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Gavrielatou N, Fortis E, Spathis A, Anastasiou M, Economopoulou P, Foukas GRP, Lelegiannis IM, Rusakiewicz S, Vathiotis I, Aung TN, Tissot S, Kastrinou A, Kotsantis I, Vagia EM, Panayiotides I, Rimm DL, Coukos G, Homicsko K, Foukas P, Psyrri A. B-cell infiltration is associated with survival outcomes following programmed cell death protein 1 inhibition in head and neck squamous cell carcinoma. Ann Oncol 2024; 35:340-350. [PMID: 38159908 DOI: 10.1016/j.annonc.2023.12.011] [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: 11/06/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Programmed cell death protein 1 (PD-1) axis blockade has become the mainstay in the treatment of recurrent and/or metastatic (R/M) head and neck squamous cell cancer (HNSCC). Programmed death-ligand 1 (PD-L1) is the only approved biomarker for patient selection; however, response rate is limited even among high expressors. Our primary objective was to investigate the association of immune cell-related biomarkers in the tumor and tumor microenvironment with PD-1 checkpoint inhibitors' outcomes in patients with R/M HNSCC. PATIENTS AND METHODS NCT03652142 was a prospective study in nivolumab-treated platinum-refractory R/M HNSCC, aiming to evaluate biomarkers of response to treatment. Tumor biopsies and blood samples were collected from 60 patients at baseline, post-treatment, and at progression. Immune cells in the tumor and stromal compartments were quantified by immunofluorescence using a five-protein panel (CD3, CD8, CD20, FoxP3, cytokeratin). Tertiary lymphoid structures (TLSs), PD-L1 expression, and peripheral blood immune cell composition were also evaluated for associations with outcome. Our findings were validated by gene set enrichment analysis (GSEA) messenger RNA in situ expression data from the same patients, for B-cell- and TLS-associated genes. RESULTS High pre-treatment density of stromal B cells was associated with prolonged progression-free survival (PFS) (P = 0.011). This result was validated by GSEA, as stromal enrichment with B-cell-associated genes showed association with response to nivolumab. PD-L1 positivity combined with high B-cell counts in stroma defined a subgroup with significantly longer PFS and overall survival (P = 0.013 and P = 0.0028, respectively). CONCLUSIONS Increased B cells in pre-treatment HNSCC biopsy samples correlate with prolonged benefit from PD-1-based immunotherapy and could further enhance the predictive value of PD-L1 expression.
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Affiliation(s)
- N Gavrielatou
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece; Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - E Fortis
- Ludwig Institute for Cancer Research, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - A Spathis
- Department of Pathology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - M Anastasiou
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - P Economopoulou
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - G R P Foukas
- Department of Pathology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - I M Lelegiannis
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - S Rusakiewicz
- Ludwig Institute for Cancer Research, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - I Vathiotis
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - T N Aung
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - S Tissot
- Ludwig Institute for Cancer Research, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - A Kastrinou
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - I Kotsantis
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - E M Vagia
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - I Panayiotides
- Department of Pathology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - D L Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - G Coukos
- Ludwig Institute for Cancer Research, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - K Homicsko
- Ludwig Institute for Cancer Research, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - P Foukas
- Department of Pathology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - A Psyrri
- Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece.
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Panayiotides I, Westaby J, Behr ER, Papadakis M, Sharma S, Finocchiaro G, Sheppard MN. Seasonal Variation in Sudden Cardiac Death: Insights from a Large United Kingdom Registry. Hellenic J Cardiol 2024:S1109-9666(24)00006-X. [PMID: 38246275 DOI: 10.1016/j.hjc.2024.01.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/29/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Sudden cardiac death (SCD) is relatively common and may occur in apparently healthy individuals. The role of seasonal variation as a risk factor for SCD is poorly understood. The aim of this study was to investigate whether SCD exhibits a predilection for specific seasons. METHODS We reviewed a database of 4751 cases of SCD (mean age 38 ± 17 years) referred to our Center for Cardiac Pathology at St George's University of London between 2000 and 2018. Clinical information was obtained from referring coroners who were asked to complete a detailed questionnaire. All cases underwent macroscopic and histological evaluation of the heart, by expert cardiac pathologists. RESULTS SCD was more common during winter (26%) and rarer during summer (24%), p = 0.161. Significant seasonal variation was not observed among cases of sudden arrhythmic death syndrome (SADS, 2910 cases) in which the heart is structurally normal. In contrast, a significant difference in seasonal distribution among decedents exhibiting cardiac structural abnormalities at the post-mortem examination (n = 1841) was observed. In this subgroup, SCDs occurred more frequently during winter (27 %) compared to summer (22%) (p = 0.007). In cases diagnosed with a myocardial disease (n = 1399), SCD was most common during the winter (27%) and least common during the summer (22%) (p = 0.027). CONCLUSIONS While SADS occurs throughout the year with no seasonal variation, SCD due to structural heart disease appears to be more common during the winter. Bio-meteorological factors may be potential triggers of SCD in individuals with an underlying structural cardiac abnormality.
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Affiliation(s)
- Ioannis Panayiotides
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Joseph Westaby
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Elijah R Behr
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Michael Papadakis
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Sanjay Sharma
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Gherardo Finocchiaro
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Mary N Sheppard
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom.
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Drogari-Apiranthitou M, Skiada A, Panayiotides I, Vyzantiadis TA, Poulopoulou A, Christofidou M, Antoniadou A, Roilides E, Iosifidis E, Mamali V, Argyropoulou A, Sympardi S, Charalampaki N, Antonakos N, Mantzana P, Mastora Z, Nicolatou-Galitis O, Orfanidou M, Pana ZD, Pavleas I, Pefanis A, Sakka V, Spiliopoulou A, Stamouli M, Tofas P, Vagiakou E, Petrikkos G. Epidemiology of Mucormycosis in Greece; Results from a Nationwide Prospective Survey and Published Case Reports. J Fungi (Basel) 2023; 9:jof9040425. [PMID: 37108880 PMCID: PMC10142618 DOI: 10.3390/jof9040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023] Open
Abstract
Mucormycosis has emerged as a group of severe infections mainly in immunocompromised patients. We analysed the epidemiology of mucormycosis in Greece in a multicentre, nationwide prospective survey of patients of all ages, during 2005–2022. A total of 108 cases were recorded. The annual incidence declined after 2009 and appeared stable thereafter, at 0.54 cases/million population. The most common forms were rhinocerebral (51.8%), cutaneous (32.4%), and pulmonary (11.1%). Main underlying conditions were haematologic malignancy/neutropenia (29.9%), haematopoietic stem cell transplantation (4.7%), diabetes mellitus (DM) (15.9%), other immunodeficiencies (23.4%), while 22.4% of cases involved immunocompetent individuals with cutaneous/soft-tissue infections after motor vehicle accident, surgical/iatrogenic trauma, burns, and injuries associated with natural disasters. Additionally, DM or steroid-induced DM was reported as a comorbidity in 21.5% of cases with various main conditions. Rhizopus (mostly R. arrhizus) predominated (67.1%), followed by Lichtheimia (8.5%) and Mucor (6.1%). Antifungal treatment consisted mainly of liposomal amphotericin B (86.3%), median dose 7 mg/kg/day, range 3–10 mg/kg/day, with or without posaconazole. Crude mortality was 62.8% during 2005–2008 but decreased significantly after 2009, at 34.9% (p = 0.02), with four times fewer haematological cases, fewer iatrogenic infections, and fewer cases with advanced rhinocerebral form. The increased DM prevalence should alert clinicians for timely diagnosis of mucormycosis in this patient population.
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Economopoulou P, Spathis A, Kotsantis I, Maratou E, Anastasiou M, Moutafi MK, Kirkasiadou M, Pantazopoulos A, Giannakakou M, Edelstein DL, Sloane H, Fredebohm J, Jones FS, Kyriazoglou A, Gavrielatou N, Foukas P, Panayiotides I, Psyrri A. Next-generation sequencing (NGS) profiling of matched tumor and circulating tumor DNA (ctDNA) in head and neck squamous cell carcinoma (HNSCC). Oral Oncol 2023; 139:106358. [PMID: 36871349 DOI: 10.1016/j.oraloncology.2023.106358] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES The aim of this pilot study was to evaluate the presence of somatic mutations in matched tumor and circulating DNA (ctDNA) samples from patients with primary head and neck squamous cell carcinoma (HNSCC) and assess the association of changes in ctDNA levels with survival. MATERIALS AND METHODS Our study included 62 patients with stage I-IVB HNSCC treated with surgery or radical chemoradiotherapy with curative intent. Plasma samples were obtained at baseline, at the end of treatment (EOT), and at disease progression. Tumor DNA was extracted from plasma (ctDNA) and tumor tissue (tDNA). The Safe Sequencing System was used assess the presence of pathogenic variants in four genes (TP53, CDKN2A, HRAS and PI3KCA) in both ctDNA and tDNA. RESULTS Forty-five patients had available tissue and plasma samples. Concordance of genotyping results between tDNA and ctDNA at baseline was 53.3%. TP53 mutations were most commonly identified at baseline in both ctDNA (32.6%) and tDNA (40%). The presence of mutations in this restricted set of 4 genes in tissue samples at baseline was associated with decreased overall survival (OS) [median 58.3 months for patients with mutations vs. 89 months for patients without mutations, p < 0.013]. Similarly, patients presenting with mutations in ctDNA had shorter OS [median 53.8 vs. 78.6 months, p < 0.037]. CtDNA clearance at EOT did not show any association with PFS or OS. CONCLUSIONS Liquid biopsy enables real-time molecular characterization of HNSCC and might predict survival. Larger studies are needed to validate the utility of ctDNA as a biomarker in HNSCC.
