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Pateras IS, Igea A, Nikas IP, Leventakou D, Koufopoulos NI, Ieronimaki AI, Bergonzini A, Ryu HS, Chatzigeorgiou A, Frisan T, Kittas C, Panayiotides IG. Diagnostic Challenges during Inflammation and Cancer: Current Biomarkers and Future Perspectives in Navigating through the Minefield of Reactive versus Dysplastic and Cancerous Lesions in the Digestive System. Int J Mol Sci 2024; 25:1251. [PMID: 38279253 PMCID: PMC10816510 DOI: 10.3390/ijms25021251] [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: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/28/2024] Open
Abstract
In the setting of pronounced inflammation, changes in the epithelium may overlap with neoplasia, often rendering it impossible to establish a diagnosis with certainty in daily clinical practice. Here, we discuss the underlying molecular mechanisms driving tissue response during persistent inflammatory signaling along with the potential association with cancer in the gastrointestinal tract, pancreas, extrahepatic bile ducts, and liver. We highlight the histopathological challenges encountered in the diagnosis of chronic inflammation in routine practice and pinpoint tissue-based biomarkers that could complement morphology to differentiate reactive from dysplastic or cancerous lesions. We refer to the advantages and limitations of existing biomarkers employing immunohistochemistry and point to promising new markers, including the generation of novel antibodies targeting mutant proteins, miRNAs, and array assays. Advancements in experimental models, including mouse and 3D models, have improved our understanding of tissue response. The integration of digital pathology along with artificial intelligence may also complement routine visual inspections. Navigating through tissue responses in various chronic inflammatory contexts will help us develop novel and reliable biomarkers that will improve diagnostic decisions and ultimately patient treatment.
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Affiliation(s)
- Ioannis S. Pateras
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Ana Igea
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Mobile Genomes, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Ilias P. Nikas
- Medical School, University of Cyprus, 2029 Nicosia, Cyprus
| | - Danai Leventakou
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Nektarios I. Koufopoulos
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Argyro Ioanna Ieronimaki
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Anna Bergonzini
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Alfred Nobels Allé 8, 141 52 Stockholm, Sweden;
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, 901 87 Umeå, Sweden;
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Republic of Korea;
| | - Antonios Chatzigeorgiou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Teresa Frisan
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, 901 87 Umeå, Sweden;
| | - Christos Kittas
- Department of Histopathology, Biomedicine Group of Health Company, 156 26 Athens, Greece;
| | - Ioannis G. Panayiotides
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
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2
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Turchini J, Sioson L, Clarkson A, Sheen A, Delbridge L, Glover A, Sywak M, Sidhu S, Gill AJ. The Presence of Typical "BRAFV600E-Like" Atypia in Papillary Thyroid Carcinoma is Highly Specific for the Presence of the BRAFV600E Mutation. Endocr Pathol 2023; 34:112-118. [PMID: 36709221 DOI: 10.1007/s12022-022-09747-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/29/2023]
Abstract
Papillary thyroid carcinomas (PTCs) are driven by a variety of molecular abnormalities including BRAF, RAS, ALK, RET, and NTRK alterations. PTCs driven by the BRAFV600E mutation, or tumours which demonstrate a similar gene expression profile to PTCs driven by this mutation, have been reported to demonstrate specific morphological features sometimes termed "BRAFV600E-like" atypia. BRAFV600E-like atypia is characterised by a well-developed papillary architecture, infiltrative growth, marked nuclear clearing, prominent intranuclear pseudoinclusions, abundant eosinophilic cytoplasm, and scattered psammoma bodies. We sought to investigate the sensitivity and specificity of these morphological features for the presence of BRAFV600E mutation in PTCs as determined by mutation specific immunohistochemistry. An unselected cohort of 495 PTCs was reviewed by a single pathologist and categorised into three groups: typical BRAFV600E-like atypia (145 cases, 29%), possible BRAFV600E-like atypia (166 cases, 33%) and little/no BRAFV600E-like atypia (184 cases, 37%). The specificity and sensitivity of typical BRAFV600E-like atypia for the BRAFV600E mutation was 97.2% and 44.3%, respectively. When typical and possible BRAFV600E-like atypia were analysed together, the specificity was 70.6% and the sensitivity was 81.7%. In the morphologically little/no BRAFV600E-like atypia group, 58 cases (31.5%) had a BRAFV600E mutation. We conclude that typical BRAFV600E-like atypia is highly specific for the presence of the BRAFV600E mutation; however, the absence of BRAFV600E-like atypia does not exclude this mutation.
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Affiliation(s)
- John Turchini
- Anatomical Pathology, Douglass Hanly Moir Pathology, 14 Giffnock Avenue, Macquarie Park, NSW, 2113, Australia.
- Discipline of Pathology, Macquarie Medical School, Macquarie University, Macquarie Park, NSW, 2109, Australia.
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia.
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, 2065, Australia.
| | - Loretta Sioson
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, 2065, Australia
| | - Adele Clarkson
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, 2065, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, NSW Health Pathology, St Leonards, NSW, 2065, Australia
| | - Amy Sheen
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, 2065, Australia
| | - Leigh Delbridge
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia
- Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Anthony Glover
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia
- Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Mark Sywak
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia
- Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Stan Sidhu
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia
- Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Anthony J Gill
- Sydney Medical School, The University of Sydney, Sydney, 2006, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, 2065, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, NSW Health Pathology, St Leonards, NSW, 2065, Australia
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Phan DAT, Phung GB, Duong TT, Hoang AV, Ngo QD, Trinh DTN, Tran TT. The Value of BRAF VE1 Immunoexpression in Pediatric Langerhans Cell Histiocytosis. Fetal Pediatr Pathol 2022; 41:558-567. [PMID: 33295826 DOI: 10.1080/15513815.2020.1857483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
IntroductionVE1 is a monoclonal antibody detecting mutant BRAF V600E protein by immunohistochemistry (IHC) with a high concordance rate with molecular analysis in many cancers. Materials and methods: BRAF V600E mutation was assessed on 94 pediatric LCH patients using sequencing analysis and VE1 immunohistochemistry with stringent and lenient-scoring criteria. Results: BRAF V600E mutation exon 15 was detected by sequencing in 47.9% of LCH cases. BRAF V600E mutation rate in multiple-system LCH was 65.2%, significantly higher than in single-system LCH (p = .001). VE1 assays showed 35.6% sensitivity, 75.5% specificity (Stringent criteria), and 91.1% sensitivity, 35.7% specificity (Lenient criteria). Conclusions: The proportion of BRAF V600E mutational status was relatively high and related to high-risk LCH. Molecular assays for BRAF mutation detection are preferred in LCH lesions. VE1 is not ready as an alternative option for LCH BRAF testing.
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Affiliation(s)
- Dang Anh Thu Phan
- Pathology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Gia Bao Phung
- Pathology Department, City Children Hospital- Ho Chi Minh City, Viet Nam
| | - Thanh Tu Duong
- Pathology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Anh Vu Hoang
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Quoc Dat Ngo
- Pathology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | | | - Thanh Tung Tran
- Pathology Department, Children's Hospital 1- Ho Chi Minh City, Viet Nam
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Comparison of Two Rapid Assays for the Detection of BRAF V600 Mutations in Metastatic Melanoma including Positive Sentinel Lymph Nodes. Diagnostics (Basel) 2022; 12:diagnostics12030751. [PMID: 35328303 PMCID: PMC8947166 DOI: 10.3390/diagnostics12030751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Testing for the BRAF mutation is mandatory for the management of patients with locally advanced or metastatic melanoma. Molecular analysis based on DNA sequencing remains the gold-standard method for the screening of the different BRAF mutations. These methods must be rapid, sensitive, and specific enough to allow optimal therapeutic management in daily practice and also to include patients in clinical trials. Here, we compared the Idylla BRAF Mutation Test and the anti-BRAF V600E (clone VE1) immunohistochemistry (IHC) in 90 melanoma samples, with a focus on a challenging cohort of 32 positive sentinel lymph nodes. The BRAF status was assessed with both methods independently of the percentage of tumor cells. The concordance rate was calculated excluding both non-contributory analyses and BRAFV600K/R/M mutants due to the specific V600E-IHC test design. The incidence of the BRAFV600E mutation was 33% with both BRAF Idylla and BRAF IHC. The agreement rate was 91% (72/79). Although the agreement rate was high, we suggest that the use of IHC is more suitable for rapid BRAF testing on sentinel lymph node biopsies when associated with a low percentage and scattered tumor cells, which gave a high risk of non-contributory analysis and/or false negative results with the IdyllaTMBRAF Mutation Test.
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Saliba M, Katabi N, Dogan S, Xu B, Ghossein RA. NRAS Q61R immunohistochemical staining in thyroid pathology: sensitivity, specificity and utility. Histopathology 2021; 79:650-660. [PMID: 33960437 DOI: 10.1111/his.14396] [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: 04/15/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022]
Abstract
AIMS The diagnosis of thyroid neoplasms relies upon the demonstration of histological parameters that can be focal and prone to subjective interpretation. We evaluated the utility of NRAS Q61R immunohistochemistry (IHC) in the diagnosis of thyroid lesions after determining its specificity and sensitivity as a surrogate marker for RAS Q61R mutation. METHOD AND RESULTS NRAS Q61R IHC was performed on 282 primary or metastatic thyroid lesions from 256 patients. RAS mutation status was collected from patients' charts. Sensitivity and specificity of NRAS Q61R IHC for detecting a RAS Q61R mutation was calculated. IHC-positive cases were reviewed to determine the diagnostic utility of NRAS Q61R IHC. NRAS Q61R immunopositivity was seen in non-neoplastic, benign and malignant thyroid lesions. NRAS Q61R antibody cross-reactivity led to the detection of NRAS Q61R, KRAS Q61R and HRAS Q61R proteins. Among primary thyroid carcinomas, immunopositivity was most frequent in papillary thyroid carcinomas, follicular variant (48.0%). The sensitivity and specificity of NRAS Q61R IHC in detecting RAS Q61R mutation was 90.6% and 92.3%, respectively. When positive, the NRAS Q61R stain was determined to be helpful in demonstrating infiltration, tumour size, capsular and/or vascular invasion and multifocality. CONCLUSION NRAS Q61R IHC is highly sensitive and specific for the detection of RAS Q61R mutations in thyroid pathology and is particularly relevant in follicular-patterned neoplasms. When evaluated alongside histological features, NRAS Q61R immunoreactivity can be instrumental in the diagnosis and classification of thyroid nodules.
