluate their prognostic impact according to ER status. Methods Immunohistochemical expression of AR and FOXA1 was evaluated on 479 consecutive BC, with complete clinical-pathological and follow up data. Fresh-frozen tissues from 65 cases were available. The expression of AR and FOXA1 with ER was validated using mRNA analyses. Survival and Cox proportional hazard analyses were used to evaluate the relationship between FOXA1, AR and prognosis. Results Expression of ER, AR and FOXA1 was observed in 78, 60 and 85% of cases respectively. Most AR+ cases (97%) were also FOXA1+. The level of FOXA1 mRNA positively correlated with level of both AR mRNA (r = 0.8975; P < 0.001) and ER mRNA (r = 0.7326; P < 0.001). In ER+ BC, FOXA1 was associated with a good prognosis independently of AR expression in the three subgroups analyzed (FOXA1+/AR+; FOXA1+/AR-; FOXA1−/AR-). Multivariate analyses confirmed that FOXA1 may provide more information than AR in Disease-Free Interval (DFI) of ER+ BC patients. Conclusion Our results suggest that in BC the expression of FOXA1 is directly related to the expression of AR. Despite that, FOXA1 is found as superior predicting marker of recurrences compared to AR in ER+ BC patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-4624-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nelson Rangel
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.,Natural and Mathematical Sciences Faculty, University of the Rosario, Bogotá, Colombia
| | - Nicoletta Fortunati
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | | | | | - Letizia Rinella
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Jasna Metovic
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Renzo Boldorini
- Division of Pathology, Department of Health Sciences, University of Eastern Piedmont and Maggiore Hospital, Novara, Italy
| | | | - Pietro Ferrando
- Division of Breast Surgery, Department of General and Specialized Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesca Marano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.,Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| |
Collapse
|
37
|
Metovic J, Bertero L, Musuraca C, Veneziano F, Annaratone L, Mariani S, Cassoni P, Bussolati G, Papotti M. Safe transportation of formalin-fixed liquid-free pathology specimens. Virchows Arch 2018; 473:105-113. [DOI: 10.1007/s00428-018-2383-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 12/12/2022]
|
38
|
Mariani S, Bertero L, Coppola V, Saracco G, Arezzo A, Francia Di Celle P, Metovic J, Marchiò C, Cassoni P. Awareness of mutational artefacts in suboptimal DNA samples: possible risk for therapeutic choices. Expert Rev Mol Diagn 2018; 18:467-475. [PMID: 29676606 DOI: 10.1080/14737159.2018.1468254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Technical biases due to PCR artefacts could represent an insidious obstacle for mutational analysis and precision medicine. METHODS The authors report a retrospective analysis by fast COLD-PCR and sequencing of 31 suboptimal tumor DNA samples obtained from FFPE tissues and liquid biopsies. RESULTS In FFPE tumor tissues and plasma liquid biopsies of patients with lung and colorectal adenocarcinoma, we observed a significant rate of artefactual KRAS mutations, unveiled by repeated analysis following UDG pretreatment as well as by simple repetition without UDG pretreatment step, thus suggesting a DNA damage different from cytosine deamination. UDG pretreatment was not only unnecessary to contrast artefacts occurrence, but also hampered the efficiency of mutational screening, reducing the analytical sensitivity. Taken individually or considered together, the reduced DNA input per reaction and UDG pretreatment limited the detection of 'real' mutated alleles, decreasing PCR sensitivity enough to hamper distinction between artefactual and true subclonal mutations of KRAS. CONCLUSIONS Careful validation of analytical sensitivities should always be carried out through standard controls, and strategies other than UDG pretreatment need to be identified to avoid both amplification of artefactual mutations and failure to identify real subclonal mutations.
