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Giaretto S, Renne SL, Rahal D, Bossi P, Colombo P, Spaggiari P, Manara S, Sollai M, Fiamengo B, Brambilla T, Fernandes B, Rao S, Elamin A, Valeri M, De Carlo C, Belsito V, Lancellotti C, Cieri M, Cagini A, Terracciano L, Roncalli M, Di Tommaso L. Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study. J Med Internet Res 2021; 23:e24266. [PMID: 33503002 PMCID: PMC7901595 DOI: 10.2196/24266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Transition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology. OBJECTIVE The aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition. METHODS A total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling. RESULTS The overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors. CONCLUSIONS Our findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology.
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Affiliation(s)
- Simone Giaretto
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Salvatore Lorenzo Renne
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Daoud Rahal
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Paola Bossi
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Paola Spaggiari
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Sofia Manara
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Mauro Sollai
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Barbara Fiamengo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Tatiana Brambilla
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Bethania Fernandes
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Stefania Rao
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Abubaker Elamin
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Marina Valeri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Camilla De Carlo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Vincenzo Belsito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Cesare Lancellotti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Miriam Cieri
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Angelo Cagini
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Luigi Terracciano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Massimo Roncalli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Luca Di Tommaso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
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Vitali E, Boemi I, Piccini S, Tarantola G, Smiroldo V, Lavezzi E, Brambilla T, Zerbi A, Carnaghi C, Mantovani G, Spada A, Lania AG. A novel insight into the anticancer mechanism of metformin in pancreatic neuroendocrine tumor cells. Mol Cell Endocrinol 2020; 509:110803. [PMID: 32251713 DOI: 10.1016/j.mce.2020.110803] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 12/12/2022]
Abstract
The antidiabetic drug metformin displays anticancer properties in several neoplasms. In pituitary NETs, aryl hydrocarbon receptor-interacting protein (AIP) is up-regulated by the somatostatin analog octreotide. Metformin inhibited QGP-1 cell proliferation in a dose- and time-dependent manner, at concentrations similar to those achievable in treated patients (-31 ± 12%, p < 0.05 vs basal at 100 μM). Moreover, metformin decreased pancreatic neuroendocrine tumors (PAN-NETs) cell proliferation (-62 ± 15%, p < 0.0001 vs basal at 10 mM), without any additive effect when combined with octreotide. Both octreotide and metformin induced AIP up-regulation. AIP silencing abolished the reduction of mTOR phosphorylation induced by metformin and octreotide. Moreover, metformin decreased HSP70, increased Zac1 and AhR expression; these effects were abolished in AIP silenced QGP-1 cells. In conclusion, metformin acts as an anticancer agent in PAN-NET cells, its activity is mediated by AIP and its interacting proteins. These findings provide a novel insight into the antitumorigenic mechanism of metformin.
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Affiliation(s)
- E Vitali
- Laboratory of Cellular and Molecular Endocrinology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.
| | - I Boemi
- Laboratory of Cellular and Molecular Endocrinology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - S Piccini
- Endocrinology and Diabetology Unit Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - G Tarantola
- Laboratory of Cellular and Molecular Endocrinology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - V Smiroldo
- Oncology Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - E Lavezzi
- Endocrinology and Diabetology Unit Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - T Brambilla
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - A Zerbi
- Pancreas Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - C Carnaghi
- Oncology Unit, Bolzano Hospital, Bolzano, Italy
| | - G Mantovani
- Endocrinology and Diabetology Unit, IRCCS Ospedale Maggiore Policlinico, Milano, Italy
| | - A Spada
- Endocrinology and Diabetology Unit, IRCCS Ospedale Maggiore Policlinico, Milano, Italy
| | - A G Lania
- Laboratory of Cellular and Molecular Endocrinology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy; Endocrinology and Diabetology Unit Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
