1
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Norimatsu Y, Maeda Y, Malara N, Fulciniti F, Kobayashi TK. A review of the directly sampled endometrial cytology on LBC samples: Classification, microscopic criteria and beyond. Cytopathology 2024; 35:350-361. [PMID: 38050704 DOI: 10.1111/cyt.13342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 12/06/2023]
Abstract
The Yokohama System for Reporting Endometrial Cytology (TYS) has been proposed by an expert meeting under the auspices of the International Academy of Cytology (IAC) in May 2016 at the IAC in Yokohama. Since its introduction, the TYS has been receiving worldwide acceptance, and this review aims to assess its global impact. The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping and the complex physiology of endometrium). Recently, the use of liquid-based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to re-evaluate the role of endometrial cytology. LBC is a useful tool in the cytologic diagnosis and follow-up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBC from endometrial cytology could be challenging since it is affected by numerous look-alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. In conclusion, our review of the published data suggests that the TYS is a valid classification scheme that has been widely accepted by cytopathologists globally, is highly reproducible and makes a valuable contribution to clinical therapeutic management. At present, molecular cytopathology is a rapidly evolving field of modern cytopathology, which underlines the effective interplay between genomics and cytology. This review aims to provide a comprehensive review of the drawbacks of endometrial cytopathology, particularly in terms of endometrial cancer diagnosis and molecular testing.
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Affiliation(s)
- Yoshiaki Norimatsu
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Yoshinobu Maeda
- Department of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - Natalia Malara
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Franco Fulciniti
- Department of Pathology, Unilabs Switzerland SA, Basel, Switzerland
| | - Tadao K Kobayashi
- Educational Institution Tenri University, Member of the Board, Nara, Japan
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2
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Tossetta G, Marzioni D. Targeting the NRF2/KEAP1 pathway in cervical and endometrial cancers. Eur J Pharmacol 2023; 941:175503. [PMID: 36641100 DOI: 10.1016/j.ejphar.2023.175503] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Cervical and endometrial cancers are among the most dangerous gynaecological malignancies, with high fatality and recurrence rates due to frequent diagnosis at an advanced stage and chemoresistance onset. The NRF2/KEAP1 signalling pathway plays an important role in protecting cells against oxidative damage due to increased reactive oxygen species (ROS) levels. NRF2, activated by ROS, induces the expression of antioxidant enzymes such as heme oxygenase, catalase, glutathione peroxidase and superoxide dismutase which neutralize ROS, protecting cells against oxidative stress damage. However, activation of NRF2/KEAP1 signalling in cancer cells results in chemoresistance, inactivating drug-mediated oxidative stress and protecting cancer cells from drug-induced cell death. We review the literature on the role of the NRF2/KEAP1 pathway in cervical and endometrial cancers, with a focus on the expression of its components and downstream genes. We also examine the role of the NRF2/KEAP1 pathway in chemotherapy resistance and how this pathway can be modulated by natural and synthetic modulators.
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Affiliation(s)
- Giovanni Tossetta
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126, Ancona, Italy; Clinic of Obstetrics and Gynaecology, Department of Clinical Sciences, Università Politecnica delle Marche, Salesi Hospital, Azienda Ospedaliero Universitaria, 60126, Ancona, Italy.
| | - Daniela Marzioni
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126, Ancona, Italy
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3
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Němejcová K, Bártů MK, Michálková R, Drozenová J, Fabian P, Fadare O, Hausnerová J, Laco J, Matěj R, Méhes G, Singh N, Stolnicu S, Škapa P, Švajdler M, Stružinská I, Cibula D, Kocian R, Lax SF, McCluggage WG, Dundr P. A comprehensive immunohistochemical analysis of IMP2 and IMP3 in 542 cases of ovarian tumors. Diagn Pathol 2023; 18:15. [PMID: 36740684 PMCID: PMC9901072 DOI: 10.1186/s13000-023-01300-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/19/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND IMP2 and IMP3 are mRNA binding proteins involved in carcinogenesis. We examined a large cohort of ovarian tumors with the aim to assess the value of IMP2 and IMP3 for differential diagnosis, and to assess their prognostic significance. METHODS Immunohistochemical analyses with antibodies against IMP2 and IMP3 were performed on 554 primary ovarian tumors including 114 high grade serous carcinomas, 100 low grade serous carcinomas, 124 clear cell carcinomas, 54 endometrioid carcinomas, 34 mucinous carcinomas, 75 mucinous borderline tumors, and 41 serous borderline tumors (micropapillary variant). The associations of overall positivity with clinicopathological characteristics were evaluated using the chi-squared test or Fisher's Exact test. RESULTS We found IMP2 expression (in more than 5% of tumor cells) in nearly all cases of all tumor types, so the prognostic meaning could not be analyzed. The positive IMP3 expression (in more than 5% of tumor cells) was most common in mucinous carcinomas (82%) and mucinous borderline tumors (81%), followed by high grade serous (67%) and clear cell carcinomas (67%). The expression was less frequent in endometrioid carcinomas (39%), low grade serous carcinomas (23%), and micropapillary variant of serous borderline tumors (20%). Prognostic significance of IMP3 could be evaluated only in low grade serous carcinomas in the case of relapse-free survival, where negative cases showed better RFS (p = 0.033). CONCLUSION Concerning differential diagnosis our results imply that despite the differences in expression in the different ovarian tumor types, the practical value for diagnostic purposes is limited. Contrary to other solid tumors, we did not find prognostic significance of IMP3 in ovarian cancer, with the exception of RFS in low grade serous carcinomas. However, the high expression of IMP2 and IMP3 could be of predictive value in ovarian carcinomas since IMP proteins are potential therapeutical targets.
