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Harvey M, Lane B, Cisek R, Veres SP, Kreplak L, Tokarz D. Histological staining alters circular dichroism SHG measurements of collagen. OPTICS LETTERS 2024; 49:3705-3708. [PMID: 38950247 DOI: 10.1364/ol.523689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/28/2024] [Indexed: 07/03/2024]
Abstract
Circular dichroism second harmonic generation microscopy (CDSHG) is a powerful imaging technique, which allows three-dimensional visualization of collagen fibril orientation in tissues. However, recent publications have obtained contradictory results on whether CDSHG can be used to reveal the relative out-of-plane polarity of collagen fibrils. Here we compare CDSHG images of unstained tendon and tendon which has been stained with hematoxylin and eosin. We find significant differences in the CDSHG between these two conditions, which explain the recent contradictory results within the literature.
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2
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Garcia APV, Taborda DYO, Reis LA, de Paula AM, Cassali GD. Collagen modifications predictive of lymph node metastasis in dogs with carcinoma in mixed tumours. Front Vet Sci 2024; 11:1362693. [PMID: 38511192 PMCID: PMC10951072 DOI: 10.3389/fvets.2024.1362693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Mixed tumours in the canine mammary gland are the most common histological type in routine diagnosis. In general, these neoplasms have a favourable prognosis that does not evolve into metastatic disease. However, some cases develop into lymph node metastases and are associated with worse patient survival rates. Methods Here is a retrospective study of 46 samples of primary mixed tumours of the canine mammary gland: 15 cases of benign mixed tumours (BMT), 16 cases of carcinoma in mixed tumours without lymph node metastasis (CMT), and 15 cases of carcinomas in mixed tumours with lymph node metastasis (CMTM). In addition, we selected 23 cases of normal mammary glands (NMT) for comparison. The samples were collected from biopsies performed during nodulectomy, simple mastectomy, regional mastectomy, or unilateral/bilateral radical mastectomy. We used multiphoton microscopy, second harmonic generation, and two-photon excited fluorescence, to evaluate the characteristics of collagen fibres and cellular components in biopsies stained with haematoxylin and eosin. We performed Ki67, ER, PR, and HER-2 immunostaining to define the immunophenotype and COX-2. We showed that carcinomas that evolved into metastatic disease (CMTM) present shorter and wavier collagen fibres as compared to CMT. Results and discussion When compared to NMT and BMT the carcinomas present a smaller area of fibre coverage, a larger area of cellular coverage, and a larger number of individual fibres. Furthermore, we observed a correlation between the strong expression of COX-2 and a high rate of cell proliferation in carcinomas with a smaller area covered by cell fibres and a larger number of individual fibres. These findings highlight the fundamental role of collagen during tumour progression, especially in invasion and metastatic dissemination.
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Affiliation(s)
- Ana Paula Vargas Garcia
- Laboratory of Comparative Pathology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daiana Yively Osorio Taborda
- Laboratory of Comparative Pathology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luana Aparecida Reis
- Biophotonics Laboratory, Physics Department, Institute of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Maria de Paula
- Biophotonics Laboratory, Physics Department, Institute of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Geovanni Dantas Cassali
- Laboratory of Comparative Pathology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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3
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Huang X, Fu F, Guo W, Kang D, Han X, Zheng L, Zhan Z, Wang C, Zhang Q, Wang S, Xu S, Ma J, Qiu L, Chen J, Li L. Prognostic significance of collagen signatures at breast tumor boundary obtained by combining multiphoton imaging and imaging analysis. Cell Oncol (Dordr) 2024; 47:69-80. [PMID: 37606817 DOI: 10.1007/s13402-023-00851-4] [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] [Accepted: 07/28/2023] [Indexed: 08/23/2023] Open
Abstract
PURPOSE Collagen features in breast tumor microenvironment is closely associated with the prognosis of patients. We aim to explore the prognostic significance of collagen features at breast tumor border by combining multiphoton imaging and imaging analysis. METHODS We used multiphoton microscopy (MPM) to label-freely image human breast tumor samples and then constructed an automatic classification model based on deep learning to identify collagen signatures from multiphoton images. We recognized three kinds of collagen signatures at tumor boundary (CSTB I-III) in a small-scale, and furthermore obtained a CSTB score for each patient based on the combined CSTB I-III by using the ridge regression analysis. The prognostic performance of CSTB score is assessed by the area under the receiver operating characteristic curve (AUC), Cox proportional hazard regression analysis, as well as Kaplan-Meier survival analysis. RESULTS As an independent prognostic factor, statistical results reveal that the prognostic performance of CSTB score is better than that of the clinical model combining three independent prognostic indicators, molecular subtype, tumor size, and lymph nodal metastasis (AUC, Training dataset: 0.773 vs. 0.749; External validation: 0.753 vs. 0.724; HR, Training dataset: 4.18 vs. 3.92; External validation: 4.98 vs. 4.16), and as an auxiliary indicator, it can greatly improve the accuracy of prognostic prediction. And furthermore, a nomogram combining the CSTB score with the clinical model is established for prognosis prediction and clinical decision making. CONCLUSION This standardized and automated imaging prognosticator may convince pathologists to adopt it as a prognostic factor, thereby customizing more effective treatment plans for patients.
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Affiliation(s)
- Xingxin Huang
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Fangmeng Fu
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Wenhui Guo
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Xiahui Han
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Liqin Zheng
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Zhenlin Zhan
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Chuan Wang
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Qingyuan Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China
| | - Shu Wang
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
- College of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China
| | - Shunwu Xu
- School of Electronic and Mechanical Engineering, Fujian Polytechnic Normal University, Fuqing, 350300, China
| | - Jianli Ma
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
| | - Lida Qiu
- College of Physics and Electronic Information Engineering, Minjiang University, Fuzhou, 350108, China.
| | - Jianxin Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China.
| | - Lianhuang Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China.
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Poonja S, Forero Pinto A, Lloyd MC, Damaghi M, Rejniak KA. Dynamics of Fibril Collagen Remodeling by Tumor Cells: A Model of Tumor-Associated Collagen Signatures. Cells 2023; 12:2688. [PMID: 38067116 PMCID: PMC10705683 DOI: 10.3390/cells12232688] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
Many solid tumors are characterized by a dense extracellular matrix (ECM) composed of various ECM fibril proteins. These proteins provide structural support and a biological context for the residing cells. The reciprocal interactions between growing and migrating tumor cells and the surrounding stroma result in dynamic changes in the ECM architecture and its properties. With the use of advanced imaging techniques, several specific patterns in the collagen surrounding the breast tumor have been identified in both tumor murine models and clinical histology images. These tumor-associated collagen signatures (TACS) include loosely organized fibrils far from the tumor and fibrils aligned either parallel or perpendicular to tumor colonies. They are correlated with tumor behavior, such as benign growth or invasive migration. However, it is not fully understood how one specific fibril pattern can be dynamically remodeled to form another alignment. Here, we present a novel multi-cellular lattice-free (MultiCell-LF) agent-based model of ECM that, in contrast to static histology images, can simulate dynamic changes between TACSs. This model allowed us to identify the rules of cell-ECM physical interplay and feedback that guided the emergence and transition among various TACSs.
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Affiliation(s)
- Sharan Poonja
- Integrated Mathematical Oncology Department, H. Lee Moffitt Cancer Center, Research Institute, Tampa, FL 33612, USA
| | - Ana Forero Pinto
- Integrated Mathematical Oncology Department, H. Lee Moffitt Cancer Center, Research Institute, Tampa, FL 33612, USA
- Cancer Biology PhD Program, University of South Florida, Tampa, FL 33612, USA
| | - Mark C. Lloyd
- Fujifilm Healthcare US, Inc., Lexington, MA 02421, USA;
| | - Mehdi Damaghi
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Katarzyna A. Rejniak
- Integrated Mathematical Oncology Department, H. Lee Moffitt Cancer Center, Research Institute, Tampa, FL 33612, USA
- Department of Oncologic Sciences, Morsani School of Medicine, University of South Florida, Tampa, FL 33612, USA
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5
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Ferreira CJDS, Caires IQDS, da Costa WJB, de Almeida SMV. Collagen content and C-X-C motif chemokine ligand 12 expression in neoplastic breast stroma. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221210. [PMID: 37729354 PMCID: PMC10508945 DOI: 10.1590/1806-9282.20221210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE This study aimed to evaluate the expression of C-X-C motif chemokine ligand 12 and its C-X-C chemokine receptor type 4, and the tumor-stroma ratio using collagen stromal content of breast cancer samples, correlating it with clinicopathological data. METHODS Through a retrospective cohort study, samples were obtained from female patients, over 18 years of age, with the disease in stages 1-4, who underwent mastectomy or lumpectomy. The biopsies were provided by the Oncology sector of the Hospital das Clínicas of Universidade Federal de Pernambuco, Recife city, in 2011-2014, including samples of invasive ductal carcinoma, ductal carcinoma in situ, or benign changes (fibroadenoma and hypertrophy), which were analyzed between 2020 and 2022 by immunohistochemistry for the expression of stromal cell characteristics. Collagen content was tested by Gomori staining and digital analysis of images. RESULTS Absence of stromal expression of C-X-C motif chemokine ligand 12 was associated with longer disease-free survival (disease-free survival=0.481), and expression of C-X-C chemokine receptor type 4 was associated with lower disease-free survival. An association was observed between clinicopathological variables and stromal expression of chemokines, that is, an association of stromal C-X-C motif chemokine ligand 12 with histological grade, angiolymphatic invasion, and an association between C-X-C chemokine receptor type 4 expression and histological grade. Analyses of digital pixels images of collagen and tumor cells showed a lower percentage of collagen in the invasive ductal carcinoma samples (39%), unlike samples without neoplasms (78%). CONCLUSION Low expression of C-X-C motif chemokine ligand 12 may be associated with a worse prognosis for breast cancer. Collagen staining analyzed using digital images represents an opportunity for clinical application and is indicative of the prognosis of the tumor microenvironment in breast carcinoma.