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Spadaccini M, Bhandari P, Maselli R, Spaggiari P, Alkandari AA, Varytimiadis L, Semeraro R, Di Leo M, Galtieri PA, Craviotto V, Lamonaca L, D'Amico F, Attardo S, Brambilla T, Sharma P, Hassan C, Repici A. Multi-band mucosectomy for neoplasia in patients with Barrett's esophagus: in vivo comparison between two different devices. Surg Endosc 2019; 34:3845-3852. [PMID: 31586245 DOI: 10.1007/s00464-019-07150-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/08/2018] [Accepted: 09/24/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multi-band mucosectomy (MBM) is effective and safe for Barrett's neoplasia. No studies have yet compared the efficacy and safety of the MBM devices commercially available: Duette™ (CookMedical) and Captivator™ (BostonScientific). Our aim is to compare the two devices. METHODS This is a dual-center retrospective case-control study (Rozzano, Portsmouth) comparing efficacy, safety, and histology of resected specimens between Duette™ (DUE) and Captivator™ (CAPT). Efficacy was assessed by R0 and local recurrence (LR) rate. Bleedings, perforations, and strictures were recorded as safety outcomes. Moreover, the specimens were re-examined by two pathologists, blinded about the study group, to assess the maximum thickness of both the whole specimens and the resected submucosal layer. RESULTS Seventy-six patients (38 per group) were included. The two groups did not differ in terms of baseline characteristics. R0 resection was achieved in 96.7% versus 96.3% (p = ns) and LR were recorded in 4/38 (10.5%) versus 3/38 (7.9%) in DUE and CAPT group, respectively (p = ns). Considering Duette™ versus Captivator™, 2 versus 3 patients developed a symptomatic stricture. Only one post-procedural bleeding occurred (Captivator™). Maximum medium thicknesses of specimens and of resected submucosa did not differ between the groups. CONCLUSIONS MBM is safe and effective for resecting visible lesions using either of the two available devices.
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Affiliation(s)
- Marco Spadaccini
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY, UK
| | - Roberta Maselli
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Paola Spaggiari
- Pathology Unit, Humanitas Research Hospital, 20089, Rozzano, Italy
| | - Asma A Alkandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY, UK
| | - Lazaros Varytimiadis
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY, UK
| | - Rossella Semeraro
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Milena Di Leo
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Piera Alessia Galtieri
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Vincenzo Craviotto
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Laura Lamonaca
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Ferdinando D'Amico
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Simona Attardo
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | | | - Prateek Sharma
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, 64128, USA
| | - Cesare Hassan
- Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Alessandro Repici
- Digestive Endoscopy Unit, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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Vanoli A, Albarello L, Uncini S, Fassan M, Grillo F, Di Sabatino A, Martino M, Pasquali C, Milanetto AC, Falconi M, Partelli S, Doglioni C, Schiavo-Lena M, Brambilla T, Pietrabissa A, Sessa F, Capella C, Rindi G, La Rosa S, Solcia E, Paulli M. Neuroendocrine Tumors (NETs) of the Minor Papilla/Ampulla: Analysis of 16 Cases Underlines Homology With Major Ampulla NETs and Differences From Extra-Ampullary Duodenal NETs. Am J Surg Pathol 2019; 43:725-736. [PMID: 30913089 DOI: 10.1097/pas.0000000000001234] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Neuroendocrine tumors (NETs) of the minor papilla/ampulla (MIPA) are rare and poorly studied. Only individual case reports and no comprehensive analysis are available from the literature. We collected 16 MIPA NETs and investigated their clinicopathologic and immunohistochemical features, including markers such as somatostatin, pancreatic polypeptide, gastrin, serotonin, MUC1, cytokeratin 7, and somatostatin receptors type 2A and 5. The median age at diagnosis was 57.5 years, and the female-to-male ratio was 2.2:1. The median NET size was 1.45 cm, and most (94%) were low-grade (G1) tumors. Similarly to what was observed in the major ampulla, 3 histotypes were found: (i) ampullary-type somatostatin-producing tumors (ASTs, 10 cases), characterized by somatostatin expression in most tumor cells, focal-to-extensive tubulo-acinar structures, often with psammoma bodies, MUC1 reactivity, and no or rare membranous reactivity for somatostatin receptor type 2A; (ii) gangliocytic paragangliomas (3 cases), characterized by the coexistence of 3 tumor cell types: epithelioid, often reactive for pancreatic polypeptide, ganglion-like cells, and S100 reactive sustentacular/stromal cells; and (iii) ordinary nonfunctioning NETs (3 cases), resembling those more commonly observed in the extra-ampullary duodenum. Comparable histotypes could also be recognized among the 30 MIPA NETs from the literature. No NET-related patient death among MIPA cases was observed during a median follow-up of 38 months; however, MIPA ASTs showed lymph node metastases and invasion of the duodenal muscularis propria or beyond in 44% and 40% of cases, respectively. In conclusion, MIPA NETs closely resemble tumors arising in the major ampulla, with predominance of ASTs.
