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Wu Y, Wang S, Zhang W, Zhu F, Zhang L, Chen S, Ye C, Sun Y, Huang X, Celentano A, Ni Y. Prognostic impact of muscle invasion in buccal mucosa squamous cell carcinoma. Oral Dis 2023. [PMID: 37727981 DOI: 10.1111/odi.14744] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/26/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE The objective of the study was to assess the prognostic value of muscle invasion (MI), a key histopathological feature of tumor aggressiveness, and construct a superior prognostic prediction model combining the current TNM staging system. MATERIALS AND METHODS MI was analyzed in the whole-slide images from a total of 301 patients with primary buccal mucosa squamous cell carcinoma (BMSCC). Survival times of patients with/without MI were evaluated by Kaplan-Meier analysis. MI was further combined with the TNM staging system to explore its predictive value for prognosis. Moreover, 204 cases of head and neck carcinoma from the TCGA database were included. RESULTS MI positive rate reached to 76% (229/301) in patients with BMSCC. MI was associated with poor overall survival (p = 0.012) and disease-free survival (p = 0.022). The novel system (TNM staging combined with MI) revealed strong predictive performance, with the largest area under the curve (OS: p < 0.001, DFS: p < 0.004). MI and the established classification system were also had good predictive ability in the TCGA cohort. CONCLUSIONS MI is an independent predictor of poor prognosis of BMSCC. The inclusion of MI in prediction system can augment the risk stratification of patients with oral squamous cell carcinoma and may assist in the clinical decision-making process.
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Affiliation(s)
- Yan Wu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shuai Wang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Weixian Zhang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Feng Zhu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Lei Zhang
- Department of Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Sheng Chen
- Department of Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chuanjin Ye
- Department of Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yawei Sun
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xiaofeng Huang
- Department of Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Yanhong Ni
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Hu X, Sun C, Ren X, Ge S, Xie C, Li X, Zhu Y, Ding H. Contrast-enhanced Ultrasound Combined With Elastography for the Evaluation of Muscle-invasive Bladder Cancer in Rats. J Ultrasound Med 2023; 42:1999-2011. [PMID: 36896871 DOI: 10.1002/jum.16216] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES By comparing with the control group, we evaluated the usefulness of contrast-enhanced ultrasound (CEUS) combined with elastography for the assessment of muscle invasion by bladder cancer (MIBC) in a Sprague-Dawley (SD) rat model. METHODS In the experimental group, 40 SD rats developed in situ bladder cancer (BLCA) in response to N-methyl-N-nitrosourea treatment, whereas 40 SD rats were included in the control group for comparison. We compared PI, Emean , microvessel density (MVD), and collagen fiber content (CFC) between the two groups. In the experimental group, Bland-Altman test was used to assess the relationships between various parameters. The largest Youden value was used as the cut-off point, and binomial logistic regression analysis was performed to analyze the PI and Emean . Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic power of parameters, individually and in combination. RESULTS The PI, Emean , MVD, and CFC were significantly lower in the control group than in the experimental group (P < .05). The PI, Emean , MVD, and CFC were significantly higher for MIBC than for non-muscle-invasive bladder cancer (P < .05). There were significant correlations between PI and MVD, and between Emean and CFC. The diagnostic efficiency analysis showed PI had the highest sensitivity, CFC had the highest specificity, and PI + Emean had the highest diagnostic efficacy. CONCLUSION CEUS and elastography can distinguish lesions from normal tissue. PI, MVD, Emean , and CFC were useful for the detection of BLCA myometrial invasion. The comprehensive utilization of PI and Emean improved diagnostic accuracy and have clinical application.