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Affiliation(s)
- Panagiota Economopoulou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Aris Spathis
- Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Ioannis Kotsantis
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Eirini Maratou
- Second Department of Internal Medicine and Research Institute, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Maria Anastasiou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Myrto K Moutafi
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Maria Kirkasiadou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Anastasios Pantazopoulos
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Maria Giannakakou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Daniel L Edelstein
- Medical Affairs, Sysmex Inostics Inc., 1812 Ashland Ave #500, Baltimore, MD 21205, USA
| | - Hillary Sloane
- Medical Affairs, Sysmex Inostics Inc., 1812 Ashland Ave #500, Baltimore, MD 21205, USA
| | - Johannes Fredebohm
- Research and Innovation, Sysmex Inostics GmbH, Alkenried 88, 20251 Hamburg, Germany.
| | - Frederick S Jones
- Research and Innovation, Sysmex Inostics GmbH, Alkenried 88, 20251 Hamburg, Germany.
| | - Anastasios Kyriazoglou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Niki Gavrielatou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece.
| | - Periklis Foukas
- Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Ioannis Panayiotides
- Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece
| | - Amanda Psyrri
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462 Haidari, Athens, Greece.
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Economopoulou P, Papanikolaou C, Spathis A, Kotsantis I, Gavrielatou N, Anastasiou M, Stellas D, Panayiotides I, Foukas P, Souliotis V, Psyrri A. 661MO Evaluation of the DNA damage response (DDR) network as predictor of nivolumab efficacy in head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.785] [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: 11/01/2022] Open
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Gavrielatou N, Anastasiou M, Fortis E, Gkotzamanidou M, Spathis A, Economopoulou P, Rusakiewicz S, Vagia EM, Panayiotides I, Coukos G, Foukas P, Psyrri A. P-78 Predictive biomarkers for response to nivolumab in head and neck squamous cell carcinoma (HNSCC) (NCT#03652142). Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00365-1] [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: 11/28/2022]
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Sgouros D, Rigopoulos D, Panayiotides I, Apalla Z, Arvanitis DK, Theofili M, Theotokoglou S, Syrmali A, Theodoropoulos K, Pappa G, Damaskou V, Stratigos A, Katoulis A. Novel Insights for Patients with Multiple Basal Cell Carcinomas and Tumors at High-Risk for Recurrence: Risk Factors, Clinical Morphology, and Dermatoscopy. Cancers (Basel) 2021; 13:3208. [PMID: 34198960 PMCID: PMC8269292 DOI: 10.3390/cancers13133208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Basal cell carcinoma (BCC) quite frequently presents as multiple tumors in individual patients. Neoplasm's risk factors for local recurrence have a critical impact on therapeutic management. OBJECTIVE To detect risk factors for multiple BCCs (mBCC) in individual patients and to describe clinical and dermatoscopic features of low- and high-risk tumors. MATERIALS & METHODS Our study included 225 patients with 304 surgically excised primary BCCs. All patients' medical history and demographics were recorded. Clinical and dermatoscopic images of BCCs were evaluated for predefined criteria and statistical analyses were performed. RESULTS Grade II-III sunburns before adulthood (OR 2.146, p = 0.031) and a personal history of BCC (OR 3.403, p < 0.001) were the major predisposing factors for mBCC. Clinically obvious white color (OR 3.168, p < 0.001) and dermatoscopic detection of white shiny lines (OR 2.085, p = 0.025) represented strongly prognostic variables of high-risk BCC. Similarly, extensive clinico-dermatoscopic ulceration (up to 9.2-fold) and nodular morphology (3.6-fold) raise the possibility for high-risk BCC. On the contrary, dermatoscopic evidence of blue-black coloration had a negative prognostic value for high-risk neoplasms (light OR 0.269, p < 0.001/partial OR 0.198, p = 0.001). CONCLUSIONS Profiling of mBCC patients and a thorough knowledge of high-risk tumors' clinico-dermatoscopic morphology could provide physicians with important information towards prevention of this neoplasm.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Ioannis Panayiotides
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Zoe Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, 54643 Thessaloniki, Greece;
| | - Dimitrios K. Arvanitis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Melpomeni Theofili
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Sofia Theotokoglou
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Anna Syrmali
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Konstantinos Theodoropoulos
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Georgia Pappa
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Vasileia Damaskou
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Alexander Katoulis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
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Kalogeraki A, Tamiolakis D, Moustou E, Panayiotides I, Yannopoulos A, Vakis A, Katzilakis N, Stiakaki E. Cerebrospinal fluid and intraoperative squash cytology of childhood ependymoma. Acta Biomed 2021; 92:e2021107. [PMID: 33988164 PMCID: PMC8182596 DOI: 10.23750/abm.v92i2.9996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022]
Abstract
Ependymomas are glial neoplasms of central nervous system originated from the ependymal lining of the brain ventricles and spinal cord central canal, and rarely exfoliated into cerebrospinal fluid (CSF). In this case we report the cytomorphological and immunocytomorphological features of ependymoma in CSF and intraoperative squash preparations, confirmed by histology.
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Sgouros D, Theofili M, Damaskou V, Theotokoglou S, Theodoropoulos K, Stratigos A, Theofilis P, Panayiotides I, Rigopoulos D, Katoulis A. Dermoscopy as a Tool in Differentiating Cutaneous Squamous Cell Carcinoma From Its Variants. Dermatol Pract Concept 2021; 11:e2021050. [PMID: 33954021 DOI: 10.5826/dpc.1102a50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background Dermoscopic features of cutaneous squamous cell carcinoma (cSCC) have been widely studied, but their accuracy should be further investigated. Objectives This study assessed the diagnostic accuracy of a set of predetermined dermoscopic structures for 3 variants of cSCC, namely Bowen disease, keratoacanthoma and invasive cSCC. Methods Dermoscopic images of 56 histopathologically confirmed cSCC lesions (9 Bowen disease lesions, 7 keratoacanthomas, and 40 invasive cSCCs) were examined, and the diagnostic accuracy of dermoscopic structures was assessed. Discriminative ability of statistically significant positive predictors was determined using receiver operating characteristic (ROC) curves, and defined as an area under the ROC curve >0.700. Results Dermoscopic structures with statistical significance and discriminative ability were: for Bowen disease, clustered glomerular vessels and erosions; for keratoacanthoma, a central keratin plug; and for invasive cSCC, a mixed color of the background. Clustered and glomerular vessels had, for Bowen disease, perfect diagnostic accuracy, with: sensitivity of 88.9% for both features; specificity of 97.9% and 93.6%, respectively; positive predictive value (PPV) of 88.9% and 72.7%, respectively; and negative predictive value (NPV) of 97.8% for both. Erosions had, for BD, high specificity (87.2%) and NPV (91.1%), but low sensitivity (55.6%) and PPV (45.5%). A central keratin plug had, for keratoacanthoma, high specificity (87.8%) and NPV (93.5%), but low sensitivity (57.1%) and PPV (40%). A mixed background color had, for invasive cSCC, high specificity (81.3%) and PPV (89.7%), but low sensitivity (65%) and NPV (48.2%). Conclusion Dermoscopy accurately differentiates BD, through clustered glomerular vessels, from keratoacanthoma and invasive cSCC. Dermoscopic structures of keratoacanthoma and invasive cSCC overlap, and only histopathologic analysis differentiates them precisely.
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Affiliation(s)
- Dimitrios Sgouros
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Melpomeni Theofili
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasileia Damaskou
- Second Department of Pathology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Sofia Theotokoglou
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Konstantinos Theodoropoulos
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexander Stratigos
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Theofilis
- Department of Internal Medicine, General Hospital of Nikaia Agios Panteleimon, Piraeus, Greece
| | - Ioannis Panayiotides
- Second Department of Pathology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Rigopoulos
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexander Katoulis
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Economopoulou P, Kotsantis I, Papaxoinis G, Gavrielatou N, Anastasiou M, Pantazopoulos A, Kavourakis G, Gkolfinopoulos S, Panayiotides I, Delides A, Psyrri A. Association of autoimmunity with survival in patients with recurrent/metastatic head and neck squamous cell carcinoma treated with nivolumab. Oral Oncol 2020; 111:105013. [PMID: 32977184 DOI: 10.1016/j.oraloncology.2020.105013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events (irAEs) that occur as a consequence of enhanced immune response due to T-cell activation. The objective of this retrospective study was to investigate the association between irAEs and disease outcome in patients with recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS This study included 89 patients with R/M HNSCC who were treated with nivolumab in our center from October 2015 to January 2020. Overall survival (OS) and post-progression survival (PPS) were calculated from the date of nivolumab initiation or from the date of progression on nivolumab respectively to the date of death or censored at the last date of follow up. RESULTS Twenty-four patients (27%) developed irAEs, with more common thyroiditis (N = 13, 14.6%). ORR did not differ between patients with irAEs (29.2%) and patients without irAEs (21.9%, p = 0.576). Median PFS was similar between the two groups (3.1 months for patients with irAEs vs. 2.6 months for patients without irAEs, p = 0.412). Median OS was significantly longer in patients with irAEs (17.9 vs. 6.3 months in patients without irAEs, log-rank p = 0.004). Additionally, median PPS was significantly improved in patients who developed irAEs (10.2 months vs. 2.8 months for patients without irAEs, log-rank p = 0.001). In multivariate analysis, the development of irAEs and response to nivolumab were shown to be independent prognostic factors for favorable OS and PPS. CONCLUSIONS The development of irAEs is a strong predictor of improved survival in patients with advanced HNSCC treated with nivolumab.
