1
|
Sugita S, Tanaka K, Oda Y, Nojima T, Konishi N, Machida R, Kita R, Fukuda H, Ozaki T, Hasegawa T. Prognostic evaluation of the Ki-67 labeling system in histological grading of non-small round cell sarcoma: a supplementary analysis of a randomized controlled trial, JCOG1306. Jpn J Clin Oncol 2024; 54:675-680. [PMID: 38391203 DOI: 10.1093/jjco/hyae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Soft tissue sarcoma (STS) has various histological types and is rare, making it difficult to evaluate the malignancy of each histological type. Thus, comprehensive histological grading is most important in the pathological examination of STS. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading system is most commonly used in daily pathological analysis of STS. Among the FNCLCC grading system parameters, mitotic count is a key morphological parameter reflecting the proliferative activity of tumor cells, although its reproducibility may be lacking. Here, we compared the prognostic utility of the conventional and modified FNCLCC grading systems in JCOG1306. METHODS We analyzed 140 patients with non-small round cell sarcoma. We performed Ki-67 immunostaining using open biopsy specimens before preoperative chemotherapy in all patients. We assessed histological grade in individual cases by conventional FNCLCC grading (tumor differentiation, mitotic count, and necrosis) and modified FNCLCC grading using the Ki-67 labeling index instead of mitotic count. We conducted univariable and multivariable Cox regression analyses to investigate the influence of grade on overall survival. RESULTS In univariable analysis, prognosis was worse for patients with conventional FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (hazard ratio [HR] 4.21, 95% confidence interval [CI] 1.47-12.05, P = 0.008). Moreover, prognosis was worse in patients with modified FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (HR 4.90, 95% CI 1.64-14.65, P = 0.004). In multivariable analysis including both conventional and modified FNCLCC grading, the modified grading more strongly affected overall survival (HR 6.70, 95% CI 1.58-28.40, P = 0.010). CONCLUSIONS The modified FNCLCC grading system was superior to the conventional system in predicting the prognosis of patients with non-small round cell sarcoma according to this supplementary analysis of data from the randomized controlled trial JCOG1306.
Collapse
Affiliation(s)
- Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo
| | - Kazuhiro Tanaka
- Department of Advanced Medical Sciences, Oita University, Yufu, Oita
| | - Yoshinao Oda
- Department of Anatomic Pathology, Kyushu University, Fukuoka
| | - Takayuki Nojima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku, Ishikawa
| | - Naomi Konishi
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Ryunosuke Machida
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Ryosuke Kita
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Haruhiko Fukuda
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University, Okayama, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo
| |
Collapse
|
2
|
FINDIK S, KANYILMAZ G. GastroClinicopathologic Characteristics of Gastrointestinal Stromal Tumors and Prognostic Importance of Ki-67 Labeling Index: May be a New Prognostic Marker. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1021049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
3
|
Laurila RE, Böhling TO, Blomqvist CP, Karlsson C, Tukiainen EJ, Repo J, Sampo MM. Visual Counting and Automated Image-analytic Assessment of Ki-67 and their Prognostic Value in Synovial Sarcoma. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:7-14. [PMID: 35400010 PMCID: PMC8962852 DOI: 10.21873/cdp.10070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ki-67 is a widely used proliferation marker reflecting prognosis in various tumors. However, visual assessment and scoring of Ki-67 suffers from marked inter-observer and intra-observer variability. We aimed to assess the concordance of manual counting and automated image-analytic scoring methods for Ki-67 in synovial sarcoma. PATIENTS AND METHODS Tissue microarrays from 34 patients with synovial sarcoma were immunostained for Ki-67 and scored both visually and with 3DHistech QuantCenter. RESULTS The automated assessment of Ki-67 expression was in good agreement with the visually counted Ki-67 (r Pearson =0.96, p<0.001). In a Cox regression model automated [hazard ratio (HR)=1.047, p=0.024], but not visual (HR=1.063, p=0.053) assessment method associated high Ki-67 scores with worse overall survival. CONCLUSION The automated Ki-67 assessment method appears to be comparable to the visual method in synovial sarcoma and had a significant association to overall survival.
