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Perotti D, Williams RD, Wegert J, Brzezinski J, Maschietto M, Ciceri S, Gisselsson D, Gadd S, Walz AL, Furtwaengler R, Drost J, Al-Saadi R, Evageliou N, Gooskens SL, Hong AL, Murphy AJ, Ortiz MV, O'Sullivan MJ, Mullen EA, van den Heuvel-Eibrink MM, Fernandez CV, Graf N, Grundy PE, Geller JI, Dome JS, Perlman EJ, Gessler M, Huff V, Pritchard-Jones K. Hallmark discoveries in the biology of Wilms tumour. Nat Rev Urol 2024; 21:158-180. [PMID: 37848532 DOI: 10.1038/s41585-023-00824-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/19/2023]
Abstract
The modern study of Wilms tumour was prompted nearly 50 years ago, when Alfred Knudson proposed the 'two-hit' model of tumour development. Since then, the efforts of researchers worldwide have substantially expanded our knowledge of Wilms tumour biology, including major advances in genetics - from cloning the first Wilms tumour gene to high-throughput studies that have revealed the genetic landscape of this tumour. These discoveries improve understanding of the embryonal origin of Wilms tumour, familial occurrences and associated syndromic conditions. Many efforts have been made to find and clinically apply prognostic biomarkers to Wilms tumour, for which outcomes are generally favourable, but treatment of some affected individuals remains challenging. Challenges are also posed by the intratumoural heterogeneity of biomarkers. Furthermore, preclinical models of Wilms tumour, from cell lines to organoid cultures, have evolved. Despite these many achievements, much still remains to be discovered: further molecular understanding of relapse in Wilms tumour and of the multiple origins of bilateral Wilms tumour are two examples of areas under active investigation. International collaboration, especially when large tumour series are required to obtain robust data, will help to answer some of the remaining unresolved questions.
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Affiliation(s)
- Daniela Perotti
- Predictive Medicine: Molecular Bases of Genetic Risk, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Richard D Williams
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Section of Genetics and Genomics, Faculty of Medicine, Imperial College London, London, UK
| | - Jenny Wegert
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, Wuerzburg University, Wuerzburg, Germany
| | - Jack Brzezinski
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Mariana Maschietto
- Research Center, Boldrini Children's Hospital, Campinas, São Paulo, Brazil
| | - Sara Ciceri
- Predictive Medicine: Molecular Bases of Genetic Risk, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - David Gisselsson
- Cancer Cell Evolution Unit, Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Genetics, Pathology and Molecular Diagnostics, Office of Medical Services, Skåne, Sweden
| | - Samantha Gadd
- Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Amy L Walz
- Division of Hematology,Oncology, Neuro-Oncology, and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Rhoikos Furtwaengler
- Division of Pediatric Oncology and Hematology, Department of Pediatrics, Inselspital Bern University, Bern, Switzerland
| | - Jarno Drost
- Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands
- Oncode Institute, Utrecht, Netherlands
| | - Reem Al-Saadi
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Histopathology, Great Ormond Street Hospital for Children, London, UK
| | - Nicholas Evageliou
- Divisions of Hematology and Oncology, Children's Hospital of Philadelphia, CHOP Specialty Care Center, Vorhees, NJ, USA
| | - Saskia L Gooskens
- Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands
| | - Andrew L Hong
- Aflac Cancer and Blood Disorders Center, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Andrew J Murphy
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael V Ortiz
- Department of Paediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maureen J O'Sullivan
- Histology Laboratory, Children's Health Ireland at Crumlin, Dublin, Ireland
- Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
| | - Elizabeth A Mullen
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | | | - Conrad V Fernandez
- Division of Paediatric Hematology Oncology, IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Norbert Graf
- Department of Paediatric Oncology and Hematology, Saarland University Hospital, Homburg, Germany
| | - Paul E Grundy
- Department of Paediatrics Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - James I Geller
- Division of Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey S Dome
- Division of Oncology, Center for Cancer and Blood Disorders, Children's National Hospital and the Department of Paediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Elizabeth J Perlman
- Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Manfred Gessler
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, Wuerzburg University, Wuerzburg, Germany
- Comprehensive Cancer Center Mainfranken, Wuerzburg, Germany
| | - Vicki Huff
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Atwa AM, Hafez AT, Abdelhameed M, Dawaba M, Nabeeh A, Helmy TE. Does immunohistochemical staining of P53, Ki 67 and cyclin A accurately predict Wilms tumor recurrence and survival? Arab J Urol 2022; 20:107-114. [PMID: 35935912 PMCID: PMC9354635 DOI: 10.1080/2090598x.2022.2058240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/12/2022] [Indexed: 11/02/2022] Open
Abstract
Objective To evaluate whether p53, cyclin A and ki67 immunohistochemical (IHC) assay can be used as predictors for Wilms' tumor (WT) unfavorable outcomes. Methods It is a non-concurrent cohort study including patients who underwent nephrectomy for WT from January 2000 to December 2015 in a tertiary referral center. Over a 5- year follow-up, unfavorable events, including relapse and cancer-specific mortality (CSM), were recorded. P53, cyclin A, and ki67 IHC assay were carried out for formalin-fixed paraffin-embedded WT samples. Results After excluding those who did not meet the inclusion criteria, 75 patients were enrolled. Of the patients, 15/75 (20%) experienced WT relapse while 11/75 (14.6%) died of WT over five years. Unfavorable histology (UFH), including prominent blastemal components and anaplasia, was found in 15/75 (20%) children.Cyclin A immunopositivity was associated with high rates of relapse and CSM. P53 and ki67 positive IHC assay did not show any statistically significant association with unfavorable outcomes. Other risk factors e.g. advanced staging, UFH, extracapsular extension, tumor rupture, lymphadenopathy, and venous thrombosis were not associated with poor prognosis. However, the presence of residual tumors was accompanied by lower survival rates. Conclusion Cyclin A IHC assay can be used as a predictor of WT recurrence and CSM. Further studies with prospective patterns and a larger sample size are needed.Abbreviations: WT: Wilms' tumor, UFH: unfavorable histology, IHC: immunohistochemical, PI: proliferation index, RFS: relapse-free survival, CSS: cancer-specific survival, FH: favorable histology, CSM: cancer-specific mortality, CDK: cyclin-dependent kinase.
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Affiliation(s)
- Ahmed M Atwa
- Urology department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Ashraf T Hafez
- Urology department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Mohamed Abdelhameed
- Pathology department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Mohamed Dawaba
- Urology department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Adel Nabeeh
- Urology department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Tamer E Helmy
- Urology department, Urology and Nephrology Center, Mansoura University, Egypt
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Wang J, Lou S, Huang X, Mo Y, Wang Z, Zhu J, Tian X, Shi J, Zhou H, He J, Ruan J. The association of miR34b/c and TP53 gene polymorphisms with Wilms tumor risk in Chinese children. Biosci Rep 2020; 40:222181. [PMID: 32083300 PMCID: PMC7048686 DOI: 10.1042/bsr20194202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023] Open
Abstract
Wilms tumor is the most common pediatric malignancy in the kidney. The miR34b/c is a downstream target gene of the transcription factor p53. The important role of TP53 mutations, the methylation of miR34b/c, and the interaction between these two molecules in tumorigenesis have been well documented. Due to the biological connection between p53 and miR34b/c, in the present study, we investigated the association between polymorphisms in these two molecules and Wilms tumor susceptibility through genotyping two important functional polymorphisms (miR34b/c rs4938723 T>C and TP53 rs1042522 C>G) in 183 cases and 603 controls. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) derived from the logistic regression analysis were used to assess the correlation of miR34b/c rs4938723 and TP53 rs1042522 polymorphisms with Wilms tumor risk. Our results indicated that the association of miR34b/c rs4938723 and TP53 rs1042522 polymorphisms with Wilms tumor susceptibility was not statistically significant. Stratified analysis by age, gender, and clinical stage, as well as combined effect analysis were also performed, yet, no significant association was found. In conclusion, our study indicated a lack of association between the two selected polymorphisms and Wilms tumor susceptibility. Our findings need to be verified in studies with larger sample size in the future.
