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McKenzie CA, Gupta R, Jackett L, Anderson L, Chen V, Dahlstrom JE, Dray M, Farshid G, Hemmings C, Karim R, Kench JG, Klebe S, Kramer N, Kumarasinghe P, Maclean F, Morey A, Nguyen MA, O'Toole S, Rowbotham B, Salisbury ELC, Scolyer RA, Stewart K, Waring L, Cooper CL, Cooper WA. Looking beyond workforce parity: addressing gender inequity in pathology. Pathology 2023; 55:760-771. [PMID: 37573162 DOI: 10.1016/j.pathol.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/14/2023]
Abstract
While women pathologists have made up over one-third of pathologists in the Australian workforce for over 15 years and at least 50% since 2019, they are under-represented in senior leadership roles, scientific publications, grant recipients, editorial boards, key presentations, and professional awards. This is not unique to pathology and is seen in the broader medical and academic community. Barriers to gender equity and equality in pathology, medicine and academia include gender stereotypes, gender-based discrimination, structural and organisational barriers as well as broader social and cultural barriers. A diverse leadership reflective of the whole professional body and the broader community is important for optimal health outcomes. It is the responsibility and moral duty of individuals and organisations to address any gender disparities, inequities, and inequalities by monitoring, identifying, and acting on gender biases and systemic barriers that hinder appropriate levels of representation by women.
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Affiliation(s)
- Catriona A McKenzie
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | - Lyndal Anderson
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Vivien Chen
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Haematology Concord Repatriation and General Hospital, Sydney, NSW, Australia
| | - Jane E Dahlstrom
- ACT Pathology Canberra Health Services, Canberra, ACT, Australia; Australian National University, Canberra, ACT, Australia
| | | | - Gelareh Farshid
- SA Pathology, Adelaide, SA, Australia; University of Adelaide, Adelaide, SA, Australia
| | - Chris Hemmings
- Department of Anatomic Pathology Canterbury Health Laboratories, Christchurch, New Zealand; Department of Pathology and Biomedical Science University of Otago, Christchurch, New Zealand
| | - Rooshdiya Karim
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - James G Kench
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Sonja Klebe
- SA Pathology, Adelaide, SA, Australia; Flinders University, Adelaide, SA, Australia
| | | | | | - Fiona Maclean
- Douglass Hanly Moir Pathology Sonic Healthcare, Sydney, NSW, Australia; Macquarie University, Sydney, NSW, Australia
| | - Adrienne Morey
- ACT Pathology Canberra Health Services, Canberra, ACT, Australia; Australian National University, Canberra, ACT, Australia
| | - Minh Anh Nguyen
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Sandra O'Toole
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; School of Medicine, University of Western Sydney, Sydney, NSW, Australia
| | - Beverley Rowbotham
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia; The University of Queensland, Brisbane, Qld, Australia
| | - Elizabeth L C Salisbury
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia; School of Medicine, University of Western Sydney, Sydney, NSW, Australia; ICPMR Westmead Hospital, NSW Health Pathology, Westmead, NSW, Australia
| | - Richard A Scolyer
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | | | | | - Caroline L Cooper
- The University of Queensland, Brisbane, Qld, Australia; Pathology Queensland, Princess Alexandra Hospital, Brisbane, Qld, Australia
| | - Wendy A Cooper
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; School of Medicine, University of Western Sydney, Sydney, NSW, Australia
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Kővári B, El Naili R, Pereira DV, Kumarasinghe P, De Boer WB, Jiang K, Pimiento JM, Fukuda M, Misdraji J, Kushima R, Lauwers GY. Fundic gland polyps related to diverse aetiologies show subtle morphologic differences: A multicentre retrospective study. Histopathology 2022; 80:827-835. [DOI: 10.1111/his.14623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Bence Kővári
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
- Department of Pathology University of Szeged, Albert Szent‐Györgyi Medical School
| | | | | | | | - W. Bastiaan De Boer
- Department of Pathology PathWest Laboratory –University of Western Australia
| | - Kun Jiang
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
| | - Jose M. Pimiento
- Department of Gastrointestinal Oncology H. Lee Moffitt Cancer Center & Research Institute
| | | | | | - Ryoji Kushima
- Department of Pathology Shiga University of Medical Science
| | - Gregory Y Lauwers
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
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Shi C, Badgwell BD, Grabsch HI, Gibson MK, Hong SM, Kumarasinghe P, Lam AK, Lauwers G, O'Donovan M, van der Post RS, Tang L, Ushiku T, Vieth M, Selinger CI, Webster F, Nagtegaal ID. Data Set for Reporting Carcinoma of the Stomach in Gastrectomy. Arch Pathol Lab Med 2021; 146:1072-1083. [DOI: 10.5858/arpa.2021-0225-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/06/2022]
Abstract
Context.—
A standardized detailed surgical pathology report is the cornerstone of gastric cancer management.
Objective.—
To guide management and prognostication for patients with gastric carcinomas globally, the International Collaboration on Cancer Reporting aimed to produce an evidence-based international pathology reporting data set with a panel of globally recognized expert pathologists and clinicians.
Design.—
Based on published guidelines/data sets for gastric carcinomas, a working draft was developed by the chair of the expert panel of pathologists and clinicians. The draft was then circulated to the panel and discussed in a series of teleconferences and email communications until consensus was achieved. The draft data set was uploaded on the International Collaboration on Cancer Reporting Web site for public comment. The data set was reviewed in consideration of the feedback, and a final version was approved by the panel.
Results.—
This data set was developed for gastrectomy specimens for primary gastric carcinomas, including neuroendocrine carcinomas and mixed neuroendocrine-nonneuroendocrine neoplasms. Well-differentiated neuroendocrine tumors, nonepithelial malignancies, and secondary tumors were excluded from this data set. The final data set contains 15 core (required) elements and 8 noncore (recommended) elements. A commentary is provided for each element.