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Affiliation(s)
- Alessandro Vanoli
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia
- Anatomic Pathology, IRCCS San Matteo Hospital Foundation, Pavia
| | | | - Stefania Uncini
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit
| | - Federica Grillo
- Department of Surgical Science and Integrated Diagnostics (DISC), Pathology Unit, University of Genoa
- San Martino Hospital, Genoa
| | - Antonio Di Sabatino
- First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia
| | - Michele Martino
- First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia
| | - Claudio Pasquali
- Department of Surgery 1 Pancreatic and Endocrine Digestive Surgical Unit, University of Padua, Padua
| | - Anna C Milanetto
- Department of Surgery 1 Pancreatic and Endocrine Digestive Surgical Unit, University of Padua, Padua
| | - Massimo Falconi
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University
| | - Stefano Partelli
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University
| | | | | | - Tatiana Brambilla
- Pathology Unit, Humanitas Research Hospital, Humanitas University, Rozzano, Milan
| | - Andrea Pietrabissa
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of General Surgery 2, University of Pavia and IRCCS San Matteo Hospital Foundation, Pavia
| | - Fausto Sessa
- Department of Medicine and Surgery, Anatomic Pathology Unit, University of Insubria, Varese
| | - Carlo Capella
- Department of Medicine and Surgery, Anatomic Pathology Unit, University of Insubria, Varese
| | - Guido Rindi
- Institute of Anatomic Pathology
- Rome ENETS Center of Excellence, University Hospital Foundation A. Gemelli IRCCS-Catholic University of Sacred Heart, Rome, Italy
| | - Stefano La Rosa
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrico Solcia
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia
| | - Marco Paulli
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia
- Anatomic Pathology, IRCCS San Matteo Hospital Foundation, Pavia
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Virdis M, Bonifacio C, Brambilla T, Capretti G, De Nittis P, Uccelli F, Zerbi A. Thrombosis of the dorsal vein of the penis as first clinical presentation of pancreatic cancer metastatic to the penis. Tumori Journal 2019; 105:NP43-NP47. [DOI: 10.1177/0300891619849273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Though metastatic disease is a common presentation of pancreatic adenocarcinoma, localization to the penis is an extremely rare event despite its abundant vascularization. Primary cancers responsible for penile metastases usually occur in prostate and rectum and are often associated with disseminated malignancy and poor prognosis. Case description: A 66-year-old man was diagnosed with adenocarcinoma of the tail of the pancreas after the onset of thrombosis of the dorsal vein of the penis; pubis ultrasound and total body computed tomography scan were negative for metastases at other sites. The patient was submitted to distal pancreatectomy with splenectomy for a pT3 N1 G4 pancreatic ductal adenocarcinoma. Three weeks after discharge, the patient returned to the outpatient clinic complaining of a painful permanent turgidity of the penis shaft. Ultrasound revealed a complete replacement of the cavernosal bodies by multiple nodular masses and a penile biopsy confirmed metastases from the primary pancreatic cancer. The patient started chemotherapy with NAB-paclitaxel and gemcitabine, with excellent control of symptoms. However, the disease progressed to bone and liver and the patient died 9 months after surgery. Conclusions: Penile localization is an extremely rare event and a standard of care has not been elaborated. Treatments are palliative and mainly aimed at pain relief and can comprise chemotherapy, radiotherapy, and surgery. Identification of venous thrombosis as an early sign of involvement could potentially offer patients an earlier diagnosis and a better treatment option.
