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Boulle G, Velut Y, Mansuet-Lupo A, Gibault L, Blons H, Fournel L, Boni A, Cremer I, Wislez M, Duchatelle V, Trédaniel J, Hammond SA, Herbst R, Alifano M, Giraud P, Damotte D. Chemoradiotherapy efficacy is predicted by intra-tumour CD8+/FoxP3+ double positive T cell density in locally advanced N2 non-small-cell lung carcinoma. Eur J Cancer 2020; 135:221-229. [PMID: 32610210 DOI: 10.1016/j.ejca.2020.04.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Radiotherapy is a standard of care for locally advanced stage III N2 non-small-cell lung carcinoma (NSCLC) combined with surgery/chemotherapy. Radiotherapy is hypothesised to induce tumour immunogenic cell death, to release neoantigen resulting in intra-tumoural immune infiltration and abscopal effect. Conversely, it has not been demonstrated if immune cells are necessary to drive radiotherapy efficacy and predict patient's survival. PATIENTS AND METHODS We retrospectively analysed tumour samples and clinical data from 113 patients, 89 resected (PORT) and 24 non-resected (DRC) N2-NSCLC treated with chemotherapy and radiotherapy (same radiotherapy department from 2002 to 2015). The immune environment was characterised with in situ multiplex staining (CD8, FoxP3, PD-L1 and cytokeratin) and correlated with clinical data and survival. RESULTS High density of CD8+ T cells was associated with OS (p = 0.04, HR = 1.93 [0.99-3.78]) and DFS (p = 0.003, HR = 2.42 [1.31-4.47]) in the PORT. High density of CD8+/FoxP3+ double positive cells was associated with OS (p = 0.01, HR = 1.97 [1.11-3.48]) in the whole population, with OS (p = 0.05, HR = 1.92 [0.98-3.74]) and PFS (p = 0.03, HR = 1.83 [1.03-3.23]) in the PORT without reaching significance for the DRC. Intermediate PD-L1 expression in tumour cells (TPS = 1-49%) was associated with a higher survival in the PORT. CONCLUSIONS Intra-tumoural CD8+ T cell and particularly CD8+/FoxP3+ double positive T cell densities predict survival in stage III N2-NSCLC suggesting the need for a pre-existing intra-tumour immunity to mediate the action of radiotherapy. Density of CD8+/FoxP3+ cells was the best predictor of patient's survival in multivariate analysis and could represent a biomarker of radiotherapy efficacy.
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Affiliation(s)
- G Boulle
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - Y Velut
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - A Mansuet-Lupo
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Paris, France
| | - L Gibault
- Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - H Blons
- University Paris Descartes, Paris, France; INSERM UMRS 1147, Paris, France; Department of Biochemistry, APHP, Hôpital Européen Georges Pompidou, Paris, France
| | - L Fournel
- University Paris Descartes, Paris, France; Department of Thoracic Surgery, APHP, Hôpital Cochin, Paris, France; INSERM U1124, Paris, France
| | - A Boni
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - I Cremer
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - M Wislez
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; Department of Respiratory Medicine, APHP, Hôpital Cochin, Paris, France
| | - V Duchatelle
- Department of Pathology, St Joseph Hospital, Paris, France
| | - J Trédaniel
- University Paris Descartes, Paris, France; INSERM U1124, Paris, France; Department of Oncology, St Joseph Hospital, Paris, France
| | - S A Hammond
- Research and Early Discovery, Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - R Herbst
- Research and Early Discovery, Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - M Alifano
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Thoracic Surgery, APHP, Hôpital Cochin, Paris, France
| | - P Giraud
- University Paris Descartes, Paris, France; APHP, Hôpital Européen Georges Pompidou, Department of Radiotherapy, Paris, France
| | - D Damotte
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Paris, France.
