1
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Rinaldi L, Chiuso F, Senatore E, Borzacchiello D, Lignitto L, Iannucci R, Donne RD, Fuggi M, Reale C, Russo F, Russo NA, Giurato G, Rizzo F, Sellitto A, Santangelo M, De Biase D, Paciello O, D'Ambrosio C, Amente S, Garbi C, Dalla E, Scaloni A, Weisz A, Ambrosino C, Insabato L, Feliciello A. Downregulation of praja2 restrains endocytosis and boosts tyrosine kinase receptors in kidney cancer. Commun Biol 2024; 7:208. [PMID: 38379085 PMCID: PMC10879500 DOI: 10.1038/s42003-024-05823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is the most common kidney cancer in the adult population. Late diagnosis, resistance to therapeutics and recurrence of metastatic lesions account for the highest mortality rate among kidney cancer patients. Identifying novel biomarkers for early cancer detection and elucidating the mechanisms underlying ccRCC will provide clues to treat this aggressive malignant tumor. Here, we report that the ubiquitin ligase praja2 forms a complex with-and ubiquitylates the AP2 adapter complex, contributing to receptor endocytosis and clearance. In human RCC tissues and cells, downregulation of praja2 by oncogenic miRNAs (oncomiRs) and the proteasome markedly impairs endocytosis and clearance of the epidermal growth factor receptor (EGFR), and amplifies downstream mitogenic and proliferative signaling. Restoring praja2 levels in RCC cells downregulates EGFR, rewires cancer cell metabolism and ultimately inhibits tumor cell growth and metastasis. Accordingly, genetic ablation of praja2 in mice upregulates RTKs (i.e. EGFR and VEGFR) and induces epithelial and vascular alterations in the kidney tissue.In summary, our findings identify a regulatory loop between oncomiRs and the ubiquitin proteasome system that finely controls RTKs endocytosis and clearance, positively impacting mitogenic signaling and kidney cancer growth.
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Affiliation(s)
- Laura Rinaldi
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Francesco Chiuso
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Emanuela Senatore
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Domenica Borzacchiello
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Luca Lignitto
- Cancer Research Center of Marseille (CRCM), CNRS, Aix Marseille Univ, INSERM, Institut Paoli-Calmettes, Marseille, France
| | - Rosa Iannucci
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Rossella Delle Donne
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Mariano Fuggi
- Department of Advanced Biomedical Sciences, University Hospital Federico II, Naples, Italy
| | - Carla Reale
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino, Italy
| | - Filomena Russo
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino, Italy
| | | | - Giorgio Giurato
- Genome Research Center for Health, Baronissi (SA), Italy
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry SMS, Baronissi (SA), Italy
| | - Francesca Rizzo
- Genome Research Center for Health, Baronissi (SA), Italy
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry SMS, Baronissi (SA), Italy
| | - Assunta Sellitto
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry SMS, Baronissi (SA), Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University Hospital Federico II, Naples, Italy
| | - Davide De Biase
- Department of Pharmacy, University of Salerno, Salerno, Italy
| | - Orlando Paciello
- Department of Veterinary Medicine and Animal Production, Pathology Unit, University Federico II, Naples, Italy
| | - Chiara D'Ambrosio
- Proteomics, Metabolomics and Mass Spectrometry Laboratory, ISPAAM, National Research Council, Portici (Naples), Italy
| | - Stefano Amente
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Corrado Garbi
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
| | - Emiliano Dalla
- Department of Medicine, University of Udine, Udine, Italy
| | - Andrea Scaloni
- Proteomics, Metabolomics and Mass Spectrometry Laboratory, ISPAAM, National Research Council, Portici (Naples), Italy
| | - Alessandro Weisz
- Genome Research Center for Health, Baronissi (SA), Italy
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry SMS, Baronissi (SA), Italy
| | - Concetta Ambrosino
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino, Italy
- Department of Science and Technology University of Sannio, Sannio, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University Hospital Federico II, Naples, Italy
| | - Antonio Feliciello
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy.
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2
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Conte M, Poggio P, Monti M, Petraglia L, Cabaro S, Bruzzese D, Comentale G, Caruso A, Grimaldi M, Zampella E, Gencarelli A, Cervasio MR, Cozzolino F, Monaco V, Myasoedova V, Valerio V, Ferro A, Insabato L, Bellino M, Galasso G, Graziani F, Pucci P, Formisano P, Pilato E, Cuocolo A, Perrone Filardi P, Leosco D, Parisi V. Isolated Valve Amyloid Deposition in Aortic Stenosis: Potential Clinical and Pathophysiological Relevance. Int J Mol Sci 2024; 25:1171. [PMID: 38256243 PMCID: PMC10815971 DOI: 10.3390/ijms25021171] [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: 11/27/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Amyloid deposition within stenotic aortic valves (AVs) also appears frequent in the absence of cardiac amyloidosis, but its clinical and pathophysiological relevance has not been investigated. We will elucidate the rate of isolated AV amyloid deposition and its potential clinical and pathophysiological significance in aortic stenosis (AS). In 130 patients without systemic and/or cardiac amyloidosis, we collected the explanted AVs during cardiac surgery: 57 patients with calcific AS and 73 patients with AV insufficiency (41 with AV sclerosis and 32 without, who were used as controls). Amyloid deposition was found in 21 AS valves (37%), 4 sclerotic AVs (10%), and none of the controls. Patients with and without isolated AV amyloid deposition had similar clinical and echocardiographic characteristics and survival rates. Isolated AV amyloid deposition was associated with higher degrees of AV fibrosis (p = 0.0082) and calcification (p < 0.0001). Immunohistochemistry analysis suggested serum amyloid A1 (SAA1), in addition to transthyretin (TTR), as the protein possibly involved in AV amyloid deposition. Circulating SAA1 levels were within the normal range in all groups, and no difference was observed in AS patients with and without AV amyloid deposition. In vitro, AV interstitial cells (VICs) were stimulated with interleukin (IL)-1β which induced increased SAA1-mRNA both in the control VICs (+6.4 ± 0.5, p = 0.02) and the AS VICs (+7.6 ± 0.5, p = 0.008). In conclusion, isolated AV amyloid deposition is frequent in the context of AS, but it does not appear to have potential clinical relevance. Conversely, amyloid deposition within AV leaflets, probably promoted by local inflammation, could play a role in AS pathophysiology.
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Affiliation(s)
- Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
- Casa di Cura San Michele, 81024 Caserta, Italy; (A.C.)
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (P.P.)
| | - Maria Monti
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, 5, 80131 Naples, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | | | | | - Emilia Zampella
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Annarita Gencarelli
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Maria Rosaria Cervasio
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Flora Cozzolino
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Vittoria Monaco
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | | | | | - Adele Ferro
- Institute of Biostructure and Bioimaging, CNR, 80145 Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Francesca Graziani
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Pietro Pucci
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Alberto Cuocolo
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
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Zito Marino F, Buono S, Montella M, Giannatiempo R, Messina F, Casaretta G, Arpino G, Vita G, Fiorentino F, Insabato L, Sgambato A, Orditura M, Franco R, Accardo M. NTRK gene aberrations in triple-negative breast cancer: detection challenges using IHC, FISH, RT-PCR, and NGS. J Pathol Clin Res 2023; 9:367-377. [PMID: 37143440 PMCID: PMC10397374 DOI: 10.1002/cjp2.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/31/2023] [Accepted: 04/07/2023] [Indexed: 05/06/2023]
Abstract
Triple-negative breast cancer (TNBC) is usually an aggressive disease with a poor prognosis and limited treatment options. The neurotrophic tyrosine receptor kinase (NTRK) gene fusions are cancer type-agnostic emerging biomarkers approved by the Food and Drug Administration (FDA), USA, for the selection of patients for targeted therapy. The main aim of our study was to investigate the frequency of NTRK aberrations, i.e. fusions, gene copy number gain, and amplification, in a series of TNBC using different methods. A total of 83 TNBCs were analyzed using pan-TRK immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), real-time polymerase chain reaction (RT-PCR), and RNA-based next-generation sequencing (NGS). Of 83 cases, 16 showed pan-TRK positivity although no cases had NTRK-fusions. Indeed, FISH showed four cases carrying an atypical NTRK1 pattern consisting of one fusion signal and one/more single green signals, but all cases were negative for fusion by NGS and RT-PCR testing. In addition, FISH analysis showed six cases with NTRK1 amplification, one case with NTRK2 copy number gain, and five cases with NTRK3 copy number gain, all negative for pan-TRK IHC. Our data demonstrate that IHC has a high false-positive rate for the detection of fusions and molecular testing is mandatory; there is no need to perform additional molecular tests in cases negativity for NTRK by IHC. In conclusion, the NTRK genes are not involved in fusions in TNBC, but both copy number gain and amplification are frequent events, suggesting a possible predictive role for other NTRK aberrations.
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Affiliation(s)
- Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Simona Buono
- Pathology Unit, Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | | | | | | | - Grazia Arpino
- Department of Clinical Medicine and SurgeryUniversity of Naples Federico IINaplesItaly
| | - Giulia Vita
- Anatomical Pathology Department, IRCCS CROBRionero in VultureItaly
| | | | - Luigi Insabato
- Department of Advanced Biomedical Sciences, Pathology SectionUniversity of Naples “Federico II”NaplesItaly
| | - Alessandro Sgambato
- Scientific Direction, Centro di Riferimento Oncologico della Basilicata (IRCCS‐CROB)Rionero in VultureItaly
| | - Michele Orditura
- Division of Medical Oncology, Department of Precision Medicine, School of MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
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4
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Pegoraro F, Santangelo D, Santangelo A, Pelosio L, Jamshidi A, Camera L, Imbriaco M, Mainolfi CG, Insabato L, Accarino R, Giuliano M, Carlomagno N, D'Alessandro V, Santangelo ML. R0 surgical resection of giant dedifferentiated retroperitoneal liposarcomas in the COVID era with and without nephrectomy: A case report. Oncol Lett 2023; 26:410. [PMID: 37600332 PMCID: PMC10436160 DOI: 10.3892/ol.2023.13996] [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] [Received: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 08/22/2023] Open
Abstract
Retroperitoneal sarcomas (RPSs) are rare findings that can grow into large masses without eliciting severe symptoms. At present, surgical resection is the only radical therapy, whenever it can be performed with the aim to achieve a complete removal of the tumor. The present report describes two consecutive cases of RPSs that resulted in dedifferentiated liposarcomas (DDLPSs) and these patients underwent R0 surgical resection with and without a nephron-sparing procedure. The diagnostic workup, the surgical approach, the impact of late surgical management due to the COVID pandemic and the latest literature on the topic are discussed and analyzed. The patients, who refused to undergo any medical examination during the prior 2 years due to the COVID pandemic, were admitted to Federico II University Hospital (Naples, Italy) complaining about weight loss and general abdominal discomfort. In the first case, a primitive giant abdominal right neoplasm of retroperitoneal origin enveloping and medializing the right kidney was observed. The second patient had a similar primitive retroperitoneal giant left neoplasm, which did not affect the kidney. Given the characteristics of the masses and the absence of distant metastases, after a multidisciplinary discussion, radical surgical removal was carried out for both patients. The lesions appeared well-defined from the surrounding tissues, and markedly compressed all the adjacent organs, without signs of infiltration. In the first patient, the right kidney was surrounded and undetachable from the tumor and it was removed en bloc with the mass. The second patient benefited from a nephron-sparing resection, due to the existence of a clear cleavage plane. The postoperative courses were uneventful. Both the histological examinations were oriented towards a DDLPS and both patients benefited from adjuvant chemotherapy. In conclusion, the treatment of giant RPS is still challenging and requires multidisciplinary treatment as well as, when possible, radical surgical removal. The lack of tissue infiltration and the avoidance of excision or reconstruction of major organs (including the kidney) could lead to an easier postoperative course and an improved prognosis. When possible, surgical management of recurrences or incompletely resected masses must be pursued. Since the COVID pandemic caused limited medicalization of a number of population groups and delayed diagnosis of other oncologic diseases, an increased number of DDLPSs could be expected in the near future.
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Affiliation(s)
- Francesca Pegoraro
- Operative Unit of Hepato-Biliary-Pancreatic, Minimally Invasive and Robotic Surgery and Kidney Transplantation, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Domenico Santangelo
- Department of Radiology, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Alfonso Santangelo
- Department of General Surgery and Emergency Surgery, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Luigi Pelosio
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Akbar Jamshidi
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Camera
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Massimo Imbriaco
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Ciro Gabriele Mainolfi
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Insabato
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Rossella Accarino
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Mario Giuliano
- Operative Unit of Medical Oncology, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Nicola Carlomagno
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Vincenzo D'Alessandro
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Michele L. Santangelo
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
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Conza D, Mirra P, Fiory F, Insabato L, Nicolò A, Beguinot F, Ulianich L. Metformin: A New Inhibitor of the Wnt Signaling Pathway in Cancer. Cells 2023; 12:2182. [PMID: 37681914 PMCID: PMC10486775 DOI: 10.3390/cells12172182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
The biguanide drug metformin is widely used in type 2 diabetes mellitus therapy, due to its ability to decrease serum glucose levels, mainly by reducing hepatic gluconeogenesis and glycogenolysis. A considerable number of studies have shown that metformin, besides its antidiabetic action, can improve other disease states, such as polycystic ovary disease, acute kidney injury, neurological disorders, cognitive impairment and renal damage. In addition, metformin is well known to suppress the growth and progression of different types of cancer cells both in vitro and in vivo. Accordingly, several epidemiological studies suggest that metformin is capable of lowering cancer risk and reducing the rate of cancer deaths among diabetic patients. The antitumoral effects of metformin have been proposed to be mainly mediated by the activation of the AMP-activated protein kinase (AMPK). However, a number of signaling pathways, both dependent and independent of AMPK activation, have been reported to be involved in metformin antitumoral action. Among these, the Wingless and Int signaling pathway have recently been included. Here, we will focus our attention on the main molecular mechanisms involved.
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Affiliation(s)
- Domenico Conza
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
| | - Paola Mirra
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
| | - Francesca Fiory
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Antonella Nicolò
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
| | - Francesco Beguinot
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
| | - Luca Ulianich
- URT Genomics of Diabetes, Institute of Endocrinology and Experimental Oncology, National Research Council & Department of Translational Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (A.N.); (F.B.)
