1
|
Senore C, Riggi E, Armaroli P, Bonelli L, Sciallero S, Zappa M, Arrigoni A, Casella C, Crosta C, Falcini F, Ferrero F, Fracchia M, Giuliani O, Risio M, Russo AG, Visioli CB, Rosso S, Segnan N. Long-Term Follow-up of the Italian Flexible Sigmoidoscopy Screening Trial. Ann Intern Med 2022; 175:36-45. [PMID: 34748376 DOI: 10.7326/m21-0977] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recent reports showed that the protective effect of flexible sigmoidoscopy (FS) screening was maintained up to17 years, although differences were reported by sex. OBJECTIVE To assess long-term reduction of colorectal cancer (CRC) incidence and mortality after a single FS screening. DESIGN Parallel randomized controlled trial. (ISRCTN registry number: 27814061). SETTING 6 centers in Italy. PARTICIPANTS Persons aged 55 to 64 years expressing interest in having FS screening if invited, recruited from 1995 to 1999 and followed until 2012 (incidence) and 2014 to 2016 (mortality). INTERVENTION Eligible persons were randomly assigned (1:1 ratio) to either the once-only FS screening group or control (usual care) group. MEASUREMENTS Incidence and mortality rate ratios (RRs) and rate differences. RESULTS A total of 34 272 persons (17 136 in each group) were included in the analysis; 9911 participants had screening in the intervention group. Median follow-up was 15.4 years for incidence and 18.8 years for mortality. Incidence of CRC was reduced by 19% (RR, 0.81 [95% CI, 0.71 to 0.93]) in the intention-to-treat (ITT) analysis, comparing the intervention with the control group, and by 33% (RR, 0.67 [CI, 0.56 to 0.81]) in the per protocol (PP) analysis, comparing participants screened in the intervention group with the control persons. Colorectal cancer mortality was reduced by 22% (RR, 0.78 [CI, 0.61 to 0.98]) in the ITT analysis and by 39% (RR, 0.61 [CI, 0.44 to 0.84]) in the PP analysis. Incidence of CRC was statistically significantly reduced among both men and women. Colorectal cancer mortality was statistically significantly reduced among men (ITT RR, 0.73 [CI, 0.54 to 0.97]) but not among women (ITT RR, 0.90 [CI, 0.59 to 1.37]). LIMITATION Self-selection of volunteers from the general population sample targeted for recruitment may limit generalizability. CONCLUSION The strong protective effect of a single FS screening for CRC incidence and mortality was maintained up to 15 and 19 years, respectively. PRIMARY FUNDING SOURCE Italian Association for Cancer Research, Italian National Research Council, Istituto Oncologico Romagnolo, Fondo "E. Tempia," University of Milan, and Local Health Unit ASL-Torino.
Collapse
Affiliation(s)
- Carlo Senore
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Emilia Riggi
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Paola Armaroli
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Luigina Bonelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy (L.B., S.S., C.C.)
| | | | | | | | - Claudia Casella
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy (L.B., S.S., C.C.)
| | | | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Meldola, Forlì, Italy (F.F., O.G.)
| | | | | | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Meldola, Forlì, Italy (F.F., O.G.)
| | - Mauro Risio
- FPO-IRCCS Candiolo Cancer Institute, Turin, Italy (M.R.)
| | - Antonio G Russo
- Agency for Health Protection of the Metropolitan Area of Milan, Milan, Italy (A.G.R.)
| | | | - Stefano Rosso
- Piedmont Cancer Registry, University Hospital Città della Salute e della Scienza, Turin, Italy (S.R.)
| | - Nereo Segnan
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | | |
Collapse
|
2
|
Rex DK, Risio M, Hassan C. Prioritizing an oncologic approach to endoscopic resection of pedunculated colorectal polyps. Gastrointest Endosc 2021; 94:155-159. [PMID: 33931206 DOI: 10.1016/j.gie.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/05/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Douglas K Rex
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mauro Risio
- Institute for Cancer Research and Treatment, Candiolo (Torino), Italy
| | | |
Collapse
|
3
|
Vennelaganti S, Cuatrecasas M, Vennalaganti P, Kennedy KF, Srinivasan S, Patil DT, Plesec T, Lanas A, Hörndler C, Andraws N, Cherian R, Mathur S, Hassan C, Repici A, Klotz D, Musulen E, Risio M, Castells A, Gupta N, Sharma P. Interobserver Agreement Among Pathologists in the Differentiation of Sessile Serrated From Hyperplastic Polyps. Gastroenterology 2021; 160:452-454.e1. [PMID: 32950521 DOI: 10.1053/j.gastro.2020.09.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Sreekar Vennelaganti
- Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri
| | - Miriam Cuatrecasas
- Department of Pathology, Hospital Clinic and Biobank Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Prashanth Vennalaganti
- Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri; Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas
| | - Kevin F Kennedy
- Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri
| | - Sachin Srinivasan
- Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri
| | | | | | - Angel Lanas
- Gastroenterology, Aragón Health Research Institute, University of Zaragoza, CIBERehd, Zaragoza Spain
| | - Carlos Hörndler
- Gastroenterology, Aragón Health Research Institute, University of Zaragoza, CIBERehd, Zaragoza Spain
| | - Nevene Andraws
- Pathology, Veterans Affairs Medical Center, Kansas City, Missouri
| | - Rachel Cherian
- Pathology, Veterans Affairs Medical Center, Kansas City, Missouri
| | - Sharad Mathur
- Pathology, Veterans Affairs Medical Center, Kansas City, Missouri
| | - Cesare Hassan
- Gastroenterology and Hepatology, Istituto Clinico Humanitas, Milan, Italy
| | - Alessandro Repici
- Gastroenterology and Hepatology, Istituto Clinico Humanitas, Milan, Italy
| | - Dagmar Klotz
- Pathology, Oslo University Hospital, Oslo, Norway
| | - Eva Musulen
- Pathology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Mauro Risio
- Pathology, Institute of Cancer Research and Treatment, Candiolo-Torino, Italy
| | - Antoni Castells
- Department of Gastroenterology, Hospital Clinic of Barcelona, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Catalonia, Spain
| | - Neil Gupta
- Gastroenterology, Loyola University, Maywood, Illinois
| | - Prateek Sharma
- Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri; Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas.
| |
Collapse
|
4
|
Giaccone G, Risio M, Bonardi G, Calciati A. Stevens-Johnson Syndrome and Fatal Pulmonary Toxicity to Combination Chemotherapy Containing Bleomycin: A Case Report. Tumori 2018; 72:331-3. [PMID: 2426851 DOI: 10.1177/030089168607200316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bleomycin is a commonly used anticancer agent; in particular, it is an important component of multidrug regimens for germ cell tumors. The limiting toxicity of bleomycin is represented by pulmonary interstitial fibrosis; mucocutaneous side effects are common, but usually harmless. We describe a case of a young girl who developed Stevens-Johnson syndrome following the administration of bleomycin in a three-drug regimen containing vinblastine and cisplatin, for an ovarian immature teratoma. The severe dermatologic toxicity was kept under control, but a rapidly evolving respiratory insufficiency due to lung fibrosis developed soon thereafter and caused the patient's death.
Collapse
|
5
|
Ricci R, Giustiniani MC, Gessi M, Lanza P, Castri F, Biondi A, Persiani R, Vecchio FM, Risio M. Telocytes are the physiological counterpart of inflammatory fibroid polyps and PDGFRA-mutant GISTs. J Cell Mol Med 2018; 22:4856-4862. [PMID: 30117724 PMCID: PMC6156396 DOI: 10.1111/jcmm.13748] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/08/2018] [Accepted: 05/29/2018] [Indexed: 12/23/2022] Open
Abstract
PDGFRA mutations in the gastrointestinal (GI) tract can cause GI stromal tumour (GIST) and inflammatory fibroid polyp (IFP). Hitherto no cell type has been identified as a physiological counterpart of the latter, while interstitial Cajal cells (ICC) are considered the precursor of the former. However, ICC hyperplasia (ICCH), which strongly supports the ICC role in GIST pathogenesis, has been identified in germline KIT-mutant settings but not in PDGFRA-mutant ones, challenging the precursor role of ICC for PDGFRA-driven GISTs. Telocytes are a recently described interstitial cell type, CD34+/PDGFRA+. Formerly considered fibroblasts, they are found in many organs, including the GI tract where they are thought to be involved in neurotransmission. Alongside IFPs and gastric GISTs, GI wall "fibrosis" has been reported in germline PDGFRA-mutants. Taking the opportunity offered by its presence in a germline PDGFRA-mutant individual, we demonstrate that this lesion is sustained by hyperplastic telocytes, constituting the PDGFRA-mutant counterpart of germline KIT mutation-associated ICCH. Moreover, our findings support a pathogenetic relationship between telocyte hyperplasia and both IFPs and PDGFRA-mutant GISTs. We propose the term "telocytoma" for defining IFP, as it conveys both the pathogenetic (neoplastic) and histotypic ("telocytary") essence of this tumour, unlike IFP, which rather evokes an inflammatory-hyperplastic lesion.
Collapse
Affiliation(s)
- Riccardo Ricci
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Maria Cristina Giustiniani
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Marco Gessi
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Paola Lanza
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Federica Castri
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Alberto Biondi
- Department of Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Roberto Persiani
- Department of Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Fabio M Vecchio
- Department of Pathology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Mauro Risio
- Department of Pathology, Emeritus, IRCC, Candiolo, Italy
| |
Collapse
|
6
|
Puppa G, Senore C, Sheahan K, Vieth M, Lugli A, Zlobec I, Pecori S, Wang LM, Langner C, Mitomi H, Nakamura T, Watanabe M, Ueno H, Chasle J, Conley SA, Herlin P, Lauwers GY, Risio M. Diagnostic reproducibility of tumour budding in colorectal cancer: a multicentre, multinational study using virtual microscopy. Histopathology 2016; 61:562-75. [PMID: 22765314 DOI: 10.1111/j.1365-2559.2012.04270.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [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: 12/20/2022]
Abstract
AIMS Despite the established prognostic relevance of tumour budding in colorectal cancer, the reproducibility of the methods reported for its assessment has not yet been determined, limiting its use and reporting in routine pathology practice. METHODS AND RESULTS A morphometric system within telepathology was devised to evaluate the reproducibility of the various methods published for the assessment of tumour budding in colorectal cancer. Five methods were selected to evaluate the diagnostic reproducibility among 10 investigators, using haematoxylin and eosin (H&E) and AE1-3 cytokeratin-immunostained, whole-slide digital scans from 50 pT1-pT4 colorectal cancers. The overall interobserver agreement was fair for all methods, and increased to moderate for pT1 cancers. The intraobserver agreement was also fair for all methods and moderate for pT1 cancers. Agreement was dependent on the participants' experience with tumour budding reporting and performance time. Cytokeratin immunohistochemistry detected a higher percentage of tumour budding-positive cases with all methods compared to H&E-stained slides, but did not influence agreement levels. CONCLUSION An overall fair level of diagnostic agreement for tumour budding in colorectal cancer was demonstrated, which was significantly higher in early cancer and among experienced gastrointestinal pathologists. Cytokeratin immunostaining facilitated detection of budding cancer cells, but did not result in improved interobserver agreement.
