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Diebold M, Soltermann A, Hottinger S, Haile SR, Bubendorf L, Komminoth P, Jochum W, Grobholz R, Theegarten D, Berezowska S, Darwiche K, Oezkan F, Kohler M, Franzen DP. Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study. Respir Res 2017; 18:210. [PMID: 29246159 PMCID: PMC5732426 DOI: 10.1186/s12931-017-0693-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 08/23/2017] [Accepted: 12/04/2017] [Indexed: 01/01/2023] Open
Abstract
Background Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10–25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators. Methods In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologically proven SFTP which had been surgically resected between 2000 und 2015. After systematic and extensive IHC staining on tissue microarrays, the results were analyzed and compared to histomorphological and clinical data for their possible prognostic value. Results In total, 78 patients (mean age 61 ± 11 years) were included. Of these, 9 patients (11%) had an adverse outcome including SFTP recurrence (n = 6) or SFTP-related death (n = 3). Mean overall survival was 172 ± 13 months. 1 and 10-year event-free survival rates were 99% and 93%. In the multivariable analysis only MIB-1 proliferation index (Ki-67) ≥10% (HR 12.3, CI 1.1–139.5, p = 0.043), ≥4 mitoses per 10 high power fields (HR 36.5, CI 1.2–1103.7, p = 0.039) and tumor size larger than 10 cm (HR 81.8, CI 1.7–4016.8, p = 0.027) were independently associated with adverse outcome. Conclusion A high proliferation rate by MIB-1 IHC was associated with impaired outcome. Upon this, we established a new score using mitosis, necrosis, size of the tumor and MIB-1, which performed better than the traditional scores in our data set. This prognostic score could help to better evaluate outcome of SFTP, but requires external validation.
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Affiliation(s)
- Matthias Diebold
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
| | - Alex Soltermann
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Selma Hottinger
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Sarah R Haile
- Institute of Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
| | - Lukas Bubendorf
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Paul Komminoth
- Institute of Pathology, Triemli City Hospital, Zurich, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Rainer Grobholz
- Department of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Dirk Theegarten
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Kaid Darwiche
- Department of Interventional Pulmonology, Ruhrlandklinik, University Hospital Essen, Essen, Germany
| | - Filiz Oezkan
- Department of Interventional Pulmonology, Ruhrlandklinik, University Hospital Essen, Essen, Germany.,James Thoracic Oncology Center, Ohio State University, Columbus, OH, USA
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Daniel P Franzen
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
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Brock M, Hottinger S, Diebold M, Soltermann A, Jochum W, Kohler M, Huber LC, Franzen DP. Low tissue levels of miR-125b predict malignancy in solitary fibrous tumors of the pleura. Respir Res 2017; 18:43. [PMID: 28253927 PMCID: PMC5335791 DOI: 10.1186/s12931-017-0528-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/24/2017] [Indexed: 12/14/2022] Open
Abstract
Background Solitary fibrous tumors of the pleura (SFTP) are rare neoplasia of the chest. A subset of SFTP follows a malignant course, sometimes several years after complete resection. Traditional scoring systems based on clinical and histological features are poor predictors of biological behavior. This study aimed to investigate tumor-associated miRNAs expression as novel biomarkers to predict the clinical behavior of SFTP. Methods Formalin-fixed and paraffin-embedded SFTP tissues blocks from patients surgically resected between 1992 and 2013 at two tertiary care teaching hospitals were included. SFTP tumors were categorized as either malignant or benign variants according to the WHO classification. Following miRNAs levels were measured: let-7a, miR-16b, miR-17, miR-21, miR-31, miR-34a, miR-92a, miR-125a, miR-125b, miR-195-5b, miR-203a, and miR-223. Differential gene expressions which were calculated with the threshold cycle (Ct) method were compared among the two variants. Results Thirty-eight patients (40% male, mean age 62.2 (±10.9) years) were included. Expression levels of miR-125b showed a significant difference between benign compared to malignant variants (−3.08 ± 0.93 vs. -2.22 ± 1.36, p = 0.0068). Furthermore, lower levels of miR-125b were found to be associated with increased tumor size (p = 0.0414). Thus, downregulation of miR-125b indicates malignant transformation. All other investigated miRNAs were not associated with grading of SFTP. Conclusions Our data suggest a potential role of miR-125b in the pathogenesis of tumor growth and malignant transformation of SFTP, respectively. Further studies have to address the potential use of miRNA-125b as a biomarker or therapeutic target in SFTP.