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6
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Sirico A, Simonelli S, Pignatiello S, Fulgione C, Sarno L, Chiuso F, Maruotti GM, Sansone M, Guida M, Insabato L. BDNF and NGF Expression in Preneoplastic Cervical Disease According to HIV Status. Int J Mol Sci 2023; 24:10729. [PMID: 37445902 DOI: 10.3390/ijms241310729] [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] [Received: 05/02/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Neurotrophins, such as BDNF and NGF, are overexpressed in tumor cells in cervical cancer, and HIV infection is associated with the upregulation of neurotrophin expression. Therefore, we aimed to investigate whether BDNF and NGF are overexpressed in preneoplastic cervical disease from HIV-infected women. METHODS Women with preneoplastic cervical lesions (cervical intraepithelial neoplasia grade 2 or 3) were prospectively enrolled and grouped according to their HIV status. Samples from Loop Electrosurgical Excision Procedure (LEEP) for suspected cervical cancer were obtained, and immunohistochemistry was performed to evaluate BDNF and NGF expression. RESULTS We included in our analysis 12 HIV-infected patients who were matched with 23 HIV-negative patients as a control group. Immunohistochemistry analysis showed that BDNF expression was significantly higher in cervical preneoplastic lesions from HIV-positive women than in the lesions from the control group. In particular, BDNF was expressed in 8/12 HIV-positive patients and 7/23 HIV-negative patients (66.7% vs. 30.4%, χ2 = 4.227; p = 0.040). NGF expression was not significantly higher in cervical preneoplastic lesions from HIV-positive women compared with that in the lesions from the control group. In particular, NGF was expressed in 8/12 HIV-positive patients and in 12/23 HIV-negative patients (66.7% vs. 52.2% χ2 = 0.676; p = 0.411). Logistic regression analysis showed that the HIV status is an independent predictor of BDNF expression in pre-invasive preneoplastic cervical disease when considered alone (crude OR 4.6, 95% CI 0.027-20.347; p = 0.046) and when analyzed with other co-factors (adjusted OR 6.786, 95% CI 1.084-42.476; p = 0.041). CONCLUSIONS In preneoplastic cervical disease, BDNF expression is higher in HIV-infected women than in non-infected controls, and this is independent of the clinical features of the patients and from the presence of the HPV-HR genotype. BDNF can play a key role as a link between the pathways by which HIV and HPV interact to accelerate cervical cancer progression and invasion. These data can be useful to better understand the role of neurotrophins in the cancerogenesis of cervical cancer and the possible therapeutic strategies to improve disease outcomes.
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Affiliation(s)
- Angelo Sirico
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Saverio Simonelli
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | | | - Caterina Fulgione
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Laura Sarno
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco Chiuso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Matilde Sansone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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7
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Travaglino A, Arciuolo D, Raffone A, Santoro A, Piermattei A, Navarra E, Minucci A, Mascolo M, Scaglione G, D'alessandris N, Valente M, Inzani F, Mollo A, Insabato L, Zannoni GF. Endometrial carcinomas with dyshesive, eosinophilic, and vacuolated (histiocyte-like) tumor cells: a reactive-like phenotype associated with aggressive behavior. Virchows Arch 2023; 482:635-640. [PMID: 36205778 DOI: 10.1007/s00428-022-03411-7] [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] [Received: 06/10/2022] [Revised: 08/10/2022] [Accepted: 09/08/2022] [Indexed: 10/10/2022]
Abstract
Herein, we present a clinicopathological and molecular analysis of four cases of endometrial carcinoma (EC) diffusely exhibiting dyshesive cells with wide eosinophilic and vacuolated cytoplasm (histiocyte-like tumor cells, HLTCs). We compared these HLTCs to similar cells found in microcystic, elongated and fragmented (MELF) pattern (n = 20) or after neoadjuvant chemotherapy (NAC) (n = 5). The four cases were endometrioid, serous, clear cell, and gastric-type; all were at FIGO stage ≥ III. HLTCs showed an epithelial Müllerian phenotype and at least focal CK20, HNF1β, and CK5/6 expression, with aberrant e-cadherin and β-catenin expression; two cases were MMR-deficient, and one was p53-abnormal; all were POLE wild type. MELF-associated and NAC-associated HLTCs showed similar morphological/immunophenotypical features. However, MELF-associated HLTCs were mainly intraglandular and inflammation-associated, did not form a distinct tumor component, and showed no relationship with lymph node metastases. In conclusion, different histotypes of EC may show a prominent HLTC component, which shows peculiar morphological/immunophenotypical features and appears associated with aggressive behavior.
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Affiliation(s)
- Antonio Travaglino
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Damiano Arciuolo
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Pathology, Catholic University of the Sacred Hearth, Rome, Italy
| | - Antonio Raffone
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria Di Bologna. S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Angela Santoro
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessia Piermattei
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Elena Navarra
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Minucci
- Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Massimo Mascolo
- Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Giulia Scaglione
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Michele Valente
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Frediano Inzani
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Institute of Pathology, Catholic University of the Sacred Hearth, Rome, Italy.
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8
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Travaglino A, Raffone A, Raimondo D, Gencarelli A, Esposito I, Gallo C, Improda FP, Vitale SG, Mollo A, Casadio P, Seracchioli R, Zullo F, Insabato L. Diagnostic and prognostic value of Bcl-2 in uterine leiomyosarcoma. Arch Gynecol Obstet 2023; 307:379-386. [PMID: 35344084 PMCID: PMC9918573 DOI: 10.1007/s00404-022-06531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 03/14/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Uterine leiomyosarcoma (uLMS) may show loss of expression of B-cell lymphoma-2 (Bcl-2) protein. It has been suggested that Bcl-2 loss may both be a diagnostic marker and an unfavorable prognostic marker in uLMS. OBJECTIVE To define the diagnostic and prognostic value of Bcl-2 loss in uLMS through a systematic review and meta-analysis. METHODS Electronic databases were searched from their inception to May 2020 for all studies assessing the diagnostic and prognostic value of Bcl-2 loss of immunohistochemical expression in uLMS. Data were extracted to calculate odds ratio (OR) for the association of Bcl-2 with uLMS vs leiomyoma variants and smooth-muscle tumors of uncertain malignant potential (STUMP), and hazard ratio (HR) for overall survival; a p value < 0.05 was considered significant. RESULTS Eight studies with 388 patients were included. Loss of Bcl-2 expression in uLMS was not significantly associated with a diagnosis of uLMS vs leiomyoma variants and STUMP (OR = 2.981; p = 0.48). Bcl-2 loss was significantly associated with shorter overall survival in uLMS (HR = 3.722; p = 0.006). High statistical heterogeneity was observed in both analyses. CONCLUSION Loss of Bcl-2 expression appears as a significant prognostic but not diagnostic marker in uLMS. The high heterogeneity observed highlights the need for further research and larger studies.
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Affiliation(s)
- Antonio Travaglino
- grid.4691.a0000 0001 0790 385XAnatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria Di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy. .,Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, NaplesNaples, Italy.
| | - Diego Raimondo
- grid.6292.f0000 0004 1757 1758Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria Di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
| | - Annarita Gencarelli
- grid.4691.a0000 0001 0790 385XAnatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Italia Esposito
- grid.4691.a0000 0001 0790 385XGynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131 NaplesNaples, Italy
| | - Cinzia Gallo
- grid.411489.10000 0001 2168 2547Gynecology and Obstetrics Unit, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Paolo Improda
- grid.4691.a0000 0001 0790 385XGynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131 NaplesNaples, Italy
| | - Salvatore Giovanni Vitale
- grid.8158.40000 0004 1757 1969Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Mollo
- grid.11780.3f0000 0004 1937 0335Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Paolo Casadio
- grid.6292.f0000 0004 1757 1758Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria Di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
| | - Renato Seracchioli
- grid.6292.f0000 0004 1757 1758Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria Di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
| | - Fulvio Zullo
- grid.4691.a0000 0001 0790 385XGynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131 NaplesNaples, Italy
| | - Luigi Insabato
- grid.4691.a0000 0001 0790 385XAnatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
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Travaglino A, Arciuolo D, Santoro A, Raffone A, Pedone Anchora L, Piermattei A, Martinelli M, Mollo A, Onori ME, Minucci A, Inzani F, Fanfani F, Insabato L, Zannoni GF. Corded and hyalinized endometrioid endometrial carcinoma with high-grade features: a clinicopathological and TCGA-based molecular analysis. Virchows Arch 2022; 482:671-678. [PMID: 36550216 DOI: 10.1007/s00428-022-03472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Corded and hyalinized endometrioid carcinoma (CHEC) typically shows low-grade features and "no specific molecular profile" (NSMP). This study aimed to perform a clinicopathological and molecular characterization of endometrial CHEC with high-grade features. Immunohistochemistry for cytokeratin AE1/AE3, e-cadherin, β-catenin, estrogen receptor, progesterone receptor, p53, p16, and mismatch repair proteins was performed. A next-generation sequencing kit was used to assess POLE, POLD1, APC, MLH1, MSH2, MSH6, PMS2, MUTYH, EPCAM, and CTNNB1. Molecular groups, i.e., POLE-mutant, mismatch repair deficient (MMRd), p53-abnormal, and NSMP, were assigned according to the TCGA classifier. Six high-grade endometrial CHECs were identified. The mean age was 57.5 years; 5/6 cases were uterine-confined. Five cases showed a diffusely and markedly atypical corded component and a MMRd or p53-abnormal signature; additional features included single-cell keratinization, necrosis, osteoid or myxoid/chondro-myxoid matrix, foci of anaplasia, and nuclear β-catenin expression. The remaining case showed a low mitotic count and a NSMP phenotype, with focal bizarre cells in an otherwise classical CH endometrioid carcinoma. All cases showed variably reduced expression of epithelial markers and hormone receptors in the corded component. No mutations were found in any of the analyzed genes. In conclusion, high-grade CHECs are a heterogeneous subset of biphasic endometrial carcinoma which show similarities and differences with classical CHEC and carcinosarcoma. These cases often show MMRd or p53-abnormal signatures.
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Affiliation(s)
- Antonio Travaglino
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Damiano Arciuolo
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Life Health and Public Health, Catholic University of the Sacred Hearth, Rome, Italy
| | - Angela Santoro
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Antonio Raffone
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria Di Bologna. S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Luigi Pedone Anchora
- Gynecologic Oncology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessia Piermattei
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Manuela Martinelli
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana, " University of Salerno, Baronissi, Italy
| | - Maria Elisabetta Onori
- Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Minucci
- Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Frediano Inzani
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Fanfani
- Department of Life Health and Public Health, Catholic University of the Sacred Hearth, Rome, Italy
- Gynecologic Oncology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Gian Franco Zannoni
- Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Department of Life Health and Public Health, Catholic University of the Sacred Hearth, Rome, Italy.
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10
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Lionetti R, DE Luca M, Raffone A, Travaglino A, Coppellotti A, Peltrini R, Bracale U, D'Ambra M, Insabato L, Zullo F, D'Armiento M, Corcione F. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis. Minerva Obstet Gynecol 2022; 74:356-363. [PMID: 33944524 DOI: 10.23736/s2724-606x.21.04797-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Krukenberg tumor (KT) is defined as a secondary neoplasm of the ovary. While ovarian metastases account for about 30% of ovarian tumors, KTs are rare, accounting for about 1-2% of the total. The rarity of KT is at least in part responsible for the lack of a precise clinic-pathological characterization of these tumors. Clinically, KT may have a subtle clinical presentation, with few symptomatic manifestations and nonspecific clinical signs, even though in literature there is disagreement about the clinical presentation of these patients; such difficulties in the diagnostic framework often leads to a delayed diagnosis with serious consequences on the patient outcome. We aimed to provide a clinico-pathological characterization of Krukenberg Tumor (KT) through a systematic review and meta-analysis to improve the diagnosis and management of KT. EVIDENCE ACQUISITION Electronic databases were searched for all studies assessing clinico-pathological features of KT series. Pooled prevalence of each clinical or pathological factor was calculated according to the random-effect model. EVIDENCE SYNTHESIS Forty-eight studies with 3025 KT patients were included; 39.7% of patients were ≥50 and 39.8% were postmenopausal. The most common primary tumor sites were stomach (42.5%), colon-rectum (26.1%), breast (9.3%), and appendix (5%); 48.7% of KTs were synchronous with the primary tumor, 64.3% were bilateral, 40.5% had a diameter ≥10 cm; 55.3% showed extraovarian extent and 49% showed peritoneal involvement. The most common presenting symptoms were ascites (51.7%), palpable mass (31.3%), pain (29.3%), abdominal distention (28.7%), irregular bleeding (9.1%), asymptomatic (11.2%). CONCLUSIONS KT shows a highly variable presentation. Understanding the prevalence of clinico-pathological factors may be helpful to improve the diagnosis and management of KT.
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Affiliation(s)
- Ruggero Lionetti
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marcello DE Luca
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy -
| | - Antonio Raffone
- Service of Obstetrics and Gynecology, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Service of Pathological Anatomy, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Alberto Coppellotti
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Roberto Peltrini
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Umberto Bracale
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Michele D'Ambra
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Fulvio Zullo
- Service of Obstetrics and Gynecology, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria D'Armiento
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Corcione
- Service of Minimally Invasive Oncological and General Surgery, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
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11
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Pace M, Guadagno E, Russo D, Gencarelli A, Carlea A, Di Spiezio A, Bertuzzi C, Mascolo M, Grimaldi F, Insabato L. Myeloid Sarcoma of the Breast as Blast Phase of JAK2-Mutated (Val617Phe Exon 14p) Essential Thrombocythemia: A Case Report and a Systematic Literature Review. Pathobiology 2022; 90:123-130. [PMID: 35850113 DOI: 10.1159/000525163] [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] [Received: 07/17/2021] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Myeloid sarcoma (MS) is a mass-forming proliferation of myeloid blasts. Frequently, it arises as blast phase of pre-existing myeloproliferative, myelodysplastic disorders or consequent to bone marrow transplant. Its molecular characterization has become an increasingly important requirement for the diagnostic definition of this solid leukemia. CASE PRESENTATION Our case report concerns an MS arising in the breast of a woman with a previous diagnosis of JAK2-mutated essential thrombocythemia (Val617Phe exon 14p) mimicking, on histology, a lobular carcinoma of the breast. The immunohistochemical study of the neoplasm provided the key that solved the diagnostic doubt and the immunohistochemical evaluation of NPM protein expression, which turn out to be negative, provided a clear indication on the molecular status and prognosis of the disease. A year later, the neoplasm relapsed in the pelvic area. DISCUSSION This diagnostic challenge led us to review the literature of the past 10 years concerning MS of the breast. To the best of our knowledge, this was the first case of MS of the breast occurring in a patient with a history of essential thrombocythemia and recurred in the pelvic region.