Collapse
Affiliation(s)
- Giacomo Puppa
- Division of Pathology, 'G. Fracastoro' City Hospital, Verona, ItalyAOUS Giovanni Battista, CPO Piemonte, SCDO Epidemiologia dei Tumori, Torino, ItalyDepartment of Histopathology and Centre for Colorectal Disease, St Vincent's University Hospital School of Medicine and Medical Science, University College Dublin, Dublin, IrelandInstitute of Pathology, Klinikum Bayreuth, Bayreuth, GermanyInstitute of Pathology, University of Bern, Bern, SwitzerlandDepartment of Pathology, Section of Anatomical Pathology, Policlinico G. B. Rossi, University of Verona, Verona, ItalyDepartment of Cellular Pathology, John Radcliffe Hospital, Headington, Oxford, UKInstitute of Pathology, Medical University of Graz, Graz, AustriaDepartment of Human Pathology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, JapanDepartment of Surgery, National Defense Medical College, Namiki, Tokorozawa, Saitama, JapanDepartment of Pathology, François Baclesse Comprehensive Cancer Center, Caen, FrancePathology Media Lab, Pathology Service, Massachusetts General Hospital, Boston, MA, USAGroupe Régional d'Etudes sur le Cancer, François Baclesse Comprehensive Cancer Center, University of Caen, Caen, FranceGastrointestinal Pathology Service and Division of Surgical Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USAUnit of Pathology, Institute for Cancer Research and Treatment-IRCC, Candiolo, Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Risio M, Hassan C, Sottile A, Saglia A, Segnan N, Senore C. Histological features of advanced colorectal adenomas detected by endoscopy and fecal immunochemical test. Endoscopy 2015; 47:903-9. [PMID: 26021311 DOI: 10.1055/s-0034-1392203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS The detection of advanced adenomas within organized screening programs using either immunochemical fecal occult blood test (FIT) or endoscopy has been associated with the prevention of colorectal cancer. The histological changes and pathogenetic mechanisms that lead to the detection of such lesions by either of these screening methods have not yet been addressed. PATIENTS AND METHODS The histological specimens of 50 advanced adenomas detected by FIT were compared with those of 50 advanced adenomas detected by primary endoscopy screening that were matched for size and histology. The following variables were systematically recorded: 1) histopathological changes compatible with luminal bleeding induced by ischemia; 2) hypoxia in the adenomatous tissue, assessed through the expression of carbonic anhydrase IX; and 3) microvessel quantitative analysis, evaluated by CD31 and CD105 immunostains. All specimens were reviewed blindly by an expert gastrointestinal pathologist. RESULTS Histopathological changes associated with ischemia-related luminal bleeding were significantly more frequent in FIT-positive than in endoscopy-detected advanced adenomas (78 % vs. 14 %; P < 0.001). Carbonic anhydrase IX expression was also significantly higher in FIT-detected advanced adenomas (immunohistochemical score: 12.0 vs. 4.1; P < 0.001). Conversely, no differences were found in microvessel density. CONCLUSIONS The detection of advanced adenomas by FIT screening appears to be related to ischemia-associated luminal bleeding, which, in turn, may be due to periods of hypoxia. The absence of such changes in endoscopy-detected advanced adenomas would suggest that the two screening methods may be complementary for the detection of advanced neoplasia within organized screening programs.
Collapse
Affiliation(s)
- Mauro Risio
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | - Cesare Hassan
- Unit of Epidemiology, Centre for Cancer Prevention, Turin, Italy
| | - Antonino Sottile
- Unit of Clinical Biochemistry, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | - Alberto Saglia
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | - Nereo Segnan
- Unit of Epidemiology, Centre for Cancer Prevention, Turin, Italy
| | - Carlo Senore
- Unit of Epidemiology, Centre for Cancer Prevention, Turin, Italy
| |
Collapse
|
8
|
Kojima M, Puppa G, Kirsch R, Basturk O, Frankel WL, Vieth M, Lugli A, Sheahan K, Yeh M, Lauwers GY, Risio M, Shimazaki H, Iwaya K, Kage M, Akiba J, Ohkura Y, Horiguchi S, Shomori K, Kushima R, Nomura S, Ajioka Y, Adsay V, Ochiai A. Blood and lymphatic vessel invasion in pT1 colorectal cancer: an international concordance study. J Clin Pathol 2015; 68:628-32. [DOI: 10.1136/jclinpath-2014-202805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 04/13/2015] [Indexed: 12/31/2022]
|
9
|
Senetta R, Duregon E, Sonetto C, Spadi R, Mistrangelo M, Racca P, Chiusa L, Munoz FH, Ricardi U, Arezzo A, Cassenti A, Castellano I, Papotti M, Morino M, Risio M, Cassoni P. YKL-40/c-Met expression in rectal cancer biopsies predicts tumor regression following neoadjuvant chemoradiotherapy: a multi-institutional study. PLoS One 2015; 10:e0123759. [PMID: 25875173 PMCID: PMC4398550 DOI: 10.1371/journal.pone.0123759] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 10/16/2014] [Accepted: 01/21/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Neoadjuvant chemo-radiotherapy (CRT) followed by surgical resection is the standard treatment for locally advanced rectal cancer, although complete tumor pathological regression is achieved in only up to 30% of cases. A clinicopathological and molecular predictive stratification of patients with advanced rectal cancer is still lacking. Here, c-Met and YKL-40 have been studied as putative predictors of CRT response in rectal cancer, due to their reported involvement in chemoradioresistance in various solid tumors. MATERIAL AND METHODS A multicentric study was designed to assess the role of c-Met and YKL-40 expression in predicting chemoradioresistance and to correlate clinical and pathological features with CRT response. Immunohistochemistry and fluorescent in situ hybridization for c-Met were performed on 81 rectal cancer biopsies from patients with locally advanced rectal adenocarcinoma. All patients underwent standard (50.4 gy in 28 fractions + concurrent capecitabine 825 mg/m2) neoadjuvant CRT or the XELOXART protocol. CRT response was documented on surgical resection specimens and recorded as tumor regression grade (TRG) according to the Mandard criteria. RESULTS A significant correlation between c-Met and YKL-40 expression was observed (R = 0.43). The expressions of c-Met and YKL-40 were both significantly associated with a lack of complete response (86% and 87% of c-Met and YKL-40 positive cases, p< 0.01 and p = 0.006, respectively). Thirty of the 32 biopsies co-expressing both markers had partial or absent tumor response (TRG 2-5), strengthening their positive predictive value (94%). The exclusive predictive role of YKL-40 and c-Met was confirmed using a multivariate analysis (p = 0.004 and p = 0.007 for YKL-40 and c-Met, respectively). TRG was the sole morphological parameter associated with poor outcome. CONCLUSION c-Met and YKL-40 expression is a reliable predictor of partial/absent response to neoadjuvant CRT in rectal cancer. Targeted therapy protocols could take advantage of prior evaluations of c-MET and YKL-40 expression levels to increase therapeutic efficacy.
Collapse
Affiliation(s)
- Rebecca Senetta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Cristina Sonetto
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Rossella Spadi
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Massimiliano Mistrangelo
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Patrizia Racca
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Luigi Chiusa
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Alberto Arezzo
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Adele Cassenti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Mario Morino
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Mauro Risio
- Candiolo Cancer Institute—FPO (Fondazione del Piemonte per l'0ncologia), IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Candiolo, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
- * E-mail:
| |
Collapse
|
10
|
Casorzo L, Dell'Aglio C, Sarotto I, Risio M. Aurora kinase A gene copy number is associated with the malignant transformation of colorectal adenomas but not with the serrated neoplasia progression. Hum Pathol 2015; 46:411-8. [DOI: 10.1016/j.humpath.2014.11.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/12/2014] [Accepted: 11/23/2014] [Indexed: 12/23/2022]
|
11
|
Righi A, Sarotto I, Casorzo L, Cavalchini S, Frangipane E, Risio M. Tumour budding is associated with hypoxia at the advancing front of colorectal cancer. Histopathology 2015; 66:982-90. [PMID: 25381897 DOI: 10.1111/his.12602] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 08/02/2014] [Accepted: 11/04/2014] [Indexed: 12/31/2022]
Abstract
AIMS The tumour budding ability to predict cancer progression is felt to be worthy of investigation with regard to its biological properties. This study was aimed at evaluating the role of hypoxia and microvascularization in the morphogenesis of tumour budding in colorectal carcinoma. METHODS AND RESULTS The immunohistochemical expression of hypoxia-inducible factor-1α (HIF-1α) and carbonic anhydrase IX in cancer cells and CD105 in carcinoma-induced microvascularization were assessed in 479 colorectal cancers. Furthermore, MET proto-oncogene, receptor tyrosine kinase (MET) gene amplification was searched using fluorescence in-situ hybridization (FISH). Carbonic anhydrase IX and HIF-1α overall scores differed significantly in low- compared to high-grade tumour budding cancers (P < 0.001), both in pT1 and in pT2-4 tumours. Intratumour analysis of budding foci showed a striking absence of carbonic anhydrase IX immunostain in detaching cells with respect to the surrounding microsectors. The mean microvessel density values were significantly higher in the low- compared to the high-grade tumour budding groups (P < 0.001). A similar copy number of MET gene was detected in the two groups. CONCLUSIONS Our study shows that tumour budding is associated with hypoxia induced by hypovascularization at the advancing front of colorectal cancer and that budding cells express a HIF-1α-mediated hypoxic tumour phenotype. MET gene amplification is not related to tumour budding morphogenesis.
Collapse
Affiliation(s)
- Alberto Righi
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Ivana Sarotto
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Laura Casorzo
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Silvia Cavalchini
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Elena Frangipane
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Mauro Risio
- Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| |
Collapse
|
12
|
Morino M, Risio M, Bach S, Beets-Tan R, Bujko K, Panis Y, Quirke P, Rembacken B, Rullier E, Saito Y, Young-Fadok T, Allaix ME. Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference. Surg Endosc 2015; 29:755-73. [DOI: 10.1007/s00464-015-4067-3] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 01/07/2015] [Indexed: 12/13/2022]
|
13
|
Affiliation(s)
- M Risio
- Department of Pathology, Candiolo Cancer Institute, Candiolo-Torino, Italy
| |
Collapse
|
14
|
Casazza A, Finisguerra V, Capparuccia L, Camperi A, Swiercz JM, Rizzolio S, Rolny C, Christensen C, Bertotti A, Sarotto I, Risio M, Trusolino L, Weitz J, Schneider M, Mazzone M, Comoglio PM, Tamagnone L. Sema3E–Plexin D1 signaling drives human cancer cell invasiveness and metastatic spreading in mice. J Clin Invest 2013. [DOI: 10.1172/jci74037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
15
|
Lucci-Cordisco E, Risio M, Venesio T, Genuardi M. The growing complexity of the intestinal polyposis syndromes. Am J Med Genet A 2013; 161A:2777-87. [PMID: 24124059 DOI: 10.1002/ajmg.a.36253] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/05/2013] [Indexed: 12/12/2022]
Abstract
Familial adenomatous polyposis has been the first form of inherited intestinal polyposis to be recognized. For a long time it has been considered the main polyposis syndrome, associated with an easily recognizable phenotype, with a marginal role attributed to a few very rare hamartomatous conditions. More recently, it has been gradually demonstrated that the intestinal polyposes encompass a range of conditions within a wide spectrum of disease severity, polyp histology, and extraintestinal manifestations. A growing number of genes and phenotypes has been identified, and heterogeneity of somatic molecular pathways underlying epithelial transformation in different syndromes and associated tumors has been documented. Increasing knowledge on the molecular bases and more widespread use of genetic tests has shown phenotypic overlaps between conditions that were previously considered distinct, highlighting diagnostic difficulties. With the advent of next generation sequencing, the diagnosis and the classification of these syndromes will be progressively based more on genetic testing results. However, the phenotypic variability documented among patients with mutations in the same genes cannot be fully explained by different expressivity, indicating a role for as yet unknown modifying factors. Until the latter will be identified, the management of patients with polyposis syndromes should be guided by both clinical and genetic findings.