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Markus MA, Ferrari DP, Alves F, Ramos-Gomes F. Effect of tissue fixation on the optical properties of structural components assessed by non-linear microscopy imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:3988-4002. [PMID: 37799688 PMCID: PMC10549744 DOI: 10.1364/boe.488453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 10/07/2023]
Abstract
Fixation methods such as formalin are commonly used for the preservation of tissue with the aim of keeping their structure as close as possible to the native condition. However, fixatives chemically interact with tissue molecules, such as collagen in the extracellular matrix (ECM) or myosin, and may thus modify their structure. Taking advantage of the second- and third-harmonic generation (SHG and THG) emission capabilities of such components, we used nonlinear two-photon microscopy (NL2PM) to evaluate the effect that preservation methods, such as chemical fixatives, have on the nonlinear capabilities of protein components within mouse tissues. Our results show that depending on the preservation technique used, the nonlinear capabilities of collagen, lipid droplets and myosin microarchitecture are strongly affected. Parameters of collagen fibers, such as density and branch points, especially in collagen-sparse regions, e.g., in kidneys, were found to be altered upon formalin fixation. Moreover, cryo-freezing drastically reduced SHG signals from myosin. Our findings provide valuable information to select the best tissue fixation method for visualization and quantification of structural proteins, such as collagen and myosin by advanced NL2PM imaging techniques. This may advance the interpretation of the role these proteins play in disease.
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Affiliation(s)
- M. Andrea Markus
- Translational Molecular Imaging Group,
Max-Planck Institute for Multidisciplinary Sciences, Hermann-Rein-Str. 3, 37075 Göttingen, Germany
| | - Daniele P. Ferrari
- Translational Molecular Imaging Group,
Max-Planck Institute for Multidisciplinary Sciences, Hermann-Rein-Str. 3, 37075 Göttingen, Germany
| | - Frauke Alves
- Translational Molecular Imaging Group,
Max-Planck Institute for Multidisciplinary Sciences, Hermann-Rein-Str. 3, 37075 Göttingen, Germany
- Clinic of Haematology and Medical Oncology, Institute of Interventional and Diagnostic Radiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Fernanda Ramos-Gomes
- Translational Molecular Imaging Group,
Max-Planck Institute for Multidisciplinary Sciences, Hermann-Rein-Str. 3, 37075 Göttingen, Germany
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Prado TP, Jara CP, Dias Bóbbo VC, Carraro RS, Sidarta-Oliveira D, de Mendonça GRA, Velloso LA, Araújo EP. A Free Fatty Acid Synthetic Agonist Accelerates Wound Healing and Improves Scar Quality in Mice. Biol Res Nurs 2023; 25:353-366. [PMID: 36444640 DOI: 10.1177/10998004221142331] [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] [Indexed: 04/17/2024]
Abstract
BACKGROUND Impaired wound healing is a health problem around the world, and the search for a novel product to repair wounded skin is a major topic in the field. GW9508 is a synthetic molecule described as a selective agonist of free fatty acid receptors (FFARs) 1 and 4, and there is evidence of its anti-inflammatory effects on several organs of the body. PURPOSE Here, we aimed to evaluate the effects of topical GW9508 on wound healing in mice. RESEARCH DESIGN First, we used bioinformatic methods to determine the expression of FFAR1 and FFAR4 mRNA in the skin from a human cell atlas assembled with single-cell transcriptomes. Next, we employed 6-week-old C57BL6J mice with 2 wounds inflicted in the back. The mice were randomly divided into 2 groups, a control group, which received topical vehicle, and a treatment group, which received GW9508, for 12 days. The wound was monitored by photographic documentation every 2 days, and samples were collected at day 6 and 12 post injury for RT-PCR, western blot and histology analyses. RESULTS FFAR1 and FFAR4 mRNA are expressed in skin cells in similar amounts to those in other tissues. Topical GW9508 accelerated wound healing and decreased gene expression of IL-10 and metalloproteinase 9 on days 6 and 12 post injury. It increased the quantity of Collagen I and improved the organization of collagen fibres. Conclusions: Our results show that GW9508 could be an attractive drug treatment for wounded skin. Future studies need to be performed to assess the impact of GW9508 in chronic wound models.
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Affiliation(s)
- Thais P Prado
- Nursing School, Laboratory of Cell Signaling Obesity and Comorbidities Center, OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
| | - Carlos P Jara
- Nursing School, Laboratory of Cell Signaling Obesity and Comorbidities Center, OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
| | - Vanessa C Dias Bóbbo
- Nursing School, Laboratory of Cell Signaling Obesity and Comorbidities Center, OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
| | - Rodrigo S Carraro
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Davi Sidarta-Oliveira
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Guilherme R A de Mendonça
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Licio A Velloso
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Eliana P Araújo
- Nursing School, Laboratory of Cell Signaling Obesity and Comorbidities Center, OCRC, University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences, Laboratory of Cell Signaling, Obesity and Comorbidities Center - OCRC, University of Campinas, Campinas, Brazil
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Gomes EFA, Paulino Junior E, de Lima MFR, Reis LA, Paranhos G, Mamede M, Longford FGJ, Frey JG, de Paula AM. Prostate cancer tissue classification by multiphoton imaging, automated image analysis and machine learning. JOURNAL OF BIOPHOTONICS 2023; 16:e202200382. [PMID: 36806587 DOI: 10.1002/jbio.202200382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/07/2023]
Abstract
Prostate carcinoma, a slow-growing and often indolent tumour, is the second most commonly diagnosed cancer among men worldwide. The prognosis is mainly based on the Gleason system through prostate biopsy analysis. However, new treatment and monitoring strategies depend on a more precise diagnosis. Here, we present results by multiphoton imaging for prostate tumour samples from 120 patients that allow to obtain quantitative parameters leading to specific tumour aggressiveness signatures. An automated image analysis was developed to recognise and quantify stromal fibre and neoplastic cell regions in each image. The set of metrics was able to distinguish between non-neoplastic tissue and carcinoma areas by linear discriminant analysis and random forest with accuracy of 89% ± 3%, but between Gleason groups of only 46% ± 6%. The reactive stroma analysis improved the accuracy to 65% ± 5%, clearly demonstrating that stromal parameters should be considered as additional criteria for a more accurate diagnosis.
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Affiliation(s)
- Egleidson F A Gomes
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo Paulino Junior
- Departamento de Anatomia Patológica e Medicina Legal, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Luana A Reis
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Giovanna Paranhos
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marcelo Mamede
- Departamento Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Ana Maria de Paula
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Karancsi Z, Hagenaars SC, Németh K, Mesker WE, Tőkés AM, Kulka J. Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens. Virchows Arch 2023:10.1007/s00428-023-03555-0. [PMID: 37198327 DOI: 10.1007/s00428-023-03555-0] [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: 12/14/2022] [Revised: 03/29/2023] [Accepted: 04/27/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE Tumour-stroma ratio (TSR) is an important prognostic and predictive factor in several tumour types. The aim of this study is to determine whether TSR evaluated in breast cancer core biopsies is representative of the whole tumour. METHOD Different TSR scoring methods, their reproducibility, and the association of TSR with clinicopathological characteristics were investigated in 178 breast carcinoma core biopsies and corresponding resection specimens. TSR was assessed by two trained scientists on the most representative H&E-stained digitised slides. Patients were treated primarily with surgery between 2010 and 2021 at Semmelweis University, Budapest. RESULTS Ninety-one percent of the tumours were hormone receptor (HR)-positive (luminal-like). Interobserver agreement was highest using 100 × magnification (κcore = 0.906, κresection specimen = 0.882). The agreement between TSR of core biopsies and resection specimens of the same patients was moderate (κ = 0.514). Differences between the two types of samples were most frequent in cases with TSR scores close to the 50% cut-off point. TSR was strongly correlated with age at diagnosis, pT category, histological type, histological grade, and surrogate molecular subtype. A tendency was identified for more recurrences among stroma-high (SH) tumours (p = 0.07). Significant correlation was detected between the TSR and tumour recurrence in grade 1 HR-positive breast cancer cases (p = 0.03). CONCLUSIONS TSR is easy to determine and reproducible on both core biopsies and in resection specimens and is associated with several clinicopathological characteristics of breast cancer. TSR scored on core biopsies is moderately representative for the whole tumour.