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Affiliation(s)
- Maelle Saliba
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronald A Ghossein
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Ilié M, Lantéri E, Chamorey E, Thamphya B, Hamila M, Montaudié H, Picard-Gauci A, Gardrat S, Passeron T, Lassalle S, Long-Mira E, Cherfils-Vicini J, Gilson E, Hofman V, Hofman P. Association of TRF2 expression and myeloid-derived suppressor cells infiltration with clinical outcome of patients with cutaneous melanoma. Oncoimmunology 2021; 10:1901446. [PMID: 33796413 PMCID: PMC7993190 DOI: 10.1080/2162402x.2021.1901446] [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] [Indexed: 11/09/2022] Open
Abstract
The outcome of patients with cutaneous melanoma has been strongly modified by recent advances obtained with Immune Checkpoint Inhibitors (ICIs). However, despite this breakthrough, durable response to ICIs is limited to a subset of patients. We investigated whether the expression of TRF2, which preserves telomere integrity, and have an effect on tumor immunosurveillance notably by directly recruiting and activating myeloid-derived suppressor cells (MDSCs), could be a prognostic biomarker in patients with relapsed or metastatic melanoma based on different treatment regimens. We evaluated retrospectively the association of TRF2 expressed in melanoma cells in combination with intratumoral CD33+ CD15+ CD14- MDSCs, as detected by immunohistochemistry and quantified by digital analysis, to clinicopathological features and overall survival (OS) among 48 patients treated with ICIs and 77 patients treated with other treatment options. The densities/mm2 of TRF2+ cells (P=.003) and CD33+ cells (P=.004) were individually significantly related to poor OS. In addition, only the combined expression of CD33+/CD15+/CD14- cells/mm2 was significantly correlated to poor OS (P=.017) in the whole study population as well as in patients treated by ICIs (P=.023). There was no significant difference in OS when analyzing the other markers individually or in combination according to the treatment regimen. The pre-treatment assessment of TRF2 expression and CD33+ cells/mm2 along with the density of CD33+/CD15+/CD14- cells/mm2 could assess OS and better predict clinical response of patients with melanoma treated by ICIs.
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Affiliation(s)
- Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,The Department is the Biobank, Université Côte d'Azur, University Hospital Federation OncoAge, Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Nice, France
| | - Elisabeth Lantéri
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France
| | - Emmanuel Chamorey
- Biostatistics Unit, Antoine Lacassagne Comprehensive Cancer Center, Nice, France
| | - Brice Thamphya
- Biostatistics Unit, Antoine Lacassagne Comprehensive Cancer Center, Nice, France
| | - Marame Hamila
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France
| | - Henri Montaudié
- Department of Dermatology, Université Côte d'Azur, Archet Hospital, Nice, France
| | | | | | - Thierry Passeron
- Department of Dermatology, Université Côte d'Azur, Archet Hospital, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,The Department is the Biobank, Université Côte d'Azur, University Hospital Federation OncoAge, Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,The Department is the Biobank, Université Côte d'Azur, University Hospital Federation OncoAge, Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Nice, France
| | - Julien Cherfils-Vicini
- CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - Eric Gilson
- CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Department of Medical Genetics, CHU Nice, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,The Department is the Biobank, Université Côte d'Azur, University Hospital Federation OncoAge, Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, University Hospital Federation OncoAge, Pasteur Hospital, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,The Department is the Biobank, Université Côte d'Azur, University Hospital Federation OncoAge, Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Nice, France
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Rashid FA, Tabassum S, Khan MS, Ansari HR, Asif M, Sheikh AK, Sameer Aga S. VE1 immunohistochemistry is an adjunct tool for detection of BRAF V600E mutation: Validation in thyroid cancer patients. J Clin Lab Anal 2020; 35:e23628. [PMID: 33305405 PMCID: PMC7891529 DOI: 10.1002/jcla.23628] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy among other endocrine tumors, and BRAFV600E is a frequent genetic mutation occurring in the disease. Although different molecular techniques, most importantly sequencing has been widely recognized as a gold standard but molecular diagnosis remains an expensive, laborious, and time‐intensive process. Recently, immunohistochemistry (IHC) with anti‐BRAF V600E (VE1) antibody has increased practical utility and implemented clinically for the detection of BRAFV600E mutation. Therefore, the study aimed to evaluate diagnostic accuracy of VE1 IHC for detecting the BRAFV600E mutation frequency and clinical implementation in diagnostic laboratories. In this study, 72 formalin fixed paraffin‐embedded tissues (FFPE) were used to determine the BRAFV600E mutation status using IHC and Sanger sequencing. The mutation was found in 29% and 28% cases using IHC and Sanger sequencing, respectively. Furthermore, the results showed 100% sensitivity, 98.07% specificity, 95.2% positive predictive value, and 100% negative predictive value. Notably, significant associations were found between BRAFV600E status and tumor stage, tumor focality, and extrathyroidal extensions, respectively. VE1 IHC was found to be a highly sensitive, specific, and diagnostically accurate method in this cohort. Therefore, BRAFV600E detection through IHC has been considered as the best tailored technique for routine pathology laboratories.
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Affiliation(s)
- Faiza A. Rashid
- Department of Biological SciencesInternational Islamic UniversityIslamabadPakistan
| | - Sobia Tabassum
- Department of Biological SciencesInternational Islamic UniversityIslamabadPakistan
| | - Mosin S. Khan
- Government Medical College Srinagar and Associated SMHS and Superspeciality HospitalSrinagarIndia
| | - Hifzur R. Ansari
- King Abdullah International Medical Research CenterKing Saud bin Abdulaziz University for Health SciencesMinistry of National Guard Health AffairsJeddahSaudi Arabia
| | - Muhammad Asif
- Department of HistopathologyArmed Forces Institute of Pathologycentral Military HospitalRawalpindiPakistan
| | - Ahmareen K. Sheikh
- Department of PathologyPakistan Institute of Medical SciencesIslamabadPakistan
| | - Syed Sameer Aga
- Basic Medical SciencesCollege of Medicine‐ JeddahKing Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research CenterMinistry of National Guard Health AffairsJeddahKingdom of Saudi Arabia
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8
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Parker KG, White MG, Cipriani NA. Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis. Head Neck Pathol 2020; 14:1067-1079. [PMID: 32358715 PMCID: PMC7669962 DOI: 10.1007/s12105-020-01166-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
The evaluation of surgically resected papillary thyroid carcinomas (PTC) by immunohistochemistry (IHC) for BRAF mutation has diagnostic, prognostic and therapeutic implications. The goal of this meta-analysis was to perform a systematic review of studies using the VE1 clone (specific for detection of the BRAF V600E mutation) on formalin-fixed paraffin embedded (FFPE) thyroid surgical resection specimens for primary papillary thyroid carcinoma. The authors' molecular techniques, immunohistochemistry protocols, and scoring methods for VE1 immunostaining were also evaluated. This study included 4079 PTCs representing data from 23 studies. The results extracted from each study were split into two different groups, direct sequencing group or PCR group, based on the molecular "gold standard" method used to compare VE1 IHC staining. In the direct sequencing group, the IHC sensitivity was 100% (95% CI 0.97-1.00) and specificity 84% (95% 0.72-0.91). In the PCR group the sensitivity was 98% (95% CI 0.96-0.99) and specificity 89% (95% CI 0.82-0.94). Although immunohistochemical procedures varied by author, the overall performance of the VE1 clone shows that it is highly sensitive and relatively specific for detecting the BRAF V600E mutation in surgical resection specimens. However, standardization of immunohistochemical procedural method and scoring/interpretation criteria may improve the reliability and reproducibility for the use of VE1 clone for future practice.
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Affiliation(s)
- Kyle G Parker
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA.
| | - Michael G White
- Department of General Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nicole A Cipriani
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA
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9
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Choden S, Keelawat S, Jung CK, Bychkov A. An affordable immunohistochemical approach to estimate the prevalence of BRAFV600E in large cohort studies-establishing the baseline rate of BRAF mutation in an institutional series of papillary thyroid carcinoma from Thailand. Gland Surg 2020; 9:1867-1877. [PMID: 33224862 DOI: 10.21037/gs-20-388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Papillary thyroid carcinoma (PTC) accounts for the majority of diagnoses of thyroid carcinoma. BRAFV600E mutation is the most common genetic alteration in PTC, which has diagnostic and prognostic significance. The rate of BRAFV600E mutation in PTC from Thailand has not been reported. Our purpose was to estimate the prevalence of BRAF mutation in a large institutional series using an affordable approach, which combined mutation-specific immunohistochemistry (IHC) with VE1 antibody and tissue microarray (TMA). Methods A total of 476 PTC cases plotted on TMA were employed for determining the mutation status in this study. The cancer tissue of initial 100 cases (pilot study) were analyzed for BRAFV600E mutation by using both direct sequencing and VE1 immunostaining. For the subsequent PTC cases, VE1 IHC was used as an alternative to direct sequencing for the detection of mutation. Univariate and multivariate analyses were done to determine the association of clinicopathological variables with BRAFV600E mutation. Results In the pilot study, VE1 IHC showed excellent analytical performance (κ=0.884) for detecting BRAFV600E mutation in PTC TMA as compared to direct sequencing. The prevalence of BRAFV600E in the whole cohort was 60.9% by using VE1 IHC. The mutation was commonly seen in tall cell (92.9%) and classic (70.2%) variants of PTC. Multivariate analysis (P<0.05) showed association of BRAFV600E with histological type of tumor, extrathyroidal extension, and absence of Hashimoto's thyroiditis. Conclusions In conclusion, BRAFV600E mutation was detected in 60.9% of Thai PTC and it was associated with several aggressive clinicopathological variables of thyroid cancer. VE1 IHC proved as a reliable method able to replace direct sequencing for detection of the mutation. A combination of mutation-specific IHC and TMA allows conducting large cohort studies more labor-saving and cost-efficiently.
