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Xu Z, Li H, Yu X, Luo J, Zhang Z. Clinical characterization of hemophagocytic lymphohistiocytosis caused by immune checkpoint inhibitors: a review of published cases. Hematology 2024; 29:2340144. [PMID: 38606818 DOI: 10.1080/16078454.2024.2340144] [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: 11/08/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE An association exists between immune checkpoint inhibitors and hemophagocytic lymphohistiocytosis (HLH). Therefore, the main objective of this study was to collect data on this rare but potentially life-threatening immune-related adverse reaction to identify the medications that cause it, the clinical characteristics, and effective treatments. METHODS Literature in English and Chinese on immune checkpoint inhibitors causing HLH published from August 2014 to March 2024 was analyzed. Immune checkpoint inhibitors, immunotherapy, anti-PD-1, PD-L1 inhibitors, HLH, hemophagocytic lymphohistiocytosis, hemophagocytic syndrome keywords were used to find the literature on China Knowledge Network, Wanfang, PubMed and Emabase Databases. RESULTS AND DISCUSSION Twenty-four studies were included, with a total of 27 patients (18 males and 9 females) with a mean age of 58 years (range 26-86). The mean time to the onset of symptoms was 10.3 weeks (7 days-14 months). The main clinical characteristics were fever, cytopenia, splenomegaly, methemoglobinemia, hypofibrinogenemia, and bone marrow biopsy showed phagocytosis. Twenty-two patients improved after the treatment with steroids, cytokine blocking therapy and symptomatic treatment, four patients died, and one patient was not described. CONCLUSION HLH should be not underestimated as a potentially serious adverse effect of immune checkpoint inhibitors since appropriate treatments may save the life of patients.
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Affiliation(s)
- Zhiya Xu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Huilan Li
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xinyi Yu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jia Luo
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Zanling Zhang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China
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Lemoine Laroussinie M, Pioche M, Calavas L, Fenouil T, Saurin JC, Pasquer A, Benech N. Cold snaring biopsies to increase screening efficacy during endoscopic surveillance of patients at high risk of diffuse gastric cancer. Endoscopy 2024; 56:E213-E214. [PMID: 38428917 PMCID: PMC10907120 DOI: 10.1055/a-2262-7988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
| | - Mathieu Pioche
- Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Laura Calavas
- Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Tanguy Fenouil
- Anatomopathology Unit, Hospices Civils de Lyon, Lyon, France
| | | | - Arnaud Pasquer
- Surgery Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Benech
- Hepatogastroenterology Unit, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
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Zheng XJ, Chen Y, Yao L, Li XL, Sun D, Li YQ. Identification of new hub- ferroptosis-related genes in Lupus Nephritis. Autoimmunity 2024; 57:2319204. [PMID: 38409788 DOI: 10.1080/08916934.2024.2319204] [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: 10/26/2023] [Accepted: 02/11/2024] [Indexed: 02/28/2024]
Abstract
Background: Lupus Nephritis (LN) is the primary causation of kidney injury in systemic lupus erythematosus (SLE). Ferroptosis is a programmed cell death. Therefore, understanding the crosstalk between LN and ferroptosis is still a significant challenge. Methods: We obtained the expression profile of LN kidney biopsy samples from the Gene Expression Omnibus database and utilised the R-project software to identify differentially expressed genes (DEGs). Then, we conducted a functional correlation analysis. Ferroptosis-related genes (FRGs) and differentially expressed genes (DEGs) crossover to select FRGs with LN. Afterwards, we used CIBERSORT to assess the infiltration of immune cells in both LN tissues and healthy control samples. Finally, we performed immunohistochemistry on LN human renal tissue. Results: 10619 DEGs screened from the LN biopsy tissue were identified. 22 hub-ferroptosis-related genes with LN (FRGs-LN) were screened out. The CIBERSORT findings revealed that there were significant statistical differences in immune cells between healthy control samples and LN tissues. Immunohistochemistry further demonstrated a significant difference in HRAS, TFRC, ATM, and SRC expression in renal tissue between normal and control groups. Conclusion: We developed a signature that allowed us to identify 22 new biomarkers associated with FRGs-LN. These findings suggest new insights into the pathology and therapeutic potential of LN ferroptosis inhibitors and iron chelators.
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Affiliation(s)
- Xiao-Jie Zheng
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Chen
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Li Yao
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao-Li Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Da Sun
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan-Qiu Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Tan J, Zhang H, Liu L, Li J, Fu Q, Li Y, Wu C, Deng R, Wang J, Xu B, Chen W, Yang S, Wang C. Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy. Ren Fail 2024; 46:2314630. [PMID: 38345067 PMCID: PMC10863519 DOI: 10.1080/0886022x.2024.2314630] [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: 08/17/2023] [Accepted: 01/31/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND No study has validated, compared and adapted scoring systems for prognosis prediction based on donor kidney core biopsy (CB), with less glomeruli than wedge biopsy. METHODS A total of 185 donor kidney CB specimens were reviewed using seven scoring systems. The association between the total score, item scores, score-based grading, and allograft prognosis was investigated. In specimens with less than ten glomeruli (88/185, 47.6%), scoring systems were modified by adjusting weights of the item scores. RESULTS The Maryland aggregate pathology index (MAPI) score-based grading and periglomerular fibrosis (PGF) associated with delayed graft function (DGF) (Grade: OR = 1.59, p < 0.001; PGF: OR = 1.06, p = 0.006). Total score, score-based grading and chronic lesion score in scoring systems associated with one-year and 3-year eGFR after transplantation. Total-score-based models had similar predictive capacities for eGFR in all scoring systems, except MAPI and Ugarte. Score of glomerulosclerosis (GS), interstitial fibrosis (IF), tubular atrophy (TA), and arteriolar hyalinosis (AH) had good eGFR predictive capacities. In specimens with less than ten glomeruli, modified scoring systems had better eGFR predictive capacities than original scoring systems. CONCLUSIONS Scoring systems could predict allograft prognosis in paraffin-embedded CB with ten more glomeruli. A simple and pragmatic scoring system should include GS, IF, TA and AH, with weights assigned based on predictive capacity for prognosis. Replacing GS scores with tubulointerstitial scores could significantly improve the predictive capacity of eGFR. The conclusion should be further validated in frozen section.
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Affiliation(s)
- Jinghong Tan
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huanxi Zhang
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Longshan Liu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory on Organ Donation and Transplant Immunology, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
| | - Jun Li
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Fu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chenglin Wu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ronghai Deng
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiali Wang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bowen Xu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenfang Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shicong Yang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Changxi Wang
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Dong T, Jing L, Wang Y, Xiao J. A key to unlocking the door: water pressure method for endoscopic submucosal dissection of a superficial non-ampullary duodenal epithelial tumor with a history of multiple biopsies. Endoscopy 2024; 56:E8-E9. [PMID: 38194979 PMCID: PMC10776276 DOI: 10.1055/a-2218-2670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Tao Dong
- Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lin Jing
- Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yaohui Wang
- Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jun Xiao
- Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Chen J, Zhao Y. Pre-treatment [ 18F]FDG PET/CT for assessing bone marrow involvement and prognosis in patients with newly diagnosed peripheral T-cell lymphoma. Hematology 2024; 29:2325317. [PMID: 38465661 DOI: 10.1080/16078454.2024.2325317] [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: 12/31/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Abstract
PURPOSE To explore the value of [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in assessing bone marrow involvement (BMI) and prognosis in newly diagnosed peripheral T-cell lymphomas (PTCLs) before treatment. METHODS This retrospective study included 201 eligible PTCLs who received pre-bone marrow biopsy (BMB) and PET/CT. The status of bone marrow (BM) by PET was assessed using a visual examination and a quantitative index (the maximal standardized uptake value [SUVmax] of BM divided by the SUVmax of the liver [M/L]). RESULTS Totally 148 patients had no evidence of BMI by PET or BMB; BMI was detected by both methods in 16 patients. The sensitivity and specificity of PET/CT for patients with confirmed BMI by BMB were 43.2% and 90.2%, respectively (κ = 0.353). In addition, 25 patients assessed by PET/CT staging (having stage I to II disease) had no evidence of BMI detected by both PET/CT and BMB. Image-guided biopsy was also recommended when PET/CT showed a focal FDG uptake outside the iliac crest. Survival analysis revealed that BMB was significant for overall survival (OS) (P = 0.020) while M/L for both progression free survival (P = 0.002) and OS (P < 0.001). In multivariate analysis, M/L (HR 1.825, 95% CI 1.071-3.110, P = 0.027) was an independent prognostic factor for OS. There were no statistical differences at the genetic level about BMI confirmed by PET or BMB. CONCLUSION PET/CT has a complementary role in assessing BMI and an ability to predict prognosis in PTCL patients.
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Affiliation(s)
- Jing Chen
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yi Zhao
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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7
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Fraleigh DC, Pallin LJ, Friedlaender AS, Barlow J, Henry AE, Waples DM, Oglesby T, Fleming AH. The influence of biopsy site and pregnancy on stable isotope ratios in humpback whale skin. Rapid Commun Mass Spectrom 2024; 38:e9746. [PMID: 38576213 DOI: 10.1002/rcm.9746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
RATIONALE Stable isotope analysis (SIA) of free-swimming mysticetes using biopsies is often limited in sample size and uses only one sample per individual, failing to capture both intra-individual variability and the influence of demographic and physiological factors on isotope ratios. METHODS We applied SIA of δ13C and δ15N to humpback whale (Megaptera novaeangliae) biopsies taken during the foraging season along the western Antarctic Peninsula to quantify intra-individual variation from repeatedly sampled individuals, as well as to determine the effect of biopsy collection site, sex, and pregnancy on isotope ratios. RESULTS There was substantial variability in δ13C from multiple biopsies taken from the same individuals, though δ15N was much more consistent. Side of the body (left versus right) and biopsy location (dorsal, anterior, ventral, and posterior) did marginally affect the isotopic composition of δ15N but not δ13C. Pregnancy had a significant effect on both δ13C and δ15N, where pregnant females were depleted in both when compared to non-pregnant females and males. CONCLUSIONS These results indicate that isotopic signatures are influenced by multiple endogenous and exogenous factors and emphasize value in accounting for intra-individual variability and pregnancy status within a sampled population. Placed within an ecological context, the endogenous variability in δ13C observed here may be informative for future isotopic analyses.
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Affiliation(s)
- Devin C Fraleigh
- Center for Marine Science, University of North Carolina Wilmington, Wilmington, North Carolina, USA
- Department of Oceanography, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Logan J Pallin
- Department of Ecology and Evolutionary Biology, University of California Santa Cruz, Santa Cruz, California, USA
| | - Ari S Friedlaender
- Institute for Marine Science, University of California Santa Cruz, Santa Cruz, California, USA
- Department of Ocean Sciences, University of California Santa Cruz, Santa Cruz, California, USA
| | - Jay Barlow
- NOAA Southwest Fisheries Science Center, San Diego, California, USA
| | - Annette E Henry
- NOAA Southwest Fisheries Science Center, San Diego, California, USA
| | | | - Teris Oglesby
- Duke University Marine Laboratory, Beaufort, North Carolina, USA
| | - Alyson H Fleming
- Center for Marine Science, University of North Carolina Wilmington, Wilmington, North Carolina, USA
- Department of Forest & Wildlife Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Zamora Z, Lui LY, Sparks LM, Justice J, Lyles M, Gentle L, Gregory H, Yeo RX, Kershaw EE, Stefanovic-Racic M, Newman AB, Kritchevsky S, Toledo FGS. Percutaneous biopsies of skeletal muscle and adipose tissue in individuals older than 70: methods and outcomes in the Study of Muscle, Mobility and Aging (SOMMA). GeroScience 2024; 46:3419-3428. [PMID: 38315316 PMCID: PMC11009187 DOI: 10.1007/s11357-024-01087-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
Biopsies of muscle and adipose tissue (AT) are useful tools to gain insights into the aging processes in these tissues. However, they are invasive procedures and their risk/benefit profile in older adults can be altered by sarcopenia, frailty, poor healing, and multimorbidity. Their success rates, safety, and tolerability in a geriatric population have not been reported in detail. Investigators in the Study of Muscle, Mobility, and Aging (SOMMA) performed biopsies of muscle and AT in older adults and prospectively collected data on biopsy success rates, safety, and tolerability. We report here the methods and outcomes of these two procedures. In total, 861 participants (aged 70-94) underwent percutaneous biopsies of the Vastus lateralis muscle with a Bergstrom needle. A subset (n = 241) also underwent percutaneous biopsies of the abdominal subcutaneous AT with the tumescent liposuction technique. Success rate was assessed by the percentage of biopsies yielding adequate specimens for analyses; tolerability by pain scores; and safety by frequency of adverse events. All data were prospectively collected. The overall muscle biopsy success rate was 97.1% and was modestly lower in women. The AT biopsy success rate was 95.9% and slightly lower in men. Minimal or no pain was reported in 68% of muscle biopsies and in 83% of AT biopsies. Adverse events occurred in 2.67% of muscle biopsies and 4.15% of AT biopsies. None was serious. In older adults, percutaneous muscle biopsies and abdominal subcutaneous AT biopsies have an excellent safety profile, often achieve adequate tissue yields for analyses, and are well tolerated.
