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Prencipe B, Delprete C, Garolla E, Corallo F, Gravina M, Natalicchio MI, Buongiorno D, Bevilacqua V, Altini N, Brunetti A. An Explainable Radiogenomic Framework to Predict Mutational Status of KRAS and EGFR in Lung Adenocarcinoma Patients. Bioengineering (Basel) 2023; 10:747. [PMID: 37508774 PMCID: PMC10376018 DOI: 10.3390/bioengineering10070747] [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: 06/05/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
The complex pathobiology of lung cancer, and its spread worldwide, has prompted research studies that combine radiomic and genomic approaches. Indeed, the early identification of genetic alterations and driver mutations affecting the tumor is fundamental for correctly formulating the prognosis and therapeutic response. In this work, we propose a radiogenomic workflow to detect the presence of KRAS and EGFR mutations using radiomic features extracted from computed tomography images of patients affected by lung adenocarcinoma. To this aim, we investigated several feature selection algorithms to identify the most significant and uncorrelated sets of radiomic features and different classification models to reveal the mutational status. Then, we employed the SHAP (SHapley Additive exPlanations) technique to increase the understanding of the contribution given by specific radiomic features to the identification of the investigated mutations. Two cohorts of patients with lung adenocarcinoma were used for the study. The first one, obtained from the Cancer Imaging Archive (TCIA), consisted of 60 cases (25% EGFR, 23% KRAS); the second one, provided by the Azienda Ospedaliero-Universitaria 'Ospedali Riuniti' of Foggia, was composed of 55 cases (16% EGFR, 28% KRAS). The best-performing models proposed in our study achieved an AUC of 0.69 and 0.82 on the validation set for predicting the mutational status of EGFR and KRAS, respectively. The Multi-layer Perceptron model emerged as the top-performing model for both oncogenes, in some cases outperforming the state of the art. This study showed that radiomic features can be associated with EGFR and KRAS mutational status in patients with lung adenocarcinoma.
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Affiliation(s)
- Berardino Prencipe
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
| | - Claudia Delprete
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
| | - Emilio Garolla
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Fabio Corallo
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Matteo Gravina
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Maria Iole Natalicchio
- Molecular Oncology and Pharmacogenomics Laboratory, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Domenico Buongiorno
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
- Apulian Bioengineering SRL, Via delle Violette 14, 70026 Modugno, Italy
| | - Vitoantonio Bevilacqua
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
- Apulian Bioengineering SRL, Via delle Violette 14, 70026 Modugno, Italy
| | - Nicola Altini
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
| | - Antonio Brunetti
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70126 Bari, Italy
- Apulian Bioengineering SRL, Via delle Violette 14, 70026 Modugno, Italy
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Loizzi V, Cicinelli E, Del Vecchio V, Arezzo F, Deromemaj X, Kardhashi A, Paradiso A, Legge F, Natalicchio MI, Resta L, Resta N, Loconte DC, Cormio G. A prospective multicentric study of risk-reducing salpingo-oophorectomy in BRCA mutation patients. Acta Biomed 2022; 93:e2022051. [PMID: 36043985 PMCID: PMC9534247 DOI: 10.23750/abm.v93i4.11695] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIM OF THE WORK BRCA1/2 are tumour-suppressor genes involved in DNA homologous recombination and ovarian cancer development. The study evaluated the risk of tumor cancer in women presenting the BRCA mutations. METHODS Risk-reducing surgery (RRS) was performed in 100 patients carrying BRCA1 (aged between 30-73 years, median age was 51 years) and BRCA 2 mutation (aged between 36-70 years, median age was 53 years). Fifty-eight patients had previous history of breast cancer. RESULTS Between the 100 patients, 82 women underwent risk-reducing salpingo-oophorectomy (RRSO) through a laparoscopic minimally invasive approach, 7 (7 %) underwent laparoscopic RRSO and contextual hysterectomy, 1 woman (1 %) underwent RRSO through a laparotomic approach and 10 women (10 %) laparotomic RRSO and hysterectomy. During 5 (5 %) laparoscopic RRSO, prophylactic bilateral mastectomy was also performed. Early and late complication occurred in 3 patients (3 %). Two patients (2 %) were found to have occult Serous Tubal Intraepithelial Carcinoma (STIC) and three patients (3 %) occult cancer. CONCLUSIONS RRSO is safe and feasible in BRCA mutation carriers. The procedure is effective for genetic prevention of ovarian cancer.
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Affiliation(s)
- Vera Loizzi
- Obstetrics and Gynecology Unit, Interdisciplinar Department of Medicine, University of Bari, Italy
| | - Ettore Cicinelli
- Obstetrics and Gynecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Vittoria Del Vecchio
- Obstetrics and Gynecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Francesca Arezzo
- Gynecology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Xheni Deromemaj
- Obstetrics and Gynecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Anila Kardhashi
- Gynecology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Angelo Paradiso
- Institutional BioBank, Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Francesco Legge
- Gynecologic Oncology Unit, General Regional Hospital “F. Miulli” of Acquaviva delle Fonti, Italy
| | | | | | - Nicoletta Resta
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Daria Carmela Loconte
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Gennaro Cormio
- Gynecology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Interdisciplinar Department of Medicine, University of Bari, Italy
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Patruno M, De Summa S, Resta N, Caputo M, Costanzo S, Digennaro M, Pilato B, Bagnulo R, Pantaleo A, Simone C, Natalicchio MI, De Matteis E, Tarantino P, Tommasi S, Paradiso A. Spectrum of Germline Pathogenic Variants in BRCA1/2 Genes in the Apulian Southern Italy Population: Geographic Distribution and Evidence for Targeted Genetic Testing. Cancers (Basel) 2021; 13:cancers13184714. [PMID: 34572941 PMCID: PMC8467705 DOI: 10.3390/cancers13184714] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 01/02/2023] Open
Abstract
Simple Summary BRCA1 and BRCA2 are two major high-penetrance breast/ovarian cancer predisposition genes, whose mutations can lead to high risk and early onset of breast and ovarian cancer. Numerous studies are focused on spectrum and prevalence of BRCA1/2 mutations worldwide. This is the first study that exclusively focused on native Apulian probands. We found that ten recurrent BRCA1/2 pathogenic variants account for more than half of the patients with proven HBOC syndrome from Apulia. Besides BRCA1 c.5266dupC, which is present in significant numbers in every Apulian province, the other PVs occur at a high frequency in some areas and not others. In-depth knowledge of the mutation spectrum of the target population and of the relatively small number of recurrent mutations is crucial to develop a specific cost-effective strategy for mutation screening and a program for breast–ovarian cancer control and prevention through more liberal, yet rational, genetic testing and counseling. Abstract BRCA1/2-associated hereditary breast and ovarian cancer is the most common form of hereditary breast and ovarian cancer and occurs in all ethnicities and racial populations. Different BRCA1/BRCA2 pathogenic variants (PVs) have been reported with a wide variety among populations. In this study, we retrospectively analyzed prevalence and geographic distribution of pathogenic germline BRCA1/2 variants in families from Apulia in southern Italy and evaluated the genotype–phenotype correlations. Data were collected from Oncogenetic Services present in Apulian hospitals and a shared database was built containing Apulian native probands (n = 2026) that had undergone genetic testing from 2004 to 2019. PVs were detected in 499 of 2026 (24.6%) probands and 68.5% of them (342 of 499) were in the BRCA1 gene. We found 65 different PVs in BRCA1 and 46 in BRCA2. There were 10 most recurrent PVs and their geographical distribution appears to be significantly specific for each province. We have assumed that these PVs are related to the historical and geopolitical changes that occurred in Apulia over time and/or to a “founder effect”. Broader knowledge of BRCA1/2 prevalence and recurring PVs in specific geographic areas could help establish more flexible genetic testing strategies that may enhance our ability to detect high-risk subjects.
