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Yuan J, Xie D, Fang S, Meng F, Wu Y, Shan D, Shao N, Wang B, Tian Z, Wang Y, Xu C, Chen X. Qualitative and quantitative MRI analysis of alveolar soft part sarcoma: correlation with histological grade and Ki-67 expression. Insights Imaging 2024; 15:142. [PMID: 38866951 PMCID: PMC11169322 DOI: 10.1186/s13244-024-01687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/02/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE To investigate the correlation between MRI findings and histological features for preoperative prediction of histological grading and Ki-67 expression level in alveolar soft part sarcoma (ASPS). METHODS A retrospective analysis was conducted on 63 ASPS patients (Jan 2017-May 2023). All patients underwent 3.0-T MRI examinations, including conventional sequences, dynamic contrast-enhanced scans with time-intensity curve analysis, and diffusion-weighted imaging with apparent diffusion coefficient (ADC) measurements. Patients were divided into low-grade (histological Grade I) and high-grade (histological Grade II/III) groups based on pathology. Immunohistochemistry was used to assess Ki-67 expression levels in ASPS. Statistical analysis included chi-square tests, Wilcoxon rank-sum test, binary logistic regression analysis, Spearman correlation analysis, and receiver operating characteristic curve analysis of various observational data. RESULTS There were 29 low-grade and 34 high-grade patients (26 males and 37 females) and a wide age range (5-68 years). Distant metastasis, tumor enhancement characteristics, and ADC values were independent predictors of high-grade ASPS. High-grade ASPS had lower ADC values (p = 0.002), with an area under the curve (AUC), sensitivity, and specificity of 0.723, 79.4%, and 58.6%, respectively, for high-grade prediction. There was a negative correlation between ADC values and Ki-67 expression (r = -0.526; p < 0.001). When the cut-off value of ADC was 0.997 × 10-3 mm²/s, the AUC, sensitivity, and specificity for predicting high Ki-67 expression were 0.805, 65.6%, and 83.9%, respectively. CONCLUSION Qualitative and quantitative MRI parameters are valuable for predicting histological grading and Ki-67 expression levels in ASPS. CRITICAL RELEVANCE STATEMENT This study will help provide a more nuanced understanding of ASPS and guide personalized treatment strategies. KEY POINTS There is limited research on assessing ASPS prognosis through MRI. Metastasis, enhancement, and ADC correlated with histological grade; ADC related to Ki-67 expression. MRI provides clinicians with valuable information on ASPS grading and proliferation activity.
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Affiliation(s)
- Junhui Yuan
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Deshun Xie
- Department of Radiology, Heze Municipal Hospital, Heze, Shandong, China
| | - Shaobo Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Fan Meng
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yue Wu
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Dongqiu Shan
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Nannan Shao
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Bangmin Wang
- Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Zhichao Tian
- Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yuanyuan Wang
- Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Chunmiao Xu
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
| | - Xuejun Chen
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
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Luo H, Weng X, Zhong Z, Shan X, Lin W, Li S, Gu C. Spindle cell embryonal rhabdomyosarcoma of the prostate in an adult patient: a case report and review of the literature. J Int Med Res 2024; 52:3000605241234755. [PMID: 38501994 PMCID: PMC10953018 DOI: 10.1177/03000605241234755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Rhabdomyosarcoma of the prostate is a rare mesenchymal tumor that originates from undifferentiated mesenchymal cells. Spindle cell rhabdomyosarcoma is a variant of embryonal rhabdomyosarcoma. The vast majority of these two pathological types occur in children, with only a few adult cases reported to date, and both are associated with poor clinical outcomes. We herein report a case involving a man in his early 40s with spindle cell embryonal rhabdomyosarcoma of the prostate. His chief complaint was difficult urination. The diagnosis was confirmed by puncture biopsy of the prostate, and pelvic lymph node metastasis was already present at the time of diagnosis. The patient underwent three courses of chemotherapy. However, his response to the treatment was very poor, and he died of the disease 4 months after diagnosis.
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Affiliation(s)
- Hanwen Luo
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiangtao Weng
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zibin Zhong
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiongwei Shan
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wenli Lin
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Siyi Li
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Chiming Gu
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
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Sengüven Toközlü B, Sapkota D, Vallenari EM, Schreurs O, Søland TM. Cortactin expression in a Norwegian cohort of human papilloma virus negative oral squamous cell carcinomas of the mobile tongue. Eur J Oral Sci 2023; 131:e12925. [PMID: 36790139 DOI: 10.1111/eos.12925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023]
Abstract
Oral squamous cell carcinoma of the tongue (OTSCC) is the most common malignancy among oral squamous cell carcinomas and is frequently associated with an unfavorable prognosis. Local spread and distant metastasis are important causes of poor prognosis in OTSCC. Cortactin amplification and overexpression, a common molecular alteration in oral squamous cell carcinomas, have been linked to invasion and metastasis of tumor cells. However, the intra-tumor expression pattern and prognostic significance of cortactin in human papillomavirus (HPV) negative OTSCC is not fully investigated. Immunohistochemical analysis using tissue microarray consisting of formalin-fixed and paraffin-embedded HPV negative OTSCC (n = 123) specimens showed overexpression of cortactin at tissue cores from invading fronts as compared to the corresponding center cores. High overall cortactin expression was found to be associated with advanced (larger) tumor size and the occurrence of distance metastasis. Kaplan-Meier survival analysis showed that patients with high overall cortactin expression were associated with reduced 5-year survival. Multivariate Cox regression analysis identified high cortactin expression to be an independent prognostic factor in OTSCC. Additionally, siRNA-mediated silencing of cortactin was found to suppress the proliferative and invasive abilities of OTSCC cells in an organotypic co-culture model. Overexpression of cortactin is a promising prognostic marker in HPV-negative OTSCC.
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Affiliation(s)
- B Sengüven Toközlü
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Oslo, Turkey
| | - D Sapkota
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - E M Vallenari
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - O Schreurs
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - T M Søland
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Li X, Hu Y, Xie Y, Lu R, Li Q, Tao H, Chen S. Whole-tumor histogram analysis of diffusion-weighted imaging and dynamic contrast-enhanced MRI for soft tissue sarcoma: correlation with HIF-1alpha expression. Eur Radiol 2022; 33:3961-3973. [PMID: 36462043 DOI: 10.1007/s00330-022-09296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/02/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To investigate the correlation of histogram metrics from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters with HIF-1alpha expression in soft tissue sarcoma (STS). METHODS We enrolled 71 patients with STS who underwent 3.0-T MRI, including conventional MRI, DWI, and DCE-MRI sequences. Location, maximum tumor diameter, envelope, T2-weighted tumor heterogeneity, peritumoral edema, peritumoral enhancement, necrosis, tail-like pattern, bone invasion, and vessel/nerve invasion and/or encasement were determined using conventional MRI images. The whole-tumor histogram metrics were calculated on the apparent diffusion coefficient (ADC), Ktrans, Kep, and Ve maps. Independent-samples t test and one-way ANOVA were used for testing the differences between normally distributed categorical data with HIF-1alpha expression. Pearson and Spearman correlations and multiple linear regression analyses were performed to determine the correlations between histogram metrics and HIF-1alpha expression. Survival curves were plotted using the Kaplan-Meier method. RESULTS Regarding conventional MRI features, only highly heterogeneous on T2-weighted images (55.6 ± 19.9% vs. 45.4 ± 20.5%, p = 0.041) and more than 50% necrotic area (57.3 ± 20.4% vs. 43.9 ± 19.7%, p = 0.002) were prone to indicate STS with higher HIF-1alpha expression. Histogram metrics obtained from ADC (mean, median, 10th, and 25th percentile values), Ktrans (mean, median, 75th, and 90th percentile values), and Kep (90th percentile values) were significantly correlated with HIF-1alpha expression. Multiple linear regression analysis demonstrated that more than 50% necrosis, ADCskewness, Ktrans90th, and grade III were independently associated with HIF-1alpha expression. CONCLUSION DWI and DCE-MRI histogram parameters were significantly correlated with HIF-1alpha expression in STS. KEY POINTS • DWI and DCE-MRI histogram parameters are correlated with HIF-1alpha expression in STS. • More than 50% necrosis, ADCskewness, Ktrans90th, and grade III were independently associated with HIF-1alpha expression in STS.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China
| | - Yiwen Hu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China
| | - Yuxue Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China
| | - Rong Lu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China
| | - Qing Li
- MR Collaborations, Siemens Healthineers Ltd., Shanghai, China
| | - Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China.
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 2 middle Wulumuqizhong Road, Shanghai, China.
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Zhang Y, Zhao H, Liu Y, Zeng M, Zhang J, Hao D. Diagnostic Performance of Dynamic Contrast-Enhanced MRI and 18F-FDG PET/CT for Evaluation of Soft Tissue Tumors and Correlation with Pathology Parameters. Acad Radiol 2022; 29:1842-1851. [PMID: 35396157 DOI: 10.1016/j.acra.2022.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/05/2022] [Accepted: 03/06/2022] [Indexed: 01/26/2023]
Abstract
RATIONALE AND OBJECTIVES To assess the diagnostic performance of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) parameters in evaluating the biological behavior of soft tissue tumors. MATERIALS AND METHODS We retrospectively analyzed DCE-MRI and 18F-FDG PET/CT parameters in 78 patients with pathology-confirmed soft tissue tumors. A total of 78 patients had undergone DCE-MRI examination, while 24 patients with malignant soft tissue tumor had undergone 18F-FDG PET/CT examination. Microvessel density (MVD) and the Ki-67 labeling index (LI) were detected using immunohistochemistry. Differences in parameters (Ktrans, Kep, Ve, MVD, and Ki-67 LI) between benign and malignant tumors were compared. Differences in parameters (Ktrans, Kep, Ve, MVD, and SUVmax) between high- and low-proliferation malignant tumors (grouped by Ki-67 LI) were compared. Correlation of the DCE-MRI and 18F-FDG PET/CT parameters with MVD and Ki-67 LI was analyzed. RESULTS Only the Ktrans, Kep, MVD, and Ki-67 LI differed significantly between the benign and malignant soft tissue tumors (all p < 0.001). Only Kep (p = 0.033) and SUVmax (p = 0.001) differed significantly between high- and low-proliferation malignant soft tissue tumors. Ktrans, Kep, and SUVmax correlated positively with MVD (r = 0.805, 0.778, 0.730, respectively; all p < 0.001), and with Ki-67 LI (r = 0.721, 0.685, 0.655, respectively; all p < 0.001). CONCLUSION DCE-MRI and 18F-FDG PET/CT parameters indicate soft tissue tumor biological behavior and can be used to differentiate between benign and malignant soft tissue tumors and between high- and low-proliferation malignant soft tissue tumors.
