1
|
Stoilov B, Truong VK, Gronthos S, Vasilev K. Noninvasive and Microinvasive Nanoscale Drug Delivery Platforms for Hard Tissue Engineering. ACS Appl Bio Mater 2023; 6:2925-2943. [PMID: 37565698 DOI: 10.1021/acsabm.3c00095] [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] [Indexed: 08/12/2023]
Abstract
Bone tissue plays a crucial role in protecting internal organs and providing structural support and locomotion of the body. Treatment of hard tissue defects and medical conditions due to physical injuries, genetic disorders, aging, metabolic syndromes, and infections is more often a complex and drawn out process. Presently, dealing with hard-tissue-based clinical problems is still mostly conducted via surgical interventions. However, advances in nanotechnology over the last decades have led to shifting trends in clinical practice toward noninvasive and microinvasive methods. In this review article, recent advances in the development of nanoscale platforms for bone tissue engineering have been reviewed and critically discussed to provide a comprehensive understanding of the advantages and disadvantages of noninvasive and microinvasive methods for treating medical conditions related to hard tissue regeneration and repair.
Collapse
Affiliation(s)
- Borislav Stoilov
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
| | - Vi Khanh Truong
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
| | - Stan Gronthos
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide/SAHMRI, North Terrace, Adelaide, South Australia 5001, Australia
| | - Krasimir Vasilev
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
| |
Collapse
|
2
|
Bakhtiary F. µAVR: Endoscopic Microinvasive Aortic Valve Surgery With Automated Suturing Technology for Enhanced Patient Outcomes. Innovations (Phila) 2023; 18:365-371. [PMID: 37462274 DOI: 10.1177/15569845231185819] [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] [Indexed: 09/05/2023]
Abstract
Modern heart surgery should strive toward the most durable therapeutic results and enhanced patient recoveries. Novel customized technology is available to advance the evolution of less invasive heart valve replacement surgery and ultimately facilitate "microinvasive" techniques utilizing very small bone-sparing incisions and endoscopy. In this article, we present our approach to aortic valve replacement, including the use of automated suturing devices to improve the surgical ergonomics and reliability of these procedures. This patient-centered approach can be safely performed by surgeons interested in offering the benefits of truly minimally invasive cardiac surgery to improve patient outcomes. We believe that each patient should be offered personalized surgery to provide the optimized procedure and aortic valve replacement to suit their individual needs and preferences.
Collapse
Affiliation(s)
- Farhad Bakhtiary
- Department of Cardiac Surgery, University Hospital Bonn, Germany
| |
Collapse
|
3
|
Ambrosini-Spaltro A, Di Donato F, Saragoni L, Cserni G, Rakha E, Foschini MP. Prognostic Markers of Microinvasive Breast Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15113007. [PMID: 37296968 DOI: 10.3390/cancers15113007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: The prognostic factors of microinvasive (≤1 mm) breast carcinoma are not completely clear. The aim of this study was to perform a systematic review and meta-analysis to clarify these factors. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. Two databases were interrogated, PubMed and Embase, and papers in English were included to address this question. The selected studies were those that reported on female patients affected by microinvasive carcinoma, and on prognostic factors with a hazard ratio (HR) for disease-free survival (DFS) and overall survival (OS). (3) Results: In total, 618 records were identified. After removing duplicates (166), identification, and screening (336 by title and abstract alone, 116 by full text and eventual supplementary material), 5 papers were selected. Seven different meta-analyses were conducted in this study, all referring to DFS, analyzing the following prognostic factors: estrogen receptor, progesterone receptor, HER2 status, multifocality and grade of microinvasion, patient's age, and lymph node status. Only lymph node status was associated with prognosis and DFS (total number of cases: 1528; Z = 1.94; p = 0.05). The other factors examined did not significantly affect prognosis (p > 0.05). (4) Conclusions: Positive lymph node status significantly worsens prognosis in patients with microinvasive breast carcinoma.