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Affiliation(s)
- Zeke Zamora
- Internal Medicine Section On Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Li-Yung Lui
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Jamie Justice
- Internal Medicine Section On Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary Lyles
- Internal Medicine Section On Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Landon Gentle
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Heather Gregory
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Reichelle X Yeo
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Erin E Kershaw
- Division of Endocrinology and Metabolism, Dept. of Medicine, School of Medicine, University of Pittsburgh, 200 Lothrop Street BST-W1055, Pittsburgh, PA, 15261, USA
| | - Maja Stefanovic-Racic
- Division of Endocrinology and Metabolism, Dept. of Medicine, School of Medicine, University of Pittsburgh, 200 Lothrop Street BST-W1055, Pittsburgh, PA, 15261, USA
| | - Anne B Newman
- Dept. of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen Kritchevsky
- Internal Medicine Section On Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Frederico G S Toledo
- Division of Endocrinology and Metabolism, Dept. of Medicine, School of Medicine, University of Pittsburgh, 200 Lothrop Street BST-W1055, Pittsburgh, PA, 15261, USA.
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Murphy J, Patel A, Hughes S, Rehousek P, Drake J, Sumathi V, Botchu R, Mark Davies A. Bone metastases from chondroblastoma: a rare pattern of metastatic disease in an adult. Skeletal Radiol 2024; 53:1219-1224. [PMID: 37934213 DOI: 10.1007/s00256-023-04491-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
Chondroblastoma is a rare benign tumor, typically presenting in the first two decades. Systemic metastases in chondroblastoma are extremely rare and it is the rarity of these metastases which lead the World Health Organisation to re-classify this lesion from "intermediate" to "benign" in its updated classification of bone tumors in 2020. We present an unusual case of a 55 year-old male patient who presented with multiple FDG-avid bone lesions on a background of conventional chondroblastoma of the rib excised at another institution 11-years previously. Two of these lesions were also histologically-proven as conventional chondroblastoma at biopsy. This case highlights that, although rare, metastases can be seen in patients with chondroblastoma. To our knowledge, this is the only case with an unusual pattern of metastases limited to bone.
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Affiliation(s)
- Jennifer Murphy
- Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
| | - Anish Patel
- Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Simon Hughes
- Department of Spinal Surgery, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Petr Rehousek
- Department of Spinal Surgery, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - John Drake
- Department of Histopathology, Birmingham Heartlands Hospital, Birmingham, UK
| | - Vaiyapuri Sumathi
- Department of Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Rajesh Botchu
- Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - A Mark Davies
- Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Kozakowski N. The histomorphology of the senescent kidney - the clinical relevance of specimen and biopsy findings in the elderly native kidneys. Curr Opin Urol 2024; 34:170-175. [PMID: 38410848 DOI: 10.1097/mou.0000000000001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW Renal pathology is crucial in diagnosing the ageing kidney. Recent technological advances enabled high-resolution molecular investigations into the complex mechanisms of ageing and senescence. RECENT FINDINGS The pathological analysis of large kidney tissue collections coupled with computer-assisted morphometry contributed to the establishment of age-related reference values for glomerular or vascular sclerosis, interstitial fibrosis, and tubular atrophy. Furthermore, new high-throughput proteomic and transcriptomic platforms have entered the field of pathology. When coupled with morphology information, these techniques facilitated the study of extracellular matrix modifications and the senescent immune system in the ageing kidney. Finally, iatrogenic complications are now frequent indications for diagnostic kidney biopsies in older patients, potentially accelerating kidney senescence. SUMMARY Recent pathology literature supports identifying and prognosticating sclerosing processes in ageing kidneys.
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Affiliation(s)
- Nicolas Kozakowski
- Medical University of Vienna, Department of Pathology, Vienna, Austria; General Hospital, Waehringer Guertel, Vienna, Austria
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Hill W, Sotlar K, Hautmann A, Kolb HJ, Ullmann J, Hausmann A, Schmidt M, Tischer J, Pham TT, Rank A, Hoechstetter MA. Late transplant-associated thrombotic microangiopathy verified in bone marrow biopsy specimens is associated with chronic GVHD and viral infections. Eur J Haematol 2024; 112:819-831. [PMID: 38243840 DOI: 10.1111/ejh.14174] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES To describe late transplant-associated thrombotic microangiopathy (TA-TMA) as chronic endothelial complication in bone marrow (BM) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS BM specimens along with conventional diagnostic parameters were assessed in 14 single-institutional patients with late TA-TMA (more than 100 days after HCST), including 11 late with history of early TA-TMA, 10 with early TA-TMA (within 100 days), and 12 non TA-TMA patients. Three non-HSCT patients served as control. The time points of BM biopsy were +1086, +798, +396, and +363 days after HSCT, respectively. RESULTS Late TA-TMA patients showed an increase of CD34+ and von Willebrand Factor (VWF)+ microvascular endothelial cells with atypical VWF+ conglomerates forming thickened VWF+ plaque sinus in the BM compared to patients without late TA-TMA and non-HSCT. Severe chronic (p = .002), steroid-refractory GVHD (p = .007) and reactivation of HHV6 (p = .002), EBV (p = .003), and adenovirus (p = .005) were pronounced in late TA-TMA. Overall and relapse-free survival were shorter in late TA-TMA than in patients without late TA-TMA (5-year OS and RFS: 78.6% vs. 90.2%, 71.4% vs. 86.4%, respectively). CONCLUSION Chronic allo-immune microangiopathy in BM associated with chronic, steroid-refractory GVHD and/or viral infections are key findings of late, high-risk TA-TMA, which deserves clinical attention.
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Affiliation(s)
- Wolfgang Hill
- Department of Internal Medicine III, University Hospital Munich, University of Munich, Munich, Germany
| | - Karl Sotlar
- University Institute of Pathology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Anke Hautmann
- Private Practice and Day Clinic for Hematology and Oncology, Regensburg, Germany
| | - Hans-Jochem Kolb
- Department of Internal Medicine III, University Hospital Munich, University of Munich, Munich, Germany
| | - Johanna Ullmann
- Department of Internal Medicine III, University Hospital Munich, University of Munich, Munich, Germany
| | - Andreas Hausmann
- Department of Internal Medicine I, Academic Teaching Hospital, München Klinik Schwabing, Munich, Germany
| | - Michael Schmidt
- Munich Cancer Registry, Institute for Medical Information Processing, Biometry, and Epidemiology, University of Munich, Munich, Germany
| | - Johanna Tischer
- Department of Internal Medicine III, University Hospital Munich, University of Munich, Munich, Germany
| | - Thu-Trang Pham
- Department of Internal Medicine I, Academic Teaching Hospital, München Klinik Schwabing, Munich, Germany
| | - Andreas Rank
- Department of Hematology and Oncology, University Hospital Augsburg, University of Augsburg, Augsburg, Germany
| | - Manuela A Hoechstetter
- Department of Internal Medicine I, Academic Teaching Hospital, München Klinik Schwabing, Munich, Germany
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Favorito LA. MRI and biopsy in prostate cancer are the hot topic in this number of International Brazilian Journal of Urology. Int Braz J Urol 2024; 50:234-236. [PMID: 38598827 DOI: 10.1590/s1677-5538.ibju.2024.03.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Affiliation(s)
- Luciano A Favorito
- Unidade de Pesquisa Urogenital - Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
- Serviço de Urologia, Hospital Federal da Lagoa, Rio de Janeiro, RJ, Brasil
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13
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Xu N, Wang X, Dai T, Liu N, Ding Y, Chen J, Tian L, Fang Y, Zhang Y, Li G. Non-invasive imaging for predicting labial salivary gland biopsy outcomes in patients with suspected primary Sjögren syndrome. Clin Rheumatol 2024; 43:1683-1692. [PMID: 38568436 DOI: 10.1007/s10067-024-06949-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/02/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024]
Abstract
To identify the value of salivary gland ultrasound (SGUS) combined with magnetic resonance imaging (MRI) and magnetic resonance sialography (MRS) in predicting the results of labial salivary gland biopsy (LSGB) in patients with suspected primary Sjögren syndrome (pSS), and construct a nomogram model to predict LSGB results. A total of 181 patients who were admitted with suspected pSS from December 2018 to April 2023 were examined and divided into a training set (n = 120) and a validation set (n = 61). Baseline data of the two groups were examined, and the value of SGUS, MRI, and MRS in predicting LSGB was analyzed. Multivariate logistic analysis was used to screen for risk factors, and nomogram prediction models were constructed using these results. In the training set, the SGUS, MRI, and MRS scores of patients in the LSGB + group were higher than those in the LSGB - group (all P < 0.001). The positive prediction value (PPV) was 91% for an SGUS score of 3, and 82% for MRI and MRS scores of 2 or more. We developed a nomogram prediction model based on SGUS, MRI, and MRS data, and it had a concordance index (C-index) of 0.94. The Hosmer-Lemeshow test (χ2 = 3.17, P = 0.92) also indicated the nomogram prediction model had good accuracy and calibration for prediction of LSGB results. A nomogram model based on SGUS, MRI, and MRS results can help rheumatologists decide whether LSGB should be performed in patients with suspected pSS.
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Affiliation(s)
- Nan Xu
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Xuanhan Wang
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Tiantian Dai
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Nianxing Liu
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Yimin Ding
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Jinqiong Chen
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Longlong Tian
- Department of Rheumatology and Immunology, Qingdao West Coast New District People's Hospital, Qingdao, 266000, People's Republic of China
| | - Yuxuan Fang
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Yongbin Zhang
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China
| | - Guoqing Li
- Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People's Republic of China.
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14
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Collins MH, Arva NC, Bernieh A, Lopez-Nunez O, Pletneva M, Yang GY. Histopathology of Eosinophilic Esophagitis. Immunol Allergy Clin North Am 2024; 44:205-221. [PMID: 38575219 DOI: 10.1016/j.iac.2023.12.008] [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: 04/06/2024]
Abstract
Microscopic examination of esophageal biopsies is essential to diagnose eosinophilic esophagitis (EoE). Eosinophil inflammation is the basis for the diagnosis, but additional abnormalities may contribute to persistent symptoms and epithelial barrier dysfunction. Both peak eosinophil count and assessments of additional features should be included in pre-therapy and post-therapy pathology reports. Pathologic abnormalities identified in esophageal biopsies of EoE are reversible in contrast to esophageal strictures.