Conclusions.—
The International Collaboration on Cancer Reporting has published freely available, evidence-based data sets for gastric cancer reporting. Standardized reporting has been shown to improve patient care and facilitates data exchange and analysis for quality assurance, cancer epidemiology, and clinical and basic research.
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Affiliation(s)
- Chanjuan Shi
- From the Department of Pathology, Duke University School of Medicine, Durham, North Carolina (Shi)
| | - Brian D. Badgwell
- The Division of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston (Badgwell)
| | - Heike I. Grabsch
- The Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands (Grabsch)
- The Division of Pathology & Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom (Grabsch)
| | - Michael K. Gibson
- The Division of Hematology and Oncology, Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (Gibson)
| | - Seung-Mo Hong
- The Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (Hong)
| | - Priyanthi Kumarasinghe
- PathWest Laboratory Medicine, PathWest QEII Medical Center, Perth, Australia (Kumarasinghe)
| | - Alfred K. Lam
- Pathology, School of Medicine, Gold Coast Campus, Griffith University, Gold Coast, Australia (Lam)
- Pathology Queensland, Gold Coast University Hospital, Southport, Australia (Lam)
- Faculty of Medicine, The University of Queensland, Herston, Australia (Lam)
| | - Gregory Lauwers
- The Department of Pathology, Moffitt Cancer Center, Tampa, Florida (Lauwers)
| | - Maria O'Donovan
- The Histopathology Department, Cambridge University Hospitals NHS Foundation Trust Addenbrookes Hospital, Cambridge, United Kingdom (O'Donovan)
| | - Rachel S. van der Post
- The Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands (van der Post and Nagtegaal)
| | - Laura Tang
- The Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, (Tang)
| | - Tetsuo Ushiku
- The Department of Pathology and Diagnostic Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Ushiku)
| | - Michael Vieth
- The Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, Klinikum Bayreuth, Germany (Vieth)
| | | | - Fleur Webster
- The International Collaboration on Cancer Reporting, Sydney, Australia (Webster)
| | - Iris D. Nagtegaal
- The Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands (van der Post and Nagtegaal)
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Liu CY, Chen CC, Bychkov A, Agarwal S, Zhu Y, Hang JF, Lai CR, Na HY, Park SY, Li W, Liu Z, Jain D, Suzuki A, Hirokawa M, Chia N, Nga ME, Jitpasutham T, Keelawat S, Satoh S, Gunawardena D, Kumarasinghe P, Jung CK, Kakudo K. Constitutive Cytomorphologic Features of Medullary Thyroid Carcinoma Using Different Staining Methods. Diagnostics (Basel) 2021; 11:diagnostics11081396. [PMID: 34441330 PMCID: PMC8392035 DOI: 10.3390/diagnostics11081396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Accurate preoperative identification of medullary thyroid carcinoma (MTC) is challenging due to a spectrum of cytomorphologic features. However, there is a scarcity of studies describing the cytomorphologic features as seen on fine-needle aspiration (FNA) smears prepared using different staining methods. (2) Methods: We performed a retrospective study on MTC cases with available FNA slides from 13 hospitals distributed across 8 Asia-Pacific countries. The differences in the constitutive cytomorphologic features of MTC with each cytopreparatory method were recorded. A comparative analysis of cytologic characteristics was carried out with appropriate statistical tests. (3) Results: Of a total of 167 MTC samples retrospectively recruited, 148 (88.6%) were interpreted as MTC/suspicious for MTC (S-MTC). The staining methods used were Papanicolaou, hematoxylin-eosin, and Romanowsky stains. Seven out of the eleven cytologic criteria can be readily recognized by all three cytopreparatory methods: high cellularity, cellular pleomorphism, plasmacytoid cells, round cells, dyshesive cells, salt-and-pepper chromatin, and binucleation or multinucleation. An accurate diagnosis was achieved in 125 (84.5%) of the 148 samples whose FNAs exhibited five or more atypical features. Conclusions: The present work is the first study on MTC to compare the morphological differences among the cytologic staining techniques. We investigated the constitutive features and the reliability of diagnostic parameters. A feasible scoring system based upon cytomorphologic data alone is proposed to achieve a high degree of diagnostic accuracy.
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Affiliation(s)
- Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City 221, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 221, Taiwan
- Correspondence: ; Tel.: +886-226482121-3741
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan;
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
| | - Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, Chiba 296-8602, Japan;
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India; (S.A.); (D.J.)
| | - Yun Zhu
- Department of Pathology, Jiangsu Institution of Nuclear Medicine, Wuxi 214063, China;
| | - Jen-Fan Hang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (J.-F.H.); (C.-R.L.)
| | - Chiung-Ru Lai
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (J.-F.H.); (C.-R.L.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Hee Young Na
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea; (H.Y.N.); (S.Y.P.)
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea; (H.Y.N.); (S.Y.P.)
| | - Weiwei Li
- Department of Pathology, Shandong University School of Basic Medical Sciences, Jinan 250012, China;
| | - Zhiyan Liu
- Department of Pathology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China;
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India; (S.A.); (D.J.)
| | - Ayana Suzuki
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe 650-0011, Japan; (A.S.); (M.H.)