Collapse
Affiliation(s)
- Riikka E Laurila
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| | | | - Carl P Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Örebro University, School of Health sciences, Örebro, Sweden
| | | | - Erkki J Tukiainen
- Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Mika M Sampo
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Could computed tomography be used as a surrogate of endoscopic ultrasonography in the screening and surveillance of small gastric Gastrointestinal stromal tumors? Eur J Radiol 2020; 135:109463. [PMID: 33338760 DOI: 10.1016/j.ejrad.2020.109463] [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] [Received: 11/01/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate whether computed tomography (CT) could be used for screening and surveillance of small gastric gastrointestinal stromal tumors (gGISTs). METHOD A total of 162 pathologically confirmed small gGISTs (≤2 cm) between September 2007 and November 2019 were retrospectively enrolled. Thirty-six lesions received contrast-enhanced CT after they were identified by endoscopy and EUS, and forty-three lesions received CT alone before surgery. The detection rate of CT for ≤1 cm gGISTs (micro-gGISTs) and 1-2 cm gGISTs (mini-gGISTs) was investigated, and the detection rate of CT alone was compared with that of CT following endoscopy and EUS. The relationship between EUS- and CT-detected high-risk features were assessed. RESULTS CT demonstrated a favorable detection rate for mini-gGISTs previously identified by EUS and endoscopy, whereas CT alone showed an inferior detection rate (100 % vs. 75 %, p = 0.02). CT showed a poor detection rate for micro-gGISTs, both for lesions received CT after identified by EUS and endoscopy, and those received CT alone (33.3 % vs. 14.8 %, p = 0.372). CT-detected heterogeneous enhancement pattern and presence of calcification were strongly correlated with heterogeneous echotexture (Spearman's ρ=0.66, p < 0.001) and echogenic foci (Spearman's ρ=0.79, p < 0.001) on EUS, respectively. CT-detected necrosis was moderately correlated with cystic spaces on EUS (Spearman's ρ=0.42, p = 0.02). No correlation was found between EUS- and CT- assessed irregular border. CONCLUSIONS CT could potentially be considered as a surrogate of EUS for surveillance of mini-gGISTs instead of micro-gGISTs, whereas couldn't be used as a screening modality for either micro- or mini-gGISTs.
Collapse
|
5
|
Grizzi F, Borroni EM, Qehajaj D, Stifter S, Chiriva-Internati M, Cananzi FCM. The Complex Nature of Soft Tissue Sarcomas, Including Retroperitoneal Sarcomas. CURRENT TREATMENT OF RETROPERITONEAL SARCOMAS 2019:21-32. [DOI: 10.1007/978-88-470-3980-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
|
6
|
Ando T, Goto H, Date K, Takeda M. Surgical Experience of a Case of Primary Leiomyosarcoma of the Left Common Iliac Artery That Presented as Acute Heart Failure Involving an Arteriovenous Fistula. Ann Vasc Dis 2018; 11:243-247. [PMID: 30116420 PMCID: PMC6094035 DOI: 10.3400/avd.cr.17-00127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Primary leiomyosarcoma of the left common iliac artery with development of an arteriovenous fistula is extremely rare. Here we report the case of a 78-year-old woman with primary vascular leiomyosarcoma that presented as acute heart failure involving an arteriovenous fistula. She underwent surgery; however, after the diagnosis of leiomyosarcoma, she did not seek active treatment. She died 8 months after the surgery. This case report supports the need to document and follow-up a primary leiomyosarcoma of the iliac artery, especially when a case includes the presentation of an arteriovenous fistula (AVF). Vascular leiomyosarcoma should be included in the differential diagnosis of an AVF.
Collapse
Affiliation(s)
- Takashi Ando
- Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Hiroshi Goto
- Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Kazuma Date
- Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Makoto Takeda
- Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Kanagawa, Japan
| |
Collapse
|
7
|
Luo G, Hu Y, Zhang Z, Wang P, Luo Z, Lin J, Cheng C, Yang Y. Clinicopathologic significance and prognostic value of Ki-67 expression in patients with gastric cancer: a meta-analysis. Oncotarget 2018; 8:50273-50283. [PMID: 28488584 PMCID: PMC5564848 DOI: 10.18632/oncotarget.17305] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/06/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prognostic value and clinicopathologic significance of Ki-67 expression in gastric cancer patients was controversial. This meta-analysis was performed to clarify the prognostic value and clinicopathologic significance of Ki-67 expression in gastric cancer patients. MATERIALS AND METHODS Several electronic databases were searched for eligible studies. The pooled odds ratio (OR), hazard ratios (HR) and 95% confidence interval(CI) were calculated to explore the prognostic value and clinicopathologic significance of Ki-67 expression for disease free survival and overall survival. RESULTS Totally 5600 gastric cancer patients from 29 studies were included in this study. High Ki-67 expression was significantly related with Lauren's classification (OR = 1.70; P = 0.001; 95%CI: 1.40-2.06) and tumor size(OR = 1.54; P = 0.006; 95%CI: 1.14-2.09). However, high Ki-67 expression was not significantly associated with lymph node metastasis (OR = 1.37; P = 0.138; 95% CI: 0.90-2.08) , tumor stage (OR = 1.31; P = 0.296; 95% CI: 0.79-2.16) and tumor differentiation (OR = 1.03; P = 0.839; 95% CI: 0.78-1.35). The pooled HRs were 1.87(P = 0.001; 95% CI 1.30-2.69) for disease free survival and 1.23(P = 0.005; 95% CI 1.06-1.42) for overall survival. CONCLUSIONS High Ki-67 expression may serve as a predictive biomarker for poor prognosis in gastric cancer patients. Stratification by Ki-67 expression may be a consideration for selection of therapeutic regimen and integrated managements.
