1
|
Koyuncu CF, Lu C, Bera K, Zhang Z, Xu J, Toro P, Corredor G, Chute D, Fu P, Thorstad WL, Faraji F, Bishop JA, Mehrad M, Castro PD, Sikora AG, Thompson LD, Chernock RD, Lang Kuhs KA, Luo J, Sandulache V, Adelstein DJ, Koyfman S, Lewis JS, Madabhushi A. Computerized tumor multinucleation index (MuNI) is prognostic in p16+ oropharyngeal carcinoma. J Clin Invest 2021; 131:145488. [PMID: 33651718 DOI: 10.1172/jci145488] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUNDPatients with p16+ oropharyngeal squamous cell carcinoma (OPSCC) are potentially cured with definitive treatment. However, there are currently no reliable biomarkers of treatment failure for p16+ OPSCC. Pathologist-based visual assessment of tumor cell multinucleation (MN) has been shown to be independently prognostic of disease-free survival (DFS) in p16+ OPSCC. However, its quantification is time intensive, subjective, and at risk of interobserver variability.METHODSWe present a deep-learning-based metric, the multinucleation index (MuNI), for prognostication in p16+ OPSCC. This approach quantifies tumor MN from digitally scanned H&E-stained slides. Representative H&E-stained whole-slide images from 1094 patients with previously untreated p16+ OPSCC were acquired from 6 institutions for optimization and validation of the MuNI.RESULTSThe MuNI was prognostic for DFS, overall survival (OS), or distant metastasis-free survival (DMFS) in p16+ OPSCC, with HRs of 1.78 (95% CI: 1.37-2.30), 1.94 (1.44-2.60), and 1.88 (1.43-2.47), respectively, independent of age, smoking status, treatment type, or tumor and lymph node (T/N) categories in multivariable analyses. The MuNI was also prognostic for DFS, OS, and DMFS in patients with stage I and stage III OPSCC, separately.CONCLUSIONMuNI holds promise as a low-cost, tissue-nondestructive, H&E stain-based digital biomarker test for counseling, treatment, and surveillance of patients with p16+ OPSCC. These data support further confirmation of the MuNI in prospective trials.FUNDINGNational Cancer Institute (NCI), NIH; National Institute for Biomedical Imaging and Bioengineering, NIH; National Center for Research Resources, NIH; VA Merit Review Award from the US Department of VA Biomedical Laboratory Research and Development Service; US Department of Defense (DOD) Breast Cancer Research Program Breakthrough Level 1 Award; DOD Prostate Cancer Idea Development Award; DOD Lung Cancer Investigator-Initiated Translational Research Award; DOD Peer-Reviewed Cancer Research Program; Ohio Third Frontier Technology Validation Fund; Wallace H. Coulter Foundation Program in the Department of Biomedical Engineering; Clinical and Translational Science Award (CTSA) program, Case Western Reserve University; NCI Cancer Center Support Grant, NIH; Career Development Award from the US Department of VA Clinical Sciences Research and Development Program; Dan L. Duncan Comprehensive Cancer Center Support Grant, NIH; and Computational Genomic Epidemiology of Cancer Program, Case Comprehensive Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, the US Department of VA, the DOD, or the US Government.