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Affiliation(s)
- Sonam Choden
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Andrey Bychkov
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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10
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Detection of BRAF V600E Mutation in Ganglioglioma and Pilocytic Astrocytoma by Immunohistochemistry and Real-Time PCR-Based Idylla Test. DISEASE MARKERS 2020; 2020:8880548. [PMID: 32879641 PMCID: PMC7448243 DOI: 10.1155/2020/8880548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/21/2020] [Accepted: 07/31/2020] [Indexed: 11/17/2022]
Abstract
The BRAF V600E mutation is an important oncological target in certain central nervous system (CNS) tumors, for which a possible application of BRAF-targeted therapy grows continuously. In the present study, we aim to determine the prevalence of BRAF V600E mutations in a series of ganglioglioma (GG) and pilocytic astrocytoma (PA) cases. Simultaneously, we decided to verify whether the combination of fully automated tests—BRAF-VE1 immunohistochemistry (IHC) and Idylla BRAF mutation assay—may be useful to accurately predict it in the case of specified CNS tumors. The study included 49 formalin-fixed, paraffin-embedded tissues, of which 15 were GG and 34 PA. Immunohistochemistry with anti-BRAF V600E (VE1) antibody was performed on tissue sections using the VentanaBenchMark ULTRA platform. All positive or equivocal cases on IHC and selected negative ones were further assessed using the Idylla BRAF mutation assay coupled with the Idylla platform. The BRAF-VE1 IHC was positive in 6 (6/49; 12.3%) and negative in 39 samples (39/49; 79.6%). The interpretation of immunostaining results was complicated in 4 cases, of which 1 tested positive for the Idylla BRAF mutation assay. Therefore, the overall positivity rate was 14.3%. This included 2 cases of GG and 5 cases of PA. Our study found that BRAF V600E mutations are moderately frequent in PA and GG and that for these tumor entities, IHC VE1 is suitable for screening purposes, but all negative, equivocal, and weak positive cases should be further tested with molecular biology techniques, of which the Idylla system seems to be a promising tool.
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VE1 Immunohistochemistry Improves the Limit of Genotyping for Detecting BRAFV600E Mutation in Papillary Thyroid Cancer. Cancers (Basel) 2020; 12:cancers12030596. [PMID: 32150939 PMCID: PMC7139976 DOI: 10.3390/cancers12030596] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/29/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023] Open
Abstract
Detection of BRAFV600E is useful for making diagnosis and risk stratification of papillary thyroid carcinoma (PTC). Molecular testing, however, is not always available for routine clinical use. To assess the clinical utility and reliability of VE1 immunohistochemistry (IHC) for detecting BRAFV600E mutation in PTC, VE1 IHC was performed on the tissue microarrays of 514 patients with PTC and was compared with Sanger sequencing results. Of 514 PTC cases, 433 (84.2%) were positive for VE1 expression. Among 6 discordant cases between VE1 IHC and Sanger sequencing, 3 initial VE1-false negative cases turned out to be true false negative on repeat testing, and 3 VE1-false positive cases showed BRAFV600E mutation using digital PCR analysis. PTCs with low variant allele fraction were positive for VE1 IHC but were not detected using sequencing. VE1 IHC showed 99.3% sensitivity, 100% specificity, 100% positive predictive value, and 96.4% negative predictive value. The BRAFV600E mutation was significantly associated with older age, multifocality, extrathyroidal extension, lymph node metastasis, and advanced tumor stage. In conclusion, VE1 IHC is a reliable method for detecting BRAFV600E mutation in PTC specimens.
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12
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Bence C, Hofman V, Chamorey E, Long-Mira E, Lassalle S, Albertini AF, Liolios I, Zahaf K, Picard A, Montaudié H, Lacour JP, Passeron T, Andea AA, Ilie M, Hofman P. Association of combined PD-L1 expression and tumour-infiltrating lymphocyte features with survival and treatment outcomes in patients with metastatic melanoma. J Eur Acad Dermatol Venereol 2019; 34:984-994. [PMID: 31625630 DOI: 10.1111/jdv.16016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/20/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent advances obtained with immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1) protein have significantly improved the outcome of patients with metastatic melanoma. The PD-L1 expression in tumour cells as detected by immunohistochemistry is a predictive biomarker in some solid tumours, but appears insufficient as prognostic or predictive factor of response to ICIs in metastatic melanomas. OBJECTIVES We investigated whether the presence and the features of pretreatment CD8+ tumour-infiltrating T lymphocytes (TILs) could be a complementary prognostic or predictive biomarker in patients with metastatic melanoma. METHODS In this retrospective study, we evaluated the association of PD-L1 expression ≥5% of tumour cells combined with TIL features (CD8, CD28, Ki67) with the overall survival (OS) among 51 patients treated with ICIs and 54 patients treated with other treatment options (non-ICIs). RESULTS PD-L1 positivity was observed in 33% and 39% of primary melanomas and matched metastases, respectively, with, however, poor concordance between the primary and the matched metastatic site (κ = 0.283). No significant association was noted between PD-L1 expression and CD8+ TIL profile analysed as single markers and OS or response to immunotherapy. Instead, their combined analysis in primary melanoma samples showed that the PD-L1-/CD8+ status was significantly associated with prolonged OS in the whole population (P = 0.04) and in the subgroup treated with non-ICIs (P = 0.009). Conversely, the PD-L1+/CD8+ status was a good prognostic factor in patients treated with ICIs (P = 0.022), whereas was significantly associated with poor prognosis in patients treated with non-ICIs (P = 0.014). While the expression of CD28 was not related to outcome, the Ki67 expression was significantly associated with poor OS in the subgroup CD8+ TIL+/PD-L1- (P = 0.02). CONCLUSIONS The pretreatment combination of PD-L1 expression with the level of CD8+ TILs could better assess OS and predict therapeutic response of patients with metastatic melanoma treated by either immunotherapy or other treatment regimens.
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Affiliation(s)
- C Bence
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - E Chamorey
- Biostatistics Unit, Antoine Lacassagne Comprehensive Cancer Center, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | | | | | - K Zahaf
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - A Picard
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - J P Lacour
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - A A Andea
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - P Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
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14
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Singarayer R, Mete O, Perrier L, Thabane L, Asa SL, Van Uum S, Ezzat S, Goldstein DP, Sawka AM. A Systematic Review and Meta-Analysis of the Diagnostic Performance of BRAF V600E Immunohistochemistry in Thyroid Histopathology. Endocr Pathol 2019; 30:201-218. [PMID: 31300997 DOI: 10.1007/s12022-019-09585-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Immunohistochemistry (IHC) in evaluating thyroid surgical specimens may facilitate diagnostic and prognostic evaluation, with potential therapeutic implications. We performed a systematic review and meta-analysis examining the analytic validity of IHC in detecting BRAFV600E mutations in thyroid cancer (primary or metastatic). We screened citations from three electronic databases (until December 20, 2018), supplemented by a hand search of authors' files and cross-references of reviews. Citations and full-text papers were independently reviewed in duplicate, and consensus was achieved on inclusion of papers. Two reviewers independently critically appraised and abstracted data from included papers. Random-effect meta-analyses were conducted for sensitivity and specificity estimates. We reviewed 1499 unique citations and 93 full-text articles. We included 1 systematic review and 30 original articles. The published review (from 2015) needed to be updated as there were multiple subsequent original studies. The pooled sensitivity of IHC in detecting a BRAFV600E mutation was 96.8% (95% confidence interval [CI] at 94.1%, 98.3%) (29 studies, including 2659 BRAFV600E mutant tumors). The IHC pooled specificity was 86.3% (95% CI 80.7%, 90.4%) (28 studies, including 1107 BRAFV600E wild-type specimens). These meta-analyses were subject to statistically significant heterogeneity, partly explained by antibody type (sensitivity and specificity) and tissue/tumor type (specificity). In conclusion, BRAF IHC is highly sensitive and reasonably specific in detecting the BRAFV600E mutation; however, there is some variability in analytic performance.
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Affiliation(s)
- Ranjit Singarayer
- Thyroid Fellow, University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C, Canada
| | - Ozgur Mete
- Department of Pathology, University Health Network and University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 11 EN-422, Toronto, Ontario, M5G 2C4, Canada
| | - Laure Perrier
- University of Toronto Libraries, University of Toronto, 130 St. George St, Toronto, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Biostatistics Unit, 3rd Floor, Martha Wing, Room H-325, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada
| | - Sylvia L Asa
- Department of Pathology, University Health Network and University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 11 EN-422, Toronto, Ontario, M5G 2C4, Canada
| | - Stan Van Uum
- Division of Endocrinology, Western University, London, Ontario, Canada
- Division of Endocrinology & Metabolism, St Joseph's Health Care London, Room B5-130, 268 Grosvenor Street, London, Ontario, Canada
| | - Shereen Ezzat
- Department of Endocrine Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Toronto General Hospital, 585 University Avenue, 9NU-986, Toronto, Ontario, M5G 2N2, Canada
| | - David P Goldstein
- Department of Otolaryngology, Head and Neck Surgery, University Health Network and University of Toronto, Toronto, Canada
- Princess Margaret Cancer Centre, 610 University Avenue, Suite 3-950, Toronto, Ontario, M5G 2M9, Canada
| | - Anna M Sawka
- Division of Endocrinology, University Health Network and University of Toronto, Toronto, Canada.
- Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C4, Canada.
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15
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Exploration of BRAFV600E as a diagnostic adjuvant in the non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Hum Pathol 2018; 82:32-38. [DOI: 10.1016/j.humpath.2018.06.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/15/2018] [Accepted: 06/21/2018] [Indexed: 12/14/2022]
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16
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Long-Mira E, Ilie M, Chamorey E, Leduff-Blanc F, Montaudié H, Tanga V, Allégra M, Lespinet-Fabre V, Bordone O, Bonnetaud C, Schiappa R, Butori C, Bence C, Lacour JP, Hofman V, Hofman P. Monitoring BRAF and NRAS mutations with cell-free circulating tumor DNA from metastatic melanoma patients. Oncotarget 2018; 9:36238-36249. [PMID: 30546839 PMCID: PMC6281416 DOI: 10.18632/oncotarget.26343] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/01/2018] [Indexed: 01/05/2023] Open
Abstract
The mutation status of the BRAF and NRAS genes in tumor tissue is used to select patients with metastatic melanoma for targeted therapy. Cell-free circulating DNA (cfDNA) represents an accessible, non-invasive surrogate sample that could provide a snapshot of the BRAF and NRAS genotype in these patients. We investigated the feasibility of the Idylla™ assay for detection of BRAF and NRAS mutations in cfDNA of 19 patients with metastatic melanoma at baseline and during the course of treatment. The cfDNA genotype obtained with Idylla was compared to the results obtained with matched-tumor tissue and to clinical outcome. At baseline, 47% of patients harbored a BRAFV600 mutation in their cfDNA. Two months after targeted treatment the BRAFV600 mutant cfDNA was undetectable in all patients and 3 were disease-free. Moreover, 15% of patients harbored a NRAS mutation that was detected with plasma before treatment. The sensitivity and specificity were 80% and 89% for the BRAF status, and 79% and 100% for the NRAS status in pretreatment cfDNA compared to results obtained with a tissue test. Due to the small size of the population, no significant correlation was observed between the presence of BRAF or NRAS mutations in cfDNA and the metastatic tumor load or overall survival. In conclusion, this study demonstrated that evaluation with the Idylla system of the BRAF and NRAS mutation status in cfDNA may be a surrogate for determination of the BRAF and NRAS status in tumor tissue.