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Affiliation(s)
- Margherita Patruno
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
- Correspondence: (M.P.); (S.D.S.)
| | - Simona De Summa
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
- Correspondence: (M.P.); (S.D.S.)
| | - Nicoletta Resta
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Mariapia Caputo
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Silvia Costanzo
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
| | - Maria Digennaro
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
| | - Brunella Pilato
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Rosanna Bagnulo
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Antonino Pantaleo
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Cristiano Simone
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
- Medical Genetics, National Institute of Gastroenterology “S. de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | | | | | - Paolo Tarantino
- Medical Genetics Unit, “Vito Fazzi” Hospital, 73100 Lecce, Italy;
| | - Stefania Tommasi
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Angelo Paradiso
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
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La Rocca F, Grieco V, Ruggieri V, Zifarone E, Villani O, Zoppoli P, Russi S, Laurino S, Falco G, Calice G, Marinaccio A, Natalicchio MI, Albano F, Musto P. Superiority of Droplet Digital PCR Over Real-Time Quantitative PCR for JAK2 V617F Allele Mutational Burden Assessment in Myeloproliferative Neoplasms: A Retrospective Study. Diagnostics (Basel) 2020; 10:diagnostics10030143. [PMID: 32150880 PMCID: PMC7151190 DOI: 10.3390/diagnostics10030143] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/11/2022] Open
Abstract
JAK2V617F mutational status is an essential diagnostic index in myeloproliferative neoplasms (MPNs). Although widely used for detection of JAK2 V617F mutation in peripheral blood (PB), sensitive real-time quantitative PCR (qPCR) presents some methodological limitations. Recently, emerging alternative technologies, like digital droplet PCR (ddPCR), have been reported to overcome some of qPCR’s technical drawbacks. The purpose of this study was to compare the diagnostic utility of ddPCR to qPCR for JAK2 V617F detection and quantification in samples from MPNs patients. Sensitivity and specificity of qPCR and ddPCR in the detection of the mutation were assessed by using a calibrator panel of mutated DNA on 195 JAK2 positive MPN samples. Based on our results, ddPCR proved to be a suitable, precise, and sensitive method for detection and quantification of the JAK2 V617F mutation.
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Affiliation(s)
- Francesco La Rocca
- Laboratory of Clinical Research and Advanced Diagnostics, IRCCS-CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture (Pz), Italy; (F.L.R.); (V.G.)
| | - Vitina Grieco
- Laboratory of Clinical Research and Advanced Diagnostics, IRCCS-CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture (Pz), Italy; (F.L.R.); (V.G.)
| | - Vitalba Ruggieri
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata (CROB); 85028 Rionero in Vulture (Pz), Italy; (P.Z.); (S.R.); (S.L.); (G.C.)
- Correspondence:
| | - Emanuela Zifarone
- Trial Office, IRCCS-CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture (Pz), Italy;
| | - Oreste Villani
- Hematology and Stem Cell Transplantation Unit, IRCCS-CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture (Pz), Italy;
| | - Pietro Zoppoli
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata (CROB); 85028 Rionero in Vulture (Pz), Italy; (P.Z.); (S.R.); (S.L.); (G.C.)
| | - Sabino Russi
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata (CROB); 85028 Rionero in Vulture (Pz), Italy; (P.Z.); (S.R.); (S.L.); (G.C.)
| | - Simona Laurino
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata (CROB); 85028 Rionero in Vulture (Pz), Italy; (P.Z.); (S.R.); (S.L.); (G.C.)
| | - Geppino Falco
- Department of Biology, University of Naples Federico II, 80138 Naples, Italy;
- Biogem, Istituto di Biologia e Genetica Molecolare, Via Camporeale, 83031 Ariano Irpino (AV), Italy
| | - Giovanni Calice
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata (CROB); 85028 Rionero in Vulture (Pz), Italy; (P.Z.); (S.R.); (S.L.); (G.C.)
| | - Anna Marinaccio
- Section of Clinic Pathology, OO.RR., 71122 Foggia, Italy; (A.M.); (M.I.N.)
| | | | - Francesco Albano
- Unit of Hematology and Stem Cell Transplantation, AOU Policlinico Consorziale “Giovanni XXIII”, “Aldo Moro” University, 70124 Bari, Italy; (F.A.); (P.M.)
| | - Pellegrino Musto
- Unit of Hematology and Stem Cell Transplantation, AOU Policlinico Consorziale “Giovanni XXIII”, “Aldo Moro” University, 70124 Bari, Italy; (F.A.); (P.M.)
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Lepore S, Lettini G, Condelli V, Sisinni L, Piscazzi A, Simeon V, Zoppoli P, Pedicillo MC, Natalicchio MI, Pietrafesa M, Landriscina M. Comparative Gene Expression Profiling of Tobacco-Associated HPV-Positive versus Negative Oral Squamous Carcinoma Cell Lines. Int J Med Sci 2020; 17:112-124. [PMID: 31929745 PMCID: PMC6945558 DOI: 10.7150/ijms.35133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 11/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background: HPV-positive oral squamous cell carcinomas (OSCCs) are specific biological and clinical entities, characterized by a more favorable prognosis compared to HPV-negative OSCCs and occurring generally in non-smoking and non-drinking younger individuals. However, poor information is available on the molecular and the clinical behavior of HPV-positive oral cancers occurring in smoking/drinking subjects. Thus, this study was designed to compare, at molecular level, two OSCC cell lines, both derived from drinking and smoking individuals and differing for presence/absence of HPV infection. Methods: HPV-negative UPCI-SCC-131 and HPV16-positive UPCI-SCC-154 cell lines were compared by whole genome gene expression profiling and subsequently studied for activation of Wnt/βCatenin signaling pathway by the expression of several Wnt-target genes, βCatenin intracellular localization, stem cell features and miRNA let-7e. Gene expression data were validated in head and neck squamous cell carcinoma (HNSCC) public datasets. Results: Gene expression analysis identified Wnt/βCatenin pathway as the unique signaling pathway more active in HPV-negative compared to HPV-positive OSCC cells and this observation was confirmed upon evaluation of several Wnt-target genes (i.e., Cyclin D1, Cdh1, Cdkn2a, Cd44, Axin2, c-Myc and Tcf1). Interestingly, HPV-negative OSCC cells showed higher levels of total βCatenin and its active form, increase of its nuclear accumulation and more prominent stem cell traits. Furthermore, miRNA let-7e was identified as potential upstream regulator responsible for the downregulation of Wnt/βCatenin signaling cascade since its silencing in UPCI-SCC-154 cell resulted in upregulation of Wnt-target genes. Finally, the analysis of two independent gene expression public datasets of human HNSCC cell lines and tumors confirmed that Wnt/βCatenin pathway is more active in HPV-negative compared to HPV-positive tumors derived from individuals with smoking habit. Conclusions: These data suggest that lack of HPV infection is associated with more prominent activation of Wnt/βCatenin signaling pathway and gain of stem-like traits in tobacco-related OSCCs.
