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Chen ZT, Yan JN, Zhu AQ, Wang LF, Wang Q, Li L, Guo LH, Li XL, Xu HX. High-frequency ultrasound for differentiation between high-risk basal cell carcinoma and cutaneous squamous cell carcinoma. Skin Res Technol 2021; 28:410-418. [PMID: 34923684 PMCID: PMC9907640 DOI: 10.1111/srt.13121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/16/2021] [Indexed: 12/07/2022]
Abstract
BACKGROUND The similar visual appearance of high-risk basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) may cause confusion for diagnosis. High-frequency ultrasound (HFUS) may provide additional intralesional information and thus help to distinguish them. METHOD In this retrospective study, we analyzed the clinical characteristics, HFUS grayscale, and color Doppler flow imaging (CDFI) features of pathologically confirmed high-risk BCC and cSCC lesions (n = 65 vs n = 68). Subsequently, discrimination models based on the significant HFUS features were established. RESULTS Between high-risk BCC and cSCC lesions, the HFUS grayscale features of the lesion size (10.0 mm vs 17.4 mm), thickness (3.1 mm vs 5.9 mm), internal hyperechoic spots (80.0% vs 23.5%), and posterior acoustic shadowing (16.9% vs 66.2%) were statistically different (all p < 0.001). As for the CDFI features, high-risk BCC lesions mainly appeared as pattern II (47.7%), while cSCC lesions mainly appeared as pattern III (66.2%). Based on the above five features, an optimal discrimination model was established with a sensitivity of 91.2%, a specificity of 87.7%, and an accuracy of 89.5%. CONCLUSION HFUS features, including size, thickness, internal hyperechoic spots, posterior acoustic shadowing, and Doppler vascularity pattern, are useful for differential diagnosis between high-risk BCC and cSCC.
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Affiliation(s)
- Zi-Tong Chen
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Jian-Na Yan
- Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - An-Qi Zhu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Li-Fan Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Qiao Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Liang Li
- Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
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Efficiency of long-term high-dose intravenous ascorbic acid therapy in locally advanced basal cell carcinoma - a pilot study. Postepy Dermatol Alergol 2019; 37:548-558. [PMID: 32994778 PMCID: PMC7507164 DOI: 10.5114/ada.2019.83027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/30/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction The anti-cancer properties of high-dose intravenous ascorbic acid have been demonstrated in various malignancies. In our recent study, we tested topically applied ascorbic acid to treat basal cell carcinoma (BCC), and achieved a good clinical response. Aim Based on these results, we decided to examine the efficacy and tolerability of high-dose intravenous ascorbic acid (IVA) for locally advanced BCC. Material and methods In this pilot study, patients diagnosed with locally advanced BCC who were not amenable to radiation, surgical or local therapy (no other treatment option was available at the time) received intravenous ascorbic acid (1–1.8 g/kg), in an outpatient setting, 1–3 times per week for a mean duration of 42 ±23.6 weeks. This therapy was generally well tolerated. Results Among 4 patients who had a total of 165 (mean: 41 ±51, range: 1–114) skin lesions, 3 patients achieved stable disease and one had progressive disease. There was substantial variability in individual tumor response to therapy. With the aid of two-photon microscopy and second harmonic generation imaging techniques, alterations in collagen structure were observed between tumor nests during IVA therapy. Conclusions Our results suggest that IVA is well tolerated in a small group of patients with extensive BCCs. However, in the era of smoothened (Smo) receptor inhibitors, it may only be considered as an adjuvant therapy in treatment-resistant cases.
