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Marghescu AȘ, Vlăsceanu S, Preda M, Țigău M, Dumitrache-Rujinski Ș, Leonte DG, Măgheran ED, Tudor A, Bădărău IA, Georgescu L, Costache M. Navigating the Maze: Exploring Non-Oncological Complexities in Non-Small-Cell Lung Cancer. Cancers (Basel) 2024; 16:1903. [PMID: 38791982 PMCID: PMC11120337 DOI: 10.3390/cancers16101903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Pulmonary oncological pathologies are an important public health problem and the association with other pulmonary lesions may pose difficulties in diagnosis and staging or require different treatment options. To address this complexity, we conducted a retrospective observational study at the Marius Nasta Institute of Pneumophthisiology, Bucharest, Romania. Our study focused on patients admitted in 2019 with non-small-cell lung carcinoma and associated pulmonary lesions identified through surgical resection specimens. Among the 314 included patients, multiple pulmonary nodules were observed on macroscopic examination, with 12% (N = 37) exhibiting nonmalignant etiologies upon microscopic examination. These findings underscore the challenge of preoperative staging. Patients with coexisting nonmalignant lesions were similar in age, smoking habits, and professional or environmental exposure by comparison with those who presented only malignant lesions. The presentation of coexisting malignant and nonmalignant lesions may pose difficulties in diagnosing and staging pulmonary cancer.
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Affiliation(s)
- Angela-Ștefania Marghescu
- Pathology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-Ș.M.); (M.C.)
- Department of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (M.Ț.); (L.G.)
| | - Silviu Vlăsceanu
- Physiology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Thoracic Surgery, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania
| | - Mădălina Preda
- Department of Microbiology, Parasitology and Virology, Faculty of Midwives and Nursing, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Laboratory of Medical Microbiology, Marius Nasta Institute of Pneumology, 050159 Bucharest, Romania
| | - Mirela Țigău
- Department of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (M.Ț.); (L.G.)
| | - Ștefan Dumitrache-Rujinski
- Pulmonology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pulmonology Department, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania
| | - Diana Gabriela Leonte
- Pathology Department, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.T.)
| | - Elena Doina Măgheran
- Pathology Department, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.T.)
| | - Adrian Tudor
- Pathology Department, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.T.)
| | - Ioana Anca Bădărău
- Physiology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Livia Georgescu
- Department of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, Romania; (M.Ț.); (L.G.)
| | - Mariana Costache
- Pathology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-Ș.M.); (M.C.)
- Pathology Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania
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Ho I, Chen S, Yip Y, Ho CL. The Complementary Role of PET to Pathology in Differentiating the Primary Origin of a Malignant Skin Nodule from Liver or Lung. Nucl Med Mol Imaging 2023; 57:38-43. [PMID: 36643947 PMCID: PMC9832204 DOI: 10.1007/s13139-022-00777-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 01/18/2023] Open
Abstract
Metastasis from unknown primary is always a challenge because finding the true primary tumor significantly affects subsequent management. We present a case of malignant abdominal wall nodule initially diagnosed as metastasis from hepatocellular carcinoma through excisional biopsy and immunohistochemical (IHC) staining. Dual-tracer positron emission tomography/computed tomography (PET/CT) with 11C-acetate and 18F-FDG, however, showed metabolic findings in favor of metastasis from lung origin, which was finally confirmed by ensuing a lung biopsy with additional IHC stains. This case illustrates the complementary molecular role of PET to pathology, particularly when dual-tracer or multi-tracer PET is used in conjunction with pathology methods for cross referencing and confirmation.
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Affiliation(s)
- Ivan Ho
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Sirong Chen
- Department of Nuclear Medicine & PET, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, China
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Yu Yip
- Department of Nuclear Medicine & PET, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, China
| | - Chi Lai Ho
- Department of Nuclear Medicine & PET, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, China
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3
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Gabelloni M, Faggioni L, Fusco R, Simonetti I, De Muzio F, Giacobbe G, Borgheresi A, Bruno F, Cozzi D, Grassi F, Scaglione M, Giovagnoni A, Barile A, Miele V, Gandolfo N, Granata V. Radiomics in Lung Metastases: A Systematic Review. J Pers Med 2023; 13:jpm13020225. [PMID: 36836460 PMCID: PMC9967749 DOI: 10.3390/jpm13020225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
Due to the rich vascularization and lymphatic drainage of the pulmonary tissue, lung metastases (LM) are not uncommon in patients with cancer. Radiomics is an active research field aimed at the extraction of quantitative data from diagnostic images, which can serve as useful imaging biomarkers for a more effective, personalized patient care. Our purpose is to illustrate the current applications, strengths and weaknesses of radiomics for lesion characterization, treatment planning and prognostic assessment in patients with LM, based on a systematic review of the literature.