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Affiliation(s)
- Xing Hu
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuanyu Sun
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinping Ren
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shengyang Ge
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunmei Xie
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiangyu Li
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingfeng Zhu
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
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Islam NU, Jehangir M, Parry AH, Nazir SS, Bilal S. Diagnostic performance of multiparametric MRI based Vesical Imaging-Reporting and Data System (VI-RADS) scoring in discriminating between non-muscle invasive and muscle invasive bladder cancer. Pol J Radiol 2023; 88:e356-e364. [PMID: 37701172 PMCID: PMC10493860 DOI: 10.5114/pjr.2023.130807] [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: 04/21/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose The purpose of the present study was to assess the diagnostic accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) scoring system in predicting muscle infiltration of bladder cancer (BC) on a pre-operative multiparametric magnetic resonance imaging (mpMRI). Methods The prospective study enrolled patients with bladder lesions detected on a preliminary ultrasonography or cystoscopy. The patients underwent mpMRI on a 3T MRI scanner followed by surgery within 2 weeks. The tumours were assigned a VI-RADS score by 2 experienced abdominal radiologists. The VI-RADS score was compared with postoperative histopathological findings to confirm detrusor muscle infiltration. The diagnostic performance of VI-RADS for predicting muscle invasion was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results A total of 60 patients were included in the study with a male: female ratio of 4.4 : 1. Transurethral resection of bladder tumour (TURBT) was performed in 47 (78.4%) and radical cystectomy in 13 (21.6%) patients. 19 (31.7%) had non-muscle invasive invasive BC (NMIBCa) and 41 (68.3%) had muscle invasive BC (MIBCa) on histopathology. There was a significant association between VI-RADS score and its components with muscle invasion (p < 0.05). A VI-RADS score of ≥ 3 had a sensitivity of 97.56% (95% CI: 0.87-0.99%), specificity of 73.68% (95% CI: 0.49-0.91), positive predictive value of 88.9% (95% CI: 0.79-0.94), negative predictive value of 93.33% (95% CI: 0.66-0.99), and diagnostic accuracy of 90% (95% CI: 0.80-0.96) for prediction of muscle invasion. Conclusion VI-RADS scoring system pre-operatively predicts the likelihood of muscle invasion in BC with a satisfactory diagnostic performance, and it should be incorporated in the diagnostic work-up of BC patients.
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Affiliation(s)
- Naseer ul Islam
- Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Majid Jehangir
- Government Medical College, Srinagar, Jammu and Kashmir, India
| | | | | | - Sheikh Bilal
- Government Medical College, Srinagar, Jammu and Kashmir, India
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Sachdeva S, Suresh PK, Basavaiah SH, Sahu KK, Sreeram S, Kini H, Kini JR, Pinto AC. p16 expression in urothelial carcinoma: Experience from a tertiary care center in coastal South India. J Cancer Res Ther 2023; 19:1330-1334. [PMID: 37787303 DOI: 10.4103/jcrt.jcrt_1243_21] [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: 10/04/2023]
Abstract
Background Urothelial carcinomas (UC) account for 6 and 2% of all cancers in men and women, respectively. Human papillomavirus (HPV) is one of the causative agents in cancers of the uterine cervix and head and neck. The role of HPV is also being studied in cancers of the urinary bladder, penis, and prostate. As p16-INK4a is a surrogate marker for high-risk HPVE7 oncoprotein, this study aims to highlight the utility of p16 immunohistochemistry (IHC) in the evaluation of HPV-associated UC. Materials and Methods A retrospective study was conducted on UC of the bladder received in the Pathology department between January 2013 and December 2018. Bladder biopsies from non-neoplastic lesions served as controls. IHC was done for the detection of the p16 antigen. The p16 staining was recorded as positive, when there was strong staining in >50% of tumor nuclei. The p16 positive and negative tumors were compared based on age, gender, tumor size, grade, and muscle invasion. P value <0.05 was considered statistically significant. Results The expression of p16 was analyzed in 72 UC and compared with 20 non-neoplastic cases, of which 26.4% of the cases showed p16 expression. The p16 expression was absent in the non-neoplastic lesions. While the majority (87.5%) of the low-grade tumors were negative for p16 expression, 43.8% high-grade tumors were positive. Similarly, a larger proportion of invasive carcinomas (38.8%) expressed p16 as compared to non-invasive carcinomas (13.8%). Thus, p16 expression showed a significant association with grade and stage in these malignancies (P < 0.05). Conclusion The p16 expression was associated with high-grade and muscle-invasive UC. The p16 was absent in all non-neoplastic and precursor lesions. Thus, it can provide essential information not only about HPV association but also on the prognostic implications for the patients.
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Affiliation(s)
- Sanjana Sachdeva
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pooja K Suresh
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sridevi H Basavaiah
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kausalya K Sahu
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saraswathy Sreeram
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hema Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jyoti R Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amanda C Pinto
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kim SI, Choi Y. Botulinum Toxin Injection for Intractable Pain in Cancer Patients With Psoas Muscle Invasion. J Pain Symptom Manage 2022; 63:e441-e444. [PMID: 34890725 DOI: 10.1016/j.jpainsymman.2021.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 10/06/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022]
Abstract
Muscle invasion (MI) in patients with far-advanced cancer is often accompanied with pain. Conventional treatments used for pain relief may be associated with several side effects. We describe two cases of botulinum toxin injection (BTI) for relieving intractable pain in patients of far-advanced cancer having MI. The patients presented with persistent intractable pain that did not respond to conventional treatments, such as analgesic medications, epidural steroid injection, and radiotherapy. BTI relieved the intractable pain in these cases for at least 9-12 weeks without any reported side effects. We suggest that BTI can be an alternative method to relieve intractable pain associated with MI in patients with far-advanced cancer.