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe 650-0011, Japan; (A.S.); (M.H.)
| | - Noel Chia
- Department of Pathology, National University Hospital, Singapore 119074, Singapore; (N.C.); (M.E.N.)
| | - Min En Nga
- Department of Pathology, National University Hospital, Singapore 119074, Singapore; (N.C.); (M.E.N.)
| | - Tikamporn Jitpasutham
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (T.J.); (S.K.)
| | - Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (T.J.); (S.K.)
| | - Shinya Satoh
- Department of Endocrine Surgery, Yamashita Thyroid and Parathyroid Clinic, Fukuoka 812-0034, Japan;
| | - Dilini Gunawardena
- School of Pathology & Laboratory Medicine, University of Western Australia, Perth, WA 6009, Australia; (D.G.); (P.K.)
| | - Priyanthi Kumarasinghe
- School of Pathology & Laboratory Medicine, University of Western Australia, Perth, WA 6009, Australia; (D.G.); (P.K.)
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Kennichi Kakudo
- Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Osaka 594-0073, Japan;
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Lam AK, Bourke MJ, Chen R, Fiocca R, Fujishima F, Fujii S, Jansen M, Kumarasinghe P, Langer R, Law S, Meijer SL, Muldoon C, Novelli M, Shi C, Tang L, Nagtegaal ID. Dataset for the reporting of carcinoma of the esophagus in resection specimens: recommendations from the International Collaboration on Cancer Reporting. Hum Pathol 2021; 114:54-65. [PMID: 33992659 DOI: 10.1016/j.humpath.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES A standardized data set for esophageal carcinoma pathology reporting was developed based on the approach of the International Collaboration on Cancer Reporting (ICCR) for the purpose of improving cancer patient outcomes and international benchmarking in cancer management. MATERIALS AND METHODS The ICCR convened a multidisciplinary international expert panel to identify the best evidence-based clinical and pathological parameters for inclusion in the data set for esophageal carcinoma. The data set incorporated the current edition of the World Health Organization Classification of Tumours of the Digestive System, and Tumour-Node-Metastasis staging systems. RESULTS The scope of the data set encompassed resection specimens of the esophagus and esophagogastric junction with tumor epicenter ≤20 mm into the proximal stomach. Core reporting elements included information on neoadjuvant therapy, operative procedure used, tumor focality, tumor site, tumor dimensions, distance of tumor to resection margins, histological tumor type, presence and type of dysplasia, tumor grade, extent of invasion in the esophagus, lymphovascular invasion, response to neoadjuvant therapy, status of resection margin, ancillary studies, lymph node status, distant metastases, and pathological staging. Additional non-core elements considered useful to report included clinical information, specimen dimensions, macroscopic appearance of tumor, and coexistent pathology. CONCLUSIONS This is the first international peer-reviewed structured reporting data set for surgically resected specimens of the esophagus. The ICCR carcinoma of the esophagus data set is recommended for routine use globally and is a valuable tool to support standardized reporting, to benefit patient care by providing diagnostic and prognostic best-practice parameters.
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Affiliation(s)
- Alfred K Lam
- Pathology, School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, Queensland, 4222, Australia; Pathology Queensland, Gold Coast University Hospital, Southport, Queensland, 4222, Australia; Faculty of Medicine, The University of Queensland, Herston, Queensland, 4006, Australia.
| | - Michael J Bourke
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, 2145, Australia; University of Sydney, Westmead Clinical School, Sydney, New South Wales, 2145, Australia.
| | - Renyin Chen
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450052, Henan Province, PR China.
| | - Roberto Fiocca
- Department of Pathology, University of Genova and IRCCS Policlinico San Martino, 16132, Genova, Italy.
| | - Fumiyoshi Fujishima
- Department of Pathology, Tohoku University Hospital, Aoba-ku, Sendai, 980-8574, Japan.
| | - Satoshi Fujii
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan; Department of Pathology and Clinical Laboratories, National Cancer Centre Hospital East, Kashiwa, 6-5-1, Japan.
| | - Marnix Jansen
- University College London (UCL) Cancer Institute, London, United Kingdom; University College London Hospitals NHS Trust, London, WC1E 6DD, United Kingdom.
| | - Priyanthi Kumarasinghe
- PathWest Laboratory Medicine, PathWest QEII Medical Centre, Perth, 6009, Western Australia, Australia.
| | - Rupert Langer
- Institute of Pathology, University of Bern, 3012 Bern, Switzerland.
| | - Simon Law
- Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
| | - Sybren L Meijer
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, 1105, AZ, the Netherlands.
| | - Cian Muldoon
- Histopathology Department, St James's Hospital, Dublin, D08 NHY1, Ireland.
| | - Marco Novelli
- Research Department of Pathology, University College London Medical School, London, WC1E 6DD, United Kingdom.
| | - Chanjuan Shi
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27708, United States.
| | - Laura Tang
- Department of Pharmacy, Memorial Sloan Kettering Cancer Centre, New York City, NY, 10065, United States.
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Centre, Nijmegen, 6500, the Netherlands.