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Affiliation(s)
- Elodie Long-Mira
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Université Côte d'Azur, CNRS, INSERM, IRCAN, FHU OncoAge, Team 4, Nice, France
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Marius Ilie
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Université Côte d'Azur, CNRS, INSERM, IRCAN, FHU OncoAge, Team 4, Nice, France
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Emmanuel Chamorey
- Antoine Lacassagne Comprehensive Cancer Center, FHU OncoAge, Biostatistics Unit, Nice, France
| | - Florence Leduff-Blanc
- Université Côte d'Azur, CHU Nice, Department of Dermatology, Archet Hospital, Nice, France
| | - Henri Montaudié
- Université Côte d'Azur, CHU Nice, Department of Dermatology, Archet Hospital, Nice, France
| | - Virginie Tanga
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Maryline Allégra
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | | | - Olivier Bordone
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Christelle Bonnetaud
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Renaud Schiappa
- Antoine Lacassagne Comprehensive Cancer Center, FHU OncoAge, Biostatistics Unit, Nice, France
| | - Catherine Butori
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
| | - Coraline Bence
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
| | - Jean-Philippe Lacour
- Université Côte d'Azur, CHU Nice, Department of Dermatology, Archet Hospital, Nice, France
| | - Véronique Hofman
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Université Côte d'Azur, CNRS, INSERM, IRCAN, FHU OncoAge, Team 4, Nice, France
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
| | - Paul Hofman
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Université Côte d'Azur, CNRS, INSERM, IRCAN, FHU OncoAge, Team 4, Nice, France
- Université Côte d'Azur, CHU Nice, FHU OncoAge, Hospital-Integrated Biobank, Nice, France
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17
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Yang Q, Huo S, Sui Y, Du Z, Zhao H, Liu Y, Li W, Wan X, Liu T, Zhang G. Mutation Status and Immunohistochemical Correlation of KRAS, NRAS, and BRAF in 260 Chinese Colorectal and Gastric Cancers. Front Oncol 2018; 8:487. [PMID: 30416987 PMCID: PMC6212577 DOI: 10.3389/fonc.2018.00487] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022] Open
Abstract
KRAS, NRAS and BRAF are kinases involved in the RAS-RAF-MAPK signaling pathway and also potential tumor-driven genes. Patients with KRAS/NRAS/BRAF mutations are resistant to anti-EGFR monoclonal antibody therapy. The main purpose of this study is to investigate the mutation status and distribution of KRAS/NRAS/BRAF in Chinese colorectal and gastric cancers, and to explore the histopathological changes and related immunohistochemical marker changes caused by these mutations. The mutation status of KRAS (exons 2, codon 12/13), NRAS (exons 2/3/4, codon 12/13/59/61/117/146) and BRAF (exons 15, codon 600) were detected by amplification refractory mutation system polymerase chain reaction (ARMS-PCR) in 86 colon cancer, 140 rectal cancer and 34 gastric cancer tissues. Then, the frequencies and distribution of KRAS/NRAS/BRAF mutations were described in detail. Furthermore, the relationship between KRAS/NRAS/BRAF mutations and the features of histopathological and related immunohistochemical markers were analyzed. The results showed that KRAS/NRAS/BRAF mutation rates in colon cancer were 44.2, 1.2, and 3.5%; in rectal cancer were 37.1, 4.3, and 0.7%; in gastric cancer were none, none and 2.9%. The mutation rate of KRAS in female (48.8%) is significantly higher than that of male (27.8%), and the mutation rate increased with the higher degree of differentiation. Additionally, the mutation rate of BRAF detected by ARMS-PCR (1.77%) was significantly lower than that by immunohistochemistry (4.11%). It also showed that the KRAS/NRAS/BRAF mutation status had a certain relationship with the expression of some immunohistochemical markers. This study provides more data support for clinical research on KRAS/NRAS/BRAF mutation in CRCs or gastric cancers.
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Affiliation(s)
- Qiwei Yang
- Medical Research Center, The Second Hospital of Jilin University, Changchun, China
| | - Sibo Huo
- Department of General Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Yujie Sui
- Medical Research Center, The Second Hospital of Jilin University, Changchun, China
| | - Zhenwu Du
- Medical Research Center, The Second Hospital of Jilin University, Changchun, China.,Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Haiyue Zhao
- Center of Reproductive Medicine and Center of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, China
| | - Yu Liu
- Department of General Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Wei Li
- Department of General Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Xin Wan
- Department of General Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Tongjun Liu
- Department of General Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Guizhen Zhang
- Medical Research Center, The Second Hospital of Jilin University, Changchun, China.,Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
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18
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Immunohistochemistry is a feasible method to screen BRAF V600E mutation in colorectal and papillary thyroid carcinoma. Exp Mol Pathol 2018; 105:153-159. [DOI: 10.1016/j.yexmp.2018.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/08/2018] [Accepted: 07/11/2018] [Indexed: 12/27/2022]
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19
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Smith AL, Williams MD, Stewart J, Wang WL, Krishnamurthy S, Cabanillas ME, Roy-Chowdhuri S. Utility of the BRAF p.V600E immunoperoxidase stain in FNA direct smears and cell block preparations from patients with thyroid carcinoma. Cancer Cytopathol 2018; 126:406-413. [PMID: 29579361 DOI: 10.1002/cncy.21992] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND The identification of BRAF mutations in thyroid cancer has prognostic and therapeutic implications. Although the gold standard for identifying BRAF mutations is molecular testing, the ability to perform BRAF p.V600E immunostaining on fine-needle aspiration (FNA) samples can facilitate the rapid triaging of patients to treatment options. METHODS A total of 50 thyroid carcinoma FNA samples, including papillary (29 samples), poorly differentiated (10 samples), anaplastic (9 samples), and Hurthle cell (2 samples) carcinomas, with a known BRAF p.V600E mutation status were selected for the current study. Immunostaining was performed on smears and cell block sections using an anti-BRAF p.V600E antibody (clone VE1). The results were compared with the known mutation status obtained by molecular testing and/or immunostaining of surgical pathology material from the same patient. RESULTS Of the total of 50 cases, 26 cases had smears available for the evaluation of BRAF p.V600E immunostaining; positive immunostaining was noted in 16 samples and negative immunostaining was noted in 4 samples, whereas 6 cases were equivocal. Of the 34 cases for which cell blocks were available for evaluation, BRAF p.V600E immunostaining was positive in 17 cases, negative in 16 cases, and equivocal in 1 case. The overall sensitivity and specificity of BRAF p.V600E immunostaining on the cell block preparation was 94.4% and 100%, respectively, whereas for the smears it was 80% and 63.6%, respectively. CONCLUSIONS BRAF p.V600E immunostaining can be performed reliably on thyroid FNA cell block preparations. However, false-positive results on direct smears limit their utility and therefore need to be interpreted with caution. Cancer Cytopathol 2018;126:406-13. © 2018 American Cancer Society.
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Affiliation(s)
- Amber L Smith
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michelle D Williams
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John Stewart
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wei-Lien Wang
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Savitri Krishnamurthy
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Maria E Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sinchita Roy-Chowdhuri
- Division of Pathology and Laboratory Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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20
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Song YS, Jung CK, Jung KC, Park YJ, Won JK. Rare Manifestations of Anaplastic Thyroid Carcinoma: the Role of BRAF Mutation Analysis. J Korean Med Sci 2017; 32:1721-1726. [PMID: 28875621 PMCID: PMC5592191 DOI: 10.3346/jkms.2017.32.10.1721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/13/2016] [Indexed: 12/05/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is difficult to distinguish from other cancers, especially when its pathological features are atypical for ATC or when the tumor is totally undifferentiated and occurs after a considerable lapse of time, in an area remote from the original site of the tumor. Here, we present two patients (68-year-old man and 56-year-old woman) with rare manifestations of ATC, which were initially thought to be other malignancies. Immunohistochemical tests, using various markers, failed to provide information about the origin of these tumors. However, both patients had a history of papillary thyroid carcinoma (PTC) from several years ago and BRAF mutations were observed in the undifferentiated tumors, as well as in the previous PTCs. Therefore, we could make a diagnosis of ATC derived from PTC. As such, BRAF mutation analysis may serve as a useful tool for ATC diagnosis in challenging ATC cases.
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Affiliation(s)
- Young Shin Song
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chan Kwon Jung
- Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyeong Cheon Jung
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Szymonek M, Kowalik A, Kopczyński J, Gąsior-Perczak D, Pałyga I, Walczyk A, Gadawska-Juszczyk K, Płusa A, Mężyk R, Chrapek M, Góźdź S, Kowalska A. Immunohistochemistry cannot replace DNA analysis for evaluation of BRAF V600E mutations in papillary thyroid carcinoma. Oncotarget 2017; 8:74897-74909. [PMID: 29088832 PMCID: PMC5650387 DOI: 10.18632/oncotarget.20451] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/25/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The BRAF V600E mutation is the most common genetic event occurring in papillary thyroid cancer (PTC). Recently, the possibility of using immunohistochemistry (IHC) to detect the BRAF V600E mutation has been reported. MATERIALS AND METHODS In 140 patients with classical PTC, the status of the BRAF V600E mutation was determined by IHC (using two alternative staining protocols, IHC-1 and IHC-2) and molecular biology methods: Sanger sequencing (SEQ) and real-time PCR (qPCR). RESULTS The BRAF V600E mutation was detected in 57.1% (80/140) patients by IHC-1 and 62.9% (88/140) patients by IHC-2. The highest correlation in detecting the BRAF V600E mutation was found between IHC-2 and qPCR (94.2%), and between IHC-1 and qPCR (83.9%). Correlations between IHC-1 and SEQ and between IHC-2 and SEQ were 71.5% and 76.2%, respectively. The IHC-2 protocol had higher sensitivity, PPV, and NPV, and Cohen's kappa than IHC- 1. The presence of BRAF V600E mutation in IHC-2 statistically correlated with age at diagnosis, histopathological stage, and extrathyroidal extension. CONCLUSIONS The results obtained in this study indicate a lack of concordance between BRAF V600E detection by IHC and molecular methods. The IHC method cannot replace molecular methods for the detection of the BRAF V600E mutation.