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Affiliation(s)
- Kristýna Němejcová
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800, Prague 2, Czech Republic.
| | - Michaela Kendall Bártů
- grid.411798.20000 0000 9100 9940Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800 Prague 2, Czech Republic
| | - Romana Michálková
- grid.411798.20000 0000 9100 9940Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800 Prague 2, Czech Republic
| | - Jana Drozenová
- grid.4491.80000 0004 1937 116XDepartment of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, 10034 Prague, Czech Republic
| | - Pavel Fabian
- grid.419466.8Department of Oncological Pathology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Oluwole Fadare
- grid.266100.30000 0001 2107 4242Department of Pathology, University of California San Diego, San Diego, CA USA
| | - Jitka Hausnerová
- grid.10267.320000 0001 2194 0956Department of Pathology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jan Laco
- grid.4491.80000 0004 1937 116XThe Fingerland Department of Pathology, Charles University Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Radoslav Matěj
- grid.411798.20000 0000 9100 9940Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800 Prague 2, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, 10034 Prague, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Gábor Méhes
- grid.7122.60000 0001 1088 8582Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, 4032 Hungary
| | - Naveena Singh
- grid.4868.20000 0001 2171 1133Department of Cellular Pathology, Barts Health NHS Trust, and Blizard Institute of Core Pathology, Queen Mary University of London, London, UK
| | - Simona Stolnicu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Târgu Mureș, Romania
| | - Petr Škapa
- grid.412826.b0000 0004 0611 0905Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Marián Švajdler
- grid.4491.80000 0004 1937 116XŠikl’s Department of Pathology, The Faculty of Medicine and Faculty Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ivana Stružinská
- grid.411798.20000 0000 9100 9940Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800 Prague 2, Czech Republic
| | - David Cibula
- grid.411798.20000 0000 9100 9940Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic
| | - Roman Kocian
- grid.411798.20000 0000 9100 9940Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic
| | - Sigurd F. Lax
- grid.9970.70000 0001 1941 5140Department of Pathology, Hospital Graz II, Graz, Austria, and Johannes Kepler University Linz, Linz, Austria
| | - W. Glenn McCluggage
- grid.412915.a0000 0000 9565 2378Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - Pavel Dundr
- grid.411798.20000 0000 9100 9940Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 12800 Prague 2, Czech Republic
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4
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Devis‐Jauregui L, Vidal A, Plata‐Peña L, Santacana M, García‐Mulero S, Bonifaci N, Noguera‐Delgado E, Ruiz N, Gil M, Dorca E, Llobet FJ, Coll‐Iglesias L, Gassner K, Martinez‐Iniesta M, Rodriguez‐Barrueco R, Barahona M, Marti L, Viñals F, Ponce J, Sanz‐Pamplona R, Piulats JM, Vivancos A, Matias‐Guiu X, Villanueva A, Llobet‐Navas D. Generation and Integrated Analysis of Advanced Patient-Derived Orthoxenograft Models (PDOX) for the Rational Assessment of Targeted Therapies in Endometrial Cancer. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 10:e2204211. [PMID: 36373729 PMCID: PMC9811454 DOI: 10.1002/advs.202204211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/18/2022] [Indexed: 05/19/2023]
Abstract
Clinical management of endometrial cancer (EC) is handicapped by the limited availability of second line treatments and bona fide molecular biomarkers to predict recurrence. These limitations have hampered the treatment of these patients, whose survival rates have not improved over the last four decades. The advent of coordinated studies such as The Cancer Genome Atlas Uterine Corpus Endometrial Carcinoma (TCGA_UCEC) has partially solved this issue, but the lack of proper experimental systems still represents a bottleneck that precludes translational studies from successful clinical testing in EC patients. Within this context, the first study reporting the generation of a collection of endometrioid-EC-patient-derived orthoxenograft (PDOX) mouse models is presented that is believed to overcome these experimental constraints and pave the way toward state-of-the-art precision medicine in EC. The collection of primary tumors and derived PDOXs is characterized through an integrative approach based on transcriptomics, mutational profiles, and morphological analysis; and it is demonstrated that EC tumors engrafted in the mouse uterus retain the main molecular and morphological features from analogous tumor donors. Finally, the molecular properties of these tumors are harnessed to assess the therapeutic potential of trastuzumab, a human epidermal growth factor receptor 2 (HER2) inhibitor with growing interest in EC, using patient-derived organotypic multicellular tumor spheroids and in vivo experiments.
