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Melissourgou-Syka L, Gillespie MA, O'Cathail SM, Sansom OJ, Steele CW, Roxburgh CSD. A Review of Scheduling Strategies for Radiotherapy and Immune Checkpoint Inhibition in Locally Advanced Rectal Cancer. JOURNAL OF IMMUNOTHERAPY AND PRECISION ONCOLOGY 2023; 6:187-197. [PMID: 38143952 PMCID: PMC10734391 DOI: 10.36401/jipo-23-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/07/2023] [Accepted: 07/15/2023] [Indexed: 12/26/2023]
Abstract
Colorectal cancer (CRC) is the third most common malignancy across the globe and, despite advances in treatment strategies, survival rates remain low. Rectal cancer (RC) accounts for most of these cases, and traditional management strategies for advanced disease include total neoadjuvant therapy (TNT) with chemoradiotherapy followed by curative surgery. Unfortunately, approximately 10-15% of patients have no response to treatment or have recurrence at a short interval following radiotherapy. The introduction of immunotherapy in the form of immune checkpoint blockade (ICB) in metastatic colorectal cancer has improved clinical outcomes, yet most patients with RC present with microsatellite stable disease, which lacks the immune-rich microenvironment where ICB is most effective. There is evidence that combining radiotherapy with ICB can unlock the mechanisms that drive resistance in patients; however, the sequencing of these therapies is still debated. This review offers a comprehensive overview of clinical trials and preclinical models that use radiotherapy-immunotherapy combinations in RC in an attempt to extrapolate the ideal sequencing of the two treatment modalities. The results highlight the dearth of evidence to answer the question of whether ICB should be given before, during, or after radiotherapy, yet it is suggested that improving the relevance of our preclinical models will provide a platform with higher translational value and will lead to appropriate clinical trial designs.
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Affiliation(s)
- Lydia Melissourgou-Syka
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland
- CRUK Beatson Institute, Glasgow, Scotland
| | | | - Sean M. O'Cathail
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland
- Beatson West of Scotland Cancer Centre, Glasgow, Scotland
| | - Owen J. Sansom
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland
- CRUK Beatson Institute, Glasgow, Scotland
| | - Colin W. Steele
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland
- CRUK Beatson Institute, Glasgow, Scotland
- Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, Scotland
| | - Campbell S. D. Roxburgh
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland
- Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, Scotland
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Toh JWT, Phan K, Reza F, Chapuis P, Spring KJ. Rate of dissemination and prognosis in early and advanced stage colorectal cancer based on microsatellite instability status: systematic review and meta-analysis. Int J Colorectal Dis 2021; 36:1573-1596. [PMID: 33604737 DOI: 10.1007/s00384-021-03874-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION For the past two decades, microsatellite instability (MSI) has been reported as a robust clinical biomarker associated with survival advantage attributed to its immunogenicity. However, MSI is also associated with high-risk adverse pathological features (poorly differentiated, mucinous, signet cell, higher grade) and exhibits a double-edged sword phenomenon. We performed a systematic review and meta-analysis to evaluate the rate of dissemination and the prognosis of early and advanced stage colorectal cancer based on MSI status. METHODS A systematic literature search of original studies was performed on Ovid searching MEDLINE, Embase, Cochrane Database of Systematic Reviews, American College of Physicians ACP Journal Club, Database of Abstracts of Reviews of Effects DARE, Clinical Trials databases from inception of database to June 2019. Colorectal cancer, microsatellite instability, genomic instability and DNA mismatch repair were used as key words or MeSH terms. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Data were pooled using a random-effects model with odds ratio (OR) as the effect size. Statistical analysis was performed using RevMan ver 5.3 Cochrane Collaboration. RESULTS From 5288 studies, 136 met the inclusion criteria (n = 92,035; MSI-H 11,746 (13%)). Overall, MSI-H was associated with improved OS (OR, 0.81; 95% CI 0.73-0.90), DFS (OR, 0.73; 95% CI 0.66-0.81) and DSS (OR, 0.69; 95% CI 0.52-0.90). Importantly, MSI-H had a protective effect against dissemination with a significantly lower rate of lymph node and distant metastases. By stage, the protective effect of MSI-H in terms of OS and DFS was observed clearly in stage II and stage III. Survival in stage I CRC was excellent irrespective of MSI status. In stage IV CRC, without immunotherapy, MSI-H was not associated with any survival benefit. CONCLUSIONS MSI-H CRC was associated with an overall survival benefit with a lower rate of dissemination. Survival benefit was clearly evident in both stage II and III CRC, but MSI-H was neither a robust prognostic marker in stage I nor stage IV CRC without immunotherapy.