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Affiliation(s)
- Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | | | - Iwona Pałyga
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | | | | | - Agnieszka Płusa
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | - Ryszard Mężyk
- Cancer Epidemiology, Holycross Cancer Center, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Science, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Góźdź
- Oncology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University in Kielce, Poland
| | - Aldona Kowalska
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University in Kielce, Poland
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Evaluation of molecular diagnostic approaches for the detection of BRAF p.V600E mutations in papillary thyroid cancer: Clinical implications. PLoS One 2017. [PMID: 28636673 PMCID: PMC5479585 DOI: 10.1371/journal.pone.0179691] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Differentiated papillary thyroid cancer (PTC) is the most common cancer of the endocrine system. PTC has a very good prognosis and a high 5 year survival rate; however, some patients are unresponsive to treatment, and their diagnosis eventually results in death. Recent efforts have focused on searching for prognostic and predictive factors that may enable treatment personalization and monitoring across the course of the disease. The presence of the BRAF mutation is considered to contribute to the risk of poor clinical course, according to American Thyroid Association (ATA) recommendations. The method used for genotyping can impact the predicted mutation frequency; however, ATA recommendations do not address this issue. We evaluated the molecular diagnostic (BRAF p.V600E mutation) results of 410 patients treated for PTC. We thoroughly analyzed the impact of three different BRAF mutation detection methods, Sanger Sequencing (Seq), allele-specific amplification PCR (ASA-PCR), and quantitative PCR (qPCR), on the frequency of mutation detection in 399 patients. Using Seq, we detected the BRAF mutation in 37% of patients; however, we were able to detect BRAF mutations in 57% and 60% of patients using the more sensitive ASA-PCR and qPCR technologies, respectively. Differences between methods were particularly marked in the thyroid papillary microcarcinoma group; BRAF p.V600E mutations were found in 37% of patients using Seq and 63% and 66% of patients using ASA-PCR and qPCR, respectively. We also evaluated how these different diagnostic methods were impacted by DNA quality. Applying methods with different sensitivities to the detection of BRAF p.V600E mutations may result in different results for the same patient; such data can influence stratification of patients into different risk groups, leading to alteration of treatment and follow-up schemes.
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Abd Elmageed ZY, Sholl AB, Tsumagari K, Al-Qurayshi Z, Basolo F, Moroz K, Boulares AH, Friedlander P, Miccoli P, Kandil E. Immunohistochemistry as an accurate tool for evaluating BRAF-V600E mutation in 130 samples of papillary thyroid cancer. Surgery 2017; 161:1122-1128. [DOI: 10.1016/j.surg.2016.06.081] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/21/2016] [Accepted: 06/27/2016] [Indexed: 02/07/2023]
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Values of molecular markers in the differential diagnosis of thyroid abnormalities. J Cancer Res Clin Oncol 2016; 143:913-931. [PMID: 28008451 DOI: 10.1007/s00432-016-2319-9] [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] [Received: 11/03/2016] [Accepted: 12/02/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Thyroid cancer (TC), follicular adenoma (FA) and Hashimoto's thyroiditis (HT) are three of the most frequently reported abnormalities that affect the thyroid gland. A frequent co-occurrence along with similar histopathological features is observed between TC and FA as well as between TC and HT. The conventional diagnostic methods such as histochemical analysis present complications in differential diagnosis when these abnormalities occur simultaneously. Hence, the authors recognize novel methods based on screening genetic defects of thyroid abnormalities as viable diagnostic and prognostic methods that could complement the conventional methods. METHODS We have extensively reviewed the existing literature on TC, FA and HT and also on three genes, namely braf, nras and ret/ptc, that could be used to differentially diagnose the three abnormalities. Emphasis was also given to the screening methods available to detect the said molecular markers. RESULTS AND CONCLUSION It can be conferred from the analysis of the available data that the utilization of braf, nras and ret/ptc as markers for the therapeutic evaluation of FA and HT is debatable. However, molecular screening for braf, nras and ret/ptc mutations proves to be a conclusive method that could be employed to differentially diagnose TC from HT and FA in the instance of a suspected co-occurrence. Thyroid cancer patients can be highly benefited from the screening for the said genetic markers, especially the braf gene due to its diagnostic value as well as due to the availability of personalized medicine targeted specifically for braf mutants.
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Zhou F, Moreira AL. Lung Carcinoma Predictive Biomarker Testing by Immunoperoxidase Stains in Cytology and Small Biopsy Specimens: Advantages and Limitations. Arch Pathol Lab Med 2016; 140:1331-1337. [PMID: 27588333 DOI: 10.5858/arpa.2016-0157-ra] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT - In the burgeoning era of molecular genomics, immunoperoxidase (IPOX) testing grows increasingly relevant as an efficient and effective molecular screening tool. Patients with lung carcinoma may especially benefit from the use of IPOX because most lung carcinomas are inoperable at diagnosis and only diagnosed by small tissue biopsy or fine-needle sampling. When such small specimens are at times inadequate for molecular testing, positive IPOX results still provide actionable information. OBJECTIVE - To describe the benefits and pitfalls of IPOX in the detection of biomarkers in lung carcinoma cytology specimens and small biopsies by summarizing the currently available commercial antibodies, preanalytic variables, and analytic considerations. DATA SOURCES - PubMed. CONCLUSIONS - Commercial antibodies exist for IPOX detection of aberrant protein expression due to EGFR L858R mutation, EGFR E746_A750 deletion, ALK rearrangement, ROS1 rearrangement, and BRAF V600E mutation, as well as PD-L1 expression in tumor cells. Automated IPOX protocols for ALK and PD-L1 detection were recently approved by the Food and Drug Administration as companion diagnostics for targeted therapies, but consistent interpretive criteria remain to be elucidated, and such protocols do not yet exist for other biomarkers. The inclusion of cytology specimens in clinical trials would expand patients' access to testing and treatment, yet there is a scarcity of clinical trial data regarding the application of IPOX to cytology, which can be attributed to trial designers' lack of familiarity with the advantages and limitations of cytology. The content of this review may be used to inform clinical trial design and advance IPOX validation studies.
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Affiliation(s)
- Fang Zhou
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Drs Zhou and Moreira); and the Department of Pathology, New York University Langone Medical Center, New York, New York (Dr Moreira)
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Martinuzzi C, Pastorino L, Andreotti V, Garuti A, Minuto M, Fiocca R, Bianchi-Scarrà G, Ghiorzo P, Grillo F, Mastracci L. A combination of immunohistochemistry and molecular approaches improves highly sensitive detection of BRAF mutations in papillary thyroid cancer. Endocrine 2016; 53:672-80. [PMID: 26296380 DOI: 10.1007/s12020-015-0720-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/08/2015] [Indexed: 12/19/2022]
Abstract
The optimal method for BRAF mutation detection remains to be determined despite advances in molecular detection techniques. The aim of this study was to compare, against classical Sanger sequencing, the diagnostic performance of two of the most recently developed, highly sensitive methods: BRAF V600E immunohistochemistry (IHC) and peptide nucleic-acid (PNA)-clamp qPCR. BRAF exon 15 mutations were searched in formalin-fixed paraffin-embedded tissues from 86 papillary thyroid carcinoma using the three methods. The limits of detection of Sanger sequencing in borderline or discordant cases were quantified by next generation sequencing. BRAF mutations were found in 74.4 % of cases by PNA, in 71 % of cases by IHC, and in 64 % of cases by Sanger sequencing. Complete concordance for the three methods was observed in 80 % of samples. Better concordance was observed with the combination of two methods, particularly PNA and IHC (59/64) (92 %), while the combination of PNA and Sanger was concordant in 55 cases (86 %). Sensitivity of the three methods was 99 % for PNA, 94.2 % for IHC, and 89.5 % for Sanger. Our data show that IHC could be used as a cost-effective, first-line method for BRAF V600E detection in daily practice, followed by PNA analysis in negative or uninterpretable cases, as the most efficient method. PNA-clamp quantitative PCR is highly sensitive and complementary to IHC as it also recognizes other mutations besides V600E and it is suitable for diagnostic purposes.
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Affiliation(s)
- Claudia Martinuzzi
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Lorenza Pastorino
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Virginia Andreotti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Anna Garuti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Michele Minuto
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Surgery 1 Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Roberto Fiocca
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanna Bianchi-Scarrà
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy.
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
| | - Federica Grillo
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Luca Mastracci
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
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Cabanillas ME, Busaidy NL, Khan SA, Gunn GB, Dadu R, Rao SN, Waguespack SG. Molecular diagnostics and anaplastic thyroid carcinoma: the time has come to harvest the high hanging fruit. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2016. [DOI: 10.2217/ije-2016-0007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Targeted therapies have played a major role in cancer therapeutics, starting with the discovery of a drug against BCR–ABL rearrangements in chronic myelogenous leukemia. This led to the first approval of a targeted agent in cancer and since, many others have followed. Anaplastic thyroid cancer (ATC) is an aggressive carcinoma with few curative options. Although previous cytotoxic chemotherapy and kinase inhibitor therapies have not proven efficacious in ATC, some of the newer drugs appear to be promising. A case report and a comprehensive review of the current standard of care, genetics, modern therapeutic drugs and clinical trials are presented, in order to outline where we currently stand and where the future lies in the quest for a cure for ATC.