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Pai RK, Pai RK, Schaeffer DF, Choi WT, Kumarasinghe P, Brown I, Lauwers GY. Editorial: the microscope holds the key to predict need for biologic therapy in immunotherapy-checkpoint inhibitory colitis. Authors' reply. Aliment Pharmacol Ther 2021; 53:638-639. [PMID: 33566423 DOI: 10.1111/apt.16245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Rish K Pai
- Department of Laboratory Medicine & Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Reetesh K Pai
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - David F Schaeffer
- Department of Pathology, University of British Columbia, Vancouver, BC, Canada
| | - Won-Tak Choi
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Priyanthi Kumarasinghe
- Department of Anatomical Pathology, PathWest Laboratory Medicine and University of Western Australia, Perth, WA, Australia
| | - Ian Brown
- Envoi Specialist Pathologists, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Gregory Y Lauwers
- Department of Pathology, Henry L. Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Richards C, Levic K, Fischer J, Eglinton T, Ramsay G, Kumarasinghe P, Raftopoulos S, Brown I. International validation of a risk prediction algorithm for patients with malignant colorectal polyps. Colorectal Dis 2020; 22:2105-2113. [PMID: 32931132 DOI: 10.1111/codi.15365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/31/2020] [Indexed: 02/08/2023]
Abstract
AIM The optimal management strategy for patients with endoscopically resected malignant colorectal polyps (MCP) has yet to be defined. The aim of this study was to validate a published decision-making tool, termed the Scottish Polyp Cancer Study (SPOCS) algorithm, on a large international population. METHODS The SPOCS algorithm allocates patients to risk groups based on just two variables: the polyp resection margin and the presence of lymphovascular invasion (LVI). The risk groups are termed low (clear margin, LVI absent), medium (clear margin, LVI present) or high (involved/non-assessable margin). The International Polyp Cancer Collaborative was formed to validate the algorithm on data from Australia, Denmark, UK and New Zealand. RESULTS In total, 1423 patients were included in the final dataset. 680/1423 (47.8%) underwent surgical resection and 108/680 (15.9%) had residual disease (luminal disease 8.8%, lymph node metastases 8.8%). The SPOCS algorithm classified 602 patients as low risk (in which 1.5% had residual disease), 198 patients as medium risk (in which 7.1% had residual disease) and 484 as high risk (in which 14.5% had residual disease) (P < 0.001, χ2 test). Receiver operating characteristic curve analysis demonstrated good accuracy of the algorithm in predicting residual disease (area under the curve 0.732, 95% CI 0.687-0.778, P < 0.001). When patients were designated as low risk, the negative predictive value was 98.5%. CONCLUSION The SPOCS algorithm can be used to predict the risk of residual disease in patients with endoscopically resected MCPs. Surgery can be safely avoided in patients who have a clear margin of excision and no evidence of LVI.
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Affiliation(s)
- C Richards
- Department of Surgery, Raigmore Hospital, Inverness, UK
| | - K Levic
- Gastrounit - Surgical Division, Copenhagen University Hospital, Copenhagen, Denmark
| | - J Fischer
- Department of General Surgery, North Shore Hospital, Auckland, New Zealand
| | - T Eglinton
- Department of Surgery, University of Otago, Dunedin, New Zealand
| | - G Ramsay
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK
| | - P Kumarasinghe
- Pathwest, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - S Raftopoulos
- Department of Gastroenterology, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - I Brown
- Envoi Specialist Pathologists, Brisbane, Queensland, Australia
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Pateria P, Chong A, Muwanwella N, Siah C, Kumarasinghe P, Raftopoulos S. To Investigate Outcomes In Endoscopic Management Of Early Oesophageal Adenocarcinoma In Barrett's Oesophagus: Experience At Three Australian Tertiary Centres. Intern Med J 2020; 52:633-639. [PMID: 33073906 DOI: 10.1111/imj.15104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/05/2020] [Accepted: 10/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Barrett's oesophagus (BO) is known precursor of oesophageal adenocarcinoma (EAC). Early EAC includes T1a (invasion into mucosa) and T1b (invasion into submucosa but not muscularis propria). Endoscopic mucosal resection (EMR) provides accurate histological staging and definitive treatment for early EAC. Post EMR, the remaining Barrett's is eradicated with radiofrequency ablation (RFA). However, there is a paucity of long-term Australian data. AIMS To investigate the efficacy and long-term outcomes of EMR and RFA in management of early EAC. METHODS Retrospective analysis of patients early EAC treated endoscopically at three Western Australian tertiary centres, with at least 12-months follow-up, over last 10-years. RESULTS Sixty-seven patients with early EAC (61 T1a and 6 T1b) were treated with EMR. Complete Barrett's eradication was done by EMR in 31/67 patients whereas 36/67 patients underwent RFA for residual Barrett's. EMR changed pinch biopsy histology from HGD (n=33), HGD suspicious for IMC (n=5) and LGD (n=1) to early EAC in 58.2% (n=39) patients. During a mean follow-up of 37.2 months (IQR 20, 56), complete remission of dysplasia (CRD) and intestinal metaplasia (CRIM) was seen in 97% (n=65) and 89.5% (n=60) patients. One patient with T1b EAC underwent oesophagectomy. No cases developed metachronous EAC, progression to invasive adenocarcinoma or development of nodal/distant metastasis. Complications were endoscopically treated haematemesis (n=1) and strictures (n=16) requiring dilatations. 3 patients died due to causes unrelated to IMC. CONCLUSION EMR in conjunction with RFA is an effective and safe management for early EAC. EMR provides accurate staging and has low complication rates. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Puraskar Pateria
- Department of gastroenterology and hepatology, Fiona Stanley Hospital, 11, Robin Warren Dr, Murdoch, Western Australia, 6150
| | - Andre Chong
- Department of gastroenterology and hepatology, Fiona Stanley Hospital, 11, Robin Warren Dr, Murdoch, Western Australia, 6150