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Affiliation(s)
- Panagiota Economopoulou
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Ioannis Kotsantis
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - George Papaxoinis
- Second Department of Medical Oncology, Agios Savvas Anticancer Hospital, Athens, Greece
| | - Niki Gavrielatou
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Maria Anastasiou
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Anastasios Pantazopoulos
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - George Kavourakis
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Stavros Gkolfinopoulos
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Ioannis Panayiotides
- Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece
| | - Alexandros Delides
- Second Otolaryngology Department, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece.
| | - Amanda Psyrri
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 1(st) Rimini St, 12462, Haidari, Athens, Greece.
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11
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Katoulis AC, Mortaki D, Sgouros D, Liakou AI, Bozi E, Koumaki D, Tzima K, Panayiotides I. Lichen Planopilaris Developing at the Margins of a Sebaceous Nevus of Jadassohn: Co-existence or Etiologic Association? Indian J Dermatol 2020; 65:136-138. [PMID: 32180601 PMCID: PMC7059478 DOI: 10.4103/ijd.ijd_122_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Sebaceous nevus (SN), is a skin hamartoma, combining a variety of epidermal, follicular, sebaceous, and apocrine abnormalities. Although usually present at birth, it may become apparent later in life appearing as a yellowish-brown, verrucous plaque with alopecia. SN is implicated with secondary tumors arising on the hairless plaque during the adulthood. Lichen planopilaris is a common, primary lymphocytic scarring alopecia of unknown etiology, characterized by lichenoid/interface perifollicular lymphocytic infiltrate occurring at the level of the infundibulum and the isthmus. Here, we present a case of a 48-year-old Caucasian male with lichen planopilaris lesions developing at the periphery of a preexisting SN. Our case raises the question, whether the development of lichen planopilaris was coincidental, or is it indicative of an etiologic association between the lichen planopilaris and SN.
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Affiliation(s)
- Alexander C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Despina Mortaki
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Aikaterini I Liakou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Dimitra Koumaki
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Korina Tzima
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Ioannis Panayiotides
- Department of Pathology, National and Kapodistrian University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece
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12
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Liakea A, Tsagari E, Spathis A, Kampoli A, Durán Moreno J, Kefalidi E, Kapetanakis E, Kostopanagiotou K, Koumarianou A, Panayiotides I, Kavantzas N, Tomos P, Foukas P. Prognostic significance of elements of the adaptive immunity in the microenvironment of early-stage non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz258.012] [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: 11/12/2022] Open
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13
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Ntavatzikos A, Spathis A, Patapis P, Machairas N, Vourli G, Peros G, Papadopoulos I, Panayiotides I, Koumarianou A. TYMS/KRAS/BRAF molecular profiling predicts survival following adjuvant chemotherapy in colorectal cancer. World J Gastrointest Oncol 2019; 11:551-566. [PMID: 31367274 PMCID: PMC6657223 DOI: 10.4251/wjgo.v11.i7.551] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/30/2019] [Accepted: 06/12/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who may benefit from adjuvant chemotherapy. Molecular profiling could guide treatment decisions in these patients. Thymidylate synthase (TYMS) gene polymorphisms, KRAS and BRAF could be included in the molecular profile under consideration.
AIM To investigate the association of TYMS gene polymorphisms, KRAS and BRAF mutations with survival of CRC patients treated with chemotherapy.
METHODS A retrospective study studied formalin-fixed paraffin-embedded tissues (FFPEs) of consecutive patients treated with adjuvant chemotherapy during January/2005-January/2007. FFPEs were analysed with PCR for the detection of TYMS polymorphisms, mutated KRAS (mKRAS) and BRAF (mBRAF). Patients were classified into three groups (high, medium and low risk) according to 5’UTR TYMS polymorphisms Similarly, based on 3’UTR polymorphism ins/loss of heterozygosity (LOH) patients were allocated into two groups (high and low risk of relapse, respectively). Cox regression models examined the associated 5-year survival outcomes.
RESULTS One hundred and thirty patients with early stage CRC (stage I-II: 55 patients; stage III 75 patients; colon: 70 patients; rectal: 60 patients) were treated with surgery and chemotherapy. The 5-year disease free survival and overall survival rate was 61.6% and 73.9% respectively. 5’UTR polymorphisms of intermediate TYMS polymorphisms (2RG/3RG, 2RG/LOH, 3RC/LOH) were associated with lower risk for relapse [hazard ratio (HR) 0.320, P = 0.02 and HR 0.343, P = 0.013 respectively] and death (HR 0.368, P = 0.031 and HR 0.394, P = 0.029 respectively). The 3’UTR polymorphism ins/LOH was independently associated with increased risk for disease recurrence (P = 0.001) and death (P = 0.005). mBRAF (3.8% of patients) was associated with increased risk of death (HR 4.500, P = 0.022) whereas mKRAS (39% of patients) not.
CONCLUSION Prospective validating studies are required to confirm whether 2RG/3RG, 2RG/LOH, 3RC/LOH, absence of ins/LOH and wild type BRAF may indicate patients at lower risk of relapse following adjuvant chemotherapy.
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Affiliation(s)
- Anastasios Ntavatzikos
- Hematology-Oncology Unit, 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens 12462, Greece
| | - Aris Spathis
- Department of Cytopathology, National and Kapodistrian University of Athens, Medical School, “ATTIKON” University Hospital, Athens 12462, Greece
| | - Paul Patapis
- 3rd Department of Surgery, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens 12462, Greece
| | - Nikolaos Machairas
- 3rd Department of Surgery, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens 12462, Greece
| | - Georgia Vourli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - George Peros
- Department of Surgery, Medical School, National and Kapodistrian University of Athens, Evgenideio Therapeutirio S.A., “I AGIA TRIAS”, Athens 11528, Greece
| | - Iordanis Papadopoulos
- Department of Surgery, Medical School, National and Kapodistrian University of Athens, Evgenideio Therapeutirio S.A., “I AGIA TRIAS”, Athens 11528, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, University of Athens, Medical School, “ATTIKON” University Hospital, Athens 12462, Greece
| | - Anna Koumarianou
- Hematology-Oncology Unit, 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens 12462, Greece
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14
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Psyrri A, Gavrielatou N, Spathis A, Anastasiou M, Fortis E, Gkotzamanidou M, Kladi-Skandali A, Kousidou E, Economopoulou P, Kotsantis I, Rusakiewicz S, Vagia EM, Panayiotides I, Coukos G, Foukas P. Predictive biomarkers for response to nivolumab in head and neck squamous cell carcinoma (HNSCC) (NCT#03652142). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6060 Background: Tumor immune cell compositions determine response to immunotherapy. For a better understanding of the mechanisms of resistance to nivolumab in HNSCC, we sought to investigate a prospective cohort of longitudinal HNSCC samples from recurrent/metastatic HNSCC pts treated with nivolumab and identify biomarkers of response and resistance. We will specifically focus on modulation of immune markers following two cycles of nivolumab. Methods: Patients with platinum-refractory HNSCC with no contraindication to nivolumab therapy are included in this study. Tumor biopsies are performed at baseline, 24-72 hours after the second cycle and at progression with appropriate written informed consent. Samples were assessed for the presence of Tertiary Lymphoid Structures (TLS), PD-L1 expression (TPS and CPS) and CD8 T cell infiltrates combined with Ki67 (CD8/Ki67 double IHC stain). The primary outcome measure of the study is change in the percentage of immune cells in post treatment compared to baseline biopsies. Secondary endpoints include safety of performing a second biopsy, best overall response rate, biomarker expression in association with response and survival. Evaluation of other biomarkers including tumor mutational burden, HLA class I and II expression and adaptive immunity cell populations using multiplex IF is ongoing. Results: Of 20 patients evaluable for response, 14 had PD (8 of whom showed hyper-progression) and 6 attained disease control (1 with PR). PD-L1 status (CPS or TPS) was not altered by treatment (p = 0.905) and CPS > 20 pre-treatment showed a favorable trend towards response (p = 0.117). Absence of tertiary lymphoid structures was associated with disease progression (p = 0.0374). Infiltrating plasma cell count remained unchanged pre- and post-treatment and was unrelated to response (p = 0.458). The percentage of proliferating CD8+ T cells (CD8+/Ki67+) increased in post-treatment biopsies in the entire population (p = 0.022) and especially in progressors (p = 0.039). Pre-treatment CD8+ T cell density was higher in patients with hyper-progression compared to progressors (p = 0.029). Conclusions: Increased percentage of proliferating CD8+ T cells in progressors might represent dysfunctional T cells as has been recently shown in melanoma pts (Li H et al Cell 2019) and clinical efforts to reactivate intratumoral T cells may augment the efficacy of PD1 checkpoint inhibitors. Clinical trial information: NCT03652142.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - George Coukos
- University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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15
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Chrelias G, Pergialiotis V, Damaskou V, Parthenis C, Oikonomou M, Pappa V, Panayiotides I, Papantoniou N. Investigation of the potential association of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in postmenopausal patients with evidence of endometrial pathology. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.349] [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: 10/27/2022]
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16
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Pergialiotis V, Pouliakis A, Parthenis C, Damaskou V, Chrelias C, Papantoniou N, Panayiotides I. The utility of artificial neural networks and classification and regression trees for the prediction of endometrial cancer in postmenopausal women. Public Health 2018; 164:1-6. [DOI: 10.1016/j.puhe.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/23/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
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17
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Ntavatzikos A, Spathis A, Patapis P, Peros G, Panayiotides I, Papadopoulos I, Koumarianou A. Implications of thymidylate synthase gene polymorphisms, KRAS and BRAF mutations in the survival of patients with colorectal cancer treated with adjuvant chemotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.071] [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: 11/12/2022] Open
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18
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Pergialiotis V, Oikonomou M, Damaskou V, Kalantzis D, Chrelias C, Tsantes AE, Panayiotides I. Platelet to lymphocyte and neutrophil to lymphocyte ratio as predictive indices of endometrial carcinoma: Findings from a retrospective series of patients and meta-analysis. J Gynecol Obstet Hum Reprod 2018; 47:511-516. [PMID: 30153505 DOI: 10.1016/j.jogoh.2018.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/21/2018] [Accepted: 08/24/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND The purpose of the present study is to present new data concerning the diagnostic efficacy of neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios in detecting endometrial carcinoma and to summarize the existing knowledge by accumulating all the available data in the existing literature. MATERIALS AND METHODS We retrospectively identified patients with evidence of endometrial pathology (vaginal bleeding or increased endometrial thickness) that undergone dilatation and curettage. For the meta-analysis we used the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases to identify relevant articles in the field. RESULTS In our retrospective series we identified 106 women with endometrioid endometrial carcinoma and 72 controls. PLR and NLR values were comparable among the two groups (p>.05). Eleven studies were included in the present systematic review with a total of 4168 patients. The meta-analysis included 1013 patients. PLR values were not significantly different among the two groups. On the other hand, NLR was significantly raised among patients with endometrial carcinoma (MD 0.73, 95% CI 0.01, 1.45). CONCLUSION The findings of our meta-analysis support that NLR values are significantly elevated in patients with endometrial cancer compared to controls. Moreover, there seem to be evidence to support that both PLR and NLR values increase in patients with advanced stage disease, including positive lymph nodes, lymphovascular space involvement and distant metastases. Future studies are needed in this field to reach firm conclusions and these should specifically target patients with advanced stage disease.