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Affiliation(s)
- Juxiang Wang
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Susu Lou
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Xiaokai Huang
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Yixiao Mo
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Zhen Wang
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Jinhong Zhu
- Department of Clinical Laboratory, Biobank, Harbin Medical University Cancer Hospital, Harbin 150040, Heilongjiang, China
| | - Xiaoqian Tian
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Jiandong Shi
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Haixia Zhou
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Jing He
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
- Correspondence: Jichen Ruan () or Jing He ()
| | - Jichen Ruan
- Department of Hematology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
- Correspondence: Jichen Ruan () or Jing He ()
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Holl EK, Routh JC, Johnston AW, Frazier V, Rice HE, Tracy ET, Nair SK. Immune expression in children with Wilms tumor: a pilot study. J Pediatr Urol 2019; 15:441.e1-441.e8. [PMID: 30981637 DOI: 10.1016/j.jpurol.2019.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/13/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Given improvements in multimodality therapy, survival among children with Wilms tumor (WT) exceeds 90%. However, 15% of children with favorable histology and 50% of children with anaplastic WT experience recurrence or progression. Of patients with advanced disease, only 50% survive to adulthood. In adult malignancies (including renal tumors), patient survival has improved with the advent of immunotherapy. However, little is known about the immune microenvironment of WT, making the potential role of immunotherapy unclear. OBJECTIVE The objective of the study is to perform an exploratory, descriptive analysis of the immune milieu in WT. STUDY DESIGN Between 2016 and 2017, all pediatric patients with WT, some of whom received neoadjuvant chemotherapy, underwent ex vivo wedge biopsy at the time of nephrectomy. The fresh tumor tissue and peripheral blood samples were analyzed for infiltrating immune infiltrate and effector cells using flow cytometry. Immunohistochemistry was performed for CD4, CD8, and PD-L1 expression. Matched blood samples were obtained for each patient, and circulating immune cells were analyzed by flow cytometry. RESULTS A total of six patients were enrolled. One patient with neuroblastoma was excluded. The remaining five patients included the following: two with unilateral WT (resected before chemotherapy), two with bilateral WT (resected after neoadjuvant chemotherapy), and one with Denys-Drash syndrome, end-stage renal disease, and history of WT in the contralateral kidney. Immune analysis showed that WT were infiltrated by immune cells regardless of chemotherapy status. CD8 and CD4 T cells were present in the tumor tissue and exhibited an activated phenotype. Elevated levels of natural killer (NK) cells were observed in the tumors (Figure). Immune checkpoint PD-L1 was also found expressed in one of the tumors stained. DISCUSSION In this pilot study, it was found that WTs were infiltrated by immune cells (CD45+) both before and after chemotherapy. Elevated levels of NK cells infiltrating the tumor specimens, which were quantitatively increased compared with levels of NK cells circulating in the blood, were noted. T cells, particularly CD4+ and CD8+ T cells, were present in tumor specimens. Tumor-infiltrating CD4 and CD8 T cells displayed an activated phenotype as defined by increased expression of human leukocyte antigen-DR isotype (HLA-DR), programmed cell death protein 1 (PD1), and CD57. Together, these findings suggest that WT microenvironment is immune engaged and may be susceptible to immunotherapy similar to other malignancies. CONCLUSIONS These pilot data suggest an immune-engaged tumor microenvironment is present within WT. This implies that WT may be susceptible to immunotherapy similar to adult renal tumors and other adult malignancies. Follow-up studies are currently underway.