Collapse
Affiliation(s)
| | - Francesco Di Donato
- Pathology Unit, Santa Maria delle Croci Hospital, AUSL Romagna, 48121 Ravenna, Italy
- School of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40139 Bologna, Italy
| | - Luca Saragoni
- Pathology Unit, Santa Maria delle Croci Hospital, AUSL Romagna, 48121 Ravenna, Italy
| | - Gábor Cserni
- Department of Pathology, Bács-Kiskun County Teaching Hospital, 6000 Kecskemét, Hungary
- Department of Pathology, University of Szeged, 6725 Szeged, Hungary
| | - Emad Rakha
- Histopathology Department, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Maria Pia Foschini
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bellaria Hospital, 40139 Bologna, Italy
| |
Collapse
|
4
|
Fiocco A, Pittarello D, D’Onofrio A, Mastro F, Gerosa G, Colli A. First in human neochordae retensioning for recurrence of mitral regurgitation after neochord procedure. Front Cardiovasc Med 2023; 10:1120323. [PMID: 37255710 PMCID: PMC10225496 DOI: 10.3389/fcvm.2023.1120323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/10/2023] [Indexed: 06/01/2023] Open
Abstract
The Neochord procedure is a viable option to treat degenerative mitral valve regurgitation in selected patients. Left ventricle reverse remodeling can cause neochord-relative elongation and reprolapse of the treated leaflet, leading to failure. We present a clinical case of extensive ventricle reverse remodeling after neochord implantation and the first-in-man off-pump surgical retensioning of the previously implanted artificial chords.
Collapse
Affiliation(s)
- Alessandro Fiocco
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Demetrio Pittarello
- Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Augusto D’Onofrio
- Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Florinda Mastro
- Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Andrea Colli
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
5
|
Bucchi L, Costa S, Mancini S, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Zamagni F, Giorgi Rossi P, Campari C, Canuti D, Sassoli de Bianchi P, Ferretti S, Falcini F. Clinical Epidemiology of Microinvasive Cervical Carcinoma in an Italian Population Targeted by a Screening Programme. Cancers (Basel) 2022; 14:cancers14092093. [PMID: 35565224 PMCID: PMC9103092 DOI: 10.3390/cancers14092093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 04/15/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary According to this population-based study, 3750 patients living in the Emilia-Romagna Region (northern Italy) were registered with cervical carcinoma between 1995–2016, including 2942 eligible patients. The likelihood of stage IA cervical carcinoma (n = 876, 29.8%) did not change over time, decreased with increasing patient age, and was lower for patients with adenocarcinoma and grade 3–4 disease. Three hundred and fifty (40.0%) patients had a conservative treatment, 317 (36.2%) had hysterectomy, 197 (22.5%) had hysterectomy with lymph node dissection (LND), and 12 (1.4%) had a conservative treatment with LND. The proportion of hysterectomy decreased from 70.6% in 1995–1999 to 46.9% in 2011–2016. The likelihood of hysterectomy increased above the age of 40. Among screening-aged (25–64 years) patients, the likelihood of hysterectomy did not differ between screen-detected and non-screen-detected ones. Hysterectomy was increasingly combined with LND. High tumour grade was the strongest determinant of LND during hysterectomy. Abstract (1) Background: This population-based study aimed at identifying the factors associated with the likelihood of detection of stage IA cervical carcinoma—versus the detection of stage IB through IV cervical carcinoma—and the patterns of surgical treatment. (2) Methods: Between 1995–2016, 3750 patients living in the Emilia-Romagna Region (northern Italy) were registered with cervical carcinoma, including 2942 eligible patients (median age, 53). Multivariate analysis was performed using binary logistic regression models. (3) Results: The likelihood of stage IA cervical carcinoma (n = 876, 29.8%) did not change over time, decreased with increasing patient age, and was lower for patients with adenocarcinoma and grade 3–4 disease. Three hundred and fifty (40.0%) patients had a conservative treatment, 317 (36.2%) had hysterectomy, 197 (22.5%) had hysterectomy with lymph node dissection (LND), and 12 (1.4%) had a conservative treatment with LND. The proportion of hysterectomy decreased from 70.6% in 1995–1999 to 46.9% in 2011–2016. The likelihood of hysterectomy increased above the age of 40. Among screening-aged (25–64 years) patients, the likelihood of hysterectomy did not differ between screen-detected and non-screen-detected ones. Hysterectomy was increasingly combined with LND. High tumour grade was the strongest determinant of LND during hysterectomy. (4) Conclusions: This study provided a multifaceted overview of stage IA cervical carcinoma over the last decades.