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Lupu M, Caruntu C, Popa MI, Voiculescu VM, Zurac S, Boda D. Vascular patterns in basal cell carcinoma: Dermoscopic, confocal and histopathological perspectives. Oncol Lett 2019; 17:4112-4125. [PMID: 30944604 PMCID: PMC6444327 DOI: 10.3892/ol.2019.10070] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most prevalent skin cancer in the Caucasian population. A variety of different phenotypic presentations of BCC are possible. Although BCCs rarely metastasize, these tumors commonly destroy underlying tissues and should therefore be treated promptly. As vascular formation and angiogenesis are indicators of tumor development and progression, the presence of blood vessels, their morphology and architecture are important markers in skin lesions, providing critical information towards pathogenesis and diagnosis. BCC commonly lacks pigmentation, therefore it is important to emphasize the usefulness of vascular feature detection, recognition, quantification and interpretation. To answer the question of whether vascular patterns observed on dermoscopy, reflectance confocal microscopy (RCM) and histopathology might reflect the biologic behavior of BCCs, we undertook this review article. Several studies have sought, by various means, to identify vascular features associated with the more aggressive BCC phenotypes. Dermoscopic vascular pattern assessment can facilitate diagnostic discrimination between BCC subtypes, more aggressive BCCs displaying less or no pink coloration and a relative absence of central tumor vessels. RCM, a novel, non-invasive imaging technique, allows for the quantification of blood vessel size, density, and flow intensity in BCCs. BCCs are distinguished on RCM chiefly by vessels that branch and intertwine between neoplastic aggregates, a pattern strongly reflecting tumor neo-angiogenesis. The analysis of these vascular morphological and distribution patterns can provide further support in the diagnosis, assessment, or monitoring of BCCs. Histopathology shows significantly higher microvessel densities in the peritumoral stroma of BCCs, when compared to normal skin or benign tumors. This angiogenic response in the stroma is associated with local aggressiveness, therefore the quantification of peritumoralmicrovessels may further assist with tumor evaluation. How dermoscopy and RCM vascular patterns in BCC correlate with histopathological subtype and thus help in discriminating aggressive subtypes definitely deserves further investigation.
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Affiliation(s)
- Mihai Lupu
- Department of Dermatology, MEDAS Medical Center, 030442 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Maria Iris Popa
- Department of Plastic and Reconstructive Surgery, 'Bagdasar Arseni' Clinical Emergency Hospital, 041915 Bucharest, Romania
| | - Vlad Mihai Voiculescu
- Department of Dermatology, 'Elias' University Emergency Hospital, 011461 Bucharest, Romania
| | - Sabina Zurac
- Department of Pathology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050653 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniel Boda
- Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.,Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Kakasheva-Mazhenkovska L, Kostovski M, Gjokik G, Janevska V. Assessment of Density of Neovascularization in Lower Lip Squamous Cell Carcinoma in Relation To Neoplasm Differentiation Grade in Patients with and without Neck Lymph Nodes Metastasis. Open Access Maced J Med Sci 2019; 7:19-23. [PMID: 30740153 PMCID: PMC6352486 DOI: 10.3889/oamjms.2019.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of the lower lip is a relatively rare carcinoma, with the incidence of 1 to 2%, but it is the most common carcinoma in the oral cavity accounting for 25-30% of all malignant oral tumours. AIM This study aimed to determine the role of neovascularisation in the process of tumour progression. METHODS We analysed the surgical specimens obtained from 60 patients with squamous cell carcinoma (SCC) of the lower lip. The examined group consisted of 45 specimens of patients without metastasis and 15 specimens of patients with metastasis in the regional lymph nodes. Histopathological slides were immunohistochemically stained with an antibody against CD34 and by hematoxylin & eosin staining for routine histopathological examination. RESULTS The results obtained showed a statistically significant difference in the density of neovascularisation between groups of the SCC with different grade of differentiation (Kruskal-Wallis test: H (2, N = 60) = 30.0943, p = 0.00001). Statistical analysis also showed a significant difference in the density of vascularisation of lower lip SCC between patients without metastasis and patients with neck metastasis (Mann-Whitney U test, p = 0.000198). Applying Pearson's chi-square test, we found a highly significant statistical difference in grade of SCC differentiation in patients with and without neck metastasis (p = 0.0000). CONCLUSION In conclusion, the density of neoangiogenesis is increased in tumours with poorer differentiation and in patients with neck metastasis. So, the density of neovascularisation of the primary lip SCC may predict the tumour progression.