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Fournel L, Janet-Vendroux A, Canny-Hamelin E, Mansuet-Lupo A, Guinet C, Bobbio A, Damotte D, Alifano M. [Malignant pleural mesothelioma: The role of surgery]. Rev Pneumol Clin 2018; 74:351-358. [PMID: 30316650 DOI: 10.1016/j.pneumo.2018.09.006] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Malignant pleural mesothelioma (MPM) is a rare and highly aggressive disease, whose incidence is increasing. Asbestos is the primary causal agent. STATE OF KNOWLEDGE Knowledge about MPM has evolved. Thoracoscopy is essential for diagnosis of MPM. It allows performing pleural biopsies, to study the extent of the disease and to relieve dyspnea. The pathological diagnosis is also better codified with immunohistochemistry and with analysis by expert of Mesopath group. Curative surgical treatments are pleurectomy decortication and extended pneumonectomy in combination with chemotherapy and/or radiotherapy. Those heavy treatments improve survival in highly selected patients. For the other patients, supportive measures will be considered to reduce pain and dyspnea. PROSPECT Radical surgical treatment is only offered in therapeutic trials or multimodal treatment. Its place is not formally established. New therapies associated to surgical treatment are being studied. CONCLUSIONS Surgical management of MPM has to be operated in specialized teams where the survival benefit and quality of life is discussed case by case.
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Affiliation(s)
- L Fournel
- Service de chirurgie thoracique, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - A Janet-Vendroux
- Service de chirurgie thoracique, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - E Canny-Hamelin
- Service de chirurgie thoracique, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - A Mansuet-Lupo
- Service d'anatomopathologie, université Paris Descartes, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - C Guinet
- Service de radiologie, université Paris Descartes, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - A Bobbio
- Service de chirurgie thoracique, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - D Damotte
- Service d'anatomopathologie, université Paris Descartes, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - M Alifano
- Service de chirurgie thoracique, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris-Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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Mansuet-Lupo A, Lococo F, Larousserie F, Alifano M, Saliceti R. Dedifferentiated primary mediastinal liposarcoma mimicking a thymic tumor. Pathologica 2017; 109:401-404. [PMID: 29449733] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Mediastinal tumors are heterogeneous and the diagnosis depends on their location in the mediastinum. The most frequent tumors are germinal tumor, lymphoma and thymoma. The clinical and radiological aspects are often not sufficient to orient the diagnosis and biopsy is necessary to confirmed it. Here, we present a rare case of an anterior mediastinal mass incidentally detected in a 63 years old man during assessment for asthma. The lesion was presumptively diagnosed as a thymic epithelial tumor based on location and radiological characteristics. Surgical biopsy revealed a primary dedifferentiated mediastinal liposarcoma with multiple lung metastases.
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Affiliation(s)
- A Mansuet-Lupo
- Paris V University
- Department of Pathology Groupe Hospitalier Hôpitaux Universitaires Paris Centre, Assistance Publique, Hopitaux de Paris, France
| | - F Lococo
- Unit of Thoracic Surgery, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - F Larousserie
- Paris V University
- Department of Pathology Groupe Hospitalier Hôpitaux Universitaires Paris Centre, Assistance Publique, Hopitaux de Paris, France
| | - M Alifano
- Paris V University
- Department of Pathology Groupe Hospitalier Hôpitaux Universitaires Paris Centre, Assistance Publique, Hopitaux de Paris, France
| | - R Saliceti
- Paris V University
- Department of Thoracic Surgery, Cochin-Hôtel Dieu Hospital, Assistance Publique, Hopitaux de Paris, France
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Hélage S, Revel M, Chabi M, Audureau É, Ferretti G, Laurent F, Alifano M, Mansuet-Lupo A, Buy J, Vadrot D. Solitary fibrous tumor of the pleura: Can computed tomography features help predict malignancy? A series of 56 patients with histopathological correlates. Diagn Interv Imaging 2016; 97:347-53. [DOI: 10.1016/j.diii.2015.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 10/22/2022]
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Gaucher S, Bobbio A, Mansuet-Lupo A, Hamelin-Canny E, Hautier A, Nicolas C, Alifano M. Late costal osteomyelitis with a cutaneous fistula after flame burns: a case report. J Wound Care 2016; 25:104, 106-7. [PMID: 26878303 DOI: 10.12968/jowc.2016.25.2.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chest wall defects are an unusual complication of burn injury, generally seen after high-voltage electrical burns. Here we report the case of a 57-year-old man who developed costal chondritis and osteomyelitis 23 months after flame injury, which covered 50% of the total body surface area. Management included the resection of two ribs and coverage with an omental flap, overlaid by a split-thickness skin graft during the same surgical procedure. Declaration of interest: The authors have no conflict of interest to declare.