Collapse
Affiliation(s)
- Lauro Bucchi
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Silvano Costa
- Department of Gynaecology, Madre Fortunata Toniolo Hospital, 40141 Bologna, Italy;
| | - Silvia Mancini
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
- Correspondence:
| | - Flavia Baldacchini
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Orietta Giuliani
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Alessandra Ravaioli
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Rosa Vattiato
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Federica Zamagni
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Cinzia Campari
- Cancer Screening Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Debora Canuti
- Department of Health, Emilia-Romagna Region, 40127 Bologna, Italy; (D.C.); (P.S.d.B.)
| | | | - Stefano Ferretti
- Department of Translational Medicine, University of Ferrara and Local Health Authority, 44121 Ferrara, Italy;
| | - Fabio Falcini
- Emilia-Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (L.B.); (F.B.); (O.G.); (A.R.); (R.V.); (F.Z.); (F.F.)
- Local Health Authority, 47121 Forlì, Italy
| | | |
Collapse
|
6
|
Takahashi M, Sakai K, Iwasa N, Wada M, Hino M, Kurahashi T, Ueno M, Nakagawa H. Validation of the FIGO 2018 staging system of cervical cancer: Retrospective analysis of FIGO 2009 stage IB1 cervical cancer with tumor under 2 cm. J Obstet Gynaecol Res 2021; 47:1871-1877. [PMID: 33611822 DOI: 10.1111/jog.14713] [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: 09/28/2020] [Revised: 01/10/2021] [Accepted: 01/29/2021] [Indexed: 12/01/2022]
Abstract
AIM The International Federation of Gynecology and Obstetrics (FIGO) revised the cervical cancer staging system in 2018. This study aims to validate the revised staging system in patients with tumors <2 cm in size who were classified as FIGO 2009 stage IB1. METHODS We evaluated 62 women with stage IB1 cervical cancer (FIGO 2009) who underwent radical hysterectomy as the initial treatment between November 2004 and August 2018 in our institution. The patients with FIGO 2009 stage IB1 and tumors <2 cm in size were enrolled. We reclassified their stage according to the FIGO 2018 staging system and analyzed their clinicopathological data retrospectively. RESULTS Twenty-five patients met the inclusion criteria. According to the FIGO 2018 classification, 9 (36.0%) patients were classified as stage IA, 13 (52.0%) as stage IB1, and 3 (12.0%) as stage IIIC, respectively. One (11.1%), six (46.2%), and three (100%) patients with lymphovascular space invasion were classified as stage IA, IB1, and IIIC, respectively. No significant differences were found in the 5-year overall survival or progression-free survival among the three stages. CONCLUSIONS As many as 36.0% of patients classified as FIGO 2009 stage IB1 with a tumor <2 cm in size were classified as stage IA in the FIGO 2018 classification. For these cases, a treatment less invasive than radical hysterectomy or radiotherapy might be sufficient. Our results suggest that cervical cancer patients with tumors <2 cm should be carefully diagnosed by performing cervical conization and assessed the pathological findings before hysterectomy.
Collapse
Affiliation(s)
- Mio Takahashi
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Kensuke Sakai
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan.,Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Naomi Iwasa
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Michiko Wada
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Makiko Hino
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Takashi Kurahashi
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Mari Ueno
- Department of Pathology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Hiroyuki Nakagawa
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| |
Collapse
|
7
|
Rosdahl JA, Gupta D. Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment. Clin Ophthalmol 2020; 14:231-243. [PMID: 32158182 PMCID: PMC6986542 DOI: 10.2147/opth.s239772] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 12/24/2019] [Indexed: 12/05/2022] Open
Abstract
Glaucoma is a common blinding disease; while there is no cure, effective treatments include medications, laser, and incisional surgery. There is significant interest from patients and doctors to develop safer surgical options throughout the spectrum of disease, to minimize treatment burden in mild glaucoma patients and to minimize risk of complications in patients needing more aggressive treatment. Surgical procedures called Minimally or Micro-Invasive Glaucoma Surgery (MIGS) are growing in popularity. Eighty-seven prospective studies on MIGS were identified and assessed for quality. Most (74%) did not have a control group. Twelve of the highest quality were reviewed. MIGS procedures appeared to have fewer complications, and lowered intraocular pressure, and reduced medication use. Studies were limited by small sample size, narrow spectrum of glaucomatous disease, and/or conflicts of interest. There is a need for high quality, independently funded and performed, comparative studies on the MIGS to help make treatment decisions.