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Affiliation(s)
- Se Il Kim
- Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - YongMin Choi
- Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.
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Harryman WL, Marr KD, Nagle RB, Cress AE. Integrins and Epithelial-Mesenchymal Cooperation in the Tumor Microenvironment of Muscle-Invasive Lethal Cancers. Front Cell Dev Biol 2022; 10:837585. [PMID: 35300411 PMCID: PMC8921537 DOI: 10.3389/fcell.2022.837585] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Muscle-invasive lethal carcinomas traverse into and through this specialized biophysical and growth factor enriched microenvironment. We will highlight cancers that originate in organs surrounded by smooth muscle, which presents a barrier to dissemination, including prostate, bladder, esophageal, gastric, and colorectal cancers. We propose that the heterogeneity of cell-cell and cell-ECM adhesion receptors is an important driver of aggressive tumor networks with functional consequences for progression. Phenotype heterogeneity of the tumor provides a biophysical advantage for tumor network invasion through the tensile muscle and survival of the tumor network. We hypothesize that a functional epithelial-mesenchymal cooperation (EMC)exists within the tumor invasive network to facilitate tumor escape from the primary organ, invasion and traversing of muscle, and navigation to metastatic sites. Cooperation between specific epithelial cells within the tumor and stromal (mesenchymal) cells interacting with the tumor is illustrated using the examples of laminin-binding adhesion molecules—especially integrins—and their response to growth and inflammatory factors in the tumor microenvironment. The cooperation between cell-cell (E-cadherin, CDH1) and cell-ECM (α6 integrin, CD49f) expression and growth factor receptors is highlighted within poorly differentiated human tumors associated with aggressive disease. Cancer-associated fibroblasts are examined for their role in the tumor microenvironment in generating and organizing various growth factors. Cellular structural proteins are potential utility markers for future spatial profiling studies. We also examine the special characteristics of the smooth muscle microenvironment and how invasion by a primary tumor can alter this environment and contribute to tumor escape via cooperation between epithelial and stromal cells. This cooperative state allows the heterogenous tumor clusters to be shaped by various growth factors, co-opt or evade immune system response, adapt from hypoxic to normoxic conditions, adjust to varying energy sources, and survive radiation and chemotherapeutic interventions. Understanding the epithelial-mesenchymal cooperation in early tumor invasive networks holds potential for both identifying early biomarkers of the aggressive transition and identification of novel agents to prevent the epithelial-mesenchymal cooperation phenotype. Epithelial-mesenchymal cooperation is likely to unveil new tumor subtypes to aid in selection of appropriate therapeutic strategies.
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Affiliation(s)
- William L Harryman
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, United States
| | - Kendra D Marr
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, United States.,Cancer Biology Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, United States.,Medical Scientist Training Program, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Ray B Nagle
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, United States.,Department of Pathology, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Anne E Cress
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, United States.,Department of Cellular and Molecular Medicine and Department of Radiation Oncology, College of Medicine, University of Arizona, Tucson, AZ, United States
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Lee TH, Heo JH, Jeong JY, Lee GH, Park DS, Kim TH. Low Expression of EphB2, EphB3, and EphB4 in Bladder Cancer: Novel Potential Indicators of Muscular Invasion. Yonsei Med J 2021; 62:679-690. [PMID: 34296545 PMCID: PMC8298868 DOI: 10.3349/ymj.2021.62.8.679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/03/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Eph receptors are differentially expressed in numerous malignant tumors. This study intended to analyze the roles of EphB receptors (EphB2, B3, and B4) in urinary bladder cancer. MATERIALS AND METHODS Tissue microarray-based immunohistochemical analysis was used to investigate the expression patterns of EphB2, EphB3, and EphB4 in 154 bladder cancer specimens. Immunohistochemical staining was conducted examining the extent of stained cells and staining intensity. EphB was considered to be highly expressed when the intensity of staining was more than moderate in >25% of cells in the tissue section. Small interfering RNA (siRNA) was used to knock down EphB expression in bladder cancer cell lines (T24, 5637) to determine the effects of EphB on tumor cell invasion, proliferation, and migration. RESULTS EphB receptors (B2, B3, and B4) were detected in 40.9% (EphB2, 63/154), 71.4% (EphB3, 110/154), and 53.2% (EphB4, 82/154) of bladder cancer specimens. Low expression of EphB2, B3, and B4 receptors were significantly associated with higher tumor grade (EphB2, p<0.001; EphB3, p=0.032; EphB4, p<0.001) and muscular invasion (EphB2, p=0.002; EphB3, p=0.009; EphB4, p<0.001). No obvious correlation was observed with other clinicopathological variables, such as age, sex, recurrence, lymph node involvement, metastasis, and overall survival. Inactivation of EphB receptors by siRNA transfection increased cell viability, tumor cell invasion, proliferation, and migration in comparison with untransfected cancer cells. CONCLUSION Low expression of EphB receptors (B2, B3, and B4) can be a predictive marker for muscular invasion of bladder cancer.