Collapse
Affiliation(s)
- Emanuela Lucci-Cordisco
- Institute of Medical Genetics, "A. Gemelli" School of Medicine, Catholic University, Rome, Italy
| | | | | | | |
Collapse
|
16
|
Venesio T, Balsamo A, Errichiello E, Ranzani GN, Risio M. Oxidative DNA damage drives carcinogenesis in MUTYH-associated-polyposis by specific mutations of mitochondrial and MAPK genes. Mod Pathol 2013; 26:1371-81. [PMID: 23599153 DOI: 10.1038/modpathol.2013.66] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/28/2013] [Accepted: 01/28/2013] [Indexed: 12/29/2022]
Abstract
MUTYH is a DNA-base-excision-repair gene implicated in the activation of nuclear and mitochondrial cell-death pathways. MUTYH germline mutations cause an inherited polyposis, MUTYH-associated-polyposis, characterized by multiple adenomas and increased susceptibility to colorectal cancer. Since this carcinogenesis remains partially unknown, we searched for nuclear and mitochondrial gene alterations that may drive the tumorigenic process. Ninety-six adenomas and 7 carcinomas from 12 MUTYH-associated-polyposis and 13 classical/attenuated adenomatous polyposis patients were investigated by sequencing and pyrosequencing for the presence of mutations in KRAS, BRAF, MT-CO1/MT-CO2 and MT-TD genes. KRAS mutations were identified in 24% MUTYH-associated-polyposis vs 15% classical/attenuated familial polyposis adenomas; mutated MUTYH-associated-polyposis adenomas exhibited only c.34G>T transversions in codon 12, an alteration typically associated with oxidative DNA damage, or mutations in codon 13; neither of these mutations was found in classical/attenuated familial polyposis adenomas (P<0.001). Mutated MUTYH-associated-polyposis carcinomas showed KRAS c.34G>T transversions, prevalently occurring with BRAFV600E; none of the classical/attenuated familial polyposis carcinomas displayed these alterations. Comparing mitochondrial DNA from lymphocytes and adenomas of the same individuals, we detected variants in 82% MUTYH-associated-polyposis vs 38% classical/attenuated familial polyposis patients (P=0.040). MT-CO1/MT-CO2 missense mutations, which cause aminoacid changes, were only found in MUTYH-associated-polyposis lesions and were significantly associated with KRAS mutations (P=0.0085). We provide evidence that MUTYH-associated-polyposis carcinogenesis is characterized by the occurrence of specific mutations in both KRAS and phylogenetically conserved genes of mitochondrial DNA which are involved in controlling oxidative phosphorylation; this implies the existence of a colorectal tumorigenesis in which changes in mitochondrial functions cooperate with RAS-induced malignant transformation.
Collapse
Affiliation(s)
- Tiziana Venesio
- Unit of Pathology, Institute for Cancer Research and Treatment, Candiolo, (Torino), Italy
| | | | | | | | | |
Collapse
|
17
|
Abstract
Adenomas represent the morphological precursors of the vast majority of colorectal cancers: although every adenoma has the capacity of malignant evolution, most adenomas stabilize their progression or even regress. Pathological factors are predictive of the natural history of adenomas in terms of potential and time interval for becoming malignant. Regression of adenomas is histologically well established, but it is thought to be a dynamic process, with cycling phases of regression and growth. Colorectal carcinoma invading the submucosa but not the muscular layer represents the earliest form of clinically relevant colorectal cancer. Grade of differentiation of carcinoma, lymphovascular invasion, and state of the resection margin predict the risk of metastasis. Microstaging of invasive cancer together with tumuor budding allow the metastatic risk to be further stratified into minimal, low, and high. Two distinct profiles are identifiable in the natural history of cancerous adenomas: blocking the growth of early cancer and allowing its progression towards advanced cancer. Thus, biomarkers to distinguish between progressive and non-progressive pT1 neoplasia are needed.
Collapse
Affiliation(s)
- M Risio
- Department of Pathology, Institute for Cancer Research and Treatment, Strada Provinciale 142, 10060 Candiolo-Torino, Italy.
| |
Collapse
|
18
|
Marsoni S, Bertotti A, Sartore-Bianchi A, Leone F, Lonardi S, Ciardiello F, Pinto C, Aglietta M, Zagonel V, Gambacorta M, Grigioni WF, Rugge M, Risio M, Martino C, Valtorta E, Bardelli A, Trusolino L, Comoglio PM, Siena S. Dual anti-HER2 treatment of patients with HER2-positive metastatic colorectal cancer: The HERACLES trial (HER2 Amplification for Colo-rectaL Cancer Enhanced Stratification). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.tps3648] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS3648 Background: We identified HER2 amplification as a potential onco-driver and marker of de novo resistance to anti-EGFR therapy in mCRC PTS for which other known genetic alterations conferring resistance to anti EGFR antibodies were excluded. Exploiting direct transfer xenografts of mCRC surgical samples in mice (xenoPTS), we conducted a multi-arm study in HER2-amplified xenoPTS showing that combinations of lapatinib (L) and trastuzumab (T), or L and pertuzumab (P) induced long-lasting tumor regressions while monotherapy with L led to stabilization and either monotherapy with T or P were ineffective (Bertotti et al. Cancer Discov 2011). The combination of P+T has a strong rationale for treatment of HER2-amplified mCRC, since combining the two agents is synergic in HER2+ breast cancers failing T (Baselga et al. JCO 2010), suggesting a cooperative mechanism of inhibition. On these findings we designed the HERACLES trial. Methods: HERACLES is an independent Phase II, 2-sequential cohort trial, assessing the response rate (RR) of T combined with either L (Cohort A) or P (Cohort B), in m CRC PTS harbouring an amplified HER2 tumor (SISH). Endpoints are RR and PFS. For each cohort sample size was calculated according to the Fleming & Hern 1- stage design under identical assumptions: H0 = RR 10%, H1= RR 30%. With a =0.05, power=0.85, 27 patient are required in each cohort (54 patients overall). A or B will be considered positive if ≥ 6 responses/27 PTS are observed. Detection and quantitation of genetic alterations in circulating tumor DNA (liquid biopsy) and Her2 ECD in plasma as potential markers of secondary resistance will be done q14 days until relapse. Eligibility: CRC histology with KRAS WT, HER2 IHC 3+ ≥50% cells, prior treatment with fluoropirimidines, oxaliplatin, irinotecan, anti EGFR moABs based regimens ± Bevacizumab; measurable disease (RECIST v1.0), ECOG PS ≤1, adequate organ function. Response is assessed q8w. Treatment: L 1000 mg daily po + T 4 mg/kg iv load, then 2 mg/kg iv weekly. Enrollment: since trial start (8/12/12) 198 PTS have been HER2 screened, 10 found positive and 7 are in treatment. EudraCT number : 2012-002128-33. Clinical trial information: 2012-002128-33.
Collapse
Affiliation(s)
- Silvia Marsoni
- Clinical Trial Coordination Unit - IRCC Istitute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | - Andrea Bertotti
- Laboratory of Molecular Pharmacology - IRCC Institute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | | | - Francesco Leone
- Division of Medical Oncology - IRCC Istitute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | - Sara Lonardi
- Medical Oncology 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Massimo Aglietta
- Division of Medical Oncology - IRCC Istitute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | | | - Marcello Gambacorta
- S.C. Anatomia Istologia Patologica e Citogenetica - Ospedale Niguarda Ca' Granda, Milan, Italy
| | | | - Massimo Rugge
- Second Unit of Pathology, Padova Teaching Hospital, Padova, Italy
| | - Mauro Risio
- Unit of Pathology, Institute for Cancer Research and Treatment, Candiolo, Italy
| | - Cosimo Martino
- Clinical Trial Coordination Unit - IRCC Istitute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | | | - Alberto Bardelli
- Laboratory of Molecular Genetics - IRCC Institute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | - Livio Trusolino
- Laboratory of Molecular Pharmacology - IRCC Institute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | - Paolo M. Comoglio
- Scientific Direction - IRCC Institute for Cancer Research and Treatment at Candiolo, Candiolo, Italy
| | | |
Collapse
|
19
|
Righi A, Asioli S, Caliendo V, Macripò G, Picciotto F, Risio M, Eusebi V, Bussolati G. An ultrasonography-cytology protocol for the diagnostic management of regional nodes in a subset of patients with Merkel cell carcinoma of the skin. Br J Dermatol 2013; 168:563-70. [DOI: 10.1111/bjd.12107] [Citation(s) in RCA: 17] [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] [Indexed: 11/29/2022]
|
20
|
von Karsa L, Patnick J, Segnan N, Atkin W, Halloran S, Lansdorp-Vogelaar I, Malila N, Minozzi S, Moss S, Quirke P, Steele RJ, Vieth M, Aabakken L, Altenhofen L, Ancelle-Park R, Antoljak N, Anttila A, Armaroli P, Arrossi S, Austoker J, Banzi R, Bellisario C, Blom J, Brenner H, Bretthauer M, Camargo Cancela M, Costamagna G, Cuzick J, Dai M, Daniel J, Dekker E, Delicata N, Ducarroz S, Erfkamp H, Espinàs JA, Faivre J, Faulds Wood L, Flugelman A, Frkovic-Grazio S, Geller B, Giordano L, Grazzini G, Green J, Hamashima C, Herrmann C, Hewitson P, Hoff G, Holten I, Jover R, Kaminski MF, Kuipers EJ, Kurtinaitis J, Lambert R, Launoy G, Lee W, Leicester R, Leja M, Lieberman D, Lignini T, Lucas E, Lynge E, Mádai S, Marinho J, Maučec Zakotnik J, Minoli G, Monk C, Morais A, Muwonge R, Nadel M, Neamtiu L, Peris Tuser M, Pignone M, Pox C, Primic-Zakelj M, Psaila J, Rabeneck L, Ransohoff D, Rasmussen M, Regula J, Ren J, Rennert G, Rey J, Riddell RH, Risio M, Rodrigues V, Saito H, Sauvaget C, Scharpantgen A, Schmiegel W, Senore C, Siddiqi M, Sighoko D, Smith R, Smith S, Suchanek S, Suonio E, Tong W, Törnberg S, Van Cutsem E, Vignatelli L, Villain P, Voti L, Watanabe H, Watson J, Winawer S, Young G, Zaksas V, Zappa M, Valori R. European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy 2013; 45:51-9. [PMID: 23212726 PMCID: PMC4482205 DOI: 10.1055/s-0032-1325997] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010. They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.