Collapse
Affiliation(s)
- Can F Koyuncu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.,Louis Stokes Cleveland Veterans Affairs (VA) Medical Center, Cleveland, Ohio, USA
| | - Cheng Lu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kaustav Bera
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Zelin Zhang
- Nanjing University of Information Science and Technology, Nanjing, China
| | - Jun Xu
- Nanjing University of Information Science and Technology, Nanjing, China
| | - Paula Toro
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - German Corredor
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.,Louis Stokes Cleveland Veterans Affairs (VA) Medical Center, Cleveland, Ohio, USA
| | | | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Wade L Thorstad
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Justin A Bishop
- University of Texas (UT) Southwestern Medical Center, Dallas, Texas, USA
| | - Mitra Mehrad
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Patricia D Castro
- Department of Otolaryngology, Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew G Sikora
- Department of Otolaryngology, Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.,ENT Section, Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | | | - R D Chernock
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Jingqin Luo
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Vlad Sandulache
- Department of Otolaryngology, Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.,ENT Section, Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | | | | | - James S Lewis
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.,Louis Stokes Cleveland Veterans Affairs (VA) Medical Center, Cleveland, Ohio, USA
| |
Collapse
|
3
|
Watson RF, Chernock RD, Zhang KH, Michel LS, Adkins DR, El-Mofty SK, Lewis JS. Epidermal Growth Factor Receptor Expression in Spindle Cell Carcinomas of the Head and Neck. Head Neck Pathol 2015; 9:360-8. [PMID: 25563452 PMCID: PMC4542797 DOI: 10.1007/s12105-014-0604-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 12/30/2014] [Indexed: 12/20/2022]
Abstract
Spindle cell carcinoma (SpCC) is an uncommon head and neck squamous cell carcinoma (SCC) variant consisting of spindled and/or pleomorphic cells with epithelial differentiation. Epidermal growth factor receptor (EGFR) is expressed by >90 % of conventional SCC, and high level expression is associated with a poorer prognosis. Anti-EGFR therapies are commonly used to treat head and neck SCC. However, no studies have evaluated EGFR expression in SpCC. Cases of SpCC were retrieved from department files. The diagnosis required either a biphasic lesion with a squamous neoplastic component, or a purely spindle cell or pleomorphic tumor with immunohistochemical positivity for epithelial markers. EGFR immunohistochemistry was performed and was quantified in quartiles. Medical records were reviewed for clinical follow up information. EGFR was expressed in 21/30 (70 %) cases, including in the squamous component in 18/19 (95 %) and the spindle cell component in only 12/30 (40 %). Where the spindle cell component was positive, the intensity and distribution were lower than for the squamous component. Recurrent tumors were predominantly (80-90 %) of the spindle cell component, and had low (or absent) EGFR expression. Kaplan-Meier survival analysis showed no statistically significant differences in overall or disease free survival between the EGFR expressing and non-expressing groups (p = 0.414 and 0.19, respectively). SpCCs of the head and neck have a poor prognosis, and markedly reduced EGFR expression. EGFR-specific therapies may not be ideal for SpCC patients, which may lack EGFR expression, but further studies are needed.
Collapse
Affiliation(s)
- R. F. Watson
- />Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St Louis, MO USA
| | - R. D. Chernock
- />Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St Louis, MO USA , />Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St Louis, MO USA
| | - K. H. Zhang
- />Division of Oncology, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO USA
| | - L. S. Michel
- />Division of Oncology, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO USA
| | - D. R. Adkins
- />Division of Oncology, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO USA
| | - S. K. El-Mofty
- />Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St Louis, MO USA , />Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St Louis, MO USA
| | - J. S. Lewis
- />Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St Louis, MO USA , />Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St Louis, MO USA
| |
Collapse
|
4
|
Khan RA, Chernock RD, Lewis JS. Seromucinous hamartoma of the nasal cavity: a report of two cases and review of the literature. Head Neck Pathol 2011; 5:241-7. [PMID: 21618016 PMCID: PMC3173540 DOI: 10.1007/s12105-011-0269-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 05/14/2011] [Indexed: 11/25/2022]
Abstract
The sinonasal tract is a complex anatomic site, home to a wide variety of reactive, inflammatory, benign, and malignant lesions. Inflammatory polyps and papillomas are usually easily recognized by pathologists. A poorly understood lesion that has been more clearly defined in recent years is the nasal hamartoma. The epithelial subtypes include seromucinous hamartoma, respiratory epithelial adenomatoid hamartoma, and hybrid lesions. Seromucinous hamartomas have only been recognized and substantially reported over the past few years. They are a diagnostic challenge, needing to be distinguished from low grade adenocarcinomas, and are of interest because most of the basic questions about their pathophysiology remain unanswered. Herein, we present two novel cases of seromucinous hamartoma with features that partly expand the morphologic spectrum of these lesions, discuss the differential diagnosis, and review the literature to compare our findings with previously reported cases with the aim of better understanding this interesting entity.