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Affiliation(s)
- Vasilios Pergialiotis
- Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece.
| | - Maria Oikonomou
- Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - Vasileia Damaskou
- Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios Kalantzis
- Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Chrelias
- Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Panayiotides
- Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
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Katoulis AC, Diamanti K, Sgouros D, Liakou AI, Bozi E, Tzima K, Panayiotides I, Rigopoulos D. Frontal fibrosing alopecia: is the melanocyte of the upper hair follicle the antigenic target? Int J Dermatol 2018; 57:e37-e38. [PMID: 29732556 DOI: 10.1111/ijd.14021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/27/2018] [Accepted: 04/08/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Alexander C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Konstantina Diamanti
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Aikaterini I Liakou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Evaggelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Korina Tzima
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Dimitris Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
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20
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Katoulis A, Diamanti K, Sgouros D, Liakou A, Bozi E, Avgerinou G, Panayiotides I, Rigopoulos D. Is there a pathogenetic link between frontal fibrosing alopecia, androgenetic alopecia and fibrosing alopecia in a pattern distribution? J Eur Acad Dermatol Venereol 2018; 32:e218-e220. [DOI: 10.1111/jdv.14748] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- A.C. Katoulis
- 2nd Department of Dermatology and Venereology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - K. Diamanti
- 2nd Department of Dermatology and Venereology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - D. Sgouros
- 2nd Department of Dermatology and Venereology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - A.I. Liakou
- 2nd Department of Dermatology and Venereology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - E. Bozi
- 2nd Department of Dermatology and Venereology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - G. Avgerinou
- 1st Department of Dermatology and Venereology; University of Athens Medical School; ‘A. Syggros’ Hospital; Athens 16121 Greece
| | - I. Panayiotides
- 2nd Department of Pathology; University of Athens Medical School; Attikon Hospital; Athens 12462 Greece
| | - D. Rigopoulos
- 1st Department of Dermatology and Venereology; University of Athens Medical School; ‘A. Syggros’ Hospital; Athens 16121 Greece
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Margari N, Pouliakis A, Aninos D, Meristoudis C, Stamataki M, Panayiotides I, Karakitsos P. Internal quality control in an academic cytopathology laboratory for the introduction of a new reporting system for endometrial cytology. Diagn Cytopathol 2017; 45:883-888. [PMID: 28731534 DOI: 10.1002/dc.23787] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND To evaluate reproducibility of a reporting system for endometrial cytology. METHODS Cytologic slides from 49 patients, prepared via liquid based cytology, were blindly examined by five cytopathologists of various experience levels, applying a recently introduced reporting system as previously reported. The agreement among cytopathologists was evaluated via Kappa (κ) statistics and the Kendall's Coefficient of Variation (W); cytologic results were compared with the relevant histologic report. RESULTS Substantial agreement among all five raters was found in the benign, ACE-L and malignant categories, fair agreement in inadequate and ACE-H categories, whereas only slight agreement in ACE-U. For the three more experienced cytopathologists, an almost perfect agreement was found in inadequate, benign, and ACE-L categories, substantial agreement in ACE-H and malignant categories and fair agreement in ACE-U category. Overall agreement for all five cytopathologists and for all categories was moderate, whereas it was very high for the three senior raters. Using the Kendall's test, both five cytopathologists (W = 0.81) and the three senior ones (W = 0.93) had very high agreement. Sensitivity: 83.33-92.59%, specificity: 83.33-94.74%, ROC area: 71.72-90.3%. CONCLUSION Application of appropriate statistical tests shows that integration of a new reporting cytologic system is effective with an overall accuracy around 90%. Both statistical tests applied disclosed lower agreement rates among both all five raters and the three most experienced ones in the intermediate categories constituting the gray zone, thus delineating the need for better training of cytopathologists to correctly identify diagnostic criteria for classification of a given case into these categories.
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Affiliation(s)
- Niki Margari
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
| | - Abraham Pouliakis
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
| | - Dionysios Aninos
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
| | - Christos Meristoudis
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece.,Institute of Pathology, Aalborg University Hospital, Ladegardsgade 3, Aalborg, 9100, Denmark
| | - Magdalini Stamataki
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
| | - Petros Karakitsos
- Department of Cytopathology, National and Kapodistrian University of Athens, "Attikon", University Hospital, 1, Rimini street, Haidari, GR-12462, Athens, Greece
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Papanikolaou IS, Apostolopoulos P, Tziatzios G, Vlachou E, Sioulas AD, Polymeros D, Karameris A, Panayiotides I, Alexandrakis G, Dimitriadis GD, Triantafyllou K. Lower adenoma miss rate with FUSE vs. conventional colonoscopy with proximal retroflexion: a randomized back-to-back trial. Endoscopy 2017; 49:468-475. [PMID: 28107765 DOI: 10.1055/s-0042-124415] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background and study aims Full-spectrum colonoscopy (FSC) promises to increase adenoma detection by providing a wider field of view. The aim of this study was to compare adenoma miss rates of FSC with those of conventional colonoscopy complemented by right-colon re-examination using scope retroflexion (CC/R). Patients and methods At two tertiary endoscopy facilities, patients who were scheduled for colonoscopy for the assessment of symptoms or for colorectal cancer screening/surveillance were randomized (1:1) to undergo same-day, back-to-back colonoscopies (FSC or CC/R first), performed by one of five endoscopists who had documented adenoma detection rates > 35 %. Per-protocol data were analyzed. Results We randomized 220 patients. There were five FSC technical failures (three air pump and two left screen); therefore, 107 and 108 cases were analyzed in the FSC and CC/R index procedure arms, respectively. Withdrawal times were similar for FSC and CC/R (7.7 minutes vs. 7.6 minutes). Overall, we detected 3 cancers and 153 adenomas (FSC = 92; CC/R = 61); 81 were detected in the proximal colon, 3 of which were detected by retroflexed examination. By per-lesion analysis, FSC showed a significantly lower adenoma miss rate compared with CC/R overall (10.9 % [95 % confidence interval (CI) 3.8 to 18.1] vs. 33.7 % [95 %CI 23.4 to 44.1]) and in the proximal colon (13.9 % [95 %CI 2.6 to 25.2] vs. 42.2 % [95 %CI 27.8 to 56.7]). The advanced adenoma miss rate was lower with FSC overall (4.3 % [95 %CI - 4.0 to 12.7] vs. 25.9 % [95 %CI 9.4 to 42.5]). There were no adverse events. Conclusions FSC outperformed conventional colonoscopy with right-colon scope retroflexion in the detection of missed adenomas, both overall and in the proximal colon, even when performed by experienced endoscopists.Trial registered at ClinicalTrials.gov (NCT02117674).
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Affiliation(s)
- Ioannis S Papanikolaou
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - Georgios Tziatzios
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Erasmia Vlachou
- Department of Gastroenterology, 417 Army Veterans Hospital, Athens, Greece
| | - Athanasios D Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Dimitrios Polymeros
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - Ioannis Panayiotides
- Second Department of Pathology, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - George D Dimitriadis
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
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Leventakos K, Tsiodras S, Kelesidis T, Kefala M, Kottaridi C, Spathis A, Gouloumi AR, Pouliakis A, Pappas A, Sioulas V, Chrelias C, Karakitsos P, Panayiotides I. γH2Ax Expression as a Potential Biomarker Differentiating between Low and High Grade Cervical Squamous Intraepithelial Lesions (SIL) and High Risk HPV Related SIL. PLoS One 2017; 12:e0170626. [PMID: 28118377 PMCID: PMC5261776 DOI: 10.1371/journal.pone.0170626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/07/2017] [Indexed: 01/10/2023] Open
Abstract
Background γH2AX is a protein biomarker for double-stranded DNA breakage; its expression was studied in cervical squamous intraepithelial lesions and carcinomas. Methods Immunostaining for phospho-γH2AX was performed in sections from histologically confirmed cervical SIL and carcinomas, as well as from normal cervices used as controls. In total, 275 cases were included in the study: 112 low grade SIL (LGSIL), 99 high grade SIL (HGSIL), 24 squamous cell carcinoma (SCC), 12 adenocarcinoma and 28 cervical specimens with no essential lesions. Correlation of histological grading, high risk vs. low risk HPV virus presence, activated vs. non-activated status (by high risk HPV mRNA expression) and γH2AX expression in both basal and surface segments of the squamous epithelium was performed. Results Gradual increase of both basal and surface γH2AX expression was noted up from normal cervices to LGSIL harboring a low risk HPV type, to LGSIL harboring a high risk virus at a non-activated state (p<0.05). Thereafter, both basal and surface γH2AX expression dropped in LGSIL harboring a high risk virus at an activated state and in HGSIL. Conclusions γH2AX could serve as a potential biomarker discriminating between LGSIL and HGSIL, as well as between LGSIL harboring high risk HPV at an activated state.