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Affiliation(s)
- E K Holl
- Division of Surgical Sciences, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA.
| | - J C Routh
- Division of Pediatric Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA; Division of Urologic Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - A W Johnston
- Division of Urologic Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - V Frazier
- Division of Surgical Sciences, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - H E Rice
- Division of Pediatric Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA; Division of Urologic Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - E T Tracy
- Division of Pediatric Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA; Division of Urologic Surgery, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - S K Nair
- Division of Surgical Sciences, Dept of Surgery, Duke University School of Medicine, Durham, NC, USA
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Ding Y, Guo X, Liu X, Li J, Li N, Xu C. Expression and clinical significance of p73 in Wilms tumor in children. Oncol Lett 2019; 17:5435-5440. [PMID: 31186762 PMCID: PMC6507322 DOI: 10.3892/ol.2019.10249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/21/2019] [Indexed: 11/18/2022] Open
Abstract
Expression and clinical significance of p73 in children with Wilms tumor (WT) were investigated. A retrospective analysis was carried out on 50 children diagnosed with WT in the People's Hospital of Rizhao, from July 2013 to January 2015 (study group), and 20 healthy children with similar age and sex who received health examinations in the same hospital during the same period (control group). The relative expression of p73 mRNA in the peripheral blood of each group was detected by reverse transcription-quantitative PCR (RT-qPCR) in order to study the association between p73 and the clinicopathological parameters of WT, as well as the impact of p73 on the patient prognosis. The two groups were not statistically different in respect to the clinical data of patients (P>0.05); the expression level of p73 in the blood samples of the study group was significantly higher than that of the control group (t=11.44, P<0.01); the expression of p73 in the study group was associated with factors, including tumor size, pathological type and lymphatic metastasis. Considering the mean value of the expression of p73 (3.32) as the boundary, the patients with expression value of p73 <3.32 were studied as the low-expression group, and patients with expression value of p73 >3.32 comprised the high-expression group. At the end of the follow-up, the median survival time and the survival rate of the patients in the high-expression group were significantly lower than those of the low-expression group (P<0.05). The high expression of p73 in the peripheral blood of children with WT was positively correlated with the clinical stage of the tumor, and was closely related with the low survival rate of patients.
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Affiliation(s)
- Yan Ding
- Department of Pediatrics (II), People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
| | - Xiaohui Guo
- Department of Child Health Care, The Third People's Hospital of Linyi, Linyi, Shandong 276000, P.R. China
| | - Xinxin Liu
- Department of Spine Surgery, The Affiliated Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, Shandong 266001, P.R. China
| | - Jitao Li
- Electrocardiogram Room, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China
| | - Ning Li
- Department of Pathology, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China
| | - Cong Xu
- Department of Pediatrics (II), People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
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Ota Y, Naiki T, Nakagawa M, Naiki-Ito A, Hamamoto S, Etani T, Iida K, Nozaki S, Ando R, Kawai N, Yasui T. Laparoscopic radical surgery produces a good prognosis in an elderly patient with small Wilms' tumor. IJU Case Rep 2019; 2:73-76. [PMID: 32743377 PMCID: PMC7292114 DOI: 10.1002/iju5.12041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/03/2018] [Indexed: 11/06/2022] Open
Abstract
Introduction Renal nephroblastoma, also known as Wilms' tumor, is the most common malignant renal tumor to affect children. Although rare in adults, nephroblastoma in adults is often found in its advanced stages and has a poorer prognosis than cases occurring in childhood. No report has described the efficacy of laparoscopic surgery in small diameter renal tumors in elderly patients. Case presentation Here, we report a very rare case of 71-year-old woman with asymptomatic small nephroblastoma removed by laparoscopic radical nephrectomy. Conclusion The patient refused additional treatments but shows no sign of recurrence 15 months after surgery. These findings support, therefore, that laparoscopic surgery may be effective for small nephroblastoma in elderly patients refusing other treatment modalities.