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Affiliation(s)
- Lena Kakasheva-Mazhenkovska
- Institute of Histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Marko Kostovski
- Institute of Histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gjorgje Gjokik
- University Clinic for Plastic and Reconstructive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Vesna Janevska
- Institute of Pathology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Kakasheva-Mazhenkovska L, Basheska N, Crvenkova S, Gordana P, Milenkova L, Janevska V, Serafimoski V. Correlation Between Microvessel Density and Morphological Features in Skin Squamous Cell Carcinoma. ACTA ACUST UNITED AC 2017; 38:63-73. [PMID: 28593886 DOI: 10.1515/prilozi-2017-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Abnormal angiogenesis is described in tumor growth and it facilitates its metastatic spread. Tumors with high angiogenic activity belong to the category of aggressive tumors with poor prognosis for patients. The aim of this study was to determine the blood vessels density (BVD), i.e. neovascularization at the tumor invasive front in skin squamous cell carcinoma (SCC) in order to determine its possible role in the tumor progression, and to correlate it to the blood vessels density of healthy skin and with the prognostic parameters of the TNM classification: T status, depth of tumor invasion (DI) and tumor histological grade (G), which were also correlated between each other. MATERIAL AND METHODS The material consisted of surgical specimens obtained from 30 patients with skin SCC, who underwent surgery. Tissue samples were routinely processed by standard paraffin technique stained by Hematoxilin-Eosin and immunohistochemically with antibodies against smooth muscle actin (SMA) and CD34. The BVD in the invasive front of the neoplasms was correlated to the healthy skin, tumor status (pT), depth of invasion and grade of histological differentiation (pG). RESULTS The histological analysis has shown a high statistical difference in the density of blood vessels in SCC compared to the healthy skin and statistical difference in BVD in neoplasms with different depth of invasion and different grade of differentiation. The density of neovascularzation increased with the deeper invasion and the worse differentiation. CONCLUSION The increased vascularization at the invasive front of SCC with deeper invasion and worse differentiation has pointed out to its possible role in neoplasm progression.
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Affiliation(s)
- Lena Kakasheva-Mazhenkovska
- Institute of Medical, Experimental and Applied Histology and Embryology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje
| | - Neli Basheska
- Department of Histopathology and Clinical Cytology, University Clinic of Radiotherapy and Oncology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje
| | - Simonida Crvenkova
- University Clinic of Radiotherapy and Oncology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje, Republic of Macedonia, Institute for radiotherapy and oncology, Skopje
| | - Petrushevska Gordana
- Institute of Pathology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje
| | - Liljana Milenkova
- Institute of Medical, Experimental and Applied Histology and Embryology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje
| | - Vesna Janevska
- Institute of Pathology, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje
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Pastushenko I, Gracia-Cazaña T, Vicente-Arregui S, Van den Eynden GG, Ara M, Vermeulen PB, Carapeto FJ, Van Laere SJ. Squamous cell carcinomas of the skin explore angiogenesis-independent mechanisms of tumour vascularization. J Skin Cancer 2014; 2014:651501. [PMID: 24891955 PMCID: PMC4033430 DOI: 10.1155/2014/651501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/10/2014] [Accepted: 04/12/2014] [Indexed: 11/19/2022] Open
Abstract
Aims. To evaluate the vascularization in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin. Methods. We performed CD31 (i.e., panendothelial marker) and CD105 (i.e., proliferating endothelium marker) immunostaining on samples of 70 SCCs and 70 BCCs of the skin. We evaluated the relative blood vessel area using the Chalkley counting method in each histologic subtype of these tumours. We calculated the degree of proliferation of blood vessel endothelium dividing CD105-Chalkley score by CD31-Chalkley score. Results. We found significantly higher peritumoral and intratumoral blood vessel area in SCC when compared to BCC (both with CD31 and CD105). Chalkley counts differed significantly between groups with different BCC histologic subtypes and SCC with different grade of differentiation. Surprisingly, the degree of proliferation of blood vessel endothelium was higher in BCC when compared to SCC. Conclusions. While SCC exhibited significantly higher intratumoral and peritumoral blood vessel areas compared to BCC, the relatively low rate of proliferating endothelium in this tumour type suggests the existence of endothelial-sprouting-independent mechanisms of vascularization in SCC.