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Affiliation(s)
- Mirella Pace
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy
| | - Elia Guadagno
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy
| | - Annarita Gencarelli
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy
| | - Annunziata Carlea
- Department of Neurosciences, Reproductive Sciences and Dentistry, Gynecology Unit-Federico II University Hospital of Naples, Naples, Italy
| | - Attilio Di Spiezio
- Department of Public Health, Gynecology Unit-Federico II University Hospital of Naples, Naples, Italy
| | - Clara Bertuzzi
- Department of Experimental, Diagnostic and Specialty Medicine, Hematopathology Unit, University of Bologna, Bologna, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy
| | - Francesco Grimaldi
- Department of Clinical Medicine and Surgery, Hematology Unit, Federico II University Hospital of Naples, Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, Pathology Section- Federico II University Hospital of Naples, Naples, Italy,
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12
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Romano V, Ruocco MR, Carotenuto P, Barbato A, Venuta A, Acampora V, De Lella S, Vigliar E, Iaccarino A, Troncone G, Calì G, Insabato L, Russo D, Franco B, Masone S, Velotti N, Accurso A, Pellegrino T, Fiume G, Belviso I, Montagnani S, Avagliano A, Arcucci A. Generation and Characterization of a Tumor Stromal Microenvironment and Analysis of Its Interplay with Breast Cancer Cells: An In Vitro Model to Study Breast Cancer-Associated Fibroblast Inactivation. Int J Mol Sci 2022; 23:ijms23126875. [PMID: 35743318 PMCID: PMC9224278 DOI: 10.3390/ijms23126875] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023] Open
Abstract
Breast cancer-associated fibroblasts (BCAFs), the most abundant non-cancer stromal cells of the breast tumor microenvironment (TME), dramatically sustain breast cancer (BC) progression by interacting with BC cells. BCAFs, as well as myofibroblasts, display an up regulation of activation and inflammation markers represented by α-smooth muscle actin (α-SMA) and cyclooxygenase 2 (COX-2). BCAF aggregates have been identified in the peripheral blood of metastatic BC patients. We generated an in vitro stromal model consisting of human primary BCAFs grown as monolayers or 3D cell aggregates, namely spheroids and reverted BCAFs, obtained from BCAF spheroids reverted to 2D cell adhesion growth after 216 h of 3D culture. We firstly evaluated the state of activation and inflammation and the mesenchymal status of the BCAF monolayers, BCAF spheroids and reverted BCAFs. Then, we analyzed the MCF-7 cell viability and migration following treatment with conditioned media from the different BCAF cultures. After 216 h of 3D culture, the BCAFs acquired an inactivated phenotype, associated with a significant reduction in α-SMA and COX-2 protein expression. The deactivation of the BCAF spheroids at 216 h was further confirmed by the cytostatic effect exerted by their conditioned medium on MCF-7 cells. Interestingly, the reverted BCAFs also retained a less activated phenotype as indicated by α-SMA protein expression reduction. Furthermore, the reverted BCAFs exhibited a reduced pro-tumor phenotype as indicated by the anti-migratory effect exerted by their conditioned medium on MCF-7 cells. The deactivation of BCAFs without drug treatment is possible and leads to a reduced capability of BCAFs to sustain BC progression in vitro. Consequently, this study could be a starting point to develop new therapeutic strategies targeting BCAFs and their interactions with cancer cells.
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Affiliation(s)
- Veronica Romano
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Maria Rosaria Ruocco
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy;
| | - Pietro Carotenuto
- TIGEM, Telethon Institute of Genetics and Medicine, 80078 Naples, Italy; (P.C.); (A.B.); (B.F.)
- Medical Genetics, Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy
| | - Anna Barbato
- TIGEM, Telethon Institute of Genetics and Medicine, 80078 Naples, Italy; (P.C.); (A.B.); (B.F.)
| | - Alessandro Venuta
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Vittoria Acampora
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Sabrina De Lella
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Antonino Iaccarino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Gaetano Calì
- IEOS Istituto di Endocrinologia e Oncologia Sperimentale ‘G. Salvatore’, National Council of Research, 80131 Naples, Italy;
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (L.I.); (D.R.)
| | - Daniela Russo
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (L.I.); (D.R.)
| | - Brunella Franco
- TIGEM, Telethon Institute of Genetics and Medicine, 80078 Naples, Italy; (P.C.); (A.B.); (B.F.)
- Medical Genetics, Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy
- Scuola Superiore Meridionale, School for Advanced Studies, 80138 Naples, Italy
| | - Stefania Masone
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Nunzio Velotti
- Department of Advanced Biochemical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Antonello Accurso
- Department of General, Oncological, Bariatric and Endocrine-Metabolic Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Tommaso Pellegrino
- DAI Chirurgia Generale, Endocrinologia, Ortopedia e Riabilitazione, Azienda Ospedaliera Universitaria Federico II, 80131 Naples, Italy;
| | - Giuseppe Fiume
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Immacolata Belviso
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Stefania Montagnani
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
| | - Angelica Avagliano
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
- Correspondence: (A.A.); (A.A.); Tel.: +39-081-7463422 (A.A. & A.A.)
| | - Alessandro Arcucci
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (V.R.); (A.V.); (V.A.); (S.D.L.); (E.V.); (A.I.); (G.T.); (I.B.); (S.M.)
- Correspondence: (A.A.); (A.A.); Tel.: +39-081-7463422 (A.A. & A.A.)
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Arciuolo D, Travaglino A, Raffone A, Santoro A, Russo G, Minucci A, Inzani F, Mollo A, Pedone Anchora L, Fanfani F, Insabato L, Zannoni GF. Endometrial giant cell carcinoma: new insights from a morphological, immunohistochemical, and molecular analysis of three cases. Virchows Arch 2022; 481:321-326. [PMID: 35305145 DOI: 10.1007/s00428-022-03310-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
Herein, we present a morphological, immunohistochemical, and molecular analysis of three cases of endometrial giant cell carcinoma (EGCC) with a literature review. Patient age was 55 to 76 years. The tumors were limited to the uterus and showed dyshesive, bizarre giant cells with numerous atypical mitoses. Minor components were low-grade endometrioid, spindled/myxoid (case nos. 1 and 2), serous (case no. 3), and undifferentiated (all cases). The giant cells were e-cadherin-, cytokeratins/EMA + (focal/multifocal), hormone receptors + (focal/multifocal), vimentin + , p16 + (diffuse), CD68-, α-FP-, β-HCG-, muscle markers-, CD10-, and ERG-. Case no. 3 was p53-abnormal. All cases were mismatch repair-proficient and microsatellite-stable. No POLE mutations were detected. Based on our and previous reports, EGCC is often accompanied by a conventional carcinomatous component (mostly endometrioid) and shows partial loss epithelial markers and negativity for specific differentiation markers. EGCC shows evident similarities to both undifferentiated/dedifferentiated carcinoma and carcinosarcoma and should be managed similarly. Unlike the latter two, EGCC might preferentially derive from "no-specific-molecular-profile" carcinomas.
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Affiliation(s)
- Damiano Arciuolo
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Travaglino
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliera Univeristaria Di Bologna. S. Orsola Hospital, University of Bologna, Bologna, Italy. .,Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy.
| | - Angela Santoro
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianluca Russo
- Molecular Pathology Unit, Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Angelo Minucci
- Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Frediano Inzani
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Luigi Pedone Anchora
- Gynecologic Oncology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Fanfani
- Gynecologic Oncology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gian Franco Zannoni
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child's Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Travaglino A, Raffone A, Santoro A, Raimondo D, Orsini B, Casadio P, Zullo F, Seracchioli R, Zannoni GF, Insabato L, Mollo A. Clinicopathological Features Associated with Microsatellite Instability/Mismatch Repair Deficiency in Uterine Carcinosarcoma: A Quantitative Systematic Review. Pathobiology 2022; 89:198-204. [PMID: 35231921 DOI: 10.1159/000521876] [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] [Received: 10/06/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Recent studies suggested that microsatellite instability/mismatch repair deficiency (MSI/MMR-d) might define a clinicopathologically distinct subset of uterine carcinosarcomas (UCSs). OBJECTIVE The aim of this study was to compare clinicopathological features between MSI/MMR-d and microsatellite-stable/mismatch repair-proficient (MSS/MMR-p) UCSs. METHODS A quantitative systematic review was performed by searching electronic databases from January 2000 to January 2021. All studies assessing MSI/MMR status in UCS were included. Odds ratio (OR) with a significant two-tailed p value <0.05 was used to assess the association of MSI/MMR-d with clinicopathological features. RESULTS Eleven studies with 783 patients were included. MSI/MMR-d was directly associated with endometrioid (pure: p < 0.001; pure + mixed: p < 0.001), undifferentiated/dedifferentiated (p < 0.001), and clear cell carcinoma component (p = 0.046), and inversely associated with age >60 (p = 0.034), serous carcinoma component (pure: p < 0.001; pure + mixed: p < 0.001), heterologous sarcoma component (p = 0.027), TP53-mutation/p53-abnormal expression (p < 0.001), and recurrence (p < 0.001). MSI/MMR-d showed no significant association with advanced FIGO stage (OR = 1.259; p = 0.517), low-grade carcinoma component (pure: p = 0.596; pure + mixed: p = 0.307), mixed carcinoma component (p = 1), and proportion of patients "dead of disease" (p = 0.352), "alive with disease" (p = 1) or with "no evidence of disease" (p = 0.458). CONCLUSION MSI/MMR-d UCSs show younger age, more common endometrioid, undifferentiated or clear cell carcinoma component, and less common serous carcinoma component, heterologous sarcoma component, and TP53 mutation than MSS/MMR-p UCSs. Given the discrepancy between recurrence rate and oncologic outcomes at the last follow-up, further studies are necessary to define whether MSI/MMR-d UCSs have better prognosis.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.,Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Angela Santoro
- Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy
| | - Diego Raimondo
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Benedetta Orsini
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Paolo Casadio
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Renato Seracchioli
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Gian Franco Zannoni
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy.,Catholic University of Sacred Heart, Rome, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Mesolella M, Allosso S, Insabato L, Franca RA, Salerno G. Isolated neurofibromas of the great auricular nerve: A rare localization in a pediatric patient with neurofibromatosis type-1. Ear Nose Throat J 2022:1455613221077598. [PMID: 35187958 DOI: 10.1177/01455613221077598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Peripheral nerve sheath tumors encompass a spectrum of well-defined clinicopathologic entities, ranging from benign tumors, such as neurofibromas, to high grade malignant neoplasms termed malignant peripheral nerve sheath tumors. Morphologic variability of these tumors is wide, and they engender some of the most controversial, difficult differential diagnoses. Localized neurofibromas often involve a major nerve and result typically in fusiform expansion of the nerve trunk (intraneural subtype). We report a case of circumscribed solitary neurofibromas in a 14-year-old boy with NF1 who presented to our department with a left neck swelling. The neurofibromas lesion involved the anterior branch of the great auricular nerve. The sensory symptoms initially reported by the patient (paresthesia and hyperesthesia) in the lower preauricular region. Surgical treatment represents the therapeutic method of choice in the approach to neurofibromas, considering functional disorders and possible aesthetic deformities. The case described presented difficulties in surgical excision, based on risk of functional and aesthetic results.
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Affiliation(s)
- Massimo Mesolella
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, 478484University Federico II of Naples, Naples, Italy
| | - Salvatore Allosso
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, 478484University Federico II of Naples, Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, 9307University Federico II, Naples, Italy
| | - Raduan Ahmed Franca
- Department of Advanced Biomedical Sciences, 9307University Federico II, Naples, Italy
| | - Grazia Salerno
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, 478484University Federico II of Naples, Naples, Italy
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Mainenti PP, Stanzione A, Cuocolo R, Grosso RD, Danzi R, Romeo V, Raffone A, Sardo ADS, Giordano E, Travaglino A, Insabato L, Scaglione M, Maurea S, Brunetti A. MRI radiomics: a machine learning approach for the risk stratification of endometrial cancer patients. Eur J Radiol 2022; 149:110226. [DOI: 10.1016/j.ejrad.2022.110226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/28/2022] [Accepted: 02/17/2022] [Indexed: 12/31/2022]
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Inzani F, Angelico G, Santoro A, Travaglino A, Insabato L, Raffone A, Arciuolo D, Scaglione G, D'Alessandris N, Valente M, Carlino A, Rindi G, Zannoni GF. SATB2 is expressed in neuroendocrine carcinoma of the uterine cervix. Virchows Arch 2022; 480:873-877. [PMID: 35091815 DOI: 10.1007/s00428-021-03255-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/24/2021] [Accepted: 12/05/2021] [Indexed: 12/24/2022]
Abstract
Neuroendocrine carcinoma (NEC) of the uterine cervix is less characterized than neuroendocrine neoplasms of other sites such as of the digestive system and the lung. Special AT-rich sequence-binding protein 2 (SATB2) recently emerged as a marker of well-differentiated neuroendocrine tumors of the lower gastrointestinal (GI) tract. Among NECs, SATB2 is more frequently expressed in cutaneous Merkel cell carcinoma than in NEC of other anatomical sites. In our study, we performed an immunohistochemical study of SATB2 in 16 NECs of the uterine cervix, where the expression of these markers is still undefined. SATB2 was expressed in 12/16 cervical NECs (75%), with 7/16 cases (44%) showing SATB2 positivity in ≥ 50% of cells. In 7 cervical NECs associated with a non-neuroendocrine component, the expression of SATB2 was restricted to the neuroendocrine component. SATB2 was positive in all cases that expressed CDX2 (n = 7) and TTF1 (n = 5), with no evident association with p16 and p53. Our study demonstrated that SATB2 is often expressed in NECs of the uterine cervix. This information should be taken into account when assessing the origin of a NEC.