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Affiliation(s)
- Yu Zhang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Haijing Zhao
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yayi Liu
- Department of Radiology, Qingdao Women and Children's Hospital, Qingdao, China
| | - Manqin Zeng
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun Zhang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dapeng Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Yang Y, Zhang L, Wang T, Jiang Z, Li Q, Wu Y, Cai Z, Chen X. MRI Fat‐Saturated T2‐Weighted
Radiomics Model for Identifying the Ki‐67 Index of Soft Tissue Sarcomas. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yang Yang
- Department of Radiology Hospital of Chengdu University of Traditional Chinese Medicine Chengdu People's Republic of China
| | - Liyuan Zhang
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Ting Wang
- Department of Plastic Surgery The First People's Hospital of Yibin Yibin People's Republic of China
| | - Zhiyuan Jiang
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Qingqing Li
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Yinghua Wu
- Department of Radiology Hospital of Chengdu University of Traditional Chinese Medicine Chengdu People's Republic of China
| | - Zhen Cai
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Xi Chen
- Sichuan College of Traditional Chinese Medicine Mianyang People's Republic of China
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Li X, Tao J, Zhu Y, Yin Z, Zhang Y, Wang S. Soft tissue sarcoma: intravoxel incoherent motion and diffusion kurtosis imaging parameters correlate with the histological grade and Ki-67 expression. Acta Radiol 2022; 64:1546-1555. [PMID: 36259287 DOI: 10.1177/02841851221131931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Accurate prediction of the histological grade and Ki-67 expression of soft tissue sarcoma (STS) before surgery is essential for the subsequent diagnosis, treatment, and prognostic evaluation of patients. PURPOSE To evaluate intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in predicting the histological grade and Ki-67 expression of STS. MATERIAL AND METHODS A total of 40 patients underwent 3-T MRI, including conventional sequences; IVIM and DKI parameters were obtained. All patients were divided into a low-grade (grade 1 and grade 2) group and a high-grade (grade 3) group through pathological analysis. Ki-67 expression of each lesion was calculated. Chi-square test, independent sample t-test, Mann-Whitney U test, Pearson, Spearman, and receiver operating characteristic curve analysis were performed. RESULTS There were 17 patients in the low-grade group and 23 in the high-grade group. Ki-67 expression was in the range of 10%-80%. D value was inversely correlated with Ki-67 expression. MK value showed a moderate positive correlation with Ki-67 expression. Regarding histological grading, only the peritumoral enhancement was statistically different between low- and high-grade STS on conventional MRI (P=0.024). The high-grade group had significantly higher MK value and lower D and MD value than the low-grade group. MK value showed the best diagnostic performance. The combination of MK and MD yielded the highest specificity (88.24%), and the combination of D, MK, and MD yielded the best area under the curve value (0.841) and sensitivity (95.65%). CONCLUSION IVIM and DKI parameters were correlated with Ki-67 expression and could help differentiate between low- and high-grade STS.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Juan Tao
- Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yifeng Zhu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Zhenzhen Yin
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yu Zhang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
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Wang P, Xu D, Hu Y, Li H, Li A. Correlation between quantitative parameters of CEUS and Ki-67 labeling index in soft-tissue sarcoma. Acta Radiol 2022:2841851221115081. [PMID: 35903876 DOI: 10.1177/02841851221115081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Apart from the immunohistochemical Ki-67 labeling index (LI), clinicians need a non-invasive and convenient way to predict the prognosis of patients with soft-tissue sarcoma (STS). PURPOSE To investigate the correlation between quantitative parameters of contrast-enhanced ultrasound (CEUS) and Ki-67 LI in STS. MATERIAL AND METHODS A total of 25 patients diagnosed with STS who underwent CEUS examination using SonoVue®, between January 2019 to November 2020, were included in the study. They were then divided into a high-proliferation group and low-proliferation group according to 30% Ki-67 positive tumor cells. The quantitative parameters in the semi-automatic time intensity curve analysis software, including arrival time, time to peak, peak intensity, rise time (RT), rise slope, 50% wash-out time, and 50% wash-out intensity, were extracted from the time intensity curve of CEUS by two independent observers. Statistical evaluation of the correlation and difference between CEUS quantitative parameters and Ki-67 LI between the two groups was performed. According to the area under the curve (AUC) analysis, optimal cutoff points of parameters with significant difference were determined. RESULTS CEUS RT of the high-proliferation group in STS was significantly higher than that of the low-proliferation group (ρ = 0.509, P = 0.01). The most reasonable cutoff to distinguish between low- and high-proliferation groups was 10.84 s. The sensitivity, specificity, and the AUC were 86.7%, 80%, and 0.80, respectively. CONCLUSION CEUS RT was correlated with Ki-67 LI of STS, which can be used as a minimally invasive auxiliary tool to predict the prognosis of STS in clinical practice.
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Affiliation(s)
- Pingping Wang
- Department of Ultrasound, 162752Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China
| | - Di Xu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yu Hu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Ao Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Arterial Spin Labeling Perfusion in Determining the IDH1 Status and Ki-67 Index in Brain Gliomas. Diagnostics (Basel) 2022; 12:diagnostics12061444. [PMID: 35741254 PMCID: PMC9221904 DOI: 10.3390/diagnostics12061444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/30/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to evaluate the relationship between tumor blood flow (TBF) measured by the pseudo-continuous arterial spin labeling (PCASL) method and IDH1 mutation status of gliomas as well as Ki-67 proliferative index. Methods. The study included 116 patients with newly diagnosed gliomas of various grades. They received no chemotherapy or radiotherapy before MRI. IDH1 status assessment was performed after tumor removal in 106 cases—48 patients were diagnosed with wildtype gliomas (Grade 1−2—6 patients, Grade 3−4—42 patients) and 58 patients were diagnosed with mutant forms of gliomas (Grade 1−2—28 patients, Grade 3−4—30 patients). In 64 cases out of 116 Ki-67 index was measured. Absolute and normalized tumor blood flow values were measured on 3D PCASL maps. Results. TBF and normalized TBF (nTBF) in wildtype gliomas were significantly higher than in IDH1-mutant gliomas (p < 0.001). ASL perfusion showed high values of sensitivity and specificity in the differential diagnosis of gliomas with distinct IDH1 status (for TBF: specificity 75%, sensitivity 77.6%, AUC 0.783, cutoff 80.57 mL/100 g/min, for nTBF: specificity 77.1%, sensitivity 79.3%, AUC 0.791, cutoff 4.7). TBF and nTBF in wildtype high-grade gliomas (HGG) were significantly higher than in mutant forms (p < 0.001). ASL perfusion showed the following values of sensitivity and specificity in the diagnosis of mutant HGG and wildtype HGG (for TBF: specificity 83.3%, sensitivity 60%, AUC 0.719, cutoff 84.18 mL/100 g/min, for nTBF: specificity 88.1%, sensitivity 60%, AUC 0.729, cutoff 4.7). There was a significant positive correlation between tumor blood flow and Ki-67 (for TBF Rs = 0.63, for nTBF Rs = 0.61). Conclusion. ASL perfusion may be an informative factor in determining the IDH1 status in brain gliomas preoperative and tumor proliferative activity.
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Zhang K, Dai Y, Liu Y, Tao J, Pan Z, Xie L, Wang S. Soft tissue sarcoma: IVIM and DKI parameters correlate with Ki-67 labeling index on direct comparison of MRI and histopathological slices. Eur Radiol 2022; 32:5659-5668. [DOI: 10.1007/s00330-022-08646-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 12/27/2022]
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11
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Shaker N, Patel A, Tozbikian G, Parwani A. Anastomosing hemangioma: A case report of a benign tumor often misdiagnosed as a malignant epithelioid angiosarcoma. Urol Case Rep 2022; 42:102023. [PMID: 35530542 PMCID: PMC9073214 DOI: 10.1016/j.eucr.2022.102023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022] Open
Abstract
Anastomosing hemangioma (AH), a rare benign genitourinary tract hemangioma is subject to frequent misdiagnosis due to its rarity and clinical, histological, and immunohistochemical similarities it shares with several diagnoses, including well-differentiated angiosarcoma (AS). This is particularly true of angiosarcoma, nearly identical to AH when presented in tissue samples of limited size. Lack of specific clinical and radiologic manifestations on initial preoperative assessment, coupled with limited diagnostic experience or awareness, can lead to misinterpretation of this entity, potentially leading to unnecessary clinical management. We present an initial misdiagnosis of AS which, upon review of the entire lesion, was identified as AH.
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Laurila RE, Böhling TO, Blomqvist CP, Karlsson C, Tukiainen EJ, Repo J, Sampo MM. Visual Counting and Automated Image-analytic Assessment of Ki-67 and their Prognostic Value in Synovial Sarcoma. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:7-14. [PMID: 35400010 PMCID: PMC8962852 DOI: 10.21873/cdp.10070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ki-67 is a widely used proliferation marker reflecting prognosis in various tumors. However, visual assessment and scoring of Ki-67 suffers from marked inter-observer and intra-observer variability. We aimed to assess the concordance of manual counting and automated image-analytic scoring methods for Ki-67 in synovial sarcoma. PATIENTS AND METHODS Tissue microarrays from 34 patients with synovial sarcoma were immunostained for Ki-67 and scored both visually and with 3DHistech QuantCenter. RESULTS The automated assessment of Ki-67 expression was in good agreement with the visually counted Ki-67 (r Pearson =0.96, p<0.001). In a Cox regression model automated [hazard ratio (HR)=1.047, p=0.024], but not visual (HR=1.063, p=0.053) assessment method associated high Ki-67 scores with worse overall survival. CONCLUSION The automated Ki-67 assessment method appears to be comparable to the visual method in synovial sarcoma and had a significant association to overall survival.