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Affiliation(s)
- Konstantinos Leventakos
- 2 Department of Pathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- 4 Department of Internal Medicine, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Tsiodras
- 4 Department of Internal Medicine, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- * E-mail:
| | - Theodore Kelesidis
- 4 Department of Internal Medicine, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Kefala
- 2 Department of Pathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christine Kottaridi
- Department of Cytopathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aris Spathis
- Department of Cytopathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Alina-Roxani Gouloumi
- 2 Department of Pathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Abraham Pouliakis
- Department of Cytopathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Asimakis Pappas
- 3 Department of Obstetrics and Gynecology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Sioulas
- 3 Department of Obstetrics and Gynecology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Chrelias
- 3 Department of Obstetrics and Gynecology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Karakitsos
- Department of Cytopathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Panayiotides
- 2 Department of Pathology, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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24
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Papageorgiou SG, Tsiodras S, Siakallis G, Bazani E, Spathis A, Poulakou G, Korkolopoulou P, Panayiotides I, Pappa V. Epstein barr virus hemophagocytic lymphohistiocytosis related to rituximab use and immunopathogenetic insights. Pathol Res Pract 2016; 212:1194-1198. [DOI: 10.1016/j.prp.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/17/2016] [Accepted: 10/13/2016] [Indexed: 01/07/2023]
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Katoulis AC, Sgouros D, Argenziano G, Rallis E, Panayiotides I, Rigopoulos D. Surgical suturing-induced melanocytic nevi. A new type of eruptive melanocytic nevi? J Dermatol Case Rep 2016; 10:49-52. [PMID: 28400894 DOI: 10.3315/jdcr.2016.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Nevogenesis is a complex process involving several pathogenetic mechanisms, including genetic factors, hormonal influences and UV-radiation. Trauma has been described as a triggering factor for an alternative pathway of nevogenesis. Eruptive melanocytic nevi (EMN), related either to immunosuppression or to blistering disorders, represent a special type of nevi probably induced by the disruption of the dermo-epidermal junction and consequent proliferation of quiescent pigment cells during re-epithelization. MAIN OBSERVATIONS We report two patients with three melanocytic nevi that developed de novo along the direction of surgical suturing, following surgical operation for other reason. The lesions exhibited special dermoscopic characteristics and histology revealed features of acquired melanocytic nevi. CONCLUSIONS Such cases may represent a new type of eruptive nevus, the surgical suturing-induced nevus, which should be included in the differential diagnosis of new pigmentation developing within a scar.
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Affiliation(s)
- Alexander C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Giuseppe Argenziano
- Dermatology Unit, 2nd University of Naples, 43 Antonio Vivaldi str, 81100, Caserta CE, Naples, Italy
| | - Efstathios Rallis
- Department of Dermatology, Veterans Administration Hospital, 10 Monis Petraki str, 11521, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
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Katoulis AC, Diamanti K, Sgouros D, Liakou AI, Alevizou A, Bozi E, Damaskou V, Panayiotides I, Rigopoulos D. Frontal Fibrosing Alopecia and Vitiligo: Coexistence or True Association? Skin Appendage Disord 2016; 2:152-155. [PMID: 28232924 DOI: 10.1159/000452449] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/12/2016] [Indexed: 12/19/2022] Open
Abstract
Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia characterized by a progressive band-like recession of the frontotemporal hairline and frequent loss of the eyebrows. It predominantly affects postmenopausal women. Coexistence of FFA and vitiligo is rarely reported in the literature. We retrospectively studied 20 cases diagnosed with FFA in a 14-month period in our Department. Among them, there were 2 cases, a 72-year-old woman and a 48-year-old man, who developed FFA on preexisting vitiligo of the forehead. Anatomical colocalization of the two dermatoses supports the notion that a causal link may exist and their association may not be coincidental. We suggest that interrelated immunologic events and pathologic processes may underlie both these skin conditions.
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Affiliation(s)
- Alexandros C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Konstantina Diamanti
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Aikaterini I Liakou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Antigoni Alevizou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Vasileia Damaskou
- 2nd Department of Pathology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Dimitrios Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
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Panos Z, Giannopoulos G, Papangeli E, Antalis E, Pavli A, Spathis A, Poulakou G, Dimitriadis G, Panayiotides I, Boumpas D, Tsiodras S. Aseptic abscess syndrome associated with traveler's diarrhea after a trip to Malaysia. IDCases 2016; 6:23-5. [PMID: 27672562 PMCID: PMC5035335 DOI: 10.1016/j.idcr.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/11/2016] [Indexed: 11/20/2022] Open
Abstract
The first, to our knowledge, case of the aseptic abscesses syndrome as a complication of traveler’s diarrhea after a trip to Malaysia is presented. The patient failed to respond to several antimicrobials. The diagnosis was histologically confirmed and the patient only responded to immunomodulatory therapy with corticosteroids and methotrexate. Travel physicians should be aware of this entity reviewed herein in the context of traveler’s diarrhea.
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Affiliation(s)
- Zois Panos
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - George Giannopoulos
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Eymorfia Papangeli
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Emmanouil Antalis
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Androula Pavli
- Travel Medicine Office, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Aris Spathis
- Department of Cytopathology, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Garyfalia Poulakou
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - George Dimitriadis
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Dimitrios Boumpas
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Sotirios Tsiodras
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
- Corresponding author at: 4th Department of Internal Medicine University General Hospital “Attikon”, 1 Rimini street, Chaidari, Athens 12462, Greece.4th Department of Internal MedicineNational and Kapodistrian University of Athens School of MedicineUniversity General Hospital “Attikon”AthensGreece
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Margari N, Pouliakis A, Anoinos D, Terzakis E, Koureas N, Chrelias C, Marios Makris G, Pappas A, Bilirakis E, Goudeli C, Damaskou V, Papantoniou N, Panayiotides I, Karakitsos P. A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy. Diagn Cytopathol 2016; 44:888-901. [DOI: 10.1002/dc.23605] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/11/2016] [Accepted: 08/22/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Niki Margari
- Department of Cytopathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Abraham Pouliakis
- Department of Cytopathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Dionysios Anoinos
- Department of Cytopathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Emmanouil Terzakis
- 2nd Department of Gynecology; “Saint Savvas” Anticancer Hospital; Athens 11522 Greece
| | - Nikolaos Koureas
- 2nd Department of Gynecology; “Saint Savvas” Anticancer Hospital; Athens 11522 Greece
| | - Charalampos Chrelias
- 3rd Department of Obstetrics and Gynecology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - George Marios Makris
- 3rd Department of Obstetrics and Gynecology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Assimakis Pappas
- Department of Obstetrics and Gynecology, Division of Colposcopy; Mhtera Maternity Hospital; Athens Greece
| | - Evripidis Bilirakis
- 1st Department of Obstetrics and Gynecology; General Maternity District Hospital “Helena Venizelou,”; Athens 115 21 Greece
| | - Christina Goudeli
- 2nd Department of Gynecology; “Saint Savvas” Anticancer Hospital; Athens 11522 Greece
| | - Vasileia Damaskou
- 2nd Department of Pathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Nicolaos Papantoniou
- 3rd Department of Obstetrics and Gynecology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
| | - Petros Karakitsos
- Department of Cytopathology; National and Kapodistrian University of Athens, “ATTIKON” University Hospital; Athens 12462 Greece
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Goumenou A, Panayiotides I, Mahutte NG, Matalliotakis I, Fragouli Y, Arici A. Immunohistochemical Expression of p53, MDM2, and p21Wafi Oncoproteins in Endometriomas But Not Adenomyosis. ACTA ACUST UNITED AC 2016; 12:263-6. [PMID: 15866118 DOI: 10.1016/j.jsgi.2005.01.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 01/15/2023]
Abstract
OBJECTIVE p53, MDM2, and p21Waf1 are oncoproteins that regulate the cell cycle. The purpose of this study was to examine the distribution of p53, MDM2, and p21Waf1 oncoprotein expression in endometriomas and in adenomyosis. METHODS Tissue samples from 25 women with pathologically confirmed endometriomas and 31 women with pathologically confirmed adenomyosis were analyzed. Expression of p53, MDM2, and p21Waf1 oncoproteins was assessed by immunohistochemical nuclear staining. RESULTS p53, MDM2, and p21Waf1 expression were detected in 20%, 60%, and 80% of endometrioma tissue samples, respectively. All endometrioma tissue samples expressing p53 also tested positive for both MDM2 and p21Waf1. MDM2 expression was significantly higher in the proliferative than in the secretory phase of the cycle. In contrast, all 31 adenomyosis tissue samples were negative for p53, MDM2, and p21Waf1 expression. CONCLUSION The expression of p53, MDM2, and p21Waf1 suggests a role for these oncoproteins in the regulation of endometrioma cell growth, but not in adenomyosis.