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Affiliation(s)
- Frediano Inzani
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- ENETS Center of Excellence, Neuroendocrine Tumor (NET) Center, Rome, Italy
| | - Giuseppe Angelico
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Angela Santoro
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Antonio Travaglino
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Damiano Arciuolo
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Giulia Scaglione
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Nicoletta D'Alessandris
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Michele Valente
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Angela Carlino
- Section of Anatomic Pathology, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00100, Rome, Italy
| | - Guido Rindi
- ENETS Center of Excellence, Neuroendocrine Tumor (NET) Center, Rome, Italy
- Section of Anatomic Pathology, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00100, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Gian Franco Zannoni
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
- Catholic University of Sacred Heart, Rome, Italy.
- Department of Woman and Child Health, UCSC, and Fondazione Policlinico Gemelli, Rome, Italy.
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Travaglino A, Raffone A, Raimondo D, Reppuccia S, Ruggiero A, Arena A, Casadio P, Zullo F, Insabato L, Seracchioli R, Mollo A. Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis. Arch Gynecol Obstet 2022; 306:423-431. [PMID: 35034160 PMCID: PMC9349085 DOI: 10.1007/s00404-021-06385-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/24/2021] [Accepted: 12/20/2021] [Indexed: 12/15/2022]
Abstract
Background In the last years, mutations in the exon 3 of CTNNB1 have emerged as a possible prognostic factor for recurrence in early stage endometrioid endometrial carcinoma, especially in cases with no specific molecular profile (NSMP). Objective To define the prognostic value of CTNNB1 mutations in early stage endometrioid endometrial carcinoma, through a systematic review and meta-analysis. Methods Electronic databases were searched from their inception to November 2020 for all studies assessing the prognostic value of CTNNB1 mutation in early stage (FIGO I–II) endometrioid endometrial carcinoma. Odds ratio (OR) for tumor recurrence and hazard ratio (HR) for disease-free survival (DFS) were calculated with a significant p value < 0.05. Results Seven studies with 1031 patients were included. Four studies were suitable for meta-analysis of OR and showed significant association between CTNNB1 mutation and the absolute number of recurrence (OR = 3.000; p = 0.019); the association became stronger after excluding patients with known molecular status other than NSMP (HR = 5.953; p = 0.012). Three studies were suitable for meta-analysis of HR and showed no significant association between CTNNB1 mutation and decreased DFS (HR = 1.847; p = 0.303); the association became significant after excluding patients with known molecular status other than NSMP (HR = 2.831; p = 0.026). Conclusion CTNNB1 mutation is significantly associated with recurrence in early stage endometrioid endometrial carcinomas, especially in the NSMP, appearing potentially useful in directing adjuvant treatment.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy. .,Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy.
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy
| | - Sabrina Reppuccia
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Alessandro Ruggiero
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Alessandro Arena
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy.
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081, Baronissi, Italy
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Raffone A, Travaglino A, Raimondo D, Neola D, Maletta M, Santoro A, Insabato L, Casadio P, Fanfani F, Zannoni GF, Zullo F, Seracchioli R, Mollo A. Lymphovascular space invasion in endometrial carcinoma: A prognostic factor independent from molecular signature. Gynecol Oncol 2022; 165:192-197. [DOI: 10.1016/j.ygyno.2022.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/30/2022]
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Casadio P, Raffone A, Travaglino A, Raimondo D, Zizolfi B, Armano G, Buonaiuto R, Insabato L, Mollo A, Seracchioli R, Di Spiezio Sardo A. Oncologic outcomes of conservative treatment of atypical polypoid adenomyoma of the uterus: a two‐center experience. Int J Gynaecol Obstet 2021; 159:79-85. [DOI: 10.1002/ijgo.14077] [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: 09/04/2021] [Revised: 11/25/2021] [Accepted: 12/17/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology Department of Medical and Surgical Sciences (DIMEC) IRCCS Azienda Ospedaliero Univeristaria di Bologna. S. Orsola Hospital University of Bologna Via Massarenti 13 Bologna 40138 Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology Department of Medical and Surgical Sciences (DIMEC) IRCCS Azienda Ospedaliero Univeristaria di Bologna. S. Orsola Hospital University of Bologna Via Massarenti 13 Bologna 40138 Italy
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II Naples Italy
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology Department of Medical and Surgical Sciences (DIMEC) IRCCS Azienda Ospedaliero Univeristaria di Bologna. S. Orsola Hospital University of Bologna Via Massarenti 13 Bologna 40138 Italy
| | - Brunella Zizolfi
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Giulia Armano
- Department of Medicine and Surgery University of Parma Italy
| | - Roberto Buonaiuto
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Luigi Insabato
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II Naples Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana" University of Salerno 84081 Baronissi Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology Department of Medical and Surgical Sciences (DIMEC) IRCCS Azienda Ospedaliero Univeristaria di Bologna. S. Orsola Hospital University of Bologna Via Massarenti 13 Bologna 40138 Italy
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Franca RA, Crocetto F, Pandolfo SD, Ponsiglione A, Franzese CA, Imbriaco M, Imbimbo C, Insabato L. Cystadenoma of the seminal vesicle – Potential diagnostic pitfall: A case report and literature review. Journal of Clinical Urology 2021. [DOI: 10.1177/20514158211059059] [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
Background: Cystadenomas of the seminal vesicles are benign cystic tumours, currently classified into the group of mixed epithelial-stromal tumours (MEST). Primary tumours arising in the seminal vesicles are quite rare, benign tumours being rarer than malignant ones, with only a few cases reported in the English literature since 1944. Cystadenomas represent a potential diagnostic pitfall, as they can be clinically confused with malignant neoplasms and histologically with non-neoplastic inflammatory lesions or other cystic tumours, even malignant. Objective and methods: We report a case of a 23-year-old man presenting with a cystic mass of the seminal vesicle, clinically suspected to be a malignant neoplasm. On pathological examination, a diagnosis of cystadenoma was made. Diagnostic criteria to make a diagnosis of this tumour are questionable. Therefore, we carried out a literature review in attempt to compare clinico-pathological findings of 28 cases reported in the English literature as cystadenomas of the seminal vesicle. Results: Only 28 cases of cystadenomas of seminal vesicles were reported in the English literature. The available data show the difficulty to rule out malignancy preoperatively in a patient with a solid-cystic mass in the pelvic region, and that morphological findings observed were often reported incompletely. Conclusions: The current classification appears debatable, as well as histopathological criteria to diagnose a cystadenoma of the seminal vesicle. For the proper management of these lesions, a multidisciplinary approach is mandatory. Level of evidence: Not applicable
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Affiliation(s)
- Raduan Ahmed Franca
- Department of Advanced Biomedical Sciences, University of Naples ‘Federico II’, Italy
| | - Felice Crocetto
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples ‘Federico II’, Italy
| | - Savio Domenico Pandolfo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples ‘Federico II’, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples ‘Federico II’, Italy
| | | | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples ‘Federico II’, Italy
| | - Ciro Imbimbo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples ‘Federico II’, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples ‘Federico II’, Italy
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22
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Pepe F, Pisapia P, Russo G, Nacchio M, Pallante P, Vigliar E, De Angelis C, Insabato L, Bellevicine C, De Placido S, Troncone G, Malapelle U. BRCA1/2 NGS Somatic Testing in Clinical Practice: A Short Report. Genes (Basel) 2021; 12:genes12121917. [PMID: 34946865 PMCID: PMC8702012 DOI: 10.3390/genes12121917] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
High-grade serous ovarian carcinoma (HGSOC) is the most common subtype of all ovarian carcinomas. HGSOC harboring BRCA1/2 germline or somatic mutations are sensitive to the poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi). Therefore, detecting these mutations is crucial to identifying patients for PARPi-targeted treatment. In the clinical setting, next generation sequencing (NGS) has proven to be a reliable diagnostic approach BRCA1/2 molecular evaluation. Here, we review the results of our BRCA1/2 NGS analysis obtained in a year and a half of diagnostic routine practice. BRCA1/2 molecular NGS records of HGSOC patients were retrieved from our institutional archive covering the period from January 2020 to September 2021. NGS analysis was performed on the Ion S5™ System (Thermo Fisher Scientific, Waltham, MA, USA) with the Oncomine™ BRCA Research Assay panel (Thermo Fisher Scientific). Variants were classified as pathogenic or likely pathogenic according to the guidelines of the American College of Medical Genetics and Genomics by using the inspection of Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) and ClinVar (NCBI) databases. Sixty-five HGSOC patient samples were successfully analyzed. Overall, 11 (16.9%) out of 65 cases harbored a pathogenic alteration in BRCA1/2, in particular, six BRCA1 and five BRCA2 pathogenic variations. This study confirms the efficiency and high sensitivity of NGS analysis in detecting BRCA1/2 germline or somatic variations in patients with HGSOC.
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Affiliation(s)
- Francesco Pepe
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Gianluca Russo
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Mariantonia Nacchio
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Pierlorenzo Pallante
- Institute for Experimental Endocrinology and Oncology (IEOS) “G. Salvatore”, National Research Council (CNR), 80131 Naples, Italy;
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (C.D.A.); (S.D.P.)
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, 80131 Naples, Italy;
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (C.D.A.); (S.D.P.)
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
- Correspondence: ; Fax: +(011)-390-817-463-679
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (P.P.); (G.R.); (M.N.); (E.V.); (C.B.); (U.M.)
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23
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Travaglino A, Raffone A, Gencarelli A, Micheli M, Franco L, Zullo F, Mollo A, Di Spiezio Sardo A, Bifulco G, Insabato L. Dusp6 immunohistochemistry is associated with the response of atypical endometrial hyperplasia and early endometrial cancer to conservative treatment. Int J Gynaecol Obstet 2021; 158:742-747. [PMID: 34837386 DOI: 10.1002/ijgo.14050] [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] [Received: 08/05/2021] [Revised: 11/06/2021] [Accepted: 11/25/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Dual-specificity phosphatase 6 (Dusp6) was proposed as a predictive marker of response of atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC) to conservative treatment. However, its predictive accuracy has never been calculated. We aimed to define it in conservatively treated AEH and EEC. METHODS All patients <45 years with AEH or EEC and conservatively treated with hysteroscopic resection + LNG-IUD insertion from 2007 to 2018 were retrospectively assessed. Dusp6 immunohistochemical expression was assessed and dichotomized as "strong" vs "weak". Relative risk (RR) for "no regression" and "recurrence" or AEH/EEC was calculated. Predictive accuracy was calculated as sensitivity, specificity, positive and negative predictive values (PPV, NPV) and area under the curve (AUC) on receiver operating characteristic curve. RESULTS Thirty-six women were included. Weak Dusp6 immunohistochemical expression was significantly associated with increased risk of resistance to treatment, with a RR = 16 (P = 0.0074); predictive accuracy analysis showed sensitivity = 80%, specificity = 90%, PPV = 57.1%, NPV = 96.4%, AUC = 0.85. A weak Dusp6 expression was not significantly associated with the risk of recurrence after an initial regression (RR = 0.4; P = 0.53). CONCLUSION Weak Dusp6 expression appears as a significant predictor of resistance of AEH/EEC to fertility-sparing treatment, with moderate predictive accuracy. Weak Dusp6 expression is significantly associated with resistance of atypical endometrial hyperplasia or early endometrial cancer to fertility-sparing treatment, with moderate predictive accuracy.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Annarita Gencarelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Laura Franco
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Attilio Di Spiezio Sardo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy.,Gynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giuseppe Bifulco
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Raffone A, Travaglino A, Raimondo D, Maletta M, De Vivo V, Visiello U, Casadio P, Seracchioli R, Zullo F, Insabato L, Mollo A. Uterine carcinosarcoma vs endometrial serous and clear cell carcinoma: A systematic review and meta-analysis of survival. Int J Gynaecol Obstet 2021; 158:520-527. [PMID: 34797919 PMCID: PMC9543416 DOI: 10.1002/ijgo.14033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/27/2021] [Revised: 11/06/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
Background It is unclear whether uterine carcinosarcoma (UCS) is more aggressive than endometrial serous carcinoma (SC) and clear cell carcinoma (CCC). Objectives To compare the prognosis of UCS to that of endometrial SC and CCC, through a systematic review and meta‐analysis. Methods Four electronic databases were searched from January 2000 to October 2020. All studies assessing hazard ratio (HR) for death in UCS vs SC and/or CCC. HRs for death with 95% confidence interval were extracted and pooled by using a random‐effect model. A significant P‐value <0.05 was adopted. Results Six studies with 11 029 patients (4995 with UCS, 4634 with SC, 1346 with CCC and 54 with either SC or CCC) were included. UCS showed a significantly worse prognosis than SC/CCC both overall (HR = 1.51; P = 0.008) and at early stage (HR = 1.58; P < 0.001). Similar results were found for UCS vs SC (HR = 1.53; P < 0.001) and UCS vs CCC (HR = 1.60; P < 0.001). Conclusions Compared to SC and CCC, UCS has a significantly worse prognosis, with a 1.5–1.6‐fold increased risk of death. This might justify a more aggressive treatment for UCS compared to SC and CCC. Further studies are necessary to define the prognostic impact of different molecular subgroups. Uterine carcinosarcoma shows worse prognosis than serous and clear cell carcinoma; this could impact patient management.
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Affiliation(s)
- Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy.,Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Manuela Maletta
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Valentino De Vivo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | | | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
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25
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Travaglino A, Raffone A, Santoro A, Raimondo D, Improda FP, Cariati F, De Marco M, Casadio P, Seracchioli R, Zullo F, Insabato L, Zannoni GF. Risk of Recurrence in Uterine Leiomyoma with Bizarre Nuclei: a Systematic Review and Meta-Analysis. Geburtshilfe Frauenheilkd 2021; 81:1217-1223. [PMID: 34754271 PMCID: PMC8568503 DOI: 10.1055/a-1533-1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022] Open
Abstract
Objective
Leiomyoma with bizarre nuclei (LBN) is a variant of uterine leiomyoma, which has replaced the previous category of “atypical leiomyoma” and must be distinguished from smooth muscle tumors of uncertain malignant potential (STUMP). However, previously published series of “atypical leiomyoma” might have included both LBN and STUMP, due to the lack of strict diagnostic criteria. Based on such hypothesis, we aimed to define the risk of recurrence in LBN.