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Affiliation(s)
- Zsófia Karancsi
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary.
| | - Sophie C Hagenaars
- Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Kristóf Németh
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary
| | - Wilma E Mesker
- Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Anna Mária Tőkés
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary
| | - Janina Kulka
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary
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10
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He J, Kang D, Shen T, Zheng L, Zhan Z, Xi G, Ren W, Chen Z, Qiu L, Xu S, Li L, Chen J. Label-free detection of invasive micropapillary carcinoma of the breast using multiphoton microscopy. JOURNAL OF BIOPHOTONICS 2023; 16:e202200224. [PMID: 36251459 DOI: 10.1002/jbio.202200224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/15/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Invasive micropapillary carcinoma of the breast (IMPC) is a rare form of breast cancer with unique histological features, and is associated with high axillary lymph node metastasis and poor clinical prognosis. Thus, IMPC should be diagnosed in time to improve the treatment and management of patients. In this study, multiphoton microscopy (MPM) is used to label-free visualize the morphological features of IMPC. Our results demonstrate that MPM images are well in agreement with hematoxylin and eosin staining and epithelial membrane antigen staining, indicating MPM is comparable to traditional histological analysis in identifying the tissue structure and cell morphology. Statistical analysis shows significant differences in the circumference and area of the glandular lumen and cancer nest between the different IMPC cell clusters with complete glandular lumen morphology, and also shows difference in collagen length, width, and orientation, indicating the invasive ability of different morphologies of IMPC may be different.
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Affiliation(s)
- Jiajia He
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Tingfeng Shen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Liqin Zheng
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Zhenlin Zhan
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Gangqin Xi
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Wenjiao Ren
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Zhong Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Lida Qiu
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
- College of Physics and Electronic Information Engineering, Minjiang University, Fuzhou, China
| | - Shuoyu Xu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lianhuang Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
| | - Jianxin Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
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11
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Pancreatic Cancer Presents Distinct Nanomechanical Properties During Progression. Ann Biomed Eng 2023:10.1007/s10439-023-03168-3. [PMID: 36813931 DOI: 10.1007/s10439-023-03168-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
Cancer progression is closely related to changes in the structure and mechanical properties of the tumor microenvironment (TME). In many solid tumors, including pancreatic cancer, the interplay among the different components of the TME leads to a desmoplastic reaction mainly due to collagen overproduction. Desmoplasia is responsible for the stiffening of the tumor, poses a major barrier to effective drug delivery and has been associated with poor prognosis. The understanding of the involved mechanisms in desmoplasia and the identification of nanomechanical and collagen-based properties that characterize the state of a particular tumor can lead to the development of novel diagnostic and prognostic biomarkers. In this study, in vitro experiments were conducted using two human pancreatic cell lines. Morphological and cytoskeleton characteristics, cells' stiffness and invasive properties were assessed using optical and atomic force microscopy techniques and cell spheroid invasion assay. Subsequently, the two cell lines were used to develop orthotopic pancreatic tumor models. Tissue biopsies were collected at different times of tumor growth for the study of the nanomechanical and collagen-based optical properties of the tissue using Atomic Force Microscopy (AFM) and picrosirius red polarization microscopy, respectively. The results from the in vitro experiments demonstrated that the more invasive cells are softer and present a more elongated shape with more oriented F-actin stress fibers. Furthermore, ex vivo studies of orthotopic tumor biopsies on MIAPaCa-2 and BxPC-3 murine tumor models highlighted that pancreatic cancer presents distinct nanomechanical and collagen-based optical properties relevant to cancer progression. The stiffness spectrums (in terms of Young's modulus values) showed that the higher elasticity distributions were increasing during cancer progression mainly due desmoplasia (collagen overproduction), while a lower elasticity peak was evident - due to cancer cells softening - on both tumor models. Optical microscopy studies highlighted that collagen content increases while collagen fibers tend to form align patterns. Consequently, during cancer progression nanomechanical and collagen-based optical properties alter in relation to changes in collagen content. Therefore, they have the potential to be used as novel biomarkers for assessing and monitoring tumor progression and treatment outcomes.
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12
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Ghannam SF, Rutland CS, Allegrucci C, Mongan NP, Rakha E. Defining invasion in breast cancer: the role of basement membrane. J Clin Pathol 2023; 76:11-18. [PMID: 36253088 DOI: 10.1136/jcp-2022-208584] [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: 09/08/2022] [Accepted: 10/01/2022] [Indexed: 12/27/2022]
Abstract
Basement membrane (BM) is an amorphous, sheet-like structure separating the epithelium from the stroma. BM is characterised by a complex structure comprising collagenous and non-collagenous proteoglycans and glycoproteins. In the breast, the thickness, density and composition of the BM around the ductal lobular system vary during differing development stages. In pathological conditions, the BM provides a physical barrier that separates proliferating intraductal epithelial cells from the surrounding stroma, and its absence or breach in malignant lesions is a hallmark of invasion and metastases. Currently, diagnostic services often use special stains and immunohistochemistry (IHC) to identify the BM in order to distinguish in situ from invasive lesions. However, distinguishing BM on stained sections, and differentiating the native BM from the reactive capsule or BM-like material surrounding some invasive malignant breast tumours is challenging. Although diagnostic use of the BM is being replaced by myoepithelial cell IHC markers, BM is considered by many to be a useful marker to distinguish in situ from invasive lesions in ambiguous cases. In this review, the structure, function and biological and clinical significance of the BM are discussed in relation to the various breast lesions with emphasis on how to distinguish the native BM from alternative pathological tissue mimicking its histology.
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Affiliation(s)
- Suzan F Ghannam
- Division of cancer and stem cells, school of Medicine, University of Nottingham, Nottingham, UK
- Histology and Cell Biology, Suez Canal University Faculty of Medicine, Ismailia, Egypt
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
| | - Catrin Sian Rutland
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
| | - Cinzia Allegrucci
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
| | - Nigel P Mongan
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
- Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
| | - Emad Rakha
- Division of cancer and stem cells, school of Medicine, University of Nottingham, Nottingham, UK
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
- Histopathology,school of Medicine, University of Nottingham School of Medicine, Nottingham, UK
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13
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LaBelle SA, Dinkins SS, Hoying JB, Budko EV, Rauff A, Strobel HA, Lin AH, Weiss JA. Matrix anisotropy promotes angiogenesis in a density-dependent manner. Am J Physiol Heart Circ Physiol 2022; 322:H806-H818. [PMID: 35333118 PMCID: PMC8993529 DOI: 10.1152/ajpheart.00072.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022]
Abstract
Angiogenesis is necessary for wound healing, tumorigenesis, implant inosculation, and homeostasis. In each situation, matrix structure and mechanics play a role in determining whether new vasculatures can establish transport to new or hypoxic tissues. Neovessel growth and directional guidance are sensitive to three-dimensional (3-D) matrix anisotropy and density, although the individual and integrated roles of these matrix features have not been fully recapitulated in vitro. We developed a tension-based method to align 3-D collagen constructs seeded with microvessel fragments in matrices of three levels of collagen fibril anisotropy and two levels of collagen density. The extent and direction of neovessel growth from the parent microvessel fragments increased with matrix anisotropy and decreased with density. The proangiogenic effects of anisotropy were attenuated at higher matrix densities. We also examined the impact of matrix anisotropy in an experimental model of neovessel invasion across a tissue interface. Matrix density was found to dictate the success of interface crossing, whereas interface curvature and fibril alignment were found to control directional guidance. Our findings indicate that complex configurations of matrix density and alignment can facilitate or complicate the establishment or maintenance of vascular networks in pathological and homeostatic angiogenesis. Furthermore, we extend preexisting methods for tuning collagen anisotropy in thick constructs. This approach addresses gaps in tissue engineering and cell culture by supporting the inclusion of large multicellular structures in prealigned constructs.NEW & NOTEWORTHY Matrix anisotropy and density have a considerable effect on angiogenic vessel growth and directional guidance. However, the current literature relies on 2-D and simplified models of angiogenesis (e.g., tubulogenesis and vasculogenesis). We present a method to align 3-D collagen scaffolds embedded with microvessel fragments to different levels of anisotropy. Neovessel growth increases with anisotropy and decreases with density, which may guide angiogenic neovessels across tissue interfaces such as during implant inosculation and tumorigenesis.