| | - Niroshan Muwanwella
- Department of gastroenterology and hepatology, Royal Perth Hospital, Victoria Square, Perth, Western Australia, 6000
| | - Chiang Siah
- Department of gastroenterology and hepatology, Royal Perth Hospital, Victoria Square, Perth, Western Australia, 6000
| | - Priyanthi Kumarasinghe
- Pathwest QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009.,University of Western Australia, Crawley, Western Australia, 6009
| | - Spiro Raftopoulos
- Department of gastroenterology and hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia, 6009.,University of Western Australia, Crawley, Western Australia, 6009
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Wang YH, Bychkov A, Chakrabarti I, Jain D, Liu Z, He S, Hanum SF, Bakrin I, Templo F, Nguyen T, Kumarasinghe P, Jung CK, Kakudo K, Chen CC. Impact of the COVID-19 pandemic on cytology practice: An international survey in the Asia-Pacific region. Cancer Cytopathol 2020; 128:895-904. [PMID: 32931161 DOI: 10.1002/cncy.22354] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/07/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The purpose of the current study was to examine the impact of coronavirus disease 2019 (COVID-19) on various aspects of cytology practice in the Asia-Pacific region. METHODS An online questionnaire was distributed to cytopathology laboratories in 24 Asia-Pacific countries to explore the impact of restrictive measures on access to health care, use of general and personal protective equipment (PPE), and changes in cytology workflow and workload from February to April 2020. RESULTS A total of 167 cytopathology laboratories from 24 countries responded to the survey; the majority reported that restrictive measures that limited the accessibility of health care services had been implemented in their cities and/or countries (80.8%) and their hospitals (83.8%). The respondents noted that COVID-19 had an impact on the cytologic workflow as well as the workload. Approximately one-half of the participants reported the implementation of new biosafety protocols (54.5%) as well as improvements in laboratory facilities (47.3%). Rearrangement or redeployment of the workforce was reported in 53.3% and 34.1% of laboratories, respectively. The majority of the respondents reported a significant reduction (>10%) in caseload associated with both gynecological (82.0%) and nongynecological specimens (78.4%). Most laboratories reported no significant change in the malignancy rates of both gynecological (67.7%) and nongynecological specimens (58.7%) compared with the same period in 2019. CONCLUSIONS The results of the survey demonstrated that the COVID-19 pandemic resulted in a significant reduction in the number of cytology specimens examined along with the need to implement new biosafety protocols. These findings underscore the need for the worldwide standardization of biosafety protocols and cytology practice.
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Affiliation(s)
- Yeh-Han Wang
- Department of Anatomic Pathology, Taipei Institute of Pathology, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, Japan
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Zhiyan Liu
- Department of Pathology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shurong He
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Ikmal Bakrin
- Department of Pathology, Faculty of Medicine and Health Sciences, Putra Malaysia University, Serdang, Malaysia
| | - Felipe Templo
- Division of Laboratory Medicine, Philippine Heart Center, Quezon City, Philippines
| | - Truong Nguyen
- Department of Pathology, Cho Ray Hospital, Ho Chi Minh, Vietnam
| | - Priyanthi Kumarasinghe
- Department of Anatomical Pathology, PathWest, Perth, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kennichi Kakudo
- Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Japan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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10
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Liu CY, Bychkov A, Agarwal S, Zhu Y, Hang JF, Lai CR, Na HY, Li W, Liu Z, Jain D, Suzuki A, Hirokawa M, Chia N, Nga ME, Jitpasutham T, Keelawat S, Park SY, Satoh S, Chen CC, Gunawardena D, Kumarasinghe P, Jung CK, Kakudo K. Cytologic diagnosis of medullary thyroid carcinoma in the Asia-Pacific region. Diagn Cytopathol 2020; 49:60-69. [PMID: 32827355 DOI: 10.1002/dc.24586] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/20/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The accurate preoperative identification of medullary thyroid carcinoma (MTC) is challenging due to the rarity of tumor and variable cytologic appearance. The Asian experience with diagnosing MTC by fine-needle aspiration (FNA) was scarcely reported. METHODS Cases of MTC with available FNA slides were enrolled from 13 hospitals representing 8 Asia-Pacific countries. Clinicopathological information, including sample preparation technique, staining method, original cytologic diagnosis and review diagnosis were collected. RESULTS Of a total of 145 MTC cases retrospectively recruited, 99 (68.3%) were initially interpreted as MTC/suspicious for MTC (S-MTC). The distribution of original FNA diagnostic categories was not associated with the staining method or sample preparation technique. The staining methods used were Papanicolaou, hematoxylin-eosin and Romanowsky stains. Liquid-based cytology (LBC) was used only in three countries. After reviewing all cases, the diagnostic rate of MTC/S-MTC increased to 91.7% (133/145). Cases with initially unrecognized MTC had either marked pleomorphism or cytology mimicking papillary carcinoma or follicular neoplasm. Although LBC provided certain benefits, there was no significant difference in diagnostic accuracy between conventional smear and LBC. Immunocytochemistry was available in 38 cases (26.2%), all of which were correctly recognized as MTC. CONCLUSION Our report summarizes how MTC is handled in contemporary Asian thyroid FNA practice. Although the detection rate of MTC by cytology alone is less satisfactory, integration with ancillary tests could achieve an excellent performance. The recognition of constitutive cytomorphologic features is needed for each cytopreparatory method, which may result in a lower threshold to initiate further workup for MTC.