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Affiliation(s)
- Tae Ho Lee
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jin Hyung Heo
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ju Yeon Jeong
- Clinical Research Institute, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Gee Hoon Lee
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong Soo Park
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tae Hoen Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- Clinical Research Institute, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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McKenzie RM, Parhar HS, Ng TL, Prisman E. Muscle invasion in oropharyngeal carcinoma undergoing transoral robotic surgery. Head Neck 2020; 43:1194-1201. [PMID: 33355962 DOI: 10.1002/hed.26582] [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: 05/20/2020] [Revised: 10/15/2020] [Accepted: 12/08/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUNDS Pathologic features of oropharyngeal squamous cell carcinoma (OPSCC) treated with trans-oral robotic surgery predict prognosis and adjuvant therapy. We hypothesized that pathologic muscle invasion (pMI) is associated with poor pathological markers. METHODS Retrospective review of surgically treated OPSCC to identify pMI and its association with poor pathologic markers. RESULTS pMI was present in 12/37 patients, and compared to non-pMI, was associated with higher rates of lymphovascular invasion (75% vs. 36%, p = 0.03), perineural invasion (16.7% vs. 0%, p = 0.04), extranodal extension (66.7% vs. 20%, p < 0.01), and tumor stage (8.3% vs. 48% pT1, 75% vs. 52% pT2 and 16.7% vs. 0% pT3). pMI was associated with having a positive margin on main specimen (41.7% vs. 12%, p = 0.04) but not after considering additional margins. CONCLUSIONS Muscle invasion was associated with higher pathologic tumor staging, poor pathologic factors, and higher rates of positive margin on main specimen.
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Affiliation(s)
- Robert M McKenzie
- Division of Otolaryngology - Head & Neck Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Harman S Parhar
- Division of Otolaryngology - Head & Neck Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tony L Ng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eitan Prisman
- Division of Otolaryngology - Head & Neck Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Liu S, Xu F, Xu T, Yan Y, Yao X, Tang G. Evaluation of Vesical Imaging-Reporting and Data System (VI-RADS) scoring system in predicting muscle invasion of bladder cancer. Transl Androl Urol 2020; 9:445-451. [PMID: 32420150 PMCID: PMC7215047 DOI: 10.21037/tau.2020.02.16] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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] [Indexed: 01/13/2023] Open
Abstract
Background To investigate the accuracy of using the Vesical Imaging-Reporting and Data System (VI-RADS) scoring system in prediction preoperative muscle invasion of bladder cancer. Methods The study retrospectively reviewed consecutive patients with bladder cancer who received multiparametric magnetic resonance imaging (MRI) between January 2017 and June 2019. Clinical and pathological parameters were collected. Bladder tumors were re-evaluated with 5-point VI-RADS scoring system by two experienced radiologists independently. The VI-RADS score was compared with postoperative pathology for each tumor for determining muscle invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each VI-RADS cutoff. Results A total of 126 patients were included in analysis, with 82 patients received transurethral resection of bladder tumor (TURBt) while 44 underwent radical cystectomy. Fifty patients were muscle-invasive bladder cancer and 76 were non-muscle invasive tumor confirmed pathologically. VI-RADS score was only predictive factor to muscle invasion in multivariate analysis. Setting VI-RADS score greater than or equal to 4 reached the best sensitivity and specificity of 94.00% and 92.11%, with PPV and NPV value of 88.68% and 95.89%. Conclusions VI-RADS score system is a promising and effective modality in determining detrusor muscle invasion of bladder cancer preoperatively.