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Affiliation(s)
- Margaret H Collins
- Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Pathology ML1035, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Nicoleta C Arva
- Department of Pathology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Anas Bernieh
- Pathology ML1035, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave.nue Cincinnati, OH 45229, USA
| | - Oscar Lopez-Nunez
- Pathology ML1035, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave.nue Cincinnati, OH 45229, USA
| | - Maria Pletneva
- Department of Pathology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132, USA
| | - Guang-Yu Yang
- Department of Pathology, Ward Building Ward 4-115, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL. 60611, USA
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15
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Choi S, Borowsky PA, Morgan O, Kwon D, Zhao W, Koru-Sengul T, Gilna G, Net J, Kesmodel S, Goel N, Patel Y, Griffiths A, Feinberg JA, Kangas-Dick A, Andaz C, Giuliano C, Zelenko N, Manasseh DM, Borgen P, Rojas KE. A Multi-institutional Analysis of Factors Influencing the Rate of Positive MRI Biopsy Among Women with Early-Stage Breast Cancer. Ann Surg Oncol 2024; 31:3141-3153. [PMID: 38286883 DOI: 10.1245/s10434-024-14954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND The use of preoperative magnetic resonance imaging (MRI) for early-stage breast cancer (ESBC) is increasing, but its utility in detecting additional malignancy is unclear and delays surgical management (Jatoi and Benson in Future Oncol 9:347-353, 2013. https://doi.org/10.2217/fon.12.186 , Bleicher et al. J Am Coll Surg 209:180-187, 2009. https://doi.org/10.1016/j.jamcollsurg.2009.04.010 , Borowsky et al. J Surg Res 280:114-122, 2022. https://doi.org/10.1016/j.jss.2022.06.066 ). The present study sought to identify ESBC patients most likely to benefit from preoperative MRI by assessing the positive predictive values (PPVs) of ipsilateral and contralateral biopsies. METHODS A retrospective cohort study included patients with cTis-T2N0-N1 breast cancer from two institutions during 2016-2021. A "positive" biopsy result was defined as additional cancer (PositiveCancer) or cancer with histology often excised (PositiveSurg). The PPV of MRI biopsies was calculated with respect to age, family history, breast density, and histology. Uni- and multivariate logistic regression determined whether combinations of age younger than 50 years, dense breasts, family history, and pure ductal carcinoma in situ (DCIS) histology led to higher biopsy yield. RESULTS Of the included patients, 447 received preoperative MRI and 131 underwent 149 MRI-guided biopsies (96 ipsilateral, 53 contralateral [18 bilateral]). PositiveCancer for ipsilateral biopsy was 54.2%, and PositiveCancer for contralateral biopsy was 17.0%. PositiveSurg for ipsilateral biopsy was 62.5%, and PositiveSurg for contralateral biopsy was 24.5%. Among the contralateral MRI biopsies, patients younger than 50 years were less likely to have PositiveSurg (odds ratio, 0.02; 95% confidence interval, 0.00-0.84; p = 0.041). The combinations of age, density, family history, and histology did not lead to a higher biopsy yield. CONCLUSION Historically accepted factors for recommending preoperative MRI did not appear to confer a higher MRI biopsy yield. To prevent delays to surgical management, MRI should be carefully selected for individual patients most likely to benefit from additional imaging.
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Affiliation(s)
- Seraphina Choi
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
| | - Peter A Borowsky
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
| | - Orly Morgan
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
| | - Deukwoo Kwon
- Division of Biostatistics, Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Wei Zhao
- Division of Biostatistics, Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Tulay Koru-Sengul
- Division of Biostatistics, Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Gareth Gilna
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
| | - Jose Net
- Division of Breast Imaging, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Susan Kesmodel
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Neha Goel
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Yamini Patel
- Wright Center for Graduate Medical Education, Scranton, PA, USA
| | - Alexa Griffiths
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | | | | | | | | | - Natalie Zelenko
- Department of Radiology, Maimonides Medical Center, Brooklyn, NY, USA
| | | | - Patrick Borgen
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Kristin E Rojas
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
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16
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de Nattes T, Beadle J, Roufosse C. Biopsy-based transcriptomics in the diagnosis of kidney transplant rejection. Curr Opin Nephrol Hypertens 2024; 33:273-282. [PMID: 38411022 PMCID: PMC10990030 DOI: 10.1097/mnh.0000000000000974] [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: 02/28/2024]
Abstract
PURPOSE OF REVIEW The last year has seen considerable progress in translational research exploring the clinical utility of biopsy-based transcriptomics of kidney transplant biopsies to enhance the diagnosis of rejection. This review will summarize recent findings with a focus on different platforms, potential clinical applications, and barriers to clinical adoption. RECENT FINDINGS Recent literature has focussed on using biopsy-based transcriptomics to improve diagnosis of rejection, in particular antibody-mediated rejection. Different techniques of gene expression analysis (reverse transcriptase quantitative PCR, microarrays, probe-based techniques) have been used either on separate samples with ideally preserved RNA, or on left over tissue from routine biopsy processing. Despite remarkable consistency in overall patterns of gene expression, there is no consensus on acceptable indications, or whether biopsy-based transcriptomics adds significant value at reasonable cost to current diagnostic practice. SUMMARY Access to biopsy-based transcriptomics will widen as regulatory approvals for platforms and gene expression models develop. Clinicians need more evidence and guidance to inform decisions on how to use precious biopsy samples for biopsy-based transcriptomics, and how to integrate results with standard histology-based diagnosis.
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Affiliation(s)
- Tristan de Nattes
- Univ Rouen Normandie, INSERM U1234, CHU Rouen, Department of Nephrology, Rouen, France
| | - Jack Beadle
- Centre for Inflammatory Diseases, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Candice Roufosse
- Centre for Inflammatory Diseases, Department of Immunology and Inflammation, Imperial College London, London, UK
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17
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Gu J, Chery L, González GMN, Huff C, Strom S, Jones JA, Griffith DP, Canfield SE, Wang X, Huang X, Roberson P, Meng QH, Troncoso P, Ittmann M, Covinsky M, Scheurer M, Irizarry Ramirez M, Pettaway CA. A west African ancestry-associated SNP on 8q24 predicts a positive biopsy in African American men with suspected prostate cancer following PSA screening. Prostate 2024; 84:694-705. [PMID: 38477020 DOI: 10.1002/pros.24686] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/28/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND African American (AA) men have the highest incidence and mortality rates of prostate cancer (PCa) among all racial groups in the United States. While race is a social construct, for AA men, this overlaps with west African ancestry. Many of the PCa susceptibility variants exhibit distinct allele frequencies and risk estimates across different races and contribute substantially to the large disparities of PCa incidence among races. We previously reported that a single-nucleotide polymorphism (SNP) in 8q24, rs7824364, was strongly associated with west African ancestry and increased risks of PCa in both AA and Puerto Rican men. In this study, we determined whether this SNP can predict biopsy positivity and detection of clinically significant disease (Gleason score [GS] ≥ 7) in a cohort of AA men with suspected PCa. METHODS SNP rs7824364 was genotyped in 199 AA men with elevated total prostate-specific antigen (PSA) (>2.5 ng/mL) or abnormal digital rectal exam (DRE) and the associations of different genotypes with biopsy positivity and clinically significant disease were analyzed. RESULTS The variant allele carriers were significantly over-represented in the biopsy-positive group compared to the biopsy-negative group (44% vs. 25.7%, p = 0.011). In the multivariate logistic regression analyses, variant allele carriers were at a more than a twofold increased risk of a positive biopsy (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.06-4.32). Moreover, the variant allele was a predictor (OR = 2.26, 95% CI = 1.06-4.84) of a positive biopsy in the subgroup of patients with PSA < 10 ng/mL and normal DRE. The variant allele carriers were also more prevalent in cases with GS ≥ 7 compared to cases with GS < 7 and benign biopsy. CONCLUSIONS This study demonstrated that the west African ancestry-specific SNP rs7824364 on 8q24 independently predicted a positive prostate biopsy in AA men who were candidates for prostate biopsy subsequent to PCa screening.
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Affiliation(s)
- Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lisly Chery
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Chad Huff
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sara Strom
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey A Jones
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
- Department of Urology, Baylor College of Medicine, Houston, Texas, USA
- Urology Section, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Donald P Griffith
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Steven E Canfield
- Division of Urology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Xuemei Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xuelin Huang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Pamela Roberson
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qing H Meng
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Patricia Troncoso
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael Ittmann
- Department of Pathology, Baylor College of Medicine, Houston, Texas, USA
| | - Michael Covinsky
- Division of Pathology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Michael Scheurer
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Margarita Irizarry Ramirez
- Department of Graduate Studies, Clinical Laboratory Sciences, School of Health Professions, University of Puerto Rico, San Juan, Puerto Rico
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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18
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Huang CY, Chang RF, Lin CY, Hsieh MS, Liao PC, Wang YJ, Kao YC, Porta L, Lin PY, Lee CC, Lee YH. Deep-learning model to improve histological grading and predict upstaging of atypical ductal hyperplasia / ductal carcinoma in situ on breast biopsy. Histopathology 2024; 84:983-1002. [PMID: 38288642 DOI: 10.1111/his.15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 04/04/2024]
Abstract
AIMS Risk stratification of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS), diagnosed using breast biopsy, has great clinical significance. Clinical trials are currently exploring the possibility of active surveillance for low-risk lesions, whereas axillary lymph node staging may be considered during surgical planning for high-risk lesions. We aimed to develop a machine-learning algorithm based on whole-slide images of breast biopsy specimens and clinical information to predict the risk of upstaging to invasive breast cancer after wide excision. METHODS AND RESULTS Patients diagnosed with ADH/DCIS on breast biopsy were included in this study, comprising 592 (740 slides) and 141 (198 slides) patients in the development and independent testing cohorts, respectively. Histological grading of the lesions was independently evaluated by two pathologists. Clinical information, including biopsy method, lesion size, and Breast Imaging Reporting and Data System (BI-RADS) classification of ultrasound and mammograms, were collected. Deep DCIS consisted of three deep neural networks to evaluate nuclear grade, necrosis, and stromal reactivity. Deep DCIS output comprised five parameters: total patches, lesion extent, Deep Grade, Deep Necrosis, and Deep Stroma. Deep DCIS highly correlated with the pathologists' evaluations of both slide- and patient-level labels. All five parameters of Deep DCIS were significantly associated with upstaging to invasive carcinoma in subsequent wide excisional specimens. Using multivariate logistic regression, Deep DCIS predicted upstaging to invasive carcinoma with an area under the curve (AUC) of 0.81, outperforming pathologists' evaluation (AUC, 0.71 and 0.69). After including clinical and hormone receptor status information, performance further improved (AUC, 0.87). This combined model retained its predictive power in two subgroup analyses: the first subgroup included unequivocal DCIS (excluding cases of ADH and DCIS suspicious for microinvasion) (AUC, 0.83), while the second excluded cases of high-grade DCIS (AUC, 0.81). The model was validated in an independent testing cohort (AUC, 0.81). CONCLUSION This study demonstrated that deep-learning models can refine histological evaluation of ADH and DCIS on breast biopsies, which may help guide future treatment planning.
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Affiliation(s)
- Chung-Yen Huang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ruey-Feng Chang
- Center for Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Chih-Yung Lin
- Center for Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Pathology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Po-Chun Liao
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Jui Wang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chien Kao
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lorenzo Porta
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Pin-Yu Lin
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chang Lee
- Center for Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
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Sidana A, Tayebi S, Blank F, Lama DJ, Meyer M, Saeed Y, Tobler J, Hsu WW, Verma S. Magnetic resonance imaging-ultrasound fusion guided focal cryoablation for men with intermediate-risk prostate cancer. Urol Oncol 2024; 42:158.e1-158.e10. [PMID: 38245407 DOI: 10.1016/j.urolonc.2024.01.003] [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: 10/28/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Focal therapy (FT) is a form of ablative treatment offered to men with localized, organ-confined prostate cancer (CaP). Pelvic multiparametric magnetic resonance imaging (mpMRI) and mpMRI/transrectal ultrasound fusion (MRI-US) guidance enable the precise delivery of FT with limited ablation of adjacent benign tissue or vital genitourinary structures. This article presents our findings on using MRI-US to perform FT as a primary treatment for men with intermediate-risk CaP. METHODS Thirty-six men underwent MRI-US fusion-guided FT cryoablation at a single center from 2018 to 2023 as a primary treatment for intermediate-risk CaP. Following FT, quarterly prostate-specific antigen (PSA) testing and a 6 to 9 month mpMRI and combined MRI-US targeted and systematic biopsy were performed. Oncological outcomes were determined using several endpoints containing biochemical recurrence, imaging failure, and pathological failure. Functional outcomes were measured using reported erectile dysfunction/potency rates, urinary incontinence rates, and the American Urologic Association Symptom Score (AUA-SS) and Sexual Health Inventory for Men (SHIM) indices. RESULTS Median follow-up was 29.1 months, most (75%) of whom had grade group 2 CaP. Out of the 36 men, 32 (88.9%) completed the combined MRI-targeted and systematic biopsy follow-up after treatment. The study had no major complications, but 12 (33.3%) patients experienced Clavien-Dindo grade II or lower complications. For oncological outcomes, 6 (16.7%) men had biochemical recurrence, 9 (25%) showed imaging failure, and 8 (22.2%) met the criteria for positive biopsy- out-of-field vs. in-field. 88.2% of previously potent patients remained potent postoperatively at 12 months. All patients were continent at 12 months. There were no statistically significant changes in the AUA-SS and SHIM scores postoperatively. CONCLUSION MRI-US-guided cryoablation to target lesions in intermediate-risk CaP appears to be a safe treatment option, with functional outcomes indicating minimal short and intermediate-term morbidity and acceptable oncological outcomes. However, despite close monitoring and follow-up, there is still a limitation in accurately predicting/detecting pathological failure after FT. The long-term durability of FT for intermediate-risk, organ-confined CaP remains uncertain.