Collapse
Affiliation(s)
- Guanying Luo
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.,Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Yunzhao Hu
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.,Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Zhiqiao Zhang
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.,Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Peng Wang
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Zhaowen Luo
- Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Jinxin Lin
- Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - Canchang Cheng
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.,Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| | - You Yang
- Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.,Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China
| |
Collapse
|
8
|
Investigating Various Thresholds as Immunohistochemistry Cutoffs for Observer Agreement. Appl Immunohistochem Mol Morphol 2018; 25:599-608. [PMID: 27093449 DOI: 10.1097/pai.0000000000000357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Clinical translation of immunohistochemistry (IHC) biomarkers requires reliable and reproducible cutoffs or thresholds for interpretation of immunostaining. Most IHC biomarker research focuses on the clinical relevance (diagnostic, prognostic, or predictive utility) of cutoffs, with less emphasis on observer agreement using these cutoffs. From the literature, we identified 3 commonly used cutoffs of 10% positive epithelial cells, 20% positive epithelial cells, and moderate to strong staining intensity (+2/+3 hereafter) to use for investigating observer agreement. MATERIALS AND METHODS A series of 36 images of microarray cores stained for 4 different IHC biomarkers, with variable staining intensity and percentage of positive cells, was used for investigating interobserver and intraobserver agreement. Seven pathologists scored the immunostaining in each image using the 3 cutoffs for positive and negative staining. Kappa (κ) statistic was used to assess the strength of agreement for each cutoff. RESULTS The interobserver agreement between all 7 pathologists using the 3 cutoffs was reasonably good, with mean κ scores of 0.64, 0.59, and 0.62, respectively, for 10%, 20%, and +2/+3 cutoffs. A good agreement was observed for experienced pathologists using the 10% cutoff, and their agreement was statistically higher than for junior pathologists (P=0.02). In addition, the mean intraobserver agreement for all 7 pathologists using the 3 cutoffs was reasonably good, with mean κ scores of 0.71, 0.60, and 0.73, respectively, for 10%, 20%, and +2/+3 cutoffs. For all 3 cutoffs, a positive correlation was observed with perceived ease of interpretation (P<0.003). Finally, cytoplasmic-only staining achieved higher agreement using all 3 cutoffs than mixed staining patterns. CONCLUSIONS All 3 cutoffs investigated achieve reasonable strength of agreement, modestly decreasing interobserver and intraobserver variability in IHC interpretation. These cutoffs have previously been used in cancer pathology, and this study provides evidence that these cutoffs can be reproducible between practicing pathologists.