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Affiliation(s)
- Shenghua Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Feijia Xu
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Tianyuan Xu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Yang Yan
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Xudong Yao
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
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de Brot S, Grau-Roma L, Stirling-Stainsby C, Dettwiler M, Guscetti F, Meier D, Scase T, Robinson BD, Gardner D, Mongan NP. A Fibromyxoid Stromal Response is Associated with Muscle Invasion in Canine Urothelial Carcinoma. J Comp Pathol 2019; 169:35-46. [PMID: 31159949 DOI: 10.1016/j.jcpa.2019.04.003] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/03/2019] [Accepted: 04/09/2019] [Indexed: 12/01/2022]
Abstract
Canine urothelial carcinoma (UC) is the most common type of cancer of the lower urinary tract and tends to affect elderly neutered female dogs, with a high predisposition for Scottish terriers. Tumour stroma, inflammation and necrosis are poorly characterized in canine UC and their role as prognostic factors is unknown. The aims of this study were to (1) assess histologically 381 canine UCs, with emphasis on myxoid tumour stroma, inflammation and necrosis and (2) assess possible associations between these features and the available epidemiological data as well as bladder wall muscle invasion. In 103 of 381 (27%) cases, the stroma was mixed collagenous and myxoid (fibromyxoid), which was strongly associated with invasive growth of muscle (P <0.0001). Peritumoural and intratumoural inflammation was present in 308 of 345 (89%) and 287 of 381 (75%) cases, respectively, and was mostly mild and lymphoplasmacytic. One hundred and fifteen of the 381 (30%) cases showed a variable eosinophilic inflammation and 58 of 381 (15%) presented with formations of one or several lymphoid follicles. Twenty-four percent (91 of 381) of cases had tumour necrosis, which was typically mild. In 83 of 91 (91%) cases, the necrosis was comedo-like. Moderate to severe tumour necrosis was associated with the presence of moderate to predominant fibromyxoid tumour stroma (P <0.02). The results of this study indicate that fibromyxoid stroma is common in canine UC and is a strong indicator for invasive growth of muscle, which is consistent with a poor prognosis. Based on histomorphology, tumour necrosis in canine UC is best described as comedonecrosis.
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Affiliation(s)
- S de Brot
- School of Veterinary Medicine and Science, University of Nottingham, UK; Institute of Animal Pathology, University of Bern, Switzerland.
| | - L Grau-Roma
- Institute of Animal Pathology, University of Bern, Switzerland
| | | | - M Dettwiler
- Institute of Animal Pathology, University of Bern, Switzerland
| | - F Guscetti
- Institute of Veterinary Pathology, University of Zurich, Switzerland
| | - D Meier
- Zyto-Histo Diagnostics, Freienstein, Switzerland
| | - T Scase
- Bridge Pathology Ltd., Bristol, UK
| | | | - D Gardner
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - N P Mongan
- School of Veterinary Medicine and Science, University of Nottingham, UK; Weill Cornell Medical College, New York, USA
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Hiles GL, Cates AL, El-Sawy L, Day KC, Broses LJ, Han AL, Briggs HL, Emamdjomeh A, Chou A, Abel EV, Liebert M, Palmbos PL, Udager AM, Keller ET, Day ML. A surgical orthotopic approach for studying the invasive progression of human bladder cancer. Nat Protoc 2019; 14:738-755. [PMID: 30683938 PMCID: PMC6463286 DOI: 10.1038/s41596-018-0112-8] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The invasion of bladder cancer into the sub-urothelial muscle and vasculature are key determinants leading to lethal metastatic progression. However, the molecular basis is poorly understood, partly because of the lack of uncomplicated and reliable models that recapitulate the biology of locally invasive disease. We developed a surgical grafting technique, characterized by a simple, rapid, reproducible and high-efficiency approach, to recapitulate the pathobiological events of human bladder cancer invasion in mice. This technique consists of a small laparotomy and direct implantation of human cancer cells into the bladder lumen. Unlike other protocols, it does not require debriding of the urothelial lining, injection into the bladder wall, specialized imaging equipment, bladder catheterization or costly surgical equipment. With minimal practice, the procedure can be executed in <10 min. Tumors develop with a high take rate, and most cell lines exhibit local invasion within 4 weeks of implantation.