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Affiliation(s)
- Abhinav Sidana
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH; Section of Urology, Department of Surgery, The University of Chicago Medicine & Biological Sciences, Chicago, IL.
| | - Shima Tayebi
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Fernando Blank
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Daniel J Lama
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Meredith Meyer
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Yusef Saeed
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Juliana Tobler
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Wei-Wen Hsu
- Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Sadhna Verma
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
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20
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Haas M. IgA vasculitis nephritis: insights from kidney biopsies. Curr Opin Nephrol Hypertens 2024; 33:298-303. [PMID: 38411035 DOI: 10.1097/mnh.0000000000000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW To present findings indicating the value of kidney biopsy in assessing prognosis and guiding clinical approach to patients with IgA vasculitis nephritis (IgAVN), including a recent international study examining the value of the Oxford (MEST-C) classification. RECENT FINDINGS Historically, kidney biopsies with IgAVN are scored using the International Society for Kidney Diseases in Children (ISKDC) classification. However, this classification has limited prognostic value, and most biopsies fall into just two of the six ISKDC grades. There are few studies examining the clinical value of the Oxford classification, which is well documented to be predictive of kidney outcomes in IgA nephropathy, in IgAVN. However, a recent study of 361 biopsied patients with IgAVN showed that endocapillary hypercellularity (Oxford E1) predicted a subclass of patients showing initial improvement in kidney function with immunosuppressive treatment, followed by a later decline. SUMMARY Kidney outcome in patients with biopsied IgAVN treated with immunosuppression is determined by clinical factors and endocapillary hypercellularity. The latter is not part of the ISKDC classification and supports including MEST-C scores in biopsy reports of IgAVN. Even patients showing a good initial response to immunosuppression require long-term follow-up due to risk of subsequent kidney function decline.
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Affiliation(s)
- Mark Haas
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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21
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Wang Y, Ye Z, Wen M, Liang H, Zhang X. TransVFS: A spatio-temporal local-global transformer for vision-based force sensing during ultrasound-guided prostate biopsy. Med Image Anal 2024; 94:103130. [PMID: 38437787 DOI: 10.1016/j.media.2024.103130] [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: 08/28/2023] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
Robot-assisted prostate biopsy is a new technology to diagnose prostate cancer, but its safety is influenced by the inability of robots to sense the tool-tissue interaction force accurately during biopsy. Recently, vision based force sensing (VFS) provides a potential solution to this issue by utilizing image sequences to infer the interaction force. However, the existing mainstream VFS methods cannot realize the accurate force sensing due to the adoption of convolutional or recurrent neural network to learn deformation from the optical images and some of these methods are not efficient especially when the recurrent convolutional operations are involved. This paper has presented a Transformer based VFS (TransVFS) method by leveraging ultrasound volume sequences acquired during prostate biopsy. The TransVFS method uses a spatio-temporal local-global Transformer to capture the local image details and the global dependency simultaneously to learn prostate deformations for force estimation. Distinctively, our method explores both the spatial and temporal attention mechanisms for image feature learning, thereby addressing the influence of the low ultrasound image resolution and the unclear prostate boundary on the accurate force estimation. Meanwhile, the two efficient local-global attention modules are introduced to reduce 4D spatio-temporal computation burden by utilizing the factorized spatio-temporal processing strategy, thereby facilitating the fast force estimation. Experiments on prostate phantom and beagle dogs show that our method significantly outperforms existing VFS methods and other spatio-temporal Transformer models. The TransVFS method surpasses the most competitive compared method ResNet3dGRU by providing the mean absolute errors of force estimation, i.e., 70.4 ± 60.0 millinewton (mN) vs 123.7 ± 95.6 mN, on the transabdominal ultrasound dataset of dogs.
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Affiliation(s)
- Yibo Wang
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, No 1037, Luyou Road, Wuhan, China
| | - Zhichao Ye
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 13, Hangkong Road, Wuhan, China
| | - Mingwei Wen
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, No 1037, Luyou Road, Wuhan, China
| | - Huageng Liang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 13, Hangkong Road, Wuhan, China
| | - Xuming Zhang
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, No 1037, Luyou Road, Wuhan, China.
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22
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Mehta N, Sathyan A, Agarwal S, Bhari N. Multiple palisaded encapsulated neuromas presenting as cobblestoned plaques over palms and oral cavity. J Cutan Pathol 2024; 51:332-337. [PMID: 38246881 DOI: 10.1111/cup.14589] [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: 09/17/2023] [Revised: 12/23/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Palisaded encapsulated neuroma (PEN) is a benign circumscribed nerve sheath tumor usually seen as a solitary painless papule on the face in middle-aged adults. We report a 22-year-old male with multiple adolescent-onset PENs distributed extensively, including the oral cavity and palms, contrary to the typical presentations. The lesions formed cobblestoned plaques and were confirmed through a skin biopsy, showing characteristic nodules of wavy spindle cells forming interlacing fascicles with interspersed clefts, and positive staining for specific markers, including markers for axons and perineurium. Notably, this case deviates from the usual presentation, shedding light on atypical manifestations of PEN in a young individual without any features suggestive of a neurocutaneous syndrome or multiple endocrine neoplasia syndrome.
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Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Athira Sathyan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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23
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Ng L, Kocur OM, Xie P, Cheung S, Schlegel P, Rosenwaks Z, Palermo GD. Timing of Testicular Biopsy in Relation to Oocyte Retrieval and the Outcomes of Intracytoplasmic Sperm Injection. J Urol 2024; 211:678-686. [PMID: 38375822 DOI: 10.1097/ju.0000000000003894] [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: 09/01/2023] [Accepted: 02/02/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE We evaluate microscopic (micro) testicular sperm extraction (TESE) timing relative to oocyte retrieval on intracytoplasmic sperm injection outcome. MATERIALS AND METHODS Couples with nonobstructive azoospermia who underwent intracytoplasmic sperm injection with freshly retrieved spermatozoa were analyzed based on whether micro-TESE was performed at least 1 day prior to oocyte retrieval (TESE-day-before group) or on the day of oocyte retrieval (TESE-day-of group). Embryology and clinical outcomes were compared. RESULTS The percentage of patients who underwent a successful testicular sperm retrieval was significantly lower in the TESE-day-before cohort (62%) than in the TESE-day-of cohort (69%; odds ratio [OR] 1.4, 95% CI [1.1, 1.7], P < .001). The fertilization rate was also found to be significantly lower in the TESE-day-before group (45%) than in the TESE-day-of group (53%; OR 1.4, 95% CI [1.2, 1.7], P = .01). Although the association between the cleavage rate and TESE timing was not statistically significant, the implantation rate was found to be significantly higher in the day-before cohort (28%) than in the day-of cohort (22%; OR 0.7, 95% CI [0.6, 0.9], P = .01). Nevertheless, it was found that the clinical pregnancy and delivery rates were not statistically significantly associated with the TESE timing. CONCLUSIONS Although sperm retrieval and fertilization rates were lower in the TESE-day-before cohort, the 2 cohorts showed comparable embryologic and clinical outcomes. Micro-TESE can be performed before oocyte harvesting to provide physicians ample time to decide between cancelling oocyte retrieval or retrieving oocytes for cryopreservation.
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Affiliation(s)
- Lily Ng
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Olena M Kocur
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Philip Xie
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Stephanie Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Peter Schlegel
- Department of Urology, Weill Cornell Medical College, New York, New York
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Gianpiero D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
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24
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Alhawas F, Obaid SB, Alfawzan O, Fathaddin A, Alsuwaidan S, Alajlan A. Macular amyloidosis diagnostic outcomes of skin biopsy: A systematic review. J Cutan Pathol 2024; 51:393-397. [PMID: 38328942 DOI: 10.1111/cup.14592] [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: 08/12/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
Macular amyloidosis (MA) is a primary localized cutaneous amyloidosis, characterized by amyloid deposition in the papillary dermis. The clinical presentation includes pruritic hyperpigmented macules and patches with a reticulated or rippled pattern, primarily found on the upper back and extremities. Biopsy is an essential diagnostic tool for confirming MA. This systematic review focused on the biopsy outcomes in patients diagnosed with MA.
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Affiliation(s)
- Feras Alhawas
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Omar Alfawzan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amany Fathaddin
- Pathology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sami Alsuwaidan
- Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulmajeed Alajlan
- Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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25
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Nunes MST, Barbosa Jorge L, Yu L, Woronik V, Bitencourt Dias C. Epidemiological, immunological, and treatment response profile of patients with lupus nephritis in Brazil. Lupus 2024; 33:650-658. [PMID: 38514381 DOI: 10.1177/09612033241240869] [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: 03/23/2024]
Abstract
BACKGROUND AND HYPOTHESIS Brazil has the largest number of individuals of African descent outside Africa and a very admixed population. Among cases of lupus nephritis (LN) in the country, there are differences in incidence, and even in severity, depending on the location and characteristics of the population studied. The aim of this study was to describe the clinical and epidemiological characteristics of LN in Brazil, as well as to determine which of those characteristics would be risk factors for a poor renal prognosis. METHODS This was a retrospective, descriptive observational study of patients diagnosed with LN who underwent kidney biopsy between 1999 and 2015 in the Nephrology Department of the Hospital das Clínicas, in São Paulo, Brazil. Data were collected from electronic medical records. RESULTS We evaluated 398 patients, among who 94.1% and 77.7% tested positive for antinuclear antibodies and anti-DNA antibodies, respectively, whereas 33.7% showed the full-house pattern. The time from LN symptom onset to biopsy was <6 months in 47.5% (early biopsy group) and ≥6 months in 52.5% (late biopsy group). In the early biopsy group, the chronicity index was lower and the activity index was higher. Multivariate analysis showed that a higher chronicity index was the only independent risk factor for progression to requiring kidney replacement therapy. CONCLUSION Late biopsy seems to be associated with negative renal outcomes in LN. However, it seems that a higher chronicity index is the main predictor of a poor renal outcome among patients with LN in Brazil.
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Affiliation(s)
- Mariana Sousa Teixeira Nunes
- Laboratory of Renal Pathophysiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Lectícia Barbosa Jorge
- Laboratory of Renal Pathophysiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luis Yu
- Laboratory of Renal Pathophysiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Viktoria Woronik
- Laboratory of Renal Pathophysiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cristiane Bitencourt Dias
- Laboratory of Renal Pathophysiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
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26
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O'Halloran CP, Tannous P, Arva NC, Thrush PT, Monge M, Joong A, Magnetta DA. Histopathology, mRNA expression profile, and donor-derived cell-free DNA for assessment of rejection in pediatric heart transplantation. Pediatr Transplant 2024; 28:e14705. [PMID: 38528753 DOI: 10.1111/petr.14705] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The relationship between histopathologic and molecular ("MMDx"®) assessments of endomyocardial biopsy (EMB) and serum donor-derived cell-free DNA (ddcfDNA) in acute rejection (AR) assessment following pediatric heart transplantation (HT) is unknown. METHODS EMB sent for MMDx and histopathology from November 2021 to September 2022 were reviewed. MMDx and histopathology results were compared. DdcfDNA obtained ≤1 week prior to EMB were compared with histopathology and MMDx results. The discrimination of ddcfDNA for AR was assessed using receiver-operating curves. FINDINGS In this study, 177 EMBs were obtained for histopathology and MMDx, 101 had time-matched ddcfDNA values. MMDx and Histopathology displayed moderate agreement for T-cell-mediated rejection (TCMR, Kappa = 0.52, p < .001) and antibody-mediated rejection (ABMR, Kappa = 0.41, p < .001). Discordant results occurred in 24% of cases, most often with ABMR. Compared with no AR, ddcfDNA values were elevated in cases of AR diagnosed by both histopathology and MMDx (p < .01 for all). Additionally, ddcfDNA values were elevated in injury patterns on MMDx, even when AR was not present (p = .01). DdcfDNA displayed excellent discrimination (AUC 0.83) for AR by MMDx and/or histopathology. Using a threshold of ≥0.135%, ddcfDNA had a sensitivity of 90%, specificity of 63%, PPV of 52%, and NPV of 94%. CONCLUSIONS Histopathology and MMDx displayed moderate agreement in diagnosing AR following pediatric HT, with most discrepancies noted in the presence of ABMR. DdcfDNA is elevated with AR, with excellent discrimination and high NPV particularly when utilizing MMDx. A combination of all three tests may be necessary in some cases.