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Affiliation(s)
- Ievgenia Pastushenko
- Department of Dermatology, University Hospital “Clinico Lozano Blesa,” Calle San Juan Bosco 15, 50009 Zaragoza, Spain
| | - Tamara Gracia-Cazaña
- Department of Dermatology, University Hospital “Clinico Lozano Blesa,” Calle San Juan Bosco 15, 50009 Zaragoza, Spain
| | - Sandra Vicente-Arregui
- Department of Pathology, University Hospital “Miguel Servet,” Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain
| | - Gert G. Van den Eynden
- Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, 2610 Wilrijk, Belgium
| | - Mariano Ara
- Department of Dermatology, University Hospital “Clinico Lozano Blesa,” Calle San Juan Bosco 15, 50009 Zaragoza, Spain
| | - Peter B. Vermeulen
- Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, 2610 Wilrijk, Belgium
| | - Franciso José Carapeto
- Department of Medicine, Psychiatry and Dermatology, School of Medicine, University of Zaragoza, Calle Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Steven J. Van Laere
- Department of Pathology, University Hospital “Miguel Servet,” Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain
- Department of Oncology, KU of Leuven, Herestraat 49, 3000 Leuven, Belgium
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Sieśkiewicz A, Reszeć J, Piszczatowski B, Olszewska E, Klimiuk PA, Chyczewski L, Rogowski M. Intraoperative bleeding during endoscopic sinus surgery and microvascular density of the nasal mucosa. Adv Med Sci 2014; 59:132-5. [PMID: 24797989 DOI: 10.1016/j.advms.2013.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 10/24/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the correlation between quality of the surgical field, intraoperative bleeding during endoscopic sinus surgery (ESS) and the density of microvasculature of the nasal mucosa. MATERIAL/METHODS Nasal mucosa of 30 patients, operated for chronic rhinosinusitis, was biopsied to assess expression of CD34 antigen on vascular endothelium. Quality of surgical field was evaluated with Fromm-Boezaart scale at mean arterial pressure (MAP) of 70-80 mmHg. If at this MAP surgical field quality was not satisfactory further reduction of hemodynamic parameters was performed until 'bloodless surgical field' (grade 2 or lower) was achieved. The rate of intraoperative bleeding was calculated from the ratio of total blood loss and the operative time. The extent of the disease was assessed according to computed tomography findings using Lund-Mackay staging system. RESULTS Significant positive correlation (Spearman correlation test; p<0.05) was found between CD34 antigen expression and quality of surgical field at MAP between 70 and 80 mmHg as well as the rate of intraoperative bleeding. More intense reduction of MAP was necessary to achieve 'bloodless surgical field' in patients with high CD34 expression than in those with moderate and low expression. Lund-Mackay score correlated with quality of surgical field but not with the rate of intraoperative bleeding. CONCLUSION During ESS, it is microvascular density of the nasal mucosa rather than the extent of the disease that contributes to the intensity of intraoperative bleeding, although both factors negatively influence the quality of surgical field.