Study Design
A systematic review and meta-analysis was performed by searching 4 electronic databases for all studies assessing the outcome of patients with “atypical leiomyoma” or LBN. The pooled absolute risk of recurrence was calculated. The included studies were subdivided into two subgroups based on the criteria used: “LBN + STUMP” or “LBN-only”.
Results
Twelve studies with 433 patients were included. The pooled risk of recurrence was 5.5% overall. The funnel plot showed two cluster of studies which superimposed to the two subgroups. In the LBN + STUMP cluster/subgroup, the pooled risk of recurrence was 7.7%. In the LBN-only cluster/subgroup, the pooled risk of recurrence was 1.9%. Statistical heterogeneity was null in all analyses.
Conclusion
Our results show a risk of recurrence of 1.9% for LBN; higher recurrence rates in older studies are likely due to the inclusion of STUMPs.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.,Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Angela Santoro
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Francesco Paolo Improda
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Federica Cariati
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Fertility Unit, Maternal-Child Department, AOU Policlinico Federico II, Naples, Italy
| | - Margot De Marco
- Department of Medicine, Surgery and Odontology Schola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gian Franco Zannoni
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
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26
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Travaglino A, Raffone A, Catena U, De Luca M, Toscano P, Del Prete E, Vecchione ML, Lionetti R, Zullo F, Insabato L. Ki67 as a prognostic marker in uterine leiomyosarcoma: A quantitative systematic review. Eur J Obstet Gynecol Reprod Biol 2021; 266:119-124. [PMID: 34624740 DOI: 10.1016/j.ejogrb.2021.09.026] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/26/2021] [Accepted: 09/26/2021] [Indexed: 12/29/2022]
Abstract
Ki67 labeling index (LI) has been proposed as a prognostic factor in uterine leiomyosarcoma (uLMS), although the evidence in this field is still unclear. We aimed to assess the prognostic value of ki67 LI in uLMS. A systematic review was performed by searching electronic databases from their inception to August 2020 for all studies assessing the prognostic value of ki67 LI in uLMS. Ki67 LI was assessed to the nearest 10% to define the most prognostically accurate threshold. Cox regression survival analysis with calculation of hazard ratio (HR) of death was performed; a p-value < 0.05 was considered significant. Ten studies were included in the qualitative review, out of which 6 were suitable for quantitative review. The absolute risk of death was 0.29 for a ki67 LI < 10%, remained stable at 0.49 in the 10%-39% LI range and increased to 0.65 for a LI ≥ 40%. On univariate analysis, both 10% and 40% thresholds were significantly associated with the hazard of death, with HRs of 3.349 (p = 0.007) and 3.172 (p = 0.001), respectively. On multivariate analysis, only the 10% threshold was significantly associated with the hazard of death (HR = 2.712; p = 0.028). In conclusion, a Ki67 LI ≥ 10% is a significant prognostic factor in uLMS.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
| | - Ursula Catena
- Division of Gynecological Oncology, Department for the Protection of Women's and Children's Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS L.go A. Gemelli, Rome, Italy
| | - Marcello De Luca
- General Surgery Unit, Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Toscano
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Ester Del Prete
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria Luisa Vecchione
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Ruggero Lionetti
- Division of Gynecological Oncology, Department for the Protection of Women's and Children's Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS L.go A. Gemelli, Rome, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
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27
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Ferro M, Crocetto F, Bruzzese D, Imbriaco M, Fusco F, Longo N, Napolitano L, La Civita E, Cennamo M, Liotti A, Lecce M, Russo G, Insabato L, Imbimbo C, Terracciano D. Prostate Health Index and Multiparametric MRI: Partners in Crime Fighting Overdiagnosis and Overtreatment in Prostate Cancer. Cancers (Basel) 2021; 13:cancers13184723. [PMID: 34572950 PMCID: PMC8466029 DOI: 10.3390/cancers13184723] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 08/05/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/01/2022] Open
Abstract
Simple Summary In the last decades, the widespread use of PSA as the standard tool for prostate cancer diagnosis led to a high rate of overdiagnosis and overtreatment. More recently, multiparametric magnetic resonance imaging (mpMRI) became part of the diagnostic pathway, and several next-generation PSA-based tests (PHI, PHI density, 4Kscore, STHLM3) have been proposed. The multivariable approach promises to help with a better stratification of PCa patients at initial diagnosis. In this study, we evaluated the performance of the prostate health index (PHI) and mpMRI for the prediction of positive biopsy and of high-grade PCa at radical prostatectomy (RP). Our findings suggested that PHI had a better ability than mpMRI to predict positive biopsy, whereas a comparable performance in the identification of pathological aggressive PCa was pointed out. Notably, PHI and PHI density might represent useful biomarkers to recognize high-grade PCa in patients with low or uncertain PI-RADS scores on mpMRI. Abstract Widespread use of PSA as the standard tool for prostate cancer (PCa) diagnosis led to a high rate of overdiagnosis and overtreatment. In this study, we evaluated the performance of the prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the prediction of positive biopsy and of high-grade PCa at radical prostatectomy (RP). To this end, we prospectively enrolled 196 biopsy-naïve patients who underwent mpMRI. A subgroup of 116 subjects with biopsy-proven PCa underwent surgery. We found that PHI significantly outperformed both PI-RADS score (difference in AUC: 0.14; p < 0.001) and PHI density (difference in AUC: 0.08; p = 0.002) in the ability to predict positive biopsy with a cut-off value of 42.7 as the best threshold. Conversely, comparing the performance in the identification of clinically significant prostate cancer (csPCa) at RP, we found that PHI ≥ 61.68 and PI-RADS score ≥ 4 were able to identify csPCa (Gleason score ≥ 7 (3 + 4)) both alone and added to a base model including age, PSA, fPSA-to-tPSA ratio and prostate volume. In conclusion, PHI had a better ability than PI-RADS score to predict positive biopsy, whereas it had a comparable performance in the identification of pathological csPCa.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy;
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Dario Bruzzese
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (D.B.); (G.R.)
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.I.); (L.I.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Evelina La Civita
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Michele Cennamo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Antonietta Liotti
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Manuela Lecce
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Gianluca Russo
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (D.B.); (G.R.)
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.I.); (L.I.)
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
- Correspondence: ; Tel.: +39-8-1746-2038
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Travaglino A, Raffone A, Gencarelli A, Neola D, Oliviero DA, Alfano R, Campanino MR, Cariati F, Zullo F, Mollo A, Insabato L. p53, p16 and ki67 as immunohistochemical prognostic markers in uterine smooth muscle tumors of uncertain malignant potential (STUMP). Pathol Res Pract 2021; 226:153592. [PMID: 34481212 DOI: 10.1016/j.prp.2021.153592] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 01/20/2023]
Abstract
The risk stratification in gynecologic smooth muscle tumors of uncertain malignant potential (STUMP) is a crucial issue, but at present there are no validated prognostic markers. We aimed to assess p53, p16 and ki67 as immunohistochemical prognostic markers in STUMP through a systematic review and meta-analysis. Electronic databases were searched from their inception to July 2020. All studies assessing p53, p16 and/or ki67 immunohistochemistry in gynecologic STUMP series were included. Immunohistochemical patterns were categorized as "abnormal" vs "wild-type" for p53, "diffuse" vs "focal/negative" for p16, ≥ 10% vs 10% for ki67. The prognostic value for recurrence was assessed through Cox regression analysis; a p-value 0.05 was considered significant. Markers that resulted significant were assessed for prognostic accuracy with calculation of area under the curve (AUC) and post-test probability of recurrence. Seven studies with 171 patients were included. Significant association with disease-free survival was found for p53 (p 0.0001) and p16 (p 0.0001), but not for ki67 (p = 0.911). p53 showed sensitivity= 83%, specificity= 86%, AUC= 0.89, and post-test recurrence probabilities of 54% and 7% in the case of abnormal and wild-type expression, respectively. p16 showed sensitivity= 84%, specificity= 88%, AUC= 0.91 and post-test recurrence probabilities of 56% and 7% in the case of diffuse and focal/negative expression, respectively. In conclusion, p53 and p16 might be useful in the risk assessment of STUMP, despite not being suitable as stand-alone prognostic markers.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy.
| | - Annarita Gencarelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Daniele Neola
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Domenico Alessandro Oliviero
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Rosa Alfano
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Maria Raffaela Campanino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Federica Cariati
- Ospedale Maggiore Policlinico Milano, Milan, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy; Fertility Unit, Maternal-Child Department, AOU Policlinico Federico II, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Antonio Mollo
- Ospedale Maggiore Policlinico Milano, Milan, Italy; Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Ospedale Maggiore Policlinico Milano, Milan, Italy
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Stanzione A, Ricciardi C, Cuocolo R, Romeo V, Petrone J, Sarnataro M, Mainenti PP, Improta G, De Rosa F, Insabato L, Brunetti A, Maurea S. MRI Radiomics for the Prediction of Fuhrman Grade in Clear Cell Renal Cell Carcinoma: a Machine Learning Exploratory Study. J Digit Imaging 2021; 33:879-887. [PMID: 32314070 DOI: 10.1007/s10278-020-00336-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 02/08/2023] Open
Abstract
The Fuhrman nuclear grade is a recognized prognostic factor for patients with clear cell renal cell carcinoma (CCRCC) and its pre-treatment evaluation significantly affects decision-making in terms of management. In this study, we aimed to assess the feasibility of a combined approach of radiomics and machine learning based on MR images for a non-invasive prediction of Fuhrman grade, specifically differentiation of high- from low-grade tumor and grade assessment. Images acquired on a 3-Tesla scanner (T2-weighted and post-contrast) from 32 patients (20 with low-grade and 12 with high-grade tumor) were annotated to generate volumes of interest enclosing CCRCC lesions. After image resampling, normalization, and filtering, 2438 features were extracted. A two-step feature reduction process was used to between 1 and 7 features depending on the algorithm employed. A J48 decision tree alone and in combination with ensemble learning methods were used. In the differentiation between high- and low-grade tumors, all the ensemble methods achieved an accuracy greater than 90%. On the other end, the best results in terms of accuracy (84.4%) in the assessment of tumor grade were achieved by the random forest. These evidences support the hypothesis that a combined radiomic and machine learning approach based on MR images could represent a feasible tool for the prediction of Fuhrman grade in patients affected by CCRCC.
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Affiliation(s)
- Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Carlo Ricciardi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Renato Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy.
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Jessica Petrone
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Michela Sarnataro
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Pier Paolo Mainenti
- Institute of Biostructures and Bioimaging of the National Research Council (CNR), Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Filippo De Rosa
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80123, Naples, Italy
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Raimondo D, Raffone A, Travaglino A, Maletta M, Casadio P, Ambrosio M, Chiara Aru A, Santoro A, Franco Zannoni G, Insabato L, Mollo A, Zullo F, Seracchioli R. Impact of adenomyosis on the prognosis of patients with endometrial cancer. Int J Gynaecol Obstet 2021; 157:265-270. [PMID: 34228822 PMCID: PMC9292168 DOI: 10.1002/ijgo.13818] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/19/2021] [Accepted: 07/05/2021] [Indexed: 12/13/2022]
Abstract
Background Despite the high prevalence of adenomyosis in hysterectomy specimens of endometrial carcinoma (EC) patients, the relationship between adenomyosis and EC prognosis appears unclear. Objective To assess the prognostic value of coexistent adenomyosis in patients with EC. Methods A systematic review and meta‐analysis was performed by searching six electronic databases for studies reporting data on prognosis of EC patients with and without coexistent adenomyosis. Studies with patient selection based on prognostic factors were excluded. Pooled univariate hazard ratio (HR) analyses for overall survival (OS) and disease‐free survival (DRF) were performed, using EC patients without adenomyosis as a control group. For DFS, pooled multivariate HR analysis was also evaluable. Results Three studies of 2505 EC patients (553 with and 1952 without adenomyosis) were included. Compared with EC patients without adenomyosis, EC patients with coexistent adenomyosis showed a pooled HR of 0.533 (CI 95%, 0.329–0.864) for OS at univariate analysis; 0.536 (CI 95%, 0.334–0.859) for DFS at univariate analysis; and 0.875 (CI 95%, 0.331–2.315) for DFS at multivariate analysis. Conclusion In EC patients with coexistent adenomyosis, the risk of death is halved compared with EC patients without adenomyosis. However, the independence of this association needs to be verified in future studies. The risk of death is halved in EC patients with coexistent adenomyosis compared with EC patients without adenomyosis, whereas the risk of EC recurrence does not appear to be affected.
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Affiliation(s)
- Diego Raimondo
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Antonio Raffone
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy.,Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Manuela Maletta
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Paolo Casadio
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Marco Ambrosio
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Anna Chiara Aru
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Angela Santoro
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Renato Seracchioli
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
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Raffone A, Travaglino A, Raimondo D, Neola D, Renzulli F, Santoro A, Insabato L, Casadio P, Zannoni GF, Zullo F, Mollo A, Seracchioli R. Prognostic value of myometrial invasion and TCGA groups of endometrial carcinoma. Gynecol Oncol 2021; 162:401-406. [PMID: 34088515 DOI: 10.1016/j.ygyno.2021.05.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/24/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND 2021 ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma (EC) encourage molecular classification and propose a new prognostic risk stratification based on both pathologic and molecular features. Although deep myometrial invasion (DMI) has been considered as a crucial risk factor in EC, it is unclear if its prognostic value is independent from The Cancer Genome ATLAS (TCGA) groups. AIM To assess if the prognostic value of DMI is independent from the TCGA groups in EC patients. MATERIALS AND METHODS A systematic review and meta-analysis was performed by searching through 5 electronic databases, from their inception to March 2021, for all studies that allowed to assess DMI as a prognostic factor independent of the TCGA groups in EC patients. Pooled hazard ratio (HR) of DMI for overall survival (OS) and disease-free survival (DFS) was calculated at multivariable analyses including TCGA groups as a variable. Superficial myometrial invasion (<50% of myometrial thickness) was considered as a reference. In DFS analyses, locoregional and distant recurrence were separately considered for one study. RESULTS Five studies with 2469 patients were included in the systematic review and 3 studies with 1549 patients in the meta-analysis. Pooled HR of DMI was 1.082 (CI 95% 0.85-1.377; p = 0.524) for OS, 1.709 (CI 95% 1.173-2.491; p = 0.005) for DFS, 1.585 (CI 95% 1.154-2.178; p = 0.004) for DFS additionally considering locoregional recurrence for one study, and 1.701 (CI 95% 1.235-2.344, p = 0.001) for DFS additionally considering distant recurrence for the same study. CONCLUSIONS DMI does not appear as an independent prognostic factor for OS in EC patients; instead, it seems to affect the risk of recurrence independently from the TCGA groups. Further studies are necessary to confirm these findings and to assess the prognostic impact of DMI separately in each TCGA group.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC)., IRCCS Azienda Ospedaliero-Universitaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy.