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5
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Egan D, Moran B, Wilkinson M, Pinyol M, Guerra E, Gatius S, Matias-Guiu X, Kolch W, le Roux CW, Brennan DJ. CRABP2 - A novel biomarker for high-risk endometrial cancer. Gynecol Oncol 2022; 167:314-322. [PMID: 36163055 DOI: 10.1016/j.ygyno.2022.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/12/2022] [Accepted: 09/17/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Investigate the clinical and functional implications of elevated CRABP2 expression in endometrial cancer (EC) patients. METHODS Patients were stratified into high and low CRABP2 expression groups using a decision tree classifier. Univariate and multivariate statistical analyses determined the prognostic and clinicopathological consequences of increased CRABP2 expression. A CRABP2 gene signature was generated using differential expression analysis, and analyzed using network-based approaches. The findings were validated in The Clinical Proteomic Tumor Analysis Consortium (CPTAC), a newly generated cohort of 120 endometrial tissues, and The Cancer Dependency Map (DepMap). RESULTS 60 (11%) patients in TCGA had high CRABP2 expression, whilst 468 (89%) had low expression. High expression was associated with serous EC, reduced overall survival, advanced stage and grade. Downstream retinoic acid receptors (RARG and RARA) were correlated with CRABP2 expression and were associated with worse prognosis in serous EC. The CRABP2 gene signature was enriched for Polycomb target gene sets, and was regulated by ELP3 and BMP7. BMP7 expression was increased in the CRABP2-high group, was associated with worse prognosis, and CRISPR-Cas9 screens revealed correlations in its cell-fitness score with CRABP2 following gene knockout. The opposite was true for ELP3, suggesting opposing effects from both master regulators. CONCLUSIONS CRABP2 expression is associated with poor prognosis and advanced EC. The expression of RARA and RARG correlates with CRABP2 and are associated with worse prognosis in advanced histological subtypes. Polycomb target gene sets and two master regulators, ELP3 and BMP7, were identified as functionally relevant mechanisms driving aberrant CRABP2 expression.
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Affiliation(s)
- Donagh Egan
- Systems Biology Ireland, UCD School of Medicine, Belfield, Dublin 4, Ireland.
| | - Bruce Moran
- Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Michael Wilkinson
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Miquel Pinyol
- Department of Pathology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, Spain
| | - Esther Guerra
- Department of Pathology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Spain
| | - Sonia Gatius
- Department of Pathology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, Spain
| | - Xavier Matias-Guiu
- Department of Pathology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, Spain; Department of Pathology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Spain
| | - Walter Kolch
- Systems Biology Ireland, UCD School of Medicine, Belfield, Dublin 4, Ireland; Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Donal J Brennan
- Systems Biology Ireland, UCD School of Medicine, Belfield, Dublin 4, Ireland
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6
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Mota A, Oltra SS, Selenica P, Moiola CP, Casas-Arozamena C, López-Gil C, Diaz E, Gatius S, Ruiz-Miro M, Calvo A, Rojo-Sebastián A, Hurtado P, Piñeiro R, Colas E, Gil-Moreno A, Reis-Filho JS, Muinelo-Romay L, Abal M, Matias-Guiu X, Weigelt B, Moreno-Bueno G. Intratumor genetic heterogeneity and clonal evolution to decode endometrial cancer progression. Oncogene 2022; 41:1835-1850. [PMID: 35145232 PMCID: PMC8956509 DOI: 10.1038/s41388-022-02221-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 01/12/2022] [Accepted: 01/27/2022] [Indexed: 12/12/2022]
Abstract
Analyzing different tumor regions by next generation sequencing allows the assessment of intratumor genetic heterogeneity (ITGH), a phenomenon that has been studied widely in some tumor types but has been less well explored in endometrial carcinoma (EC). In this study, we sought to characterize the spatial and temporal heterogeneity of 9 different ECs using whole-exome sequencing, and by performing targeted sequencing validation of the 42 primary tumor regions and 30 metastatic samples analyzed. In addition, copy number alterations of serous carcinomas were assessed by comparative genomic hybridization arrays. From the somatic mutations, identified by whole-exome sequencing, 532 were validated by targeted sequencing. Based on these data, the phylogenetic tree reconstructed for each case allowed us to establish the tumors’ evolution and correlate this to tumor progression, prognosis, and the presence of recurrent disease. Moreover, we studied the genetic landscape of an ambiguous EC and the molecular profile obtained was used to guide the selection of a potential personalized therapy for this patient, which was subsequently validated by preclinical testing in patient-derived xenograft models. Overall, our study reveals the impact of analyzing different tumor regions to decipher the ITGH in ECs, which could help make the best treatment decision.