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Affiliation(s)
- Andrzej Sieśkiewicz
- Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.
| | - Joanna Reszeć
- Department of Pathomorphology, Medical University of Bialystok, Bialystok, Poland
| | | | - Ewa Olszewska
- Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland
| | | | - Lech Chyczewski
- Department of Pathomorphology, Medical University of Bialystok, Bialystok, Poland
| | - Marek Rogowski
- Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland
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Titz B, Kozak KR, Jeraj R. Computational modelling of anti-angiogenic therapies based on multiparametric molecular imaging data. Phys Med Biol 2012; 57:6079-101. [PMID: 22972469 DOI: 10.1088/0031-9155/57/19/6079] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Computational tumour models have emerged as powerful tools for the optimization of cancer therapies; ideally, these models should incorporate patient-specific imaging data indicative of therapeutic response. The purpose of this study was to develop a tumour modelling framework in order to simulate the therapeutic effects of anti-angiogenic agents based upon clinical molecular imaging data. The model was applied to positron emission tomography (PET) data of cellular proliferation and hypoxia from a phase I clinical trial of bevacizumab, an antibody that neutralizes the vascular endothelial growth factor (VEGF). When using pre-therapy PET data in combination with literature-based dose response parameters, simulated follow-up hypoxia data yielded good qualitative agreement with imaged hypoxia levels. Improving the quantitative agreement with follow-up hypoxia and proliferation PET data required tuning of the maximum vascular growth fraction (VGF(max)) and the tumour cell cycle time to patient-specific values. VGF(max) was found to be the most sensitive model parameter (CV = 22%). Assuming availability of patient-specific, intratumoural VEGF levels, we show how bevacizumab dose levels can potentially be 'tailored' to improve levels of tumour hypoxia while maintaining proliferative response, both of which are critically important in the context of combination therapy. Our results suggest that, upon further validation, the application of image-driven computational models may afford opportunities to optimize dosing regimens and combination therapies in a patient-specific manner.
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Affiliation(s)
- Benjamin Titz
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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9
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Blood vessel density in Basal cell carcinomas and benign trichogenic tumors as a marker for differential diagnosis in dermatopathology. J Skin Cancer 2010; 2011:241382. [PMID: 21152127 PMCID: PMC2990102 DOI: 10.1155/2011/241382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 08/27/2010] [Accepted: 09/15/2010] [Indexed: 12/22/2022] Open
Abstract
In order to get insight into the density of blood vessels in the stroma of benign and malignant trichogenic neoplasms, immunohistological quantification of CD 31 positive vessels was performed in 112 tumors, comprised of 50 BCCs of nodular (35) or morphoeic (15) growth patterns, 17 Pinkus' tumors, as well as 17 trichoepitheliomas of which 6 were desmoplastic, 8 trichofolliculomas, and 20 trichoblastomas. Methods. Vessel density was counted within the tumors, in the tumor-surrounding stroma, and, as a control, in the normal skin of the operation specimen. The results were compared using statistical methods. Results. Whereas, irrespective of the patients' age and location of tumors, the vessel density in normal skin showed no significant differences (8.8 ± 2.7), the counts in the peritumoral stroma revealed significant differences between the different tumors investigated. The highest counts were obtained in BCC (24.7 ± 6.7) and the lowest in benign trichogenic neoplasms (around 14) Pinkus' tumors revealed intermediate counts (19.7 ± 6.6). The vessel densities within the tumors were generally low, and no correlation to the dignity was found. Conclusion. Determination of blood vessel density in the peritumoral stroma may be an additional parameter for differential diagnosis of trichogenic tumors of uncertain dignity.