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Affiliation(s)
- Maria E Cabanillas
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
| | - Naifa L Busaidy
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
| | - Saad A Khan
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
| | - Ramona Dadu
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
| | - Sarika N Rao
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
| | - Steven G Waguespack
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center; Houston, TX, USA
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Gertz RJ, Nikiforov Y, Rehrauer W, McDaniel L, Lloyd RV. Mutation in BRAF and Other Members of the MAPK Pathway in Papillary Thyroid Carcinoma in the Pediatric Population. Arch Pathol Lab Med 2016; 140:134-9. [PMID: 26910217 DOI: 10.5858/arpa.2014-0612-oa] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Papillary thyroid carcinoma (PTC) is an uncommon tumor in the pediatric population. A limited number of studies have examined genetic mutations affecting the mitogen-activated protein kinase (MAPK) pathway in the pediatric population. OBJECTIVE To examine mutations affecting this pathway in PTC in our pediatric population and compare the BRAF V600E mutation rates in pediatric and adult tumors. DESIGN Eighty-four patients, including 14 pediatric and 70 adult, with PTC were tested for the BRAF V600E mutation by using real-time polymerase chain reaction and sequencing. Additionally, we examined the rate of RAS point mutations with real-time polymerase chain reaction and rearrangements of RET/PTC1 and RET/PTC3 in the pediatric group with fluorescence in situ hybridization. Clinical and histologic data were compared as well. RESULTS Of 77 tumors that had an interpretable result, the BRAF V600E mutant was identified in 4 of 13 pediatric patients (31%) and 43 of 64 adult patients (67%), which was a significant difference (using Fisher exact test, P = .03). One pediatric and 6 adult cases did not reveal an interpretable result with melting curve analysis. One of these cases harbored a rare 3-base pair deletion mutation (c.1799_1801delTGA). Mutations in RAS genes were not seen in any pediatric tumors. One tumor with a RET/PTC1 rearrangement and another with RET/PTC3 were identified in the pediatric population (15%). CONCLUSIONS The rate of the BRAF V600E mutation in the pediatric population is significantly lower than that seen in the adult population. Mutations in RAS do not contribute significantly to pediatric PTC. This experience from our institution adds to the growing body of knowledge regarding tumor genetics in pediatric PTC.
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Affiliation(s)
- Ryan J Gertz
- From the Department of Pathology, MD Anderson Cancer Center, Houston, Texas (Dr Gertz)
| | - Yuri Nikiforov
- the Division of Molecular Genomic Pathology, University of Pittsburgh, Pennsylvania (Dr Nikiforov)
| | - William Rehrauer
- the Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison (Drs Lloyd and Rehrauer)
| | - Lee McDaniel
- and the School of Public Health, Louisiana State University, New Orleans (Dr McDaniel). Dr Gertz is now located at the Department of Pathology, OhioHealth Riverside Methodist Hospital, Columbus, Ohio
| | - Ricardo V Lloyd
- the Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison (Drs Lloyd and Rehrauer)
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29
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Chai YJ, Yi JW, Jee HG, Kim YA, Kim JH, Xing M, Lee KE. Significance of the BRAF mRNA Expression Level in Papillary Thyroid Carcinoma: An Analysis of The Cancer Genome Atlas Data. PLoS One 2016; 11:e0159235. [PMID: 27410688 PMCID: PMC4943731 DOI: 10.1371/journal.pone.0159235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background BRAFV600E is the most common mutation in papillary thyroid carcinoma (PTC), and it is associated with high-risk prognostic factors. However, the significance of the BRAF mRNA level in PTC remains unknown. We evaluated the significance of BRAF mRNA expression level by analyzing PTC data from The Cancer Genome Atlas (TCGA) database. Methods Data from 499 patients were downloaded from the TCGA database. After excluding other PTC variants, we selected 353 cases of classic PTC, including 193 cases with BRAFV600E and 160 cases with the wild-type BRAF. mRNA abundances were measured using RNA-Seq with the Expectation Maximization algorithm. Results The mean BRAF mRNA level was significantly higher in BRAFV600E patients than in patients with wild-type BRAF (197.6 vs. 179.3, p = 0.031). In wild-type BRAF patients, the mean BRAF mRNA level was higher in cases with a tumor > 2 cm than those with a tumor ≤ 2.0 cm (189.4 vs. 163.8, p = 0.046), and was also higher in cases with lymph node metastasis than in those without lymph node metastasis (188.5 vs. 157.9, p = 0.040). Within BRAFV600E patients, higher BRAF mRNA expression was associated with extrathyroidal extension (186.4 vs. 216.4, p = 0.001) and higher T stage (188.1 vs. 210.2, p = 0.016). Conclusions A higher BRAF mRNA expression level was associated with tumor aggressiveness in classic PTC regardless of BRAF mutational status. Evaluation of BRAF mRNA level may be helpful in prognostic risk stratification of PTC.
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Affiliation(s)
- Young Jun Chai
- Department of Surgery, Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 156–70, Korea
- Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
| | - Jin Wook Yi
- Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
| | - Hyeon-Gun Jee
- Center for Chronic Disease, Research Institute, National Medical Center, Seoul, Korea
| | - Young A Kim
- Department of Pathology, Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 156–70, Korea
| | - Ju Han Kim
- Division of Biomedical Informatics, Systems Biomedical Informatics Research Center, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
| | - Mingzhao Xing
- Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, 1830E Monument St, Ste 333, Baltimore, Maryland, 21287, United States of America
| | - Kyu Eun Lee
- Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110–744, Korea
- * E-mail:
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Oishi N, Kondo T, Vuong HG, Nakazawa T, Mochizuki K, Kasai K, Inoue T, Tahara I, Hirokawa M, Miyauchi A, Katoh R. Immunohistochemical detection of NRASQ61R protein in follicular-patterned thyroid tumors. Hum Pathol 2016; 53:51-7. [DOI: 10.1016/j.humpath.2016.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/02/2016] [Accepted: 02/12/2016] [Indexed: 12/31/2022]
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Use of monoclonal antibodies to detect specific mutations in formalin-fixed, paraffin-embedded tissue sections. Hum Pathol 2016; 53:168-77. [DOI: 10.1016/j.humpath.2016.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/10/2016] [Accepted: 03/12/2016] [Indexed: 02/08/2023]
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Mitchell B, Dhingra JK, Mahalingam M. BRAF and Epithelial-Mesenchymal Transition: Lessons From Papillary Thyroid Carcinoma and Primary Cutaneous Melanoma. Adv Anat Pathol 2016; 23:244-71. [PMID: 27145091 DOI: 10.1097/pap.0000000000000113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The increased prevalence of BRAF mutations in thyroid carcinoma and primary cutaneous melanoma (PCM) hint that dysregulation of BRAF might contribute to the noted association between PCM and thyroid carcinoma. A recent study evaluating the rate of BRAFV600E mutations among patients who had been diagnosed with primary papillary thyroid carcinoma (PTC) and PCM showed that patients with either PCM or PTC were at an increased risk of developing the other as a second primary malignant neoplasm. Furthermore, the authors noted that samples from patients suffering from both malignancies exhibited a higher rate of incidence of the BRAFV600E mutation, compared with patients not suffering from both malignancies. These studies support the hypothesis that the pathogenesis of these 2 malignancies might share a conserved molecular pattern associated with dysregulation of the BRAF protein. One mechanism through which BRAF might contribute to PCM and thyroid carcinoma progression is through induction of epithelial-mesenchymal transition (EMT). Specifically, the Snail/E-cadherin axis has been demonstrated as a pathway dysregulated by BRAF, leading to EMT in both malignancies. Our analysis focuses on the results of these recent investigations, and through a review of select molecules relevant to EMT, looks to provide a context by which to better understand the relevance and role of stromal-parenchymal signaling and the BRAF mutation in the pathogenesis of PTC and PCM.
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Affiliation(s)
- Brendon Mitchell
- *University of Florida College of Medicine, Gainesville, FL †Department of Otolaryngology, Tufts Medical center, Boston, MA ‡Dermatopathology Section, Department of Pathology and Laboratory Medicine, VA Consolidated Laboratories, West Roxbury, MA
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Moghaddam PA, Virk R, Sakhdari A, Prasad ML, Cosar EF, Khan A. Five Top Stories in Thyroid Pathology. Arch Pathol Lab Med 2016; 140:158-70. [PMID: 26910221 DOI: 10.5858/arpa.2014-0468-ra] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Thyroid carcinoma is the most common malignant tumor of endocrine organs, yet it only accounts for approximately 1% of all cancers in the United States with more than 35,000 new cases diagnosed each year and more than 450,000 people living with this disease. While most tumors can be diagnosed without much difficulty, a few tumor types, especially tumors with follicular pattern, sometimes pose a diagnostic challenge. OBJECTIVE To discuss morphologic, immunohistochemical, and molecular features of thyroid tumors. We also explore the clinicopathologic features of papillary microcarcinoma and medullary microcarcinoma and how the latter is related and differentiated from C-cell hyperplasia. Finally with the ever-growing list of organ systems involved in immunoglobulin (Ig) G4-related diseases, we discuss the still not completely explored IgG-4-related thyroid disease. DATA SOURCES Data were obtained from review of the pertinent peer-reviewed literature and institutional experience. CONCLUSIONS Histomorphologic evaluation still remains the gold standard for diagnosis in most cases of thyroid diseases. The application of ancillary studies such as immunohistochemistry and molecular diagnosis, including next-generation sequencing, is becoming more common.
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Affiliation(s)
- Parnian Ahmadi Moghaddam
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Renu Virk
- and the Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Drs Virk and Prasad)
| | - Ali Sakhdari
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Manju L Prasad
- and the Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Drs Virk and Prasad)
| | - Ediz F Cosar
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Ashraf Khan
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
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Patil DT, Ma S, Konishi M, Carver PD, Pukay M, Beadling C, Corless CL, Rubin BP. Utility of BRAF V600E mutation-specific immunohistochemistry in detecting BRAF V600E-mutated gastrointestinal stromal tumors. Am J Clin Pathol 2015; 144:782-9. [PMID: 26486743 DOI: 10.1309/ajcprk3v2eiiupqz] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES As patients with BRAF V600E mutation respond to BRAF inhibitors, it is important to identify these mutations to stratify patients for the appropriate therapy. In this study, we evaluated the utility of a BRAF V600E allele-specific antibody in gastrointestinal stromal tumors (GISTs). METHODS BRAF V600E mutation-specific immunohistochemistry (negative, weak, or moderate/strong expression) and BRAF sequencing were performed on 38 consecutive GISTs diagnosed between January 2013 and April 2014. RESULTS GISTs from a cohort of 25 men and 13 women (mean age, 61 years; range, 39-88 years) were localized to the stomach (18), small bowel (10), colon (three), rectum (two), and pelvis/omentum (five). Strong and diffuse cytoplasmic BRAF expression was noted in two (5%) of 38 cases, while eight (21%) of 38 cases showed weak staining, and 28 (74%) of 38 cases were negative. Both of the strongly positive cases arose in the stomach, occurring in a 42-year-old and a 47-year-old woman, respectively. The lesions measured 0.8 and 1 cm, showed spindle cell morphology, and had no risk of progressive disease by Miettinen criteria. Both cases showed heterozygous BRAF V600E, while no BRAF mutations were detected in cases with weak or negative BRAF expression. CONCLUSIONS BRAF V600E mutation-specific immunohistochemistry is a highly sensitive and specific method for detecting BRAF-mutated GISTs.