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Affiliation(s)
- Anastasia Goumenou
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, Crete, Greece
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Prevezas C, Triantafyllopoulou I, Belyayeva H, Sgouros D, Konstantoudakis S, Panayiotides I, Rigopoulos D. Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants. Skin Appendage Disord 2016; 1:202-8. [PMID: 27386467 DOI: 10.1159/000445386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/09/2016] [Indexed: 11/19/2022] Open
Abstract
Onychomatricoma is a rare benign fibroepithelial filamentous tumor originating from the nail matrix. It typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate. The giant variant can easily confuse the clinician due to its extensive nail dystrophy that can mask the characteristic features of this tumor. Benign (fibrokeratoma, ungual fibroma, onycholytic matricoma) and malignant entities (Bowen's disease, squamous cell carcinoma, onycholytic carcinoma) are mimics of the disease. Nail surgery can facilitate the diagnosis, which should always be confirmed by histology, as rare variants do exist.
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Affiliation(s)
- Christos Prevezas
- Nail Disorders Unit, Second Department of Dermatology, Attikon University Hospital, Athens, Greece
| | | | - Helena Belyayeva
- Nail Disorders Unit, Second Department of Dermatology, Attikon University Hospital, Athens, Greece
| | - Dimitrios Sgouros
- Nail Disorders Unit, Second Department of Dermatology, Attikon University Hospital, Athens, Greece
| | | | | | - Dimitrios Rigopoulos
- Nail Disorders Unit, Second Department of Dermatology, Attikon University Hospital, Athens, Greece
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Drogari-Apiranthitou M, Panayiotides I, Galani I, Konstantoudakis S, Arvanitidis G, Spathis A, Gouloumi AR, Tsakiraki Z, Tsiodras S, Petrikkos G. Diagnostic value of a semi-nested PCR for the diagnosis of mucormycosis and aspergillosis from paraffin-embedded tissue: A single center experience. Pathol Res Pract 2016; 212:393-7. [PMID: 26874574 DOI: 10.1016/j.prp.2016.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/08/2015] [Accepted: 02/01/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The main aim of our study was to investigate the diagnostic value of a molecular method for the diagnosis of mucormycosis and aspergillosis from formalin-fixed and paraffin-embedded (FFPE) tissues. METHODS A retrospective chart review identified all cases with histology reports mentioning the presence of fungi with morphological characteristics of either Aspergillus or mucormycetes, for the period 2005-2012. Paraffin blocks were retrieved from the archives of the Department of Pathology. A semi-nested PCR specific for the detection of mucormycetes and Aspergillus species was applied in FFPE tissue from the above blocks. Results were compared with those of histological (gold standard) and microbiological methods. RESULTS Twenty cases with fungal hyphae in tissue were revealed. Mucormycetes were detected in 9 cases (45%) by PCR, in only 4 of which culture was available. Species of Aspergillus were detected in 8 cases (40%) by PCR, two of which were co-infection with mucormycetes. Five patients had other fungi, non-detectable with this specific PCR. At least one sample per patient was positive by PCR. Seven out of 30 samples tested overall were false negative. The calculated sensitivity of this method in our setting was 79.3% (95% CI: 60.3-91.9%); specificity was 100%. CONCLUSIONS The specific PCR used appears to be an easy and useful tool for the prompt and accurate diagnosis of mucormycosis and aspergillosis, in combination with histology and direct examination. Mucormycosis was more frequent than aspergillosis during the study period, highlighting the importance of continuous epidemiological surveillance of these serious infections.
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Affiliation(s)
- Maria Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4th Dept. of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece.
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Irene Galani
- Infectious Diseases Research Laboratory, 4th Dept. of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Stefanos Konstantoudakis
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Georgios Arvanitidis
- Infectious Diseases Research Laboratory, 4th Dept. of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Aris Spathis
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Alina-Roxani Gouloumi
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Zoi Tsakiraki
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - Sotirios Tsiodras
- Infectious Diseases Research Laboratory, 4th Dept. of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
| | - George Petrikkos
- Infectious Diseases Research Laboratory, 4th Dept. of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens, Greece
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Strilakou A, Perelas A, Lazaris A, Papavdi A, Karkalousos P, Giannopoulou I, Kriebardis A, Panayiotides I, Liapi C. Immunohistochemical determination of the extracellular matrix modulation in a rat model of choline-deprived myocardium: the effects of carnitine. Fundam Clin Pharmacol 2015; 30:47-57. [PMID: 26501493 DOI: 10.1111/fcp.12163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 09/06/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022]
Abstract
Choline has been identified as an essential nutrient with crucial role in many vital biological functions. Recent studies have demonstrated that heart dysfunction can develop in the setting of choline deprivation even in the absence of underlying heart disease. Matrix metalloproteinases (MMPs) are responsible for extracellular matrix degradation, and the dysregulation of MMP-2 and MMP-9 has been involved in the pathogenesis of various cardiovascular disorders. The aim of the study was to investigate the role of MMPs and their inhibitors (TIMPs), in the pathogenesis of choline deficiency-induced cardiomyopathy, and the way they are affected by carnitine supplementation. Male Wistar Albino adult rats were divided into four groups and received standard or choline-deficient diet with or without L-carnitine in drinking water (0.15% w/v) for 1 month. Heart tissue immunohistochemistry for MMP-2, MMP-9, TIMP-1, and TIMP-2 was performed. Choline deficiency was associated with suppressed immunohistochemical expression of MMP-2 and an increased expression of TIMP-2 compared to control, while it had no impact on TIMP-1. MMP-9 expression was decreased without, however, reaching statistical significance. Carnitine did not affect MMP-2, MMP-9, TIMP-1 or TIMP-2 expression. The pattern of TIMP and MMP modulation observed in a choline deficiency setting appears to promote fibrosis. Carnitine, although shown to suppress fibrosis, does not seem to affect MMP-2, MMP-9, TIMP-1 or TIMP-2 expression. Further studies will be required to identify the mechanism underlying the beneficial effects of carnitine.
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Affiliation(s)
- Athina Strilakou
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Apostolos Perelas
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Andreas Lazaris
- 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Asteria Papavdi
- 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Petros Karkalousos
- Department of Medical Laboratories, Technological Institute of Athens, Agiou Spyridonos and Dimitsanas Street, Egaleo, 12210, Athens, Greece
| | - Ioanna Giannopoulou
- 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Anastasios Kriebardis
- Department of Medical Laboratories, Technological Institute of Athens, Agiou Spyridonos and Dimitsanas Street, Egaleo, 12210, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, 1Rimini Street, Chaidari, 12462, Athens, Greece
| | - Charis Liapi
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527, Athens, Greece
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Chatzinasiou F, Papadavid E, Korkolopoulou P, Levidou G, Panayiotides I, Theodoropoulos K, Pogka V, Asimakopoulos C, Rigopoulos D. An unusual case of diffuse Merkel cell carcinoma successfully treated with low dose radiotherapy. Dermatol Ther 2015; 28:282-6. [DOI: 10.1111/dth.12238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Euaggelia Papadavid
- 2 Department of Dermatology; Attikon General University Hospital; Athens Greece
| | - Penelope Korkolopoulou
- Department of Pathology; Laikon General Hospital, National and Kapodistrian University; Athens Greece
| | - Georgia Levidou
- Department of Pathology; Laikon General Hospital, National and Kapodistrian University; Athens Greece
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Koumaki D, Papadavid E, Panayiotides I, Shtukkert E, Dinopoulos A, Rigopoulos D. Henoch‐Schönlein Purpura in a child induced by Valproic Acid. Clin Transl Allergy 2015. [PMCID: PMC4400919 DOI: 10.1186/2045-7022-5-s1-p15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dimitra Koumaki
- University of Athens Medical School“Attikon” University Hospital2nd Department of Dermatology and VenereologyHaidariAthensGreece
| | - Evangelia Papadavid
- University of Athens Medical School“Attikon” University Hospital2nd Department of Dermatology and VenereologyHaidariAthensGreece
| | - Ioannis Panayiotides
- University of Athens Medical School2nd Department of PathologyHaidariAthensGreece
| | - Ekaterina Shtukkert
- Medical School University of Athens“Attikon” General Hospital3rd Department of PaediatricsHaidariAthensGreece
| | - Argyrios Dinopoulos
- Medical School University of Athens“Attikon” General Hospital3rd Department of PaediatricsHaidariAthensGreece
| | - Dimitrios Rigopoulos
- University of Athens Medical School“Attikon” University Hospital2nd Department of Dermatology and VenereologyHaidariAthensGreece
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Kouloulias V, Tolia M, Tsoukalas N, Papaloucas C, Pistevou-Gombaki K, Zygogianni A, Mystakidou K, Kouvaris J, Papaloucas M, Psyrri A, Kyrgias G, Gennimata V, Leventakos K, Panayiotides I, Liakouli Z, Kelekis N, Papaloucas A. Is there any Potential Clinical Impact of Serum Phosphorus and Magnesium in Patients with Lung Cancer at First Diagnosis? A Multi-institutional Study. Asian Pac J Cancer Prev 2015; 16:77-81. [DOI: 10.7314/apjcp.2015.16.1.77] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zygouris D, Pouliakis A, Margari N, Chrelias C, Terzakis E, Koureas N, Panayiotides I, Karakitsos P. Classification of endometrial lesions by nuclear morphometry features extracted from liquid-based cytology samples: a system based on logistic regression model. Anal Quant Cytopathol Histpathol 2014; 36:189-198. [PMID: 25291856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To investigate the potential of a computerized system for the discrimination of benign from malignant endometrial nuclei and lesions. STUDY DESIGN A total of 228 histologically confirmed liquid-based cytological smears were collected: 117 within normal limits cases, 66 malignant cases, 37 hyperplasias without atypia, and 8 cases of hyperplasia with atypia. From each case we extracted nuclear morphometric features from about 100 nuclei using a custom image analysis system. Initially we performed feature selection, and subsequently we applied a logistic regression model that classified each nucleus as benign or malignant. Based on the results of the nucleus classification process, we constructed an algorithm to discriminate endometrium cases as benign or malignant. RESULTS The proposed system had an overall accuracy for the classification of endometrial nuclei equal to 83.02%, specificity of 85.09%, and sensitivity of 77.01%. For the case classification the overall accuracy was 92.98%, specificity was 92.86%, and sensitivity was 93.24%. CONCLUSION The proposed computerized system can be applied for the classification of endometrial nuclei and lesions as it outperformed the standard cytological diagnosis. This study highlights interesting diagnostic features of endometrial nuclear morphology, and the proposed method can be a useful tool in the everyday practice of the cytological laboratory.