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Affiliation(s)
- Riikka E Laurila
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| | | | - Carl P Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Örebro University, School of Health sciences, Örebro, Sweden
| | | | - Erkki J Tukiainen
- Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Mika M Sampo
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
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Wang P, Li H, Hu Y, Peng X, Ye X, Xu D, Li A. Relationship Between Ultrasound Features and Ki-67 Labeling Index of Soft Tissue Sarcoma. Front Oncol 2021; 11:687878. [PMID: 34262871 PMCID: PMC8273548 DOI: 10.3389/fonc.2021.687878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/07/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives To explore the relationship between ultrasound (US) features and Ki-67 labeling index (LI) of soft tissue sarcoma (STS). Methods Forty-six patients with 47 STS lesions, between September 2014 and April 2020, were enrolled in the study. Point-biserial correlation analysis and Spearman’s correlation analysis were utilized to examining the relationship between the US features and the Ki-67 LI of STS. The differences of US features between high and low Ki-67 proliferation groups were statistically analyzed by independent t test, Wilcoxon rank-sum test, and Fisher’s exact test. The optimal cut-off points of US features revealing significant differences were estimated by the maximum Youden index. Results A moderate correlation between the vascular density grade and the Ki-67 LI (ρ = 0.409, P = 0.004) was found in this study. In addition, other ultrasound features were irrelevant to the Ki-67 LI. The cut-off for differentiating low- and high-proliferation groups was grade II according to the best Youden index. The area under receiver operating characteristic (ROC) curve was 0.74 (p = 0.011) with a sensitivity of 60.6% and specificity of 78.6%. Conclusions Only the vascular density grade of STS had a weak positive correlation with Ki-67 LI, and might be capable of predicting the proliferation of STS. Other ultrasonographic features of STS such as shape and tumor margin have no correlation with Ki-67 LI.
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Affiliation(s)
- Pingping Wang
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Hu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaojing Peng
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinhua Ye
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Di Xu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ao Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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14
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Dye FS, Larraufie P, Kay R, Darwish T, Rievaj J, Goldspink DA, Meek CL, Middleton SJ, Hardwick RH, Roberts GP, Percival-Alwyn JL, Vaughan T, Ferraro F, Challis BG, O'Rahilly S, Groves M, Gribble FM, Reimann F. Characterisation of proguanylin expressing cells in the intestine - evidence for constitutive luminal secretion. Sci Rep 2019; 9:15574. [PMID: 31666564 PMCID: PMC6821700 DOI: 10.1038/s41598-019-52049-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/10/2019] [Indexed: 12/14/2022] Open
Abstract
Guanylin, a peptide implicated in regulation of intestinal fluid secretion, is expressed in the mucosa, but the exact cellular origin remains controversial. In a new transgenic mouse model fluorescent reporter protein expression driven by the proguanylin promoter was observed throughout the small intestine and colon in goblet and Paneth(-like) cells and, except in duodenum, in mature enterocytes. In Ussing chamber experiments employing both human and mouse intestinal tissue, proguanylin was released predominantly in the luminal direction. Measurements of proguanylin expression and secretion in cell lines and organoids indicated that secretion is largely constitutive and requires ER to Golgi transport but was not acutely regulated by salt or other stimuli. Using a newly-developed proguanylin assay, we found plasma levels to be raised in humans after total gastrectomy or intestinal transplantation, but largely unresponsive to nutrient ingestion. By LC-MS/MS we identified processed forms in tissue and luminal extracts, but in plasma we only detected full-length proguanylin. Our transgenic approach provides information about the cellular origins of proguanylin, complementing previous immunohistochemical and in-situ hybridisation results. The identification of processed forms of proguanylin in the intestinal lumen but not in plasma supports the notion that the primary site of action is the gut itself.
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Affiliation(s)
- Florent Serge Dye
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Department of Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Pierre Larraufie
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Richard Kay
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Tamana Darwish
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Juraj Rievaj
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Dosage Form Design & Development, AstraZeneca, Cambridge, UK
| | - Deborah A Goldspink
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Claire L Meek
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Stephen J Middleton
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Richard H Hardwick
- Barrett's Oesophagus and Oesophago-gastric Cancer, Gastroenterology Services, Addenbrooke's Hospital, Cambridge, UK
| | - Geoffrey P Roberts
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | | | - Tris Vaughan
- Department of Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Franco Ferraro
- Department of Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Benjamin G Challis
- Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Stephen O'Rahilly
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Maria Groves
- Department of Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK.
| | - Fiona M Gribble
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Frank Reimann
- Wellcome/MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
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15
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Lee JH, Yoon YC, Seo SW, Choi YL, Kim HS. Soft tissue sarcoma: DWI and DCE-MRI parameters correlate with Ki-67 labeling index. Eur Radiol 2019; 30:914-924. [PMID: 31630234 DOI: 10.1007/s00330-019-06445-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/12/2019] [Accepted: 09/10/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the correlation of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging (MRI) parameters with Ki-67 labeling index (LI) in soft tissue sarcoma (STS). METHODS The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Thirty-six patients with STS who underwent 3.0-T MRI, including diffusion-weighted and dynamic contrast-enhanced MRI, between July 2011 and February 2018, were included in this study. The mean and minimum apparent diffusion coefficients (ADCs) (ADCmean and ADCmin, respectively), volume transfer constant, reflux rate, and volume fraction of the extravascular extracellular matrix of each lesion were independently analyzed by two readers. Their relationship with the Ki-67 LI was examined using Spearman's correlation analyses. Differences between low- and high-proliferation groups based on Ki-67 LI were evaluated statistically. Optimal cut-off points were determined using the area under the curve analysis for significant parameters. Interobserver agreement was assessed with the intraclass correlation coefficient. RESULTS ADCmean (ρ = - 0.333, p = 0.047) was significantly and inversely correlated with Ki-67 LI. The high-proliferation group showed a significantly lower ADCmean than did the low-proliferation group (median, 1.08 vs. 1.20; p = 0.048). When a cut-off ADCmean value of 1.16 × 10-3 mm2/s was used, the sensitivity, specificity, and area under the curve for differentiating low- and high-proliferation groups were 75.0%, 60.0%, and 0.712, respectively. Interobserver agreements between the two readers were almost perfect for all parameters. CONCLUSIONS ADCmean was correlated with Ki-67 LI and could help differentiate between STS with low and high proliferation potential. KEY POINTS • ADC meanwas significantly and inversely correlated with Ki-67 labeling index in soft tissue sarcoma. • In the high-proliferation group, ADC meanvalues were significantly lower than those of the low-proliferation group.
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Affiliation(s)
- Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Sung Wook Seo
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun Su Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
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16
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Nair NU, Das A, Rogkoti VM, Fokkelman M, Marcotte R, de Jong CG, Koedoot E, Lee JS, Meilijson I, Hannenhalli S, Neel BG, de Water BV, Le Dévédec SE, Ruppin E. Migration rather than proliferation transcriptomic signatures are strongly associated with breast cancer patient survival. Sci Rep 2019; 9:10989. [PMID: 31358840 PMCID: PMC6662662 DOI: 10.1038/s41598-019-47440-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/28/2019] [Indexed: 12/24/2022] Open
Abstract
The efficacy of prospective cancer treatments is routinely estimated by in vitro cell-line proliferation screens. However, it is unclear whether tumor aggressiveness and patient survival are influenced more by the proliferative or the migratory properties of cancer cells. To address this question, we experimentally measured proliferation and migration phenotypes across more than 40 breast cancer cell-lines. Based on the latter, we built and validated individual predictors of breast cancer proliferation and migration levels from the cells' transcriptomics. We then apply these predictors to estimate the proliferation and migration levels of more than 1000 TCGA breast cancer tumors. Reassuringly, both estimates increase with tumor's aggressiveness, as qualified by its stage, grade, and subtype. However, predicted tumor migration levels are significantly more strongly associated with patient survival than the proliferation levels. We confirmed these findings by conducting siRNA knock-down experiments on the highly migratory MDA-MB-231 cell lines and deriving gene knock-down based proliferation and migration signatures. We show that cytoskeletal drugs might be more beneficial in patients with high predicted migration levels. Taken together, these results testify to the importance of migration levels in determining patient survival.
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Affiliation(s)
- Nishanth Ulhas Nair
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
- Cancer Data Science Lab, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, USA
| | - Avinash Das
- Department of Biostatistics and Computational Biology, Harvard School of Public Health, Boston, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
| | - Vasiliki-Maria Rogkoti
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Michiel Fokkelman
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Richard Marcotte
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1L7, Canada
- National Research Council Canada, Montreal, Canada
| | - Chiaro G de Jong
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Esmee Koedoot
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Joo Sang Lee
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
- Cancer Data Science Lab, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, USA
| | - Isaac Meilijson
- Department of Statistics and Operations Research, School of Mathematical Sciences, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Sridhar Hannenhalli
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Benjamin G Neel
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1L7, Canada
- Laura and Isaac Perlmutter Cancer Centre, NYU-Langone Medical Center, New York City, NY, 10016, USA
- Alexandria Center for Life Science, New York, NY, 10016, USA
| | - Bob van de Water
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Sylvia E Le Dévédec
- Division of Drug Discovery and Safety, LACDR, Leiden University, Leiden, The Netherlands
| | - Eytan Ruppin
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA.
- Cancer Data Science Lab, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, USA.
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, 69978, Israel.