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Affiliation(s)
- Silvia Lepore
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Giacomo Lettini
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Valentina Condelli
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Lorenza Sisinni
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Annamaria Piscazzi
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Vittorio Simeon
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
- Medical Statistics Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pietro Zoppoli
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Maria Carmela Pedicillo
- Anatomic Pathology Unit, Department of Clinic and Experimental Medicine; University of Foggia, Italy
| | | | - Michele Pietrafesa
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Matteo Landriscina
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
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De Falco V, Natalicchio MI, Napolitano S, Coppola N, Conzo G, Martinelli E, Zanaletti N, Vitale P, Giunta EF, Vietri MT, Vitiello PP, Ciardiello D, Marinaccio A, De Vita F, Ciardiello F, Troiani T. A case report of a severe fluoropyrimidine-related toxicity due to an uncommon DPYD variant. Medicine (Baltimore) 2019; 98:e15759. [PMID: 31124962 PMCID: PMC6571425 DOI: 10.1097/md.0000000000015759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION Fluoropyrimidines such as 5-fluorouracil (5-FU) and its orally active prodrug, capecitabine, are widely used in the treatment of gastrointestinal cancer, including colorectal cancer. Dihydropyrimidine dehydrogenase (DPD) plays an important role in the 5-FU metabolism. Dihydropyrimidine dehydrogenase gene (DPYD) is a highly polymorphic gene with several hundreds of reported genetic variants and DPD activity levels vary considerably among individuals, with different 5-FU-related efficacy and toxicity. About 5% of the population is deficient in DPD enzyme activity. The most well studied DPYD variant is the IVS14+1G>A, also known as DPYD *2A. In this report, we present a case of a patient with a double heterozygote DPYD variant (DPYD activity score: 0,5 according to Clinical Pharmacogenetics Implementation Consortium) who experienced a severe fluoropyrimidine-related toxicity resolved without any consequence. PATIENT CONCERNS A 46-years-old Caucasian man with diagnosis of left colon adenocarcinoma underwent left hemicolectomy on July 2017: pT3 G3 N1c M0. According to the disease stage, he started an adjuvant therapy with XELOX using capecitabine at 50% of total dose, because of his DPYD IVS14+1G>A variant, detected before the treatment. DIAGNOSIS After few days, despite of this dose reduction, he experienced life-threatening adverse events such as mucositis G3, diarrhea G3, neutropenia G4, thrombocytopenia G4, and hyperbilirubinemia G3 according to Common Terminology Criteria for Adverse Events v 5.0. INTERVENTIONS As first, we set up an intensive rehydration therapy, antibiotic and antifungal prophylaxis, Granulocyte-Colony Stimulating Factors, and supportive blood transfusions. Additional genetic tests revealed a double heterozygote variant of DPYD gene (DPYD IVS14+1G>A and 2846A>T) which is a very rare situation and only 3 cases are described in literature, all of them concluded with patient's death. OUTCOMES After 3 weeks of intensive therapy, the patient was fully recovered. Furthermore, all the whole-body CT scans performed since discharge from the hospital until now, have confirmed no evidence of disease. CONCLUSIONS Recent studies demonstrated that screening strategy for the most common DPYD variants allowed for avoiding toxicities and saving money. This report underlines the importance of genotyping DPYD before treatment and emphasizes the role of genotype-guided dose individualization.
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Affiliation(s)
- Vincenzo De Falco
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | | | - Stefania Napolitano
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nicola Coppola
- Malattie Infettive, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania Luigi Vanvitelli
| | - Giovanni Conzo
- UOC di Chirurgia Generale ed Oncologica, Università degli Studi della Campania Luigi Vanvitelli
| | - Erika Martinelli
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Nicoletta Zanaletti
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Pasquale Vitale
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Emilio Francesco Giunta
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Maria Teresa Vietri
- UOC Patologia clinica e molecolare, Dipartimento di Medicina di Precisione, DAI dei Sevizi di laboratorio e Sanità pubblica, Università degli Studi della Campania Luigi Vanvitelli, Complesso di S. Andrea delle Dame, Napoli, Italia
| | - Pietro Paolo Vitiello
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Davide Ciardiello
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Anna Marinaccio
- Laboratorio di Biologia Molecolare, Ospedale Riuniti, Foggia, Italia
| | - Ferdinando De Vita
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
| | - Teresa Troiani
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli
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Guida M, Tommasi S, Strippoli S, Natalicchio MI, De Summa S, Pinto R, Cramarossa A, Albano A, Pisconti S, Aieta M, Ridolfi R, Azzariti A, Guida G, Lorusso V, Colucci G. The search for a melanoma-tailored chemotherapy in the new era of personalized therapy: a phase II study of chemo-modulating temozolomide followed by fotemustine and a cooperative study of GOIM (Gruppo Oncologico Italia Meridionale). BMC Cancer 2018; 18:552. [PMID: 29747595 PMCID: PMC5946485 DOI: 10.1186/s12885-018-4479-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 05/02/2018] [Indexed: 01/05/2023] Open
Abstract
Background It is frequently asked whether chemotherapy can still play a role in metastatic melanoma considering the effectiveness of the available drugs today, including antiCTLA4/antiPD1 immunotherapy and antiBRAF/antiMEK inhibitors. However, only approximately half of patients respond to these drugs, and the majority progress after 6–11 months. Therefore, a need for other therapeutic options is still very much apparent. We report the first large trial of a sequential full dose of fotemustine (FM) preceded by a low dose of temozolomide (TMZ) as a chemo-modulator in order to inactivate the DNA repair action of O(6)-methylguanine DNA-methyltransferase (MGMT). Primary endpoints were overall response and safety. We also evaluated specific biological parameters aiming to tailor these chemotherapies to selected patients. Methods A total of 69 consecutive patients were enrolled. The main features included a median age of 60 years (21–81) and M1c stage, observed in 74% of the patients, with brain metastases in 15% and high LDH levels in 42% of the patients. The following schedule was used: oral TMZ 100 mg/m2 on days 1 and 2 and FM iv 100 mg/m2 on day 2, 4 h after TMZ; A translational study aiming to analyse MGMT methylation status and base-excision repair (BER) gene expression was performed in a subset of 14 patients. Results We reported an overall response rate of 30.3% with 3 complete responses and a disease control rate of 50.5%. The related toxicity rate was low and mainly of haematological types. Although our population had a very poor prognosis, we observed a PFS of 6 months and an OS of 10 months. A non-significant correlation with response was found with the mean expression level of the three genes involved in the BER pathway (APE1, XRCC1 and PARP1), whereas no association was found with MGMT methylation status. Conclusion This schedule could represent a good alternative for patients who are not eligible for immune or targeted therapy or whose previous therapies have failed. Trial registration EUDRACT 2009–016487-36l; date of registration 23 June 2010. Electronic supplementary material The online version of this article (10.1186/s12885-018-4479-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michele Guida
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy.