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Affiliation(s)
- James W T Toh
- Department of Surgery, Division of Colorectal Surgery, Westmead Hospital, Sydney, NSW, Australia. .,Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. .,Discipline of Surgery, The University of New South Wales, Sydney, NSW, Australia. .,Medical Oncology, Ingham Institute for Applied Medical Research, School of Medicine Western Sydney University and South Western Clinical School, University of New South Wales, NSW, Sydney, Australia.
| | - Kevin Phan
- Department of Surgery, Division of Colorectal Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - Faizur Reza
- Department of Surgery, Division of Colorectal Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - Pierre Chapuis
- Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Kevin J Spring
- Medical Oncology, Ingham Institute for Applied Medical Research, School of Medicine Western Sydney University and South Western Clinical School, University of New South Wales, NSW, Sydney, Australia
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Zeng Z, Yan Q, Chen G, Zhang X, Huang J, Fu K, Peng X, Xiao S. Characteristics of colorectal carcinoma patients with PMS2 defects detected by immunohistochemistry. Eur J Cancer Prev 2021; 30:251-257. [PMID: 32826709 PMCID: PMC8011511 DOI: 10.1097/cej.0000000000000620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022]
Abstract
Lynch syndrome is the most prevalent form of familial colorectal cancer (CRC) and is caused by pathogenic germline mismatch repair (MMR) gene mutations. MLH1, MSH2 and MSH6 mutations have been well studied, but the rate and characteristics of PMS2 mutations are rare, especially in China. This study enrolled 1706 unselected patients with CRC who underwent colorectal resection from June 2016 to November 2018, the MMR status and clinicopathological features were analysed. A total of 11.8% of patients with CRC had defects in at least one MMR-related protein. Among them, 8.3% were identified with PMS2 defects, and 3.1% of patients had isolated PMS2 defects. Compared with MMR-proficient CRC, PMS2-defect CRC occurred more frequently in the right colon and less frequently in the rectum, had more poorly differentiated and mucinous carcinoma cases, and had fewer perineural invasions and a lower pN stage but a more advanced pT stage and a larger tumour size. In the cases with PMS2 defect, there were fewer tumours in the right colon, fewer poorly differentiated cases and smaller tumour sizes than in the cases with both MLH1 and PMS2 defects. In addition, in cases with isolated PMS2 defects, there were more tumours in the right colon and, more mucinous carcinoma cases than in cases with MMR-proficient CRCs, but had a similar cancer onset age. This study identified the rate, clinicopathological and age characteristics of PMS2 defects in CRCs in China and highlighted the importance of universal screening and germline detection of PMS2 in CRC.