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Affiliation(s)
- Matteo Virdis
- Pancreatic Surgery Unit, Hospital Health Direction, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Cristiana Bonifacio
- Unit of Diagnostic Radiology, Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Giovanni Capretti
- Pancreatic Surgery Unit, Hospital Health Direction, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Pasquale De Nittis
- Unit of Diagnostic Radiology, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Fara Uccelli
- Pancreatic Surgery Unit, Hospital Health Direction, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Alessandro Zerbi
- Pancreatic Surgery Unit, Hospital Health Direction, Humanitas Research Hospital, Rozzano (MI), Italy
- General Surgery, Humanitas University, Rozzano (MI), Italy
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Destro A, Russo C, Spaggiari P, Armenia S, Bellofiore E, Lorini M, Brambilla T, Cimino M, Spinelli A, Personeni N, Rimassa L, Di Tommaso L, Roncalli M. The impact of mass spectrometry multigenic platform on the management of metastatic colorectal patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.113] [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: 11/13/2022] Open
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7
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Brambilla T, Fiamengo B, Tinterri C, Testori A, Grassi MM, Sciarra A, Abbate T, Gatzemeier W, Roncalli M, Di Tommaso L. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review. Front Med (Lausanne) 2015; 2:37. [PMID: 26131451 PMCID: PMC4469115 DOI: 10.3389/fmed.2015.00037] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/20/2015] [Indexed: 11/16/2022] Open
Abstract
Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38–45 and 62–55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.
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Affiliation(s)
- Tatiana Brambilla
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | - Barbara Fiamengo
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | - Corrado Tinterri
- Senology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | - Alberto Testori
- Senology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | | | - Amedeo Sciarra
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | - Tommaso Abbate
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | | | - Massimo Roncalli
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
| | - Luca Di Tommaso
- Pathology Unit, Humanitas Clinical and Research Hospital , Milan , Italy
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8
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Federici D, Conti E, Muggiasca ML, Ferrari S, Arcaini L, Brambilla T, Meroni M, Agarossi A. Laparoscopic conservative surgery in tubal pregnancy. MINIM INVASIV THER 2009. [DOI: 10.3109/13645709409152730] [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: 11/13/2022]
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9
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Federici D, Brambilla T, Lacelli B, Arcaini L, Motta G, Agarossi A, Muggiasca L, Conti M. Pain relief after combined medical and laparoscopic conservative treatment of stage III–IV endometriosis: A comparison with medical therapy. MINIM INVASIV THER 2009. [DOI: 10.3109/13645709609152702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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10
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Verga U, Ferrero S, Vicentini L, Brambilla T, Cirello V, Muzza M, Beck-Peccoz P, Fugazzola L. Histopathological and molecular studies in patients with goiter and hypercalcitoninemia: reactive or neoplastic C-cell hyperplasia? Endocr Relat Cancer 2007; 14:393-403. [PMID: 17639053 DOI: 10.1677/erc-06-0053] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [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: 11/27/2022]
Abstract
The cut-off values able to differentiate between reactive or neoplastic C-cell hyperplasia (CCH) or to predict sporadic medullary thyroid cancer (MTC) are still debated both for basal and stimulated calcitonin (bCT and sCT). In the present study, the prevalence and the histological patterns of CCH in 15 patients with multinodular goiter (MNG), bCT>10 pg/ml and sCT levels >50 pg/ml were studied. As controls, 16 patients with MNG and bCT levels <10 pg/ml and 4 patients with familial (FMTC) were included. For each case, calcitonin (CT) immunoreactive cells were counted in 60 consecutive high-power fields (400x) and CCH classified as focal, diffuse, nodular, or neoplastic. RET genetic analyses were performed at the germline and tissue levels in MTC and CCH cases. In patients with MNG, sCT levels >50 pg/ml were associated with CCH or MTC, being the total number of C-cells/60 fields significantly higher than that found in MNG with normal bCT (P = 0.0008) and comparable with that detected in FMTCs. In the group with sCT>50 pg/ml, the C-cells displayed a neoplastic phenotype. Neither germline nor somatic RET mutations were found. In conclusion, sCT levels >50 pg/ml were always associated with CCH, without correlation between CT levels and the number of C-cells or the final diagnosis. The C-cells had a morphology and distribution pattern similar to those observed in FMTC. Thus, sCT levels >50 pg/ml indicate the presence of CCH with a possible preneoplastic potential, suggesting the opportunity to perform a prophylactic surgical treatment.
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Affiliation(s)
- Uberta Verga
- Endocrine Unit, Department of Medical Sciences, University of Milan and Fondazione Policlinico IRCCS, Milan, Italy
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