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Affiliation(s)
- Matthias Brock
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Selma Hottinger
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Matthias Diebold
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Alex Soltermann
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Lars C Huber
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Daniel P Franzen
- Department of Pulmonology, University Hospital Zurich, University of Zurich, Rämistr. 100, 8091, Zurich, Switzerland.
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Robert J, Brack M, Hottinger S, Kadner A, Baur HR. A rare case of left ventricular cardiac myxoma with obstruction of the left ventricular outflow tract and atypical involvement of the mitral valve. European Journal of Echocardiography 2009; 10:593-5. [DOI: 10.1093/ejechocard/jep031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Cerny A, Ettlin D, Betschen K, Berchtold E, Hottinger S, Neftel KA. Weil's disease after a rat bite. Eur J Med 1992; 1:315-6. [PMID: 1341617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A Cerny
- Medizinische und Chirurgische Klinik, Zieglerspital, Bern, Switzerland
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Cerny A, Hauser C, Eich G, Sieber R, Hottinger S, Neftel KA. [Livedo reticularis and multiple vascular occlusions in a patient with HLA-B27-negative spondyloarthrosis and antiphospholipid antibodies]. Schweiz Med Wochenschr 1992; 122:1020-3. [PMID: 1626251] [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: 12/27/2022]
Abstract
We report the case of a 74-year-old patient with HLA-B27 negative spondylarthropathy presenting with acute disseminated vascular occlusions. The presence of livedo reticularis prompted a search for antiphospholipid antibodies which were found to be markedly elevated. Histopathological examination revealed noninflammatory vascular obstruction. The clinical evolution was rapidly fatal in spite of corticosteroid treatment. Livedo reticularis can be an important diagnostic clue to various types of underlying disease. Increased levels of antiphospholipid antibodies have been associated with thrombosis and thromboembolism, especially in the context of autoimmune diseases such as systemic lupus erythematosus. This paper reports antiphospholipid antibody-associated noninflammatory vascular occlusions in a patient with HLA-B27 negative spondylarthropathy. The pathogenetic mechanism of antiphospholipid antibody-mediated vascular occlusions is not completely understood and optimal therapy remains to be defined.
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Affiliation(s)
- A Cerny
- Medizinische Abteilung, Zieglerspital, Bern
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Abstract
Based on excellent results of successive single chest thumping (CT) and serial chest thumping (SCT) for the interruption of ventricular tachycardia (VT) in experimental animals with subacute myocardial infarction, the SCT method was applied for the treatment of VT in patients with coronary artery disease (CAD). SCT was successful in terminating 13 of 19 episodes of VT (68%) in 8 of 14 patients (57%). Conversion of VT was immediate in 9 episodes in 6 patients and latent in 4 episodes in 2 patients. Complications were rare but significant. In one case, SCT resulted in a ventricular asystole and in another case SCT accelerated the rate of VT from 167/min to 242/min, requiring electroconversion. Neither a short duration of VT nor a preserved left ventricular function seemed to enhance conversion by SCT. For interruption of VT in patients with CAD, SCT is not as successful as in the experimental animal model and, therefore, should not be used as a routine method. It may be applied in selected patients under hospital conditions with a standby defibrillator.
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Affiliation(s)
- M Gertsch
- Department of Cardiology, Medical University Clinic, Inselspital Bern, Switzerland
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Abstract
Behavioral arousal may trigger malignant cardiac arrhythmias. To study the effect of arousal on ventricular tachycardia, pigs were instrumented with catheters to measure mean arterial pressure and sample plasma catecholamines and left anterior descending coronary artery snares for occlusion 1 wk later. Bipolar pacing catheters were placed in the right ventricular apex to induce ventricular tachycardia. One week after occlusion, electrophysiological testing was repeated before and immediately after arousal caused either by restraining and lifting the pig in a canvas sling or by bringing a stall mate into the room. The number of stimuli needed to induce monomorphic ventricular tachycardia was reduced by both types of arousal (P less than 0.05) compared with control conditions. Ventricular tachycardia rate was increased 60 +/- 17 beats/min after lifting stimulation (P less than 0.05). When beta 1-receptor blockade was induced by metoprolol, inducibility of ventricular tachycardia and rate were not different from control. Thus, in pigs, arousal may facilitate arrhythmogenesis. This effect may be mediated by sympathetic neural activity in the heart because it was annulled by beta 1-adrenergic blockade.