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Bountris P, Haritou M, Pouliakis A, Margari N, Kyrgiou M, Spathis A, Pappas A, Panayiotides I, Paraskevaidis EA, Karakitsos P, Koutsouris DD. An intelligent clinical decision support system for patient-specific predictions to improve cervical intraepithelial neoplasia detection. Biomed Res Int 2014; 2014:341483. [PMID: 24812614 PMCID: PMC4000928 DOI: 10.1155/2014/341483] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 02/10/2014] [Accepted: 03/16/2014] [Indexed: 12/24/2022]
Abstract
Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV), including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS), composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%), high specificity (97.1%), high positive predictive value (89.4%), and high negative predictive value (97.1%), for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.
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Affiliation(s)
- Panagiotis Bountris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Iroon Politechniou 9, 15773 Zografou Campus, Athens, Greece
| | - Maria Haritou
- Institute of Communication and Computer Systems, National Technical University of Athens, Iroon Politechniou 9, 15773 Zografou Campus, Athens, Greece
| | - Abraham Pouliakis
- Department of Cytopathology, School of Medicine, University General Hospital “ATTIKON”, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Niki Margari
- Department of Cytopathology, School of Medicine, University General Hospital “ATTIKON”, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Maria Kyrgiou
- West London Gynaecological Cancer Center, Queen Charlotte's and Chelsea, Hammersmith Hospital, Imperial Healthcare NHS Trust, London W12 0HS, UK
- Division of Surgery and Cancer, Faculty of Medicine, Imperial College, London W12 0NN, UK
| | - Aris Spathis
- Department of Cytopathology, School of Medicine, University General Hospital “ATTIKON”, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Asimakis Pappas
- 3rd Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, School of Medicine, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, University General Hospital “ATTIKON”, School of Medicine, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Evangelos A. Paraskevaidis
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, St. Niarchou Str, 45500 Ioannina, Greece
| | - Petros Karakitsos
- Department of Cytopathology, School of Medicine, University General Hospital “ATTIKON”, University of Athens, Rimini 1, 12462 Athens, Greece
| | - Dimitrios-Dionyssios Koutsouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Iroon Politechniou 9, 15773 Zografou Campus, Athens, Greece
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Papadavid E, Panayiotides I, Dalamaga M, Giatrakou S, Stavrianeas N, Rigopoulos D, Makris M. Reply to: Pityriasis rosea and pityriasis rosea-like eruptions. J Am Acad Dermatol 2013; 70:196-7. [PMID: 24355267 DOI: 10.1016/j.jaad.2013.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 09/14/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Evangelia Papadavid
- Second Department of Dermatology and Allergy Unit D Kalogeromitros, Athens University Medical School, Attikon University General Hospital, Athens, Greece.
| | - Ioannis Panayiotides
- Second Department of Pathology, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Maria Dalamaga
- Department of Clinical Biochemistry, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Sophia Giatrakou
- Second Department of Dermatology and Allergy Unit D Kalogeromitros, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Stavrianeas
- Second Department of Dermatology and Allergy Unit D Kalogeromitros, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Dimitrios Rigopoulos
- Second Department of Dermatology and Allergy Unit D Kalogeromitros, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Michael Makris
- Second Department of Dermatology and Allergy Unit D Kalogeromitros, Athens University Medical School, Attikon University General Hospital, Athens, Greece
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Pouliakis A, Margari C, Margari N, Chrelias C, Zygouris D, Meristoudis C, Panayiotides I, Karakitsos P. Using classification and regression trees, liquid-based cytology and nuclear morphometry for the discrimination of endometrial lesions. Diagn Cytopathol 2013; 42:582-91. [DOI: 10.1002/dc.23077] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 10/29/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Abraham Pouliakis
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | | | - Niki Margari
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Charalampos Chrelias
- 3rd Department of Obstetrics and Gynecology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Dimitrios Zygouris
- 3rd Department of Obstetrics and Gynecology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Christos Meristoudis
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Petros Karakitsos
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
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40
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Katoulis AC, Kanelleas A, Tzima K, Sgouros D, Tsigri A, Rigopoulos D, Panayiotides I. Clinico-epidemiological data on non-melanoma skin cancer in Greece: 5-year experience (2005-2009) in a tertiary referral center. Int J Dermatol 2013; 53:e307-9. [PMID: 24134833 DOI: 10.1111/ijd.12273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alexander C Katoulis
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School "Attikon" General University Hospital, Athens, Greece
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Mastorakis E, Meristoudis C, Margari N, Pouliakis A, Leventakos K, Chroniaris N, Panayiotides I, Karakitsos P. Fine needle aspiration cytology of nodular thyroid lesions: a 2-year experience of the Bethesda system for reporting thyroid cytopathology in a large regional and a university hospital, with histological correlation. Cytopathology 2013; 25:120-8. [PMID: 23551656 DOI: 10.1111/cyt.12062] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Thyroid fine needle aspiration (FNA) contributes to the appropriate management of nodular thyroid lesions. The introduced categories in the Bethesda system for reporting thyroid cytopathology (TBSRTC) are associated with an implied cancer risk, providing a clinical management guideline. This study aims to evaluate the reproducibility of this implied risk and to compare the results from two different cytopathology departments. METHODS Five hundred histologically confirmed FNAs, studied since the introduction of TBSRTC, were obtained from 4208 and 3587 FNAs performed in a large regional hospital in Herakleion, Crete (group A) and a university hospital in Athens (group B), respectively. Reports were issued according to TBSRTC. Aspirates were prepared with ThinPrep(®) and evaluated by two experienced cytopathologists. The reproducibility and accuracy were evaluated. RESULTS The proportion test for suspicious for malignancy (SFM) and malignant (M) cytology reports (P < 0.0001), and the number of malignancies on histology (P < 0.0001), were significantly higher in group A than in group B, consistent with a higher incidence of thyroid carcinomas in southern Greece. Although the malignancy rates were higher in group A than in group B for all categories, except M (A, 99.3%; B, 100%), the difference was only significant for benign aspirates (P = 0.0303). Malignancy rates for all categories in group A were above the TBSRTC recommended range, but were consistent with an increased prevalence of malignancy in that centre, differences in reporting practice and the variable ranges reported in the literature. There was lower sensitivity (P = 0.019) and overall accuracy (P = 0.003) in group A relative to group B, but no difference in specificity. CONCLUSIONS TBSRTC provides valuable information for the appropriate management of nodular thyroid lesions, both in a university and a large regional hospital.
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Affiliation(s)
- E Mastorakis
- Department of Cytopathology, Venizeleion-Pananeion' General Hospital, Herakleion, Greece
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42
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Diamantopoulou S, Spathis A, Chranioti A, Anninos D, Stamataki M, Chrelias C, Pappas A, Panayiotides I, Karakitsos P. Liquid based cytology and HPV DNA testing in a Greek population compared to colposcopy and histology. CLIN EXP OBSTET GYN 2013; 40:131-136. [PMID: 23724527] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Screening for cervical cancer in Greece is still unorganised and based on self- motivation. The purpose of this study was to evaluate the accuracy of cytological findings from a large observational population sample, originating from Western Athens, in association with reflex DNA test, colposcopic estimation, and final histologic diagnosis. The rate of invasive carcinoma, both squamous cell and adenocarcinoma, is indicative of a largely unscreened population. In this study, the estimated overall prevalence of human papilloma virus (HPV) was 41.1%, with HPV positivity at 37.4% of cytologically normal women. HPV testing did not seem to improve sensitivity of cytology for atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LGSIL) cases in identifying CIN 2+ lesions, but outperformed cytology in detecting CIN3+ for cytological high-grade squamous intraepithelial lesion (HGSIL) cases. For HGSIL cases sensitivity of colposcopy for detecting CIN3+ was comparable to cytology.
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Affiliation(s)
- S Diamantopoulou
- Third Department of Obstetrics and Gynaecology, University General Hospital ATTIKON, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Chranioti A, Spathis A, Aga E, Meristoudis C, Pappas A, Panayiotides I, Karakitsos P. Comparison of two commercially available methods for HPV genotyping: CLART HPV2 and Linear Array HPV Genotyping tests. Anal Quant Cytopathol Histpathol 2012; 34:257-263. [PMID: 23301385] [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: 06/01/2023]
Abstract
OBJECTIVE To compare the clinical efficiency of two commercially available HPV DNA detection and typing tests. The CLART HPV2 test, a novel HPV test based on DNA microarrays that can identify 35 HPV genotypes, was compared to the Linear Array HPV Genotyping (LA) test, a more widely used test able to identify 37 HPV genotypes. STUDY DESIGN The CLART test was evaluated by comparing the genotyping results of 538 ThinPrep Pap tests with the LA test as well as with the cytological and histological findings. RESULTS The exact same types and results were identified in 86.1% of the samples (kappa = 0.74). The tests showed excellent agreement in HPV positivity and identification of single and multiple infections (concordance rate 88.7%, kappa = 0.827). CONCLUSION The CLART test demonstrated results comparable to those of the LA test in clinical sensitivity as measured by the positive predictive value of CIN2+ in ASCUS (67.3% vs. 57.1%), while overall it exhibited higher sensitivity, specificity, positive and negative predictive values and area under curves than the LA test in all cytological and histological subgroups analyzed.