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17
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Rhabdomyosarcoma disease spread evaluation on CT scans: Association with primary tumor size and Ki-67 proliferation marker. Clin Imaging 2019; 56:41-46. [DOI: 10.1016/j.clinimag.2019.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/09/2019] [Accepted: 02/11/2019] [Indexed: 11/19/2022]
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18
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Santti K, Ihalainen H, Rönty M, Böhling T, Karlsson C, Haglund C, Tarkkanen M, Blomqvist C. High cyclin A expression, but not Ki67, is associated with early recurrence in desmoid tumors. J Surg Oncol 2018; 118:192-198. [PMID: 29878366 DOI: 10.1002/jso.25121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/07/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES Desmoid tumors are soft-tissue tumors originating from myofibroblasts with a tendency to recur after surgery. High expression of proliferation markers is associated with shortened progression-free and/or overall survival in many neoplasms, including soft-tissue sarcomas. We investigated the prognostic role of cyclin A and Ki67 in desmoid tumors by immunohistochemistry. METHODS The study included 76 patients with desmoid tumor operated at Helsinki University Hospital between 1987 and 2011. A tissue micro array (TMA) was constructed and the TMA sections were immunostained with cyclin A and Ki67 antibodies. A computer-assisted image analysis was performed. RESULTS Cyclin A expression was evaluable in 74 and Ki67 in 70 patients. Cyclin A immunopositivity varied from 0% to 9.9%, with a mean of 1.9%. Cyclin A expression correlated significantly with Ki67. Cyclin A expression was associated with recurrence-free survival (HR 1.9, 95% CI = 1.1-3.2, P = .02), as were positive margin (HR 6.0, 95% CI = 1.6-22.5, P = .008) and extremity location (HR 5.3, 95% CI = 1.7-16.8, P = 0.005). Ki67 immunopositivity varied from 0.33% to 13.8%, with a mean of 4.6%, but had no significant prognostic impact (HR 1.1, P = .2). CONCLUSIONS Our study indicates that cyclin A may be a new prognostic biomarker in surgically treated desmoid tumors.
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Affiliation(s)
- Kirsi Santti
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hanna Ihalainen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mikko Rönty
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| | - Tom Böhling
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| | - Christina Karlsson
- Department of Medical Diagnostics, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Caj Haglund
- Department of Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Reseach Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Maija Tarkkanen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Carl Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Oncology, Örebro University Hospital, Örebro, Sweden
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19
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Chung LK, Pelargos PE, Chan AM, Demos JV, Lagman C, Sheppard JP, Nguyen T, Chang YL, Hojat SA, Prins RM, Liau LM, Nghiemphu L, Lai A, Cloughesy TF, Yong WH, Gordon LK, Wadehra M, Yang I. Tissue microarray analysis for epithelial membrane protein-2 as a novel biomarker for gliomas. Brain Tumor Pathol 2017; 35:1-9. [PMID: 28887715 DOI: 10.1007/s10014-017-0300-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022]
Abstract
Epithelial membrane protein-2 (EMP2) expression is noted in many human cancers. We evaluated EMP2 as a biomarker in gliomas. A large tissue microarray of lower grade glioma (WHO grades II-III, n = 19 patients) and glioblastoma (GBM) (WHO grade IV, n = 50 patients) was stained for EMP2. EMP2 expression was dichotomized to low or high expression scores and correlated with clinical data. The mean EMP2 expression was 1.68 in lower grade gliomas versus 2.20 in GBMs (P = 0.01). The percentage of samples with high EMP2 expression was greater in GBMs than lower grade gliomas (90.0 vs. 52.6%, P = 0.001). No significant difference was found between median survival among patients with GBM tumors exhibiting high EMP2 expression and survival of those with low EMP2 expression (8.38 vs. 10.98 months, P = 0.39). However, EMP2 expression ≥2 correlated with decreased survival (r = -0.39, P = 0.001). The EMP2 expression level also correlated with Ki-67 positivity (r = 0.34, P = 0.008). The mortality hazard ratio for GBM patients with EMP2 score of 3 or higher was 1.92 (CI 0.69-5.30). Our findings suggest that elevated EMP2 expression is associated with GBM. With other biomarkers, EMP2 may have use as a molecular target for the diagnosis and treatment of gliomas.
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Affiliation(s)
- Lawrance K Chung
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Panayiotis E Pelargos
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Ann M Chan
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, 924 Westwood Blvd, Seventh Floor, Los Angeles, CA, 90095, USA
| | - Joanna V Demos
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Carlito Lagman
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - John P Sheppard
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Thien Nguyen
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Yu-Ling Chang
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, 924 Westwood Blvd, Seventh Floor, Los Angeles, CA, 90095, USA
| | - Seyed A Hojat
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, 924 Westwood Blvd, Seventh Floor, Los Angeles, CA, 90095, USA
| | - Robert M Prins
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Linda M Liau
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 8-684 Factor Building, Los Angeles, CA, 90095, USA
| | - Leia Nghiemphu
- Department of Neurology, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Albert Lai
- Department of Neurology, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Timothy F Cloughesy
- Department of Neurology, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - William H Yong
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, 924 Westwood Blvd, Seventh Floor, Los Angeles, CA, 90095, USA
| | - Lynn K Gordon
- Department of Ophthalmology, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA, 90095, USA
| | - Madhuri Wadehra
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, 924 Westwood Blvd, Seventh Floor, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 8-684 Factor Building, Los Angeles, CA, 90095, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, CA, 90095, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 8-684 Factor Building, Los Angeles, CA, 90095, USA.
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20
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Zabielska-Koczywąs K, Wojtkowska A, Dolka I, Małek A, Walewska M, Wojtalewicz A, Żbikowski A, Lechowski R. 3D chick embryo chorioallantoic membrane model as an in vivo model to study morphological and histopathological features of feline fibrosarcomas. BMC Vet Res 2017; 13:201. [PMID: 28651614 PMCID: PMC5485740 DOI: 10.1186/s12917-017-1114-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 06/14/2017] [Indexed: 11/10/2022] Open
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21
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Goodman LF, Bateni CP, Bishop JW, Canter RJ. Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma. J Surg Case Rep 2016; 2016:rjw106. [PMID: 27333918 PMCID: PMC4917179 DOI: 10.1093/jscr/rjw106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Complications from lost gallstones after cholecystectomy are rare but varied from simple perihepatic abscess to empyema and expectoration of gallstones. Gallstone complications have been reported in nearly every organ system, although reports of malignant masquerade of retained gallstones are few. We present the case of an 87-year-old woman with a flank soft tissue tumor 4 years after laparoscopic cholecystectomy. The initial clinical, radiographic and biopsy findings were consistent with soft tissue sarcoma (STS), but careful review of her case in multidisciplinary conference raised the suspicion for retained gallstones rather than STS. The patient was treated with incisional biopsy/drainage of the mass, and gallstones were retrieved. The patient recovered completely without an extensive resectional procedure, emphasizing the importance of multidisciplinary sarcoma care to optimize outcomes for potential sarcoma patients.
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Affiliation(s)
- Laura F Goodman
- Division of Surgical Oncology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Cyrus P Bateni
- Department of Radiology, UC Davis School of Medicine, Sacramento, CA, USA
| | - John W Bishop
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Robert J Canter
- Division of Surgical Oncology, UC Davis School of Medicine, Sacramento, CA, USA
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22
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Karagianni P, Lambropoulos V, Stergidou D, Fryssira H, Chatziioannidis I, Spyridakis I. Recurrent giant cell fibroblastoma: Malignancy predisposition in Kabuki syndrome revisited. Am J Med Genet A 2016; 170A:1333-8. [PMID: 26898171 DOI: 10.1002/ajmg.a.37584] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 01/25/2016] [Indexed: 11/07/2022]
Abstract
Kabuki syndrome is a genetic condition characterized by distinctive facial phenotype, mental retardation, and internal organ malformations. Mutations of the epigenetic genes KMT2D and KDM6A cause dysregulation of certain developmental genes and account for the multiple congenital anomalies of the syndrome. Eight cases of malignancies have been reported in young patients with Kabuki syndrome although a causative association to the syndrome has not been established. We report a case of a 12-year-old girl with Kabuki syndrome who developed a tumor on the right side of her neck. A relapsing tumor 19 months after initial excision, proved to be giant cell fibroblastoma. Τhis is the first report of giant cell fibroblastoma -a rare tumor of childhood- in a patient with Kabuki syndrome.
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Affiliation(s)
- Paraskevi Karagianni
- Department of Neonatology and B' NICU (Neonatal Intensive Care Unit), Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Vassilios Lambropoulos
- Second Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Dorothea Stergidou
- Department of Neonatology and B' NICU (Neonatal Intensive Care Unit), Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Helena Fryssira
- Department of Medical Genetics, University of Athens School of Medicine, "Aghia Sophia" Children's Hospital, Goudi, Athens, Greece
| | - Ilias Chatziioannidis
- Department of Neonatology and B' NICU (Neonatal Intensive Care Unit), Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Ioannis Spyridakis
- Second Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
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23
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Lei Y, Li Z, Qi L, Tong S, Li B, He W, Chen M. The Prognostic Role of Ki-67/MIB-1 in Upper Urinary-Tract Urothelial Carcinomas: A Systematic Review and Meta-Analysis. J Endourol 2015; 29:1302-8. [PMID: 26083161 DOI: 10.1089/end.2015.0420] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Upper urinary-tract urothelial carcinomas (UTUC) constitute 5% of urothelial malignancies. Prognostic biomarkers would allow lower risk surgical approaches for less aggressive UTUCs. One biomarker-Ki-67/mindbomb E3 ubiquitin protein ligase 1 (Ki-67/MIB-1)-shows promise in UTUC, but there have been conflicting findings regarding its prognostic role. The systematic review and meta-analysis aim to determine the prognostic value of Ki-67/MIB-1 in UTUC in terms of UTUC-specific mortality rate, 5-year disease-free survival, and 5-year overall survival (including disease-specific survival). METHODS A systematic review of the current literature produced 654 records. A total of 13 studies consisting of 1030 patients were finally included in the meta-analysis. Hazard ratios (HRs) with 95% confidence intervals (CI) were extracted or estimated. The individual HR estimates were combined into a pooled HR using a fixed-effects model that summed homogeneity of the individual true HRs. RESULTS Patients with Ki-67/MIB-1 overexpression displayed significantly higher UTUC-specific mortality rate (pooled HR: 2.14, 95% CI: 1.73-2.64; p<0.00001), significantly reduced 5-year disease-free survival (pooled HR: 2.27, 95% CI: 1.79-2.92; p<0.00001), and significantly reduced 5-year overall survival (pooled HR=1.77; 95% CI: 1.39-2.23 p<0.00001). There was significant heterogeneity detected in the UTUC-specific mortality rate meta-analysis (I(2)=63%) and the 5-year disease-free survival meta-analysis (I(2)=65%), but there was no significant heterogeneity detected in the 5-year overall survival meta-analysis (I(2)=0%). Egger's testing showed that none of the outcomes were influenced by publication bias (p>0.05). CONCLUSIONS Ki-67/MIB-1 overexpression shows promise as a prognostic biomarker for UTUC patients and requires further investigation.