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Affiliation(s)
- Conor P O'Halloran
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Paul Tannous
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Nicoleta C Arva
- Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Philip T Thrush
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Michael Monge
- Division of Cardiovascular Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Anna Joong
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Defne A Magnetta
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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27
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Robles NR, García-López V, García-Martínez V. Editorial for "Significance of Arterial Spin Labeling for Reducing Biopsies in Patients With Kidney Allograft Dysfunction". J Magn Reson Imaging 2024; 59:1785-1786. [PMID: 37539813 DOI: 10.1002/jmri.28930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Nicolás R Robles
- Service of Nephrology, Badajoz University Hospital, University of Extremadura, Badajoz, Spain
| | - Virginio García-López
- Department of Medical and Surgical Therapeutics, Pharmacology Area, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | - Virginio García-Martínez
- Department of Human Anatomy and Embryology, Institute of Molecular Pathology Biomarkers, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
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28
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Vettikattu NT, Daoud GE, Viswanathan K, Kaka AS. Salivary Mucinous Adenocarcinoma Masquerading as Chronic Submandibular Sialolithiasis. Laryngoscope 2024; 134:2258-2261. [PMID: 37983880 DOI: 10.1002/lary.31158] [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: 08/15/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 11/22/2023]
Abstract
A patient with chronic submandibular sialolithiasis underwent conservative treatment with appropriate imaging and multiple biopsies that continually revealed chronic inflammation. Due to continued symptoms, the patient underwent eventual excision and finaly pathology revealed salivary mucinous adenocarcinoma, which is a rare and poorly understood salivary malignancy. Persistent diagnostic workup and a high suspicion for salivary gland lesions is important for appropriate diagnosis and treatment. More attention and research on this specific entity can help future clinicians better diagnose and treat patients with a similar presentation. Laryngoscope, 134:2258-2261, 2024.
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Affiliation(s)
- Nikhil T Vettikattu
- Emory University School of Medicine, Atlanta, Georgia, U.S.A
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Georges E Daoud
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Kartik Viswanathan
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Azeem S Kaka
- Emory University School of Medicine, Atlanta, Georgia, U.S.A
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
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29
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Zhu M, Fu Q, Zang Y, Shao Z, Zhou Y, Jiang Z, Wang W, Shi B, Chen S, Zhu Y. Different diagnostic strategies combining prostate health index and magnetic resonance imaging for predicting prostate cancer: A multicentre study. Urol Oncol 2024; 42:159.e17-159.e23. [PMID: 38480077 DOI: 10.1016/j.urolonc.2024.02.009] [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: 12/28/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To explore how prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) should be used in concert to improve diagnostic capacity for clinically significant prostate cancers (CsCaP) in patients with prostate-specific antigen (PSA) between 4 and 20 ng/ml. METHODS About 426 patients fulfilling the inclusion criteria were included in this study. Univariable and multivariable logistic analyses were performed to analyze the association between the clinical indicators and CaP/CsCaP. We used the Delong test to compare the differences in the area under the curve (AUC) values of four models for CaP and CsCaP. Decision curve analysis (DCA) and calibration plots were used to assess predictive performance. We compared clinical outcomes of different diagnostic strategies constructed using different combinations of the models by the chi-square test and the McNemar test. RESULTS The AUC of PHI-MRI (a risk prediction model based on PHI and mpMRI) was 0.859, which was significantly higher than those of PHI (AUC = 0.792, P < 0.001) and mpMRI (AUC = 0.797, P < 0.001). PHI-MRI had a higher net benefit on DCA for predicting CaP and CsCaP in comparison to PHI and mpMRI. Adding the PHI-MRI in diagnostic strategies for CsCaP, such as use PHI-MRI alone or sequential use of PHI followed by PHI-MRI, could reduce the number of biopsies by approximately 20% compared to use PHI followed by mpMRI (256 vs 316, 257 vs 316, respectively). CONCLUSIONS The PHI-MRI model was superior to PHI and MRI alone. It may reduce the number of biopsies and ensure the detection rate of CsCaP under an appropriate sensitivity at the cost of an increased number of MRI scans.
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Affiliation(s)
- Meikai Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Qiang Fu
- Department of Urology, Shandong Provincial Hospital, Jinan, China
| | - Yunjiang Zang
- Department of Urology, Weifang People's Hospital, Weifang, China
| | - Zhiqiang Shao
- Department of Urology, Linyi People's Hospital, Linyi, China
| | - Yongheng Zhou
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhiwen Jiang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Wenfu Wang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Yaofeng Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China.
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30
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Gibbons CH, Levine T, Adler C, Bellaire B, Wang N, Stohl J, Agarwal P, Aldridge GM, Barboi A, Evidente VGH, Galasko D, Geschwind MD, Gonzalez-Duarte A, Gil R, Gudesblatt M, Isaacson SH, Kaufmann H, Khemani P, Kumar R, Lamotte G, Liu AJ, McFarland NR, Miglis M, Reynolds A, Sahagian GA, Saint-Hillaire MH, Schwartzbard JB, Singer W, Soileau MJ, Vernino S, Yerstein O, Freeman R. Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies. JAMA 2024; 331:1298-1306. [PMID: 38506839 PMCID: PMC10955354 DOI: 10.1001/jama.2024.0792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 03/21/2024]
Abstract
Importance Finding a reliable diagnostic biomarker for the disorders collectively known as synucleinopathies (Parkinson disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA], and pure autonomic failure [PAF]) is an urgent unmet need. Immunohistochemical detection of cutaneous phosphorylated α-synuclein may be a sensitive and specific clinical test for the diagnosis of synucleinopathies. Objective To evaluate the positivity rate of cutaneous α-synuclein deposition in patients with PD, DLB, MSA, and PAF. Design, Setting, and Participants This blinded, 30-site, cross-sectional study of academic and community-based neurology practices conducted from February 2021 through March 2023 included patients aged 40 to 99 years with a clinical diagnosis of PD, DLB, MSA, or PAF based on clinical consensus criteria and confirmed by an expert review panel and control participants aged 40 to 99 years with no history of examination findings or symptoms suggestive of a synucleinopathy or neurodegenerative disease. All participants completed detailed neurologic examinations and disease-specific questionnaires and underwent skin biopsy for detection of phosphorylated α-synuclein. An expert review panel blinded to pathologic data determined the final participant diagnosis. Exposure Skin biopsy for detection of phosphorylated α-synuclein. Main Outcomes Rates of detection of cutaneous α-synuclein in patients with PD, MSA, DLB, and PAF and controls without synucleinopathy. Results Of 428 enrolled participants, 343 were included in the primary analysis (mean [SD] age, 69.5 [9.1] years; 175 [51.0%] male); 223 met the consensus criteria for a synucleinopathy and 120 met criteria as controls after expert panel review. The proportions of individuals with cutaneous phosphorylated α-synuclein detected by skin biopsy were 92.7% (89 of 96) with PD, 98.2% (54 of 55) with MSA, 96.0% (48 of 50) with DLB, and 100% (22 of 22) with PAF; 3.3% (4 of 120) of controls had cutaneous phosphorylated α-synuclein detected. Conclusions and Relevance In this cross-sectional study, a high proportion of individuals meeting clinical consensus criteria for PD, DLB, MSA, and PAF had phosphorylated α-synuclein detected by skin biopsy. Further research is needed in unselected clinical populations to externally validate the findings and fully characterize the potential role of skin biopsy detection of phosphorylated α-synuclein in clinical care.
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Affiliation(s)
- Christopher H. Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Todd Levine
- HonorHealth Neurology, Scottsdale, Arizona
- CND Life Sciences, Scottsdale, Arizona
| | - Charles Adler
- Department of Neurology, Mayo Clinic College of Medicine, Scottsdale, Arizona
| | | | - Ningshan Wang
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | | | | | - Georgina M. Aldridge
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City
| | - Alexandru Barboi
- Department of Neurology, Northshore University Health System, Glenview, Illinois
| | | | - Douglas Galasko
- Department of Neurology, University of California, San Diego
| | | | | | - Ramon Gil
- Parkinson’s Disease Treatment Center of Southwest Florida, Port Charlotte
| | - Mark Gudesblatt
- Department of Neurology, New York University Grossman Long Island School of Medicine, New York
| | - Stuart H. Isaacson
- Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, Florida
| | - Horacio Kaufmann
- Department of Neurology, New York University Grossman School of Medicine, New York
| | - Pravin Khemani
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, Englewood, Colorado
| | | | - Andy J. Liu
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | | | - Mitchell Miglis
- Department of Neurology, Stanford University Medical Center, Palo Alto, California
| | | | | | | | | | - Wolfgang Singer
- Department of Neurology, Mayo Clinic Rochester, Rochester, New York
| | | | - Steven Vernino
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas
| | - Oleg Yerstein
- Department of Neurology, Lahey Clinic, Burlington, Massachusetts
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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31
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Miyaue N, Ochi C, Ito YH, Ando R, Sone J, Nagai M. Blepharoptosis As an Early Manifestation of Neuronal Intranuclear Inclusion Disease. Intern Med 2024; 63:1163-1166. [PMID: 38616117 DOI: 10.2169/internalmedicine.2384-23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
Neuronal intranuclear inclusion disease (NIID) exhibits diverse clinical manifestations. Our patient was a 64-year-old woman with bilateral ptosis as the chief complaint. She had bilateral miosis, and the pupil was only slightly dilated 60 min after 1% phenylephrine administration, suggesting autonomic dysfunction secondary to preganglionic sympathetic impairment. A head-up tilt test revealed asymptomatic orthostatic hypotension. She was diagnosed with NIID based on a skin biopsy and genetic testing. This study suggests that blepharoptosis is an early manifestation of NIID. Furthermore, patients with suspected NIID should be examined carefully for autonomic dysfunction.
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Affiliation(s)
- Noriyuki Miyaue
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Japan
| | - Chikako Ochi
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Japan
| | - Yuko H Ito
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Japan
| | - Rina Ando
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Japan
| | - Jun Sone
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Japan
| | - Masahiro Nagai
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Japan
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32
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Chokkalla AK, Parham MM, Fishman DS, Devaraj S. Path Towards Biopsy-Free Diagnosis of Celiac Disease in Pediatric Patients. Clin Chim Acta 2024; 557:117891. [PMID: 38555049 DOI: 10.1016/j.cca.2024.117891] [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: 02/15/2024] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Laboratory testing for celiac disease in pediatric patients integrates serology, genetic susceptibility and duodenal biopsy examination. The 2023 American College of Gastroenterology guidelines recommend a biopsy-free approach in pediatric patients utilizing tissue transglutaminase antibody titers >10 times upper limit of normal and subsequent endomysial antibody seropositivity as sufficient for diagnosis. The objective of this study is to assess the diagnostic accuracy of biopsy-free approach at our pediatric hospital. METHODS We conducted a retrospective study involving pediatric patients who underwent biopsy for diagnostic confirmation of celiac disease between May 2019 and May 2023. For these patients, the tissue transglutaminase and endomysial antibody test results were retrieved and performance of biopsy-free approach was assessed using the duodenal histology as the gold standard for celiac disease diagnosis. RESULTS Tissue transglutaminase antibody titers >10 times upper limit of normal alone demonstrated a positive predictive value of 99% for identifying celiac disease in children. Although endomysial antibody testing is underutilized at our center, its inclusion further improved the predictability to 100 %. CONCLUSION Positive predictive value of tissue transglutaminase antibody titers >10 times upper limit of normal is sufficiently high for celiac disease diagnosis in children and may allow for deferral of duodenal biopsy at diagnosis.
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Affiliation(s)
- Anil K Chokkalla
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA
| | - Margaret M Parham
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA
| | - Douglas S Fishman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Sridevi Devaraj
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA.
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Zhang J, Zhang J, Han P, Chen XZ, Zhang Y, Li W, Qin J, He L. Path planning algorithm for percutaneous puncture lung mass biopsy procedure based on the multi-objective constraints and fuzzy optimization. Phys Med Biol 2024; 69:095006. [PMID: 38394681 DOI: 10.1088/1361-6560/ad2c9f] [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: 05/18/2023] [Accepted: 02/23/2024] [Indexed: 02/25/2024]
Abstract
Objective. The percutaneous puncture lung mass biopsy procedure, which relies on preoperative CT (Computed Tomography) images, is considered the gold standard for determining the benign or malignant nature of lung masses. However, the traditional lung puncture procedure has several issues, including long operation times, a high probability of complications, and high exposure to CT radiation for the patient, as it relies heavily on the surgeon's clinical experience.Approach.To address these problems, a multi-constrained objective optimization model based on clinical criteria for the percutaneous puncture lung mass biopsy procedure has been proposed. Additionally, based on fuzzy optimization, a multidimensional spatial Pareto front algorithm has been developed for optimal path selection. The algorithm finds optimal paths, which are displayed on 3D images, and provides reference points for clinicians' surgical path planning.Main results.To evaluate the algorithm's performance, 25 data sets collected from the Second People's Hospital of Zigong were used for prospective and retrospective experiments. The results demonstrate that 92% of the optimal paths generated by the algorithm meet the clinicians' surgical needs.Significance.The algorithm proposed in this paper is innovative in the selection of mass target point, the integration of constraints based on clinical standards, and the utilization of multi-objective optimization algorithm. Comparison experiments have validated the better performance of the proposed algorithm. From a clinical standpoint, the algorithm proposed in this paper has a higher clinical feasibility of the proposed pathway than related studies, which reduces the dependency of the physician's expertise and clinical experience on pathway planning during the percutaneous puncture lung mass biopsy procedure.
