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Ianni JD, Soans RE, Sankarapandian S, Chamarthi RV, Ayyagari D, Olsen TG, Bonham MJ, Stavish CC, Motaparthi K, Cockerell CJ, Feeser TA, Lee JB. Tailored for Real-World: A Whole Slide Image Classification System Validated on Uncurated Multi-Site Data Emulating the Prospective Pathology Workload. Sci Rep 2020; 10:3217. [PMID: 32081956 PMCID: PMC7035316 DOI: 10.1038/s41598-020-59985-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/06/2020] [Indexed: 11/10/2022] Open
Abstract
Standard of care diagnostic procedure for suspected skin cancer is microscopic examination of hematoxylin & eosin stained tissue by a pathologist. Areas of high inter-pathologist discordance and rising biopsy rates necessitate higher efficiency and diagnostic reproducibility. We present and validate a deep learning system which classifies digitized dermatopathology slides into 4 categories. The system is developed using 5,070 images from a single lab, and tested on an uncurated set of 13,537 images from 3 test labs, using whole slide scanners manufactured by 3 different vendors. The system's use of deep-learning-based confidence scoring as a criterion to consider the result as accurate yields an accuracy of up to 98%, and makes it adoptable in a real-world setting. Without confidence scoring, the system achieved an accuracy of 78%. We anticipate that our deep learning system will serve as a foundation enabling faster diagnosis of skin cancer, identification of cases for specialist review, and targeted diagnostic classifications.
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Affiliation(s)
| | | | | | | | | | - Thomas G Olsen
- Department of Dermatology, Boonshoft School of Medicine, Wright State University School of Medicine, Dayton, Ohio, USA
- Dermatopathology Laboratory of Central States, Dayton, Ohio, USA
| | | | | | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | | | - Jason B Lee
- Departments of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Fowke JH, Motley SS. Statin use linked with a decrease in the conversion from high-grade prostatic intraepithelial neoplasia (HGPIN) to prostate cancer. Carcinogenesis 2019; 39:819-825. [PMID: 29617729 DOI: 10.1093/carcin/bgy050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/02/2018] [Indexed: 12/31/2022] Open
Abstract
The roles of obesity, metabolic dysregulation and systemic inflammation to advance prostate carcinogenesis are unclear. This study investigates metabolic and inflammatory factors in the transition from high-grade prostatic intraepithelial neoplasia (HGPIN) to prostate cancer (PC). We prospectively followed 160 men diagnosed with HGPIN at biopsy and therefore at high-risk and clinically monitored for PC. Analyses investigated body mass index (BMI), waist circumference, waist-hip ratio (WHR), height, fat mass, lean mass percent body fat, NSAIDs, statins, metformin, diabetes, hypertension, hypercholesterolemia representing metabolic dysregulation on the risk of a PC diagnosis during follow-up. Systemic inflammation was estimated through measurement of 13 plasma cytokine levels. Statin use was significantly linked with overall PC at follow-up [odds ratio (OR) = 0.45, (0.23, 0.91), P = 0.03], with a somewhat stronger link with high-grade [OR = 0.39, (0.15, 1.04), P = 0.06] PC compared with low-grade PC [OR = 0.50, (0.23, 1.12), P = 0.09]. Non-statin cholesterol-lowering medications, BMI, WHR, diabetes, hypertension and percent body fat were not significantly associated with PC. Although blood IL-12p70, IL-2 and IL-1β levels were significantly lower among statin users, inflammatory markers were not significantly linked with PC and did not explain the observed relationship between statins and lower PC risk. In summary, this prospective study of HGPIN patients at high risk for PC finds that statin use was significantly associated with reduced risk of PC detection at follow-up. Systemic markers of inflammation did not mediate this association, suggesting that statins affect PC progression through alternative pathways.