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Affiliation(s)
- Ye Lei
- 1 Department of Urology, Xiangya Hospital, Central South University , Changsha, China
| | - Zengbo Li
- 2 Department of General Surgery, Xiangya Hospital, Central South University , Changsha, China
| | - Lin Qi
- 1 Department of Urology, Xiangya Hospital, Central South University , Changsha, China
| | - Shiyu Tong
- 1 Department of Urology, Xiangya Hospital, Central South University , Changsha, China
| | - Bin Li
- 3 Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University , Shijiazhuang, China
| | - Wei He
- 1 Department of Urology, Xiangya Hospital, Central South University , Changsha, China
| | - Minfeng Chen
- 1 Department of Urology, Xiangya Hospital, Central South University , Changsha, China
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GPI/AMF inhibition blocks the development of the metastatic phenotype of mature multi-cellular tumor spheroids. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2014; 1843:1043-53. [PMID: 24440856 DOI: 10.1016/j.bbamcr.2014.01.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 01/08/2014] [Accepted: 01/10/2014] [Indexed: 12/21/2022]
Abstract
Epithelial-mesenchymal transition (EMT) and cellular invasiveness are two pivotal processes for the development of metastatic tumor phenotypes. The metastatic profile of non-metastatic MCF-7 cells growing as multi-cellular tumor microspheroids (MCTSs) was analyzed by determining the contents of the EMT, invasive and migratory proteins, as well as their migration and invasiveness potential and capacity to secrete active cytokines such as the glucose phosphate isomerase/AMF (GPI/AMF). As for the control, the same analysis was also performed in MCF-7 and MDA-MB-231 (highly metastatic, MDA) monolayer cells, and in stage IIIB and IV human metastatic breast biopsies. The proliferative cell layers (PRL) of mature MCF-7 MCTSs, MDA monolayer cells and metastatic biopsies exhibited increased cellular contents (2-15 times) of EMT (β-catenin, SNAIL), migratory (vimentin, cytokeratin, and fibronectin) and invasive (MMP-1, VEGF) proteins versus MCF-7 monolayer cells, quiescent cell layers of mature MCF-7 MCTS and non-metastatic breast biopsies. The increase in metastatic proteins correlated with substantially elevated cellular abilities for migration (18-times) and invasiveness (13-times) and with the higher level (6-times) of the cytokine GPI/AMF in the extracellular medium of PRL, as compared to MCF-7 monolayer cells. Interestingly, the addition of the GPI/AMF inhibitors erythrose-4-phosphate or 6-phosphogluconate at micromolar doses significantly decreased its extracellular activity (>80%), with a concomitant diminution in the metastatic protein content and migratory tumor cell capacity, and with no inhibitory effect on tumor lactate production or toxicity on 3T3 mouse fibroblasts. The present findings provide new insights into the discovery of metabolic inhibitors to be used as complementary therapy against metastatic and aggressive tumors.
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Kim JR, Moon YJ, Kwon KS, Bae JS, Wagle S, Yu TK, Kim KM, Park HS, Lee JH, Moon WS, Lee H, Chung MJ, Jang KY. Expression of SIRT1 and DBC1 is associated with poor prognosis of soft tissue sarcomas. PLoS One 2013; 8:e74738. [PMID: 24019980 PMCID: PMC3760851 DOI: 10.1371/journal.pone.0074738] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/02/2013] [Indexed: 12/21/2022] Open
Abstract
Recently, the roles of SIRT1 and deleted in breast cancer 1 (DBC1) in human cancer have been extensively studied and it has been demonstrated that they are involved in many human carcinomas. However, their clinical significance for soft-tissue sarcomas has not been examined. In this study, we evaluated the expression and prognostic significance of the expression of SIRT1, DBC1, P53, β-catenin, cyclin D1, and KI67 in 104 cases of soft-tissue sarcomas. RESULTS: Immunohistochemical expression of SIRT1, DBC1, P53, β-catenin, and cyclin D1 were seen in 71%, 74%, 53%, 48%, and 73% of sarcomas, respectively. The expression of SIRT1, DBC1, P53, β-catenin, and cyclin D1 were significantly correlated with advanced clinicopathological parameters such as higher clinical stage, higher histological grade, increased mitotic counts, and distant metastasis. The expression of SIRT1, DBC1, P53, β-catenin, cyclin D1, and KI67 were significantly correlated with each other and positive expression of all of these predicted shorter overall survival and event-free survival by univariate analysis. Multivariate analysis revealed the expression of SIRT1 as an independent prognostic indicator for overall survival and event-free survival of sarcoma patients. In conclusion, this study demonstrates that SIRT1- and DBC1-related pathways may be involved in the progression of soft-tissue sarcomas and can be used as clinically significant prognostic indicators for sarcoma patients. Moreover, the SIRT1- and DBC1-related pathways could be new therapeutic targets for the treatment of sarcomas.
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Affiliation(s)
- Jung Ryul Kim
- Department of Orthopaedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Medicine and Research Institute for Endocrine Sciences, Jeonju, Republic of Korea
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CAMPOS MARCELO, DE CAMPOS SILVANAGISELEPEGORIN, RIBEIRO GUILHERMEGOMES, EGUCHI FLÁVIACOLTRI, SILVA SANDRAREGINAMORINIDA, DE OLIVEIRA CLEYTONZANARDO, DA COSTA ALLINIMAFRA, CURCELLI EMÍLIOCARLOS, NUNES MARCOSCEITA, PENNA VALTER, LONGATTO-FILHO ADHEMAR. Ki-67 and CD100 immunohistochemical expression is associated with local recurrence and poor prognosis in soft tissue sarcomas, respectively. Oncol Lett 2013; 5:1527-1535. [PMID: 23759874 PMCID: PMC3678859 DOI: 10.3892/ol.2013.1226] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 10/22/2012] [Indexed: 11/29/2022] Open
Abstract
Soft tissue sarcomas (STSs) are a heterogeneous group of mesenchymal tumors of >50 subtypes. However, STSs represent <1% of types of cancer. Despite this low frequency, the disease is aggressive and treatment, when possible, is based on traditional chemotherapies. A number of cases of resistance to adjuvant therapies have been reported. Metastases are commonly identified in STS patients during diagnosis and the development of effective clinical parameters is crucial for correct management of the disease. The use of biological markers in cancer is a useful tool to determine patient prognosis. Ki-67 is a protein marker for proliferation of somatic cells and is widely used in prognostic studies of various types of tumor, including STSs. Cluster of differentiation 100 (CD100) is a member of the semaphorin family. The family was initially described as axon guidance molecules important for angiogenesis, organogenesis, apoptosis and neoplasia. CD100 was previously utilized as a prognostic factor in tumors and also in STSs. In the present study, protein expression of Ki-67 and CD100 was analyzed by immunohistochemistry in samples of STS patients of the Barretos Cancer Hospital (Barretos, Brazil) to establish prognostic criteria of the disease. Results demonstrate a correlation between CD100 expression and poor prognosis, consistent with a previous study. Moreover, the expression of Ki-67 was identified to correlate with presence of local or locoregional recurrence. To the best of our knowledge, no large casuistic study has revealed this correlation between Ki-67 and local recurrence in STSs. The use of Ki-67 and CD100 as markers in clinical pathological analysis may be suitable as a prognostic criterion in disease progression.
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Affiliation(s)
- MARCELO CAMPOS
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | | | - GUILHERME GOMES RIBEIRO
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | - FLÁVIA COLTRI EGUCHI
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | | | | | - ALLINI MAFRA DA COSTA
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | | | - MARCOS CEITA NUNES
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | - VALTER PENNA
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
| | - ADHEMAR LONGATTO-FILHO
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos 14780-000
- Laboratory of Medical Investigation 14, Faculty of Medicine, University of São Paulo, São Paulo 01246-903,
Brazil
- Life and Health Sciences Research Institute, School of Health Sciences (ICVS), University of Minho, Braga 4710-057, Guimarães,
Portugal
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Lin XY, Wang L, Zhang Y, Dai SD, Wang EH. Variable Ki67 proliferative index in 65 cases of nodular fasciitis, compared with fibrosarcoma and fibromatosis. Diagn Pathol 2013; 8:50. [PMID: 23531088 PMCID: PMC3622623 DOI: 10.1186/1746-1596-8-50] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/21/2013] [Indexed: 11/14/2022] Open
Abstract
Abstract Nodular fasciitis is the most common pseudosarcomatous lesion of soft tissue. Ki67 was considered as a useful marker for distinguishing some benign and malignant lesions. To study the usefulness of Ki67 in diagnosis of nodular fasciitis, the expression of Ki67 was examined by using immunostaining in 65 nodular fasciitis specimens, 15 desmoid fibromatosis specimens and 20 fibrosarcoma specimens. The results showed that there was a variable Ki67 index in all 65 cases of nodular fasciitis, and the mean labeling index was 23.71±15.01%. In majority (70.77%) of all cases,the index was ranged from 10% to 50%, in 6.15% (4/65) of cases the higher Ki67 index (over 50%) could be seen. The Ki67 proliferative index was closely related to duration of lesion, but not to age distribution, lesion size, sites of lesions and gender. Moreover, the mean proliferative index in desmoid fibromatosis and fibrosarcoma was 3.20±1.26% and 26.15±3.30% respectively. The mean Ki67 index of nodular fasciitis was not significantly lower than fibrosarcoma, but higher than desmoid fibromatosis. The variable and high Ki67 index in nodular fasciitis may pose a diagnostic challenge. We should not misdiagnose nodular fasciitis as a sarcoma because of its high Ki67 index. The recurrence of nodular fasciitis is rare; and the utility of Ki67 immunostaining may be not suitable for recurrence assessment in nodular fasciitis. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4782335818876666
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Affiliation(s)
- Xu-Yong Lin
- Department of Pathology, China Medical University, Shenyang, China
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28
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High Nr-CAM expression is associated with favorable phenotype and late PSA recurrence in prostate cancer treated by prostatectomy. Prostate Cancer Prostatic Dis 2013; 16:159-64. [DOI: 10.1038/pcan.2012.50] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Prognostic value of proliferation in pleomorphic soft tissue sarcomas: a new look at an old measure. Hum Pathol 2012; 43:2247-54. [PMID: 22789784 DOI: 10.1016/j.humpath.2012.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/12/2012] [Accepted: 03/13/2012] [Indexed: 11/23/2022]
Abstract
Though proliferation has repeatedly shown a prognostic role in sarcomas, it has not reached clinical application. We performed a comprehensive evaluation of the prognostic role of 5 proliferation measures in a large series of soft tissue sarcomas of the extremities and the trunk wall. One hundred ninety-six primary soft tissue sarcomas of the extremities and the trunk wall were subjected to DNA flow cytometry for quantification of S-phase fraction and to immunohistochemical evaluation of Ki-67, Top2a, p21, and p27Kip1. In univariate analysis, positive expression of Ki-67 (hazard ratio = 4.5, CI = 1.6-12.1), Top2a (hazard ratio = 2.2, CI = 1.2-3.5) and high S-phase fraction (hazard ratio = 1.8, CI = 1.2-3.7) significantly correlated with risk for metastasis. When combined with currently used prognostic factors, Ki-67, S-phase fraction and Top2a fraction contributed to refined identification of prognostic risk groups. Proliferation, as assessed by expression of Ki-67 and Top2a and evaluation of S-phase fraction and applied to statistical decision-tree models, provides prognostic information in soft tissue sarcomas of the extremity and trunk wall. Though proliferation contributes independently to currently applied prognosticators, its role is particularly strong when few other factors are available, which suggests a role in preoperative decision-making related to identification of high-risk individuals who would benefit from neoadjuvant therapy.