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Affiliation(s)
- Steven A LaBelle
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Shad S Dinkins
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - James B Hoying
- Advanced Solutions Life Sciences, Manchester, New Hampshire
| | - Elena V Budko
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
| | - Adam Rauff
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | | | - Allen H Lin
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
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14
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Lahr CA, Landgraf M, Wagner F, Cipitria A, Moreno-Jiménez I, Bas O, Schmutz B, Meinert C, Cavalcanti ADS, Mashimo T, Miyasaka Y, Holzapfel BM, Shafiee A, McGovern JA, Hutmacher DW. A humanised rat model of osteosarcoma reveals ultrastructural differences between bone and mineralised tumour tissue. Bone 2022; 158:116018. [PMID: 34023543 DOI: 10.1016/j.bone.2021.116018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/06/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023]
Abstract
Current xenograft animal models fail to accurately replicate the complexity of human bone disease. To gain translatable and clinically valuable data from animal models, new in vivo models need to be developed that mimic pivotal aspects of human bone physiology as well as its diseased state. Above all, an advanced bone disease model should promote the development of new treatment strategies and facilitate the conduction of common clinical interventional procedures. Here we describe the development and characterisation of an orthotopic humanised tissue-engineered osteosarcoma (OS) model in a recently genetically engineered x-linked severe combined immunodeficient (X-SCID) rat. For the first time in a genetically modified rat, our results show the successful implementation of an orthotopic humanised tissue-engineered bone niche supporting the growth of a human OS cell line including its metastatic spread to the lung. Moreover, we studied the inter- and intraspecies differences in ultrastructural composition of bone and calcified tissue produced by the tumour, pointing to the crucial role of humanised animal models.
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Affiliation(s)
- Christoph A Lahr
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; Musculoskeletal University Centre Munich, Department of Orthopedics and Trauma Surgery, University Hospital Munich, LMU, Marchioninistraße 15, 81377 Munich, Germany
| | - Marietta Landgraf
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Ferdinand Wagner
- Musculoskeletal University Centre Munich, Department of Orthopedics and Trauma Surgery, University Hospital Munich, LMU, Marchioninistraße 15, 81377 Munich, Germany; Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Lindwurmstrasse 4, 80337 Munich, Germany
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1 OT Golm, 14476 Potsdam, Germany
| | - Inés Moreno-Jiménez
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1 OT Golm, 14476 Potsdam, Germany
| | - Onur Bas
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; ARC Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia
| | - Beat Schmutz
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD 4029, Australia
| | - Christoph Meinert
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; School of Mechanical, Medical and Process Engineering, 2 George Street, Brisbane, QLD 4001, Australia
| | - Amanda Dos Santos Cavalcanti
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Tomoji Mashimo
- Division of Animal Genetics, Laboratory Animal Research Center, Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Yoshiki Miyasaka
- Laboratory of Reproductive Engineering, Institute of Experimental Animal Sciences, Osaka University Medical School, Osaka, Japan
| | - Boris M Holzapfel
- Musculoskeletal University Centre Munich, Department of Orthopedics and Trauma Surgery, University Hospital Munich, LMU, Marchioninistraße 15, 81377 Munich, Germany
| | - Abbas Shafiee
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD 4029, Australia.
| | - Jacqui A McGovern
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; School of Mechanical, Medical and Process Engineering, 2 George Street, Brisbane, QLD 4001, Australia.
| | - Dietmar W Hutmacher
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; ARC Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia; School of Mechanical, Medical and Process Engineering, 2 George Street, Brisbane, QLD 4001, Australia.
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15
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Tishchenko A, Geernaert T, Vermeulen N, Berghmans F, Baghdasaryan T. Simultaneous modal phase and group velocity matching in microstructured optical fibers for second harmonic generation with ultrashort pulses. OPTICS EXPRESS 2022; 30:12026-12038. [PMID: 35473132 DOI: 10.1364/oe.453844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
Optical fibers provide a favorable medium for nonlinear optical processes owing to the small mode field size and concurrently high optical intensity combined with the extended interaction lengths. Second harmonic generation (SHG) is one of those processes that has been demonstrated in silica glass optical fibers. Since silica is centrosymmetric, generating SHG in an optical fiber requires poling of the glass. In addition and when one wants to use ultrashort pulses for SHG, achieving both phase and group velocity matching is crucial. Although fibers that feature either modal phase velocity or group velocity matching for SHG have been reported, the possibility of simultaneous modal phase and group velocity matching was never reported before. In this paper we address this challenge, and for the first time to our knowledge, we show that it is feasible to do so with silica microstructured optical fibers featuring at least one ring of air holes in the cladding and a heavily Germanium doped core (above 25 mol.%) by exploiting the LP01(ω) and LP02(2ω) modes at 1.06 µm pump and 0.53 µm second harmonic wavelengths. This finding can greatly impact applications requiring waveguide based SHG generation with ultrashort pulses, including microscopy, material characterization and nonlinear imaging.
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16
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Second-Harmonic Generation Imaging Reveals Changes in Breast Tumor Collagen Induced by Neoadjuvant Chemotherapy. Cancers (Basel) 2022; 14:cancers14040857. [PMID: 35205605 PMCID: PMC8869853 DOI: 10.3390/cancers14040857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 12/10/2022] Open
Abstract
Breast cancer is the most common invasive cancer in women, with most deaths attributed to metastases. Neoadjuvant chemotherapy (NACT) may be prescribed prior to surgical removal of the tumor for subsets of breast cancer patients but can have diverse undesired and off-target effects, including the increased appearance of the 'tumor microenvironment of metastasis', image-based multicellular signatures that are prognostic of breast tumor metastasis. To assess whether NACT can induce changes in two other image-based prognostic/predictive signatures derived from tumor collagen, we quantified second-harmonic generation (SHG) directionality and fiber alignment in formalin-fixed, paraffin-embedded sections of core needle biopsies and primary tumor excisions from 22 human epidermal growth factor receptor 2-overexpressing (HER2+) and 22 triple-negative breast cancers. In both subtypes, we found that SHG directionality (i.e., the forward-to-backward scattering ratio, or F/B) is increased by NACT in the bulk of the tumor, but not the adjacent tumor-stroma interface. Overall collagen fiber alignment is increased by NACT in triple-negative but not HER2+ breast tumors. These results suggest that NACT impacts the collagenous extracellular matrix in a complex and subtype-specific manner, with some prognostic features being unchanged while others are altered in a manner suggestive of a more metastatic phenotype.
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17
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Hristu R, Stanciu SG, Dumitru A, Paun B, Floroiu I, Costache M, Stanciu GA. Influence of hematoxylin and eosin staining on the quantitative analysis of second harmonic generation imaging of fixed tissue sections. BIOMEDICAL OPTICS EXPRESS 2021; 12:5829-5843. [PMID: 34692218 PMCID: PMC8515976 DOI: 10.1364/boe.428701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 05/13/2023]
Abstract
Second harmonic generation (SHG) microscopy has emerged over the past two decades as a powerful tool for tissue characterization and diagnostics. Its main applications in medicine are related to mapping the collagen architecture of in-vivo, ex-vivo and fixed tissues based on endogenous contrast. In this work we present how H&E staining of excised and fixed tissues influences the extraction and use of image parameters specific to polarization-resolved SHG (PSHG) microscopy, which are known to provide quantitative information on the collagen structure and organization. We employ a theoretical collagen model for fitting the experimental PSHG datasets to obtain the second order susceptibility tensor elements ratios and the fitting efficiency. Furthermore, the second harmonic intensity acquired under circular polarization is investigated. The evolution of these parameters in both forward- and backward-collected SHG are computed for both H&E-stained and unstained tissue sections. Consistent modifications are observed between the two cases in terms of the fitting efficiency and the second harmonic intensity. This suggests that similar quantitative analysis workflows applied to PSHG images collected on stained and unstained tissues could yield different results, and hence affect the diagnostic accuracy.