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Spencer L, Mann C, Metcalfe M, Webb M, Pollard C, Spencer D, Berry D, Steward W, Dennison A. The effect of omega-3 FAs on tumour angiogenesis and their therapeutic potential. Eur J Cancer 2009; 45:2077-86. [PMID: 19493674 DOI: 10.1016/j.ejca.2009.04.026] [Citation(s) in RCA: 159] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2009] [Revised: 04/10/2009] [Accepted: 04/24/2009] [Indexed: 12/12/2022]
Abstract
Omega-3 fatty acid (omega-3 FA) consumption has long been associated with a lower incidence of colon, breast and prostate cancers in many human populations. Human trials have demonstrated omega-3 FA to have profound anti-inflammatory effects in those with cancer. In vitro and small animal studies have yielded a strong body of evidence establishing omega-3 FA as having anti-inflammatory, anti-apoptotic, anti-proliferative and anti-angiogenic effects. This review explores the evidence and the mechanisms by which omega-3 FA may act as angiogenesis inhibitors and identifies opportunities for original research trialling omega-3 FAs as anti-cancer agents in humans. The conclusions drawn from this review suggest that omega-3 FAs in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found principally in oily fish have potent anti-angiogenic effects inhibiting production of many important angiogenic mediators namely; Vascular Endothelial Growth Factor (VEGF), Platelet-Derived Growth Factor (PDGF), Platelet-Derived Endothelial Cell Growth Factor (PDECGF), cyclo-oxygenase 2 (COX-2), prostaglandin-E2 (PGE2), nitric oxide, Nuclear Factor Kappa Beta (NFKB), matrix metalloproteinases and beta-catenin.
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Affiliation(s)
- Laura Spencer
- Department of HPB and Pancreatic Surgery, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
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11
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Chu CY, Cha ST, Lin WC, Lu PH, Tan CT, Chang CC, Lin BR, Jee SH, Kuo ML. Stromal cell-derived factor-1α (SDF-1α/CXCL12)-enhanced angiogenesis of human basal cell carcinoma cells involves ERK1/2–NF-κB/interleukin-6 pathway. Carcinogenesis 2008; 30:205-13. [DOI: 10.1093/carcin/bgn228] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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12
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Stoebner PE, Le Gallic L, Berthe ML, Boulle N, Lallemant B, Marque M, Gaspard C, Delfour C, Lavabre-Bertrand T, Martinez J, Meunier L. Decreased expression of thymidine phosphorylase/platelet-derived endothelial cell growth factor in basal cell carcinomas. Exp Dermatol 2008; 17:908-15. [PMID: 18341568 DOI: 10.1111/j.1600-0625.2008.00718.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Thymidine phosphorylase (TP)/platelet-derived endothelial cell growth factor is associated with tumor angiogenesis. We evaluated the TP mRNA and protein expression in basal cell carcinomas (BCC) and in various skin tumors including numerous BCC histological simulants. Immunohistochemistry was performed on 99 paraffin sections of formalin-fixed skin tumors using monoclonal antibodies (mAb) against TP. TP mRNA levels were measured by real time RT-PCR in whole BCCs (wBCC) and laser capture microdissected (LCM) BCC tumor cells. TP immunostaining was negative in all BCC variants and in most of the benign trichogeneic tumors studied. By contrast, TP was constantly immunodetected in actinic keratosis (AK), squamous cell carcinomas (SCC), syringomatous carcinomas (SC), basosquamous carcinomas (BSC) and melanomas. TP mRNA levels were low and statistically not different in wBCC and normal skin but were strongly downregulated in LCM-BCC as compared with LCM-normal epidermis. We concluded that (i) anti-TP mAb is an useful marker to differentiate BCC from AK, SCC, BSC and SC but not from trichoblastic tumors, (ii) the lack of TP protein expression in BCC tumoral cells is linked to transcriptional regulatory mechanisms, (iii) the low TP mRNA levels in whole BCC may be related to the low intra-tumoral microvessel density, the slow growth and the very low metastatic potential of these tumors.
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Affiliation(s)
- Pierre E Stoebner
- UMR CNRS 5247 (IBMM), Université Montpellier I, Montpellier, France.