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Affiliation(s)
- Jiayu Zhang
- College of Biomedical Engineering, Sichuan University, Chengdu, People's Republic of China
| | - Jing Zhang
- College of Biomedical Engineering, Sichuan University, Chengdu, People's Republic of China
| | - Ping Han
- Urologic Surgery, Sichuan University West China Hospital, Chengdu, People's Republic of China
- Urologic Surgery, Peoples Hospital Yibin City 2, Chengdu, People's Republic of China
| | - Xin-Zu Chen
- Gastric Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Ya'an Cancer Prevention and Control Center, People's Hospital of Ya'an City, Ya'an, People's Republic of China
| | - Yu Zhang
- College of Biomedical Engineering, Sichuan University, Chengdu, People's Republic of China
| | - Wen Li
- College of Biomedical Engineering, Sichuan University, Chengdu, People's Republic of China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hung Hom, People's Republic of China
| | - Ling He
- College of Biomedical Engineering, Sichuan University, Chengdu, People's Republic of China
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He Y, Fan Y, Song H, Shen Q, Ruan M, Chen Y, Li D, Li X, Liu Y, Zhang K, Zhang Q. A novel biopsy scheme for prostate cancer: targeted and regional systematic biopsy. BMC Urol 2024; 24:85. [PMID: 38614971 PMCID: PMC11015685 DOI: 10.1186/s12894-024-01461-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/18/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE To explore a novel biopsy scheme for prostate cancer (PCa), and test the detection rate and pathological agreement of standard systematic (SB) + targeted (TB) biopsy and novel biopsy scheme. METHODS Positive needles were collected from 194 patients who underwent SB + TB (STB) followed by radical prostatectomy (RP). Our novel biopsy scheme, targeted and regional systematic biopsy (TrSB) was defined as TB + regional SB (4 SB-needles closest to the TB-needles). The McNemar test was utilized to compare the detection rate performance for clinical significant PCa (csPCa) and clinical insignificant PCa (ciPCa). Moreover, the accuracy, positive predictive value (PPV) and negative predictive value (NPV) were investigated. The agreement between the different biopsy schemes grade group (GG) and RP GG were assessed. The concordance between the biopsy and the RP GG was evaluated using weighted κ coefficient analyses. RESULTS In this study, the overall detection rate for csPCa was 83.5% (162 of 194) when SB and TB were combined. TrSB showed better NPV than TB (97.0% vs. 74.4%). Comparing to STB, the TB-detection rate of csPCa had a significant difference (p < 0.01), while TrSB showed no significant difference (p > 0.999). For ciPCa, the overall detection rate was 16.5% (32 of 194). TrSB showed better PPV (96.6% vs. 83.3%) and NPV (97.6% vs. 92.9%) than TB. Comparing to STB, the detection rate of both schemes showed no significant difference (p = 0.077 and p = 0.375). All three schemes GG showed poor agreement with RP GG (TB: 43.3%, TrSB: 46.4%, STB: 45.9%). Using weighted κ, all three schemes showed no difference (TB: 0.48, TrSB: 0.51, STB: 0.51). In our subgroup analysis (PI-RADS = 4/5, n = 154), all three schemes almost showed no difference (Weighted κ: TB-0.50, TrSB-0.51, STB-0.50). CONCLUSION Our novel biopsy scheme TrSB (TB + 4 closest SB needles) may reduce 8 cores of biopsy compared with STB (standard SB + TB), which also showed better csPCa detection rate than TB only, but the same as STB. The pathological agreement between three different biopsy schemes (TB/TrSB/STB) GG and RP GG showed no difference.
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Affiliation(s)
- Yang He
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Yu Fan
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Haitian Song
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Qi Shen
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Mingjian Ruan
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Yuke Chen
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Derun Li
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
| | - Xueying Li
- Department of Statistics, Peking University First Hospital, Beijing, China
| | - Yi Liu
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
- Institution of Urology, PekingUniversity, Beijing, 100034, China.
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
- National Urological Cancer Center, Beijing, 100034, China.
| | - Kai Zhang
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
- Institution of Urology, PekingUniversity, Beijing, 100034, China.
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
- National Urological Cancer Center, Beijing, 100034, China.
| | - Qian Zhang
- Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
- Institution of Urology, PekingUniversity, Beijing, 100034, China
- Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
- National Urological Cancer Center, Beijing, 100034, China
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Yang S, Guo JQ, Li TX, Tang SJ. [Annual progress of interventional diagnosis and treatment of tuberculosis in 2023]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:363-370. [PMID: 38599814 DOI: 10.360/cma.j.cn112147-20231114-00308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
A series of studies on the interventional diagnosis and treatment of tuberculosis(TB)were carried out by domestic and foreign researchers in 2023. The combination of minimally invasive interventional procedures with endoscopes, guidance, material acquisition techniques by multiple ways and multichannel and highly accurate laboratory testing techniques is becoming more and more widely practiced clinically, which has played an important role in the accurate diagnosis of problematic TB. Diagnostic procedures for pulmonary TB, tracheobronchial TB, mediastinal lymphatic TB and extrapulmonary TB included conventional flexible bronchoscopy and specific types of bronchoscopy(ultrathin bronchoscopy and endobronchial ultrasound), transbronchial needle aspiration biopsy, endobronchial ultrasound and virtual bronchoscopic navigation system-guided forceps biopsy, thoracoscopic cryobiopsy of pleura, percutaneous biopsy, and so on. The time to diagnosis has been significantly reduced and the diagnostic efficacy has been improved by the clinical specimen detection using either Gene Xpert MTB/RIF, Ultra, loop-mediated isothermal amplification, metagenomic next-generation sequencing, or nanopore sequencing, etc. Interventional therapy was focused on the following diseases: pulmonary TB with massive hemoptysis, tracheobronchial TB, pleural TB and TB-related fistulas. Interventional treatment of tracheobronchial TB mainly included the application of rigid bronchoscopy, bronchoscopic cold and thermal ablation treatment, endoscopic clamp, dilatations of narrow airway with balloon and stent placement, etc. The interventional treatment of pulmonary TB complicated by massive hemoptysis included endovascular embolization, coated stent placement, etc. Interventional treatment of pleural TB involved the application of thoracoscopy, endoscopic forceps, the implantation of stent and other occlusive devices and the closure of fistulas with autologous fat transplantation. In this article, we reviewed the progress of interventional diagnosis and treatment of TB by the search of published literatures from October 2022 to September 2023.
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Affiliation(s)
- S Yang
- Department of Elderly Tuberculosis & Comprehensive Internal Medicine, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - J Q Guo
- Department of Infectious Disease, the First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - T X Li
- CentralLaboratory, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - S J Tang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
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Winetraub Y, Van Vleck A, Yuan E, Terem I, Zhao J, Yu C, Chan W, Do H, Shevidi S, Mao M, Yu J, Hong M, Blankenberg E, Rieger KE, Chu S, Aasi S, Sarin KY, de la Zerda A. Noninvasive virtual biopsy using micro-registered optical coherence tomography (OCT) in human subjects. Sci Adv 2024; 10:eadi5794. [PMID: 38598626 PMCID: PMC11006228 DOI: 10.1126/sciadv.adi5794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
Histological hematoxylin and eosin-stained (H&E) tissue sections are used as the gold standard for pathologic detection of cancer, tumor margin detection, and disease diagnosis. Producing H&E sections, however, is invasive and time-consuming. While deep learning has shown promise in virtual staining of unstained tissue slides, true virtual biopsy requires staining of images taken from intact tissue. In this work, we developed a micron-accuracy coregistration method [micro-registered optical coherence tomography (OCT)] that can take a two-dimensional (2D) H&E slide and find the exact corresponding section in a 3D OCT image taken from the original fresh tissue. We trained a conditional generative adversarial network using the paired dataset and showed high-fidelity conversion of noninvasive OCT images to virtually stained H&E slices in both 2D and 3D. Applying these trained neural networks to in vivo OCT images should enable physicians to readily incorporate OCT imaging into their clinical practice, reducing the number of unnecessary biopsy procedures.
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Affiliation(s)
- Yonatan Winetraub
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
| | - Aidan Van Vleck
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
| | - Edwin Yuan
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- Department of Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - Itamar Terem
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Jinjing Zhao
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
| | - Caroline Yu
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Warren Chan
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Hanh Do
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Saba Shevidi
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Maiya Mao
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Jacqueline Yu
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Megan Hong
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Erick Blankenberg
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Kerri E. Rieger
- Department of Pathology, Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA 94305, USA
| | - Steven Chu
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
- Departments of Physics and Molecular and Cellular Physiology, Energy, Science and Engineering Stanford University, Stanford, CA 94305, USA
| | - Sumaira Aasi
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kavita Y. Sarin
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Adam de la Zerda
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
- The Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
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Barbetta A, Rocque B, Bangerth S, Street K, Weaver C, Chopra S, Kim J, Sher L, Gaudilliere B, Akbari O, Kohli R, Emamaullee J. Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection. Sci Adv 2024; 10:eadm8841. [PMID: 38608023 PMCID: PMC11014454 DOI: 10.1126/sciadv.adm8841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/12/2024] [Indexed: 04/14/2024]
Abstract
Allograft rejection is common following clinical organ transplantation, but defining specific immune subsets mediating alloimmunity has been elusive. Calcineurin inhibitor dose escalation, corticosteroids, and/or lymphocyte depleting antibodies have remained the primary options for treatment of clinical rejection episodes. Here, we developed a highly multiplexed imaging mass cytometry panel to study the immune response in archival biopsies from 79 liver transplant (LT) recipients with either no rejection (NR), acute T cell-mediated rejection (TCMR), or chronic rejection (CR). This approach generated a spatially resolved proteomic atlas of 461,816 cells (42 phenotypes) derived from 96 pathologist-selected regions of interest. Our analysis revealed that regulatory (HLADR+ Treg) and PD1+ T cell phenotypes (CD4+ and CD8+ subsets), combined with variations in M2 macrophage polarization, were a unique signature of active TCMR. These data provide insights into the alloimmune microenvironment in clinical LT, including identification of potential targets for focused immunotherapy during rejection episodes and suggestion of a substantial role for immune exhaustion in TCMR.
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Affiliation(s)
- Arianna Barbetta
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brittany Rocque
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sarah Bangerth
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kelly Street
- Division of Biostatistics, Department of Population and Public Health, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carly Weaver
- Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Shefali Chopra
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
| | - Janet Kim
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Linda Sher
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Omid Akbari
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rohit Kohli
- Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Division of Abdominal Organ Transplantation, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Juliet Emamaullee
- Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Abdominal Organ Transplantation, Children’s Hospital Los Angeles, Los Angeles, CA, USA
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Xu Y, Shao S, Kang H, Xu Z, Wen G, Shan Y, Gong Z, Al-Sharabi A, Qu B, Ren Y, Zhang F, Guan J, Chen X. A unicentric center, multicenter, and mixed-type Castleman disease: Three case reports and a review of the literature. Medicine (Baltimore) 2024; 103:e37722. [PMID: 38608101 PMCID: PMC11018146 DOI: 10.1097/md.0000000000037722] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/05/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Due to the lack of specificity symptoms and site of onset of castleman disease (CD), it is difficult to diagnose and poses unique challenges for both patients and clinicians, leading to confusion in diagnosis and delays in treatment. To enhance understanding, we present 3 cases of CD treated at our hospital, including a single-center, multicenter, and mixed-type CD. PATIENT CONCERNS Case 1: A 53-year-old female patient was admitted with a chief complaint of "abdominal pain and fever for 10 days." Marked enlargement of inguinal lymph nodes on both sides was observed. Case 2: A 58-year-old female patient was admitted with the main complaint of "discovering a left lower abdominal mass during a routine checkup for the past 10 days." Upon deep palpation, a palpable mass of approximately 5.0 * 3.0 cm was identified in the left lower abdomen. Case 3: A 40-year-old male patient was admitted with the main complaint of "progressive right upper abdominal and lumbar back pain for over 6 months." Computed tomography examination revealed multiple nodular soft tissue masses between the abdominal aorta and inferior vena cava, with the largest measuring 5.0 * 4.0 cm. DIAGNOSES Based on the immunohistochemical results, the diagnoses for the 3 patients are as follows: Case 1: Multicentric Castleman's Disease (Mixed Type). Case 2: Pelvic Retroperitoneal Castleman Disease (Hyaline Vascular Type). Case 3: Castleman Disease Multicentric Type. INTERVENTION Case 1: cyclophosphamide 0.6-1 g + vincristine 2 mg + methylprednisolone 50 mg/5 days. Cyclophosphamide 1 g + prednisone 30-50 mg/5 days. This alternating chemotherapy cycle is repeated every 6 months. Case 2: Laparoscopic pelvic mass excision surgery. Case 3: Surgical excision of the mass. OUTCOMES Case 1: After a 43-month follow-up, the patient's general symptoms have improved compared to before, but regular chemotherapy is still necessary at present. Case 2: The patient did not take any medication postoperatively, and there has been no evidence of metastasis or recurrence during the 18-month follow-up. Case 3: The patient did not take any medication, and there has been no evidence of metastasis or recurrence during the 21-month follow-up. LESSONS SUBSECTIONS The lack of specific signs on imaging studies and nonspecific blood tests increases the difficulty of diagnosis. However, tissue biopsy remains a feasible option. Therefore, we recommend conducting thorough examinations for suspected CD patients to reduce misdiagnosis and determine the CD type for effective targeted treatment.