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Affiliation(s)
- Radu Hristu
- Center for Microcopy-Microanalysis and Information Processing, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Stefan G. Stanciu
- Center for Microcopy-Microanalysis and Information Processing, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Adrian Dumitru
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Paun
- Faculty of Automation and Computer Science, Technical University of Cluj-Napoca, 40002 Cluj-Napoca, Romania
| | - Iustin Floroiu
- Center for Microcopy-Microanalysis and Information Processing, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Mariana Costache
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - George A. Stanciu
- Center for Microcopy-Microanalysis and Information Processing, University Politehnica of Bucharest, 060042 Bucharest, Romania
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18
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Gubarkova EV, Elagin VV, Dudenkova VV, Kuznetsov SS, Karabut MM, Potapov AL, Vorontsov DA, Vorontsov AY, Sirotkina MA, Zagaynova EV, Gladkova ND. Multiphoton tomography in differentiation of morphological and molecular subtypes of breast cancer: A quantitative analysis. JOURNAL OF BIOPHOTONICS 2021; 14:e202000471. [PMID: 33522719 DOI: 10.1002/jbio.202000471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
In this study multiphoton tomography, based on second harmonic generation (SHG), and two-photon-excited fluorescence (TPEF) was used to visualize both the extracellular matrix and tumor cells in different morphological and molecular subtypes of human breast cancer. It was shown, that quantified assessment of the SHG based imaging data has great potential to reveal differences of collagen quantity, organization and uniformity in both low- and highly- aggressive invasive breast cancers. The values of quantity and uniformity of the collagen fibers distribution were significantly higher in low-aggressive breast cancer compared to the highly-aggressive subtypes, while the value representing collagen organization was lower in the former type. Additionally, it was shown, that TPEF detection of elastin fibers and amyloid protein may be used as a biomarker of detection the low-aggressive breast cancer subtype. Thus, TPEF/SHG imaging offers the possibility of becoming a useful tool for the rapid diagnosis of various subtypes of breast cancer during biopsy as well as for the intraoperative determinination of tumor-positive resection margins.
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Affiliation(s)
| | - Vadim V Elagin
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | | | | | - Maria M Karabut
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Arseny L Potapov
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | | | | | | | - Elena V Zagaynova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- Lobachevsky State University of Nizhni Novgorod, Nizhny Novgorod, Russia
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19
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Fibroblast MMP14-Dependent Collagen Processing Is Necessary for Melanoma Growth. Cancers (Basel) 2021; 13:cancers13081984. [PMID: 33924099 PMCID: PMC8074311 DOI: 10.3390/cancers13081984] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Matrix metalloproteinases (MMPs) were considered as targets for the treatment of various cancers. However, initial trials using broad inhibitors to MMPs have failed, partly attributed to the contrasting functions of these proteases acting as tumor promoters and suppressors, among other reasons. Our data now suggest that specific inhibition of MMP14 might represent a more specific approach, as loss of this protease in fibroblasts resulted in reduced growth of grafted melanomas. Here, we found that deletion of MMP14 in fibroblasts generates a matrix-rich environment that reduces tumor vascularization and melanoma cell proliferation. In in vitro and ex vivo assays, we showed that the latter is mediated by stiffening of the tissue due to collagen accumulation. Additionally, in vivo, we show that independently of MMP14 deletion, a collagen-rich stiff matrix inhibits the growth of melanomas. Abstract Skin homeostasis results from balanced synthesis and degradation of the extracellular matrix in the dermis. Deletion of the proteolytic enzyme MMP14 in dermal fibroblasts (MMP14Sf−/−) leads to a fibrotic skin phenotype with the accumulation of collagen type I, resulting from impaired proteolysis. Here, we show that melanoma growth in these mouse fibrotic dermal samples was decreased, paralleled by reduced tumor cell proliferation and vessel density. Using atomic force microscopy, we found increased peritumoral matrix stiffness of early but not late melanomas in the absence of fibroblast-derived MMP14. However, total collagen levels were increased at late melanoma stages in MMP14Sf−/− mice compared to controls. In ex vivo invasion assays, melanoma cells formed smaller tumor islands in MMP14Sf−/− skin, indicating that MMP14-dependent matrix accumulation regulates tumor growth. In line with these data, in vitro melanoma cell growth was inhibited in high collagen 3D spheroids or stiff substrates. Most importantly, in vivo induction of fibrosis using bleomycin reduced melanoma tumor growth. In summary, we show that MMP14 expression in stromal fibroblasts regulates melanoma tumor progression by modifying the peritumoral matrix and point to collagen accumulation as a negative regulator of melanoma.
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20
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de Andrade Natal R, Adur J, Cesar CL, Vassallo J. Tumor extracellular matrix: lessons from the second-harmonic generation microscopy. SURGICAL AND EXPERIMENTAL PATHOLOGY 2021. [DOI: 10.1186/s42047-021-00089-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AbstractExtracellular matrix (ECM) represents more than a mere intercellular cement. It is physiologically active in cell communication, adhesion and proliferation. Collagen is the most abundant protein, making up to 90% of ECM, and 30% of total protein weight in humans. Second-harmonic generation (SHG) microscopy represents an important tool to study collagen organization of ECM in freshly unfixed tissues and paraffin-embedded tissue samples. This manuscript aims to review some of the applications of SHG microscopy in Oncologic Pathology, mainly in the study of ECM of epithelial tumors. It is shown how collagen parameters measured by this technique can aid in the differential diagnosis and in prognostic stratification. There is a tendency to associate higher amount, lower organization and higher linearity of collagen fibers with tumor progression and metastasizing. These represent complex processes, in which matrix remodeling plays a central role, together with cancer cell genetic modifications. Integration of studies on cancer cell biology and ECM are highly advantageous to give us a more complete picture of these processes. As microscopic techniques provide topographic information allied with biologic characteristics of tissue components, they represent important tools for a more complete understanding of cancer progression. In this context, SHG has provided significant insights in human tumor specimens, readily available for Pathologists.
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21
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Garcia APV, Reis LA, Nunes FC, Longford FGJ, Frey JG, de Paula AM, Cassali GD. Canine mammary cancer tumour behaviour and patient survival time are associated with collagen fibre characteristics. Sci Rep 2021; 11:5668. [PMID: 33707516 PMCID: PMC7952730 DOI: 10.1038/s41598-021-85104-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/19/2021] [Indexed: 01/31/2023] Open
Abstract
Precise diagnosis and prognosis are key in prevention and reduction of morbidity and mortality in all types of cancers. Here we show that changes in the collagen fibres in the main histological subtypes of canine mammary gland carcinomas are directly associated with the tumour behaviour and the animal survival time and could become a useful tool in helping with diagnosis. Imaging by second harmonic generation and multiphoton excited fluorescence microscopy were performed to evaluate the collagen and cellular segment parameters in cancer biopsies. We present a retrospective study of 45 cases of canine mammary cancer analysing 836 biopsies regions including normal mammary gland tissue, benign mixed tumours, carcinoma in mixed tumour, carcinosarcoma, micropapillary carcinoma and solid carcinoma. The image analyses and the comparison between the tumour types allowed to assess the collagen fibre changes during tumour progression. We demonstrate that the collagen parameters correlate with the clinical and pathological data, the results show that in neoplastic tissues, the collagen fibres are more aligned and shorter as compared to the normal tissues. There is a clear association of the mean fibre length with the dogs survival times, the carcinomas presenting shorter collagen fibres indicate a worse survival rate.
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Affiliation(s)
- Ana P. V. Garcia
- grid.8430.f0000 0001 2181 4888Laboratório de Patologia Comparada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901 Brazil
| | - Luana A. Reis
- grid.8430.f0000 0001 2181 4888Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901 Brazil
| | - Fernanda C. Nunes
- grid.8430.f0000 0001 2181 4888Laboratório de Patologia Comparada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901 Brazil
| | | | - Jeremy G. Frey
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, SO17 1BJ UK
| | - Ana M. de Paula
- grid.8430.f0000 0001 2181 4888Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901 Brazil
| | - Geovanni D. Cassali
- grid.8430.f0000 0001 2181 4888Laboratório de Patologia Comparada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901 Brazil
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22
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Miler I, Rabasovic MD, Aleksic M, Krmpot AJ, Kalezic A, Jankovic A, Korac B, Korac A. Polarization-resolved SHG imaging as a fast screening method for collagen alterations during aging: Comparison with light and electron microscopy. JOURNAL OF BIOPHOTONICS 2021; 14:e202000362. [PMID: 33231371 DOI: 10.1002/jbio.202000362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 06/11/2023]
Abstract
Our previous study on rat skin showed that cumulative oxidative pressure induces profound structural and ultrastructural alterations in both rat skin epidermis and dermis during aging. Here, we aimed to investigate the biophotonic properties of collagen as a main dermal component in the function of chronological aging. We used second harmonic generation (SHG) and two-photon excited fluorescence (TPEF) on 5 μm thick skin paraffin sections from 15-day-, 1-month- and 21-month-old rats, respectively, to analyze collagen alterations, in comparison to conventional light and electron microscopy methods. Obtained results show that polarization-resolved SHG (PSHG) images can detect collagen fiber alterations in line with chronological aging and that this method is consistent with light and electron microscopy. Moreover, the β coefficient calculated from PSHG images points out that delicate alterations lead to a more ordered structure of collagen molecules due to oxidative damage. The results of this study also open the possibility of successfully applying this fast and label-free method to previously fixed samples.