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Affiliation(s)
- Aikaterini Chranioti
- Department of Cytopathology, School of Medicine, National and Kapodistrian University of Athens, University General Hospital Attikon, Rimini, Chaidari, Athens, Greece
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Lytras D, Foukas P, Leontara V, Kefala M, Giannakou N, Dervenis C, Panayiotides I, Karakitsos P. 407. Is Endoglin (CD105) a Superior Marker for Assessment of Microvessel Density in Pancreatic Adenocarcinoma? Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.373] [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: 10/27/2022] Open
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45
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Tsilalis T, Archondakis S, Meristoudis C, Margari N, Pouliakis A, Skagias L, Panayiotides I, Karakitsos P. Assessment of Static Telecytological Diagnoses' Reproducibility in Cervical Smears Prepared by Means of Liquid-Based Cytology. Telemed J E Health 2012; 18:516-20. [DOI: 10.1089/tmj.2011.0167] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thomas Tsilalis
- Department of Cytopathology, 401 General Army Hospital, Athens, Greece
| | | | - Christos Meristoudis
- Department of Cytopathology, “ATTIKON” University General Hospital, Athens, Greece
| | - Niki Margari
- Department of Cytopathology, “ATTIKON” University General Hospital, Athens, Greece
| | - Abraham Pouliakis
- Department of Cytopathology, “ATTIKON” University General Hospital, Athens, Greece
| | - Lazaros Skagias
- Department of Cytopathology, 401 General Army Hospital, Athens, Greece
| | - Ioannis Panayiotides
- Department of Histopathology, “ATTIKON” University General Hospital, Athens, Greece
| | - Petros Karakitsos
- Department of Cytopathology, “ATTIKON” University General Hospital, Athens, Greece
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Koliopoulos G, Chrelias C, Pappas A, Makridima S, Kountouris E, Alepaki M, Spathis A, Stathopoulou V, Panayiotides I, Panagopoulos P, Karakitsos P, Kassanos D. The diagnostic accuracy of two methods for E6&7 mRNA detection in women with minor cytological abnormalities. Acta Obstet Gynecol Scand 2012; 91:794-801. [PMID: 22486415 DOI: 10.1111/j.1600-0412.2012.01414.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the diagnostic accuracy of nucleic acid sequence based amplification (NASBA) and flow cytometry for E6&7 human papillomavirus (HPV) mRNA detection in the triage of minor cytological abnormalities. DESIGN Prospective diagnostic accuracy study. SETTING Gynecology outpatient clinics of a university hospital. POPULATION 472 women with low-grade squamous intraepithelial lesion (LSIL) or atypical squamous cells of undetermined significance (ASCUS). METHODS Residual material of the liquid-based smears was tested by NASBA and by flow cytometry for E6&E7 mRNA expression. Histological diagnosis was used as reference standard. MAIN OUTCOME MEASURES Accuracy indices of the two techniques and of type 16-specific NASBA for the detection of cervical intraepithelial neoplasia (CIN) 2+ and CIN3+, accuracy indices at age >35 years, correlation between NASBA and flow, comparison between integrated and episomal high-risk HPV infection for risk of CIN2+. RESULTS Both tests showed increased positivity rates with increasing severity of the lesion (p < 0.05, chi-squared test for trend). There was a positive correlation between NASBA and flow results (phi coefficient = 0.325). NASBA-positive cases were more likely to have CIN2+ than were NASBA-negative/DNA-positive for types 16, 18, 31, 33, 45 (25/73 vs. 4/52, p= 0.0004; Fisher's exact test). In the LSIL group the NASBA accuracy indices for CIN3+ were: sensitivity 75%, specificity 78.7% and positivity rate 20.8%, and for flow 77.8%, 64.5% and 35.9%, respectively. CONCLUSIONS NASBA has favorable specificity and positivity rates for triaging LSIL prior to colposcopy. A relatively low sensitivity warrants cytological surveillance of the NASBA-negative LSILs. Flow cytometry does not perform as well overall.
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Affiliation(s)
- George Koliopoulos
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, Athens, Greece.
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Tsiodras S, Drogari-Apiranthitou M, Pilichos K, Leventakos K, Kelesidis T, Buitrago MJ, Petrikkos G, Panayiotides I. An unusual cutaneous tumor: African histoplasmosis following mudbaths: case report and review. Am J Trop Med Hyg 2012; 86:261-3. [PMID: 22302860 DOI: 10.4269/ajtmh.2012.11-0557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
African histoplasmosis, caused by Histoplasma capsulatum var. duboisii, is endemic in Africa. The disease usually involves the skin, subcutaneous tissue, and bones. A case of African histoplasmosis presenting as a cutaneous tumor and non-healing wound in a 66-year-old immunocompetent male residing in Africa, the first ever reported following mudbaths and acupuncture, is hereby reported. Diagnosis was confirmed by means of polymerase chain reaction performed on tissue material. The patient was started on long-term itraconazole therapy and he responded well. African histoplasmosis should be included in the differential diagnosis of non-healing wounds or tumor-like lesions, especially in the context of mudbaths in an endemic area.
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Affiliation(s)
- Sotirios Tsiodras
- 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
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Tsapralis D, Panayiotides I, Peros G, Liakakos T, Karamitopoulou E. Human epidermal growth factor receptor-2 gene amplification in gastric cancer using tissue microarray technology. World J Gastroenterol 2012; 18:150-5. [PMID: 22253521 PMCID: PMC3257442 DOI: 10.3748/wjg.v18.i2.150] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 07/06/2011] [Accepted: 07/13/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess human epidermal growth factor receptor-2 (HER2)-status in gastric cancer and matched lymph node metastases by immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH).
METHODS: 120 cases of primary gastric carcinomas and 45 matched lymph node metastases from patients with full clinicopathological features were mounted onto multiple-punch and single-punch tissue microarrays, respectively, and examined for HER2 overexpression and gene amplification by IHC and CISH.
RESULTS: Twenty-four tumors (20%) expressed HER2 immunohistochemically. An IHC score of ≥ 2+ was observed in 20 tumors (16.6%). HER2 amplification was detected by CISH in 19 tumors (15.8%) and in their matched lymph node metastases. A high concordance rate was found between HER2 positivity (as detected by IHC) and HER2 gene amplification (as detected by CISH), since 19 of the 20 IHC positive cases were amplified (95%). All amplified cases had 2+ or 3+ IHC results. Amplification was associated with intestinal phenotype (P < 0.05). No association with grading, staging or survival was found.
CONCLUSION: In gastric cancer, HER2 amplification is the main mechanism for HER2 protein overexpression and is preserved in lymph node metastases.
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Triantafyllidi H, Papadakis J, Brountzos E, Arvaniti C, Theodoropoulos K, Panayiotides I, Georgakopoulos A, Tzanela M, Vassilatou E, Lekakis J, Anastasiou-Nana M. Neurofibromatosis type 1 and renal artery aneurysms: an uncommon entity of severe hypertension. Hellenic J Cardiol 2012; 53:80-86. [PMID: 22275749] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Neurofibromatosis (NF1) is a relatively common autosomal dominant disorder. Secondary causes of hypertension, such as renovascular disease, coarctation of the abdominal aorta or phaeochromocytoma, may be identified in up to 1% of patients with NF1. Usually, renal angiography, which is always used to confirm the diagnosis of renovascular hypertension, reveals stenoses and rarely bilateral or unilateral renal artery aneurysms. We present the first description of a percutaneous transluminal renal angioplasty performed in an adult female patient with NF1, severe hypertensive disease and renal artery aneurysms, in order to restore renal artery anatomy and treat renovascular hypertension.
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Affiliation(s)
- Helen Triantafyllidi
- Second Department of Cardiology, Medical School, University of Athens, ATTIKON Hospital, Athens, Greece.
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Kottaridi C, Tsiodras S, Spathis A, Chranioti A, Pappas A, Kassanos D, Panayiotides I, Karakitsos P. Clinical performance of human papillomavirus E6, E7 mRNA flow cytometric assay compared to human papillomavirus DNA typing. Anal Quant Cytol Histol 2011; 33:305-310. [PMID: 22590807] [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: 05/31/2023]
Abstract
OBJECTIVE To use flow cytometry to screen cervical samples for the overexpression of human papillomavirus (HPV) E6 and E7 mRNA and compare the performance of this assay with an HPV DNA array for the detection of high-grade cervical lesions. STUDY DESIGN Cervical samples were analyzed for HPV DNA by clinical arrays, and the overexpression of E6 and E7 viral oncogenes was monitored using an HPV mRNA detection kit that quantifies the intracellular HPV E6 and E7 mRNA on a cell-by-cell basis. RESULTS HPV positivity increased with severity of histologic lesions. On the basis of histology-confirmed CIN 2+ cases the specificity of HPV assay was 73.9% (95% CI 66.07, 80.88), whereas it was 39.3% (95% CI 31.85, 47.1) for the DNA assay. CONCLUSION The HPV assay provides an early predictor of persistent HPV infection and may improve cervical cancer screening by increasing the specificity of detecting high-grade lesions.
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Affiliation(s)
- Christine Kottaridi
- Department of Cytopathology, Attikon University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Chaidari, Athens, Greece.
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