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Qu N, Shi RL, Ma B, Gao Y, Wang Y, Ji QH. The Prediction of Sonographic features and BRAF Mutation for Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: Reply. World J Surg 2015; 40:761-3. [PMID: 26493695 DOI: 10.1007/s00268-015-3285-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ning Qu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Rong-liang Shi
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ben Ma
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yi Gao
- Department of Ultrasonography, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yu Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qing-hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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36
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Estrella JS, Tetzlaff MT, Bassett RL, Patel KP, Williams MD, Curry JL, Rashid A, Hamilton SR, Broaddus RR. Assessment of BRAF V600E Status in Colorectal Carcinoma: Tissue-Specific Discordances between Immunohistochemistry and Sequencing. Mol Cancer Ther 2015; 14:2887-95. [DOI: 10.1158/1535-7163.mct-15-0615] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 09/18/2015] [Indexed: 11/16/2022]
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Long E, Ilie M, Lassalle S, Butori C, Poissonnet G, Washetine K, Mouroux J, Lespinet V, Lacour J, Taly V, Laurent-Puig P, Bahadoran P, Hofman V, Hofman P. Why and how immunohistochemistry should now be used to screen for the BRAFV600E status in metastatic melanoma? The experience of a single institution (LCEP, Nice, France). J Eur Acad Dermatol Venereol 2015; 29:2436-43. [DOI: 10.1111/jdv.13332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/07/2015] [Indexed: 12/15/2022]
Affiliation(s)
- E. Long
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
| | - M. Ilie
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
| | - S. Lassalle
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
| | - C. Butori
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
| | - G. Poissonnet
- Department of Surgery; CLCC Antoine Lacassagne Center; Nice France
| | - K. Washetine
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Nice Hospital-Related Biobank BB-0033-00025; Pasteur Hospital; Nice France
| | - J. Mouroux
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
- Department of Thoracic Surgery; Pasteur Hospital; Nice France
| | - V. Lespinet
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
| | - J.P. Lacour
- Department of Dermatology; Archet Hospital; Nice France
| | - V. Taly
- INSERM UMR-S1147; Centre Universitaire des Saints-Pères; University Paris Sorbonne Cité; Paris France
| | - P. Laurent-Puig
- INSERM UMR-S1147; Centre Universitaire des Saints-Pères; University Paris Sorbonne Cité; Paris France
| | - P. Bahadoran
- Department of Dermatology; Archet Hospital; Nice France
| | - V. Hofman
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
- Nice Hospital-Related Biobank BB-0033-00025; Pasteur Hospital; Nice France
| | - P. Hofman
- Laboratory of Clinical and Experimental Pathology; Pasteur Hospital; Nice Cedex France
- Institute for Research on Cancer and Aging; Nice (IRCAN) CNRS UMR 7284/Inserm U1081; University of Nice Sophia Antipolis; Nice France
- Nice Hospital-Related Biobank BB-0033-00025; Pasteur Hospital; Nice France
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Pusztaszeri MP, Krane JF, Faquin WC. BRAF testing and thyroid FNA. Cancer Cytopathol 2015; 123:689-95. [PMID: 26335367 DOI: 10.1002/cncy.21614] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/18/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Marc P Pusztaszeri
- Department of Pathology, Geneva University Hospital, Geneva, Switzerland
| | - Jeffrey F Krane
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - William C Faquin
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
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Pyo JS, Sohn JH, Kang G. BRAF Immunohistochemistry Using Clone VE1 is Strongly Concordant with BRAF(V600E) Mutation Test in Papillary Thyroid Carcinoma. Endocr Pathol 2015; 26:211-7. [PMID: 25957797 DOI: 10.1007/s12022-015-9374-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of this study was to investigate the concordance between BRAF(V600E) mutation test and immunohistochemistry (IHC) and determine the diagnostic accuracy of IHC for papillary thyroid carcinoma (PTC) through a systematic review, meta-analysis, and diagnostic test accuracy review. The current systematic review and meta-analysis included 1141 PTCs in 11 eligible studies. We investigated the concordance rate and performed subgroup analysis using tissue and cytologic samples. Diagnostic test accuracy review was conducted and calculated using the value of area under curve (AUC) on the summary receiver operating characteristic (SROC) curve. The positive rate of BRAF IHC was 79.1% (903 of 1141 cases), and the BRAF(V600E) mutation was found in 76.6% (874 of 1141 cases). The concordance rates were 0.921 (95% confidence interval (CI) 0.877-0.950) and 0.894 (95% CI 0.801-0.946) in IHC positive and negative subgroups, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.97 (95% CI 0.95-0.98) and 0.78 (95% CI 0.72-0.83). The value of AUC on SROC curve was 0.983, and diagnostic odds ratio was 164.28 (95% CI 57.69-467.80). Our results showed that BRAF IHC was strongly concordant with BRAF mutation test and had high diagnostic accuracy in BRAF mutation analysis of PTC.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 78 Saemunan-gil, Jongno-gu, Seoul, 110-746, South Korea
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40
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Wobker SE, Kim LT, Hackman TG, Dodd LG. Use of BRAF v600e immunocytochemistry on FNA direct smears of papillary thyroid carcinoma. Cancer Cytopathol 2015; 123:531-9. [DOI: 10.1002/cncy.21575] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/28/2015] [Accepted: 06/01/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Sara E. Wobker
- Department of Pathology and Laboratory Medicine; University of North Carolina; Chapel Hill North Carolina
| | - Lawrence T. Kim
- Department of Surgery; University of North Carolina; Chapel Hill North Carolina
| | - Trevor G. Hackman
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina; Chapel Hill North Carolina
| | - Leslie G. Dodd
- Department of Pathology and Laboratory Medicine; University of North Carolina; Chapel Hill North Carolina
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41
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Ilie M, Long-Mira E, Funck-Brentano E, Lassalle S, Butori C, Lespinet-Fabre V, Bordone O, Gay A, Zahaf K, Poissonnet G, Lacour JP, Bahadoran P, Ballotti R, Gros A, Dutriaux C, Saiag P, Merlio JP, Vergier B, Emile JF, Hofman V, Hofman P. Immunohistochemistry as a potential tool for routine detection of the NRAS Q61R mutation in patients with metastatic melanoma. J Am Acad Dermatol 2015; 72:786-93. [PMID: 25659223 DOI: 10.1016/j.jaad.2015.01.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/26/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND It can be useful to assess the NRAS mutation status in patients with metastatic melanoma because NRAS-activating mutations confer resistance to RAF inhibitors, and NRAS-mutated patients appear to be sensitive to mitogen-activated protein kinase (MEK) inhibitors. OBJECTIVE We aimed to assess the diagnostic accuracy of an immunohistochemistry (IHC) approach using a novel anti-NRAS (Q61R) monoclonal antibody on formalin-fixed paraffin-embedded tissue samples from patients with metastatic melanoma. METHODS We conducted a retrospective multicenter cohort study on 170 patients with metastatic melanoma. The automated IHC assay was performed using the SP174 clone, and compared with results of the molecular testing. RESULTS Evaluation of a test cohort with knowledge of the mutation status established a specific IHC pattern for the mutation. In the independent blinded analysis of the remaining cases, the anti-NRAS (Q61R) antibody accurately identified all NRAS Q61R-mutated tumors, and demonstrated 100% sensitivity and specificity. LIMITATIONS Limitations include retrospective design and lack of multicenter interobserver reproducibility. CONCLUSION The NRAS (Q61R) IHC assay is reliable and specific for the evaluation of the Q61R mutation status in metastatic melanoma and may be an alternative to molecular biology in evaluation of metastatic melanoma in routine practice.
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Affiliation(s)
- Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France; Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
| | - Elisa Funck-Brentano
- EA4340-Biomarqueurs en Cancérologie et Onco-Hématologie (BCOH), University of Versailles Saint-Quentin-en-Yvelines (SQY), Boulogne, France; Department of General and Oncologic Dermatology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
| | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
| | | | | | - Alexandre Gay
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
| | - Katia Zahaf
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
| | - Gilles Poissonnet
- Surgery Department, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | | | - Philippe Bahadoran
- Dermatology Department, Archet II Hospital, Nice, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1065, Team 1, University of Nice Sophia Antipolis, Nice, France
| | - Robert Ballotti
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1065, Team 1, University of Nice Sophia Antipolis, Nice, France
| | - Audrey Gros
- Pathology and Molecular Biology Departments, Centre Hospitalier Universitaire (CHU) and EA2406 University of Bordeaux, Bordeaux, France
| | | | - Philippe Saiag
- EA4340-Biomarqueurs en Cancérologie et Onco-Hématologie (BCOH), University of Versailles Saint-Quentin-en-Yvelines (SQY), Boulogne, France; Department of General and Oncologic Dermatology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne, France
| | - Jean-Philippe Merlio
- Pathology and Molecular Biology Departments, Centre Hospitalier Universitaire (CHU) and EA2406 University of Bordeaux, Bordeaux, France
| | - Béatrice Vergier
- Pathology and Molecular Biology Departments, Centre Hospitalier Universitaire (CHU) and EA2406 University of Bordeaux, Bordeaux, France
| | - Jean François Emile
- EA4340-Biomarqueurs en Cancérologie et Onco-Hématologie (BCOH), University of Versailles Saint-Quentin-en-Yvelines (SQY), Boulogne, France; Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France; Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France; Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France.
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42
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Na JI, Kim JH, Kim HJ, Kim HK, Moon KS, Lee JS, Lee JH, Lee KH, Park JT. VE1 immunohistochemical detection of the BRAF V600E mutation in thyroid carcinoma: a review of its usefulness and limitations. Virchows Arch 2015; 467:155-68. [PMID: 25894433 DOI: 10.1007/s00428-015-1773-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 03/23/2015] [Accepted: 04/08/2015] [Indexed: 01/17/2023]
Abstract
The BRAF V600E mutation is a valuable prognostic factor in thyroid carcinoma despite lingering debate. Successful immunohistochemical (IHC) detection of the BRAF V600E mutation using a VE1 antibody was introduced recently. The objective of this study was to verify the usefulness of IHC detection of the BRAF V600E mutation in thyroid carcinoma using the VE1 antibody. IHC detection of BRAF V600E was performed on various thyroid carcinoma subtypes. IHC results were compared with those obtained from real-time polymerase chain reaction (PCR) detection. Discordant cases were re-examined using a direct sequencing method following nested PCR amplification. The BRAF V600E mutation was detected in 68 % (71/104) of papillary carcinoma cases and 78 % (7/9) of anaplastic carcinoma cases. The mutation was not detected in patients with follicular carcinoma (0/18) or in medullary carcinoma (0/21). The overall sensitivity and specificity of IHC using the VE1 antibody were 100 and 94 %, respectively, suggesting that molecular-based results were indeterminable in four VE1-positive cases. IHC using the VE1 antibody is a highly sensitive and specific method for BRAF V600E mutation detection and may represent a future replacement for DNA-based molecular tests.