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Affiliation(s)
- Yang Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Shuai Shao
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - HaoNan Kang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - ZhaoHui Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - GuoYi Wen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yan Shan
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - ZeZhong Gong
- Department of Minimal Invasive Intervention Radiology, Ganzhou People’s Hospital, Ganzhou, People’s Republic of China
| | - Abdulkarem Al-Sharabi
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - BoXin Qu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - YanYing Ren
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Fan Zhang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - JinMing Guan
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Chen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
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Hayden L, Lightner JM, Strausborger S, Franks TJ, Watson NL, Lewin-Smith MR. Particle analysis of surgical lung biopsies from deployed and non-deployed US service members during the Global War on Terrorism. PLoS One 2024; 19:e0301868. [PMID: 38603724 PMCID: PMC11008878 DOI: 10.1371/journal.pone.0301868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
The role that inhaled particulate matter plays in the development of post-deployment lung disease among US service members deployed to Southwest Asia during the Global War on Terrorism has been difficult to define. There is a persistent gap in data addressing the relationship between relatively short-term (months to a few years) exposures to high levels of particulate matter during deployment and the subsequent development of adverse pulmonary outcomes. Surgical lung biopsies from deployed service members and veterans (DSMs) and non-deployed service members and veterans (NDSMs) who develop lung diseases can be analyzed to potentially identify residual deployment-specific particles and develop associations with pulmonary pathological diagnoses. We examined 52 surgical lung biopsies from 25 DSMs and 27 NDSMs using field emission scanning electron microscopy (FE-SEM) with energy dispersive x-ray spectroscopy (EDS) to identify any between-group differences in the number and composition of retained inorganic particles, then compared the particle analysis results with the original histopathologic diagnoses. We recorded a higher number of total particles in biopsies from DSMs than from NDSMs, and this difference was mainly accounted for by geologic clays (illite, kaolinite), feldspars, quartz/silica, and titanium-rich silicate mixtures. Biopsies from DSMs deployed to other Southwest Asia regions (SWA-Other) had higher particle counts than those from DSMs primarily deployed to Iraq or Afghanistan, due mainly to illite. Distinct deployment-specific particles were not identified. Particles did not qualitatively associate with country of deployment. The individual diagnoses of the DSMs and NDSMs were not associated with elevated levels of total particles, metals, cerium oxide, or titanium dioxide particles. These results support the examination of particle-related lung disease in DSMs in the context of comparison groups, such as NDSMs, to assist in determining the strength of associations between specific pulmonary pathology diagnoses and deployment-specific inorganic particulate matter exposure.
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Affiliation(s)
- Leslie Hayden
- Institute for Functional Materials and Devices, Lehigh University, Bethlehem, Pennsylvania, United States of America
| | - James M. Lightner
- Environmental Microscopy Laboratory, Joint Pathology Center, Silver Spring, Maryland, United States of America
| | - Stacy Strausborger
- Environmental Microscopy Laboratory, Joint Pathology Center, Silver Spring, Maryland, United States of America
| | - Teri J. Franks
- Pulmonary and Mediastinal Pathology, Joint Pathology Center, Silver Spring, Maryland, United States of America
| | - Nora L. Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Michael R. Lewin-Smith
- Environmental Pathology, Joint Pathology Center, Silver Spring, Maryland, United States of America
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Stamatis P, Mohammad MA, Gisslander K, Merkel PA, Englund M, Turesson C, Erlinge D, Mohammad AJ. Myocardial infarction in a population-based cohort of patients with biopsy-confirmed giant cell arteritis in southern Sweden. RMD Open 2024; 10:e003960. [PMID: 38599652 PMCID: PMC11015192 DOI: 10.1136/rmdopen-2023-003960] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES To determine the incidence rate (IR) of myocardial infarction (MI), relative risk of MI, and impact of incident MI on mortality in individuals with biopsy-confirmed giant cell arteritis (GCA). METHODS MIs in individuals diagnosed with GCA 1998-2016 in Skåne, Sweden were identified by searching the SWEDEHEART register, a record of all patients receiving care for MI in a coronary care unit (CCU). The regional diagnosis database, with subsequent case review, identified GCA patients receiving care for MI outside of a CCU. A cohort of 10 reference subjects for each GCA case, matched for age, sex and area of residence, was used to calculate the incidence rate ratio (IRR) of MI in GCA to that in the general population. RESULTS The GCA cohort comprised 1134 individuals. During 7958 person-years of follow-up, 102 were diagnosed with incident MI, yielding an IR of 12.8 per 1000 person-years (95% CI 10.3 to 15.3). The IR was highest in the 30 days following GCA diagnosis and declined thereafter. The IRR of MI in GCA to that of the background population was 1.29 (95% CI 1.05 to 1.59). Mortality was higher in GCA patients who experienced incident MI than in those without MI (HR 2.8; 95% CI 2.2 to 3.6). CONCLUSIONS The highest incidence of MI occurs within the 30 days following diagnosis of GCA. Individuals with GCA have a moderately increased risk of MI compared with a reference population. Incident MI has a major impact on mortality in GCA.
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Affiliation(s)
- Pavlos Stamatis
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
- Department of Rheumatology, Sunderby Hospital, Luleå, Sweden
| | | | - Karl Gisslander
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
| | - Peter A Merkel
- Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Martin Englund
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Carl Turesson
- Department of Clinical Sciences Malmö, Rheumatology, Lund Universtiy, Malmö, Sweden
| | - David Erlinge
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
| | - Aladdin J Mohammad
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden
- Department of Medicine, University of Cambridge, Cambridge, UK
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Sousa P, Brás C, Menezes C, Vizcaino R, Costa T, Faria MS, Mota C. Percutaneous kidney biopsies in children: a 24-year review in a tertiary center in northern Portugal. J Bras Nefrol 2024; 46:e20230143. [PMID: 38591825 DOI: 10.1590/2175-8239-jbn-2023-0143en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/16/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Percutaneous kidney biopsy (KB) is crucial to the diagnosis and management of several renal pathologies. National data on native KB in pediatric patients are scarce. We aimed to review the demographic and clinical characteristics and histopathological patterns in children who underwent native percutaneous KB over 24 years. METHODS Retrospective observational study of patients undergoing native percutaneous KB in a pediatric nephrology unit between 1998 and 2021, comparing 3 periods: period 1 (1998-2005), period 2 (2006-2013), and period 3 (2014-2021). RESULTS We found that 228 KB were performed, 78 (34.2%) in period 1, 91 (39.9%) in period 2, and 59 (25.9%) in period 3. The median age at KB was 11 (7-14) years. The main indications for KB were nephrotic syndrome (NS) (42.9%), hematuria and/or non-nephrotic proteinuria (35.5%), and acute kidney injury (13.2%). Primary glomerulopathies were more frequent (67.1%), particularly minimal change disease (MCD) (25.4%), IgA nephropathy (12.7%), and mesangioproliferative glomerulonephritis (GN) (8.8%). Of the secondary glomerulopathies, lupus nephritis (LN) was the most prevalent (11.8%). In group 1, hematuria and/or non-nephrotic proteinuria were the main reasons for KB, as opposed to NS in groups 2 and 3 (p < 0.01). LN showed an increasing trend (period 1-3: 2.6%-5.3%) and focal segmental glomerular sclerosis (FSGS) showed a slight decreasing trend (period 1-3: 3.1%-1.8%), without statistical significance. CONCLUSIONS The main indication for KB was NS, which increased over time, justifying the finding of MCD as main histological diagnosis. LN showed an increase in incidence over time, while FSGS cases did not increase.
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Affiliation(s)
- Patrícia Sousa
- Hospital Senhora da Oliveira, Serviço de Pediatria, Guimarães, Portugal
| | - Catarina Brás
- Hospital Professor Doutor Fernando Fonseca, Serviço de Nefrologia, Lisboa, Portugal
| | - Catarina Menezes
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Serviço de Pediatria, Porto, Portugal
| | - Ramon Vizcaino
- Centro Hospitalar Universitário de Santo António, Serviço de Anatomia Patológica, Porto, Portugal
| | - Teresa Costa
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Unidade de Nefrologia Pediátrica, Serviço de Pediatria, Porto, Portugal
| | - Maria Sameiro Faria
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Unidade de Nefrologia Pediátrica, Serviço de Pediatria, Porto, Portugal
- Unidade de Ciências Biomoleculares Aplicadas, Department of Biological Science, Porto, Portugal
| | - Conceição Mota
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Unidade de Nefrologia Pediátrica, Serviço de Pediatria, Porto, Portugal
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Gu WQ, Wang L, Xu JC, Ping GQ, Han X, Wang C. [Non-primary solid malignancies of breast in needle core biopsy: a clinicopathological analysis of 23 cases]. Zhonghua Bing Li Xue Za Zhi 2024; 53:331-336. [PMID: 38556815 DOI: 10.3760/cma.j.cn112151-20231013-00258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Objective: To investigate the accurate diagnosis and differential diagnosis of non-primary solid malignant tumors in breast needle core biopsy. Methods: Twenty-three cases of breast, axilla or neck lymph nodes pathologically diagnosed as non-primary solid malignant tumors were collected at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China from January 2013 to March 2023. The differential diagnoses and diagnostic features were analyzed, based on combining clinical data, histology, and expression characteristics of biomarkers. Results: All patients were female, with age ranging from 29 to 75 years (average 56 years). The average time from the diagnosis of primary tumor to the current diagnosis was 21 months (0 to 204 months).The primary sites included the ovary (9 cases), the lung (5 cases), the gastrointestinal tract (4 cases), the pancreas, intrahepatic bile duct, thyroid gland, nasal cavity and forearm skin (1 case each). No carcinoma in situ was found in any of the cases. The morphological differences were significant among the tumors, but similar to the primary tumors. The tumors of neuroendocrine and female reproductive tract had great morphological and immunophenotypic overlaps with breast cancer. Metastatic lung cancer cells showed obvious atypia and tumor giant cells. The morphology and immunophenotype of metastatic serous carcinoma of female reproductive system might resemble invasive micropapillary carcinoma of the breast. Metastatic adenocarcinoma of the gastrointestinal tract often had features of mucous secretion. Metastatic neuroendocrine tumors were bland in appearance and morphologically similar to solid papillary carcinoma of breast, but negative for ER. TRPS1 was mostly negative (18/23) and variably positive in ovarian (4/9) and intrahepatic bile duct (1/1) tumors. Conclusions: The diagnosis of breast needle core biopsy specimen should be combined with clinical history, imaging study, and careful examination of histological features, such as presence of in situ component, morphological similarity between the primary and metastatic tumors, and using appropriate markers to differentiate the primary from metastatic tumors.