Collapse
Affiliation(s)
- Jullia A Rosdahl
- Department of Ophthalmology, Duke University, Durham, NC27710, USA
| | - Divakar Gupta
- Department of Ophthalmology, Duke University, Durham, NC27710, USA
| |
Collapse
|
8
|
Gurbuz BC, Karabulut MH, Karabulut B, Aydemir M, Inceman HN, Zemheri IE. Epithelial-myoepithelial carcinoma on lower lip and microinvasive verrucous carcinoma in vocal cord: Case report. North Clin Istanb 2019; 7:187-191. [PMID: 32259043 PMCID: PMC7117631 DOI: 10.14744/nci.2019.48991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 06/25/2019] [Indexed: 11/24/2022] Open
Abstract
Epithelial-myoepithelial carcinoma is a biphasic low-grade malignant tumor, which represents approximately 1% of all salivary gland tumors. This tumor occurs mostly in the parotid gland, followed by submandibular gland and minor salivary glands. Women, mostly fifth to the eighth decade of life, are commonly affected. Histopathologically, epithelial-myoepithelial carcinoma is composed of an inner single layer of eosinophilic cuboidal ductal cells and outer single or multiple layers of clear myoepithelial cells. We present a case of a 69 years old man who had a scar on lower the lip for 10 years and voice annoyance for three months. The biopsy for lower lip was reported "infiltrative clear cell epithelioid neoplasm" and vocal cord biopsy result was "verrucous carcinoma". After cordectomy and wedge resection of the lower lip, histopathology revealed Epithelial-Myoepithelial Carcinoma for the lower lip and microinvasive verrucous carcinoma for the left vocal cord. Our case has a very uncommon location and presentation for EMC. The tumor location was minor salivary glands of the lower lip and the clinical presentation was quite different. Coexistence with microinvasive verrucous carcinoma of the vocal cord is the other unique part of our case.
Collapse
Affiliation(s)
- Begum Calim Gurbuz
- Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Hakan Karabulut
- Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Burak Karabulut
- Department of Otolaryngology, Istanbul Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Merve Aydemir
- Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Hande Nur Inceman
- Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Itır Ebru Zemheri
- Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
9
|
Beguinot M, Dauplat MM, Kwiatkowski F, Lebouedec G, Tixier L, Pomel C, Penault-Llorca F, Radosevic-Robin N. Analysis of tumour-infiltrating lymphocytes reveals two new biologically different subgroups of breast ductal carcinoma in situ. BMC Cancer 2018; 18:129. [PMID: 29394917 PMCID: PMC5797400 DOI: 10.1186/s12885-018-4013-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/22/2018] [Indexed: 12/16/2022] Open
Abstract
Background Tumour-infiltrating lymphocytes (TILs) have been demonstrated to significantly influence prognosis and response to therapy of invasive breast cancer (IBC). Thus, it has been suggested that TIL density or/and immunophenotype could serve as biomarkers for selection of IBC patients for immunotherapy. However, much less is known about significance of TILs in breast ductal carcinoma in situ (DCIS). Methods We retrospectively investigated TIL density and immunophenotype in 96 pure DCIS and 35 microinvasive carcinomas (miCa). TIL density was assessed on H&E-stained breast biopsy sections as the percentage of tumour stromal area occupied by TILs, and classified into 4 grades: 0 (0%–9%), 1 (10–29%), 2 (30–49%) and 3 (50%–100%). TIL immunophenotype was assessed by immunohistochemistry for CD8, CD4, FoxP3, CD38 or CD20. Results Compared to pure DCIS, miCa contained significantly more cases with TIL density grade 3 (p = 0.028). Concordantly, CD8+, CD4+ and CD38+ cells were more numerous in miCa than in pure DCIS. In the pure DCIS subgroup with TIL density grades 2 and 3, all TIL subpopulations were more numerous than in the pure DCIS with TIL density grades 0 and 1, however the ratio between T-lymphocytes (CD8+ and CD4+) and B-lymphocytes (CD20+) was significantly lower (p = 0.029). On the other side, this ratio was significantly higher in miCa, in comparison with pure DCIS having TIL density grades 2 and 3 (p = 0.017). By cluster analysis of tumour cell pathobiological features we demonstrated similarity between miCa and the pure DCIS with TIL density grades 2 and 3. The only significant difference between those two categories was in the ratio of T- to B-TILs, higher in miCa. Conclusion Results indicate that TIL density level can distinguish 2 biologically different DCIS subgroups, one of which (DCIS with ≥30% TILs, the TIL-rich DCIS) is like miCa. Similarity of TIL-rich pure DCIS and miCa as well as the role of B-lymphocytes in DCIS invasiveness are worth further investigating with regards to the potential development of immunotherapy-based prevention of DCIS progression. Electronic supplementary material The online version of this article (10.1186/s12885-018-4013-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Marie Beguinot