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Affiliation(s)
- Yuya Ota
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Taku Naiki
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Motoo Nakagawa
- Department of Radiology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Aya Naiki-Ito
- Department of Experimental Pathology and Tumor Biology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Toshiki Etani
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Keitaro Iida
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Satoshi Nozaki
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Ryosuke Ando
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Noriyasu Kawai
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
| | - Takahiro Yasui
- Department of Nephro-urology Graduate School of Medical Sciences Nagoya City University Nagoya Aichi Japan
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Kiryu Y, Landsberg JH, Bakenhaster MD, Tyler-Jedlund AJ, Wilson PW. Putative histiocytic sarcoma in redfin needlefish Strongylura notata (Beloniformes: Belonidae) in Florida, USA. DISEASES OF AQUATIC ORGANISMS 2018; 132:57-78. [PMID: 30530931 DOI: 10.3354/dao03304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Redfin needlefish Strongylura notata from Florida coastal waters were observed with unusual neoplastic lesions. Affected specimens were collected from 1 Atlantic estuary (Indian River Lagoon, prevalence = 0.32%, n = 5314) and 2 Gulf of Mexico estuaries (Tampa Bay, prevalence = 0.02%, n = 10762; Charlotte Harbor, prevalence = 0.02%, n = 5112) during routine fisheries-independent monitoring surveys conducted from 1999-2009. Grossly, each lesion manifested as a large (18-30 mm × 20-50 mm), raised (approximately 10 mm), white, creamy, or pinkish nodule on the flank, dorsal trunk, base of the pectoral fin, or head. Multiple small (<5 mm) nodules possessing poorly demarcated borders with neighboring tissues on the external jaw surface and at the base of the teeth were also observed. Histopathologically, neoplastic cells were found in the dermis, beneath the skeletal muscle, and in the soft tissue at the base of teeth of the premaxilla and the dentary jaw processes. Neoplastic cells usually had prominently invaded among the myosepta of the skeletal muscle. Neoplastic parenchymal cells had the basic characteristics of atypical, mononuclear, round, histiocytic cells with an eccentric, reniform nucleus and abundant cytoplasmic vacuolation, while some exhibited bizarre nuclear pleomorphism. Transmission electron microscopy revealed that neoplastic cells had a grooved nucleus and cytoplasmic organelles with rough endoplasmic reticulum, mitochondria, Golgi apparatus, and lysosomes. Neoplastic cells had possibly metastasized to liver, spleen, and kidney. Positive immunohistochemical staining with Ki67, p53, S-100, and CD163 support neoplastic features and a putative diagnosis of histiocytic sarcoma.
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Affiliation(s)
- Yasunari Kiryu
- Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, St. Petersburg, Florida 33701, USA
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Biological Drivers of Wilms Tumor Prognosis and Treatment. CHILDREN-BASEL 2018; 5:children5110145. [PMID: 30373137 PMCID: PMC6262554 DOI: 10.3390/children5110145] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
Prior to the 1950s, survival from Wilms tumor (WT) was less than 10%. Today, a child diagnosed with WT has a greater than 90% chance of survival. These gains in survival rates from WT are attributed largely to improvements in multimodal therapy: Enhanced surgical techniques leading to decreased operative mortality, optimization of more effective chemotherapy regimens (specifically, dactinomycin and vincristine), and inclusion of radiation therapy in treatment protocols. More recent improvements in survival, however, can be attributed to a growing understanding of the molecular landscape of Wilms tumor. Particularly, identification of biologic markers portending poor prognosis has facilitated risk stratification to tailor therapy that achieves the best possible outcome with the least possible toxicity. The aim of this review is to (1) outline the specific biologic markers that have been associated with prognosis in WT and (2) provide an overview of the current use of biologic and other factors to stratify risk and assign treatment accordingly.