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Jones NB, Iwenofu H, Scharschmidt T, Kraybill W. Prognostic factors and staging for soft tissue sarcomas: an update. Surg Oncol Clin N Am 2012; 21:187-200. [PMID: 22365514 DOI: 10.1016/j.soc.2011.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Soft tissue sarcoma (STS) staging is a constantly evolving process. Grading is still of utmost importance and has been adapted into a three-tier system. The STS most difficult to categorize are those with uncertain malignant potential, such as solitary fibrous tumors, gastrointestinal stromal tumors, and glomus tumors, some of which have developed completely separate staging systems and may not even be considered sarcomas. Beyond the current TNM staging system, a multitude of prognostic factors for STS will continue to be discovered and ultimately incorporated into future revisions of the staging system.
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Affiliation(s)
- Natalie B Jones
- Department of Surgery, The Ohio State University, Columbus, OH 43210, USA
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31
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López-Guerrero JA, Machado I, Scotlandi K, Noguera R, Pellín A, Navarro S, Serra M, Calabuig-Fariñas S, Picci P, Llombart-Bosch A. Clinicopathological significance of cell cycle regulation markers in a large series of genetically confirmed Ewing's sarcoma family of tumors. Int J Cancer 2011; 128:1139-50. [PMID: 20473914 DOI: 10.1002/ijc.25424] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
More than 90% of all Ewing's Sarcoma Family of Tumors (ESFT) exhibit specific chromosomal rearrangements between the EWS gene on chromosome 22 and various members of the ETS gene family of transcription factors. The gene fusion type and other secondary genetic alterations, mainly involving cell cycle regulators, have been shown to be of prognostic relevance in ESFT. However, no conclusive results have been reported. We analyzed the clinicopathological significance of relevant cell cycle regulators in genetically confirmed ESFT. A total of 324 cases were analyzed for the immunohistochemical expression of p53, p21(Waf1/Cip1) , p27(Kip1) and Ki67 and the chromosomal alterations of the p53 and 9p21 locus by fluorescent in situ hybridization. We observed that expression of p53 (p = 0.025), p21(Waf1/Cip1) (p = 0.015) and p27(Kip1) (p = 0.013) was higher in disseminated than in localized disease. Furthermore, a cohort of 217 patients with localized disease was considered for studying the prognosis involvement of these factors on patient follow-up. The median follow-up was 39 months (range: 0.17-452) with an overall survival (OS) of 55%. Ki67 was expressed in 34% of cases and constituted an independent prognostic factor for progression free survival and OS independently of the type of treatment [hazard ratio of 2.0 (95% CI: 1.3-3.1; p = 0.003) and 1.9 (95% IC: 1.3-2.9; p = 0.007) for progression free survival and OS, respectively, being especially relevant in the group of patients which incorporated radiotherapy in their regimen schedules. In conclusion, this study demonstrates that Ki67 expression constitutes a valuable indicator of poor prognosis in localized ESFT.
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Hamamoto Y, Shomori K, Nosaka K, Haruki T, Teshima R, Ito H. Prognostic significance of Minichromosome maintenance protein 7 and Geminin expression in patients with 109 soft tissue sarcomas. Oncol Lett 2010; 1:703-709. [PMID: 22966367 DOI: 10.3892/ol_00000123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 05/28/2010] [Indexed: 01/08/2023] Open
Abstract
Minichromosome maintenance complex (MCM2-7) and Geminin are important in the prevention of DNA re-replication in the cell cycle, and are also prognostic markers for numerous human malignancies. The present study examined Minichromosome maintenance protein 7 (MCM7) and Geminin expression in human soft tissue sarcomas (STSs) to clarify their correlation to the clinicopathological factors. Immunohistochemistry was performed to detect the expression of MCM7, Geminin and Ki-67 on paraffin-embedded sections of 109 STSs. Labeling indices (LIs) of the molecules were evaluated in the tumors. Higher LIs of MCM7, Geminin and Ki-67 were significantly correlated with distant metastasis (P<0.01), histological grade (P<0.01) and poor prognosis (P<0.01), respectively. LIs of MCM7 and Geminin were significantly correlated with Ki-67 LIs, (MCM7/Ki-67: rs=0.745, P<0.01 and Geminin/Ki-67: rs=0.604, P<0.01). Multivariate analyses showed that the higher LIs of Geminin, but not MCM7 and Ki-67, were shown to be an independent factor of poorer prognosis (relative risk 2.72, P=0.013). The immunohistochemical expression of MCM7 and Geminin may be novel and useful markers for evaluating the prognosis in patients with human STS.
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Affiliation(s)
- Yuki Hamamoto
- Division of Organ Pathology, Department of Microbiology and Pathology, Tottori University, Tottori 683-8503, Japan
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Chen Z, Huang X, Ye J, Pan P, Cao Q, Yang B, Li Z, Su M, Huang C, Gu J. Immunoglobulin G is present in a wide variety of soft tissue tumors and correlates well with proliferation markers and tumor grades. Cancer 2010; 116:1953-63. [PMID: 20186824 DOI: 10.1002/cncr.24892] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The traditional view that immunoglobulin (Ig) is produced only by B lymphocytes has been challenged, because it has been demonstrated that Ig genes and proteins are expressed in epithelial cancer cells. However, whether Ig expression in nonlymphoid cells is limited to epithelial cells is unclear. Because sarcomas differ distinctly from carcinomas in their biologic and clinical features, the authors investigated the question of nonlymphoid IgG expression in soft tissue lesions. METHODS Immunohistochemistry, in situ hybridization, and polymerase chain reaction (PCR) were used to demonstrate IgG expression in 80 soft tissue lesions. The correlation between Ig expression and proliferation markers (proliferating cell nuclear antigen [PCNA], Ki-67, and cyclin D1) in sarcomas was investigated by immunohistochemical and statistical analyses. RESULTS Igkappa was identified in 97.4% of sarcomas and in 31.7% of benign lesions by immunohistochemistry. The difference was statistically significant (P < .01). Messenger RNA from the IgG1 heavy-chain constant region was also detected by in situ hybridization. Variable-diversity-joining recombination sequences of both heavy and light chains were obtained by PCR and sequencing. Moreover, the labeling index of PCNA, Ki-67, and cyclin D1 was much higher in sarcomas with high Igkappa expression than in sarcomas with low Igkappa expression (P < .01 for PCNA and cyclin D1; P < .001 for Ki-67). There were more grade 3 sarcomas with high Igkappa expression compared with grade 1 and 2 sarcomas (P < .05). CONCLUSIONS IgG was identified in a wide variety of soft tissue tumors and correlated well with proliferation markers and tumor grades. IgG may be a useful marker for cell proliferation in sarcomas.
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Affiliation(s)
- Zhengshan Chen
- Department of Pathology, Shantou University Medical College, Shantou, China
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Abstract
Tissue microarrays (TMAs) have become a standard tool for tissue-based research during the last decade. In cancer research, depending on the available data attached to the arrayed tissue, three main types of arrays are commonly manufactured. Prevalence TMAs have no further data available and are suited to estimate the frequency of the occurrence of a particular alteration. Progression arrays include tissues of different stages of disease, and are instrumental to study the role of a marker protein for tumor initiation, progression, or metastatic growth. Prognosis TMAs contain tissues with patient follow-up data. These TMAs are the key to uncover the clinical impact of molecular markers. In combination with normal tissue arrays representing healthy tissues, prevalence, progression, and prognosis TMAs allow for a rapid and comprehensive analysis of molecular markers in human cancers. TMAs are also successfully used for many noncancer applications, such as Alzheimer's or inflammatory disease research.