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Affiliation(s)
- Guadalupe Lorenzatti Hiles
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Present address: Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.,These authors contributed equally: Guadalupe Lorenzatti Hiles, Angelica L. Cates, Layla El-Sawy and Kathleen C. Day
| | - Angelica L. Cates
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Present Address: College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.,These authors contributed equally: Guadalupe Lorenzatti Hiles, Angelica L. Cates, Layla El-Sawy and Kathleen C. Day
| | - Layla El-Sawy
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,European Egyptian Pharmaceutical Industries, Alexandria, Egypt.,These authors contributed equally: Guadalupe Lorenzatti Hiles, Angelica L. Cates, Layla El-Sawy and Kathleen C. Day
| | - Kathleen C. Day
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,These authors contributed equally: Guadalupe Lorenzatti Hiles, Angelica L. Cates, Layla El-Sawy and Kathleen C. Day
| | - Luke J. Broses
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Amy L. Han
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Present address: School of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Hannah L. Briggs
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,Present address: Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Amir Emamdjomeh
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Present address: College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Andrew Chou
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Present address: College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.</address>
| | - Ethan V. Abel
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Monica Liebert
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Phillip L. Palmbos
- Division of Haematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Aaron M. Udager
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Evan T. Keller
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Correspondence: Mark L. Day, Ph.D., NCRC Building 520, Room 1348, 2800 Plymouth Rd, Ann Arbor, MI 48109, , Phone: (734) 763-9968, Fax: (734) 647-4238; Evan T. Keller, D.V.M., Ph.D., NCRC Building 14, Room 116, 2800 Plymouth Rd, Ann Arbor, MI 48109, , Phone: (734) 615-0280, Fax: (734) 763-7133
| | - Mark L. Day
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.,Correspondence: Mark L. Day, Ph.D., NCRC Building 520, Room 1348, 2800 Plymouth Rd, Ann Arbor, MI 48109, , Phone: (734) 763-9968, Fax: (734) 647-4238; Evan T. Keller, D.V.M., Ph.D., NCRC Building 14, Room 116, 2800 Plymouth Rd, Ann Arbor, MI 48109, , Phone: (734) 615-0280, Fax: (734) 763-7133
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Chandler K, Vance C, Budnick S, Muller S. Muscle invasion in oral tongue squamous cell carcinoma as a predictor of nodal status and local recurrence: just as effective as depth of invasion? Head Neck Pathol 2011; 5:359-63. [PMID: 21892763 PMCID: PMC3210217 DOI: 10.1007/s12105-011-0296-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [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: 06/07/2011] [Accepted: 08/19/2011] [Indexed: 11/29/2022]
Abstract
Tumor depth of invasion (DOI) is a histologic feature that consistently correlates with lymph node metastasis; however, there are many difficulties with accurately assessing DOI. The aim of this study was to identify a simpler and more reproducible method of determining DOI, by using skeletal muscle invasion as a surrogate marker of depth. Oral tongue squamous cell carcinoma American Joint Committee on Cancer (AJCC) stage T1 cases were identified in the Emory University Department of Pathology database. 61 cases, with a minimum of 2 years of follow-up, were included in the study. Cases were examined histologically to assess muscle invasion and DOI. The two methods of measurement were analyzed to determine the positive predictive value (PPV) of DOI or muscle invasion for both nodal disease and local recurrence. Cases with muscle invasion had a 23.3% PPV of occult lymph node metastasis. Cases with DOI of greater than 3 mm had a 29.7% PPV of occult lymph node metastasis. Cases with muscle invasion had a 43.7% PPV of local tumor recurrence. Cases with maximum DOI of greater than 3 mm had a 40.4% PPV of tumor recurrence. Although the PPV of muscle invasion in regards to nodal status was slightly less than DOI, it represents a more easily reproducible parameter which could guide surgeons in determining if the case warrants an elective neck dissection in a cN0 (clinically negative) neck. Interestingly, the PPV of local recurrence was higher with muscle invasion than DOI, and may represent an important indicator for extent of resection.
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Affiliation(s)
- Katherine Chandler
- Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Road, NE, Atlanta, GA 30322 USA
| | - Courtney Vance
- Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Road, NE, Atlanta, GA 30322 USA
| | - Steven Budnick
- Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Road, NE, Atlanta, GA 30322 USA
| | - Susan Muller
- Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Road, NE, Atlanta, GA 30322 USA
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