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Affiliation(s)
- Alba Mota
- MD Anderson International Foundation, 28033, Madrid, Spain.,Biochemistry Department, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas 'Alberto Sols' (CSIC-UAM), IdiPaz, 28029, Madrid, Spain
| | - Sara S Oltra
- MD Anderson International Foundation, 28033, Madrid, Spain.,Biochemistry Department, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas 'Alberto Sols' (CSIC-UAM), IdiPaz, 28029, Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain
| | - Pier Selenica
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Cristian P Moiola
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Carlos Casas-Arozamena
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Carlos López-Gil
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Eva Diaz
- MD Anderson International Foundation, 28033, Madrid, Spain
| | - Sonia Gatius
- Department of Pathology, Hospital U Arnau de Vilanova, University of Lleida, IRBLLEIDA, Lleida, Spain
| | | | - Ana Calvo
- Department of Gynecology, Hospital U Arnau de Vilanova, IRBLLEIDA, Lleida, Spain
| | - Alejandro Rojo-Sebastián
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain.,MD Anderson Cancer Center, Madrid, Spain
| | - Pablo Hurtado
- Roche-Chus Joint Unit, Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Roberto Piñeiro
- Roche-Chus Joint Unit, Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Eva Colas
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Antonio Gil-Moreno
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain.,Gynaecological Department, Vall Hebron University Hospital, 08035, Barcelona, Spain
| | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Laura Muinelo-Romay
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Miguel Abal
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Xavier Matias-Guiu
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.,Department of Pathology, Hospital U Arnau de Vilanova, University of Lleida, IRBLLEIDA, Lleida, Spain.,Departments of Pathology, Hospital U. de Bellvitge, Universities of Lleida and Barcelona, IDIBELL Lleida and Barcelona, Spain
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Gema Moreno-Bueno
- MD Anderson International Foundation, 28033, Madrid, Spain. .,Biochemistry Department, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas 'Alberto Sols' (CSIC-UAM), IdiPaz, 28029, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain.
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7
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Visser NCM, van der Wurff AAM, IntHout J, Reijnen C, Dabir PD, Soltani GG, Alcala LSM, Boll D, Bronkhorst CM, Bult P, Geomini PMAJ, van Hamont D, van Herk HADM, de Kievit IM, Ngo H, Pijlman BM, Snijders MPML, Vos MC, Nagtegaal ID, Massuger LFAG, Pijnenborg JMA, Bulten J. Improving preoperative diagnosis in endometrial cancer using systematic morphological assessment and a small immunohistochemical panel. Hum Pathol 2021; 117:68-78. [PMID: 34418427 DOI: 10.1016/j.humpath.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
Preoperative histopathological classification determines the primary surgical approach in endometrial carcinoma (EC) patients but has only moderate agreement between preoperative and postoperative diagnosis. The aim of the PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study is to determine whether histopathological assessment and a small panel of diagnostic biomarkers decreases discrepancies between preoperative and postoperative diagnosis in EC. Preoperative endometrial tissue of 378 included patients with EC was stained with 15 different antibodies. Clinically relevant discrepancies in grade or histological subtype between original preoperative and reviewed postoperative diagnosis were observed in 75 (20%) patients. Highest clinically relevant discrepancy was found in grade 2 ECs (20%), compared to 5% and 14% in respectively grade 1 and 3 endometrioid endometrial carcinomas (EECs). A practical two-biomarker panel with PR and p53 improved diagnostic accuracy (AUC = 0.92; 95%CI = 0.88-0.95) compared to solely morphological evaluation (AUC = 0.86). In preoperative high-grade EC, the diagnostic accuracy of histological subtype was improved by a three-immunohistochemical biomarker panel (PR, IMP3, and L1CAM) (AUC = 0.93; 95%CI = 0.88-0.98) compared to solely morphological evaluation (AUC = 0.81). In conclusion to improve correct preoperative diagnosis in EC, we recommend use of a panel of at least two easily accessible immunohistochemical biomarkers (PR and p53), only in grade 2 ECs. Overall, this will reduce clinically relevant discrepancies in tumor grade and subtype with postoperative diagnosis with 6% (from 20% to 14%). Addition of PR, IMP3, and L1CAM for histological subtyping in high-grade EECs resulted in a further decrease in discrepancies with 8% (from 20% to 12%).