| | - Stefania Tommasi
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Sabino Strippoli
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Maria Iole Natalicchio
- Laboratory of Molecular Oncology of Solid Tumors and Pharmacogenomics, Ospedali Riuniti, Viale Pinto, 1, 71122, Foggia, Italy
| | - Simona De Summa
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Rosamaria Pinto
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Antonio Cramarossa
- Radiology Department, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Anna Albano
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Salvatore Pisconti
- Medical Oncology Department, San Giuseppe Moscati Hospital, Via per Martina Franca, 74010, Statte, Taranto, Italy
| | - Michele Aieta
- Medical Oncology Department, National Institute of Cancer, Via Padre Pio, 1. 85028 Rionero in Vulture, Potenza, Italy
| | - Ruggiero Ridolfi
- Medical Oncology Department, National Cancer Institute of Romagna (IRST), Via Piero Maroncelli, 40. 47014 Meldola, Forlì, Italy
| | - Amalia Azzariti
- Clinical and Preclinical Pharmacology Laboratory, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Gabriella Guida
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Piazza Giulio Cesare, 1, 70124, Bari, Italy
| | - Vito Lorusso
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Giusepe Colucci
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
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8
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Loizzi V, Cicinelli E, Santamaria F, Murgia F, Minicucci V, Resta L, Resta N, Natalicchio MI, Ranieri G, Cormio G. BRCAmut and "founder effect": a prospective study in a single academic institution. Oncotarget 2018; 9:22353-22358. [PMID: 29854283 PMCID: PMC5976469 DOI: 10.18632/oncotarget.24959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/27/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction About 25% of ovarian cancers can be classified as hereditary. Of these, 80–90% are correleted with the Hereditary Breast–Ovarian Cancer Syndrome (HBOC), which is linked to BRCA 1/2 genes mutations. Our study was set up to study the BRCA-mutation incidence in Apulian population affected with ovarian cancer and to understand the characteristics of the ovarian disease BRCAmut-related. Results One hundred and five Apulian patients affected by ovarian cancer with serous high grade histotype, were collected. Of these, 39% were carriers of BRCA 1/2 mutation. BRCAmut patients present a lower median age of onset, a lower percentage of neoplasms in advanced stages and a lower mortality than wild type patients; BRCA-mutated patients have longer mean values of Progression Free Survival (PFS) and Overall Survival (OS). Conclusions Apulia is a geographical area with a significant BRCA-mutation incidence variation in the population affected by ovarian cancer. BRCAmut-related ovarian disease is characterized by an earlier median age of onset, an earlier diagnosis and a better outcome than the sporadic disease. Materials and Methods From July 2015 to October 2017, all ovarian cancer patients with serous high grade histotype referred to our Institution were prospectly collected. A BRCA-mutation genetic testing after counselling was offered to all of these patients. Clinical characteristics of all ovarian cancer patients were evaluated. Survival curves were estimated by Kaplan-Meier method and compared with log-rank test.
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Affiliation(s)
- Vera Loizzi
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Ettore Cicinelli
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Francesco Santamaria
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Ferdinando Murgia
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Valentina Minicucci
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Leonardo Resta
- Department of Pathology, University of Bari, Bari, Italy
| | - Nicoletta Resta
- Department of Biomedical Science and Human Oncology, Genetic Unit, University of Bari, Bari, Italy
| | | | - Girolamo Ranieri
- Interventional and Medical Oncology Unit, National Cancer Research Center, IRCCS Istituto, Oncologico "Giovanni Paolo II", Bari, Italy
| | - Gennaro Cormio
- Obstetrics and Gynecology Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.,Gynecologic Oncology Unit, IRCCS Istituto Oncologico "Giovanni Paolo II", Bari, Italy
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9
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Lazzari G, Natalicchio MI, Terlizzi A, Perri F, Silvano G. Single nucleotide polymorphisms and unacceptable late toxicity in breast cancer adjuvant radiotherapy: a case report. Breast Cancer (Dove Med Press) 2017; 9:401-406. [PMID: 28615972 PMCID: PMC5459975 DOI: 10.2147/bctt.s136048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background There has recently been a strong interest in the inter-individual variation in normal tissue and tumor response to radiotherapy (RT), because tissue radiosensitivity seems to be under genetic control. Evidence is accumulating on the role of polymorphic genetic variants, such as single nucleotide polymorphisms (SNPs) that could influence normal tissue response after radiation. The most studied SNPs include those in genes involved in DNA repair (single- and double-strand breaks, and base excision) and those active in the response to oxidative stress. Case report We present the case report of a 60-year-old woman with early breast cancer who underwent adjuvant hormone therapy and conventional radiotherapy, and subsequently developed unacceptable cosmetic toxicities of the irradiated breast requiring a genetic test of genes involved in DNA repair mechanisms. The patient was found to be heterozygous for G28152A (T/C) and C18067T (A/G) mutations in X-ray repair cross-complementing group 1 (XRCC1) and 3 (XRCC3), respectively, homozygous for A313G (G/G) mutation in glutathione S transferase Pi 1 (GSTP1), and wild-type for A4541G (A/A) in XRCC3 and G135C (G/G) in RAD51 recombinase. Conclusion The role of SNPs should be taken into account when a severe phenomenon appears in normal tissues after radiation treatment, because understanding the molecular basis of individual radiosensitivity may be useful for identifying moderately or extremely radiosensitive patients who may need tailored therapeutic strategies.