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Ooms AHAG, Gadd S, Gerhard DS, Smith MA, Guidry Auvil JM, Meerzaman D, Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y, Ma Y, Zong Z, Mungall AJ, Moore RA, Marra MA, Huff V, Dome JS, Chi YY, Tian J, Geller JI, Mullighan CG, Ma J, Wheeler DA, Hampton OA, Walz AL, van den Heuvel-Eibrink MM, de Krijger RR, Ross N, Gastier-Foster JM, Perlman EJ. Significance of TP53 Mutation in Wilms Tumors with Diffuse Anaplasia: A Report from the Children's Oncology Group. Clin Cancer Res 2016; 22:5582-5591. [PMID: 27702824 PMCID: PMC5290091 DOI: 10.1158/1078-0432.ccr-16-0985] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/17/2016] [Accepted: 08/14/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the role and significance of TP53 mutation in diffusely anaplastic Wilms tumors (DAWTs). EXPERIMENTAL DESIGN All DAWTs registered on National Wilms Tumor Study-5 (n = 118) with available samples were analyzed for TP53 mutations and copy loss. Integrative genomic analysis was performed on 39 selected DAWTs. RESULTS Following analysis of a single random sample, 57 DAWTs (48%) demonstrated TP53 mutations, 13 (11%) copy loss without mutation, and 48 (41%) lacked both [defined as TP53-wild-type (wt)]. Patients with stage III/IV TP53-wt DAWTs (but not those with stage I/II disease) had significantly lower relapse and death rates than those with TP53 abnormalities. In-depth analysis of a subset of 39 DAWTs showed seven (18%) to be TP53-wt: These demonstrated gene expression evidence of an active p53 pathway. Retrospective pathology review of TP53-wt DAWT revealed no or very low volume of anaplasia in six of seven tumors. When samples from TP53-wt tumors known to contain anaplasia histologically were available, abnormal p53 protein accumulation was observed by immunohistochemistry. CONCLUSIONS These data support the key role of TP53 loss in the development of anaplasia in WT, and support its significant clinical impact in patients with residual anaplastic tumor following surgery. These data also suggest that most DAWTs will show evidence of TP53 mutation when samples selected for the presence of anaplasia are analyzed. This suggests that modifications of the current criteria to also consider volume of anaplasia and documentation of TP53 aberrations may better reflect the risk of relapse and death and enable optimization of therapeutic stratification. Clin Cancer Res; 22(22); 5582-91. ©2016 AACR.
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Affiliation(s)
- Ariadne H A G Ooms
- Department of Pathology and Laboratory Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois
- Princess Maxima Centre for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pathology, Pathan BV, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Samantha Gadd
- Department of Pathology and Laboratory Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois
| | - Daniela S Gerhard
- Office of Cancer Genomics, National Cancer Institute, Bethesda, Maryland
| | - Malcolm A Smith
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland
| | | | - Daoud Meerzaman
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Qing-Rong Chen
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Chih Hao Hsu
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Chunhua Yan
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Cu Nguyen
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Ying Hu
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland
| | - Yussanne Ma
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
| | - Zusheng Zong
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
| | - Andrew J Mungall
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
| | - Richard A Moore
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
| | - Marco A Marra
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vicki Huff
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey S Dome
- Division of Pediatric Hematology/Oncology, Children's National Medical Center, Washington, DC
| | - Yueh-Yun Chi
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Jing Tian
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - James I Geller
- Division of Pediatric Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Charles G Mullighan
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jing Ma
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - David A Wheeler
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Oliver A Hampton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Amy L Walz
- Division of Hematology-Oncology and Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine, Chicago, Illinois
- Northwestern Medicine Developmental Therapeutics Institute, Northwestern Memorial Hospital, Chicago, Illinois
| | | | - Ronald R de Krijger
- Princess Maxima Centre for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pathology, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Nicole Ross
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
| | - Julie M Gastier-Foster
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
- Departments of Pathology and Pediatrics, Ohio State University College of Medicine, Columbus, Ohio
| | - Elizabeth J Perlman
- Department of Pathology and Laboratory Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois.