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Affiliation(s)
- Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Yun Zhu
- Department of Pathology, Jiangsu Institution of Nuclear Medicine, Wuxi, Jiangsu Province, China
| | - Jen-Fan Hang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chiung-Ru Lai
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hee Young Na
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Weiwei Li
- Department of Pathology, Shandong University School of Basic Medical Sciences, Jinan, Shandong, China
| | - Zhiyan Liu
- Department of Pathology, Shandong University School of Basic Medical Sciences, Jinan, Shandong, China
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Ayana Suzuki
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan
| | | | - Noel Chia
- Department of Pathology, National University Hospital, Singapore
| | - Min En Nga
- Department of Pathology, National University Hospital, Singapore
| | - Tikamporn Jitpasutham
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Shinya Satoh
- Department of Endocrine Surgery, Yamashita Thyroid and Parathyroid Clinic, Fukuoka, Japan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Dilini Gunawardena
- School of Pathology & Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - Priyanthi Kumarasinghe
- School of Pathology & Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kennichi Kakudo
- Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Osaka, Japan
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11
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Sriram N, Bar-Yishay I, Kumarasinghe P, Yusoff I, Segarajasingam D, Bourke MJ, Raftopoulos S. Definitive therapy of colonic angioectasia by submucosal coagulation. Endosc Int Open 2019; 7:E1773-E1777. [PMID: 31828216 PMCID: PMC6904233 DOI: 10.1055/a-0965-6688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/03/2019] [Indexed: 02/08/2023] Open
Abstract
Background and study aims Colonic angioectasia are the most common vascular lesions in the gastrointestinal tract and are among the most common causes for chronic or recurrent lower gastrointestinal bleeding. Endoscopic treatment involves a variety of techniques, all of which focus on destruction of the mucosal abnormality. However, recurrent bleeding after endoscopic treatment is common, with more than one treatment frequently necessary. We report a technique for definitive treatment of colonic angioectasia by targeting the feeding submucosal vessel. Patients and methods Analogous to endoscopic mucosal resection, a submucosal injection is made beneath the target lesion which is then removed by electrocautery snare resection of the mucosal lesion. The exposed feeding vessel is then destroyed by application of coagulation current. The resection defect is closed by clips. Results Six patients with a total of 14 colonic angioectasia were treated over the study period. All lesions were destroyed without adverse events. Conclusion Elevation, hot snare resection and coagulation (ESC) of the visible vessel for treating colonic angioectasia appears safe and effective. Larger prospective comparative studies are required to assess its specific role.
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Affiliation(s)
- Nagaraj Sriram
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Iddo Bar-Yishay
- Department of Gastroenterology, Westmead Public Hospital, Sydney, NSW, Australia
| | | | - Ian Yusoff
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia,Department of Gastroenterology, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Dev Segarajasingam
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia,Department of Gastroenterology, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Michael J. Bourke
- Department of Gastroenterology, Westmead Public Hospital, Sydney, NSW, Australia,University of Sydney, Sydney, NSW, Australia
| | - Spiro Raftopoulos
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia,Department of Gastroenterology, Hollywood Private Hospital, Perth, Western Australia, Australia,Department of Gastroenterology, Peel Health Campus, Perth, Western Australia, Australia,Corresponding author Spiro Raftopoulos Department of GastroenterologySir Charles Gairdner HospitalPerth, Western AustraliaAustralia+61288905637
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12
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Kakudo K, Bychkov A, Abelardo A, Keelawat S, Kumarasinghe P. Malpractice Climate Is a Key Difference in Thyroid Pathology Practice Between North America and the Rest of the World. Arch Pathol Lab Med 2019; 143:1171. [DOI: 10.5858/arpa.2019-0228-le] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kennichi Kakudo
- Department of Pathology, Wakayama Medical University, Wakayama, Japan
- Department of Pathology and Laboratory Medicine, Nara Hospital, Kindai University Faculty of Medicine, Ikoma, Nara, Japan
| | - Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, Japan
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Agustina Abelardo
- Department of Pathology, College of Medicine, University of the Philippines, Manila, Philippines
| | - Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Priyanthi Kumarasinghe
- Department of Anatomical Pathology, PathWest Laboratories, Needlands, Western Australia, Australia
- University of Western Australia, Crawley, Western Australia, Australia
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13
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Richards C, Kumarasinghe P, Hessamodini H, Waldron A, Fernando D, Hodder R, Jacques A, Raftopoulos S. Revising the definition of vertical margin involvement following endoscopic polypectomy may reduce unnecessary surgery in patients with malignant colorectal polyps. JGH Open 2019; 4:387-393. [PMID: 32514442 PMCID: PMC7273713 DOI: 10.1002/jgh3.12261] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/27/2019] [Indexed: 01/25/2023]
Abstract
Background and Study Aims Endoscopically resected malignant colorectal polyps (MCPs) present a dilemma regarding whether the risk of residual disease justifies a major bowel resection. Overtreatment is common, and the vast majority of patients who undergo resection have no residual tumor. The aim of this study was to investigate whether revising the definition of vertical margin involvement following MCP polypectomy could reduce unnecessary surgery. Patients and Methods This was a cohort study of consecutive patients with MCPs treated at a tertiary hospital between 2004 and 2018. Data on demographics, index colonoscopy, polyp pathology, and any subsequent surgical resection were analyzed. Polypectomy resection margins were reviewed and measured to the nearest decimal place. The ability of existing guidelines (requiring a margin clearance of ≥ 1 mm) to predict residual disease was compared to a revised version requiring a margin clearance of ≥ 0.1 mm. Results A total of 129 patients with an MCP were included. Of these 129 patients, 77 (60%) underwent surgical resection, of which 62 (81%) had no residual tumor. Existing guidelines, requiring a margin clearance of ≥ 1 mm, classified 28 patients as being at “low risk” for residual disease. Of these, four underwent surgery, but none had residual tumor (P = 0.031). Revised guidelines, requiring a margin clearance of ≥ 0.1 mm, classified 44 patients as “low risk.” Of these, in the 13 that had surgery, no residual tumor was found (P = 0.003). Conclusions Revising the definition of vertical margin involvement leads to more patients being correctly classified as being at low risk of residual disease. This has the potential to reduce unnecessary surgery in patients with MCPs.