Collapse
Affiliation(s)
| | - L. von Karsa
- International Agency for Research on Cancer, Lyon, France
| | - J. Patnick
- NHS Cancer Screening Programmes Sheffield, United Kingdom,Oxford University Cancer Screening Research Unit, Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - N. Segnan
- International Agency for Research on Cancer, Lyon, France,CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - W. Atkin
- Imperial College London, London, United Kingdom
| | - S. Halloran
- Bowel Cancer Screening Southern Programme Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom,University of Surrey, Guildford, United Kingdom
| | | | - N. Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - S. Minozzi
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - S. Moss
- The Institute of Cancer Research, Royal Cancer Hospital, Sutton, United Kingdom
| | - P. Quirke
- Leeds Institute of Molecular Medicine, St James’ University Hospital, Leeds, United Kingdom
| | - R. J. Steele
- Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - M. Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | - L. Aabakken
- Department of Medical Gastroenterology, Stavanger University Hospital, Stavanger, Norway
| | - L. Altenhofen
- Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | | | - N. Antoljak
- Croatian National Institute of Public Health, Zagreb, Croatia,University of Zagreb School of Medicine, Zagreb, Croatia
| | - A. Anttila
- Finnish Cancer Registry, Helsinki, Finland
| | - P. Armaroli
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | | | - J. Austoker
- University of Oxford, Oxford, United Kingdom
| | - R. Banzi
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - C. Bellisario
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - J. Blom
- Karolinska Institutet, Stockholm, Sweden
| | - H. Brenner
- German Cancer Research Center, Heidelberg, Germany
| | - M. Bretthauer
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - M. Camargo Cancela
- National Cancer Registry, Cork, Ireland,Formerly International Agency for Research on Cancer, Lyon, France
| | | | - J. Cuzick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | - M. Dai
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - J. Daniel
- Formerly International Agency for Research on Cancer, Lyon, France,American Cancer Society, Atlanta, Georgia, United States of America
| | - E. Dekker
- Academic Medical Centre, Amsterdam, the Netherlands
| | - N. Delicata
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - S. Ducarroz
- International Agency for Research on Cancer, Lyon, France
| | - H. Erfkamp
- University of Applied Sciences FH Joanneum, Graz, Austria
| | - J. A. Espinàs
- Catalan Cancer Strategy, L’Hospitalet de Llobregat, Spain
| | - J. Faivre
- Digestive Cancer Registry of Burgundy, INSERM U866, University and CHU, Dijon, France
| | - L. Faulds Wood
- Lynn’s Bowel Cancer Campaign, Twickenham, United Kingdom
| | - A. Flugelman
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - S. Frkovic-Grazio
- Department of Gynecological Pathology and Cytology, University Medical Center Ljubljana, Slovenia
| | - B. Geller
- University of Vermont, Burlington, Vermont, United States of America
| | - L. Giordano
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - G. Grazzini
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - J. Green
- University of Oxford, Oxford, United Kingdom
| | | | - C. Herrmann
- Formerly International Agency for Research on Cancer, Lyon, France,Cancer League of Eastern Switzerland, St. Gallen, Switzerland
| | - P. Hewitson
- University of Oxford, Oxford, United Kingdom
| | - G. Hoff
- Cancer Registry of Norway, Oslo, Norway,Telemark Hospital, Skien, Norway
| | - I. Holten
- Danish Cancer Society, Copenhagen, Denmark
| | - R. Jover
- Hospital General Universitario de Alicante, Alicante, Spain
| | - M. F. Kaminski
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | | | | | - R. Lambert
- International Agency for Research on Cancer, Lyon, France
| | - G. Launoy
- U1086 INSERM – UCBN, CHU Caen, France
| | - W. Lee
- The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | | | - M. Leja
- University of Latvia, Riga, Latvia
| | - D. Lieberman
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - T. Lignini
- International Agency for Research on Cancer, Lyon, France
| | - E. Lucas
- International Agency for Research on Cancer, Lyon, France
| | - E. Lynge
- University of Copenhagen, Copenhagen, Denmark
| | - S. Mádai
- MaMMa Healthcare Institute, Budapest, Hungary
| | - J. Marinho
- Health Administration Central Region Portugal, Aveiro, Portugal
| | | | - G. Minoli
- Gastroenterology Unit, Valduce Hospital, Como, Italy
| | - C. Monk
- GlaxoSmithKline Pharma Europe, London, United Kingdom
| | - A. Morais
- Regional Health Administration, Coimbra, Portugal
| | - R. Muwonge
- International Agency for Research on Cancer, Lyon, France
| | - M. Nadel
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - L. Neamtiu
- Prof. Dr Ion Chiricuţă, Cluj-Napoca, Romania
| | - M. Peris Tuser
- Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - M. Pignone
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - C. Pox
- Ruhr Universität, Bochum, Germany
| | - M. Primic-Zakelj
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Slovenia
| | - J. Psaila
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - L. Rabeneck
- University of Toronto and Cancer Care Ontario, Toronto, Canada
| | - D. Ransohoff
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Rasmussen
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - J. Regula
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | - J. Ren
- Formerly International Agency for Research on Cancer, Lyon, France
| | - G. Rennert
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - J. Rey
- Institut Arnault Tzanck, St Laurent du Var, France
| | | | - M. Risio
- Institute for Cancer Research and Treatment, Candiolo-Torino, Italy
| | - V. Rodrigues
- Faculdade de Medicina – Universidade de Coimbra, Coimbra, Portugal
| | - H. Saito
- National Cancer Centre, Tokyo, Japan
| | - C. Sauvaget
- International Agency for Research on Cancer, Lyon, France
| | | | | | - C. Senore
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - M. Siddiqi
- Cancer Foundation of India, Kolkata, India
| | - D. Sighoko
- Formerly International Agency for Research on Cancer, Lyon, France,The University of Chicago, Department of Medicine, Hematology–Oncology Section, Center for Clinical Cancer Genetics, Global Health, Chicago, United States of America
| | - R. Smith
- American Cancer Society, Atlanta, Georgia, United States of America
| | - S. Smith
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - S. Suchanek
- Charles University and Military University Hospital, Prague, Czech Republic
| | - E. Suonio
- International Agency for Research on Cancer, Lyon, France
| | - W. Tong
- Chinese Academy of Medical Sciences, Beijing, China
| | - S. Törnberg
- Department of Cancer Screening, Stockholm Gotland Regional Cancer Centre, Stockholm, Sweden
| | | | - L. Vignatelli
- Agenzia Sanitaria e Sociale Regionale–Regione Emilia-Romagna, Bologna, Italy
| | - P. Villain
- University of Oxford, Oxford, United Kingdom
| | - L. Voti
- Formerly International Agency for Research on Cancer, Lyon, France,University of Miami, Miami, Florida, United States of America
| | | | - J. Watson
- University of Oxford, Oxford, United Kingdom
| | - S. Winawer
- Memorial Sloan–Kettering Cancer Center, New York, United States of America
| | - G. Young
- Gastrointestinal Services, Flinders University, Adelaide, Australia
| | - V. Zaksas
- State Patient Fund, Vilnius, Lithuania
| | - M. Zappa
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - R. Valori
- NHS Endoscopy, Leicester, United Kingdom
| |
Collapse
|
21
|
Recupero D, Daniele L, Marchiò C, Molinaro L, Castellano I, Cassoni P, Righi A, Montemurro F, Sismondi P, Biglia N, Viale G, Risio M, Sapino A. Spontaneous and pronase-induced HER2 truncation increases the trastuzumab binding capacity of breast cancer tissues and cell lines. J Pathol 2012; 229:390-9. [PMID: 22806884 DOI: 10.1002/path.4074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 06/20/2012] [Accepted: 07/11/2012] [Indexed: 02/01/2023]
Abstract
A subgroup of HER2-overexpressing breast tumours co-expresses p95(HER2), a truncated HER2 receptor that retains a functional HER2 kinase domain but lacks the extracellular domain, thus impairing trastuzumab binding. We evaluated p95(HER2) expression in 99 frozen breast carcinoma samples by western blot analysis. The HER2-positive cell line BT474 treated with pervanadate or pronase was used as a positive control for p95(HER2) expression. Immunohistochemistry was performed on parallel formalin-fixed, paraffin-embedded sections of the same case series using antibodies directed against either the intra- or extra-cellular binding domain of HER2. In particular, biotinylated trastuzumab (BiotHER) was used to evaluate the binding capacity of the humanized antibody. To avoid a subjective evaluation of the score values and the percentage of immunostained cells, the slides were scanned and automatically analysed. The number of cases with HER2 overexpression (score 3+) and HER2 gene amplification was higher in the p185(HER2)-positive/p95(HER2)-positive samples than in the p185(HER2)-positive/p95(HER2)-negative group. Automated analysis confirmed a significantly higher percentage of 3+ scored cells in p95(HER2)-positive cases. Conversely, the percentage of 2+ scored cells was higher inp95(HER2)-negative cases. The status of the HER2 extracellular domain was then studied using flow cytometry on BT474 cells after pronase enzymatic digestion using trastuzumab and pertuzumab, while the presence of HER2-HER3 dimers was studied using a proximity-ligation assay. In vitro experiments showed that short-term pronase digestion of BT474 cells produced two HER2 fragments (of 95 and 150 kDa, detectable in tissue specimens as well), increased the binding affinity of trastuzumab, reduced the rate of HER2-HER3 dimers, and did not interfere with pertuzumab-binding capacity. In conclusion, the presence of p95(HER2 as detected by western blot analysis does not compromise the immunohistochemical detection of HER2. Our data suggest that a reduction of the receptor steric hindrance as induced by enzymatic shedding may facilitate the binding capacity of trastuzumab.
Collapse
Affiliation(s)
- Daniele Recupero
- Department of Biomedical Sciences and Human Oncology, University of Turin, via Santena 7, Turin, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Risio M, Geido E, Divinci A, Rapallo A, Pujic N, Rossini F, Giaretti W. DNA-ploidy analysis within selected regions of colorectal adenomas containing carcinoma. Int J Oncol 2012; 3:941-7. [PMID: 21573457 DOI: 10.3892/ijo.3.5.941] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In order to better understand the relationship of DNA ploidy, dysplasia, early cancer, and colorectal tumor progression, 11 colorectal adenomas containing carcinoma invading the submucosa were investigated using DNA flow cytometry. Multiple frozen samples were taken from the selected sectors corresponding to adenoma tissue with low-grade dysplasia, high grade dysplasia and early cancer. Sampling accuracy was performed under histologic examination by multiple cryostatic sections. Data were compared with previously reported results in non-cancerous adenomas and advanced carcinomas. Incidence of DNA aneuploidy among the dysplastic regions of the adenomas containing carcinomas resulted higher than that observed in non-cancerous adenomas (p=0.02). Furthermore, among the DNA aneuploid populations, the frequency of clones with high DNA Index (DI>1.3) was slightly higher in adenomas with cancer than in adenomas without cancer (p=0.07). We suggest that differences may exist in DNA aneuploidy evolution between these two types of lesions. In early cancer, the near-diploid clones were 57% with respect to 18% (p=0.01) in advanced cancer since in this latter case the majority of the DNA abnormal clones were in the near-hypertriploid region (82%). Thus, the acquisition of the invasive phenotype appears to be linked with the expansion and stabilization of high DNA aneuploid clones. Further analysis on a larger number of cases of adenomas containing carcinoma are necessary to validate these interpretations.
Collapse
Affiliation(s)
- M Risio
- IST,IST NAZL RIC CANC,GENOA,ITALY
| | | | | | | | | | | | | |
Collapse
|
23
|
Vieth M, Quirke P, Lambert R, von Karsa L, Risio M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Annotations of colorectal lesions. Endoscopy 2012; 44 Suppl 3:SE131-9. [PMID: 23012116 DOI: 10.1055/s-0032-1309798] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology was supplemented by an annex describing in greater detail some issues raised in the chapter, particularly details of special interest to pathologists. The content of the annex is presented here to promote international discussion and collaboration by making the issues discussed in the guidelines known to a wider professional and scientific community.
Collapse
Affiliation(s)
- M Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany.
| | | | | | | | | | | |
Collapse
|
24
|
Quirke P, Risio M, Lambert R, von Karsa L, Vieth M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44 Suppl 3:SE116-30. [PMID: 23012115 DOI: 10.1055/s-0032-1309797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology in colorectal cancer screening and diagnosis includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.
Collapse
Affiliation(s)
- P Quirke
- Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom.
| | | | | | | | | | | |
Collapse
|
25
|
Abstract
Colorectal carcinoma invading the submucosa but not the muscular layer (pT1, early invasive cancer) represents the earliest form of clinically relevant colorectal cancer in most patients. Neoplastic invasion of the submucosa, in fact, opens the way to metastasis via the lymphatic and blood vessels, and the choice between surveillance and major surgery will turn on its metastatic potential. The following histological features predict the risk of metastasis and the different clinical outcomes: grade of differentiation of carcinoma, lymphovascular invasion, state of the resection margin. Microstaging of invasive cancer, namely the width and the depth of submucosal invasion, together with tumor budding at the advancing edge allow the metastatic risk to be further stratified in minimal, low, and high. Different, although morphologically undistinguishable, tumorigenic pathways are supposed to lead to the malignant transformation of colonic mucosa and subsequently to drive the progression from early to advanced cancer: new biomarkers are needed to identify progressive and non-progressive pT1 neoplasia.