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Affiliation(s)
| | - Qijia Yan
- Department of Pathology, Xiangya Hospital, Central South University, Changsha
| | | | | | - Jia Huang
- Institute of Clinical Medicine, the First Affiliated Hospital, University of South China, Hengyang
| | - Kai Fu
- Hunan Key Laboratory of Molecular Precision Medicine, Institute of Molecular Precision Medicine and Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
| | | | - Shuai Xiao
- Department of Surgery
- Institute of Clinical Medicine, the First Affiliated Hospital, University of South China, Hengyang
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Bhattarai M, Wan Juhari WK, Lama R, Pun CB, Yusof W, Wan Abdul Rahman WF, Zakaria AD, Ahmad Amin Noordin KB, R. Shrestha T, Zilfalil BA. MLH1 and MSH2 mismatch repair protein profile using immunohistochemistry in Nepalese colorectal cancer patients. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.oa.203633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Hereditary nonpolyposis colorectal cancer, or Lynch syndrome, caused by germline mutations or genetic defects in mismatch repair (MMR) genes (MLH1, MSH2, PMS2, MSH6, and epithelial cellular adhesion molecule), is an autosomal dominant condition accounting for 2–5% of all colorectal carcinomas (CRCs). Reports on MMR loss in many populations are available; however, there are no reports on the frequency of MMR protein expression in Nepalese cohorts. Therefore, this study was aimed to assess the expression profiles of MLH1 and MSH2 protein by immunohistochemistry (IHC) in Nepalese CRC patients.
METHODS This retrospective study used archived formalin-fixed paraffin-embedded tissue blocks from 43 Nepalese CRC patients. IHC staining was performed using MLH1 and MSH2 antibodies. IHC scoring analysis was assessed using semiquantitative scoring.
RESULTS Of the 43 CRC patients, 8 (18.6%) showed loss of staining for MLH1 antibody, 5 (11.6%) showed loss of staining for MSH2 antibody, and 4 (9.3%) showed loss of staining for both MLH1 and MSH2 antibodies.
CONCLUSIONS IHC is a potential screening method of determining the MMR expression profile of Nepalese CRC patients. IHC can be performed in local clinical laboratories to find MMR protein defects in selected cases prior to expensive molecular tests.
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Toh JWT, Lim SH, MacKenzie S, de Souza P, Bokey L, Chapuis P, Spring KJ. Association Between Microsatellite Instability Status and Peri-Operative Release of Circulating Tumour Cells in Colorectal Cancer. Cells 2020; 9:cells9020425. [PMID: 32059485 PMCID: PMC7072224 DOI: 10.3390/cells9020425] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 12/21/2022] Open
Abstract
Microsatellite instability (MSI) in colorectal cancer (CRC) is a marker of immunogenicity and is associated with an increased abundance of tumour infiltrating lymphocytes (TILs). In this subgroup of colorectal cancer, it is unknown if these characteristics translate into a measurable difference in circulating tumour cell (CTC) release into peripheral circulation. This is the first study to compare MSI status with the prevalence of circulating CTCs in the peri-operative colorectal surgery setting. For this purpose, 20 patients who underwent CRC surgery with curative intent were enrolled in the study, and peripheral venous blood was collected at pre- (t1), intra- (t2), immediately post-operative (t3), and 14–16 h post-operative (t4) time points. Of these, one patient was excluded due to insufficient blood sample. CTCs were isolated from 19 patients using the IsofluxTM system, and the data were analysed using the STATA statistical package. CTC number was presented as the mean values, and comparisons were made using the Student t-test. There was a trend toward increased CTC presence in the MSI-high (H) CRC group, but this was not statistically significant. In addition, a Poisson regression was performed adjusting for stage (I-IV). This demonstrated no significant difference between the two MSI groups for pre-operative time point t1. However, time points t2, t3, and t4 were associated with increased CTC presence for MSI-H CRCs. In conclusion, there was a trend toward increased CTC release pre-, intra-, and post-operatively in MSI-H CRCs, but this was only statistically significant intra-operatively. When adjusting for stage, MSI-H was associated with an increase in CTC numbers intra-operatively and post-operatively, but not pre-operatively.