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Affiliation(s)
- Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
- Correspondence: ; Tel.: +39-050-992524
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
| | - Igino Simonetti
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Giuliana Giacobbe
- General and Emergency Radiology Department, “Antonio Cardarelli” Hospital, 80131 Naples, Italy
| | - Alessandra Borgheresi
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, 60126 Ancona, Italy
- Department of Clinical, Special and Dental Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Federico Bruno
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, 67100 L’Aquila, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, 20122 Milan, Italy
| | - Diletta Cozzi
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, 20122 Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Francesca Grassi
- Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Mariano Scaglione
- Department of Surgery, Medicine and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, 60126 Ancona, Italy
- Department of Clinical, Special and Dental Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, 20122 Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149 Genoa, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
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Lu X, Zhu X. Automatic segmentation of breast cancer histological images based on dual-path feature extraction network. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:11137-11153. [PMID: 36124584 DOI: 10.3934/mbe.2022519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The traditional manual breast cancer diagnosis method of pathological images is time-consuming and labor-intensive, and it is easy to be misdiagnosed. Computer-aided diagnosis of WSIs gradually comes into people*s sight. However, the complexity of high-resolution breast cancer pathological images poses a great challenge to automatic diagnosis, and the existing algorithms are often difficult to balance the accuracy and efficiency. In order to solve these problems, this paper proposes an automatic image segmentation method based on dual-path feature extraction network for breast pathological WSIs, which has a good segmentation accuracy. Specifically, inspired by the concept of receptive fields in the human visual system, dilated convolutional networks are introduced to encode rich contextual information. Based on the channel attention mechanism, a feature attention module and a feature fusion module are proposed to effectively filter and combine the features. In addition, this method uses a light-weight backbone network and performs pre-processing on the data, which greatly reduces the computational complexity of the algorithm. Compared with the classic models, it has improved accuracy and efficiency and is highly competitive.
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Affiliation(s)
- Xi Lu
- School of Mechanical Engineering, Southeast University, Nanjing 211189, China
| | - Xuedong Zhu
- School of Mechanical Engineering, Southeast University, Nanjing 211189, China
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Clinical validation of a next-generation sequencing-based multi-cancer early detection "liquid biopsy" blood test in over 1,000 dogs using an independent testing set: The CANcer Detection in Dogs (CANDiD) study. PLoS One 2022; 17:e0266623. [PMID: 35471999 PMCID: PMC9041869 DOI: 10.1371/journal.pone.0266623] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/23/2022] [Indexed: 12/11/2022] Open
Abstract
Cancer is the leading cause of death in dogs, yet there are no established screening paradigms for early detection. Liquid biopsy methods that interrogate cancer-derived genomic alterations in cell-free DNA in blood are being adopted for multi-cancer early detection in human medicine and are now available for veterinary use. The CANcer Detection in Dogs (CANDiD) study is an international, multi-center clinical study designed to validate the performance of a novel multi-cancer early detection “liquid biopsy” test developed for noninvasive detection and characterization of cancer in dogs using next-generation sequencing (NGS) of blood-derived DNA; study results are reported here. In total, 1,358 cancer-diagnosed and presumably cancer-free dogs were enrolled in the study, representing the range of breeds, weights, ages, and cancer types seen in routine clinical practice; 1,100 subjects met inclusion criteria for analysis and were used in the validation of the test. Overall, the liquid biopsy test demonstrated a 54.7% (95% CI: 49.3–60.0%) sensitivity and a 98.5% (95% CI: 97.0–99.3%) specificity. For three of the most aggressive canine cancers (lymphoma, hemangiosarcoma, osteosarcoma), the detection rate was 85.4% (95% CI: 78.4–90.9%); and for eight of the most common canine cancers (lymphoma, hemangiosarcoma, osteosarcoma, soft tissue sarcoma, mast cell tumor, mammary gland carcinoma, anal sac adenocarcinoma, malignant melanoma), the detection rate was 61.9% (95% CI: 55.3–68.1%). The test detected cancer signal in patients representing 30 distinct cancer types and provided a Cancer Signal Origin prediction for a subset of patients with hematological malignancies. Furthermore, the test accurately detected cancer signal in four presumably cancer-free subjects before the onset of clinical signs, further supporting the utility of liquid biopsy as an early detection test. Taken together, these findings demonstrate that NGS-based liquid biopsy can offer a novel option for noninvasive multi-cancer detection in dogs.