Collapse
Affiliation(s)
- Mauro Risio
- Department of Pathology, Institute for Cancer Research and Treatment Candiolo-Torino, Italy
| |
Collapse
|
26
|
Migliardi G, Sassi F, Torti D, Galimi F, Zanella ER, Buscarino M, Ribero D, Muratore A, Massucco P, Pisacane A, Risio M, Capussotti L, Marsoni S, Di Nicolantonio F, Bardelli A, Comoglio PM, Trusolino L, Bertotti A. Inhibition of MEK and PI3K/mTOR suppresses tumor growth but does not cause tumor regression in patient-derived xenografts of RAS-mutant colorectal carcinomas. Clin Cancer Res 2012; 18:2515-25. [PMID: 22392911 DOI: 10.1158/1078-0432.ccr-11-2683] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Gene mutations along the Ras pathway (KRAS, NRAS, BRAF, PIK3CA) occur in approximately 50% of colorectal cancers (CRC) and correlate with poor response to anti-EGF receptor (EGFR) therapies. We assessed the effects of mitogen-activated protein (MAP)/extracellular signal-regulated kinase (ERK) kinase (MEK) and phosphoinositide 3-kinase (PI3K)/mTOR inhibitors, which neutralize the major Ras effectors, in patient-derived xenografts from RAS/RAF/PIK3CA-mutant metastatic CRCs (mCRC). EXPERIMENTAL DESIGN Forty mCRC specimens harboring KRAS, NRAS, BRAF, and/or PIK3CA mutations were implanted in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. Each xenograft was expanded into four treatment arms: placebo, the MEK inhibitor AZD6244, the PI3K/mTOR inhibitor, BEZ235, or AZD6244 + BEZ235. Cases initially treated with placebo crossed over to AZD6244, BEZ235, and the anti-EGFR monoclonal antibody cetuximab. RESULTS At the 3-week evaluation time point, cotreatment of established tumors with AZD6244 + BEZ235 induced disease stabilization in the majority of cases (70%) but did not lead to overt tumor regression. Monotherapy was less effective, with BEZ235 displaying higher activity than AZD6244 (disease control rates, DCRs: AZD6244, 27.5%; BEZ235, 42.5%). Triple therapy with cetuximab provided further advantage (DCR, 88%). The extent of disease control declined at the 6-week evaluation time point (DCRs: AZD6244, 13.9%; BEZ235, 16.2%; AZD6244 + BEZ235, 34%). Cross-analysis of mice harboring xenografts from the same original tumor and treated with each of the different modalities revealed subgroups with preferential sensitivity to AZD6244 (12.5%), BEZ235 (35%), or AZD6244 + BEZ235 (42.5%); another subgroup (10%) showed equivalent response to any treatment. CONCLUSIONS The prevalent growth-suppressive effects produced by MEK and PI3K/mTOR inhibition suggest that this strategy may retard disease progression in patients. However, data offer cautionary evidence against the occurrence of durable responses.
Collapse
Affiliation(s)
- Giorgia Migliardi
- Laboratory of Molecular Pharmacology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Affiliation(s)
- Mauro Risio
- Department of Pathology, Institute for Cancer Research and Treatment Candiolo, Torino, Italy
| |
Collapse
|
28
|
Puppa G, Risio M, Sheahan K, Vieth M, Zlobec I, Lugli A, Pecori S, Wang LM, Langner C, Mitomi H, Nakamura T, Watanabe M, Ueno H, Chasle J, Senore C, Conley SA, Herlin P, Lauwers GY. Standardization of whole slide image morphologic assessment with definition of a new application: Digital slide dynamic morphometry. J Pathol Inform 2011; 2:48. [PMID: 22200031 PMCID: PMC3237062 DOI: 10.4103/2153-3539.86830] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 09/28/2011] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In histopathology, the quantitative assessment of various morphologic features is based on methods originally conceived on specific areas observed through the microscope used. Failure to reproduce the same reference field of view using a different microscope will change the score assessed. Visualization of a digital slide on a screen through a dedicated viewer allows selection of the magnification. However, the field of view is rectangular, unlike the circular field of optical microscopy. In addition, the size of the selected area is not evident, and must be calculated. MATERIALS AND METHODS A digital slide morphometric system was conceived to reproduce the various methods published for assessing tumor budding in colorectal cancer. Eighteen international experts in colorectal cancer were invited to participate in a web-based study by assessing tumor budding with five different methods in 100 digital slides. RESULTS The specific areas to be tested by each method were marked by colored circles. The areas were grouped in a target-like pattern and then saved as an .xml file. When a digital slide was opened, the .xml file was imported in order to perform the measurements. Since the morphometric tool is composed of layers that can be freely moved on top of the digital slide, the technique was named digital slide dynamic morphometry. Twelve investigators completed the task, the majority of them performing the multiple evaluations of each of the cases in less than 12 minutes. CONCLUSIONS Digital slide dynamic morphometry has various potential applications and might be a useful tool for the assessment of histologic parameters originally conceived for optical microscopy that need to be quantified.
Collapse
Affiliation(s)
- Giacomo Puppa
- Division of Pathology, G. Fracastoro, City Hospital, Verona
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Bertotti A, Migliardi G, Galimi F, Sassi F, Torti D, Isella C, Corà D, Di Nicolantonio F, Buscarino M, Petti C, Ribero D, Russolillo N, Muratore A, Massucco P, Pisacane A, Molinaro L, Valtorta E, Sartore-Bianchi A, Risio M, Capussotti L, Gambacorta M, Siena S, Medico E, Sapino A, Marsoni S, Comoglio PM, Bardelli A, Trusolino L. A molecularly annotated platform of patient-derived xenografts ("xenopatients") identifies HER2 as an effective therapeutic target in cetuximab-resistant colorectal cancer. Cancer Discov 2011; 1:508-23. [PMID: 22586653 DOI: 10.1158/2159-8290.cd-11-0109] [Citation(s) in RCA: 693] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
UNLABELLED Only a fraction of patients with metastatic colorectal cancer receive clinical benefit from therapy with anti-epidermal growth factor receptor (EGFR) antibodies, which calls for the identification of novel biomarkers for better personalized medicine. We produced large xenograft cohorts from 85 patient-derived, genetically characterized metastatic colorectal cancer samples ("xenopatients") to discover novel determinants of therapeutic response and new oncoprotein targets. Serially passaged tumors retained the morphologic and genomic features of their original counterparts. A validation trial confirmed the robustness of this approach: xenopatients responded to the anti-EGFR antibody cetuximab with rates and extents analogous to those observed in the clinic and could be prospectively stratified as responders or nonresponders on the basis of several predictive biomarkers. Genotype-response correlations indicated HER2 amplification specifically in a subset of cetuximab-resistant, KRAS/NRAS/BRAF/PIK3CA wild-type cases. Importantly, HER2 amplification was also enriched in clinically nonresponsive KRAS wild-type patients. A proof-of-concept, multiarm study in HER2-amplified xenopatients revealed that the combined inhibition of HER2 and EGFR induced overt, long-lasting tumor regression. Our results suggest promising therapeutic opportunities in cetuximab-resistant patients with metastatic colorectal cancer, whose medical treatment in the chemorefractory setting remains an unmet clinical need. SIGNIFICANCE Direct transfer xenografts of tumor surgical specimens conserve the interindividual diversity and the genetic heterogeneity typical of the tumors of origin, combining the flexibility of preclinical analysis with the informative value of population-based studies. Our suite of patient-derived xenografts from metastatic colorectal carcinomas reliably mimicked disease response in humans, prospectively recapitulated biomarker-based case stratification, and identified HER2 as a predictor of resistance to anti-epidermal growth factor receptor antibodies and of response to combination therapies against HER2 and epidermal growth factor receptor in this tumor setting.
Collapse
Affiliation(s)
- Andrea Bertotti
- Laboratory of Molecular Pharmacology, Division of Surgical Oncology, Unit of Pathology, Institute for Cancer Research and Treatment, Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Segnan N, Armaroli P, Bonelli L, Risio M, Sciallero S, Zappa M, Andreoni B, Arrigoni A, Bisanti L, Casella C, Crosta C, Falcini F, Ferrero F, Giacomin A, Giuliani O, Santarelli A, Visioli CB, Zanetti R, Atkin WS, Senore C. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial--SCORE. J Natl Cancer Inst 2011; 103:1310-22. [PMID: 21852264 DOI: 10.1093/jnci/djr284] [Citation(s) in RCA: 427] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A single flexible sigmoidoscopy at around the age of 60 years has been proposed as an effective strategy for colorectal cancer (CRC) screening. METHODS We conducted a randomized controlled trial to evaluate the effect of flexible sigmoidoscopy screening on CRC incidence and mortality. A questionnaire to assess the eligibility and interest in screening was mailed to 236,568 men and women, aged 55-64 years, who were randomly selected from six trial centers in Italy. Of the 56,532 respondents, interested and eligible subjects were randomly assigned to the intervention group (invitation for flexible sigmoidoscopy; n = 17,148) or the control group (no further contact; n = 17,144), between June 14, 1995, and May 10, 1999. Flexible sigmoidoscopy was performed on 9911 subjects. Intention-to-treat and per-protocol analyses were performed to compare the CRC incidence and mortality rates in the intervention and control groups. Per-protocol analysis was adjusted for noncompliance. RESULTS A total of 34,272 subjects (17,136 in each group) were included in the follow-up analysis. The median follow-up period was 10.5 years for incidence and 11.4 years for mortality; 251 subjects were diagnosed with CRC in the intervention group and 306 in the control group. Overall incidence rates in the intervention and control groups were 144.11 and 176.43, respectively, per 100,000 person-years. CRC-related death was noted in 65 subjects in the intervention group and 83 subjects in the control group. Mortality rates in the intervention and control groups were 34.66 and 44.45, respectively, per 100,000 person-years. In the intention-to-treat analysis, the rate of CRC incidence was statistically significantly reduced in the intervention group by 18% (rate ratio [RR] = 0.82, 95% confidence interval [CI] = 0.69 to 0.96), and the mortality rate was non-statistically significantly reduced by 22% (RR = 0.78; 95% CI = 0.56 to 1.08) compared with the control group. In the per-protocol analysis, both CRC incidence and mortality rates were statistically significantly reduced among the screened subjects; CRC incidence was reduced by 31% (RR = 0.69; 95% CI = 0.56 to 0.86) and mortality was reduced by 38% (RR = 0.62; 95% CI = 0.40 to 0.96) compared with the control group. CONCLUSION A single flexible sigmoidoscopy screening between ages 55 and 64 years was associated with a substantial reduction of CRC incidence and mortality.
Collapse
Affiliation(s)
- Nereo Segnan
- Centro di Prevenzione Oncologica Piemonte and S. Giovanni University Hospital, Turin, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Casazza A, Finisguerra V, Capparuccia L, Camperi A, Swiercz JM, Rizzolio S, Rolny C, Christensen C, Bertotti A, Sarotto I, Risio M, Trusolino L, Weitz J, Schneider M, Mazzone M, Comoglio PM, Tamagnone L. Sema3E–Plexin D1 signaling drives human cancer cell invasiveness and metastatic spreading in mice. J Clin Invest 2011. [DOI: 10.1172/jci59033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
32
|
Galimi F, Torti D, Sassi F, Isella C, Corà D, Gastaldi S, Ribero D, Muratore A, Massucco P, Siatis D, Paraluppi G, Gonella F, Maione F, Pisacane A, David E, Torchio B, Risio M, Salizzoni M, Capussotti L, Perera T, Medico E, Di Renzo MF, Comoglio PM, Trusolino L, Bertotti A. Genetic and expression analysis of MET, MACC1, and HGF in metastatic colorectal cancer: response to met inhibition in patient xenografts and pathologic correlations. Clin Cancer Res 2011; 17:3146-56. [PMID: 21447729 DOI: 10.1158/1078-0432.ccr-10-3377] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE We determined the gene copy numbers for MET, for its transcriptional activator MACC1 and for its ligand hepatocyte growth factor (HGF) in liver metastases from colorectal carcinoma (mCRC). We correlated copy numbers with mRNA levels and explored whether gain and/or overexpression of MET and MACC1 predict response to anti-Met therapies. Finally, we assessed whether their genomic or transcriptional deregulation correlates with pathologic and molecular parameters of aggressive disease. EXPERIMENTAL DESIGN One hundred three mCRCs were analyzed. Copy numbers and mRNA were determined by quantitative PCR (qPCR). Thirty nine samples were implanted and expanded in NOD (nonobese diabetic)/SCID (severe combined immunodeficient) mice to generate cohorts that were treated with the Met inhibitor JNJ-38877605. In silico analysis of MACC1 targets relied on genome-wide mapping of promoter regions and on expression data from two CRC datasets. RESULTS No focal, high-grade amplifications of MET, MACC1, or HGF were detected. Chromosome 7 polysomy and gain of the p-arm were observed in 21% and 8% of cases, respectively, and significantly correlated with higher expression of both Met and MACC1. Met inhibition in patient-derived xenografts did not modify tumor growth. Copy number gain and overexpression of MACC1 correlated with unfavorable pathologic features better than overexpression of Met. Bioinformatic analysis of putative MACC1 targets identified elements besides Met, whose overexpression cosegregated with aggressive forms of colorectal cancer. CONCLUSIONS Experiments in patient-derived xenografts suggest that mCRCs do not rely on Met genomic gain and/or overexpression for growth. On the basis of pathologic correlations and bioinformatic analysis, MACC1 could contribute to CRC progression through mechanisms other than or additional to Met transcriptional upregulation.