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Affiliation(s)
- Irena Miler
- Institute for Application of Nuclear Energy-INEP, University of Belgrade, Belgrade-Zemun, Serbia
| | | | - Marija Aleksic
- Faculty of Biology, Center for Electron Microscopy, University of Belgrade, Belgrade, Serbia
| | | | - Andjelika Kalezic
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Jankovic
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Bato Korac
- Faculty of Biology, Center for Electron Microscopy, University of Belgrade, Belgrade, Serbia
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Korac
- Faculty of Biology, Center for Electron Microscopy, University of Belgrade, Belgrade, Serbia
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Guedj N, Blaise L, Cauchy F, Albuquerque M, Soubrane O, Paradis V. Prognostic value of desmoplastic stroma in intrahepatic cholangiocarcinoma. Mod Pathol 2021; 34:408-416. [PMID: 32860001 DOI: 10.1038/s41379-020-00656-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/21/2020] [Accepted: 08/07/2020] [Indexed: 01/06/2023]
Abstract
Intrahepatic cholangiocarcinomas (iCCs) are primary tumors of the liver characterized by the presence of a desmoplastic stroma. While tumor stroma may have a protective or a pejorative value depending on the type of malignant disease, the precise role of the desmoplastic stroma in iCC remains poorly understood. The aim of the present study was to evaluate the prognostic value of stromal compartment in iCC through a multiparametric morphological analysis. Forty-nine surgically resected iCCs were included. For all cases, tumor paraffin blocks of iCCs were selected for stromal morphological characterization through quantitative and qualitative approaches using immunohistochemistry and second-harmonic generation imaging. Intratumor heterogeneity was also evaluated in regards with the different stromal features. High proportionated stromal area (PSA) (defined by stromal to tumor area ratio) was inversely correlated with vascular invasion (62.5% vs 95.7%, p = 0.006) and positively correlated with well-differentiated grade (60% vs 12.5%, p = 0.001). Patients with high PSA had a better disease-free survival (DFS) than patients with low stromal area (60% vs 10%, p = 0.077). Low activated stroma index (defined by cancer-associated fibroblasts number to stromal area ratio) was associated with a better DFS (60% vs 10%, p = 0.05). High collagen reticulation index (CRI), defined as the number of collagen fiber branches within the entire length of the collagen network, was associated with a poorer overall survival (42% vs NR, p = 0.026). Furthermore, we showed that CRI was also an homogeneous marker throughout the tumor. Based on morphological features, desmoplastic stroma seems to exert a protective effect in patients with iCC. Stromal collagen reticulation may provide additional clinically relevant information. In addition, these data support the potential value to evaluate CRI in biopsy specimen.
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Affiliation(s)
- Nathalie Guedj
- Department of Pathology, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
| | - Lorraine Blaise
- Department of Pathology, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - François Cauchy
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Miguel Albuquerque
- Department of Pathology, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Olivier Soubrane
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Valérie Paradis
- Department of Pathology, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France
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24
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Balasundaram G, Krafft C, Zhang R, Dev K, Bi R, Moothanchery M, Popp J, Olivo M. Biophotonic technologies for assessment of breast tumor surgical margins-A review. JOURNAL OF BIOPHOTONICS 2021; 14:e202000280. [PMID: 32951321 DOI: 10.1002/jbio.202000280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Breast conserving surgery (BCS) offering similar surgical outcomes as mastectomy while retaining breast cosmesis is becoming increasingly popular for the management of early stage breast cancers. However, its association with reoperation rates of 20% to 40% following incomplete tumor removal warrants the need for a fast and accurate intraoperative surgical margin assessment tool that offers cellular, structural and molecular information of the whole specimen surface to a clinically relevant depth. Biophotonic technologies are evolving to qualify as such an intraoperative tool for clinical assessment of breast cancer surgical margins at the microscopic and macroscopic scale. Herein, we review the current research in the application of biophotonic technologies such as photoacoustic imaging, Raman spectroscopy, multimodal multiphoton imaging, diffuse optical imaging and fluorescence imaging using medically approved dyes for breast cancer detection and/or tumor subtype differentiation toward intraoperative assessment of surgical margins in BCS specimens, and possible challenges in their route to clinical translation.
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Affiliation(s)
- Ghayathri Balasundaram
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | | | - Ruochong Zhang
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Kapil Dev
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Renzhe Bi
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Mohesh Moothanchery
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jürgen Popp
- Leibniz Institute of Photonic Technology, Jena, Germany
- Institute of Physical Chemistry and Abbe Center of Photonics, University Jena, Jena, Germany
| | - Malini Olivo
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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25
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Desa DE, Strawderman RL, Wu W, Hill RL, Smid M, Martens JWM, Turner BM, Brown EB. Intratumoral heterogeneity of second-harmonic generation scattering from tumor collagen and its effects on metastatic risk prediction. BMC Cancer 2020; 20:1217. [PMID: 33302909 PMCID: PMC7731482 DOI: 10.1186/s12885-020-07713-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022] Open
Abstract
Background Metastases are the leading cause of breast cancer-related deaths. The tumor microenvironment impacts cancer progression and metastatic ability. Fibrillar collagen, a major extracellular matrix component, can be studied using the light scattering phenomenon known as second-harmonic generation (SHG). The ratio of forward- to backward-scattered SHG photons (F/B) is sensitive to collagen fiber internal structure and has been shown to be an independent prognostic indicator of metastasis-free survival time (MFS). Here we assess the effects of heterogeneity in the tumor matrix on the possible use of F/B as a prognostic tool. Methods SHG imaging was performed on sectioned primary tumor excisions from 95 untreated, estrogen receptor-positive, lymph node negative invasive ductal carcinoma patients. We identified two distinct regions whose collagen displayed different average F/B values, indicative of spatial heterogeneity: the cellular tumor bulk and surrounding tumor-stroma interface. To evaluate the impact of heterogeneity on F/B’s prognostic ability, we performed SHG imaging in the tumor bulk and tumor-stroma interface, calculated a 21-gene recurrence score (surrogate for OncotypeDX®, or S-ODX) for each patient and evaluated their combined prognostic ability. Results We found that F/B measured in tumor-stroma interface, but not tumor bulk, is prognostic of MFS using three methods to select pixels for analysis: an intensity threshold selected by a blinded observer, a histogram-based thresholding method, and an adaptive thresholding method. Using both regression trees and Random Survival Forests for MFS outcome, we obtained data-driven prediction rules that show F/B from tumor-stroma interface, but not tumor bulk, and S-ODX both contribute to predicting MFS in this patient cohort. We also separated patients into low-intermediate (S-ODX < 26) and high risk (S-ODX ≥26) groups. In the low-intermediate risk group, comprised of patients not typically recommended for adjuvant chemotherapy, we find that F/B from the tumor-stroma interface is prognostic of MFS and can identify a patient cohort with poor outcomes. Conclusions These data demonstrate that intratumoral heterogeneity in F/B values can play an important role in its possible use as a prognostic marker, and that F/B from tumor-stroma interface of primary tumor excisions may provide useful information to stratify patients by metastatic risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-020-07713-4.
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Affiliation(s)
- Danielle E Desa
- Department of Biomedical Engineering, Hajim School of Engineering and Applied Sciences, University of Rochester, Rochester, New York, USA
| | - Robert L Strawderman
- Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Wencheng Wu
- Goergen Institute for Data Science, University of Rochester, Rochester, New York, USA
| | | | - Marcel Smid
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J W M Martens
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bradley M Turner
- Department of Pathology and Laboratory Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward B Brown
- Department of Biomedical Engineering, Hajim School of Engineering and Applied Sciences, University of Rochester, Rochester, New York, USA.
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Reis LA, Garcia APV, Gomes EFA, Longford FGJ, Frey JG, Cassali GD, de Paula AM. Canine mammary cancer diagnosis from quantitative properties of nonlinear optical images. BIOMEDICAL OPTICS EXPRESS 2020; 11:6413-6427. [PMID: 33282498 PMCID: PMC7687940 DOI: 10.1364/boe.400871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/20/2020] [Accepted: 10/04/2020] [Indexed: 06/07/2023]
Abstract
We present nonlinear microscopy imaging results and analysis from canine mammary cancer biopsies. Second harmonic generation imaging allows information of the collagen structure in the extracellular matrix that together with the fluorescence of the cell regions of the biopsies form a base for comprehensive image analysis. We demonstrate an automated image analysis method to classify the histological type of canine mammary cancer using a range of parameters extracted from the images. The software developed for image processing and analysis allows for the extraction of the collagen fibre network and the cell regions of the images. Thus, the tissue properties are obtained after the segmentation of the image and the metrics are measured specifically for the collagen and the cell regions. A linear discriminant analysis including all the extracted metrics allowed to clearly separate between the healthy and cancerous tissue with a 91%-accuracy. Also, a 61%-accuracy was achieved for a comparison of healthy and three histological cancer subtypes studied.