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Affiliation(s)
- Nicole C M Visser
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands; Dept. Pathology, Stichting PAMM, 5623 EJ, Eindhoven, the Netherlands.
| | | | - Joanna IntHout
- Dept. for Health Evidence, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Casper Reijnen
- Dept. Radiation Oncology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands; Dept. Obstetrics and Gynecology, Canisius Wilhelmina Hospital, 6500 GS, Nijmegen, the Netherlands
| | - Parag D Dabir
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands; Dept. Pathology, Regional Hospital, 8930, Randers, Denmark
| | - Gilda G Soltani
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Luthy S M Alcala
- Dept. Pathology, Amphia Hospital, 4800 RL, Breda, the Netherlands
| | - Dorry Boll
- Dept. Gynecology, Catharina Hospital, 5623 EJ, Eindhoven, the Netherlands
| | | | - Peter Bult
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Peggy M A J Geomini
- Dept. Obstetrics and Gynecology, Maxima Medical Centre, 5504 DB, Veldhoven and Eindhoven, the Netherlands
| | - Dennis van Hamont
- Dept. Obstetrics and Gynecology, Amphia Hospital, 4800 RL, Breda, the Netherlands
| | | | - Ineke M de Kievit
- Dept. Pathology, Canisius Wilhelmina Hospital, 6500 GS, Nijmegen, the Netherlands
| | - Huy Ngo
- Dept. Obstetrics and Gynecology, Elkerliek Hospital, 5700AB, Helmond, the Netherlands
| | - Brenda M Pijlman
- Dept. Obstetrics and Gynecology, Jeroen Bosch Hospital, 5200 ME, 's-Hertogenbosch, the Netherlands
| | - Marc P M L Snijders
- Dept. Obstetrics and Gynecology, Canisius Wilhelmina Hospital, 6500 GS, Nijmegen, the Netherlands
| | - M Caroline Vos
- Dept. Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, 5000 LC, Tilburg, the Netherlands
| | - Iris D Nagtegaal
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Leon F A G Massuger
- Dept. Obstetrics and Gynecology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Johanna M A Pijnenborg
- Dept. Obstetrics and Gynecology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Johan Bulten
- Dept. Pathology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
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8
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Abstract
This article provides an overview of the current diagnosis of endometrial carcinoma subtypes and provides updates, including the most recent molecular findings from The Cancer Genome Atlas and others. Interpretation of relevant immunohistochemistry and critical diagnostic differential diagnosis with pitfalls are discussed.