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Affiliation(s)
- Jay H Fowke
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of Epidemiology, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Saundra S Motley
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Tripathi SK, Kumar P, Trabulsi EJ, Kim S, McCue PA, Intenzo C, Berger A, Gomella L, Thakur ML. VPAC1 Targeted 64Cu-TP3805 kit preparation and its evaluation. Nucl Med Biol 2017; 51:55-61. [PMID: 28577428 DOI: 10.1016/j.nucmedbio.2017.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/26/2017] [Accepted: 04/27/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Previously, our laboratory has shown that 64Cu-TP3805 can specifically target VPAC1 receptors and be used for positron emission tomography (PET) imaging of breast (BC) and prostate cancer (PC) in humans. Present work is aimed at the formulation of a freeze-dried diaminedithiol-peptide (N2S2-TP3805) kit and it's evaluation for the preparation of 64Cu labeled TP3805. Parameters such as pH, temperature and incubation time were examined that influenced the radiolabeling efficiency and stability of the product. METHODS Kits were prepared under different conditions and radiolabeling efficiency of TP3805 kit was evaluated for a range of pH3.5-8.5, after addition of 64Cu in 30μl, 0.1M HCl. Incubation temperature (37-90°C) and time (30-120min.) were also investigated. Kits were stored at -10°C and their long term stability was determined as a function of their radiolabeling efficiency. Further, stability of 64Cu-TP3805 complex was evaluated in presence of fetal bovine serum and bovine serum albumin by using SDS polyacrylamide gel electrophoresis. Kits were then used for PET imaging of BC and PC following eIND (101550) and institutional approvals. Specificity of 64Cu-TP3805 for VPAC1 was examined with digital autoradiography (DAR) of prostate tissues obtained after prostatectomy, benign prostatic hyperplasia (BPH) tissue, and benign and malignant lymph nodes. Results were compared with corresponding tissue histology. RESULTS Radiolabeling efficiency was ≥95% at final pH ~7.2 when incubated at 50°C for 90min. Kits were stable up to 18months when stored at -10°C, and 64Cu-TP3805 complex exhibited excellent stability for up to 4h at room temperature. 64Cu-TP3805 complex did not show any transchelation even after 2h incubation at 37°C in 10% FBS as well as in BSA as determined by SDS PAGE analysis. DAR identified ≥95% of malignant lesions 11 new PC lesions, 20 high grade prostatic intraepithelial neoplasia, 2/2 ejaculatory ducts and 5/5 urethra verumontanum not previously identified The malignant lymph nodes were correctly identified by DAR and for 3/3 BPH patients, and 5/5 cysts, DAR was negative. In human BC (n=19) and PC (n=26) were imaged with 100% sensitivity. CONCLUSION Availability of ready to use N2S2-peptide kits for 64Cu labeling is convenient and eliminates possible day to day variation during its routine preparation for clinical use.
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Affiliation(s)
| | - Pardeep Kumar
- Thomas Jefferson University, Department of Radiology
| | | | - Sung Kim
- Thomas Jefferson University, Department of Radiology
| | - Peter A McCue
- Thomas Jefferson University, Department of Pathology
| | | | - Adam Berger
- Thomas Jefferson University, Department of Surgery
| | - Leonard Gomella
- Thomas Jefferson University, Department of Urology; The Sidney Kimmel Cancer Center
| | - Mathew L Thakur
- Thomas Jefferson University, Department of Radiology; The Sidney Kimmel Cancer Center.
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Abstract
Prostate cancer is a clinically heterogeneous disease, with some men having indolent disease that can safely be observed, while others have aggressive, lethal disease. Over the past decade, researchers have begun to unravel some of the genomic heterogeneity that contributes to these varying clinical phenotypes. Distinct molecular sub-classes of prostate cancer have been identified, and the uniqueness of these sub-classes has been leveraged to predict clinical outcomes, design novel biomarkers for prostate cancer diagnosis, and develop novel therapeutics. Recent work has also elucidated the temporal and spatial heterogeneity of prostate cancer, helping us understand disease pathogenesis, response to therapy, and progression. New genomic techniques have provided us with a window into the remarkable clinical and genomic heterogeneity of prostate cancer, and this new perspective will increasingly impact patient care.