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Affiliation(s)
- Colin Richards
- Department of Surgery Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Priyanthi Kumarasinghe
- Pathwest, Queen Elizabeth II Medical Centre Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Hannah Hessamodini
- Department of Gastroenterology Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Alice Waldron
- Department of Surgery Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Diharah Fernando
- Department of Surgery Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Rupert Hodder
- Department of Surgery Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Angela Jacques
- Department of Statistics Sir Charles Gairdner Hospital Perth Western Australia Australia
| | - Spiro Raftopoulos
- Department of Gastroenterology Sir Charles Gairdner Hospital Perth Western Australia Australia
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14
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Ching D, Kumarasinghe P. 36. Snapshot of malignant polyps over an 11-year period: A quality improvement project. Pathology 2019. [DOI: 10.1016/j.pathol.2018.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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15
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Ravenscroft G, Pannell S, O'Grady G, Ong R, Ee HC, Faiz F, Marns L, Goel H, Kumarasinghe P, Sollis E, Sivadorai P, Wilson M, Magoffin A, Nightingale S, Freckmann ML, Kirk EP, Sachdev R, Lemberg DA, Delatycki MB, Kamm MA, Basnayake C, Lamont PJ, Amor DJ, Jones K, Schilperoort J, Davis MR, Laing NG. Variants in ACTG2 underlie a substantial number of Australasian patients with primary chronic intestinal pseudo-obstruction. Neurogastroenterol Motil 2018; 30:e13371. [PMID: 29781137 DOI: 10.1111/nmo.13371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary chronic intestinal pseudo-obstruction (CIPO) is a rare, potentially life-threatening disorder characterized by severely impaired gastrointestinal motility. The objective of this study was to examine the contribution of ACTG2, LMOD1, MYH11, and MYLK mutations in an Australasian cohort of patients with a diagnosis of primary CIPO associated with visceral myopathy. METHODS Pediatric and adult patients with primary CIPO and suspected visceral myopathy were recruited from across Australia and New Zealand. Sanger sequencing of the genes encoding enteric gamma-actin (ACTG2) and smooth muscle leiomodin (LMOD1) was performed on DNA from patients, and their relatives, where available. MYH11 and MYLK were screened by next-generation sequencing. KEY RESULTS We identified heterozygous missense variants in ACTG2 in 7 of 17 families (~41%) diagnosed with CIPO and its associated conditions. We also identified a previously unpublished missense mutation (c.443C>T, p.Arg148Leu) in one family. One case presented with megacystis-microcolon-intestinal hypoperistalsis syndrome in utero with subsequent termination of pregnancy at 28 weeks' gestation. All of the substitutions identified occurred at arginine residues. No likely pathogenic variants in LMOD1, MYH11, or MYLK were identified within our cohort. CONCLUSIONS AND INFERENCES ACTG2 mutations represent a significant underlying cause of primary CIPO with visceral myopathy and associated phenotypes in Australasian patients. Thus, ACTG2 sequencing should be considered in cases presenting with hypoperistalsis phenotypes with suspected visceral myopathy. It is likely that variants in other genes encoding enteric smooth muscle contractile proteins will contribute further to the genetic heterogeneity of hypoperistalsis phenotypes.
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Affiliation(s)
- G Ravenscroft
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - S Pannell
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - G O'Grady
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - R Ong
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - H C Ee
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - F Faiz
- PathWest Diagnostic Genomics, QE II Medical Centre, Nedlands, WA, Australia
| | - L Marns
- PathWest Diagnostic Genomics, QE II Medical Centre, Nedlands, WA, Australia
| | - H Goel
- Hunter Genetics, Waratah, NSW, Australia
| | - P Kumarasinghe
- Faculty of Medicine and Health Sciences, University of Western Australia, Nedlands, WA, Australia
| | - E Sollis
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - P Sivadorai
- PathWest Diagnostic Genomics, QE II Medical Centre, Nedlands, WA, Australia
| | - M Wilson
- Department of Clinical Genetics, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - A Magoffin
- Department of Gastroenterology, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - S Nightingale
- Paediatric Gastroenterology, John Hunter Children's Hospital, Newcastle, NSW, Australia
| | - M-L Freckmann
- ACT Genetics, The Canberra Hospital, Woden, ACT, Australia
| | - E P Kirk
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, NSW, Australia
| | - R Sachdev
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, NSW, Australia
| | - D A Lemberg
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia
| | - M B Delatycki
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - M A Kamm
- Department of Gastroenterology, St Vincent's Hospital and University of Melbourne, Melbourne, Vic., Australia
| | - C Basnayake
- Department of Gastroenterology, St Vincent's Hospital and University of Melbourne, Melbourne, Vic., Australia
| | - P J Lamont
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - D J Amor
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - K Jones
- Faculty of Medicine and Health Sciences, University of Western Australia, Nedlands, WA, Australia
| | - J Schilperoort
- Faculty of Medicine and Health Sciences, University of Western Australia, Nedlands, WA, Australia
| | - M R Davis
- PathWest Diagnostic Genomics, QE II Medical Centre, Nedlands, WA, Australia
| | - N G Laing
- Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA, Australia.,PathWest Diagnostic Genomics, QE II Medical Centre, Nedlands, WA, Australia
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Kumarasinghe P, Bastiaan de Boer W, Hooi Ee M. Neoplasia in gastric adenocarcinoma and proximal polyposis syndrome (GAPPS): Gastric rather than intestinal phenotype. Pathology 2016. [DOI: 10.1016/j.pathol.2015.12.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Reid AL, Millward M, Pearce R, Lee M, Frank MH, Ireland A, Monshizadeh L, Rai T, Heenan P, Medic S, Kumarasinghe P, Ziman M. Markers of circulating tumour cells in the peripheral blood of patients with melanoma correlate with disease recurrence and progression. Br J Dermatol 2012; 168:85-92. [PMID: 23013138 DOI: 10.1111/bjd.12057] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Multimarker quantitative real-time polymerase chain reaction (qRT-PCR) represents an effective method for detecting circulating tumour cells in the peripheral blood of patients with melanoma. OBJECTIVES To investigate whether the phenotype of circulating melanoma cells represents a useful indicator of disease stage, recurrence and treatment efficacy. METHODS Peripheral blood was collected from 230 patients with melanoma and 152 healthy controls over a period of 3years and 9months. Clinical data and blood samples were collected from patients with primary melanoma (early stages, 0-II, n=154) and metastatic melanoma (late stages, III-IV, n=76). Each specimen was examined by qRT-PCR analysis for the expression of five markers: MLANA, ABCB5, TGFβ2, PAX3d and MCAM. RESULTS In total, 212 of the patients with melanoma (92%) expressed markers in their peripheral blood. Two markers, MLANA and ABCB5, had the greatest prognostic value, and were identified as statistically significant among patients who experienced disease recurrence within our study period, being expressed in 45% (MLANA) and 49% (ABCB5) of patients with recurrence (P=0·001 and P=0·031, respectively). For patients administered nonsurgical treatments, MCAM expression correlated with poor treatment outcome. CONCLUSIONS Circulating tumour cells were detectable at all stages of disease and long after surgical treatment, even when patients were considered disease free. Specifically, expression of ABCB5 and MLANA had significant prognostic value in inferring disease recurrence, while MCAM expression was associated with poor patient outcome after treatment, confirming multimarker qRT-PCR as a potential technique for monitoring disease status.