Collapse
Affiliation(s)
- R. A. Khan
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
| | - R. D. Chernock
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
| | - J. S. Lewis
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO USA
| |
Collapse
|
5
|
Abstract
Stromal cell-derived factor (SDF)-1alpha and its receptor, CXCR4, play an important role in cell migration, embryonic development, and human immunodeficiency virus infection. However, the cellular signaling pathways that mediate these processes are not fully elucidated. We and others have shown that the binding of SDF-1alpha to CXCR4 activates phosphatidylinositol-3 kinase (PI-3 kinase), p44/42 mitogen-associated protein kinase, and the transcription factor nuclear factor-kappaB, and it also enhances the tyrosine phosphorylation and association of proteins involved in the formation of focal adhesions. In this study, we examined the role of phosphatases in CXCR4-mediated signaling pathways. We observed significant inhibition of SDF-1alpha-induced migration by phosphatase inhibitors in CXCR4-transfected pre-B lymphoma L1.2 cells, Jurkat T cells, and peripheral blood lymphocytes. Further studies revealed that SDF-1alpha stimulation induced robust tyrosine phosphorylation in the SH2-containing phosphatase SHP2. SHP2 associated with the CXCR4 receptor and the signaling molecules SHIP, cbl, and fyn. Overexpression of wild-type SHP2 increased SDF-1alpha-induced chemotaxis. Enhanced activation of fyn and lyn kinases and the tyrosine phosphorylation of cbl were also observed. In addition, SDF-1alpha stimulation enhanced the association of cbl with PI-3 kinase, Crk-L, and 14-3-3beta proteins. Our results suggest that CXCR4-mediated signaling is regulated by SHP2 and cbl, which collectively participate in the formation of a multimeric signaling complex.
Collapse
MESH Headings
- 14-3-3 Proteins
- Adaptor Proteins, Signal Transducing
- Cells, Cultured
- Chemokine CXCL12
- Chemokines, CXC/pharmacology
- Chemotaxis, Leukocyte/drug effects
- Enzyme Inhibitors/pharmacology
- Humans
- Intracellular Signaling Peptides and Proteins
- Jurkat Cells
- Lymphocyte Activation
- Lymphocytes/drug effects
- Lymphocytes/metabolism
- Macromolecular Substances
- Nuclear Proteins/metabolism
- Phosphatidylinositol 3-Kinases/metabolism
- Phosphatidylinositol-3,4,5-Trisphosphate 5-Phosphatases
- Phosphoprotein Phosphatases/antagonists & inhibitors
- Phosphoproteins/metabolism
- Phosphoric Monoester Hydrolases/metabolism
- Phosphotyrosine/metabolism
- Protein Tyrosine Phosphatase, Non-Receptor Type 11
- Protein Tyrosine Phosphatase, Non-Receptor Type 6
- Protein Tyrosine Phosphatases/genetics
- Protein Tyrosine Phosphatases/metabolism
- Protein Tyrosine Phosphatases/physiology
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins/physiology
- Proto-Oncogene Proteins c-cbl
- Proto-Oncogene Proteins c-fyn
- Receptors, CXCR4/genetics
- Receptors, CXCR4/metabolism
- Signal Transduction
- Transfection
- Tyrosine 3-Monooxygenase/metabolism
- Ubiquitin-Protein Ligases
- src-Family Kinases/metabolism
Collapse
Affiliation(s)
- R D Chernock
- Divisions of Experimental Medicine and Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | |
Collapse
|
6
|
Abstract
The beta-chemokine receptor CCR5 has been shown to modulate cell migration, proliferation, and immune functions and to serve as a co-receptor for the human immunodeficiency virus. We and others have shown that CCR5 activates related adhesion focal tyrosine kinase (RAFTK)/Pyk2/CAK-beta. In this study, we further characterize the signaling molecules activated by CCR5 upon binding to its cognate ligand, macrophage inflammatory protein-1beta (MIP1beta). We observed enhanced tyrosine phosphorylation of the phosphatases SHP1 and SHP2 upon MIP1beta stimulation of CCR5 L1.2 transfectants and T-cells derived from peripheral blood mononuclear cells. Furthermore, we observed that SHP1 associated with RAFTK. However, using a dominant-negative phosphatase-binding mutant of RAFTK (RAFTK(m906)), we found that RAFTK does not mediate SHP1 or SHP2 phosphorylation. SHP1 and SHP2 also associated with the adaptor protein Grb2 and the Src-related kinase Syk. Pretreatment of CCR5 L1.2 transfectants or T-cells with the phosphatase inhibitor orthovanadate markedly abolished MIP1beta-induced chemotaxis. Syk was also activated upon MIP1beta stimulation of CCR5 L1.2 transfectants or T-cells and associated with RAFTK. Overexpression of a dominant-negative Src-binding mutant of RAFTK (RAFTK(m402)) significantly attenuated Syk activation, whereas overexpression of wild-type RAFTK enhanced Syk activity, indicating that RAFTK acts upstream of CCR5-mediated Syk activation. Taken together, these results suggest that MIP1beta stimulation mediated by CCR5 induces the formation of a signaling complex consisting of RAFTK, Syk, SHP1, and Grb2.
Collapse
Affiliation(s)
- R K Ganju
- Division of Experimental Medicine, Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA.
| | | | | | | | | |
Collapse
|