Collapse
|
9
|
Sugita S, Hirano H, Hatanaka Y, Fujita H, Kubo T, Kikuchi N, Ito Y, Sugawara T, Segawa K, Hisai H, Yamashita K, Nobuoka T, Matsuno Y, Hasegawa T. Image analysis is an excellent tool for quantifying Ki-67 to predict the prognosis of gastrointestinal stromal tumor patients. Pathol Int 2017; 68:7-11. [DOI: 10.1111/pin.12611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/02/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Shintaro Sugita
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Hiroshi Hirano
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Yutaka Hatanaka
- Department of Surgical Pathology; Hokkaido University Hospital; Sapporo Hokkaido Japan
| | - Hiromi Fujita
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Terufumi Kubo
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Noriaki Kikuchi
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Yumika Ito
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Taro Sugawara
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Keiko Segawa
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Hiroyuki Hisai
- Department of Gastroenterology; Japanese Red Cross Date General Hospital; Date Hokkaido Japan
| | - Kentaro Yamashita
- Department of Gastroenterology; Rheumatology and Clinical Immunology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Takayuki Nobuoka
- Department of Surgery; Oncology and Science; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology; Hokkaido University Hospital; Sapporo Hokkaido Japan
| | - Tadashi Hasegawa
- Department of Surgial Pathology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| |
Collapse
|
10
|
Diagnostic utility of Ki-67 immunohistochemistry in small endoscopic biopsies of the ureter and renal pelvis. Pathol Res Pract 2017; 213:737-741. [DOI: 10.1016/j.prp.2017.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/15/2017] [Accepted: 04/12/2017] [Indexed: 11/19/2022]
|
11
|
Ki-67 Labeling Index can be used as a Prognostic Marker in Gastrointestinal Stromal Tumor: A Systematic Review and Meta-Analysis. Int J Biol Markers 2016; 31:e204-10. [DOI: 10.5301/jbm.5000183] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 12/13/2022]
Abstract
Purpose The aim of this study was to investigate the prognostic relevance of the Ki-67 labeling index (LI) in gastrointestinal stromal tumor (GIST) through a systematic review, meta-analysis and diagnostic test accuracy review. Method The study included 1,967 GIST cases from 24 eligible studies. We investigated the correlation between high Ki-67 LI and survival and the proper criteria for high Ki-67 LI. In addition, a diagnostic test accuracy review was conducted to evaluate the predictive role of high Ki-67 LI for higher risk of tumor recurrence. Results A high Ki-67 LI was significantly correlated with worse disease-free survival (DFS) (hazard ratio [HR] 3.658, 95% confidence interval [CI] 2.687-4.979, p<0.001) and overall survival (OS) (HR 3.730, 95% CI 2.819-4.936, p<0.001). With regard to DFS and OS, the subgroup with a cutoff value of >4% for high Ki-67 LI had a higher HR than the subgroup with a ≤4% cutoff. In the diagnostic test accuracy review, a high Ki-67 LI was significantly correlated with higher risk of tumor recurrence (pooled sensitivity = 0.44, pooled specificity = 0.87, area under the curve on the summary receiver operating characteristic curve = 0.656). Conclusions Our results showed that a high Ki-67 LI was significantly correlated with worse prognosis and higher risk of tumor recurrence in GIST. Further prospective studies of the prognostic role of Ki-67 LI are necessary prior to application in clinical practice.
Collapse
|
12
|
Lower Respiratory Tract Infection of the Ferret by 2009 H1N1 Pandemic Influenza A Virus Triggers Biphasic, Systemic, and Local Recruitment of Neutrophils. J Virol 2015; 89:8733-48. [PMID: 26063430 DOI: 10.1128/jvi.00817-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/04/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Infection of the lower respiratory tract by influenza A viruses results in increases in inflammation and immune cell infiltration in the lung. The dynamic relationships among the lung microenvironments, the lung, and systemic host responses during infection remain poorly understood. Here we used extensive systematic histological analysis coupled with live imaging to gain access to these relationships in ferrets infected with the 2009 H1N1 pandemic influenza A virus (H1N1pdm virus). Neutrophil levels rose in the lungs of H1N1pdm virus-infected ferrets 6 h postinfection and became concentrated at areas of the H1N1pdm virus-infected bronchiolar epithelium by 1 day postinfection (dpi). In addition, neutrophil levels were increased throughout the alveolar spaces during the first 3 dpi and returned to baseline by 6 dpi. Histochemical staining revealed that neutrophil infiltration in the lungs occurred in two waves, at 1 and 3 dpi, and gene expression within microenvironments suggested two types of neutrophils. Specifically, CCL3 levels, but not CXCL8/interleukin 8 (IL-8) levels, were higher within discrete lung microenvironments and coincided with increased infiltration of neutrophils into the lung. We used live imaging of ferrets to monitor host responses within the lung over time with [(18)F]fluorodeoxyglucose (FDG). Sites in the H1N1pdm virus-infected ferret lung with high FDG uptake had high levels of proliferative epithelium. In summary, neutrophils invaded the H1N1pdm virus-infected ferret lung globally and focally at sites of infection. Increased neutrophil levels in microenvironments did not correlate with increased FDG uptake; hence, FDG uptake may reflect prior infection and inflammation of lungs that have experienced damage, as evidenced by bronchial regeneration of tissues in the lungs at sites with high FDG levels. IMPORTANCE Severe influenza disease is characterized by an acute infection of the lower airways that may progress rapidly to organ failure and death. Well-developed animal models that mimic human disease are essential to understanding the complex relationships of the microenvironment, organ, and system in controlling virus replication, inflammation, and disease progression. Employing the ferret model of H1N1pdm virus infection, we used live imaging and comprehensive histological analyses to address specific hypotheses regarding spatial and temporal relationships that occur during the progression of infection and inflammation. We show the general invasion of neutrophils at the organ level (lung) but also a distinct pattern of localized accumulation within the microenvironment at the site of infection. Moreover, we show that these responses were biphasic within the lung. Finally, live imaging revealed an early and sustained host metabolic response at sites of infection that may reflect damage and repair of tissues in the lungs.