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,Master Program « Biology & Health », University Paris-East Val-de-Marne (UPEC), 61 avenue du General de Gaulle, 94010, Creteil, France
| | - Marie-Melanie Dauplat
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,Present Address: Department of Pathology, Paoli-Calmettes Comprehensive Cancer Centre, 232 boulevard Sainte-Marguerite, 13009, Marseilles, France
| | - Fabrice Kwiatkowski
- Department of Clinical Research, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Guillaume Lebouedec
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Lucie Tixier
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Christophe Pomel
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Frederique Penault-Llorca
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Nina Radosevic-Robin
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France. .,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
| |
Collapse
|
10
|
Bean LM, Ward KK, Plaxe SC, McHale MT. Survival of women with microinvasive adenocarcinoma of the cervix is not improved by radical surgery. Am J Obstet Gynecol 2017; 217:332.e1-332.e6. [PMID: 28522318 DOI: 10.1016/j.ajog.2017.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 03/02/2017] [Revised: 04/28/2017] [Accepted: 05/08/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Treatment for early-invasive adenocarcinoma of the cervix remains controversial. Although data have shown similar survival rates to those seen with squamous cell carcinoma, conservative options for patients with microinvasive adenocarcinoma have not been as widely accepted. Despite comparable survival outcomes, patients with early-invasive adenocarcinoma are still routinely subjected to more radical surgical techniques than their equivalently staged squamous cell counterparts. OBJECTIVE The objective of the study was to evaluate how less radical surgery has an impact on 5 year survival in patients with microinvasive adenocarcinoma of the cervix. STUDY DESIGN The Surveillance, Epidemiology, and End Results database was queried from 1988 through 2010 to perform a retrospective analysis of women with International Federation of Gynecology and Obstetrics stage IA1 or IA2 cervical carcinoma. Five year survival by procedure type (local excision, simple hysterectomy, or radical hysterectomy) was determined for each cell type (squamous or adenocarcinoma), as was lymph node status. RESULTS Among 1567 patients with cervical adenocarcinoma, 5 year survival was 97.3% (confidence interval, 95.8-98.2%) for stage IA1 disease and 98.3% (confidence interval, 96.5%, 99.2%) for stage IA2. For comparison, the 5-year survival rates for 5,749 patients with stage IAI or lA2 squamous cell carcinoma were 96.7% (confidence interval, 96.0-97.3%) and 95.6% (confidence interval, 94.4-96.5%), respectively. For stage IA1 ACA, survival was 96.6%, 98.4% and 96.5% following excision, hysterectomy and radical hysterectomy, respectively. For stage IA2 ACA, survival rates were 100%, 96.9% and 99.4%, respectively. There was no statistical difference in survival between patients having either cell type undergoing local excision (P = .26), simple hysterectomy (P = .08), or radical hysterectomy (P = .87). We also found no statistically significant difference in survival among patients with adenocarcinoma compared by treatment type (local excision compared with simple hysterectomy [P = .64]; local excision compared with radical hysterectomy [P = .82]; or simple hysterectomy compared with radical hysterectomy [P = .70]). Among patients with adenocarcinoma, 0.97% had positive pelvic lymph nodes, none had positive aortic lymph nodes, and 91.85% had confirmed negative lymph nodes. For squamous cell carcinoma, 0.72% of patients had positive pelvic lymph nodes and 0.10% had positive aortic lymph nodes. CONCLUSION There was no significant difference in survival when patients were compared by cell type or procedure, suggesting that survival of patients with microinvasive adenocarcinoma is not improved by utilizing more invasive surgical methods. Regardless of histology, the frequency of nodal involvement was very low among both groups, supporting an overall excellent prognosis for all patients with microinvasive disease. We submit these data as evidence that preoperative planning of more conservative techniques is appropriate, not just for those with squamous histology or who desire future fertility, but for all patients with microinvasive cervical disease.