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Affiliation(s)
- James W. T. Toh
- Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney 2145, Australia
- Department of Colorectal Surgery, Concord Hospital and Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney 2137, Australia
- Correspondence: (J.W.T.T.); (K.J.S.); Tel.: +61-2-8738-9032 (K.J.S.)
| | - Stephanie H. Lim
- Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia
| | - Scott MacKenzie
- Liverpool Clinical School, Western Sydney University, Sydney 2170, Australia
| | - Paul de Souza
- Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia
- Liverpool Clinical School, Western Sydney University, Sydney 2170, Australia
| | - Les Bokey
- Liverpool Clinical School, Western Sydney University, Sydney 2170, Australia
| | - Pierre Chapuis
- Department of Colorectal Surgery, Concord Hospital and Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney 2137, Australia
| | - Kevin J. Spring
- Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia
- Liverpool Clinical School, Western Sydney University, Sydney 2170, Australia
- Correspondence: (J.W.T.T.); (K.J.S.); Tel.: +61-2-8738-9032 (K.J.S.)
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Yin X, Yang J, Liu Y, Zhang J, Xin C, Zhao H, Wang W, Shi X, Cui Z, Li G, Zhao C, Liu X. Altered expression of leptin and leptin receptor in the development of immune-mediated aplastic anemia in mice. Exp Ther Med 2019; 18:1047-1056. [PMID: 31316601 PMCID: PMC6601404 DOI: 10.3892/etm.2019.7660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 04/12/2019] [Indexed: 12/24/2022] Open
Abstract
The current study aimed to explore the levels of leptin (LEP) and LEP receptor (LEP-R) on the progression of aplastic anemia (AA) with bone marrow fat conversion. An AA model was developed by infusing C57BL/6 lymph node cells into BALB/c mice. At 0, 3, 6, 9, 12, 15 and 18 days after modeling, routine blood counts, bone marrow biopsy slides, lymphocyte subsets (CD4+ and CD8+ T cells) and cytokine levels [including interleukin (IL)-2, IL-4, IL-5 and interferon-γ] were assessed. LEP and LEP-R levels in peripheral blood serum, mesenchymal stem cells (MSCs) and bone marrow were also analyzed by enzyme-linked immunosorbent assay, polymerase chain reaction and immunohistochemistry. The relevance of LEP, LEP-R and other factors was analyzed by Pearson's correlation analysis. Peripheral pancytopenia (reduced count of white blood cells, red blood cells, hemoglobin and platelets), abnormal immune factor levels and histological changes in bone marrow sections were detected in the AA model mice, suggesting that these mice mimicked the pathological changes commonly observed in AA. In addition, following the establishment of AA, the LEP level was gradually increased and the LEP-R level was reduced in the mice over time (P<0.05). The expression of adipogenic genes, including CCAAT/enhancer-binding protein (C/EBP)α, C/EBPβ and peroxisome proliferator-activated receptor γ, was markedly increased, while the expression of the osteogenic gene runt-related transcription factor 2 was reduced compared with the levels in the control group (P<0.05). Taken together, damage to LEP-R may lead to dysregulation of LEP and the enhancement of MSCs to differentiate into adipocytes, resulting in excessive fat in bone marrow of AA patients.