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Abstract
The smaller the portion of a tumor sample that is analyzed becomes, the higher is the risk of missing important histological or molecular features that might be present only in a subset of tumor cells. Many researchers have, therefore, suggested using larger tissue cores or multiple cores from the same donor tissue to enhance the representativity of TMA studies. However, numerous studies comparing the results of TMA studies with the findings from conventional large sections have shown that all well-established associations between molecular markers and tumor phenotype or patient prognosis can be reproduced with TMAs even if only one single 0.6 mm tissue spot is analyzed. Moreover, the TMA technology has proven to be superior to large section analysis in finding new clinically relevant associations. The high number of samples that are typically included in TMA studies, and the unprecedented degree of standardization during TMA experiments and analysis often give TMA studies an edge over traditional large-section studies.
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Affiliation(s)
- Guido Sauter
- Institute of Pathology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
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Kanatas AN, Harris AT, Messenger M, Houghton D, Rogers SN. The role of molecular strategies in the evaluation of surgical margins in oropharyngeal squamous cell carcinoma. Oncol Rev 2009. [DOI: 10.1007/s12156-009-0020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Engellau J. Prognostic factors in soft tissue sarcomaTissue microarray for immunostaining, the importance of whole-tumor sections and time-dependence. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/03008820410001887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Al-Dissi AN, Haines DM, Singh B, Kidney BA. Immunohistochemical expression of vascular endothelial growth factor and vascular endothelial growth factor receptor in canine cutaneous fibrosarcomas. J Comp Pathol 2009; 141:229-36. [PMID: 19560781 DOI: 10.1016/j.jcpa.2009.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 04/28/2009] [Accepted: 05/12/2009] [Indexed: 11/27/2022]
Abstract
The expression of five markers associated with tumour angiogenesis, proliferation and apoptosis was studied in 24 canine cutaneous fibrosarcomas. Tumours were assigned histological grades and were immunohistochemically evaluated for the expression of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2). Additionally, intra-tumour microvessel density (iMVD) was assessed by immunohistochemical labelling for expression of von Willebrand factor (vWf) and tumour proliferation index (PI) was measured following labelling of Ki-67 antigen. Finally, tumour apoptotic index (AI) was determined by application of the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP end-labelling method (TUNEL). VEGF and VEGFR-2 expression were detected in 22/24 (92%) and 24/24 (100%) of fibrosarcomas, respectively. There was correlation between VEGF and VEGFR-2 expression (r = 0.51) and between histological grade and PI (r = 0.82). A significant difference in PI between tumours of different histological grade was found (P < 0.05). The median PI in grade 2 and 3 tumours (30.6 and 54.7, respectively) was significantly higher than in grade 1 tumours (6.4). Therefore, only PI correlates significantly with the histological grade of canine cutaneous fibrosarcomas. The potential for autocrine activity for VEGF exists in canine cutaneous fibrosarcomas, as VEGF and VEGFR-2 expression was found in most tumours.
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Affiliation(s)
- A N Al-Dissi
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
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Kim BS, Kang KH, Lim YA, Kim LS. Clinical Significance of p53, Ki-67 and Galectin-3 Expressions in Papillary Thyroid Carcinoma. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2009. [DOI: 10.4174/jkss.2009.77.1.29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Byung Seup Kim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Kyung Ho Kang
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Young Ah Lim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Lee Su Kim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
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Ludwig JA. Personalized therapy of sarcomas: integration of biomarkers for improved diagnosis, prognosis, and therapy selection. Curr Oncol Rep 2008; 10:329-37. [PMID: 18778559 DOI: 10.1007/s11912-008-0051-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An improved understanding of cancer's molecular diversity at the genetic, proteomic, and epigenetic levels has made it evident that "sarcoma" comprises more than 50 different types, each as unique as, for example, breast carcinoma is from colon carcinoma. Sarcomas exhibit characteristic differences in cell of origin, disease site, likelihood and site of metastasis, growth propensity, and chemosensitivity. Additionally, as many as one third of sarcomas harbor specific chromosomal translocations that can be used to discriminate one subtype from another. Although biomarkers can be integrated into clinical practice to improve diagnostic accuracy and predict treatment response, a number of challenges hinder their widespread use. This review addresses the current use of biomarkers for clinical oncology, with special emphasis on diagnosis, staging, and grading. It also discusses types of biomarkers that are emerging to aid selection of therapy for patients with sarcoma. Finally, we consider practical factors that appear to limit biomarker integration into clinical practice.
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Affiliation(s)
- Joseph A Ludwig
- Laboratory of Sarcoma Molecular Therapeutics, Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 450, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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Kubo T, Piperdi S, Rosenblum J, Antonescu CR, Chen W, Kim HS, Huvos AG, Sowers R, Meyers PA, Healey JH, Gorlick R. Platelet-derived growth factor receptor as a prognostic marker and a therapeutic target for imatinib mesylate therapy in osteosarcoma. Cancer 2008; 112:2119-29. [PMID: 18338812 DOI: 10.1002/cncr.23437] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this review was to determine whether imatinib mesylate (STI571, Gleevec) has a role in the treatment of osteosarcoma. The expression of platelet-derived growth factor (PDGF) receptor and its ligand was examined in a panel of surgical specimens obtained from 54 osteosarcoma patients, and then the expression was compared with prognosis. The effects of imatinib mesylate on growth and molecular events in 10 patient-derived osteosarcoma cell cultures were investigated. Immunohistochemical studies demonstrated frequent expression of PDGF-AA (80.4%) and PDGF-alpha receptor (79.6%) and their correlation with inferior event-free survival (P < .05). PDGF-B-B and PDGF-beta-receptor expressions were also frequent (75.4% and 86%, respectively); however, statistically significant inferior event-free survival was not demonstrated (P = .15). In vitro studies demonstrated that imatinib mesylate had a variable cytotoxic effect on various osteosarcoma primary cultures, with an IC(50) of 5.6 microM to 9.5 microM, and blocked the PDGF-induced intracellular signal transduction as well as inhibition of downstream Akt phosphorylation. Mitogen-activated protein kinase (MAPK) was constitutively activated despite PDGF stimulation and imatinib mesylate treatment in 7 of 10 osteosarcoma cultures, perhaps explaining uncontrolled proliferation and relative unresponsiveness to imatinib. Imatinib mesylate could not be viewed as having a role as a single agent at current conventional doses for the treatment of osteosarcoma. These findings predicted activity in osteosarcoma clinical trials and suggested that in vitro model systems predict clinical behavior and that PDGF and its receptor expression could potentially be used for determining prognosis of osteosarcoma.
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Affiliation(s)
- Tadahiko Kubo
- Orthopedic Surgery Service, Memorial Sloan-Kettering Cancer Center, Weil Medical College of Cornell University, New York, New York, USA
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Matsubara T, Eimoto T, Okabe M, Miyabe S, Fujiyoshi Y, Matsushita Y, Mizutani J, Yamada S, Otsuka T. Proliferation and apoptosis of tumour cells before and after neoadjuvant therapy for high-grade extremity sarcomas: divergent associations with tumour response and prognosis. Histopathology 2008; 52:706-16. [PMID: 18393971 DOI: 10.1111/j.1365-2559.2008.03015.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate proliferation and apoptosis in high-grade sarcomas of the extremities before and after preoperative radio-hyperthermo-chemotherapy (RHC) and to determine the relationship between these parameters and treatment outcomes. METHODS AND RESULTS Pre- and post-RHC specimens of 41 soft tissue and bone tumours were immunohistochemically stained for minichromosome maintenance protein (MCM) 2 and caspase 3 as proliferation and apoptosis markers, respectively, based on a preliminary study comparing them with conventional markers. Indices were calculated as a percentage of positive cells by counting tumour cells in the most frequently labelled areas. MCM2, caspase 3 and MCM2/caspase 3 (growth) indices were 45.3 +/- 21.9%, 4.1 +/- 7.1% and 82.9 +/- 104.5, respectively, in pre-RHC specimens and 35.4 +/- 30.8%, 39.2 +/- 34.6% and 5.3 +/- 11.7, respectively, in post-RHC specimens. Response scores showed positive correlation with pre-RHC MCM2 and post-RHC caspase 3 indices, inverse correlation with post-RHC MCM2 and post-RHC growth indices and no correlation with prognosis. Multivariate analysis revealed high pre-RHC MCM2 and high post-RHC growth indices as significant unfavourable prognostic factors. CONCLUSIONS High proliferative activity in untreated sarcoma may predict good response to neoadjuvant therapy, but poor prognosis, whereas a high growth index, i.e. high proliferation:apoptosis ratio in a post-neoadjuvant therapy tumour specimen may indicate poor response and poor prognosis.
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Affiliation(s)
- T Matsubara
- Department of Pathology, Nagoya City University School of Medicine, Nagoya, Japan
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Fernebro J, Engellau J, Persson A, Rydholm A, Nilbert M. Standardizing evaluation of sarcoma proliferation- higher Ki-67 expression in the tumor periphery than the center. APMIS 2007; 115:707-12. [PMID: 17550378 DOI: 10.1111/j.1600-0463.2007.apm_650.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Soft tissue sarcomas often present as large and histopathologically heterogenous tumors. Proliferation has repeatedly been identified as a prognostic factor and immunostaining for Ki-67 represents the most commonly used proliferation marker. There is, however, a lack of consensus on how to evaluate Ki-67 staining regarding optimal cut-off levels, selection of tumor areas, and the number of tumor cells to evaluate. We assessed the impact of targeting peripheral versus central tumor areas using tissue microarray-based staining for Ki-67 throughout the tumor diameter in 25 leiomyosarcomas. In 18/25 tumors, Ki-67 expression was higher in the tumor periphery. If 10% staining tumor nuclei was used as cut-off and the maximal Ki-67 staining section in the tumor periphery was considered, 21/25 tumors would have been classified as highly proliferative compared to 14/25 if the tumor center had been analyzed. Similar results were obtained also when higher cut-off levels were used and if the mean expression rather than the maximal expression was considered and the differences were neither caused by necrosis nor by hypoxia (assessed as HIF-1alpha expression). Our findings suggest that the determination of proliferation in soft tissue sarcomas should be standardized for clinical application of Ki-67 as a prognostic marker.
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Affiliation(s)
- Josefin Fernebro
- Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, Lund, Sweden.