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Affiliation(s)
- Luana A. Reis
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte-MG, Brazil
| | - Ana P. V. Garcia
- Laboratório de Patologia Comparada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte-MG, Brazil
| | - Egleidson F. A. Gomes
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte-MG, Brazil
| | | | - Jeremy G. Frey
- University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - Geovanni D. Cassali
- Laboratório de Patologia Comparada, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte-MG, Brazil
| | - Ana M. de Paula
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte-MG, Brazil
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Rosen S, Brisson BK, Durham AC, Munroe CM, McNeill CJ, Stefanovski D, Sørenmo KU, Volk SW. Intratumoral collagen signatures predict clinical outcomes in feline mammary carcinoma. PLoS One 2020; 15:e0236516. [PMID: 32776970 PMCID: PMC7416937 DOI: 10.1371/journal.pone.0236516] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022] Open
Abstract
Breast cancer is the most common cause of cancer-related deaths in women worldwide. Identification of reliable prognostic indicators and therapeutic targets is critical for improving patient outcome. Cancer in companion animals often strongly resembles human cancers and a comparative approach to identify prognostic markers can improve clinical care across species. Feline mammary tumors (FMT) serve as models for extremely aggressive triple negative breast cancer (TNBC) in humans, with high rates of local and distant recurrence after resection. Despite the aggressive clinical behavior of most FMT, current prognostic indicators are insufficient for accurately predicting outcome, similar to human patients. Given significant heterogeneity of mammary tumors, there has been a recent focus on identification of universal tumor-permissive stromal features that can predict biologic behavior and provide therapeutic targets to improve outcome. As in human and canine patients, collagen signatures appear to play a key role in directing mammary tumor behavior in feline patients. We find that patients bearing FMTs with denser collagen, as well as longer, thicker and straighter fibers and less identifiable tumor-stromal boundaries had poorer outcomes, independent of the clinical variables grade and surgical margins. Most importantly, including the collagen parameters increased the predictive power of the clinical model. Thus, our data suggest that similarities with respect to the stromal microenvironment between species may allow this model to predict outcome and develop novel therapeutic targets within the tumor stroma that would benefit both veterinary and human patients with aggressive mammary tumors.
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Affiliation(s)
- Suzanne Rosen
- Department of Clinical Sciences & Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Becky K. Brisson
- Department of Clinical Sciences & Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Amy C. Durham
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Clare M. Munroe
- Department of Clinical Sciences & Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Conor J. McNeill
- Hope Advanced Veterinary Center, Vienna, VA, United States of America
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States of America
| | - Karin U. Sørenmo
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Susan W. Volk
- Department of Clinical Sciences & Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- * E-mail:
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28
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Plekhanov AA, Sirotkina MA, Sovetsky AA, Gubarkova EV, Kuznetsov SS, Matveyev AL, Matveev LA, Zagaynova EV, Gladkova ND, Zaitsev VY. Histological validation of in vivo assessment of cancer tissue inhomogeneity and automated morphological segmentation enabled by Optical Coherence Elastography. Sci Rep 2020; 10:11781. [PMID: 32678175 PMCID: PMC7366713 DOI: 10.1038/s41598-020-68631-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 06/30/2020] [Indexed: 01/09/2023] Open
Abstract
We present a non-invasive (albeit contact) method based on Optical Coherence Elastography (OCE) enabling the in vivo segmentation of morphological tissue constituents, in particular, monitoring of morphological alterations during both tumor development and its response to therapies. The method uses compressional OCE to reconstruct tissue stiffness map as the first step. Then the OCE-image is divided into regions, for which the Young’s modulus (stiffness) falls in specific ranges corresponding to the morphological constituents to be discriminated. These stiffness ranges (characteristic "stiffness spectra") are initially determined by careful comparison of the "gold-standard" histological data and the OCE-based stiffness map for the corresponding tissue regions. After such pre-calibration, the results of morphological segmentation of OCE-images demonstrate a striking similarity with the histological results in terms of percentage of the segmented zones. To validate the sensitivity of the OCE-method and demonstrate its high correlation with conventional histological segmentation we present results obtained in vivo on a murine model of breast cancer in comparative experimental study of the efficacy of two antitumor chemotherapeutic drugs with different mechanisms of action. The new technique allowed in vivo monitoring and quantitative segmentation of (1) viable, (2) dystrophic, (3) necrotic tumor cells and (4) edema zones very similar to morphological segmentation of histological images. Numerous applications in other experimental/clinical areas requiring rapid, nearly real-time, quantitative assessment of tissue structure can be foreseen.
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Affiliation(s)
- Anton A Plekhanov
- Privolzhsky Research Medical University, Minin Square 10/1, Nizhny Novgorod, 603950, Russia
| | - Marina A Sirotkina
- Privolzhsky Research Medical University, Minin Square 10/1, Nizhny Novgorod, 603950, Russia.
| | - Alexander A Sovetsky
- Institute of Applied Physics, Russian Academy of Sciences, Ulyanov Street 46, Nizhny Novgorod, 603950, Russia
| | - Ekaterina V Gubarkova
- Privolzhsky Research Medical University, Minin Square 10/1, Nizhny Novgorod, 603950, Russia
| | - Sergey S Kuznetsov
- N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Rodionov Street 190, Nizhny Novgorod, 603126, Russia
| | - Alexander L Matveyev
- Institute of Applied Physics, Russian Academy of Sciences, Ulyanov Street 46, Nizhny Novgorod, 603950, Russia
| | - Lev A Matveev
- Institute of Applied Physics, Russian Academy of Sciences, Ulyanov Street 46, Nizhny Novgorod, 603950, Russia
| | - Elena V Zagaynova
- Privolzhsky Research Medical University, Minin Square 10/1, Nizhny Novgorod, 603950, Russia
| | - Natalia D Gladkova
- Privolzhsky Research Medical University, Minin Square 10/1, Nizhny Novgorod, 603950, Russia
| | - Vladimir Y Zaitsev
- Institute of Applied Physics, Russian Academy of Sciences, Ulyanov Street 46, Nizhny Novgorod, 603950, Russia
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The significance of stromal collagen organization in cancer tissue: An in-depth discussion of literature. Crit Rev Oncol Hematol 2020; 151:102907. [DOI: 10.1016/j.critrevonc.2020.102907] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
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30
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Castor MDGDFC, Torres LC, Mello RJVD, Natal RDA, Vassallo J. Study on collagen parameters in vulvar cancer and preneoplastic lesions by Second Harmonic Generation microscopy. Sci Rep 2020; 10:5568. [PMID: 32221321 PMCID: PMC7101353 DOI: 10.1038/s41598-020-62346-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/24/2020] [Indexed: 01/17/2023] Open
Abstract
The extracellular matrix plays an important role in cellular balance, and collagen fibers are its most important component. Over the last few years, second harmonic generation (SHG) microscopy has been used for the analysis of collagen fibers in several types of gynaecological cancers, such as breast and ovarian cancer. The value of collagen parameters obtained with this technique to gain insights on the physiopathology and on the prognostic evaluation of cancer has been advocated. Herein, we have characterized the collagen fibers in squamous cell carcinoma (VSCC) and preneoplastic lesions using the SHG microscopy. Collagen parameters, quantity, organization, and uniformity, of VSCC, adjacent skin of VSCC or preneoplastic lesions were compared with values obtained in normal tissue of healthy control. There was an evident decrease in the values of collagen fiber parameters in the VSCC. Increased quantity and uniformity of tumor associated collagen fibers were associated with the presence of lymph node metastases, which suggest a prognostic value of such parameters in the evaluation of vulvar cancer.
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Affiliation(s)
| | - Leuridan Cavalcante Torres
- Division of Pelvis, Hospital de Cancer de Pernambuco, Recife, PE, Brazil.
- Translational Research Laboratory C. A. Hart, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil.
| | | | - Rodrigo de Andrade Natal
- Laboratory of Investigative Pathology, CIPED, Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil
| | - José Vassallo
- Laboratory of Investigative Pathology, CIPED, Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil
- Department of Anatomic Pathology, AC Camargo Cancer Center, São Paulo, Brazil
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Abstract
The premise of this book is the importance of the tumor microenvironment (TME). Until recently, most research on and clinical attention to cancer biology, diagnosis, and prognosis were focused on the malignant (or premalignant) cellular compartment that could be readily appreciated using standard morphology-based imaging.