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Affiliation(s)
- Xiangcong Yin
- Hematology Diagnosis Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Jie Yang
- Hematology Diagnosis Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Yuhua Liu
- Department of Medicine, Qingzhou Traditional Chinese Medicine Hospital, Weifang, Shandong 262500, P.R. China
| | - Jian Zhang
- Department of Hematology, Rizhao People's Hospital, Rizhao, Shandong 276800, P.R. China
| | - Chunlei Xin
- Department of Hematology, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Hongguo Zhao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wei Wang
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xue Shi
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Zhongguang Cui
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Guanglun Li
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Chunting Zhao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xiaodan Liu
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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Hou JT, Zhao LN, Zhang DJ, Lv DY, He WL, Chen B, Li HB, Li PR, Chen LZ, Chen XL. Prognostic Value of Mismatch Repair Genes for Patients With Colorectal Cancer: Meta-Analysis. Technol Cancer Res Treat 2019; 17:1533033818808507. [PMID: 30411662 PMCID: PMC6259062 DOI: 10.1177/1533033818808507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
DNA mismatch repair was proposed to play a pivotal role in the development and prognosis of colorectal cancer. However, the prognostic value of mismatch repair on colorectal cancer is still unknown. The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched. The articles about mismatch repair (including hMLH1, hMSH2, hMSH3, hMSH6, hPMSH1, and hPMSH2) deficiency for the prognosis of patients with colorectal cancer were included in the study. The hazard ratio and its 95% confidence interval were used to measure the impact of mismatch repair deficiency on survival time. Twenty-one articles were included. The combined hazard ratio for mismatch repair deficiency on overall survival was 0.59 (95% confidence interval: 0.50-0.69) and that on disease-free survival was 0.57 (95% confidence interval: 0.43-0.75). In subgroup analysis, there were a significant association between overall survival and mismatch repair deficiency in Asian studies (hazard ratio: 0.67; 95% confidence interval: 0.50-0.91) and Western studies (hazard ratio: 0.56; 95% confidence interval: 0.46-0.67). For disease-free survival, the hazard ratios in Asian studies and Western studies were 0.55 (95% confidence interval: 0.38-0.81) and 0.62 (95% confidence interval: 0.50-0.78), respectively. Our meta-analysis indicated that mismatch repair could be used to evaluate the prognosis of patients with colorectal cancer.
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Affiliation(s)
- Jiang-Tao Hou
- 1 The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li-Na Zhao
- 1 The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ding-Jun Zhang
- 2 The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dong-Yong Lv
- 3 Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Ling He
- 4 The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Chen
- 1 The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui-Biao Li
- 1 The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pei-Ru Li
- 2 The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li-Zhen Chen
- 5 School of Nursing Science, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin-Lin Chen
- 6 School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
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Reis H, Krafft U, Niedworok C, Módos O, Herold T, Behrendt M, Al-Ahmadie H, Hadaschik B, Nyirady P, Szarvas T. Biomarkers in Urachal Cancer and Adenocarcinomas in the Bladder: A Comprehensive Review Supplemented by Own Data. DISEASE MARKERS 2018; 2018:7308168. [PMID: 29721106 PMCID: PMC5867586 DOI: 10.1155/2018/7308168] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/06/2018] [Indexed: 12/11/2022]
Abstract
Urachal cancer (UrC) is a rare but aggressive cancer. Due to overlapping histomorphology, discrimination of urachal from primary bladder adenocarcinomas (PBAC) and adenocarcinomas secondarily involving the bladder (particularly colorectal adenocarcinomas, CRC) can be challenging. Therefore, we aimed to give an overview of helpful (immunohistochemical) biomarkers and clinicopathological factors in addition to survival analyses and included institutional data from 12 urachal adenocarcinomas. A PubMed search yielded 319 suitable studies since 1930 in the English literature with 1984 cases of UrC including 1834 adenocarcinomas (92%) and 150 nonadenocarcinomas (8%). UrC was more common in men (63%), showed a median age at diagnosis of 50.8 years and a median tumor size of 6.0 cm. No associations were noted for overall survival and progression-free survival (PFS) and clinicopathological factors beside a favorable PFS in male patients (p = 0.047). The immunohistochemical markers found to be potentially helpful in the differential diagnostic situation are AMACR and CK34βE12 (UrC versus CRC and PBAC), CK7, β-Catenin and CD15 (UrC and PBAC versus CRC), and CEA and GATA3 (UrC and CRC versus PBAC). Serum markers like CEA, CA19-9 and CA125 might additionally be useful in the follow-up and monitoring of UrC.