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9
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Visser NCM, van der Putten LJM, van Egerschot A, Van de Vijver KK, Santacana M, Bronsert P, Hirschfeld M, Colas E, Gil-Moreno A, Garcia A, Mancebo G, Alameda F, Krakstad C, Tangen IL, Huvila J, Schrauwen S, Koskas M, Walker F, Weinberger V, Minar L, Hausnerova J, Snijders MPLM, van den Berg-van Erp S, Matias-Guiu X, Trovik J, Amant F, Massuger LFAG, Bulten J, Pijnenborg JMA. Addition of IMP3 to L1CAM for discrimination between low- and high-grade endometrial carcinomas: a European Network for Individualised Treatment of Endometrial Cancer collaboration study. Hum Pathol 2019; 89:90-98. [PMID: 31054899 DOI: 10.1016/j.humpath.2019.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 12/20/2022]
Abstract
Discrimination between low- and high-grade endometrial carcinomas (ECs) is clinically relevant but can be challenging for pathologists, with moderate interobserver agreement. Insulin-like growth factor-II mRNA-binding protein 3 (IMP3) is an oncofoetal protein that is associated with nonendometrioid endometrial carcinomas but has been limited studied in endometrioid carcinomas. The aim of this study is to investigate the diagnostic and prognostic value of IMP3 in the discrimination between low- and high-grade ECs and its added value to L1CAM. IMP3 and L1CAM expression was assessed in tumors from 378 patients treated for EC at 1 of 9 participating European Network for Individualised Treatment of Endometrial Cancer centers. IMP3 was expressed in 24.6% of the tumors. In general, IMP3 was more homogeneously expressed than L1CAM. IMP3 expression was significantly associated with advanced stage, nonendometrioid histology, grade 3 tumors, deep myometrial invasion, lymphovascular space invasion, distant recurrences, overall mortality, and disease-related mortality. Simultaneous absence of IMP3 and L1CAM expression showed the highest accuracy for identifying low-grade carcinomas (area under the curve 0.766), whereas simultaneous expression of IMP3 and L1CAM was strongly associated with high-grade carcinomas (odds ratio 19.7; 95% confidence interval 9.2-42.2). Even within endometrioid carcinomas, this combination remained superior to IMP3 and L1CAM alone (odds ratio 8.6; 95% confidence interval 3.4-21.9). In conclusion, IMP3 has good diagnostic value and together with L1CAM represents the optimal combination of diagnostic markers for discrimination between low- and high-grade ECs compared to IMP3 and L1CAM alone. Because of the homogenous expression of IMP3, this marker might be valuable in preoperative biopsies when compared to the more patchy L1CAM expression.
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Affiliation(s)
- Nicole C M Visser
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, 6500HB, Nijmegen, the Netherlands.
| | - Louis J M van der Putten
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Alex van Egerschot
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | | | - Maria Santacana
- Department of Pathology and Molecular Genetics and Oncological Pathology Group, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, 25198, Lleida, Spain
| | - Peter Bronsert
- Institute for Surgical Pathology, Medical Centre-University of Freiburg, 79085, Freiburg, Germany; Comprehensive Cancer Centre Freiburg, Medical Centre-University of Freiburg, 79106, Freiburg, Germany; Faculty of Medicine, University of Freiburg, 79085, Freiburg, Germany
| | - Marc Hirschfeld
- Department of Obstetrics and Gynaecology, University Medical Centre Freiburg, 79106, Freiburg, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), 69120, Heidelberg, Germany
| | - Eva Colas
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, CIBERONC, 08193, Barcelona, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, CIBERONC, 08193, Barcelona, Spain; Gynecological Department, Vall Hebron University Hospital, CIBERONC, 8035, Barcelona, Spain
| | - Angel Garcia
- Pathology Department, Vall Hebron University Hospital, 8035, Barcelona, Spain
| | - Gemma Mancebo
- Department of Obstetrics and Gynaecology, Hospital del Mar, 8003, Barcelona, Spain
| | - Francesc Alameda
- Department of Pathology, Hospital del Mar, 8003, Barcelona, Spain
| | - Camilla Krakstad
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Ingvild L Tangen
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Jutta Huvila
- Department of Pathology, University of Turku, 20500, Turku, Finland
| | - Stefanie Schrauwen
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, 3000, Leuven, Belgium
| | - Martin Koskas
- Obstetrics and Gynaecology Department, Bichat-Claude Bernard Hospital, 75877, Paris, France
| | - Francine Walker
- Pathology Department, Bichat-Claude Bernard Hospital, 75877, Paris, France
| | - Vit Weinberger
- Department of Obstetrics and Gynaecology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Lubos Minar
- Department of Obstetrics and Gynaecology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Jitka Hausnerova
- Department of Pathology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Marc P L M Snijders
- Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, 6500, GS, Nijmegen, the Netherlands
| | | | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics and Oncological Pathology Group, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, 25198, Lleida, Spain