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Expression patterns of CEACAM5 and CEACAM6 in primary and metastatic cancers. BMC Cancer 2007; 7:2. [PMID: 17201906 PMCID: PMC1769503 DOI: 10.1186/1471-2407-7-2] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Accepted: 01/03/2007] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Many breast, pancreatic, colonic and non-small-cell lung carcinoma lines express CEACAM6 (NCA-90) and CEACAM5 (carcinoembryonic antigen, CEA), and antibodies to both can affect tumor cell growth in vitro and in vivo. Here, we compare both antigens as a function of histological phenotype in breast, pancreatic, lung, ovarian, and prostatic cancers, including patient-matched normal, primary tumor, and metastatic breast and colonic cancer specimens. METHODS Antigen expression was determined by immunohistochemistry (IHC) using tissue microarrays with MN-15 and MN-3 antibodies targeting the A1B1- and N-domains of CEACAM6, respectively, and the MN-14 antibody targeting the A3B3 domain of CEACAM5. IHC was performed using avidin-biotin-diaminobenzide staining. The average score +/- SD (0 = negative/8 = highest) for each histotype was recorded. RESULTS For all tumors, the amount of CEACAM6 expressed was greater than that of CEACAM5, and reflected tumor histotype. In breast tumors, CEACAM6 was highest in papillary > infiltrating ductal > lobular > phyllodes; in pancreatic tumors, moderately-differentiated > well-differentiated > poorly-differentiated tumors; mucinous ovarian adenocarcinomas had almost 3-fold more CEACAM6 than serous ovarian adenocarcinomas; lung adenocarcinomas > squamous tumors; and liver metastases of colonic carcinoma > primary tumors = lymph nodes metastases > normal intestine. However, CEACAM6 expression was similar in prostate cancer and normal tissues. The amount of CEACAM6 in metastatic colon tumors found in liver was higher than in many primary colon tumors. In contrast, CEACAM6 immunostaining of lymph node metastases from breast, colon, or lung tumors was similar to the primary tumor. CONCLUSION CEACAM6 expression is elevated in many solid tumors, but variable as a function of histotype. Based on previous work demonstrating a role for CEACAM6 in tumor cell migration, invasion and adhesion, and formation of distant metastases (Blumenthal et al., Cancer Res 65: 8809-8817, 2005), it may be a promising target for antibody-based therapy.
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Hong H, Tong W, Perkins R, Fang H, Xie Q, Shi L. Multiclass Decision Forest—A Novel Pattern Recognition Method for Multiclass Classification in Microarray Data Analysis. DNA Cell Biol 2004; 23:685-94. [PMID: 15585126 DOI: 10.1089/dna.2004.23.685] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The wealth of knowledge imbedded in gene expression data from DNA microarrays portends rapid advances in both research and clinic. Turning the prodigious and noisy data into knowledge is a challenge to the field of bioinformatics, and development of classifiers using supervised learning techniques is the primary methodological approach for clinical application using gene expression data. In this paper, we present a novel classification method, multiclass Decision Forest (DF), that is the direct extension of the two-class DF previously developed in our lab. Central to DF is the synergistic combining of multiple heterogenic but comparable decision trees to reach a more accurate and robust classification model. The computationally inexpensive multiclass DF algorithm integrates gene selection and model development, and thus eliminates the bias of gene preselection in crossvalidation. Importantly, the method provides several statistical means for assessment of prediction accuracy, prediction confidence, and diagnostic capability. We demonstrate the method by application to gene expression data for 83 small round blue-cell tumors (SRBCTs) samples belonging to one of four different classes. Based on 500 runs of 10-fold crossvalidation, tumor prediction accuracy was approximately 97%, sensitivity was approximately 95%, diagnostic sensitivity was approximately 91%, and diagnostic accuracy was approximately 99.5%. Among 25 genes selected to distinguish tumor class, 12 have functional information in the literature implicating their involvement in cancer. The four types of SRBCTs samples are also distinguishable in a clustering analysis based on the expression profiles of these 25 genes. The results demonstrated that the multiclass DF is an effective classification method for analysis of gene expression data for the purpose of molecular diagnostics.
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Affiliation(s)
- Huixiao Hong
- Bioinformatics Laboratory, National Center for Toxicological Research, FDA, Jefferson, Arkansas 72079, USA
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