Collapse
Affiliation(s)
- Sara Mariani
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Luca Bertero
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Vittoria Coppola
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Giorgio Saracco
- b Department of Medical Sciences , University of Turin and Gastroenterology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Alberto Arezzo
- c Department of Surgical Sciences , University of Turin and Surgical Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | | | - Jasna Metovic
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Caterina Marchiò
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| | - Paola Cassoni
- a Department of Medical Sciences , University of Turin and Pathology Unit, Città della Salute e della Scienza Hospital , Torino , Italy
| |
Collapse
|
39
|
Rangel N, Rondon-Lagos M, Annaratone L, Osella-Abate S, Metovic J, Mano MP, Bertero L, Cassoni P, Sapino A, Castellano I. The role of the AR/ER ratio in ER-positive breast cancer patients. Endocr Relat Cancer 2018; 25:163-172. [PMID: 29386247 DOI: 10.1530/erc-17-0417] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 11/23/2017] [Accepted: 12/04/2017] [Indexed: 01/06/2023]
Abstract
The significance of androgen receptor (AR) in breast cancer (BC) management is not fully defined, and it is still ambiguous how the level of AR expression influences oestrogen receptor-positive (ER+) tumours. The aim of the present study was to analyse the prognostic impact of AR/ER ratio, evaluated by immunohistochemistry (IHC), correlating this value with clinical, pathological and molecular characteristics. We retrospectively selected a cohort of 402 ER+BC patients. On each tumour, IHC analyses for AR, ER, PgR, HER2 and Ki67 were performed and AR+ cases were used to calculate the AR/ER value. A cut-off of ≥2 was selected using receiver-operating characteristic (ROC) curve analyses. RNA from 19 cases with AR/ER≥2 was extracted and used for Prosigna-PAM50 assays. Tumours with AR/ER≥2 (6%) showed more frequent metastatic lymph nodes, larger size, higher histological grade and lower PgR levels than cases with AR/ER<2. Multivariate analysis confirmed that patients with AR/ER≥2 had worse disease-free interval (DFI) and disease-specific survival (DSS) (hazard ratios (HR) = 4.96 for DFI and HR = 8.69 for DSS, both P ≤ 0.004). According to the Prosigna-PAM50 assay, 63% (12/19) of these cases resulted in intermediate or high risk of recurrence categories. Additionally, although all samples were positive for ER assessed by IHC, the molecular test assigned 47.4% (9/19) of BCs to intrinsic non-luminal subtypes. In conclusion, the AR/ER ratio ≥2 identifies a subgroup of patients with aggressive biological features and may represent an additional independent marker of worse BC prognosis. Moreover, the Prosigna-PAM50 results indicate that a significant number of cases with AR/ER≥2 could be non-luminal tumours.
Collapse
Affiliation(s)
- Nelson Rangel
- Department of Medical SciencesUniversity of Turin, Turin, Italy
- Natural and Mathematical Sciences FacultyUniversidad del Rosario, Bogotá, Colombia
| | - Milena Rondon-Lagos
- School of Biological SciencesUniversidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
| | | | | | - Jasna Metovic
- Department of Medical SciencesUniversity of Turin, Turin, Italy
| | - Maria Piera Mano
- Department of Surgical SciencesUniversity of Turin, Turin, Italy
| | - Luca Bertero
- Department of Medical SciencesUniversity of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical SciencesUniversity of Turin, Turin, Italy
| | - Anna Sapino
- Department of Medical SciencesUniversity of Turin, Turin, Italy
- Pathology UnitFondazione del Piemonte per l'Oncologia (FPO) Candiolo Cancer Institute (IRCCS), Candiolo, Italy
| | | |
Collapse
|
40
|
Bertero L, Massa F, Metovic J, Zanetti R, Castellano I, Ricardi U, Papotti M, Cassoni P. Eighth Edition of the UICC Classification of Malignant Tumours: an overview of the changes in the pathological TNM classification criteria-What has changed and why? Virchows Arch 2017; 472:519-531. [PMID: 29209757 DOI: 10.1007/s00428-017-2276-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/02/2017] [Accepted: 11/21/2017] [Indexed: 02/07/2023]
Abstract
The TNM classification of malignant tumours is a mainstay tool in clinical practice and research for prognostic assessment of patients, treatment allocation and trial enrolment, as well as for epidemiological studies and data collection by cancer registries worldwide. Pathological TNM (pTNM) represents the pathological classification of a tumor, assigned after surgical resection or adequate sampling by biopsy, and periodical updates to the relative classification criteria are necessary to preserve its clinical relevance by integrating newly reported data. A structured approach has been put in place to fulfil this need and, based upon this process, the Eighth Edition of Union for International Cancer Control (UICC) TNM Classification of Malignant Tumours has been published, introducing many significant changes, including novel classification criteria for specific tumour types. In this review, we aim to describe the major changes introduced in the pTNM classification criteria and to summarize the evidence supporting these changes.
Collapse
Affiliation(s)
- Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy.
| | - Federica Massa
- Pathology Unit, Department of Oncology, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy
| | - Jasna Metovic
- Pathology Unit, Department of Oncology, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, CPO - Centre for Cancer Prevention, Via San Massimo 24, 10123, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy
| | - Umberto Ricardi
- Radiation Oncology Unit, Department of Oncology, University of Turin and Città della Salute e della Scienza Hospital, Via Genova 3, 10126, Turin, Italy.,Italian National Committee, Union for International Cancer Control (UICC) - TNM, Turin, Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza Hospital, Via Santena 7, 10126, Turin, Italy.,Italian National Committee, Union for International Cancer Control (UICC) - TNM, Turin, Italy
| |
Collapse
|
41
|
Castellano I, Metovic J, Balmativola D, Francia Di Celle P, Riera L, Bertetto O, Mistrangelo M, Cassoni P, Marchiò C, Sapino A. The ENDOPREDICT® molecular test for breast cancer prognosis: clinical-pathological correlations and therapeutic implications on a selected cohort of patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|