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Affiliation(s)
- Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Ulrich Krafft
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Christian Niedworok
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
| | - Thomas Herold
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Mark Behrendt
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, Netherlands
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
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Toh JWT, de Souza P, Lim SH, Singh P, Chua W, Ng W, Spring KJ. The Potential Value of Immunotherapy in Colorectal Cancers: Review of the Evidence for Programmed Death-1 Inhibitor Therapy. Clin Colorectal Cancer 2016; 15:285-291. [PMID: 27553906 DOI: 10.1016/j.clcc.2016.07.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 07/09/2016] [Accepted: 07/12/2016] [Indexed: 12/17/2022]
Abstract
Colorectal cancers (CRCs) have been identified as potential targets for immunotherapy with programmed cell death (PD)-1 inhibitors. English-language publications from MedLine and Embase that evaluated PD-1/PD ligand 1 (PD-L1) in the CRC tumor microenvironment and clinical trials that assessed PD-1 inhibitors were included. Sixteen abstracts were screened. Fifteen met the inclusion criteria. After review of the full texts, this resulted in a final reference list of 8 studies eligible for review. Five studies that assessed PD-1/PD-L1 in CRC and 3 trials that assessed PD-1 inhibitors were included. PD-1-positive (PD-1+) tumor-infiltrating lymphocytes and PD-L1+ cancer cells featured more prominently in high-level microsatellite instability (MSI-H) CRCs compared with microsatellite stable (MSS) CRCs, except in 1 study in which PD-L1 expression was higher in MSS CRCs. In the 3 trials that assessed PD-1 inhibitor, all 3 studies recruited patients with metastatic CRC (mCRC). One study also included patients with recurrent CRC. The objective response according to the Response Evaluation Criteria in Solid Tumors criteria was 0% (19 CRC patients with unknown microsatellite instability status) in the nivolumab study. In the pembrolizumab study, the objective response to PD-1 inhibitor was 40% and 0% in patients with MSI-H and MSS mCRC, respectively (10 patients in the MSI-H group, 18 patients in the MSS group). Seventy-eight percent of the patients in the MSI-H mCRC group compared with 11% in the MSS mCRC group (P < .005) showed no further disease progression at 12 weeks. In the nivolumab with or without ipilimumab study, objective partial response at 12 weeks to PD-1 inhibitor with or without cytotoxic T-lymphocyte-associated protein 4 inhibitor was 25.5% to 33.3% and 5% in the MSI-H and MSS groups, respectively (100 patients in the MSI-H group, 20 patients in the MSS group). Clinical trials that assessed PD-1 inhibitor immunotherapy in patients with CRC have recruited only small cohorts of patients with mCRC. Studies on the tumor microenvironment have been on the basis of archival specimens with different antibody PD-1 and PD-L1 preparations for immunohistochemistry, independent from immunotherapy trials. Immunotherapy with PD-1 therapy has potential benefit for immunogenic MSI-H CRCs whereas there is no evidence to date to suggest immunotherapy benefit in MSS CRCs. The available data are limited, and there is no information on non-mCRCs. Future trials are under way to determine its benefits.
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Affiliation(s)
- James W T Toh
- Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; Liverpool Clinical School, Western Sydney University, Liverpool, New South Wales, Australia; South West Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, New South Wales, Australia; Discipline of Surgery, Sydney Medical School, The University of Sydney, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia; Department of Colorectal Surgery, Westmead Hospital, Westmead, New South Wales, Australia.