| | - Jone Trovik
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Frédéric Amant
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, 3000, Leuven, Belgium; Department of Gynaecologic Oncology, Centre Gynaecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute and Amsterdam University Medical Centres, Academic Medical Centre, 1105, AZ, Amsterdam, the Netherlands
| | - Leon F A G Massuger
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Johan Bulten
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
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Cuevas D, Valls J, Gatius S, Roman-Canal B, Estaran E, Dorca E, Santacana M, Vaquero M, Eritja N, Velasco A, Matias-Guiu X. Targeted sequencing with a customized panel to assess histological typing in endometrial carcinoma. Virchows Arch 2019; 474:585-598. [PMID: 30710169 DOI: 10.1007/s00428-018-02516-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 01/17/2023]
Abstract
The two most frequent types of endometrial cancer (EC) are endometrioid (EEC) and serous carcinomas (SC). Differential diagnosis between them is not always easy. A subset of endometrial cancers shows misleading microscopical features, which cause problems in differential diagnosis, and may be a good scenario for next-generation sequencing. Previous studies have assessed the usefulness of targeted sequencing with panels of generic cancer-associated genes in EC histological typing. Based on the analysis of TCGA (The Cancer Genome Atlas), EEC and SC have different mutational profiles. In this proof of principle study, we have performed targeted sequencing analysis with a customized panel, based on the TCGA mutational profile of EEC and SC, in a series of 24 tumors (16 EEC and 8 SC). Our panel comprised coding and non-coding sequences of the following genes: ABCC9, ARID1A, ARID5B, ATR, BCOR, CCND1, CDH19, CHD4, COL11A1, CSDE1, CSMD3, CTCF, CTNNB1, EP300, ERBB2, FBXW7, FGFR2, FOXA2, KLLN, KMT2B, KRAS, MAP3K4, MKI67, NRAS, PGAP3, PIK3CA, PIK3R1, PPP2R1A, PRPF18, PTEN, RPL22, SCARNA11, SIN3A, SMARCA4, SPOP, TAF1, TP53, TSPYL2, USP36, and WRAP53. Targeted sequencing validation by Sanger sequencing and immunohistochemistry was performed in a group of genes. POLE mutation status was assessed by Sanger sequencing. The most mutated genes were PTEN (93.7%), ARID1A (68.7%), PIK3CA (50%), and KMT2B (43.7%) for EEC, and TP53 (87.5%), PIK3CA (50%), and PPP2R1A (25%) for SC. Our panel allowed correct classification of all tumors in the two categories (EEC, SC). Coexistence of mutations in PTEN, ARID1A, and KMT2B was diagnostic of EEC. On the other hand, absence of PTEN, ARID1A, and KMT2B mutations in the presence of TP53 mutation was diagnostic of SC. This proof of concept study demonstrates the suitability of targeted sequencing with a customized endometrial cancer gene panel as an additional tool for confirming histological typing.
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Affiliation(s)
- Dolors Cuevas
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Joan Valls
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Sònia Gatius
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | | | - Elena Estaran
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Eduard Dorca
- Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Maria Santacana
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Marta Vaquero
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Núria Eritja
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Ana Velasco
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain
| | - Xavier Matias-Guiu
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, CIBERONC, Lleida, Spain.
- Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
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11
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Goebel EA, Vidal A, Matias-Guiu X, Blake Gilks C. The evolution of endometrial carcinoma classification through application of immunohistochemistry and molecular diagnostics: past, present and future. Virchows Arch 2017; 472:885-896. [DOI: 10.1007/s00428-017-2279-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 01/10/2023]
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12
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Talhouk A, McAlpine JN. New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2016; 3:14. [PMID: 27999680 PMCID: PMC5154099 DOI: 10.1186/s40661-016-0035-4] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/22/2016] [Indexed: 01/13/2023]
Abstract
Endometrial carcinoma (EC) is the fourth most common cancer in women in the developed world. Classification of ECs by histomorphologic criteria has limited reproducibility and better tools are needed to distinguish these tumors and enable a subtype-specific approach to research and clinical care. Based on the Cancer Genome Atlas, two research teams have developed pragmatic molecular classifiers that identify four prognostically distinct molecular subgroups. These methods can be applied to diagnostic specimens (e.g., endometrial biopsy) with the potential to completely change the current risk stratification systems and enable earlier informed decision making. The evolution of genomic classification in ECs is shared herein, as well as potential applications and discussion of the essential research still needed in order to optimally integrate molecular classification in to current standard of care.