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Affiliation(s)
- Grazia Lazzari
- Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto
| | | | | | - Francesco Perri
- Medical Oncology Unit, Presidio Ospedaliero Centrale-Santissima Annunziata, Taranto, Italy
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Di Filippo F, Di Filippo S, Ferrari AM, Antonetti R, Battaglia A, Becherini F, Bernet L, Boldorini R, Bouteille C, Buglioni S, Burelli P, Cano R, Canzonieri V, Chiodera P, Cirilli A, Coppola L, Drago S, Di Tommaso L, Fenaroli P, Franchini R, Gianatti A, Giannarelli D, Giardina C, Godey F, Grassi MM, Grassi GB, Laws S, Massarut S, Naccarato G, Natalicchio MI, Orefice S, Palmieri F, Perin T, Roncella M, Roncalli MG, Rulli A, Sidoni A, Tinterri C, Truglia MC, Sperduti I. Erratum to: Elaboration of a nomogram to predict nonsentinel node status in breast cancer patients with positive sentinel node, intraoperatively assessed with one step nucleic amplification: Retrospective and validation phase. J Exp Clin Cancer Res 2017; 36:69. [PMID: 28511715 PMCID: PMC5434518 DOI: 10.1186/s13046-017-0540-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/10/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Franco Di Filippo
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | | | | | | | | | | | | | | | | | - Simonetta Buglioni
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | | | - Rafael Cano
- Hospital Universitario de La Ribera, Alzira, Spain
| | | | | | | | | | | | | | | | - Roberto Franchini
- Azienda Ospedaliera "Maggiore della Carità" di Novara, Novara, Italy
| | | | - Diana Giannarelli
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | | | | | | | | | - Siobhan Laws
- Hampshire Hospitals NHS Foundation Trust, England, UK
| | - Samuele Massarut
- Centro di Riferimento Oncologico NCI IRCCS - Aviano, Bari, Italy
| | | | | | | | | | - Tiziana Perin
- Centro di Riferimento Oncologico NCI IRCCS - Aviano, Bari, Italy
| | | | | | | | | | | | | | - Isabella Sperduti
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
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11
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Di Filippo F, Di Filippo S, Ferrari AM, Antonetti R, Battaglia A, Becherini F, Bernet L, Boldorini R, Bouteille C, Buglioni S, Burelli P, Cano R, Canzonieri V, Chiodera P, Cirilli A, Coppola L, Drago S, Di Tommaso L, Fenaroli P, Franchini R, Gianatti A, Giannarelli D, Giardina C, Godey F, Grassi MM, Grassi GB, Laws S, Massarut S, Naccarato G, Natalicchio MI, Orefice S, Palmieri F, Perin T, Roncella M, Roncalli MG, Rulli A, Sidoni A, Tinterri C, Truglia MC, Sperduti I. Elaboration of a nomogram to predict nonsentinel node status in breast cancer patients with positive sentinel node, intraoperatively assessed with one step nucleic amplification: Retrospective and validation phase. J Exp Clin Cancer Res 2016; 35:193. [PMID: 27931238 PMCID: PMC5146809 DOI: 10.1186/s13046-016-0460-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/19/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Tumor-positive sentinel lymph node (SLN) biopsy results in a risk of non sentinel node metastases in micro- and macro-metastases ranging from 20 to 50%, respectively. Therefore, most patients underwent unnecessary axillary lymph node dissections. We have previously developed a mathematical model for predicting patient-specific risk of non sentinel node (NSN) metastases based on 2460 patients. The study reports the results of the validation phase where a total of 1945 patients were enrolled, aimed at identifying a tool that gives the possibility to the surgeon to choose intraoperatively whether to perform or not axillary lymph node dissection (ALND). METHODS The following parameters were recorded: Clinical: hospital, age, medical record number; Bio pathological: Tumor (T) size stratified in quartiles, grading (G), histologic type, lymphatic/vascular invasion (LVI), ER-PR status, Ki 67, molecular classification (Luminal A, Luminal B, HER-2 Like, Triple negative); Sentinel and non-sentinel node related: Number of NSNs removed, number of positive NSNs, cytokeratin 19 (CK19) mRNA copy number of positive sentinel nodes stratified in quartiles. A total of 1945 patients were included in the database. All patient data were provided by the authors of this paper. RESULTS The discrimination of the model quantified with the area under the receiver operating characteristics (ROC) curve (AUC), was 0.65 and 0.71 in the validation and retrospective phase, respectively. The calibration determines the distance between predicted outcome and actual outcome. The mean difference between predicted/observed was 2.3 and 6.3% in the retrospective and in the validation phase, respectively. The two values are quite similar and as a result we can conclude that the nomogram effectiveness was validated. Moreover, the ROC curve identified in the risk category of 31% of positive NSNs, the best compromise between false negative and positive rates i.e. when ALND is unnecessary (<31%) or recommended (>31%). CONCLUSIONS The results of the study confirm that OSNA nomogram may help surgeons make an intraoperative decision on whether to perform ALND or not in case of positive sentinel nodes, and the patient to accept this decision based on a reliable estimation on the true percentage of NSN involvement. The use of this nomogram achieves two main gools: 1) the choice of the right treatment during the operation, 2) to avoid for the patient a second surgery procedure.
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Affiliation(s)
- Franco Di Filippo
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | | | | | | | | | | | | | | | | | - Simonetta Buglioni
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | | | - Rafael Cano
- Hospital Universitario de La Ribera, Alzira, Spain
| | | | | | | | | | | | | | | | - Roberto Franchini
- Azienda Ospedaliera “Maggiore della Carità” di Novara, Novara, Italy
| | | | - Diana Giannarelli
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | | | | | | | | | - Siobhan Laws
- Hampshire Hospitals NHS Foundation Trust, England, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | - Isabella Sperduti
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
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12
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Carpagnano GE, Lacedonia D, Natalicchio MI, Cotugno G, Zoppo L, Martinelli D, Antonetti R, Foschino-Barbaro MP. Viral colonization in exhaled breath condensate of lung cancer patients: Possible role of EBV and CMV. Clin Respir J 2016; 12:418-424. [PMID: 27421948 DOI: 10.1111/crj.12531] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/25/2016] [Accepted: 06/24/2016] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Today, an increasing interest is being addressed to the viral etiology of lung tumors. As a consequence, research efforts are currently being directed to the identification of the new viruses involved in lung carcinogenesis toward which the screening programs could be directed. OBJECTIVES The aim of this study was to investigate the airways colonization by the Epstein-Barr virus (EBV) and Citomegalovirus (CMV) in patients affected by lung cancer using, as a respiratory non-invasive sample, the exhaled breath condensate (EBC). METHODS About 70 lung-cancer patients and 40 controls were enrolled. All subjects underwent bronchial brushing and EBC collection. EBV-DNA and CMV-DNA were evaluated in both samples by real-time PCR assay. RESULTS They were able to detect EBV and CMV in the EBC. An increase of the EBV positivity in non-small cell lung cancer (NSCLC) patients compared with controls and of the CMV in advanced stages of lung cancer were observed. The association of the positivity of the cytology and the CMV test (in EBC or brushing) slightly increased the sensitivity of malignant diagnosis. CONCLUSION EBV and CMV resulted detectable in the EBC. In consideration of the potential involvement of these viruses in lung cancer, which was confirmed in this study, future studies in this direction were supported.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Donato Lacedonia
- Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Grazia Cotugno
- Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Luigi Zoppo
- Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Domenico Martinelli
- Department of Medical Sciences, Section of Hygiene, University of Foggia, Apulia Regional Epidemiological Observatory, Foggia, Italy
| | | | - Maria Pia Foschino-Barbaro
- Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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13
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Santoro A, Pannone G, Ninivaggi R, Petruzzi M, Santarelli A, Russo GM, Lepore S, Pietrafesa M, Laurenzana I, Leonardi R, Bucci P, Natalicchio MI, Lucchese A, Papagerakis S, Bufo P. Relationship between CK19 expression, deregulation of normal keratinocyte differentiation pattern and high risk-human papilloma virus infection in oral and oropharyngeal squamous cell carcinoma. Infect Agent Cancer 2015; 10:46. [PMID: 26672675 PMCID: PMC4678638 DOI: 10.1186/s13027-015-0041-x] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/02/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Simple epithelial keratins appear early during embryonic development and are expressed in non-stratified, ductal and pseudo-stratified epithelial tissues. CK19, the lowest molecular weight keratin, is also expressed in basal layer of squamous epithelia of mucosal surfaces. Previous studies have shown that High Risk-Human Papilloma Virus (HR-HPV) epithelial infection induces cell immortalization via E6 and E7 viral proteins and this, in turn, impairs cytokeratin expression in cancerous cells lines derived from uterine cervix. Here, we demonstrate the possible relationship between HR-HPV(+) oral/oropharyngeal cancer and the high levels of CK19 expression. METHODS We analyzed 38 cases of Oral Squamous Cell Carcinomas/ Oro-Pharyngeal Squamous Cell Carcinomas (OSCCs/OPSCCs) by Immunohistochemistry (IHC) using specific antibody (Ab) detecting CK19, by In Situ Hybridization (ISH) and Polymerase Chain Reaction (PCR) based methods in order to define the HPV infectious status. We also evaluated the variation of CK19 expression in UPCI-SCC-131 (HPV(-)) and UPCI-SCC-154 (HPV(+)) cell lines by immunocytochemistry (ICC) and flow cytometry. RESULTS CK19 OSCC/OPSCC score has been identified multiplying percentage of cancer expressing cells to staining intensity. CK19 expression score in OSCCs/OPSCCs was very different between HPV(+) (mean: 288.0 ± 24.3) and HPV(-) cancers (mean: 66.2 ± 96.9). This difference was statistically significant (p < 0.001) with a strong evidence of correlation (p < 0.001; Spearman's R: +0.72). ROC curve analysis was performed on CK19 expression index related to HPV positivity. Heterogeneous areas of immunoreactivity varying in percentage value, intensity and/or localization were observed in normal epithelium, both perilesional and distant from the tumor with important differences between HR-HPV(+) and HR-HPV(-) carcinomas. By ICC and flow cytometry, the two analyzed cell lines were both CK19 positive but showed a different level of expression, in particular it should be noted that the UPCI-SCC-154 (HPV(+)) cell line had a higher expression than UPCI-SCC-131 (HPV(-)). CONCLUSIONS In this study we demonstrated, for the first time, strong association between CK19 up-regulation and HR-HPV(+) OSCCs/OPSCCs. This test has a good accuracy. We identified ROC curve with a cut-off > 195 for HR-HPV positive results (Sensitivity: 92.3 %; Specificity: 89.3 %). Furthermore, in OSCC/OPSCC, the CK19 test may be useful in identifying HR-HPV infection, the latter being related to HPV E7 potential to disrupt normal cytokeratin expression pattern.
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Affiliation(s)
- Angela Santoro
- Department of Laboratory and Services, Institute of Histopathology and Diagnostic Cytopathology, Fondazione di Ricerca e Cura 'Giovanni Paolo II'-UCSC, Largo Agostino Gemelli, 1, Campobasso, Italy
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, Institute of Pathological Anatomy, University of Foggia, Foggia, Italy
| | - Rossella Ninivaggi
- Department of Odontostomatology and Surgery, University of Bari, Bari, Italy
| | - Massimo Petruzzi
- Department of Odontostomatology and Surgery, University of Bari, Bari, Italy
| | - Andrea Santarelli
- Department of Clinic Specialistic and Stomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giuseppe Maria Russo
- Department of Clinical and Experimental Medicine, Institute of Pathological Anatomy, University of Foggia, Foggia, Italy
| | - Silvia Lepore
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Oncological Reference Centre of Basilicata, Rionero in Vulture, Italy
| | - Michele Pietrafesa
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Oncological Reference Centre of Basilicata, Rionero in Vulture, Italy
| | - Ilaria Laurenzana
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Oncological Reference Centre of Basilicata, Rionero in Vulture, Italy
| | - Rosalia Leonardi
- Department Medical-Surgical Specialties, Section of Oral Medicine, Policlinico, University of Catania, Catania, Italy
| | - Paolo Bucci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Institute of Oral Pathology, University of Napoli 'Federico II', Naples, Italy
| | | | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties - Second University of Napoli (SUN), Naples, Italy
| | - Silvana Papagerakis
- Department of Otolaryngology - Head and Neck Oncology, University of Michigan, 500 S State St, Ann Arbor, MI 48109 USA
| | - Pantaleo Bufo
- Department of Clinical and Experimental Medicine, Institute of Pathological Anatomy, University of Foggia, Foggia, Italy
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14
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Landriscina M, Natalicchio MI, Lamacchia O, Conserva A, Piscazzi A, Ciampolillo A, Zingrillo M, Pennella A, Bufo P, Vita G, Antonetti R, Maiorano E, Giorgino F, Cignarelli M. RAS/ BRAF mutational status in familial non-medullary thyroid carcinomas: A retrospective study. Oncol Lett 2015; 10:1875-1881. [PMID: 26622768 DOI: 10.3892/ol.2015.3386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/22/2014] [Accepted: 05/20/2015] [Indexed: 12/14/2022] Open
Abstract
There are contrasting views on whether familial non-medullary thyroid carcinomas (FNMTCs) are characterized by aggressive behavior, and limited evidence exists on the prognostic value of BRAF and RAS mutations in these tumors. Thus, in the present study, clinicopathological features were analyzed in 386 non-medullary thyroid carcinomas (NMTCs), subdivided in 82 familial and 304 sporadic cases. Furthermore, the RAS and BRAF mutational statuses were investigated in a subgroup of 34 FNMTCs to address their clinical and biological significance. The results demonstrated that, compared with sporadic NMTCs, FNMTCs are characterized by significantly higher rates of multicentricity and bilaterality and are more frequently associated with chronic autoimmune thyroiditis. Notably, a statistically significant difference in the rates of multicentricity was observed by subgrouping familial tumors according to the number of relatives involved; those with ≥3 affected relatives were more likely to be multicentric. Furthermore, the FNMTC cohort exhibited higher rates of tumors >4 cm in size with extrathyroidal or lymph node involvement. However, no significant difference was observed. Similarly, no differences were observed with respect to the age of onset or the patient outcome. The mutational profiling exhibited a rate of 58.8% for BRAF V600E mutations in familial tumors, which is at the upper limit of the mutational frequency observed in historical series of sporadic thyroid cancer. A high rate of NRAS mutations (17.6%) was also observed, mostly in the follicular variant histotype. Notably, compared with BRAF/RAS-wild type FNMTCs, the familial carcinomas bearing BRAF or NRAS mutations exhibited slightly higher rates of bilaterality and multicentricity, in addition to increased frequency of locally advanced stage or lymph node involvement. The present data support the theory that FNMTCs are characterized by clinicopathological features that resemble a more aggressive phenotype and suggest that RAS/BRAF mutational analysis deserves to be further evaluated as a tool for the identification of FNMTCs with a potentially unfavorable prognosis.