Collapse
Affiliation(s)
- Francesco Galimi
- Laboratories of Molecular Pharmacology, Institute for Cancer Research and Treatment IRCC, Candiolo, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Risio M, Bussolati G, Senore C, Vigna S, Frangipane E, Segnan N, Cassoni P. Virtual microscopy for histology quality assurance of screen-detected polyps. J Clin Pathol 2011; 63:916-20. [PMID: 20876325 DOI: 10.1136/jcp.2010.080580] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM Histology quality assurance is crucial for screening programmes and can be performed by circulating glass slides, which has certain intrinsic disadvantages. The present study aimed to assess the accuracy of virtual microscopy in terms of reliability and diagnostic reproducibility in colorectal cancer screening programmes. METHODS 457 consecutive lesions detected in people undergoing colonoscopy were examined histologically in two pathology units, using both traditional optical microscopy and virtual microscopy (6-12 months later). Intra- and inter-observer agreement using the two approaches was determined using κ statistics. RESULTS Intra- and inter-observer agreements were substantially unmodified by the use of the virtual microscopy approach compared with traditional optical microscopy; moreover, for some histological features critical for patient management in colorectal cancer screening programmes (such as the presence of a villous component within the adenoma), virtual microscopy increased interobserver agreement (κ statistics 0.66 versus 0.52). CONCLUSIONS This study shows that virtual microscopy can be an effective tool for diagnostic quality assurance in colorectal cancer screening programmes, and its accuracy is equivalent to or higher than that of optical microscopy in the validation of histological criteria (eg, advanced adenoma) crucial for patient management in screening programmes.
Collapse
Affiliation(s)
- Mauro Risio
- Unit of Pathology, IRCC, Candiolo-Torino, Italy
| | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
Epithelial colorectal tumors are common pathologic entities. Their histology report should be comprehensive of a series of pathologic parameters essential for the correct clinical management of the patients. Diagnostic histologic criteria of adenomatous, serrated, inflammatory, and hamartomatous polyps and of polyposis syndromes are discussed. In addition, the pathologic features of early and advanced colorectal cancer are described and a checklist is given. Finally, molecular prognostic and predictive factors currently employed in the treatment of colorectal cancer are discussed.
Collapse
Affiliation(s)
- Giovanni Lanza
- Department of Experimental and Diagnostic Medicine, University of Ferrara, Ferrara, Italy
| | | | | | | | | | | |
Collapse
|
35
|
Vieth M, Quirke P, Lambert R, von Karsa L, Risio M. Annex to Quirke et al. Quality assurance in pathology in colorectal cancer screening and diagnosis: annotations of colorectal lesions. Virchows Arch 2011; 458:21-30. [PMID: 21061132 PMCID: PMC3016168 DOI: 10.1007/s00428-010-0997-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/24/2010] [Indexed: 12/16/2022]
Abstract
Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document includes a chapter on pathology with pan-European recommendations which take into account the diversity and heterogeneity of health care systems across the EU. The present paper is based on the annex to the pathology chapter which attempts to describe in greater depth some of the issues raised in the chapter in greater depth, particularly details of special interest to pathologists. It is presented here to make the relevant discussion known to a wider scientific audience.
Collapse
Affiliation(s)
- Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Preuschwitzerstr. 101, 95445 Bayreuth, Germany.
| | | | | | | | | |
Collapse
|
36
|
Quirke P, Risio M, Lambert R, von Karsa L, Vieth M. Quality assurance in pathology in colorectal cancer screening and diagnosis—European recommendations. Virchows Arch 2011; 458:1-19. [PMID: 21061133 PMCID: PMC3016207 DOI: 10.1007/s00428-010-0977-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [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: 08/06/2010] [Revised: 08/29/2010] [Accepted: 09/05/2010] [Indexed: 02/08/2023]
Abstract
In Europe, colorectal cancer is the most common newly diagnosed cancer and the second most common cause of cancer deaths, accounting for approximately 436,000 incident cases and 212,000 deaths in 2008. The potential of high-quality screening to improve control of the disease has been recognized by the Council of the European Union who issued a recommendation on cancer screening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document consists of ten chapters and an extensive evidence base. The content of the chapter dealing with pathology in colorectal cancer screening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancer screening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community.
Collapse
Affiliation(s)
- Phil Quirke
- Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Mauro Risio
- Pathology Department, Institute for Cancer Research and Treatment, Turin, Italy
| | - René Lambert
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Lawrence von Karsa
- Quality Assurance Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Preuschwitzerstr. 101, 95445 Bayreuth, Germany
| |
Collapse
|
37
|
Risio M, Venesio T, Kolomoets E, Armaroli P, Gallo F, Balsamo A, Muto G, D'Urso L, Puppo P, Naselli A, Segnan N. Genetic polymorphisms of CYP17A1, vitamin D receptor and androgen receptor in Italian heredo-familial and sporadic prostate cancers. Cancer Epidemiol 2010; 35:e18-24. [PMID: 21094112 DOI: 10.1016/j.canep.2010.10.003] [Citation(s) in RCA: 11] [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] [Received: 04/29/2010] [Revised: 09/27/2010] [Accepted: 10/22/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Searching for genetic and environmental factors predisposing to prostate cancer, common single-nucleotide polymorphisms in CYP17A1, CYP19A1, VDR genes, and the number of CAG repeats from AR were investigated in Italian heredo-familial prostate cancer (HFPC) patients controlled for dietary intake and life style habits. METHODS We evaluated differences between HFPC and sporadic cancers, in the pattern of common single-nucleotide polymorphisms in CYP17A1, CYP19A1, VDR genes, and the CAG repeat from AR, controlling for dietary intake and lifestyle habits in a regionwide population. Ninety-five patients with HFPC were identified and 378 sporadic prostate cancers were randomly selected as controls. Dietary intake and lifestyle habits were determined through self-administered questionnaires in all patients. Genotyping of polymorphisms for CYP17A1, CYP19A1, VDR, and the CAG repeat from AR was carried out using pyrosequencing. RESULTS HFPC cases were significantly younger than controls, whereas similar proportions of localized tumours, favourable histology, and abnormal prostate serum antigen levels (4-19 ng/ml) were detected in the two groups. A statistically evident gene-gene interaction was found: a 5-fold higher probability [odds ratio (OR)=4.83; 95% confidence interval (CI): 1.37-17.02] of HFPC was observed in the subgroup profiling VDR1 T/T genotypes coupled with VDR2 T/T genotype. Among nutrients, an increase in HFPC risk (OR=3.14; 95% CI: 1.12-8.81) was found only for zinc, when associated with the VDR2 T/T genotype. CONCLUSIONS Significant evidence for positive interactions between VDR1 and VDR2 genotypes was demonstrated, suggesting that high-risk multigenic polymorphism profiles could variously sustain HFPC tumorigenesis.
Collapse
Affiliation(s)
- Mauro Risio
- Unit of Pathology, Institute for Cancer Research and Treatment, Strada Provinciale 142, 10060 Candiolo (TO), Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Pignochino Y, Sarotto I, Peraldo-Neia C, Penachioni JY, Cavalloni G, Migliardi G, Casorzo L, Chiorino G, Risio M, Bardelli A, Aglietta M, Leone F. Targeting EGFR/HER2 pathways enhances the antiproliferative effect of gemcitabine in biliary tract and gallbladder carcinomas. BMC Cancer 2010; 10:631. [PMID: 21087480 PMCID: PMC3000850 DOI: 10.1186/1471-2407-10-631] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [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] [Received: 09/24/2009] [Accepted: 11/18/2010] [Indexed: 12/16/2022] Open
Abstract
Background Advanced biliary tract carcinomas (BTCs) have poor prognosis and limited therapeutic options. Therefore, it is crucial to combine standard therapies with molecular targeting. In this study EGFR, HER2, and their molecular transducers were analysed in terms of mutations, amplifications and over-expression in a BTC case series. Furthermore, we tested the efficacy of drugs targeting these molecules, as single agents or in combination with gemcitabine, the standard therapeutic agent against BTC. Methods Immunohistochemistry, FISH and mutational analysis were performed on 49 BTC samples of intrahepatic (ICCs), extrahepatic (ECCs), and gallbladder (GBCs) origin. The effect on cell proliferation of different EGFR/HER2 pathway inhibitors as single agents or in combination with gemcitabine was investigated on BTC cell lines. Western blot analyses were performed to investigate molecular mechanisms of targeted drugs. Results EGFR is expressed in 100% of ICCs, 52.6% of ECCs, and in 38.5% of GBCs. P-MAPK and p-Akt are highly expressed in ICCs (>58% of samples), and to a lower extent in ECCs and GBCs (<46%), indicating EGFR pathway activation. HER2 is overexpressed in 10% of GBCs (with genomic amplification), and 26.3% of ECCs (half of which has genomic amplification). EGFR or its signal transducers are mutated in 26.5% of cases: 4 samples bear mutations of PI3K (8.2%), 3 cases (6.1%) in K-RAS, 4 (8.2%) in B-RAF, and 2 cases (4.1%) in PTEN, but no loss of PTEN expression is detected. EGI-1 cell line is highly sensitive to gemcitabine, TFK1 and TGBC1-TKB cell lines are responsive and HuH28 cell line is resistant. In EGI-1 cells, combination with gefitinib further increases the antiproliferative effect of gemcitabine. In TFK1 and TGBC1-TKB cells, the efficacy of gemcitabine is increased with addiction of sorafenib and everolimus. In TGBC1-TKB cells, lapatinib also has a synergic effect with gemcitabine. HuH28 becomes responsive if treated in combination with erlotinib. Moreover, HuH28 cells are sensitive to lapatinib as a single agent. Molecular mechanisms were confirmed by western blot analysis. Conclusion These data demonstrate that EGFR and HER2 pathways are suitable therapeutic targets for BTCs. The combination of gemcitabine with drugs targeting these pathways gives encouraging results and further clinical studies could be warranted.