Collapse
|
13
|
Current breast cancer proliferative markers correlate variably based on decoupled duration of cell cycle phases. Sci Rep 2014; 4:5122. [PMID: 24874299 PMCID: PMC4038821 DOI: 10.1038/srep05122] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 05/12/2014] [Indexed: 12/23/2022] Open
Abstract
Mitotic count, PhH3, and MIB-1 are used as measures of the proportion of proliferating malignant cells in surgical pathology. They highlight different stages of the cell cycle, but little is known about how this affects their counts. This study assesses the strength of their correlations and attempts to determine the relationship between them. Proliferation counts for forty-nine consecutive cases of invasive breast carcinomas were analyzed, with the same tumor area on each stain counted using digital image analysis. The integrated optical density (IOD) of nuclei was measured as an approximation of nuclear DNA content. PhH3 strongly correlated with mitotic count (r = 0.94). Weaker correlations were found between MIB-1 versus PhH3 (r = 0.79) and mitotic count (r = 0.83). Nuclear IOD showed stronger correlation with MIB-1 (r = 0.37) than to mitotic count (r = 0.23) and PhH3 (r = 0.34). With evidence from a literature review, it is suggested that the weaker correlations with MIB-1 are not explained by count imprecision or error, but relies on temporal decorrelation between cell cycle phases. Consequences on correlation between these proliferative markers are illustrated by mathematical models.
Collapse
|
14
|
Demir L, Ekinci N, Erten C, Kucukzeybek Y, Alacacioglu A, Somali I, Can A, Dirican A, Bayoglu V, Akyol M, Cakalagaoglu F, Tarhan MO. Does immunohistochemistry provide additional prognostic data in gastrointestinal stromal tumors? Asian Pac J Cancer Prev 2014; 14:4751-8. [PMID: 24083738 DOI: 10.7314/apjcp.2013.14.8.4751] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To investigate the predictive and prognostic effects of clinicopathologic and immunohistochemical (IHC) features in patients with gastrointestinal stromal tumours (GISTs). MATERIALS AND METHODS Fifty-six patients who were diagnosed with GIST between 2002 and 2012 were retrospectively evaluated. Relationships between clinicopathologic/immunohistochemical factors and prognosis were investigated. RESULTS Median overall survival (OS) of the whole study group was 74.9 months (42.8-107.1 months), while it was 95.2 months in resectable and 44.7 months in metastatic patients respectively (p=0.007). Epitheliolid tumor morphology was significantly associated with shortened OS as compared to other histologies (p=0.001). SMA(+) tumours were significantly correlated with low (<10/50HPF) mitotic activity (p=0.034). Moreover, SMA(+) patients tended to survive longer and had significantly longer disease-free survival (DFS) times than SMA (-) patients (37.7 months vs 15.9 months; p=0.002). High Ki-67 level (≥30%) was significantly associated with shorter OS (34 vs 95.2 months; 95%CI; p=0.001). CD34 (-) tumours were significantly associated with low proliferative tumours (Ki-67<%10) (p=0.026). Median PFS (progression-free survival) of the patients who received imatinib was 36 months (27.7-44.2 months). CD34 (-) patients had significantly longer PFS times than that of negative tumours; (50.8 vs 29.8 months; p=0.045). S100 and desmin expression did not play any role in predicting the prognosis of GISTs. Multivariate analysis demonstrated that ≥10/50HPF mitotic activity/HPF was the only independent factor for risk of death in GIST patients. CONCLUSIONS Despite the negative prognostic and predictive effect of high Ki-67 and CD34 expression, mitotic activity remains the strongest prognostic factor in GIST patients. SMA positivity seems to affect GIST prognosis positively. However, large-scale, multicenter studies are required to provide supportive data for these findings.
Collapse
Affiliation(s)
- Lutfiye Demir
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Turkey E-mail :
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|