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Affiliation(s)
- Matteo Landriscina
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Foggia I-71100, Italy
| | | | - Olga Lamacchia
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Foggia I-71100, Italy
| | - Antonella Conserva
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Foggia I-71100, Italy
| | - Annamaria Piscazzi
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Foggia I-71100, Italy
| | - Anna Ciampolillo
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Bari I-70124, Italy
| | | | - Antonio Pennella
- Pathology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Foggia I-71100, Italy
| | - Pantaleo Bufo
- Pathology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Foggia I-71100, Italy
| | - Giulia Vita
- Pathology Unit, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Potenza I-85028, Italy
| | - Raffaele Antonetti
- Molecular Biology Laboratory, Riuniti Hospital, Foggia, Foggia I-71100, Italy
| | - Eugenio Maiorano
- Section of Pathology, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Bari I-70124, Italy
| | - Francesco Giorgino
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Bari I-70124, Italy
| | - Mauro Cignarelli
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Foggia I-71100, Italy
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15
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Bellanti F, Lauletta G, Villani R, Lipsi MR, Natalicchio MI, Sansonno D, Vendemiale G, Serviddio G. Combined Effects of 2 Interleukin 28B Polymorphisms on the Therapeutic Outcome of Hepatitis C Patients With Circulating Cryoglobulins. Medicine (Baltimore) 2015; 94:e1409. [PMID: 26334898 PMCID: PMC4616511 DOI: 10.1097/md.0000000000001409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/24/2015] [Accepted: 07/24/2015] [Indexed: 02/05/2023] Open
Abstract
Chronic hepatitis C is commonly associated with extrahepatic manifestations. Cryoglobulins are observed in 40% to 60% of such patients and their presence seems to modify response to therapy. The new antivirals are greatly improving the sustained virological response (SVR); however, their high cost limits the use, leaving pegylated interferon plus ribavirin (PR) still the standard-of-care therapy worldwide. Since PR therapy is burdened with several side effects, pretreatment predictions of patients who are unlikely to respond to this regimen may avoid ineffective treatment. Variants of the interleukin-28B (IL28B) gene correlate with an SVR to PR, and combined IL28B polymorphisms may improve the prediction of treatment outcome.The potential role of both rs8099917 and rs12979860 IL28B single nucleotide polymorphisms (SNPs) combined with presence of cryoglobulins in predicting SVR to PR in hepatitis C virus (HCV)-chronically infected patients was analyzed in the present study.Single and combined IL28B SNPs (rs12979860 and rs8099917) were analyzed in 64 chronic HCV patients treated with PR showing circulating cryoglobulins and compared to 108 noncryoglobulinemic subjects to verify the predictive value on the SVR.The association of rs12979860CC or rs8099917TT with SVR was confirmed in the noncryoglobulinemic group but not in cryoglobulinemic patients. Moreover, the combined determination of both SNPs improved the prediction of SVR in noncryoglobulinemic patients but not in the cryoglobulinemic subgroup.We report that both single and combined determination of IL28B rs12979860 and rs8099917 SNPs in chronic HCV patients with circulating cryoglobulins treated with PR may have a reduced predictive value of SVR.
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Affiliation(s)
- Francesco Bellanti
- From the Department of Medical and Surgical Sciences, C.U.R.E. Centre for Liver Diseases Research and Treatment, Institute of Internal Medicine, University of Foggia, Foggia, Italy (FB, RV, GV, GS); Liver Unit, Division of Internal Medicine and Clinical Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy (GL, DS); and Department of Clinical Pathology, II Laboratory, Section of Cytogenetic and Molecular Biology, University Hospital "Ospedali Riuniti", Foggia, Italy (MRL, MIN)
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16
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Natalicchio MI, Improta G, Zupa A, Cursio OE, Stampone E, Possidente L, Teresa Gerardi AM, Vita G, Martini M, Cassano A, Piccoli C, Romito S, Aieta M, Antonetti R, Barone C, Landriscina M. Pyrosequencing evaluation of low-frequency KRAS mutant alleles for EGF receptor therapy selection in metastatic colorectal carcinoma. Future Oncol 2014; 10:713-23. [PMID: 24799053 DOI: 10.2217/fon.13.233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
AIM To evaluate whether pyrosequencing (PS) improves the KRAS mutational status predictive value. PATIENTS & METHODS A retrospective analysis of KRAS mutations by PS and direct sequencing (DS) in 192 metastatic colorectal carcinomas (mCRCs), subgrouped in 51 KRAS mutated at PS and 141 KRAS wild-type at DS. RESULTS DS failed to detect low-frequency KRAS mutations in four out of 51 mCRCs, whereas PS detected 12 additional low-frequency KRAS mutations in 141 mCRCs KRAS wild-type at DS. After reanalyzing by PS 97 KRAS wild-type tumors treated with anti-EGF receptor (EGFR) antibodies, nine additional mutations were revealed in nonresponders, whereas none of responders exhibited a KRAS-mutated genotype. Of note, KRAS-mutated tumors upon PS showed a worst progression-free survival after EGFR therapy. Finally, PS allowed the detection of additional NRAS, BRAF and exon 20 PIK3CA mutations mostly in KRAS wild-type mCRCs resistant to EGFR therapy. CONCLUSION PS detection of low-frequency mutations may improve the KRAS predictive value for EGFR therapy selection.
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17
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Piscazzi A, Costantino E, Maddalena F, Natalicchio MI, Gerardi AMT, Antonetti R, Cignarelli M, Landriscina M. Activation of the RAS/RAF/ERK signaling pathway contributes to resistance to sunitinib in thyroid carcinoma cell lines. J Clin Endocrinol Metab 2012; 97:E898-906. [PMID: 22442268 DOI: 10.1210/jc.2011-3269] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
CONTEXT Sunitinib is currently being evaluated in advanced human thyroid carcinomas, based on the rationale that the vascular endothelial growth factor and platelet-derived growth factor receptors and the RET/PTC rearrangement are valuable targets for the treatment of this malignancy. However, criteria for selecting thyroid tumors that may benefit from sunitinib are lacking. DESIGN The effect of activating somatic mutations in the KRAS and BRAF genes on the responsiveness to sunitinib was evaluated in a panel of thyroid cancer cell lines harboring wild-type KRAS and BRAF genes, the RET/PTC1 rearrangement, the G12R KRAS, or the V600E BRAF mutation. RESULTS Sunitinib was found to selectively inhibit cell proliferation, induce cell accumulation in the G0-G1 phase, and inhibit the phosphorylation of ERK1/2 in both KRAS/BRAF wild-type thyroid cancer cells and in tumor cells harboring the RET/PTC rearrangement, whereas it was completely ineffective in KRAS- or BRAF-mutated thyroid carcinoma cells. This differential antitumor activity of sunitinib did not correlate with the expression profile of the vascular endothelial growth factor receptors 1, 2, and 3, platelet-derived growth factor receptor-α and cKIT genes. Of note, the constitutive activation of RAS/RAF/ERK signaling in KRAS/BRAF wild-type cells by transfection of the R12 HRAS or V600E BRAF mutants or stimulation with epithelial growth factor resulted in the loss of responsiveness to sunitinib, whereas pharmacological inhibition of MAPK kinase activity resulted in the resensitization of KRAS- or BRAF-mutated cells to the multikinase inhibitor. CONCLUSIONS The constitutive activation of the RAS/RAF/ERK pathway may favor resistance to sunitinib in thyroid carcinoma cells.