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC)., IRCCS Azienda Ospedaliero-Universitaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Daniele Neola
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Federica Renzulli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC)., IRCCS Azienda Ospedaliero-Universitaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Angela Santoro
- Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC)., IRCCS Azienda Ospedaliero-Universitaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy.
| | - Gian Franco Zannoni
- Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC)., IRCCS Azienda Ospedaliero-Universitaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
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Raffone A, Travaglino A, Gabrielli O, Micheli M, Zuccalà V, Bitonti G, Camastra C, Gargiulo V, Insabato L, Zullo F. Clinical features of ProMisE groups identify different phenotypes of patients with endometrial cancer. Arch Gynecol Obstet 2021; 303:1393-1400. [PMID: 33754186 PMCID: PMC8087601 DOI: 10.1007/s00404-021-06028-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) groups has identified four molecular prognostic groups of endometrial cancer (EC): POLE-mutated (POLE-mt), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), p53-wild-type (p53-wt). These groups might have different pathogenesis and risk factors, and might occur in different phenotypes of patients. However, these data are still lacking. OBJECTIVE To provide a clinical characterization of the ProMisE groups of EC. METHODS A systematic review and meta-analysis was performed by searching seven electronic databases from their inception to December 2020, for all studies reporting clinical characteristics of EC patients in each ProMisE group. Pooled means of age and BMI and pooled prevalence of FIGO stage I and adjuvant treatment in each ProMisE group were calculated. RESULTS Six studies with 1, 879 women were included in the systematic review. Pooled means (with standard error) and prevalence values were: in the MMR-d group, age = 66.5 ± 0.6; BMI = 30.6 ± 1.2; stage I = 72.6%; adjuvant treatment = 47.3%; in the POLE-mt group, age = 58.6 ± 2.7; BMI = 27.2 ± 0.9; stage I = 93.7%; adjuvant treatment = 53.6%; in the p53-wt group, age = 64.2 ± 1.9; BMI = 32.3 ± 1.4; stage I = 80.5%; adjuvant treatment = 45.3%; in the p53-abn group, age = 71.1 ± 0.5; BMI = 29.1 ± 0.5; stage I = 50.8%; adjuvant treatment = 64.4%. CONCLUSION The ProMisE groups identify different phenotypes of patients. The POLE-mt group included the youngest women, with the lower BMI and the highest prevalence of stage I. The p53-wt group included patients with the highest BMI. The p53-abn group included the oldest women, with the highest prevalence of adjuvant treatment and the lowest prevalence of stage I. The MMR-d group showed intermediate values among the ProMisE groups for all clinical features.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Olimpia Gabrielli
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | | | - Giovanna Bitonti
- Department of Obstetrics and Gynecology, Magna Grecia University, Catanzaro, Italy
| | - Caterina Camastra
- Department of Health Sciences, University of Catanzaro Magna Græcia, Catanzaro, Italy
| | - Valentina Gargiulo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Raffone A, Travaglino A, Raimondo D, Boccia D, Vetrella M, Verrazzo P, Granata M, Casadio P, Insabato L, Mollo A, Seracchioli R. Laparotomic versus robotic surgery in elderly patients with endometrial cancer: A systematic review and meta-analysis. Int J Gynaecol Obstet 2021; 157:1-10. [PMID: 34043235 PMCID: PMC9292514 DOI: 10.1002/ijgo.13766] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/01/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022]
Abstract
Background Although robotics has been shown to improve outcomes in some high‐difficulty surgical category patients, it is unclear if such an approach may improve outcomes in elderly patients with endometrial carcinoma (EC). Objective To compare robotic and laparotomic surgery in the treatment and staging of elderly EC patients. Materials and methods A systematic review and meta‐analysis was performed assessing the risk of overall, intra‐operative, and peri‐operative complications associated with the surgical approach (laparotomic vs robotic) for elderly patients with EC by relative risk (RR). Pooled means ± standard deviation of length of stay were compared with the unpaired t test. Subgroup analyses for overall complications were performed based on different age cut‐offs (>70, >65, and >75 years) and severity of complications (minor and major). A value of P less than 0.05 was considered significant. Results Five studies with 7629 EC patients were included. Pooled RR for robotic compared with laparotomic surgery was 0.40 (P < 0.001) for overall, 0.46 (P = 0.18) for intra‐operative, and 0.43 (P < 0.001) for peri‐operative complications. Pooled difference between means ± standard deviation of length of stay for robotic versus laparotomic surgery was −3.34 (P < 0.001). At subgroup analyses, pooled RR of overall complications for robotic surgery versus laparotomic surgery was 0.34 (P < 0.001) in the >70 years, 0.51 (P < 0.01) in the >65 years, 0.20 (P = 0.12) in the >75 years groups. Pooled RR was 0.50 (P = 0.1) in the minor complications subgroup, and 0.42 (P = 0.002) in the major complications subgroup. Conclusion Robotics might be a viable alternative to the laparotomic approach for EC in elderly patients because it significantly decreases the risk of overall and peri‐operative complications (mainly major complications), and the length of stay when compared with laparotomy. The decrease in risk of overall complications is greater with increasing patient age.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.,Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, University of Bologna, Bologna, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Diego Raimondo
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, University of Bologna, Bologna, Italy
| | - Dominga Boccia
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Martino Vetrella
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Verrazzo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marcello Granata
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Casadio
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, University of Bologna, Bologna, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Renato Seracchioli
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, University of Bologna, Bologna, Italy
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Romeo V, Cuocolo R, Apolito R, Stanzione A, Ventimiglia A, Vitale A, Verde F, Accurso A, Amitrano M, Insabato L, Gencarelli A, Buonocore R, Argenzio MR, Cascone AM, Imbriaco M, Maurea S, Brunetti A. Clinical value of radiomics and machine learning in breast ultrasound: a multicenter study for differential diagnosis of benign and malignant lesions. Eur Radiol 2021; 31:9511-9519. [PMID: 34018057 PMCID: PMC8589755 DOI: 10.1007/s00330-021-08009-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/06/2021] [Accepted: 04/22/2021] [Indexed: 01/28/2023]
Abstract
Objectives We aimed to assess the performance of radiomics and machine learning (ML) for classification of non-cystic benign and malignant breast lesions on ultrasound images, compare ML’s accuracy with that of a breast radiologist, and verify if the radiologist’s performance is improved by using ML. Methods Our retrospective study included patients from two institutions. A total of 135 lesions from Institution 1 were used to train and test the ML model with cross-validation. Radiomic features were extracted from manually annotated images and underwent a multistep feature selection process. Not reproducible, low variance, and highly intercorrelated features were removed from the dataset. Then, 66 lesions from Institution 2 were used as an external test set for ML and to assess the performance of a radiologist without and with the aid of ML, using McNemar’s test. Results After feature selection, 10 of the 520 features extracted were employed to train a random forest algorithm. Its accuracy in the training set was 82% (standard deviation, SD, ± 6%), with an AUC of 0.90 (SD ± 0.06), while the performance on the test set was 82% (95% confidence intervals (CI) = 70–90%) with an AUC of 0.82 (95% CI = 0.70–0.93). It resulted in being significantly better than the baseline reference (p = 0.0098), but not different from the radiologist (79.4%, p = 0.815). The radiologist’s performance improved when using ML (80.2%), but not significantly (p = 0.508). Conclusions A radiomic analysis combined with ML showed promising results to differentiate benign from malignant breast lesions on ultrasound images. Key Points • Machine learning showed good accuracy in discriminating benign from malignant breast lesions • The machine learning classifier’s performance was comparable to that of a breast radiologist • The radiologist’s accuracy improved with machine learning, but not significantly Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08009-2.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.,Laboratory of Augmented Reality for Health Monitoring (ARHeMLab), Department of Electrical Engineering and Information Technology, University of Naples "Federico II", Naples, Italy
| | - Roberta Apolito
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Antonio Ventimiglia
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Annalisa Vitale
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Francesco Verde
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Antonello Accurso
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Michele Amitrano
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Annarita Gencarelli
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Roberta Buonocore
- Department of Radiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | | | - Anna Maria Cascone
- Department of Radiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
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Liotti A, La Civita E, Cennamo M, Crocetto F, Ferro M, Guadagno E, Insabato L, Imbimbo C, Palmieri A, Mirone V, Liguoro P, Formisano P, Beguinot F, Terracciano D. Periprostatic adipose tissue promotes prostate cancer resistance to docetaxel by paracrine IGF-1 upregulation of TUBB2B beta-tubulin isoform. Prostate 2021; 81:407-417. [PMID: 33734457 PMCID: PMC8251776 DOI: 10.1002/pros.24117] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022]
Abstract
Growing evidence supports the pivotal role played by periprostatic adipose tissue (PPAT) in prostate cancer (PCa) microenvironment. We investigated whether PPAT can affect response to Docetaxel (DCTX) and the mechanisms associated. Conditioned medium was collected from the in vitro differentiated adipocytes isolated from PPAT which was isolated from PCa patients, during radical prostatectomy. Drug efficacy was studied by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide citotoxicity assay. Culture with CM of human PPAT (AdipoCM) promotes DCTX resistance in two different human prostate cancer cell lines (DU145 and PC3) and upregulated the expression of BCL-xL, BCL-2, and TUBB2B. AG1024, a well-known IGF-1 receptor inhibitor, counteracts the decreased response to DCTX observed in presence of AdipoCM and decreased TUBB2B expression, suggesting that a paracrine secretion of IGF-1 by PPAT affect DCTX response of PCa cell. Collectively, our study showed that factors secreted by PPAT elicits DCTX resistance through antiapoptotic proteins and TUBB2B upregulation in androgen independent PCa cell lines. These findings reveal the potential of novel therapeutic strategies targeting adipocyte-released factors and IGF-1 axis to overcome DCTX resistance in patients with PCa.
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Affiliation(s)
- Antonietta Liotti
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Evelina La Civita
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Michele Cennamo
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Felice Crocetto
- Department of NeurosciencesUniversity of Naples Federico IINaplesItaly
| | - Matteo Ferro
- Department of Urology, European Institute of OncologyIRCCSMilanItaly
| | - Elia Guadagno
- Department of Advanced Biomedical Sciences, Anatomic Pathology Unit, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, Anatomic Pathology Unit, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - Ciro Imbimbo
- Department of NeurosciencesUniversity of Naples Federico IINaplesItaly
| | | | - Vincenzo Mirone
- Department of NeurosciencesUniversity of Naples Federico IINaplesItaly
| | - Pasquale Liguoro
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Pietro Formisano
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Francesco Beguinot
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Daniela Terracciano
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
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Conza D, Mirra P, Calì G, Insabato L, Fiory F, Beguinot F, Ulianich L. Metformin Dysregulates the Unfolded Protein Response and the WNT/β-Catenin Pathway in Endometrial Cancer Cells through an AMPK-Independent Mechanism. Cells 2021; 10:cells10051067. [PMID: 33946426 PMCID: PMC8147131 DOI: 10.3390/cells10051067] [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: 02/26/2021] [Revised: 04/02/2021] [Accepted: 04/26/2021] [Indexed: 12/19/2022] Open
Abstract
Multiple lines of evidence suggest that metformin, an antidiabetic drug, exerts anti-tumorigenic effects in different types of cancer. Metformin has been reported to affect cancer cells' metabolism and proliferation mainly through the activation of AMP-activated protein kinase (AMPK). Here, we show that metformin inhibits, indeed, endometrial cancer cells' growth and induces apoptosis. More importantly, we report that metformin affects two important pro-survival pathways, such as the Unfolded Protein Response (UPR), following endoplasmic reticulum stress, and the WNT/β-catenin pathway. GRP78, a key protein in the pro-survival arm of the UPR, was indeed downregulated, while GADD153/CHOP, a transcription factor that mediates the pro-apoptotic response of the UPR, was upregulated at both the mRNA and protein level. Furthermore, metformin dramatically inhibited β-catenin mRNA and protein expression. This was paralleled by a reduction in β-catenin transcriptional activity, since metformin inhibited the activity of a TCF/LEF-luciferase promoter. Intriguingly, compound C, a well-known inhibitor of AMPK, was unable to prevent all these effects, suggesting that metformin might inhibit endometrial cancer cells' growth and survival through the modulation of specific branches of the UPR and the inhibition of the Wnt/β-catenin pathway in an AMPK-independent manner. Our findings may provide new insights on the mechanisms of action of metformin and refine the use of this drug in the treatment of endometrial cancer.
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Affiliation(s)
- Domenico Conza
- Department of Medical and Translational Sciences & Institute of Endocrinology and Experimental Oncology of CNR, University “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (F.B.)
| | - Paola Mirra
- Department of Medical and Translational Sciences & Institute of Endocrinology and Experimental Oncology of CNR, University “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (F.B.)
| | - Gaetano Calì
- Institute of Endocrinology and Molecular Oncology of CNR, University “Federico II”, 80131 Naples, Italy;
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University “Federico II”, 80131 Naples, Italy;
| | - Francesca Fiory
- Department of Medical and Translational Sciences & Institute of Endocrinology and Experimental Oncology of CNR, University “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (F.B.)
| | - Francesco Beguinot
- Department of Medical and Translational Sciences & Institute of Endocrinology and Experimental Oncology of CNR, University “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (F.B.)
| | - Luca Ulianich
- Department of Medical and Translational Sciences & Institute of Endocrinology and Experimental Oncology of CNR, University “Federico II”, 80131 Naples, Italy; (D.C.); (P.M.); (F.F.); (F.B.)