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Affiliation(s)
- A Talhouk
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, Vancouver, BC Canada
| | - J N McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, 2775 Laurel St. 6th Floor, Vancouver, BC Canada V5Z 1M9
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13
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Preoperative diagnosis of tumor grade and type in endometrial cancer by pipelle sampling and hysteroscopy: Results of a French study. Surg Oncol 2016; 25:370-377. [DOI: 10.1016/j.suronc.2016.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/19/2016] [Accepted: 08/12/2016] [Indexed: 12/18/2022]
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14
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Practical issues in the diagnosis of serous carcinoma of the endometrium. Mod Pathol 2016; 29 Suppl 1:S45-58. [PMID: 26715173 DOI: 10.1038/modpathol.2015.141] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/13/2015] [Accepted: 11/05/2015] [Indexed: 11/08/2022]
Abstract
Serous carcinoma (SC) represents ~10% of endometrial carcinomas, but is responsible for almost 40% of cancer deaths. This article reviews the main pathological features, differential diagnosis, and the usefulness of molecular pathology and immunohistochemistry in its diagnosis. Most helpful features for the diagnosis include: irregularly shaped and sized papillae, slit-like spaces, cell stratification and budding, highly atypical cells, architectural and cytological discordance in pseudoglandular tumors, as well as lack of endometrioid features. SC shows typically a predominant papillary growth, which is also found in some subtypes of endometrioid carcinoma of the endometrium (EEC). Distinction is easy when attention is paid to the presence of diffuse marked nuclear pleomorphism, but also to the complex papillary architecture. SC may also show a solid or pseudoglandular patterns, and in these cases differential diagnosis may be difficult with EEC grade 3. Moreover, a high proportion of SC may exhibit clear cells, and, thus, may be confused with clear cell carcinoma. Finally, it is sometimes difficult to distinguish mixed SC-EEC, from SC that combines papillary and pseudoglandular growths. Although there is not a single immunohistochemical marker for distinguishing SC from its mimickers, some antibodies are useful (p53, p16, IMP2, and IMP3), particularly when used in combination. Diagnosis of SC may be even more problematic in small biopsies; a diagnosis of high-grade endometrial carcinoma, SC component can not be excluded, is acceptable as a managerial approach, so it could be taken into account at the time of final surgery.
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15
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Coutinho de Souza P, Smith N, Atolagbe O, Ziegler J, Njoku C, Lerner M, Ehrenshaft M, Mason RP, Meek B, Plafker SM, Saunders D, Mamedova N, Towner RA. OKN-007 decreases free radical levels in a preclinical F98 rat glioma model. Free Radic Biol Med 2015; 87:157-68. [PMID: 26119786 PMCID: PMC6208328 DOI: 10.1016/j.freeradbiomed.2015.06.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 06/17/2015] [Accepted: 06/17/2015] [Indexed: 12/30/2022]
Abstract
Free radicals are associated with glioma tumors. Here, we report on the ability of an anticancer nitrone compound, OKN-007 [Oklahoma Nitrone 007; a disulfonyl derivative of α-phenyl-tert-butyl nitrone (PBN)] to decrease free radical levels in F98 rat gliomas using combined molecular magnetic resonance imaging (mMRI) and immunospin-trapping (IST) methodologies. Free radicals are trapped with the spin-trapping agent, 5,5-dimethyl-1-pyrroline N-oxide (DMPO), to form DMPO macromolecule radical adducts, and then further tagged by immunospin trapping by an antibody against DMPO adducts. In this study, we combined mMRI with a biotin-Gd-DTPA-albumin-based contrast agent for signal detection with the specificity of an antibody for DMPO nitrone adducts (anti-DMPO probe), to detect in vivo free radicals in OKN-007-treated rat F98 gliomas. OKN-007 was found to significantly decrease (P < 0.05) free radical levels detected with an anti-DMPO probe in treated animals compared to untreated rats. Immunoelectron microscopy was used with gold-labeled antibiotin to detect the anti-DMPO probe within the plasma membrane of F98 tumor cells from rats administered anti-DMPO in vivo. OKN-007 was also found to decrease nuclear factor erythroid 2-related factor 2, inducible nitric oxide synthase, 3-nitrotyrosine, and malondialdehyde in ex vivo F98 glioma tissues via immunohistochemistry, as well as decrease 3-nitrotyrosine and malondialdehyde adducts in vitro in F98 cells via ELISA. The results indicate that OKN-007 effectively decreases free radicals associated with glioma tumor growth. Furthermore, this method can potentially be applied toward other types of cancers for the in vivo detection of macromolecular free radicals and the assessment of antioxidants.
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Affiliation(s)
- Patricia Coutinho de Souza
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA; Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, USA
| | - Nataliya Smith
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Oluwatomisin Atolagbe
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Jadith Ziegler
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Charity Njoku
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Megan Lerner
- Department of Surgery Research Laboratory, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Marilyn Ehrenshaft
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Ronald P Mason
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Bill Meek
- Center for Health Sciences, Oklahoma State University, Tulsa, OK, USA
| | - Scott M Plafker
- Free Radical Biology & Aging, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Debra Saunders
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Nadezda Mamedova
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA
| | - Rheal A Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, 825 NE 13th St., Oklahoma City, OK 73104, USA; Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, USA.
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