Collapse
Affiliation(s)
- Ymera Pignochino
- Department of Medical Oncology, University of Torino Medical School, Institute for Cancer Research and Treatment, Candiolo, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Kishi Y, Zorzi D, Contreras CM, Maru DM, Kopetz S, Ribero D, Motta M, Ravarino N, Risio M, Curley SA, Abdalla EK, Capussotti L, Vauthey JN. Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases. Ann Surg Oncol 2010; 17:2870-6. [PMID: 20567921 DOI: 10.1245/s10434-010-1166-1] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Indexed: 02/03/2023]
Abstract
BACKGROUND The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab, pathologic response, and hepatotoxicity after hepatic resection for CLM. METHODS A total of 219 patients underwent hepatic resection following FOLFOX with or without bevacizumab and were divided into 2 groups according to the chemotherapy duration: 1-8 cycles (short duration [SD]; N = 157) and ≥9 cycles (long duration [LD]; N = 62). The frequency of complete or major pathologic response, sinusoidal injury, and major postoperative morbidity were compared. RESULTS Treatment consisting of ≥9 cycles was not associated with an increase in complete or major pathologic response (SD vs. LD, 57% vs. 55%; P = .74). The incidence of sinusoidal injury was higher in the LD group (26% vs. 42%; P = .017). The incidence of liver insufficiency was higher in the LD group (4% vs. 11%; P = .035). Sinusoidal injury did not predict postoperative liver insufficiency; multivariate analysis revealed ≥9 cycles was the only independent predictor of postoperative liver insufficiency (P = .031; odds ratio = 3.90). Chemotherapy including bevacizumab was associated with a significantly higher frequency of complete or major response in both SD and LD groups. CONCLUSIONS Extended preoperative chemotherapy increases the risk of hepatotoxicity in CLM without improving the pathologic response. The type of chemotherapy (FOLFOX with bevacizumab) has more impact on pathologic response than the duration of chemotherapy.
Collapse
Affiliation(s)
- Yoji Kishi
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
It is well known that adenomas represent the morphologically categorised precursor of the vast majority of colorectal cancers. Only few adenomas actually develop invasive cancer (progressive adenomas), although every adenoma has the capacity of malignant evolution. Most adenomas stabilise their progression or even regress. Easily identifiable but widely ranged pathological features (size, architectural growth, type, grade and gross organisation of dysplasia) are predictive of their natural history in terms of potential of cancerisation and duration of the adenoma-carcinoma sequence. Knowledge of the biological machineries sustaining the progression rates and times could be crucial to refine the natural history assumptions in screening modelling.
Collapse
Affiliation(s)
- Mauro Risio
- Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Strada Provinciale 142, Km. 3,95, 10060 Candiolo, Torino, Italy.
| |
Collapse
|
41
|
Casazza A, Finisguerra V, Capparuccia L, Camperi A, Swiercz JM, Rizzolio S, Rolny C, Christensen C, Bertotti A, Sarotto I, Risio M, Trusolino L, Weitz J, Schneider M, Mazzone M, Mazzone M, Comoglio PM, Tamagnone L. Sema3E-Plexin D1 signaling drives human cancer cell invasiveness and metastatic spreading in mice. J Clin Invest 2010; 120:2684-98. [PMID: 20664171 DOI: 10.1172/jci42118] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 05/19/2010] [Indexed: 12/14/2022] Open
Abstract
Semaphorin 3E (Sema3E) is a secreted molecule implicated in axonal path finding and inhibition of developmental and postischemic angiogenesis. Sema3E is also highly expressed in metastatic cancer cells, but its mechanistic role in tumor progression was not understood. Here we show that expression of Sema3E and its receptor Plexin D1 correlates with the metastatic progression of human tumors. Consistent with the clinical data, knocking down endogenous expression of either Sema3E or Plexin D1 in human metastatic carcinoma cells hampered their metastatic potential when injected into mice, while tumor growth was not markedly affected. Conversely, overexpression of exogenous Sema3E in cancer cells increased their invasiveness, transendothelial migration, and metastatic spreading, although it inhibited tumor vessel formation, resulting in reduced tumor growth in mice. The proinvasive and metastatic activity of Sema3E in tumor cells was dependent on transactivation of the Plexin D1-associated ErbB2/Neu oncogenic kinase. In sum, Sema3E-Plexin D1 signaling in cancer cells is crucially implicated in their metastatic behavior and may therefore be a promising target for strategies aimed at blocking tumor metastasis.
Collapse
Affiliation(s)
- Andrea Casazza
- Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Scatolini M, Grand MM, Grosso E, Venesio T, Pisacane A, Balsamo A, Sirovich R, Risio M, Chiorino G. Altered molecular pathways in melanocytic lesions. Int J Cancer 2010; 126:1869-1881. [PMID: 19795447 DOI: 10.1002/ijc.24899] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To identify gene expression changes in melanocytic lesions, biopsies from 18 common nevi (CMN), 11 dysplastic nevi (DN), 8 radial and 15 vertical growth phase melanomas (RGPM, VGPM), and 5 melanoma metastases (MTS) were analyzed using whole genome microarrays. The comparison between CMN and RGPM showed an enrichment of Gene Ontology terms related to inter and intracellular junctions, whereas the transition from RGPM to VGPM underlined the alteration of apoptosis. Upregulation of genes involved in dsDNA break repair and downregulation of cellular adhesion genes were observed in MTS with respect to VGPM. DN exhibited rather heterogeneous molecular profiles, with some proliferation genes expressed at higher levels than in CMN, altered regulation of transcription compared to RGPM and a subset of processes, such as mismatch repair, equally expressed as in VGPM. Furthermore, the expression profile of genes involved into cellular detoxification and antigen presentation split them into two classes, with different proliferation potential. Finally, molecular profiling of individual lesions identified altered biological processes, such as regulation of apoptosis, regulation of transcription and T-cell activation, not associated with specific histological classes but rather with subgroups of samples without apparent relationship. This holds true for dysplastic nevi in particular. Our data indicate that generally the intersection between stage specific and sample specific molecular alterations may lead to a more precise determination of the individual progression risk of melanocytic lesions.
Collapse
Affiliation(s)
| | | | - Enrico Grosso
- Cancer Genomics Lab, Fondo Edo Tempia, Biella, Italy
| | - Tiziana Venesio
- Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino, Italy
| | - Alberto Pisacane
- Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino, Italy
| | - Antonella Balsamo
- Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino, Italy
| | | | - Mauro Risio
- Unit of Pathology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino, Italy
| | | |
Collapse
|
43
|
Casorzo L, Corigliano M, Ferrero P, Venesio T, Risio M. Evaluation of 7q31 region improves the accuracy of EGFR FISH assay in non small cell lung cancer. Diagn Pathol 2009; 4:36. [PMID: 19889201 PMCID: PMC2781797 DOI: 10.1186/1746-1596-4-36] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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] [Received: 04/28/2009] [Accepted: 11/04/2009] [Indexed: 11/10/2022] Open
Abstract
Background Increase of EGFR gene copy number consequent to gene amplification and/or polysomy of chromosome 7 has been significantly associated with better clinical outcome in Non Small Cell Lung Cancer (NSCLC) patients treated with Tyrosin-Kinase Inhibitors (TKIs). The primary method to detect EGFR copy number is FISH (Fluorescence in Situ Hybridization), that in lung cancer requires a precise standardization due to the presence of intratumor heterogeneity and high frequency of chromosome 7 polysomy. Recommendations and interpretative guidelines to discriminate NSCLC patients into FISH positive (gene amplification and high chromosome 7 polysomy) and FISH negative have been proposed by the University of Colorado Cancer Center (UCCC). However, in a subset of cases the distinction between EGFR amplification and chromosome 7 polysomy can be controversial because of a complex pattern of multiple EGFR and centromere signals. Methods In order to distinguish more accurately these two genetic events, 20 NSCLC FISH positive patients, showing a controversial pattern of EGFR and centromere specific signals, were further evaluated for the status of 7q31 distal region. Results A discrepancy between FISH results obtained with UCCC scoring system and 7q31 control was evidenced in 2 patients (10%). Conclusion Our data strengthen the usefulness of 7q31 region evaluation to discriminate EGFR amplification from chromosome 7 polysomy in controversial EGFR FISH positive cases. Since it has been reported a possible different contribution of amplification and polysomy to TKIs susceptibility in NSCLC, the clear distinction between these two genetic events may be important to identify a subset of patients more responsive to the therapy.
Collapse
Affiliation(s)
- Laura Casorzo
- Unit of Pathology, Institute for Cancer Research and Treatment, Strada Provinciale 142, Candiolo-Torino, Italy.
| | | | | | | | | |
Collapse
|
44
|
Venesio T, Chiorino G, Balsamo A, Zaccagna A, Petti C, Scatolini M, Pisacane A, Sarotto I, Picciotto F, Risio M. In melanocytic lesions the fraction of BRAF V600E alleles is associated with sun exposure but unrelated to ERK phosphorylation. Mod Pathol 2008; 21:716-26. [PMID: 18408659 DOI: 10.1038/modpathol.2008.41] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BRAF(V600E) mutation has been frequently reported in different types of melanocytic lesions, but its role in melanomagenesis is poorly understood, having been associated with either the proliferative-induced MAPK pathway activation or the acquisition of oncogene-driven senescence. The presence of BRAF alterations has been related to sun exposure, although the molecular mechanisms underlying this event are only partly known. To elucidate the relationships among BRAF/NRAS alterations, MAPK pathway activation, and sun exposure, we examined 22 acquired nevi and 18 cutaneus melanomas from 38 patients. Microdissected tissues from each lesion were subjected to BRAF/NRAS mutation analysis by sequencing, allele-specific PCR and pyrosequencing assay. The same lesions were also examined for the expression of phosphorylated ERK1/2. Phototype and an accurate history of sun exposure were evaluated for each patient. BRAF(V600E) mutation was detected in 50% of the acquired nevi and in 70% of the cutaneus melanomas in the absence of NRAS alterations. The fraction of alleles carrying BRAF(V600E) substitution was variable but strongly associated with sun exposure. In contrast, no relationship was evidenced between the presence of this mutation and patients' phototype, phosphorylated ERK1/2 expression, or Clark's level. Our findings indicate that in melanocytic lesions, BRAF(V600E) mutation can affect a subset of the cells and is associated with the type and quantity of sun exposure. This mutation is independent of the nevo-melanoma progression and unrelated to ERK phosphorylation, suggesting that alternative mechanisms to the MAPK activation are also involved in this type of transformation.
Collapse
Affiliation(s)
- Tiziana Venesio
- Unit of Pathology, Institute for Cancer Research and Treatment, Candiolo, Torino, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Palmerini E, Fan K, Yang K, Risio M, Edelmann W, Lipkin M, Biasco G. Piroxicam increases colon tumorigenesis and promotes apoptosis in Mlh1 +/- /Apc1638(N/+) mice. Anticancer Res 2007; 27:3807-3812. [PMID: 18225536] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The present study examines the effect of piroxicam, a non-steroidal anti-inflammatory drug, on tumor development in Mlh1+/- /Apc1638(N/+) mice, in a preclinical model of human colon cancer. MATERIALS AND METHODS Mice were fed AIN-76A diet alone or premixed with piroxicam (60 ppm) for 9 weeks. The number, location and volume of tumors, and apoptosis in the flat mucosa were determined in small and large intestine. RESULTS Piroxicam reduced the number of tumors per mouse by 80% in the small intestine (0.1 vs. 0.5, p < 0.05). In contrast, piroxicam increased tumor incidence (82% vs. 10%, p < 0.01), tumor multiplicity (1.2 vs. 0.1, p < 0.01) and tumor volume (2.1 vs. 0.2 mm3, p < 0.01) in the colon. Apoptosis increased in the epithelium of the small intestine. CONCLUSION Consistent with the increased apoptosis, piroxicam reduced tumors in the small intestine. In the cecum, piroxicam increased tumorigenesis but apoptosis was not decreased, suggesting that other mechanisms besides apoptosis are involved in the differential organ-specific effect on tumorigenesis of piroxicam in this colon cancer model.