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Affiliation(s)
- A L Reid
- School of Medical Sciences, Edith Cowan University, Perth, WA, Australia
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Goh BK, Common JEA, Gan WH, Kumarasinghe P. A case of dermatopathia pigmentosa reticularis with wiry scalp hair and digital fibromatosis resulting from a recurrentKRT14mutation. Clin Exp Dermatol 2009; 34:340-3. [DOI: 10.1111/j.1365-2230.2008.02950.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Wong CH, Song C, Heng KS, Kee IHC, Tien SL, Kumarasinghe P, Khin LW, Tan KC. Plasma free hemoglobin: a novel diagnostic test for assessment of the depth of burn injury. Plast Reconstr Surg 2006; 117:1206-13. [PMID: 16582788 DOI: 10.1097/01.prs.0000200070.66604.1e] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Accurate determination of the depth of burn injury is difficult, even for experienced surgeons. The authors hypothesized that the level of plasma free hemoglobin following burn injury is correlated to the depth of burn injury, and they evaluated this hypothesis in a murine model. METHODS Full-thickness and partial-thickness burn injuries of varying sizes were inflicted on 38 and 36 male Wistar rats, respectively. Blood specimens were taken at 0, 15, 30, 45, and 60 minutes after burn injury, and the levels of plasma free hemoglobin were determined spectrophotometrically. RESULTS Full-thickness burns cause two times more hemolysis than partial-thickness burns (p < 0.05). A linear correlation was demonstrated between plasma free hemoglobin levels and total body surface area burned in both the full-thickness (r = 0.91, p < 0.001) and partial-thickness burn groups (r = 0.94, p < 0.001). The correlation between the quantity of hemolysis and the total body surface area burned was strongest at 15 minutes after the onset of burn injury. The levels of free hemoglobin peaked rapidly between 15 and 30 minutes after thermal injury and declined thereafter. CONCLUSIONS The authors' data suggest that the level of plasma free hemoglobin after burn injury is related to the size and depth of burn injury. This test can potentially be a valuable diagnostic adjunct in the assessment of burns.
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Affiliation(s)
- Chin-Ho Wong
- Department of Plastic Surgery, Singapore General Hospital, Singapore
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20
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Affiliation(s)
- Hwai-Liang Loh
- Histopathology Section, Department of Pathology, Singapore General Hospital, Singapore.
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21
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Kumarasinghe P. An analysis of 5194 fine needle aspiration biopsy samples. Ceylon Med J 1996; 41:57-60. [PMID: 8771945] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the usefulness of fine needle aspiration biopsy (FNAB) as an initial investigation in the diagnosis of mass lesions and to determine the accuracy of the test in a Sri Lankan setting. DESIGN 5149 FNAB samples were retrospectively analysed. The lesions were categorised according to the site and as benign, malignant or atypical/suspicious. Initial cytological diagnosis was compared with the histological diagnosis. Overall accuracy rate, and false positive and negative rates for thyroid, breast and lymphnode aspirates were determined. SETTING Department of Pathology, Faculty of Medicine Colombo and Asiri Hospital, Colombo. RESULTS There were 3577 thyroids, 1271 breast lumps, 167 lymph nodes, 58 extra-thyroidal head and neck, 61 deep visceral, and 60 miscellaneous lesions. 3596 (69.2%) were benign and 592 (11.3%) malignant. Histological follow up was available for 1092 (24%). The overall accuracy rate for benign and malignant lesions was 94%. False positive and negative rates for thyroid malignancies were 1.6% and 5.1% respectively. There were no false positives for breast malignancies, and the false negative rate was 6.2%. There were no false positives for lymphoid malignancies. CONCLUSIONS This cost-effective, minimally invasive technique can be applied to assess any accessible lesion with existing facilities in Sri Lanka. The accuracy and false negative and positive rates in this series are similar to those of recognised centres overseas.
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Kumarasinghe P, Jayasundera CI. Cytological diagnosis of bronchial malignancies using the fibreoptic bronchoscope. Ceylon Med J 1992; 37:41-3. [PMID: 1423748] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Bronchial brush and wash material were obtained by fibreoptic bronchoscopy in 200 patients suspected of having bronchial carcinoma. Malignancy was diagnosed in 42, giving a diagnostic yield of 21%. Bronchial brush material showed the highest yield. Morphological cell typing was done on cytological material. Technical considerations, diagnostic criteria, diagnostic yield and accuracy are discussed.
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