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Affiliation(s)
- W Q Gu
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - L Wang
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J C Xu
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - G Q Ping
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X Han
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - C Wang
- Department of Pathology, Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Hietikko R, Mirtti T, Kilpeläinen TP, Tolonen T, Räisänen-Sokolowski A, Nordling S, Hannus J, Laurila M, Taari K, Tammela TLJ, Autio R, Natunen K, Auvinen A, Rannikko A. Expected impact of MRI-targeted biopsy interreader variability among uropathologists on ProScreen prostate cancer screening trial: a pre-trial validation study. World J Urol 2024; 42:217. [PMID: 38581590 PMCID: PMC10998811 DOI: 10.1007/s00345-024-04898-2] [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: 11/08/2023] [Accepted: 02/21/2024] [Indexed: 04/08/2024] Open
Abstract
PURPOSE Prostate cancer (PCa) histology, particularly the Gleason score, is an independent prognostic predictor in PCa. Little is known about the inter-reader variability in grading of targeted prostate biopsy based on magnetic resonance imaging (MRI). The aim of this study was to assess inter-reader variability in Gleason grading of MRI-targeted biopsy among uropathologists and its potential impact on a population-based randomized PCa screening trial (ProScreen). METHODS From June 2014 to May 2018, 100 men with clinically suspected PCa were retrospectively selected. All men underwent prostate MRI and 86 underwent targeted prostate of the prostate. Six pathologists individually reviewed the pathology slides of the prostate biopsies. The five-tier ISUP (The International Society of Urological Pathology) grade grouping (GG) system was used. Fleiss' weighted kappa (κ) and Model-based kappa for associations were computed to estimate the combined agreement between individual pathologists. RESULTS GG reporting of targeted prostate was highly consistent among the trial pathologists. Inter-reader agreement for cancer (GG1-5) vs. benign was excellent (Model-based kappa 0.90, Fleiss' kappa κ = 0.90) and for clinically significant prostate cancer (csPCa) (GG2-5 vs. GG0 vs. GG1), it was good (Model-based kappa 0.70, Fleiss' kappa κ 0.67). CONCLUSIONS Inter-reader agreement in grading of MRI-targeted biopsy was good to excellent, while it was fair to moderate for MRI in the same cohort, as previously shown. Importantly, there was wide consensus by pathologists in assigning the contemporary GG on MRI-targeted biopsy suggesting high reproducibility of pathology reporting in the ProScreen trial.
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Affiliation(s)
- Ronja Hietikko
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Tuomas Mirtti
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- HUS Diagnostic Center, Department of Pathology, HUS Helsinki University Hospital, Helsinki, Finland
| | - Tuomas P Kilpeläinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Teemu Tolonen
- Fimlab Laboratories, Department of Pathology, Tampere University Hospital, Tampere, Finland
| | - Anne Räisänen-Sokolowski
- HUS Diagnostic Center, Department of Pathology, HUS Helsinki University Hospital, Helsinki, Finland
- Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Stig Nordling
- Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jill Hannus
- Fimlab Laboratories, Department of Pathology, Tampere University Hospital, Tampere, Finland
| | - Marita Laurila
- Fimlab Laboratories, Department of Pathology, Tampere University Hospital, Tampere, Finland
| | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Reija Autio
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kari Natunen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Antti Rannikko
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Omar Ali H, Abraham R, Desoubeaux G, Fahal AH, Tauber C. Evaluation of a computational model for mycetoma-causative agents identification. Trans R Soc Trop Med Hyg 2024; 118:253-263. [PMID: 38088215 DOI: 10.1093/trstmh/trad057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 11/27/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The therapeutic strategy for mycetoma relies heavily on the identification of the causative agents, which are either fungal or bacterial. While histopathological examination of surgical biopsies is currently the most used diagnostic tool, it requires well-trained pathologists, who are lacking in most rural areas where mycetoma is endemic. In this work we propose and evaluate a machine learning approach that semi-automatically analyses histopathological microscopic images of grains and provides a classification of the disease as eumycetoma or actinomycetoma. METHODS The computational model is based on radiomics and partial least squares. It is assessed on a dataset that includes 890 individual grains collected from 168 patients originating from the Mycetoma Research Centre in Sudan. The dataset contained 94 eumycetoma cases and 74 actinomycetoma cases, with a distribution of the species among the two causative agents that is representative of the Sudanese distribution. RESULTS The proposed model achieved identification of causative agents with an accuracy of 91.89%, which is comparable to the accuracy of experts from the domain. The method was found to be robust to a small error in the segmentation of the grain and to changes in the acquisition protocol. Among the radiomics features, the homogeneity of mycetoma grain textures was found to be the most discriminative feature for causative agent identification. CONCLUSION The results presented in this study support that this computational approach could greatly benefit rural areas with limited access to specialized clinical centres and also provide a second opinion for expert pathologists to implement the appropriate therapeutic strategy.
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Affiliation(s)
- Hyam Omar Ali
- Faculty of Mathematical Sciences, University of Khartoum, 11111, Khartoum, Sudan
- Mycetoma Research Centre, University of Khartoum, 11111, Khartoum, Sudan
- Boulevard Tonnellé, University of Tours, Inserm, 37032, Tours, France
- CNRS U7013, rue de Chartres, University of Orleans, 45067, Orleans, France
| | - Romain Abraham
- CNRS U7013, rue de Chartres, University of Orleans, 45067, Orleans, France
| | - Guillaume Desoubeaux
- Parasitology and Mycology Department, Bretonneau Hospital, 37032, Tours, France
- Boulevard Tonnellé, University of Tours, 37032, Tours, France
| | - Ahmed H Fahal
- Mycetoma Research Centre, University of Khartoum, 11111, Khartoum, Sudan
| | - Clovis Tauber
- Boulevard Tonnellé, University of Tours, Inserm, 37032, Tours, France
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Wei L, Kshirsagar A, Olsen J, Parghi C. HSR24-157: Standalone Performance Evaluation of an Artificial Intelligence Breast Cancer Detection Tool on Consecutively Collected Biopsy Proven Breast Cancer and Screening Negative Tomosynthesis Cases. J Natl Compr Canc Netw 2024; 22:HSR24-157. [PMID: 38580288 DOI: 10.6004/jnccn.2023.7242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
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Alter J, Kumar S, Skog J, Verma V, Schimizzi K, Yao Y, Ray CJ, Haynes B, Tutrone R. BPI24-025: Prostate Biopsies Against Medical Advice: Unveiling New Biomarker Insights for Men. J Natl Compr Canc Netw 2024; 22:BPI24-025. [PMID: 38579883 DOI: 10.6004/jnccn.2023.7258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
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Takahashi T. Cost-effectiveness analysis of prostate cancer screening and MRI. World J Urol 2024; 42:212. [PMID: 38578452 DOI: 10.1007/s00345-024-04943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
- Takeshi Takahashi
- Health and Welfare Bureau, Kitakyushu City Office, Jyonai 1-1, Kitakyushu, 803-8501, Japan.
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Furia A, Ditaranto R, Biagini E, Parisi V, Incensi A, Parisini S, Liguori R, Donadio V. Fabry disease in W162C mutation: a case report of two patients and a review of literature. BMC Neurol 2024; 24:113. [PMID: 38580906 PMCID: PMC10996216 DOI: 10.1186/s12883-024-03540-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 01/15/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Fabry disease is a multisystemic disorder characterized by deposition of globotriaosylceramide (Gb3) and its deacylated form in multiple organs, sometimes localized in specific systems such as the nervous or cardiovascular system. As disease-modifying therapies are now available, early diagnosis is paramount to improving life quality and clinical outcomes. Despite the widespread use of non-invasive techniques for assessing organ damage, such as cardiac magnetic resonance imaging (MRI) for patients with cardiac disease, organ biopsy remains the gold standard to assess organ involvement. CASE PRESENTATION The cases of two patients, father and daughter with a W162C mutation, are described. The father presented with late-onset, cardiac Fabry disease, subsequently developing systolic dysfunction and heart failure. His daughter, while asymptomatic and with normal cardiac assessment (except for slightly reduced native T1 values by cardiac MRI), had already initial myocyte Gb3 deposits on the endomyocardial biopsy, allowing her to start therapy precociously and potentially modifying the course of her disease. A review of the literature concerning the W162C mutation is then provided, showing that it is usually associated to classic, multisystemic Fabry disease rather than the cardiac-restricted form as in these two cases. CONCLUSIONS Three main points can be concluded from this report. First, the W162C mutation can present with a more variegate phenotype than that predicted on a molecular basis. Second, endomyocardial biopsy was shown in this case to precede non-invasive investigation in determining organ involvement, justifying further studies on this potentially reliable technique, Third, difficulties can arise in the management of asymptomatic female carriers.
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Affiliation(s)
- Alessandro Furia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy.
| | - Raffaello Ditaranto
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart), Bologna, Italy
| | - Elena Biagini
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart), Bologna, Italy
| | - Vanda Parisi
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart), Bologna, Italy
| | - Alex Incensi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy
| | - Sara Parisini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy
| | - Rocco Liguori
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Vincenzo Donadio
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy
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Chen Y, Liu H, Sun Y. Effect of acute inflammatory reaction induced by biopsy on tumor microenvironment. J Cancer Res Clin Oncol 2024; 150:177. [PMID: 38578317 PMCID: PMC10997701 DOI: 10.1007/s00432-024-05704-7] [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: 07/30/2023] [Accepted: 12/04/2023] [Indexed: 04/06/2024]
Abstract
When it comes to the diagnosis of solid tumors, biopsy is always the gold standard. However, traumatic and inflammatory stimuli are so closely related to tumor initiation and development that the acute inflammatory response induced by biopsy can give rise to changes in the tumor microenvironment, including recruitment of immunosuppressive cells (M2 macrophages, Treg cells, Tumor-associated neutrophils) and secretion of inflammation-associated cytokines, to create immunosuppressive conditions that enable the increase of circulating tumor cells in the peripheral circulation and promote the metastatic spread of tumors after surgery. In this review, we discuss dynamic changes and inhibitory characteristics of biopsy on tumor microenvironment. By investigating its mechanism of action and summarizing the current therapeutic strategies for biopsy-induced tumor immunosuppressive microenvironment, the future of using biopsy-induced inflammation to improve the therapeutic effects and prognosis of patients is prospected.
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Affiliation(s)
- Yuanyuan Chen
- Department of Stomatology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Hualian Liu
- Department of Stomatology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
| | - Yadong Sun
- Department of General Practice, Unit 94587 of the Chinese People's Liberation Army, Lianyungang, China
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Shimizu R, Morizane S, Yamamoto A, Yamane H, Nishikawa R, Kimura Y, Yamaguchi N, Hikita K, Honda M, Takenaka A. Assessment of the accuracy of biparametric MRI/TRUS fusion-guided biopsy for index tumor evaluation using postoperative pathology specimens. BMC Urol 2024; 24:79. [PMID: 38575912 PMCID: PMC10996083 DOI: 10.1186/s12894-024-01473-0] [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: 07/15/2023] [Accepted: 04/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Multiparametric MRI (mpMRI) is widely used for the diagnosis, surveillance, and staging of prostate cancer. However, it has several limitations, including higher costs, longer examination times, and the use of gadolinium-based contrast agents. This study aimed to investigate the accuracy of preoperatively assessed index tumors (ITs) using biparametric MRI (bpMRI)/transrectal ultrasound (TRUS) fusion biopsy compared with radical prostatectomy (RP) specimens. METHODS We included 113 patients diagnosed with prostate cancer through bpMRI/TRUS fusion-guided biopsies of lesions with a Prostate Imaging Reporting and Data System (PI-RADS) category ≥ 3. These patients underwent robot-assisted laparoscopic radical prostatectomy (RARP) at our institution between July 2017 and March 2023. We examined the localization of preoperative and postoperative ITs, the highest Gleason score (GS), and tumor diameter in these patients. RESULTS The preoperative cT stage matched the postoperative pT stage in 53 cases (47%), while 31 cases (27%) were upstaged, and 29 cases (26%) were downstaged (Weighted Kappa = 0.21). The preoperative and postoperative IT localizations were consistent in 97 cases (86%). The concordance rate between Gleason groups in targeted biopsies and RP specimens was 51%, with an upgrade in 25 cases (23%) and a downgrade in 27 cases (25%) (Weighted Kappa = 0.42). The maximum diameter of the IT and the maximum cancer core length on biopsy were correlated with the RP tumor's maximum diameter (p < 0.001 for both). CONCLUSION The diagnostic accuracy of bpMRI/TRUS fusion biopsy is comparable to mpMRI, suggesting that it can be a cost-effective and time-saving alternative.
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Affiliation(s)
- Ryutaro Shimizu
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Morizane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan.
| | - Atsushi Yamamoto
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Hiroshi Yamane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Ryoma Nishikawa
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Yusuke Kimura
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Noriya Yamaguchi
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Katsuya Hikita
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Masashi Honda
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan
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