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Affiliation(s)
- Jong-In Na
- Department of Pathology, Chonnam National University Medical School, #5 Hak-dong, Dong-gu, Gwang-ju, 501-746, South Korea
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43
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Qiu T, Lu H, Guo L, Huang W, Ling Y, Shan L, Li W, Ying J, Lv N. Detection of BRAF mutation in Chinese tumor patients using a highly sensitive antibody immunohistochemistry assay. Sci Rep 2015; 5:9211. [PMID: 25784606 PMCID: PMC4363828 DOI: 10.1038/srep09211] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 02/05/2015] [Indexed: 12/17/2022] Open
Abstract
BRAF mutations can be found in various solid tumors. But accurate and reliable screening for BRAF mutation that is compatible for clinical application is not yet available. In this study, we used an automated immunohistochemistry (IHC) staining coupled with mouse monoclonal anti-BRAF V600E (VE1) primary antibody to screen the BRAF V600E mutation in 779 tumor cases, including 611 colorectal carcinomas (CRC), 127 papillary thyroid carcinomas (PTC) and 41 malignant melanomas. Among the 779 cases, 150 cases were positive for BRAF (V600E) staining, including 38 (of 611, 6%) CRCs, 102 (of 127, 80%) PTCs and 10 (of 41, 24%) malignant melanomas. Sanger sequencing and real-time PCR confirmed the sensitivity and specificity of IHC staining for the V600E mutation are 100% and 99%, respectively. Therefore, our study demonstrates that the fully automated IHC is a reliable tool to determine BRAF mutation status in CRC, PTC and melanoma and can be used for routine clinical screen.
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Affiliation(s)
- Tian Qiu
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Haizhen Lu
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Lei Guo
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wenting Huang
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yun Ling
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Shan
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wenbin Li
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jianming Ying
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ning Lv
- Department of Pathology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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44
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Wong NACS, Wingate J, Gradhand E. An immunohistochemical study of potential diagnostic and therapeutic biomarkers of wild-type gastrointestinal stromal tumours. Histopathology 2015; 67:378-85. [DOI: 10.1111/his.12667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/02/2015] [Indexed: 12/26/2022]
Affiliation(s)
| | - Jenny Wingate
- Department of Histopathology; Bristol Royal Infirmary; Bristol UK
| | - Elise Gradhand
- Department of Histopathology; Bristol Royal Infirmary; Bristol UK
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45
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Roth RM, Hampel H, Arnold CA, Yearsley MM, Marsh WL, Frankel WL. A modified Lynch syndrome screening algorithm in colon cancer: BRAF immunohistochemistry is efficacious and cost beneficial. Am J Clin Pathol 2015; 143:336-43. [PMID: 25696791 DOI: 10.1309/ajcp4d7rxobhlkgj] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Somatic BRAF mutation in colon cancer essentially excludes Lynch syndrome. We compared BRAF V600E immunohistochemistry (IHC) with BRAF mutation in core, biopsy, and whole-section slides to determine whether IHC is similar and to assess the cost-benefit of IHC. METHODS Resection cases (2009-2013) with absent MLH1 and PMS2 and prior BRAF mutation polymerase chain reaction results were chosen (n = 57). To mimic biopsy specimens, tissue microarrays (TMAs) were constructed. In addition, available biopsies performed prior to the resection were available in 15 cases. BRAF V600E IHC was performed and graded on TMAs, available biopsy specimens, and whole-section slides. Mutation status was compared with IHC, and cost-benefit analysis was performed. RESULTS BRAF V600E IHC was similar in TMAs, biopsy specimens, and whole-section slides, with only four (7%) showing discordance between IHC and mutation status. Using BRAF V600E IHC in our Lynch syndrome screening algorithm, we found a 10% cost savings compared with mutational analysis. CONCLUSIONS BRAF V600E IHC was concordant between TMAs, biopsy specimens, and whole-section slides, suggesting biopsy specimens are as useful as whole sections. IHC remained cost beneficial compared with mutational analysis, even though more patients needed additional molecular testing to exclude Lynch syndrome.
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Affiliation(s)
- Rachel M. Roth
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Heather Hampel
- Department of Human Genetics, The Ohio State University Wexner Medical Center, Columbus
| | - Christina A. Arnold
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Martha M. Yearsley
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - William L. Marsh
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Wendy L. Frankel
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
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Abstract
The significance of BRAF mutations in neoplasia was first recognized in 2002 when mutations were discovered in a broad range of cancers. Numerous subsequent studies expanded our understanding of BRAF V600E as a critical diagnostic, prognostic, and predictive biomarker in many cancers. Additionally, the advent of small-molecule inhibitors of BRAF V600E rendered assessment of BRAF mutation status essential in tumors such as melanoma. In clinical practice, evaluation of BRAF mutation status has routinely been performed by DNA-based assays utilizing polymerase chain reaction (PCR). However, molecular testing is not available at many hospitals since it is time-consuming, expensive, and requires expertise in molecular techniques. The first BRAF V600E-specific antibody was reported in 2011 (clone VE1). A purified version of this antibody as well as a second monoclonal antibody targeted to BRAF V600E is now commercially available. In this review, clinicopathologic characteristics associated with BRAF-mutant tumors will be highlighted, and the prognostic and predictive implications of a BRAF V600E mutation will be discussed with a focus on melanoma, thyroid carcinoma and colorectal carcinoma. Additionally, we will review the correlation between immunohistochemistry and molecular results and deliberate how BRAF immunohistochemistry might be utilized in the evaluation of these tumors.
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Affiliation(s)
- Lauren L Ritterhouse
- Department of Pathology, Brigham and Women׳s Hospital, Harvard Medical School, 75 Francis St, Boston, Massachusetts 02115
| | - Justine A Barletta
- Department of Pathology, Brigham and Women׳s Hospital, Harvard Medical School, 75 Francis St, Boston, Massachusetts 02115.
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Wang TY, Liu CL, Chen MJ, Lee JJ, Pun PC, Cheng SP. Expression of haem oxygenase-1 correlates with tumour aggressiveness and BRAF V600E expression in thyroid cancer. Histopathology 2014; 66:447-56. [PMID: 25262966 DOI: 10.1111/his.12562] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 09/24/2014] [Indexed: 02/04/2023]
Abstract
AIMS Haem oxygenase-1 (HO-1) is an inducible enzyme that participates in haem degradation. Recent studies have indicated that HO-1 activation may play a role in tumour development and progression. The aim of this study was to evaluate the expression of HO-1 in thyroid cancer and its clinicopathological significance. METHODS AND RESULTS We observed up-regulation of HO-1 in papillary thyroid tumours in comparison with normal thyroid tissue. Immunohistochemical analysis revealed that 48% of papillary cancers and 36% of follicular cancers, but none of normal thyroid tissues, were positive for HO-1 expression. Among 129 differentiated thyroid cancers, HO-1 expression was associated with patient age (P = 0.001), TNM stage (P = 0.001), and Mayo Clinic metastasis, patient age, completeness of resection, local invasion and tumour size score (P = 0.001). BRAF V600E expression was evaluated immunohistochemically and validated by Sanger sequencing. There was a strong association between HO-1 and BRAF V600E expression in papillary cancers (P = 0.002). CONCLUSIONS Overexpression of HO-1 in a subset of thyroid cancers is associated with tumour aggressiveness and BRAF V600E expression. HO-1 might have a potential role in prognosis and targeted treatment in patients with thyroid cancer.
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Affiliation(s)
- Tao-Yeuan Wang
- Department of Pathology, Mackay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
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48
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Detection of the BRAF V600E mutation in colon carcinoma: critical evaluation of the imunohistochemical approach. Am J Surg Pathol 2014; 38:1235-41. [PMID: 24832158 DOI: 10.1097/pas.0000000000000229] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recently BRAF V600E mutant-specific antibody (clone VE1) became available to immunohistochemically pinpoint the occurrence of these BRAF-mutant proteins in different tumors, such as colon carcinoma. Detection of BRAF mutations is important for the accurate application of targeted therapy against BRAF serine-threonine kinase activation. In this study, we evaluated 113 colon carcinomas including 95 primary and 27 metastatic tumors with the VE1 antibody using Leica Bond-Max automated immunohistochemistry. To ensure comprehensive BRAF V600E mutation detection, all cases were evaluated using 4 molecular methods (Sanger sequencing, the Cobas 4800 BRAF V600 Mutation Test, BRAF V600 allele-specific polymerase chain reaction, and BRAF V600 quantitative polymerase chain reaction) with nearly 100% concordance. Molecular and immunohistochemical studies were blinded. Furthermore, all cases were evaluated for KRAS and NRAS mutations as parameters mutually exclusive with BRAF mutations offering parallel evidence for BRAF mutation status. Strong to moderate VE1 positivity was seen in 34 tumors. Twelve colon carcinomas showed weak VE1 immunohistochemical staining, and 67 were entirely negative. An identical c.1799T>A single nucleotide substitution leading to the BRAF V600E mutation was identified in 27 of 113 (24%) colon carcinomas. A majority of BRAF-mutant tumors were located in the right side of the colon and had mismatch-repair deficiency. V600E mutation-negative carcinomas were more often sigmoid tumors and usually showed intact mismatch-repair proteins and KRAS or NRAS mutations. The sensitivity and specificity of positive results (strong to moderate staining) of VE1 immunohistochemistry were 85% and 68%, respectively. If any positivity would be considered, then the specificity declined to 51% with no significant improvement of sensitivity. Therefore, only strong positivity should be considered when using the VE1 antibody and Leica Bond-Max automated immunohistochemistry with these parameters. Although VE1 antibody can be useful in the screening of colon carcinomas for BRAF V600E-mutant proteins, molecular genetic confirmation is always necessary for mutation diagnosis.
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