Collapse
MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Apoptosis/drug effects
- Apoptosis/genetics
- Colorectal Neoplasms, Hereditary Nonpolyposis/drug therapy
- Colorectal Neoplasms, Hereditary Nonpolyposis/genetics
- Colorectal Neoplasms, Hereditary Nonpolyposis/pathology
- Disease Models, Animal
- Epithelial Cells/drug effects
- Epithelial Cells/pathology
- Genes, APC
- Genetic Predisposition to Disease
- Intestine, Small/drug effects
- Intestine, Small/pathology
- Mice
- Mice, Mutant Strains
- MutL Protein Homolog 1
- Nuclear Proteins/genetics
- Piroxicam/pharmacology
- Random Allocation
Collapse
Affiliation(s)
- Emanuela Palmerini
- Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | | | | | | | | | | | | |
Collapse
|
46
|
Pisacane AM, Picciotto F, Risio M. CD31 and CD34 expression as immunohistochemical markers of endothelial transdifferentiation in human cutaneous melanoma. Anal Cell Pathol (Amst) 2007; 29:59-66. [PMID: 17429142 PMCID: PMC4618198 DOI: 10.1155/2007/486579] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Vasculogenic mimicry, as previously described in aggressive melanoma, is characterized by the de novo generation of intratumoral patterned vascular channels, composed of PAS-positive basement membrane in the absence of endothelial cells, providing additional microcirculation, in support to the classic tumoral angiogenesis. Methods: We investigated the immunohistochemical expression of two endothelial markers, CD31 and CD34, in tumoral cells of 60 melanomas (45 primary cutaneous and 15 metastatic) as possible evidence of vasculogenic mimicry. In addition we investigated the relationship between CD31 and CD34 expression and three pathological markers such as Clark’s level, and skin ulceration, predictive of melanoma’s aggressive behaviour, and mitotic index. Results: No cases of common melanocytic nevi immunoreacted with CD31 or CD34. Random CD31 immunoreactivity was present in 6% of Clark’s level I/II, 50% of Clark's level III and 80% Clark's level IV/V. CD34 was negative in Clark's level I/II but randomly stained the 20% and 55% of level III and IV/V respectively. 66% (10/15) of metastatic melanomas were CD31 positive showing a canalicular immunostaining pattern, conversely CD34 expression was never found. 7/8 cutaneous ulcerated melanomas immunostained for CD31 and 4/8 for CD34. CD31 immunostained 88% high/intermediate MI, and 53% of low MI melanomas. CD34 decorated the 29% of high/intermediate and 38% of low MI melanomas. Conclusions: CD31 and CD34 immunoreactivity closely parallel both the different morphologic steps of melanocytic tumor progression and the presence of histological parameters related to the aggressive behaviour. Their expression could be related to endothelial transdifferentiation of melanoma cells although a consequent functional role has not been demonstrated yet.
Collapse
Affiliation(s)
- A M Pisacane
- Unit of Pathology, Institute for Cancer Research and Treatment, 10060 Candiolo, Torino, Italy.
| | | | | |
Collapse
|
47
|
Aglietta M, Pignochino Y, Cavalloni G, Sarotto I, Penachioni J, Zanon C, Migliardi G, Piacibello W, Risio M, Bardelli A, Leone F. Somatic mutations of EGFR signal transducers and expression of tumor suppressor PTEN in biliary tract carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4582 Background: Biliary tract carcinomas express EGFR and are potential candidates to EGFR target therapies. We recently described somatic mutations of EGFR that can enhance MAPK or Akt activation (Clin Cancer Res, 2006). Some of them are identical to those previously reported to confer sensitivity to some tyrosine kinase inhibitors (TKIs) like erlotinib or gefitinib in lung cancer. Here we report a molecular analysis of EGFR transducers potentially involved in TKI response. Methods: In 49 samples of biliary tract carcinoma we performed mutational analysis of exons from 18 to 21 of EGFR, exons 9 and 20 of phosphatidylinositol 3’-kinase (PI3K), exon 2 of K-Ras, exon 15 of B-Raf and exons from 5 to 8 of PTEN. Nuclear PTEN expression was analyzed by immunohistochemistry and the expression in cancer cells was compared to that of normal cholangiocites. Results: Mutations of EGFR have been detected in 7 out of 49 samples (14.3%). One of them was a new stop-codon mutation. Five hotspot mutations of PI3K (codon 545, 546, 1048 and 1059) were found in 4 cases (8.2%); 3 cases (6.1%) had single mutations in K-Ras and 4 (8.2%) had the V599E mutation in B-Raf. In some samples, mutations of multiple trasducers were present simultaneously. PI3K mutations were significantly more frequent in EGFR mutated samples compared to wild type (28% vs. 4.7% respectively, p<0.05). A single F271L mutation of PTEN was observed (2%). We did not find loss of nuclear PTEN in biliary tract carcinoma cells; rather, a stronger labelling intensity (score 2+ or 3+) was present in biliary tract carcinoma compared to normal cholangiocites (score 1+). Moreover, the median percentage of PTEN labeled nuclei in tumor cells was 31.8%, but in samples with activating EGFR mutation was 60%, suggesting that a compensatory change in the level of the phosphatase might counteract the EGFR activition. Conclusions: These results corroborate our previous finding of EGFR pathway activation in EGFR mutated biliary tract carcinoma and suggest that an accurate analysis of the entire series of EGFR transducers may be done before planning treatments with TKIs. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- M. Aglietta
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - Y. Pignochino
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - G. Cavalloni
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - I. Sarotto
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - J. Penachioni
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - C. Zanon
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - G. Migliardi
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - W. Piacibello
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - M. Risio
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - A. Bardelli
- Institute of Cancer Research and Treatment, Candiolo, Italy
| | - F. Leone
- Institute of Cancer Research and Treatment, Candiolo, Italy
| |
Collapse
|
48
|
Segnan N, Senore C, Andreoni B, Azzoni A, Bisanti L, Cardelli A, Castiglione G, Crosta C, Ederle A, Fantin A, Ferrari A, Fracchia M, Ferrero F, Gasperoni S, Recchia S, Risio M, Rubeca T, Saracco G, Zappa M. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology 2007; 132:2304-12. [PMID: 17570205 DOI: 10.1053/j.gastro.2007.03.030] [Citation(s) in RCA: 183] [Impact Index Per Article: 10.8] [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] [Received: 09/11/2006] [Accepted: 02/22/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS We conducted a study to estimate population coverage and detection rate (DR) achievable through different strategies of colorectal cancer (CRC) screening. METHODS A population-based multicenter randomized trial comparing 3 strategies was used: (1) biennial immunologic fecal occult blood test (FIT), (2) "once only" sigmoidoscopy (FS), and (3) "once only" colonoscopy (TC). A random sample of men and women, aged 55 to 64 years, was drawn from general practitioners' (GP) rosters. Eligible subjects, randomized within GP, were mailed a personal invitation. Nonresponders in groups 2 and 3 were invited again at 12 and 24 months. Screenees with "high-risk" distal polyps (villous component >20%, high-grade dysplasia, CRC, size >or=10 mm, >2 adenomas) at FS, or with positive FIT, were referred for TC. RESULTS The attendance rate was 32.3% (1965/6075) for FIT, 32.3% (1944/6018) for FS, 26.5% (1597/6021) for TC. FIT detected 2 patients with CRC (0.1%) and 21 with an advanced adenoma (1.1%). The corresponding figures were as follows: 12 (0.6%) and 86 (4.5%) patients, respectively, for FS; 13 (0.8%) and 100 (6.3%) patients, respectively, for TC. To detect 1 advanced neoplasm, it would be necessary to invite 264 people with FIT, 60 with FS, 53 with TC. FS would have detected 27.3% of the proximal advanced neoplasms detected at TC. Assuming the same participation rate at TC as at FS, 48 TCs would be necessary to detect 1 additional advanced neoplasm missed by FS. CONCLUSIONS When participants are offered 1 screening test, participation is lower in a TC than in an FS program. However, DR of advanced neoplasia is higher with TC.
Collapse
|
49
|
Venesio T, Balsamo A, Sfiligoi C, Fuso L, Molatore S, Ranzani GN, Risio M. Constitutional high expression of an APC mRNA isoform in a subset of attenuated familial adenomatous polyposis patients. J Mol Med (Berl) 2006; 85:305-12. [PMID: 17143620 DOI: 10.1007/s00109-006-0127-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Revised: 09/27/2006] [Accepted: 09/29/2006] [Indexed: 10/23/2022]
Abstract
Familial adenomatous polyposis is an inherited condition associated with hundreds to thousands of colorectal adenomas conferring a very high risk of cancer at a young age. In addition to "classical" form, there is also an attenuated polyposis, with fewer than 100 polyps and a delayed age of cancer onset. Both classical and attenuated polyposis are characterized by a relevant phenotypic heterogeneity. The disease has been linked to constitutive mutations of either APC tumor suppressor gene, or less frequently, MYH base-excision repair gene. However, the genetic cause remains undetected in up to 70-80% of patients with the attenuated form. This analysis was performed on 26 polyposis patients with the attenuated phenotype. All patients had formerly proven to be negative for APC truncating mutations that typically represent the majority of APC gene alterations. We evaluated the APC mRNA constitutional level by real-time quantitative reverse transcription polymerase chain reaction (PCR). Eleven patients (42%) showed an anomalous APC transcription level. One patient with reduced mRNA was a carrier of a whole APC gene deletion. In seven out of the ten remaining cases, we found the increased expression of an APC mRNA isoform resulting from exon 10/15 connection and giving rise to a stable truncated peptide. Mutations neither in the invariant splice sites nor in the known transcription regulatory signals were found. Our results support the notion that in attenuated polyposis patients, a detailed investigation of APC transcription can allow detection of rare alterations. Although functional data are required, the isoform we observed might have some pathogenic role, accounting for the heterogeneous phenotype that characterizes the polyposis syndrome.
Collapse
Affiliation(s)
- Tiziana Venesio
- Unit of Pathology, Institute for Cancer Research and Treatment-IRCC, Strada Provinciale 142, 10060, Candiolo, Torino, Italy.
| | | | | | | | | | | | | |
Collapse
|
50
|
Biasco G, Nobili E, Calabrese C, Sassatelli R, Camellini L, Pantaleo MA, Bertoni G, De Vivo A, Ponz De Leon M, Poggioli G, Bedogni G, Venesio T, Varesco L, Risio M, Di Febo G, Brandi G. Impact of surgery on the development of duodenal cancer in patients with familial adenomatous polyposis. Dis Colon Rectum 2006; 49:1860-6. [PMID: 17103055 DOI: 10.1007/s10350-006-0723-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 02/08/2023]
Abstract
PURPOSE Precancerous duodenal lesions in patients with familial adenomatous polyposis can be detected with duodenoscopy and treatment may prevent the development of cancer. We proposed to determine the frequency, natural history, cumulative risk, and risk factors of the precancerous duodenal lesions in a series of patients diagnosed in northern Italy. METHODS A prospective, endoscopic, follow-up protocol was performed in 50 patients examined by gastroduodenoscopy at two years of interval or less. The presence and severity of precancerous lesions of the duodenal mucosa were evaluated by Spigelman score. Twenty-five patients (50 percent) had proctocolectomy and ileoanal anastomosis, 15 (30 percent) had colectomy and ileorectal anastomosis, and 5 (10 percent) had proctocolectomy and definitive ileostomy from 0 to 3 years before the admission to the surveillance program. All patients showed more than a thousand adenomas in the colorectal mucosa. No patients with attenuated polyposis were found. RESULTS At the first endoscopy, duodenal adenomas could be detected in 19 of 50 patients (38 percent), whereas at the end of the follow-up, 43 (86 percent) had duodenal lesions. The final mean Spigelman score increased during the follow-up period (P<0.001 respect to baseline values). No duodenal cancer could be detected. Eleven patients had or developed severe precancerous duodenal lesions (Stage IV) treated with endoscopic or surgical resection. The distribution of patients with Stage IV according to the surgery of the colon was: 2 of 25 treated with ileoanal anastomosis and 8 of 15 with ileorectal anastomosis (P=0.0024, Fisher's exact test). CONCLUSIONS Patients with familial adenomatous polyposis are at risk of significant neoplasia. The natural history of precancerous lesions might be related to surgical treatment of colorectal neoplasms.
Collapse
Affiliation(s)
- G Biasco
- Institute of Haemathology and Medical Oncology L and A Seràgnoli, Via Massarenti 9, 40138, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|