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Affiliation(s)
- S Gaucher
- Faculté de Médecine, Université Paris Descartes, 75 006 Paris, France.,Centre Pluridisciplinaire de Chirurgie Ambulatoire, Hôpitaux Universitaires Paris Centre, Site Port-Royal, AP-HP, 75 014 Paris, France
| | - A Bobbio
- Service de Chirurgie Thoracique, Hôpitaux Universitaires Paris Centre, Site Cochin, AP-HP, 75 014 Paris, France
| | - A Mansuet-Lupo
- Service de Cytologie et Anatomie Pathologiques, Hôpitaux Universitaires Paris Centre, Site Cochin, AP-HP, 75 014 Paris, France
| | - E Hamelin-Canny
- Service de Chirurgie Thoracique, Hôpitaux Universitaires Paris Centre, Site Cochin, AP-HP, 75 014 Paris, France
| | - A Hautier
- Centre des Brûlés, Service de Chirurgie Plastique, Hôpital de la Conception, 13 005 Marseille, France
| | - C Nicolas
- Service de Soins de Suite et Rééducation, 77 170 Coubert, France
| | - M Alifano
- Faculté de Médecine, Université Paris Descartes, 75 006 Paris, France.,Service de Chirurgie Thoracique, Hôpitaux Universitaires Paris Centre, Site Cochin, AP-HP, 75 014 Paris, France
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Legras A, Pecuchet N, Tallet A, Guyard A, Mansuet-Lupo A, Prieur EGL, Giraudet V, Gibault L, Damotte D, Julie C, Alifano M, Pimpec-Barthes FL, Laurent-Puig P, Fabre E, Blons H. 468 Validity of next generation sequencing in routine care for non-small cell lung cancer diagnosis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30302-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rousset P, Rousset-Jablonski C, Alifano M, Mansuet-Lupo A, Buy JN, Revel MP. Thoracic endometriosis syndrome: CT and MRI features. Clin Radiol 2013; 69:323-30. [PMID: 24331768 DOI: 10.1016/j.crad.2013.10.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/29/2013] [Accepted: 10/10/2013] [Indexed: 11/25/2022]
Abstract
Thoracic endometriosis is considered to be rare, but is the most frequent form of extra-abdominopelvic endometriosis. Thoracic endometriosis syndrome affects women of reproductive age. Diagnosis is mainly based on clinical findings, which can include catamenial pneumothorax and haemothorax, non-catamenial endometriosis-related pneumothorax, catamenial haemoptysis, lung nodules, and isolated catamenial chest pain. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this often under-diagnosed syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions.
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Affiliation(s)
- P Rousset
- Radiology Department, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France.