| | - Paul de Souza
- Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; Liverpool Clinical School, Western Sydney University, Liverpool, New South Wales, Australia; South West Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia; Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Stephanie H Lim
- Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; South West Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia
| | - Puneet Singh
- Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia
| | - Wei Chua
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia; Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Weng Ng
- Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia; Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Kevin J Spring
- Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; Liverpool Clinical School, Western Sydney University, Liverpool, New South Wales, Australia; South West Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, New South Wales, Australia
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10
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Tarantino I, Hüttner FJ, Warschkow R, Schmied BM, Diener MK, Ulrich A. Prognostic Relevance of Mucinous Subtype in a Population-based Propensity Score Analysis of 40,083 Rectal Cancer Patients. Ann Surg Oncol 2015; 23:1576-86. [PMID: 26714956 DOI: 10.1245/s10434-015-5029-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prognostic relevance of mucinous histology in colorectal cancer remains unclear, especially for rectal neoplasms. The objective of this study was to evaluate if mucinous subtype has a relevant impact on overall survival (OS) and cancer-specific survival (CSS) of patients with adenocarcinomas of the rectum. METHODS On the basis of the data set of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute of the United States, patients with rectal cancer between 2004 and 2011 were identified. Risk-adjusted Cox regression analysis and propensity score methods were used to assess OS and CSS. RESULTS In total, 40,083 patients with stage I-IV rectal cancer, of whom 2483 (6.2 %) had mucinous histology, were included in this study. In unadjusted analysis, the 5-year OS and CSS for patients with a mucinous adenocarcinoma was 54.3 % [95 % confidence interval (CI) 52.0-56.7] and 61.4 % (95 % CI 59.1-63.9) compared to 66.4 % (95 % CI 65.8-67.0) and 74.5 % (95 % CI 73.9-75.1) for patients with nonmucinous adenocarcinoma (P < 0.001). The survival disadvantage persisting in risk-adjusted Cox proportional hazard regression analysis [hazard ratio (HR) 1.23, 95 % CI 1.15-1.31, P < 0.001 and 1.25, 95 % CI 1.16-1.35, P < 0.001) disappeared after propensity score matching (OS: HR = 0.96, 95 % CI 0.76-1.21, P = 0.722; CSS: HR 1.06, 95 % CI 0.80-1.40, P = 0.693). CONCLUSIONS This population-based, propensity score matched analysis shows that mucinous histology itself does not constrain survival in rectal cancer patients. Therefore, treatment decisions should not be different according to mucinous histology.
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Affiliation(s)
- Ignazio Tarantino
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Felix J Hüttner
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.,Study Center of the German Surgical Society, University of Heidelberg, Heidelberg, Germany
| | - Rene Warschkow
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Bruno M Schmied
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Markus K Diener
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.,Study Center of the German Surgical Society, University of Heidelberg, Heidelberg, Germany
| | - Alexis Ulrich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
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11
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Cong L, Xia YP, Zhao GQ, Lin J, Xu Q, Hu LT, Qu JQ, Peng XD. Expression of vitamin D receptor and cathelicidin in human corneal epithelium cells during fusarium solani infection. Int J Ophthalmol 2015; 8:866-71. [PMID: 26558193 DOI: 10.3980/j.issn.2222-3959.2015.05.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 03/10/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To observe the expression of vitamin D receptor (VDR) in human specimen and immortalized human corneal epithelium cells (HCEC) when challenged with fusarium solani. Moreover, we decided to discover the pathway of VDR expression. Also, we would like to detect the expression of cathelicidin antimicrobial peptide (CAMP) in the downstream pathway of VDR. METHODS Immunohistochemistry was used to examine the VDR expression in HCEC from healthy and fungal keratitis patients. Real time quantitative polymerase chain reaction (qPCR) was performed to observe the messenger ribonucleic acid (mRNA) change of VDR when immortalized HCEC were challenged with fusarium solani for different hours. CAMP was detected at both mRNA and protein levels. RESULTS We found out that the VDR expression in fusarium solani keratitis patients' specimen was much more than that in healthy people. The mRNA and protein expression of VDR increased when we stimulated HCEC with fusarium solani antigen (P<0.01) and it could be inhibited by toll like receptor 2 (TLR2) monoclonal antibody. The CAMP expression was decreased because of fusarium solani antigen stimulation (P<0.01). CONCLUSION The VDR expression can be increased via TLR2/1-VDR pathway while the CAMP expression is decreased by the stimulation of fusarium solani antigen.
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Affiliation(s)
- Lin Cong
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Yi-Ping Xia
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Gui-Qiu Zhao
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Jing Lin
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Qiang Xu
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Li-Ting Hu
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Jian-Qiu Qu
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Xu-Dong Peng
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
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