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Fereidouni F, Todd A, Li Y, Chang CW, Luong K, Rosenberg A, Lee YJ, Chan JW, Borowsky A, Matsukuma K, Jen KY, Levenson R. Dual-mode emission and transmission microscopy for virtual histochemistry using hematoxylin- and eosin-stained tissue sections. BIOMEDICAL OPTICS EXPRESS 2019; 10:6516-6530. [PMID: 31853414 PMCID: PMC6913420 DOI: 10.1364/boe.10.006516] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 05/23/2023]
Abstract
In the clinical practice of pathology, trichrome stains are commonly used to highlight collagen and to help evaluate fibrosis. Such stains do delineate collagen deposits but are not molecularly specific and can suffer from staining inconsistencies. Moreover, performing histochemical stain evaluation requires the preparation of additional sections beyond the original hematoxylin- and eosin-stained slides, as well as additional staining steps, which together add cost, time, and workflow complications. We have developed a new microscopy approach, termed DUET (DUal-mode Emission and Transmission) that can be used to extract signals that would typically require special stains or advanced optical methods. Our preliminary analysis demonstrates the potential of using the resulting signals to generate virtual histochemical images that resemble trichrome-stained slides and can support clinical evaluation. We demonstrate advantages of this approach over images acquired from conventional trichrome-stained slides and compare them with images created using second harmonic generation microscopy.
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Affiliation(s)
- Farzad Fereidouni
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Austin Todd
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Yuheng Li
- Department of Computer Science, UC Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Che-Wei Chang
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Keith Luong
- Department of Electrical and Computer Engineering, UC Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Avi Rosenberg
- Renal Pathology, Department of Pathology, Johns Hopkins University and Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | - Yong-Jae Lee
- Department of Computer Science, UC Davis, One Shields Avenue, Davis, CA 95616, USA
| | - James W. Chan
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Alexander Borowsky
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Karen Matsukuma
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Kuang-Yu Jen
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
| | - Richard Levenson
- Department of Pathology and Laboratory Medicine, UC Davis Health, 4400 V Street, Sacramento, CA 95817, USA
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Desa DE, Bhanote M, Hill RL, Majeski JB, Buscaglia B, D’Aguiar M, Strawderman R, Hicks DG, Turner BM, Brown EB. Second-harmonic generation directionality is associated with neoadjuvant chemotherapy response in breast cancer core needle biopsies. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-9. [PMID: 31456385 PMCID: PMC6983524 DOI: 10.1117/1.jbo.24.8.086503] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/05/2019] [Indexed: 05/30/2023]
Abstract
Neoadjuvant chemotherapy (NACT) is routinely administered to subsets of breast cancer patients, including triple negative (TN) or human epidermal growth factor receptor 2-positive (HER2+) cancers. After NACT and subsequent surgical resection, 5% to 30% of patients have no residual invasive carcinoma, termed pathological complete response. Unfortunately, many patients experience little-to-no response after NACT and unnecessarily suffer its side effects. Methods are needed to predict an individual patient’s response to NACT. Core needle biopsies, taken before NACT, consist of tumor cells and the surrounding extracellular matrix. We performed second-harmonic generation (SHG) imaging of fibrillar collagen in core needle biopsy sections as a possible predictor of response to NACT. The ratio of forward-to-backward scattering (F/B) SHG was assessed in the “tumor bulk” and “tumor–host interface” in HER2+ and TN core needle biopsy sections. Patient response was classified post-treatment using the Residual Cancer Burden (RCB) score. In HER2+ biopsies, RCB class was associated with F/B derived from the tumor–stromal interface, but not tumor bulk. F/B was not associated with RCB class in TN biopsies. These findings suggest that F/B from needle biopsy sections may be a useful predictor of which patients will respond favorably to NACT, with the potential to help reduce overtreatment.
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Affiliation(s)
- Danielle E. Desa
- University of Rochester, Hajim School of Engineering and Applied Sciences, Department of Biomedical Engineering, Rochester, New York, United States
| | - Monisha Bhanote
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Pathology and Laboratory Medicine, Rochester, New York, United States
| | - Robert L. Hill
- Harmonigenic Corporation, Rochester, New York, United States
| | - Joseph B. Majeski
- University of Rochester, Hajim School of Engineering and Applied Sciences, Department of Biomedical Engineering, Rochester, New York, United States
| | - Brandon Buscaglia
- Rochester Institute of Technology, Kate Gleason College of Engineering, Department of Biomedical Engineering, Rochester, New York, United States
| | - Marcus D’Aguiar
- Rochester Institute of Technology, Kate Gleason College of Engineering, Department of Biomedical Engineering, Rochester, New York, United States
| | - Robert Strawderman
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Biostatistics and Computational Biology, Rochester, New York, United States
| | - David G. Hicks
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Pathology and Laboratory Medicine, Rochester, New York, United States
| | - Bradley M. Turner
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Pathology and Laboratory Medicine, Rochester, New York, United States
| | - Edward B. Brown
- University of Rochester, Hajim School of Engineering and Applied Sciences, Department of Biomedical Engineering, Rochester, New York, United States
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Natal RDA, Paiva GR, Pelegati VB, Marenco L, Alvarenga CA, Vargas RF, Derchain SF, Sarian LO, Franchet C, Cesar CL, Schmitt FC, Weigelt B, Vassallo J. Exploring Collagen Parameters in Pure Special Types of Invasive Breast Cancer. Sci Rep 2019; 9:7715. [PMID: 31118443 PMCID: PMC6531485 DOI: 10.1038/s41598-019-44156-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 05/08/2019] [Indexed: 12/20/2022] Open
Abstract
One of the promising tools to evaluate collagen in the extracellular matrix is the second-harmonic generation microscopy (SHG). This approach may shed light on the biological behavior of cancers and their taxonomy, but has not yet been applied to characterize collagen fibers in cases diagnosed as invasive breast carcinoma (BC) of histological special types (IBC-ST). Tissue sections from 99 patients with IBC-ST and 21 of invasive breast carcinoma of no special type (IBC-NST) were submitted to evaluation of collagen parameters by SHG. Tissue microarray was performed to evaluate immunohistochemical-based molecular subtype. In intratumoral areas, fSHG and bSHG (forward-SHG and backward-SHG) collagen parameters achieved their lowest values in mucinous, papillary and medullary carcinomas, whereas the highest values were found in classic invasive lobular and tubular carcinomas. Unsupervised hierarchical cluster analysis and minimal spanning tree using intratumoral collagen parameters allowed the identification of three main groups of breast cancer: group A (classic invasive lobular and tubular carcinomas); group B (IBC-NST, metaplastic, invasive apocrine and micropapillary carcinomas); and group C (medullary, mucinous and papillary carcinomas). Our findings provide further characterization of the tumor microenvironment of IBC-ST. This understanding may add information to build more consistent tumor categorization and to refine prognostication.
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Affiliation(s)
- Rodrigo de Andrade Natal
- Laboratory of Investigative and Molecular Pathology, CIPED - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil.
| | - Geisilene R Paiva
- Laboratory of Specialized Pathology, LAPE - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil
| | - Vitor B Pelegati
- Department of Quantum Electronics -Institute of Physics "Gleb Wataghin" - State University of Campinas, Rua Sérgio Buarque de Holanda, 777, Zip code: 13083-859, Campinas, São Paulo, Brazil
| | - Ludwing Marenco
- Department of Quantum Electronics -Institute of Physics "Gleb Wataghin" - State University of Campinas, Rua Sérgio Buarque de Holanda, 777, Zip code: 13083-859, Campinas, São Paulo, Brazil
| | - César A Alvarenga
- Instituto de Patologia de Campinas (Private Laboratory), Av. Andrade Neves, 1801, Zip Code: 13070-000, Campinas, São Paulo, Brazil
| | - Renato F Vargas
- Laboratory of Specialized Pathology, LAPE - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil
| | - Sophie F Derchain
- Department of Obstetrics and Gynecology - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil
| | - Luis O Sarian
- Department of Obstetrics and Gynecology - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil
| | - Camille Franchet
- Department of Pathology, University Cancer Institute, Avenue Irene Joliot Curie, 1, Zip code: 31059, Toulousse, France
| | - Carlos L Cesar
- Department of Quantum Electronics -Institute of Physics "Gleb Wataghin" - State University of Campinas, Rua Sérgio Buarque de Holanda, 777, Zip code: 13083-859, Campinas, São Paulo, Brazil.,Department of Physics, Federal University of Ceará (UFC), Campus do Pici - Bloco 922 - Zip code: 60455-760, Fortaleza, Ceará, Brazil
| | - Fernando C Schmitt
- Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP) - Porto University, Rua Dr. Roberto Frias, s/n, Zip code: 4200-465, Porto, Portugal.,National Santé Laboratory, Department of Medicine - L-3555, Dudelange, Luxembourg
| | - Britta Weigelt
- Department of Pathology - Memorial Sloan Kettering Cancer Center, York Avenue 1275, Zip code: 10065, New York, USA
| | - José Vassallo
- Laboratory of Investigative and Molecular Pathology, CIPED - Faculty of Medical Sciences - State University of Campinas, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-970, Campinas, São Paulo, Brazil.
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