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Ericson Lindquist K, Gudinaviciene I, Mylona N, Urdar R, Lianou M, Darai-Ramqvist E, Haglund F, Béndek M, Bardoczi E, Dobra K, Brunnström H. Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics. Biomolecules 2021; 11:1721. [PMID: 34827719 PMCID: PMC8615395 DOI: 10.3390/biom11111721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Accurate and reliable diagnostics are crucial as histopathological type influences selection of treatment in lung cancer. The aim of this study was to evaluate real-world accuracy and use of immunohistochemical (IHC) staining in lung cancer diagnostics. MATERIALS AND METHODS The diagnosis and used IHC stains for small specimens with lung cancer on follow-up resection were retrospectively investigated for a 15-month period at two major sites in Sweden. Additionally, 10 pathologists individually suggested diagnostic IHC staining for 15 scanned bronchial and lung biopsies and cytological specimens. RESULTS In 16 (4.7%) of 338 lung cancer cases, a discordant diagnosis of potential clinical relevance was seen between a small specimen and the follow-up resection. In half of the cases, there was a different small specimen from the same investigational work-up with a concordant diagnosis. Diagnostic inaccuracy was often related to a squamous marker not included in the IHC panel (also seen for the scanned cases), the case being a neuroendocrine tumor, thyroid transcription factor-1 (TTF-1) expression in squamous cell carcinomas (with clone SPT24), or poor differentiation. IHC was used in about 95% of cases, with a higher number of stains in biopsies and in squamous cell carcinomas and especially neuroendocrine tumors. Pre-surgical transthoracic samples were more often diagnostic than bronchoscopic ones (72-85% vs. 9-53% for prevalent types). CONCLUSIONS Although a high overall diagnostic accuracy of small specimens was seen, small changes in routine practice (such as consequent inclusion of p40 and TTF-1 clone 8G7G3/1 in the IHC panel for non-small cell cancer with unclear morphology) may lead to improvement, while reducing the number of IHC stains would be preferable from a time and cost perspective.
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Affiliation(s)
- Kajsa Ericson Lindquist
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
- Division of Pathology, Department of Clinical Sciences, Lund University, SE-221 00 Lund, Sweden
| | - Inga Gudinaviciene
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
| | - Nektaria Mylona
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
| | - Rodrigo Urdar
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
| | - Maria Lianou
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
| | - Eva Darai-Ramqvist
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden; (E.D.-R.); (F.H.)
| | - Felix Haglund
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden; (E.D.-R.); (F.H.)
- Department of Oncology-Pathology, Karolinska Institute, SE-171 77 Stockholm, Sweden
| | - Mátyás Béndek
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden; (M.B.); (E.B.); (K.D.)
| | - Erika Bardoczi
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden; (M.B.); (E.B.); (K.D.)
| | - Katalin Dobra
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden; (M.B.); (E.B.); (K.D.)
- Division of Laboratory Medicine, Department of Pathology, Karolinska Institute, SE-141 86 Stockholm, Sweden
| | - Hans Brunnström
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, SE-221 85 Lund, Sweden; (K.E.L.); (I.G.); (N.M.); (R.U.); (M.L.)
- Division of Pathology, Department of Clinical Sciences, Lund University, SE-221 00 Lund, Sweden
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Derks JL, Rijnsburger N, Hermans BCM, Moonen L, Hillen LM, von der Thüsen JH, den Bakker MA, van Suylen RJ, Speel EJM, Dingemans AMC. Clinical-Pathologic Challenges in the Classification of Pulmonary Neuroendocrine Neoplasms and Targets on the Horizon for Future Clinical Practice. J Thorac Oncol 2021; 16:1632-1646. [PMID: 34139363 DOI: 10.1016/j.jtho.2021.05.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/16/2022]
Abstract
Diagnosing a pulmonary neuroendocrine neoplasm (NEN) may be difficult, challenging clinical decision making. In this review, the following key clinical and pathologic issues and informative molecular markers are being discussed: (1) What is the preferred outcome parameter for curatively resected low-grade NENs (carcinoid), for example, overall survival or recurrence-free interval? (2) Does the WHO classification combined with a Ki-67 proliferation index and molecular markers, such as OTP and CD44, offer improved prognostication in low-grade NENs? (3) What is the value of a typical versus atypical carcinoid diagnosis on a biopsy specimen in local and metastatic disease? Diagnosis is difficult in biopsy specimens and recent observations of an increased mitotic rate in metastatic carcinoid from typical to atypical and high-grade NEN can further complicate diagnosis. (4) What is the (ir)relevance of morphologically separating large cell neuroendocrine carcinoma (LCNEC) SCLC and the value of molecular markers (RB1 gene and pRb protein or transcription factors NEUROD1, ASCL1, POU2F3, or YAP1 [NAPY]) to predict systemic treatment outcome? (5) Are additional diagnostic criteria required to accurately separate LCNEC from NSCLC in biopsy specimens? Neuroendocrine morphology can be absent owing to limited sample size leading to missed LCNEC diagnoses. Evaluation of genomic studies on LCNEC and marker studies have identified that a combination of napsin A and neuroendocrine markers could be helpful. Hence, to improve clinical practice, we should consider to adjust our NEN classification incorporating prognostic and predictive markers applicable on biopsy specimens to inform a treatment outcome-driven classification.
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Affiliation(s)
- Jules L Derks
- Department of Pulmonary Diseases, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Nicole Rijnsburger
- Department of Respiratory Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bregtje C M Hermans
- Department of Pulmonary Diseases, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Laura Moonen
- Department of Pathology, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lisa M Hillen
- Department of Pathology, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan H von der Thüsen
- Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Robert J van Suylen
- Pathology-DNA, Location Jeroen Bosch Hospital, s' Hertogenbosch, The Netherlands
| | - Ernst-Jan M Speel
- Department of Pathology, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne-Marie C Dingemans
- Department of Pulmonary Diseases, GROW School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Respiratory Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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