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Shintani K, Matsumine A, Kusuzaki K, Matsubara T, Satonaka H, Wakabayashi T, Hoki Y, Uchida A. Expression of hypoxia-inducible factor (HIF)-1alpha as a biomarker of outcome in soft-tissue sarcomas. Virchows Arch 2006; 449:673-81. [PMID: 17103226 DOI: 10.1007/s00428-006-0304-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2006] [Revised: 08/05/2006] [Accepted: 08/24/2006] [Indexed: 12/26/2022]
Abstract
Hypoxia-inducible factor (HIF)-1alpha is a transcription factor that supports the adaptation of human cancer cells to hypoxia and tumor growth and progression. The overexpression of HIF-1alpha protein has been reported to be associated with a worse prognosis in various cancers. However, the expression of HIF-1alpha in soft-tissue sarcomas has not yet been characterized. The expression of HIF-1alpha protein was immunohistochemically determined in 49 specimens of soft-tissue sarcomas including malignant fibrous histiocytoma (29 patients), synovial sarcoma (12 patients), leiomyosarcoma (four patients), and malignant peripheral nerve sheath tumors (four patients). The 49 samples consisted of 40 primary lesions and nine local recurrences. An immunohistochemical analysis showed the nuclear accumulation of HIF-1alpha protein in 35 (71.4%) samples. The expression of HIF-1alpha was negative in 14 (28.6%) cases, weak in nine (18.4%), moderate in 17 (35.4%), and strong in nine (18.4%). The patients with a strong or moderate expression of HIF-1alpha had a significantly shorter overall survival rate in comparison with those with a weak or negative expression in a univariate analysis (P = 0.029; log-rank test) and multivariate analysis (P = 0.018). This is the first report that demonstrated an overexpression of HIF-1alpha protein to be an independent prognostic factor for soft-tissue sarcomas.
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Affiliation(s)
- Ken Shintani
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu-city, Mie 514-8507, Japan
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Ruiz C, Seibt S, Al Kuraya K, Siraj AK, Mirlacher M, Schraml P, Maurer R, Spichtin H, Torhorst J, Popovska S, Simon R, Sauter G. Tissue microarrays for comparing molecular features with proliferation activity in breast cancer. Int J Cancer 2006; 118:2190-4. [PMID: 16331604 DOI: 10.1002/ijc.21581] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Tissue microarrays (TMAs) are potentially suited to find associations between molecular features and clinical outcome. Enhanced cell proliferation, as measured by Ki67 immunohistochemistry, is related to poor patient prognosis in many different tumor types. Ki67 expression shows considerable intratumoral heterogeneity. It is unclear if the TMA format is suitable for the analysis of potentially heterogeneous markers because of the small size of TMA spots. We have analyzed a breast cancer TMA containing 2,517 breast tissues, including 2,222 neoplastic and 295 normal or premalignant samples, for Ki67 labeling index (Ki67 LI) and additional markers with a known relationship to Ki67 LI by immunohistochemistry (ER, PR, Bcl-2, Egfr, p16, p53) and Fluorescence in situ hybridization (HER2, MDM2, CCND1, MYC). A high Ki67 LI was linked to tumor phenotype including grade (p < 0.0001), stage (p < 0.0001), nodal stage (p = 0.0018), and patient prognosis (p < 0.0001), elevated protein levels of p53, p16 and Egfr, reduced levels of Bcl2, ER, and PR (p < 0.0001 each), as well as amplifications of HER2, MYC, CCND1 and MDM2 (p < 0.0001 each). In summary, all expected associations between Ki67 and the analyzed molecular markers could be reproduced with high statistical significance using a TMA containing only one tissue sample per tumor, measuring 0.6 mm in diameter. We conclude that associations with cell proliferation can be reliably analyzed in a TMA format.
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Affiliation(s)
- Christian Ruiz
- Institute of Pathology, University Hospital Basel, 4031 Basel, Switzerland
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Valera V, Yokoyama N, Walter B, Okamoto H, Suda T, Hatakeyama K. Clinical significance of Ki-67 proliferation index in disease progression and prognosis of patients with resected colorectal carcinoma. Br J Surg 2005; 92:1002-7. [PMID: 15931661 DOI: 10.1002/bjs.4858] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The prognostic role of proliferation markers in patients with colorectal neoplasia is inconclusive. The aim of this study was to evaluate proliferation markers in patients with colorectal carcinoma, to relate these to standard clinicopathological findings and to investigate their potential role in the prediction of long-term survival. METHODS Archived formalin-fixed, paraffin-embedded tissue samples from a cohort of 106 patients who underwent curative resection for colorectal carcinoma were analysed to determine a Ki-67 (MIB-1)-derived proliferation index (PI) using a double immunostaining technique. The relationship between PI and standard clinicopathological variables was assessed and its association with long-term survival evaluated. RESULTS A significant association was found between PI and tumour (T) status (P = 0.001), lymph node (N) involvement (P = 0.0098), the presence of distant metastases (P < 0.010) and advanced stage of disease (P < 0.001). On multivariate analysis, PI was shown to be an independent prognostic factor for long-term survival (hazard ratio 2.1 (95 per cent confidence interval 1.1 to 4.1); P = 0.032). CONCLUSION Cell proliferation is significantly associated with tumour progression and may be used to identify patients with a predicted adverse outcome after resection of colorectal carcinoma.
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Affiliation(s)
- V Valera
- Department of Surgery, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.
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Åhlén J, Wejde J, Brosjö O, von Rosen A, Weng WH, Girnita L, Larsson O, Larsson C. Insulin-Like Growth Factor Type 1 Receptor Expression Correlates to Good Prognosis in Highly Malignant Soft Tissue Sarcoma. Clin Cancer Res 2005. [DOI: 10.1158/1078-0432.206.11.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Purpose: To evaluate known and suggested prognostic markers, especially insulin-like growth factor type 1 receptor (IGF-1R), in highly malignant soft tissue sarcomas (STS).
Experimental Design: A cohort of 101 patients with primary STS of high malignancy grade was studied with respect to development of metastasis, local recurrence, and survival during a minimum of 5 years follow-up. All tumors were analyzed by immunohistochemistry for expression of Ki-67, p53, p27, Bcl-2, IGF-1R, and microvessel density. The traditional clinical variables size, malignancy grade (3 or 4), necrosis, mitotic frequency, infiltrative tumor growth, vascular invasion, depth, and surgical margins were also evaluated.
Results: A significant association was shown between high expression of IGF-1R and favorable outcome. Among STS with positive IGF-1R immunoreactivity, cases with high expression (76-100% positive cells) had the best outcome, whereas cases with the lowest expression (1-25% positive cells) had the worst. As expected, large tumor size (>11 cm), presence of necrosis, high mitotic count, intralesional surgery, and deep location were all significantly associated with poor outcome, both in univariate and multivariate analyses. No difference in outcome was observed between cases of malignancy grade 3 versus 4, whereas the included and more objective variables necrosis and mitotic count were found to be reliable prognostic markers.
Conclusion: IGF-1R expression is a common feature of highly malignant STS. Further elucidation of the role of IGF-1R and the IGF system in STS may both provide a basis for development of new prognostic tools in STS, as well as shed light on the basic mechanisms of the STS development.
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Affiliation(s)
- Jan Åhlén
- 1Molecular Medicine, Departments of
- 2Surgery,
- 3Orthopedics, and
- 4Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Wejde
- 4Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | - Leonard Girnita
- 4Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
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Rotenberg L, Verhille R, Schulz-Wendtland R, Verswijfel G, Gelin J, Van Migem D, Janssens JP. Multicenter clinical experience with large core soft tissue biopsy without vacuum assistance. Eur J Cancer Prev 2004; 13:491-8. [PMID: 15548942 DOI: 10.1097/00008469-200412000-00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The increasing interest in accurate pretreatment diagnosis of solid tumours by morphology, immunohistochemistry, genetics and molecular biology requires clinicians to obtain undamaged large core biopsies. Simultaneously, medical imaging and surgery give priority to minimal tissue injury, affordable technology and optimal patient compliance. A new large core soft tissue biopsy device has been developed to meet the above criteria. After intensive preclinical testing, 30 patients gave informed consent and 26 underwent the new diagnostic biopsy procedure. The sample was studied by morphology, immunohistochemistry and, where indicated, by molecular biology. Successful diagnosis was considered when in line with clinical follow-up and, as for all malignant lesions, when confirmed by open biopsy or surgery. No difficulties in the technique were encountered in 25 patients. In one patient the procedure was prematurely stopped because of anxiety. In all other 25 procedures a complete diagnosis was reached with regard to morphology, immunohistochemistry and molecular biology. A number of radiologists suggested some automation of the technique. This new large core soft tissue biopsy system performs well in the clinical context without injury to the breast parenchyma or artefacts in the harvested tissue specimen. The system meets almost all of the proposed technical and financial requirements. Automation is underway.
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Affiliation(s)
- L Rotenberg
- Centre de Radiologie Henri Hartmann, 26 boulevard Victor Hugo, 92200 Neuilly sur Seine, France
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Simon R, Mirlacher M, Sauter G. Tissue microarrays for early target evaluation. DRUG DISCOVERY TODAY. TECHNOLOGIES 2004; 1:41-48. [PMID: 24981266 DOI: 10.1016/j.ddtec.2004.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Early assessment of the probable biological importance of drug targets, the potential market size of a successful new drug, and possible treatment side effects are critical for risk management in drug development. A comprehensive molecular epidemiology analysis involving thousands of well-characterized human tissues will thus provide vital information for strategic decision-making. Tissue microarray (TMA) technology is ideally suited for such projects. The simultaneous analysis of thousands of tissues enables highly standardized, fast and affordable translational research studies of unprecedented scale.:
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Affiliation(s)
- Ronald Simon
- Division of Molecular Pathology, Institute of Pathology, Basel University Hospital, Schoenbeinstrasse 40, CH-4031 Basel, Switzerland
| | - Martina Mirlacher
- Division of Molecular Pathology, Institute of Pathology, Basel University Hospital, Schoenbeinstrasse 40, CH-4031 Basel, Switzerland
| | - Guido Sauter
- Division of Molecular Pathology, Institute of Pathology, Basel University Hospital, Schoenbeinstrasse 40, CH-4031 Basel, Switzerland.
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