- Correspondence: ; Tel.: +39-081-7463248
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Travaglino A, Raffone A, Gencarelli A, Saracinelli S, Zullo F, Insabato L. Diagnostic Pitfalls Related to Morular Metaplasia in Endometrioid Carcinoma: An Underestimated Issue. Pathobiology 2021; 88:261-266. [PMID: 33887731 DOI: 10.1159/000515491] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/25/2021] [Indexed: 11/19/2022] Open
Abstract
Here, we present a case that highlights the crucial pitfalls related to the presence of morular metaplasia (MM) in endometrioid carcinoma, which are insufficiently recognized in the routine pathology practice. A 45-year-old woman underwent hysterectomy with rectosigmoidectomy due to a 11-cm mass involving uterus, right ovary, and rectosigmoid colon. Histologically, the lesion appeared as a predominantly solid carcinoma with a minor glandular component. Results of the first immunohistochemical analysis suggested a colorectal origin (PAX8-, CK7-, WT1-, hormone receptors-, and CDX2+ in the absence of mucinous features). Subsequent immunohistochemistry (nuclear β-catenin+, CD10+, and low ki67 in the solid areas) supported a diagnosis of endometrioid carcinoma with diffuse MM. This case remarks that morphological and immunohistochemical features of MM may conceal the glandular architecture and the typical immunophenotype of endometrioid carcinomas. Acknowledging the diagnostic issues related to MM appears crucial to avoid misdiagnosis and inappropriate patient management.
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Affiliation(s)
- Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Annarita Gencarelli
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Serena Saracinelli
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.,Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Travaglino A, Raffone A, Gencarelli A, Caldarelli C, Granata M, Santoro A, Zannoni GF, Mollo A, Zullo F, Insabato L. Stanford parameters stratify the risk of recurrence in gynecologic smooth muscle tumors of uncertain malignant potential. APMIS 2021; 129:283-290. [PMID: 33786917 DOI: 10.1111/apm.13135] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/26/2021] [Indexed: 12/28/2022]
Abstract
Smooth muscle tumor of uncertain malignant potential (STUMP) is an ill-defined category of neoplasms, which represent a diagnostic challenge. We aimed to assess whether the Stanford parameters, that is, high mitotic index (≥10/10HPF), significant atypia (moderate-to-severe), and coagulative tumor cell necrosis (CTCN), even when focal or ambiguous, may be used to stratify the risk of recurrence in gynecological smooth muscle tumor of uncertain malignant potential (STUMP). Electronic databases were searched from their inception to October 2019. All studies assessing the Stanford parameters in gynecological STUMP series were included. STUMPs were subdivided according to the presence of the three Stanford parameters: high mitotic index, significant atypia, and CTCN. A Kaplan-Meier survival analysis was performed for recurrence-free survival; hazard ratio (HR) was calculated in each category. Fourteen studies with 219 STUMPs were included. In 15.5% of cases, none of the three Stanford parameters were present, with a recurrence risk of 5.9%; 2.7% of cases showed high mitotic index alone, with a recurrence risk of 0% (HR = not calculable); 43.8% of cases showed significant atypia alone, with a recurrence risk of 18.7% (HR = 3.3; p = 0.012); 26.5% of cases showed CTCN alone, with a recurrence risk of 17.2% (HR = 3.1; p = 0.029); and 11.4% of cases showed at least two Stanford parameters, with a recurrence risk of 32% (HR = 7.5; p = 0.003). Stanford parameters may stratify the risk of recurrence of STUMP. Significant atypia and CTCN, but not high mitotic index, may be stand-alone risk factors for recurrence in STUMP. The presence of at least two Stanford parameters, even if equivocal (e.g., uncertain or focal CTCN, focal significant atypia, mitotic index around 10/10HPF), might still be enough to support a diagnosis of leiomyosarcoma. Further studies are necessary in this field.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Annarita Gencarelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Carola Caldarelli
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marcello Granata
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Angela Santoro
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
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Raffone A, Catena U, Travaglino A, Masciullo V, Spadola S, Della Corte L, Piermattei A, Insabato L, Zannoni GF, Scambia G, Zullo F, Bifulco G, Fanfani F, Di Spiezio Sardo A. Mismatch repair-deficiency specifically predicts recurrence of atypical endometrial hyperplasia and early endometrial carcinoma after conservative treatment: A multi-center study. Gynecol Oncol 2021; 161:795-801. [PMID: 33812697 DOI: 10.1016/j.ygyno.2021.03.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Deficient expression of mismatch repair proteins (MMR) has been suggested to be a predictor of resistance of atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EEC) to conservative treatment. AIMS To assess the predictive value of MMR immunohistochemistry in patients conservatively treated for AEH and EEC, and to calculate its predictive accuracy. MATERIALS AND METHODS All patients with AEH or EEC conservatively treated with hysteroscopic resection plus progestins in two referral centers from January 2004 to July 2019 were retrospectively assessed. Immunohistochemistry for MMR was ad hoc performed. Study outcomes were: (i) the association of a deficient immunohistochemical expression of MMR with resistance and recurrence of AEH and EEC after conservative treatment, and (ii) the accuracy of MMR immunohistochemistry in predicting the outcome of conservative treatment. Relative risk (RR) for the associations, and sensitivity, specificity and area under the curve (AUC) on receiver operating characteristic curve for the predictive accuracy were calculated. RESULTS Sixty-nine women, (47 AEH and 22 EEC) were included; deficient MMR expression was observed in 8.7% of cases. Resistance to conservative treatment was more common in MMR-deficient than MMR-proficient cases (33.3% vs 15.9%; RR = 2.1), but with no statistical significance (p = 0.2508). On the other hand, recurrence was significantly more common in MMR-deficient than MMR-proficient cases (100% vs 26.4%; RR = 3.8; p < 0.0001). In predicting recurrence, a deficient immunohistochemical expression of MMR showed sensitivity = 22.2%, specificity = 100%, and AUC = 0.61. CONCLUSION Deficient MMR immunohistochemical expression does not imply resistance of AEH/EEC to conservative treatment. On the other hand, MMR-deficiency appears as a highly specific predictor of recurrence of AEH/EEC after initial regression.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Ursula Catena
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
| | - Valeria Masciullo
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Saveria Spadola
- Unità di Gineco-Patologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luigi Della Corte
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessia Piermattei
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gian Franco Zannoni
- Unità di Gineco-Patologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Bifulco
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Fanfani
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
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Raffone A, Travaglino A, Raimondo D, Boccellino MP, Maletta M, Borghese G, Casadio P, Insabato L, Mollo A, Zullo F, Seracchioli R. Tumor-infiltrating lymphocytes and POLE mutation in endometrial carcinoma. Gynecol Oncol 2021; 161:621-628. [PMID: 33715893 DOI: 10.1016/j.ygyno.2021.02.030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Polymerase-ε (POLE)-mutated endometrial carcinomas (ECs) have displayed an increased number of tumor-infiltrating lymphocytes (TIL) compared to POLE-wild-type ECs. However, it is unclear if TIL may aid in identifying POLE-mutated ECs when molecular data are unavailable. The identification of a POLE mutation surrogate may be crucial to translate TCGA/ProMisE risk assessment in the clinical practice. AIM To assess TIL as histological surrogate of POLE mutation in EC. MATERIALS AND METHODS Seven electronic databases were searched from their inception to September 2020 for studies that allowed data extraction about TIL and TCGA/ProMisE groups of EC. We calculated pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR) and area under the curve (AUC) on SROC curves of TIL in distinguishing POLE-mutated from i) POLE-wild-type, ii) no specific molecular profile (NSMP), iii) POLE-wild-type/MMR-proficient, iii) MMR-deficient ECs. RESULTS 10 studies assessing 1169 women were included in the qualitative analysis. TIL-high pattern showed: sensitivity = 0.65, specificity = 0.63, LR + =2.06, LR- = 0.48, DOR = 4.39, AUC = 0.7532 for POLE-mutant vs POLE-wild-type ECs; sensitivity = 0.85, specificity = 0.73, LR + =2.80, LR- = 0.22, DOR = 15.17 for POLE-mutant vs NSMP ECs; sensitivity = 0.85, specificity = 0.66, LR + =2.49, LR- = 0.25, DOR = 10.30 for POLE-mutant vs POLE-wild-type/MMR-proficient ECs; sensitivity = 0.68, specificity = 0.44, LR + =1.38, LR- = 0.64, DOR = 2.68, AUC = 0.6694 for POLE-mutant vs MMR-deficient ECs. CONCLUSION TIL-high pattern shows a moderate accuracy in distinguishing POLE-mutated from POLE-wild-type ECs after the exclusion of MMR-deficient cases. TIL might be considered in an integrate algorithm to identify POLE-mutated ECs when sequencing is unavailable. Further studies are necessary in this regard.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy.
| | - Maria Pia Boccellino
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Manuela Maletta
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Giulia Borghese
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC). IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital. University of Bologna, Via Massarenti 13, Bologna 40138, Italy
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Stanzione A, Maurea S, Danzi R, Cuocolo R, Galatola R, Romeo V, Raffone A, Travaglino A, Di Spiezio Sardo A, Insabato L, Pace L, Scaglione M, Brunetti A, Mainenti PP. MRI to assess deep myometrial invasion in patients with endometrial cancer:A multi-reader study to evaluate the diagnostic role of different sequences. Eur J Radiol 2021; 138:109629. [PMID: 33713906 DOI: 10.1016/j.ejrad.2021.109629] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The identification of deep myometrial invasion (DMI) represents a fundamental aspect in patients with endometrial cancer (EC) for accurate disease staging. It can be detected on MRI using T2-weighted (T2-w), diffusion weighted (DWI) and dynamic contrast enhanced sequences (DCE). Aim of the study was to perform a multi-reader evaluation of such sequences to identify the most accurate and its reliability for the best protocol. METHODS In this multicenter retrospective study, MRI were independently evaluated by 4 radiologists (2 senior and 2 novice) with a sequence-based approach to identify DMI. The performance of the entire protocol was also evaluated. A comparison between the different sequences assessed by the same reader was performed using receiver operating curve and post-hoc analysis. Intraclass Correlation Coefficient (ICC) was used to assess inter- and intra-observer variability. RESULTS A total of 92 patients were included. The performance of the readers did not show significant differences among DWI, DCE and the entire protocol. For only one senior radiologist, who reached the highest diagnostic accuracy with the entire protocol (82,6 %), both DWI (p = 0,0197) and entire protocol (p = 0,0039) were found significantly superior to T2-w. The highest inter-observer agreement was obtained with the entire protocol by expert readers (ICC = 0,77). CONCLUSIONS For the detection of DMI, the performances of DWI and DCE alone and that of a complete protocol do not significantly differ, even though the latter ensures the highest reliability particularly for expert readers. In cases in which T2-w and DWI are consistent, an unenhanced protocol could be proposed.
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Affiliation(s)
- Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Roberta Danzi
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno, CE, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Roberta Galatola
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Antonio Travaglino
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Italy
| | - Mariano Scaglione
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno, CE, Italy; Teeside University & Department of Radiology, James Cook University Hospital, Marton Rd, Middlesbrough, TS4 3BW, UK
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Pier Paolo Mainenti
- Institute of Biostructures and Bioimaging of the National Research Council, Naples, Italy
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Travaglino A, Raffone A, Santoro A, Gencarelli A, Angelico G, Spadola S, Marzullo L, Zullo F, Insabato L, Zannoni GF. Prognostic significance of atypical mitotic figures in smooth muscle tumors of uncertain malignant potential (STUMP) of the uterus and uterine adnexa. APMIS 2021; 129:165-169. [PMID: 33445214 DOI: 10.1111/apm.13114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/08/2021] [Indexed: 12/19/2022]
Abstract
We aimed to assess whether the presence of atypical mitotic figures (AMF) in smooth muscle tumors of uncertain malignant potential (STUMP) of the uterus and uterine adnexa is associated with increased risk of recurrence, and the association of AMF with the Stanford criteria, that is, significant cytologic atypia, mitotic index ≥ 10/10HPF, and coagulative tumor cell necrosis (CTCN). A systematic review was performed to identify all studies reporting the presence of AMF and oncologic outcomes in STUMP series. Fisher's exact test was used to assess the association of AMF with the three Stanford parameters. Kaplan-Meier and Cox regression survival analyses with hazard ratio (HR) calculation were performed to assess the association between AMF and STUMP recurrence. A p-value < 0.05 was considered significant. Five studies with 80 STUMPs were included, out of which 23.8% had AMF. AMF were significantly associated with the presence of significant atypia (p = 0.023), but not with the presence of a mitotic index ≥ 10/10HPF (p = 0.769), CTCN (p = 1), or more than one Stanford parameter (p = 0.171). AMF was not significantly associated with the risk of STUMP recurrence at both univariate (HR = 0.366; p = 0.188) and multivariate analyses (HR = 0.528; p = 0.463). In STUMP of the uterus and uterine adnexa, AMF are more common in the case of significant cytologic atypia, but do not seem to increase the risk of recurrence. Further studies are necessary in this regard.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Angela Santoro
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Annarita Gencarelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Angelico
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Saveria Spadola
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Liberato Marzullo
- Department of Medicine, Surgery and Odontology Schola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
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Raffone A, Travaglino A, Angelino A, Esposito R, Orlandi G, Toscano P, Mollo A, Insabato L, Sansone M, Zullo F. Gardnerella vaginalis and Trichomonas vaginalis infections as risk factors for persistence and progression of low-grade precancerous cervical lesions in HIV-1 positive women. Pathol Res Pract 2021; 219:153349. [PMID: 33530017 DOI: 10.1016/j.prp.2021.153349] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Gardnerella vaginalis (GV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for persistence and/or progression of low-grade cervical precancerous lesions (CIN1/L-SIL). In patients with Human Immunodeficiency Virus (HIV), who have an increased baseline risk of CIN1/L-SIL progression, the role of GV and TV is undefined. We aimed to investigate the prognostic impact of GV and TV infections on CIN1/L-SIL in HIV-positive women. HIV-1-positive women with L-SIL were retrospectively included. The risk of persistence or progression in the case of any infection (primary outcome), only GV (GV+), only TV (TV+), or GV and TV coinfection (secondary outcomes) was calculated compared to women with no GV or TV infections (NI), by using relative risk (RR) and multivariate logistic regression, with a significant p-value>0.05;. One hundred and ninety-two patients were included (18.2 %GV+, 15.6 %TV+, 5.2 % coinfection, 60.9 %NI); 58 CIN1/L-SIL showed persistence and 46 progression. RR for persistence/progression of CIN1/L-SIL in the case of any infection was 1.56 (1.21-2.01; p = 0.0006) compared to NI. RR for persistence alone was 1.91 (1.25-2.09; p = 0.0026) in GV+, 1.2 (0.63-2.3; p = 0.5736) in TV+, and 2.06 (1.09-3.9; p = 0.0254) in coinfection. RR for progression alone was 1.94 (1.06-3.4; p = 0.0311) in GV+, 2.14 (1.25-3.67; p = 0.0058) in TV+, and 2.73 (1.39-5.37; p = 0.0036) in coinfection. On multivariate analysis, the presence of any infection was significantly associated with persistence/progression (p = 0.002), GV + with persistence (p = 0.019) and TV + with progression (p = 0.016). In conclusion, GV infection is a risk factor for persistence of CIN1/L-SIL in HIV-positive women, while TV infection is a risk factor for progression. Women with these infections may require a closer and more careful follow-up of CIN1/L-SIL.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
| | - Antonio Angelino
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Rosanna Esposito
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuliana Orlandi
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Toscano
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Matilde Sansone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Raffone A, Seracchioli R, Raimondo D, Maletta M, Travaglino A, Raimondo I, Giaquinto I, Orsini B, Insabato L, Pellicano M, Zullo F. Prevalence of adenomyosis in endometrial cancer patients: a systematic review and meta-analysis. Arch Gynecol Obstet 2021; 303:47-53. [PMID: 33098006 PMCID: PMC7854401 DOI: 10.1007/s00404-020-05840-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Several studies have assessed the histological co-existence of endometrial carcinoma (EC) and adenomyosis. However, the significance of this association is still unclear. OBJECTIVE To assess the prevalence of adenomyosis in women with EC for a better understanding of the association between the two diseases. MATERIALS AND METHODS A systematic review and meta-analysis was performed by searching electronics databases from their inception to March 2020, for all studies that allowed extraction of data about prevalence of adenomyosis in EC patients. Adenomyosis prevalence was calculated for each included study and as pooled estimate, with 95% confidence interval (CI). RESULTS Eight retrospective cohort studies assessing 5573 EC patients were included in our analysis. Of total, 1322 were patients with adenomyosis, and 4251 were patients without adenomyosis. Pooled prevalence of adenomyosis in EC patients was 22.6% (95% CI 12.7-37.1%). CONCLUSION Adenomyosis prevalence in EC patients was not different from that reported for other gynecological conditions. The supposed association between the two diseases appears unsupported.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Renato Seracchioli
- Gynecology and Human Reproduction Physiopathology, Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), IRCCS S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Diego Raimondo
- Gynecology and Human Reproduction Physiopathology, Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), IRCCS S. Orsola Hospital, University of Bologna, Bologna, Italy.