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MESH Headings
- Adenocarcinoma, Follicular/drug therapy
- Adenocarcinoma, Follicular/genetics
- Adenocarcinoma, Follicular/metabolism
- Antineoplastic Agents/pharmacology
- Carcinoma, Papillary/drug therapy
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/metabolism
- Cell Line, Tumor
- Drug Resistance, Neoplasm/physiology
- Extracellular Signal-Regulated MAP Kinases/metabolism
- Humans
- Indoles/pharmacology
- MAP Kinase Signaling System/drug effects
- MAP Kinase Signaling System/physiology
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Protein-Tyrosine Kinases/genetics
- Protein-Tyrosine Kinases/metabolism
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins B-raf/genetics
- Proto-Oncogene Proteins B-raf/metabolism
- Proto-Oncogene Proteins c-ret/genetics
- Proto-Oncogene Proteins c-ret/metabolism
- Proto-Oncogene Proteins p21(ras)
- Pyrroles/pharmacology
- Sunitinib
- Thyroid Neoplasms/drug therapy
- Thyroid Neoplasms/genetics
- Thyroid Neoplasms/metabolism
- ras Proteins/genetics
- ras Proteins/metabolism
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Affiliation(s)
- Annamaria Piscazzi
- Dipartimento di Scienze Mediche e del Lavoro, Università degli Studi di Foggia, Viale Pinto, 1-71100 Foggia, Italy
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18
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Carpagnano GE, Koutelou A, Natalicchio MI, Martinelli D, Ruggieri C, Di Taranto A, Antonetti R, Carpagnano F, Foschino-Barbaro MP. HPV in exhaled breath condensate of lung cancer patients. Br J Cancer 2011; 105:1183-90. [PMID: 21952627 PMCID: PMC3208494 DOI: 10.1038/bjc.2011.354] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: A recent intriguing carcinogenetic hypothesis for lung cancer foresees its viral aetiology. The human papilloma virus (HPV) is the main virus actually recognised in the pathogenesis of lung cancer. The aim of this study was to investigate, for the first time to our knowledge, the presence of HPV in the exhaled breath condensate (EBC) of lung cancer patients. Materials and method: We enrolled 89 patients affected by lung cancer and 68 controls. HPV infections were investigated in their EBC, paired bronchial brushing and neoplastic lung tissue through genotyping. Results: We were able to detect HPV in the EBC, bronchial brushing and neoplastic lung tissue. We described the presence of an HPV infection in 16.4% of the subjects affected by non-small cell lung cancer, but in none of the controls. HPV 16 and 31 turned out to be the most widespread genotypes. The HPV positivity in airways as well as in the smoking habit was seen to independently increase the individual's susceptibility to developing lung cancer. Conclusion: When summing up, we demonstrated the possibility to identify an HPV infection in the EBC of lung cancer patients; further, we supported the notion that the EBC is a suitable tool to study airway colonisation. That being said, although further studies are needed to confirm our results, we retain the study of HPV in EBC to be very interesting in terms of future programmes involving lung-cancer screening.
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Affiliation(s)
- G E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, Faculty of Medicine, University of Foggia, Foggia, Italy.
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19
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Del Prete R, Di Taranto AM, Lipsi MR, Natalicchio MI, Antonetti R, Miragliotta G. Simultaneous detection of viruses and Toxoplasma gondii in cerebrospinal fluid specimens by multiplex polymerase chain reaction-based reverse hybridization assay. New Microbiol 2009; 32:143-146. [PMID: 19579690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The lack of rapidity and the low sensitivity and specificity of traditional laboratory methods limits their usefulness in the laboratory diagnosis of viral central nervous system (CNS) infections. This study describes the use of a commercially available multiplex polymerase chain reaction (mPCR)-based reverse hybridization assay (RHA) for the simultaneous detection of the genomes of 8 viruses and Toxoplasma gondii in cerebrospinal fluids (CSF) from 181 patients suspected of having viral meningitis. Twenty-two/181 (12.15%) CSF samples resulted positive by mPCR. Eighteen/22 were positive for 1 viral pathogen, whereas a dual infection was detected in 4/22 samples. Epstein-Barr virus (EBV) was the most commonly detected virus (6/22), followed by herpes simplex virus type-1 (HSV-1) (5/22) and -2 (HSV-2) (4/22). Cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), and Epstein-Barr virus (EBV) were detected in 1 specimen each. Two CSF samples were co-infected by HSV-1/HSV-2, 1 sample by HHV-6/T. gondii, and 1 sample by EBV/EV, respectively. Our data support the usefulness of mPCR as a rapid molecular method for the simultaneous detection of major viral pathogens and T. gondii in aseptic meningitis also to allow the earlier application of specific antiviral therapy.
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Affiliation(s)
- Raffaele Del Prete
- Section of Microbiology, Department of Clinical Medicine, Immunology, Infectious Diseases, University of Bari, Italy
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Brandonisio O, Marangi A, Panaro MA, Marzio R, Natalicchio MI, Zizzadoro P, De Santis U. Prevalence of Cryptosporidium in children with enteritis in southern Italy. Eur J Epidemiol 1996; 12:187-90. [PMID: 8817198 DOI: 10.1007/bf00145505] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 02/02/2023]
Abstract
Cryptosporidium parvum is a protozoan which causes self-limiting diarrhea in immunocompetent subjects, and severe life-threatening disease in immunocompromised patients. Cryptosporidiosis is more common in developing countries and in infants. In this paper we have evaluated the prevalence of C. parvum in 368 hospitalized children with enteritis, of whom 359 were immunocompetent and 9 HIV-infected. Stool specimens were concentrated by sedimentation and stained with a modified Ziehl-Neelsen method. Cryptosporidium parvum oocysts were found in 7 (1.90%) out of 368 subjects. Six of these were immunocompetent (with an infection rate in this population of 1.67%) and 1 HIV-infected, asymptomatic except for diarrhea. In all children symptoms of enteritis and oocyst excretion cleared within 10 days. These results indicate that the prevalence of C. parvum as a causative agent of diarrheal illness in hospitalized immunocompetent children is rather low in our region (Apulia, South Italy).
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Affiliation(s)
- O Brandonisio
- Istituto di Microbiologia Medica, Università di Bari, Italy
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