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10
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Abstract
PURPOSE Wilms tumor is the most common childhood renal malignancy and the fourth most common childhood cancer. Many biomarkers have been studied but there has been no comprehensive summary. We systematically reviewed the literature on biomarkers in Wilms tumor to quantify the prognostic implications of the presence of individual tumor markers. MATERIALS AND METHODS We searched for English language studies from 1980 to 2015 performed in patients younger than 18 years with Wilms tumor and prognostic data. The protocol was conducted per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two reviewers abstracted data in duplicate using a standard evaluation form. We performed descriptive statistics, then calculated relative risks and 95% confidence intervals for markers appearing in multiple level II or III studies. RESULTS A total of 40 studies were included examining 32 biomarkers in 7,381 patients with Wilms tumor. Studies had a median of 61 patients, 24 biomarker positive patients per series and a median followup of 68.4 months. Median percentages of patients with stages 1, 2, 3, 4 and 5 tumors were 28.5%, 26.4%, 24.5%, 14.1% and 1.7%, respectively, and 10.2% had anaplasia. The strongest negative prognostic association was loss of heterozygosity at 11p15, with a risk of recurrence of 5.00, although loss of heterozygosity at 1p and gain of function at 1q were also strongly linked to increased recurrence (2.93 and 2.86, respectively). CONCLUSIONS Several tumor markers are associated with an increased risk of recurrence or a decreased risk of overall survival in patients with Wilms tumor. These data suggest targets for development of diagnostic tests and potential therapies.
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11
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Maschietto M, Williams RD, Chagtai T, Popov SD, Sebire NJ, Vujanic G, Perlman E, Anderson JR, Grundy P, Dome JS, Pritchard-Jones K. TP53 mutational status is a potential marker for risk stratification in Wilms tumour with diffuse anaplasia. PLoS One 2014; 9:e109924. [PMID: 25313908 PMCID: PMC4196953 DOI: 10.1371/journal.pone.0109924] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/04/2014] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The presence of diffuse anaplasia in Wilms tumours (DAWT) is associated with TP53 mutations and poor outcome. As patients receive intensified treatment, we sought to identify whether TP53 mutational status confers additional prognostic information. PATIENTS AND METHODS We studied 40 patients with DAWT with anaplasia in the tissue from which DNA was extracted and analysed for TP53 mutations and 17p loss. The majority of cases were profiled by copy number (n = 32) and gene expression (n = 36) arrays. TP53 mutational status was correlated with patient event-free and overall survival, genomic copy number instability and gene expression profiling. RESULTS From the 40 cases, 22 (55%) had TP53 mutations (2 detected only after deep-sequencing), 20 of which also had 17p loss (91%); 18 (45%) cases had no detectable mutation but three had 17p loss. Tumours with TP53 mutations and/or 17p loss (n = 25) had an increased risk of recurrence as a first event (p = 0.03, hazard ratio (HR), 3.89; 95% confidence interval (CI), 1.26-16.0) and death (p = 0.04, HR, 4.95; 95% CI, 1.36-31.7) compared to tumours lacking TP53 abnormalities. DAWT carrying TP53 mutations showed increased copy number alterations compared to those with wild-type, suggesting a more unstable genome (p = 0.03). These tumours showed deregulation of genes associated with cell cycle and DNA repair biological processes. CONCLUSION This study provides evidence that TP53 mutational analysis improves risk stratification in DAWT. This requires validation in an independent cohort before clinical use as a biomarker.
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Affiliation(s)
- Mariana Maschietto
- Cancer Section, Institute of Child Health, University College London, London, United Kingdom
| | - Richard D. Williams
- Cancer Section, Institute of Child Health, University College London, London, United Kingdom
| | - Tasnim Chagtai
- Cancer Section, Institute of Child Health, University College London, London, United Kingdom
| | - Sergey D. Popov
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London, United Kingdom
| | - Neil J. Sebire
- Departments of Histopathology, Great Ormond Street Hospital, London, United Kingdom
| | - Gordan Vujanic
- Department of Pathology, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Elizabeth Perlman
- Department of Pathology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, United States of America
| | - James R. Anderson
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Paul Grundy
- Departments of Pediatrics and of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey S. Dome
- Division of Pediatric Hematology/Oncology, Children's National Medical Center, Washington, District of Columbia, United States of America
| | - Kathy Pritchard-Jones
- Cancer Section, Institute of Child Health, University College London, London, United Kingdom
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