Collapse
Affiliation(s)
- Lisa M Bean
- Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA.
| | - Kristy K Ward
- Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA; Division of Gynecologic Oncology, University of Florida Jacksonville, Jacksonville, FL
| | - Steven C Plaxe
- Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA
| | - Michael T McHale
- Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA
| |
Collapse
|
11
|
Abstract
Introduction The advent of Microinvasive Glaucoma Surgery (MIGS) offers a novel approach in the treatment of glaucoma with the number of procedures developing at an exciting pace. Areas Covered MIGS procedures aim to lower intraocular pressure (IOP) via four mechanisms: (1) increasing trabecular outflow, (2) increasing outflow via suprachoroidal shunts, (3) reducing aqueous production, and (4) subconjunctival filtration. A comprehensive search for published studies for each Microinvasive Glaucoma Surgery (MIGS) device or procedure was undertaken using the electronic database PubMed. Search terms included 'minimally invasive glaucoma surgery', 'microincisional glaucoma surgery', and 'microinvasive glaucoma surgery'. A manual search for each device or procedure was also performed. After review, randomized control trials and prospective studies were preferentially included. Expert Opinion These procedures offer several benefits: an improved safety profile allowing for intervention in earlier stages of glaucoma, combination with cataract surgery, and decreased dependence on patient compliance with topical agents. Established MIGS procedures have proven efficacy and more recent devices and procedures show promising results. Despite this, further study is needed to assess the long term IOP-lowering effectiveness of these procedures. Particularly, rigorous study with more randomized control trials and head-to-head comparisons would allow for better informed clinical and surgical decision-making. MIGS offers new solutions for glaucoma treatment.
Collapse
Affiliation(s)
- Emily M Schehlein
- University of Maryland School of Medicine, Department of Ophthalmology and Visual Sciences, 419 W Redwood Street, Suite 420, Baltimore, MD 21201
| | - Mona A Kaleem
- University of Maryland School of Medicine, Department of Ophthalmology and Visual Sciences, 419 W Redwood Street, Suite 420, Baltimore, MD 21201
| | - Ramya Swamy
- University of Maryland School of Medicine, Department of Ophthalmology and Visual Sciences, 419 W Redwood Street, Suite 420, Baltimore, MD 21201
| | - Osamah J Saeedi
- University of Maryland School of Medicine, Department of Ophthalmology and Visual Sciences, 419 W Redwood Street, Suite 420, Baltimore, MD 21201
| |
Collapse
|
12
|
Gugnani N, Pandit IK, Gupta M, Josan R. Caries infiltration of noncavitated white spot lesions: A novel approach for immediate esthetic improvement. Contemp Clin Dent 2012; 3:S199-202. [PMID: 23230363 PMCID: PMC3514922 DOI: 10.4103/0976-237x.101092] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [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] [Indexed: 12/03/2022] Open
Abstract
The earliest evidence of demineralization on the smooth enamel surface of a crown is a white spot lesion. The conventional treatment of these white spot lesions includes topical fluoride application, iamproving the oral hygiene, and use of remineralizing agents. The following article illustrates the use of a novel approach to treat smooth surface noncavitated white spot lesions microinvasively based on infiltration of enamel caries with low-viscosity light curing resins called infiltrants. This treatment aims upon both the prevention of caries progression and improving esthetics, by diminishing the opacity.
Collapse
Affiliation(s)
- Neeraj Gugnani
- Department of Pedodontic and Preventive Dentistry, DAV Dental College, Yamuna Nagar, India
| | | | | | | |
Collapse
|