| | - Manuela Maletta
- Gynecology and Human Reproduction Physiopathology, Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), IRCCS S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Ivano Raimondo
- Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
- School in Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ilaria Giaquinto
- Gynecology and Human Reproduction Physiopathology, Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), IRCCS S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Benedetta Orsini
- Gynecology and Human Reproduction Physiopathology, Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), IRCCS S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Massimiliano Pellicano
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Ascione R, Crocetto F, Ponsiglione A, Pandolfo SD, Gencarelli A, Insabato L, Imbriaco M, Imbimbo C. A Rare Case of Solitary Fibrous Tumour of the Pelvis in an 18-Year-Old Young Man: CT and MRI Features with Pathologic Correlations. Res Rep Urol 2020; 12:687-690. [PMID: 33403203 PMCID: PMC7778436 DOI: 10.2147/rru.s284777] [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: 10/01/2020] [Accepted: 11/16/2020] [Indexed: 11/23/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are mesenchymal neoplasms of fibroblastic origin, even if commonly seen in the pleura, they can occur anywhere in the body. SFT presents as a slow growing, often asymptomatic mass, generally affecting middle-aged adults regardless of the sex. We report a rare case of an 18-year-old man referred to our institution to perform computed tomography (CT) and magnetic resonance imaging (MRI), to investigate a pelvic mass incidentally discovered at abdominal ultrasound examination. A well circumscribed, heterogenous and hypervascular lesion was described at imaging, with absence of calcifications, hemorrhage, necrosis nor cystic degeneration. The mass removal was performed via the Da Vinci-assisted robotic surgery. Histopathological evaluation confirmed the diagnosis of SFT. CT and MRI can aid the identification of SFT, providing useful information which needs to be supported by histopathological analysis.
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Affiliation(s)
- Raffaele Ascione
- Department of Advanced Biomedical Science, University "Federico II", Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Human Reproduction and Odontostomatology, University "Federico II", Naples, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Science, University "Federico II", Naples, Italy
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Human Reproduction and Odontostomatology, University "Federico II", Naples, Italy
| | - Annarita Gencarelli
- Department of Advanced Biomedical Science, University "Federico II", Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Science, University "Federico II", Naples, Italy
| | - Massimo Imbriaco
- Department of Advanced Biomedical Science, University "Federico II", Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Human Reproduction and Odontostomatology, University "Federico II", Naples, Italy
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Mollo A, Battagliese A, Mascolo M, Raffone A, Travaglino A, D'Armiento M, Insabato L, Zullo F. Hysteroscopic Intact Removal of Angular and Caesarean Scar Pregnancy: A Novel and Markedly Less Invasive Surgical Treatment. Gynecol Obstet Invest 2020; 86:55-62. [PMID: 33302286 DOI: 10.1159/000510510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/22/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Ectopic pregnancy is the most common cause of mortality during the first trimester of pregnancy, and intrauterine ectopic pregnancies show significantly higher morbidity and mortality than extrauterine ones. Despite being less invasive, safety and effectiveness of the hysteroscopic treatment are still unclear. Moreover, such approach is not standardized. We aimed to evaluate safety and effectiveness of hysteroscopic intact removal of angular or cesarean section scar pregnancies, defining a novel and markedly less invasive hysteroscopic technique with a 5-mm Bettocchi hysteroscope or a 3.5-mm Versascope hysteroscope. MATERIALS AND METHODS Medical records and video archives were reviewed for all the patients with angular or caesarean scar pregnancies treated with hysteroscopic intact removal technique from January 2000 to December 2018 at our Department. Success and complication rates were assessed. RESULTS Four patients with angular (n = 1) or cesarean scar pregnancy (n = 3) met inclusion criteria. Case #1 was treated with bipolar resectoscope, cases #2 and #3 with 5-mm Bettocchi hysteroscope, and case #4 with 3.5-mm Versascope hysteroscope. Cases #2-4 did not require cervical dilatation. Before hysteroscopic treatment, cases #2-4 underwent unsuccessful medical therapy with multiple-dose methotrexate. Hysteroscopic treatment success rate was 100%, while complication rate was 0%. All patients were treated with a novel technique: hysteroscopic intact removal of angular or cesarean scar pregnancies. Such technique was described step-by-step. CONCLUSIONS Hysteroscopic treatment of angular and cesarean scar pregnancies may be a safe and effective minimally invasive option. The novel technique of hysteroscopic intact removal technique may allow a markedly less invasive approach.
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Affiliation(s)
- Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy,
| | - Alessandra Battagliese
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria D'Armiento
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy
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Travaglino A, Raffone A, Gencarelli A, Saracinelli S, Riccardi C, Mollo A, Zullo F, Insabato L. Clinico-pathological features associated with mismatch repair deficiency in endometrial undifferentiated/dedifferentiated carcinoma: A systematic review and meta-analysis. Gynecol Oncol 2020; 160:579-585. [PMID: 33276986 DOI: 10.1016/j.ygyno.2020.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/14/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Endometrial undifferentiated/dedifferentiated carcinoma (UDC/DDC) is a recently described aggressive variant of endometrial carcinoma, which shows mismatch repair (MMR) deficiency in about half of cases. AIM To assess whether MMR-deficient UDC/DDC have distinct clinico-pathological features. MATERIALS AND METHODS A systematic review and meta-analysis was performed by searching 4 electronic databases from their inception to October 2020 for all studies reporting clinicopathological characteristics of UDC/DDC series. Student t-test (for continuous variables), Cox regression analysis (for overall survival) and odds ratio (OR, for dichotomous variables) were used with a significant p-value < 0.05; data were pooled by using a random effect model. RESULTS Twelve studies were included. MMR-deficiency was significantly associated with older age (p = 0.024), p53-wild-type (p = 0.005), ARID1A loss (p = 0.001) and PD-L1 expression (p = 0.019), but not with overall survival (p = 0.307), extension beyond corpus (p = 0.787) or beyond uterus (p = 0.403), presence of a differentiated component (p = 0.461), loss of expression of cytokeratins (p = 0.698), EMA (p = 0.309), estrogen receptor (p = 0.605), PAX8 (p = 0.959), SMARCA4/BRG1 (p = 0.321), SMARCB1/INI1 (p = 0.225) or claudin-4 (p = 0.094), or POLE exonuclease domain mutation p = (0.773). CONCLUSIONS In UDC/DDC, MMR-deficiency appears associated with older age, p53-wild type and ARID1A loss, suggesting the possibility of a distinct pathway underlying dedifferentiation; the association with PD-L1 expression is attributable to the high mutational load and may have therapeutic implications. On the other hand, MMR-deficiency appears not to be associated with prognosis, stage, loss of differentiation markers or POLE mutation.
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Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
| | - Annarita Gencarelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Serena Saracinelli
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Carla Riccardi
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
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Raffone A, Travaglino A, Zullo FM, Gencarelli A, Micheli M, Miranda S, De Franciscis P, Insabato L, Di Spiezio Sardo A, Zullo F, Bifulco G. Predictive Accuracy of Progesterone Receptor B in Young Women with Atypical Endometrial Hyperplasia and Early Endometrial Cancer Treated with Hysteroscopic Resection plus LNG-IUD Insertion. J Minim Invasive Gynecol 2020; 28:1244-1253. [PMID: 33122144 DOI: 10.1016/j.jmig.2020.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVE The immunohistochemical expression of isoform B of the progesterone receptor (PRB) has shown promising results in predicting the response of atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC) to conservative treatment. We aimed to calculate the accuracy of PRB as a predictive marker of conservative treatment outcome in AEH or EEC. DESIGN Retrospective cohort study. SETTING University of Naples Federico II, Naples, Italy. PATIENTS Thirty-six consecutive premenopausal women <45 years of age with AEH (n = 29) or EEC (n = 7) conservatively treated from January 2007 to June 2018 were retrospectively assessed. INTERVENTIONS All patients had been treated with hysteroscopic resection plus levonorgestrel-releasing intrauterine device insertion and followed for at least 1 year. The immunohistochemical expression of PRB was separately assessed in the glands and stroma of the lesion and dichotomized as "weak" or "normal." MEASUREMENT AND MAIN RESULTS The treatment outcomes considered were (1) treatment failure (i.e., a combined outcome including no regression or recurrence); (2) no regression; and (3) recurrence. The predictive accuracy of PRB immunohistochemistry was assessed by calculating sensitivity (SE), specificity (SP), and area under the receiver operating characteristic curve (AUC). A weak glandular PRB expression showed SE = 70%, SP = 77%, and AUC = 0.74 for treatment failure; SE = 66.7%, SP = 70%, and AUC = 0.68 for no regression; and SE = 75%, SP = 68.8%, and AUC = 0.72 for recurrence. A weak stromal PRB expression showed SE = 100%, SP = 53.8%, and AUC = 0.77 for treatment failure; SE = 100%, SP = 46.7%, and AUC = 0.73 for no regression; and SE = 100%, SP = 43.8%, and AUC = 0.72 for recurrence. CONCLUSION A weak stromal PRB expression is a highly sensitive predictive marker of both no response and recurrence of AEH and EEC conservatively treated.
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Affiliation(s)
- Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Antonio Travaglino
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy.
| | - Francesco Maria Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Annarita Gencarelli
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Mariacarolina Micheli
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Sergio Miranda
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Pasquale De Franciscis
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Luigi Insabato
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Attilio Di Spiezio Sardo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
| | - Giuseppe Bifulco
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences, and Dentistry (Drs. Raffone, Miranda, F. Zullo, and Bifulco); Department of Public Health (Dr. Sardo), Anatomic Pathology Unit; Department of Advanced Biomedical Sciences (Drs. Travaglino, Gencarelli, and Insabato), University of Naples Federico II, Obstetrics and Gynecology Unit; Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli (Drs. F.M. Zullo and Franciscis); Pathology Unit, Monaldi Hospital (Dr. Micheli), Naples, Italy
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49
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Travaglino A, Raffone A, Gencarelli A, Mollo A, Zullo F, Insabato L. Endometrial Gastric-type Carcinoma: An Aggressive and Morphologically Heterogenous New Histotype Arising From Gastric Metaplasia of the Endometrium. Am J Surg Pathol 2020; 44:1002-1004. [PMID: 32251008 DOI: 10.1097/pas.0000000000001474] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Antonio Raffone
- Gynecology and Obstetrics Unit Department of Neurosciences Reproductive Sciences and Dentistry University of Naples "Federico II" Naples, Italy
| | | | - Antonio Mollo
- Gynecology and Obstetrics Unit Department of Neurosciences Reproductive Sciences and Dentistry University of Naples "Federico II" Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit Department of Neurosciences Reproductive Sciences and Dentistry University of Naples "Federico II" Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences
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50
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Quercia V, Saccone G, Raffone A, Travaglino A, Favale M, D’Alessandro P, Arduino B, Carbone IF, Insabato L, Ribuffo D, Zullo F. Use of Negative Pressure Wound Therapy Systems after Radical Vulvectomy for Advanced Vulvar Cancer. Cancer Invest 2020; 38:531-534. [DOI: 10.1080/07357907.2020.1817484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Vittorio Quercia
- Department of Surgery Pietro Valdoni, Sapienza University of Rome, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Travaglino
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Mariano Favale
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Pietro D’Alessandro
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Bruno Arduino
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Luigi Insabato
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Diego Ribuffo
- Department of Surgery Pietro Valdoni, Sapienza University of Rome, Rome, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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