| | - C Rousset-Jablonski
- Gynecologic Department, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Lyon, France
| | - M Alifano
- Thoracic Surgery Department, Groupe Hospitalier Cochin Hôtel-Dieu, AP-HP, Université Paris Descartes, Paris, France
| | - A Mansuet-Lupo
- Pathology Department, Groupe Hospitalier Cochin Hôtel-Dieu, AP-HP, Université Paris Descartes, Paris, France
| | - J-N Buy
- Radiology Department, Groupe Hospitalier Cochin Hôtel-Dieu, AP-HP, Université Paris Descartes, Paris, France
| | - M-P Revel
- Radiology Department, Groupe Hospitalier Cochin Hôtel-Dieu, AP-HP, Université Paris Descartes, Paris, France
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Kauffmann A, Rosselli F, Lazar V, Winnepenninckx V, Mansuet-Lupo A, Dessen P, van den Oord JJ, Spatz A, Sarasin A. High expression of DNA repair pathways is associated with metastasis in melanoma patients. Oncogene 2007; 27:565-73. [PMID: 17891185 DOI: 10.1038/sj.onc.1210700] [Citation(s) in RCA: 189] [Impact Index Per Article: 11.1] [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: 01/23/2023]
Abstract
We have identified a gene-profile signature for human primary malignant melanoma associated with metastasis to distant sites and poor prognosis. We analyse the differential gene expression by looking at whole biological pathways rather than individual genes. Among the most significant pathways associated with progression to metastasis, we found the DNA replication (P=10(-14)) and the DNA repair pathways (P=10(-16)). We concentrated our analysis on DNA repair and found that 48 genes of this category, among a list of 234 genes, are associated with metastatic progression. These genes belong essentially to the pathways allowing recovery of stalled replication forks due to spontaneous blockage or induced DNA lesions. Because almost all these differentially expressed repair genes were overexpressed in primary tumors with bad prognosis, we speculate that primary melanoma cells that will metastasize try to replicate in a fast and error-free mode. In contrast to the progression from melanocytes to primary melanoma, genetic stability appears to be necessary for a melanoma cell to give rise to distant metastasis. This overexpression of repair genes explains nicely the extraordinary resistance of metastatic melanoma to chemo- and radio-therapy. Our results may open a new avenue for the discovery of drugs active on human metastatic melanoma.
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Affiliation(s)
- A Kauffmann
- Laboratory of Genomes and Cancer, FRE2939 CNRS, Gustave-Roussy Institute, Villejuif and University Paris-Sud, Orsay, France
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Mansuet-Lupo A, Laurent I, Bayou EH, Mathieu MC, Delaloge S, Suciu V, Vielh P. FNAC of a breast lesion after treatment for carcinoma. Cytopathology 2007; 19:323-5. [PMID: 17573911 DOI: 10.1111/j.1365-2303.2007.00462.x] [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: 11/29/2022]
Affiliation(s)
- A Mansuet-Lupo
- Department of Medical Biology and Pathology, Institut de cancérologie Gustave Roussy, Villejuif, France
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Mansuet-Lupo A, Rouger P, Van Huffel V. [DNA typing: analysis of difficult cases]. Transfus Clin Biol 2007; 14:343-7. [PMID: 17574893 DOI: 10.1016/j.tracli.2007.04.020] [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: 04/23/2007] [Accepted: 04/27/2007] [Indexed: 11/26/2022]
Abstract
DNA fingerprinting is a tool to identify individual and allows to resolve many difficult cases. Their application fields are various: paternity or maternity testing, criminal affairs (crime, identity usurpation, identity substitution...). This review relates some interesting and atypical cases.
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Affiliation(s)
- A Mansuet-Lupo
- Institut national de la transfusion sanguine, 6, rue Alexandre-Cabanel, 75739 Paris cedex 15, France.
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Mansuet-Lupo A, Rouger P, Van Huffel V. [Point about DNA profiling: technologies, applications, and legislation]. Transfus Clin Biol 2007; 14:334-42. [PMID: 17462937 DOI: 10.1016/j.tracli.2007.03.001] [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: 02/16/2007] [Accepted: 03/09/2007] [Indexed: 10/23/2022]
Abstract
Molecular biology progress in DNA fingerprinting has revolutionized forensic science. It's a reliable tool to identify an individual; it provides a true "genetic identity card". It's based of the concept that no two individuals can have an identical DNA pattern except identical twins. This article is a clarification on current technologies used in DNA profiling, their applications and its legislation, according a special place to the national databases (FNAEG), which is in great development for the moment.
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Affiliation(s)
- A Mansuet-Lupo
- Institut national de la transfusion sanguine, 6, rue Alexandre-Cabanel, 75739 Paris cedex 15, France.
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