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Affiliation(s)
- D A Kirby
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115
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Abstract
Sustained monomorphic ventricular tachycardia (VT) is of clinical importance but has not been readily modeled in conscious animals. Eleven pigs had myocardial infarction induced by pulling snares previously placed around the left anterior descending (LAD) coronary artery. Six days after occlusion, bipolar pacing catheters were inserted in the right ventricular apex for induction of VT. Testing was repeated in conscious pigs on 6 out of 8 to 19 days after infarction. Monomorphic VT was induced in each animal during each session, using three to four extrastimuli. VT was terminated by burst pacing in 74% of trials; average VT rate was 362 +/- 26 beats/min. VT was prevented in four of eight animals by procainamide and in five of eight animals by magnesium, but was not prevented by lidocaine or metoprolol. The model may be useful in the study of potentially malignant ventricular tachyarrhythmias, important prodromes for sudden death.
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Affiliation(s)
- D A Kirby
- Department of Nutrition, Harvard School of Public Health
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Gertsch M, Hottinger S, Mettler D, Leupi F, Gurtner HP. Conversion of induced ventricular tachycardia by single and serial chest thumps: a study in domestic pigs 1 week after experimental myocardial infarction. Am Heart J 1989; 118:248-55. [PMID: 2750646 DOI: 10.1016/0002-8703(89)90182-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A single chest thump (CT) is widely accepted in the emergency treatment of ventricular asystole, whereas there exists controversy about this method for the interruption of ventricular tachycardia (VT). Hitherto, delivering serial chest thumps (SCTs) has been described only once for the treatment of VT. A systematic analysis for interruption of VT by CT or SCTs (or both) is lacking. We have therefore investigated this subject in five domestic pigs after experimental myocardial infarction. Manual conversion was attempted in 20 induced VTs. Six VTs were converted by CT, seven VTs were converted by the first SCTs, and six VTs were converted by the last of multiple (two to seven) SCTs. The overall success was 95%. There were no serious complications. The rate of successful SCTs exceeded the rate of VT by 10% to 126%. The technique of SCTs, the mechanisms of manual conversion, and the controversial opinions regarding the value of precordial thumping in asystole, VT, and ventricular fibrillation are discussed. SCTs should be practiced only very cautiously in patients until further experience is available.
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Affiliation(s)
- M Gertsch
- Department of Cardiology, Medical University Clinic, Inselspital Bern, Switzerland
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Tschumper A, Streuli H, Hottinger S, Zimmermann A, Müller U. [Fulminant hepatitis in Listeria septicemia]. Schweiz Med Wochenschr 1987; 117:2010-2. [PMID: 3124266] [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: 01/04/2023]
Abstract
We report on a 44-year-old male patient admitted with acute severe icteric hepatitis. Listeria monocytogenes was isolated from blood cultures. The further course was complicated by meningitis and the patient finally died of multiorgan failure. Autopsy revealed nodular cirrhosis of the liver with cholestatic hepatitis and focal subacute liver dystrophy, as well as granulating meningitis. The case is discussed in the context of five previously published observations on hepatitis due to Listeria monocytogenes.
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Affiliation(s)
- A Tschumper
- Medizinische Klinik, Zieglerspital und Pathologisches Institut der Universität, Bern
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Hottinger S, Mettler D, Leupi F, Gertsch M. [Effect of amiodarone on stimulatory convertibility and degeneration into ventricular fibrillation of induced ventricular tachycardias in the pig]. Schweiz Med Wochenschr 1985; 115:1594-6. [PMID: 4081686] [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: 01/08/2023]
Abstract
Intravenous amiodarone has a clear anti-arrhythmic effect on induced sustained ventricular tachycardia (VT) in pigs with subacute myocardial infarction. Degeneration of the VT into ventricular fibrillation is almost abolished, and conversion of VT into sinus rhythm by programmed stimulation is enhanced.
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Hottinger S, Rollinghoff W, Wietholtz H, Preisig R. Filter trapping of 14CO2: a simple and quantitative method for studying cell metabolism in hepatocyte monolayers. Biochem Pharmacol 1982; 31:1803-6. [PMID: 6809010 DOI: 10.1016/0006-2952(82)90693-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Hottinger S, Biland F, Bender S, Hadorn B. [Effect of secretine sniff on exocrine pancreatic function in cystic fibrosis (author's transl)]. Schweiz Rundsch Med Prax 1975; 64:1209-13. [PMID: 1178645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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