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Affiliation(s)
- Jonathan Shoag
- Department of Urology, NewYork–Presbyterian Hospital, Weill Cornell Medical College, New York, USA
| | - Christopher E Barbieri
- Department of Urology, NewYork–Presbyterian Hospital, Weill Cornell Medical College, New York, USA
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medical College, New York, USA
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El-Maqsoud NMRA, Osman NAA, El-Hamid AMA, El-Bab TKF, Galal EM. GOLPH3 and YB-1 Are Novel Markers Correlating With Poor Prognosis in Prostate Cancer. World J Oncol 2015; 6:473-484. [PMID: 28983350 PMCID: PMC5624675 DOI: 10.14740/wjon952w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 02/06/2023] Open
Abstract
Background Prostate cancer is a common and aggressive cancer among men. Despite advances in the treatment, the mechanisms involved in progression are still unclear. New prognostic markers should be explored for better design of patient-specific therapeutic regimens. Methods This study was performed on 120 patients stratified as 76 with prostatic carcinoma, 12 with low-grade prostate intraepithelial lesion, 12 with high-grade prostate intraepithelial lesion and 20 with benign prostate hyperplasia. Immunohistochemical study was done for Golgi phosphoprotein 3 (GOLPH3) and Y-box binding protein-1 (YB-1) analysis. Correlation with clinicopathological data and overall survival was analyzed. Results Both GOLPH3 and YB-1 showed increased expression from benign to malignant tumors. In prostatic carcinoma, cytoplasmic GOLPH3 was associated with Gleason score, stage and androgen receptor (P = 0.034, P < 0.001, and P = 0.008 respectively). Nuclear YB-1 expression was associated with Gleason score and androgen receptor (P = 0.018 and P = 0.024 respectively). Cytoplasmic YB-1 expression was associated with Gleason score, stage and androgen receptor (P = 0.008, P = 0.027, and P < 0.001 respectively). High Gleason score (P = 0.004), high stage (P < 0.001) and androgen receptor (P = 0.006) were the only detected adverse prognostic clinicopathological factors. Moderate/intense GOLPH3 and high nuclear and cytoplasmic YB-1 expression were correlated with shorter overall survival (P < 0.001, P = 0.020, and P < 0.001 respectively). In the multivariate analysis, moderate/intense GOLPH3 expression was the only predictor of overall survival (P = 0.025). Conclusions High GOLPH3 and nuclear/cytoplasmic YB-1 expression correlated with poor prognosis in prostate cancer. Both markers can be promising targets for new treatment strategies.
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Matthew AG, Davidson T, Ochs S, Currie KL, Petrella A, Finelli A. Risk perception and psychological morbidity in men at elevated risk for prostate cancer. ACTA ACUST UNITED AC 2015; 22:e462-9. [PMID: 26715884 DOI: 10.3747/co.22.2679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE As prostate-specific antigen (psa) makes prostate cancer (pca) screening more accessible, more men are being identified with conditions that indicate high risk for developing pca, such as elevated psa and high-grade intraepithelial neoplasia (hgpin). In the present study, we assessed psychological well-being and risk perception in individuals with those high-risk conditions. METHODS A questionnaire consisting of a psychological symptom survey, a trait risk-aversion survey, and a cancer-specific risk perception survey was administered to 168 patients with early-stage localized pca and 69 patients at high risk for pca (n = 16 hgpin, n = 53 psa > 4 ng/mL). Analysis of variance was used to examine differences in psychological well-being and appraisal of risk between the groups. RESULTS Compared with the pca group, the high-risk group perceived their risk of dying from something other than pca to be significantly lower (p = 0.007). However, pca patients reported significantly more clinically important psychological symptoms. CONCLUSIONS The identification of prostate conditions that predict progression to cancer might not result in the psychological symptoms commonly experienced by pca patients, but does appear to be related to a distorted perception of the disease's mortal risk. Patients with pca experience reduced psychological well-being, but better understand the risks of pca recurrence and death. Education on the risks and outcomes of pca can help at-risk men to view health assessments with reduced worry.
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Affiliation(s)
- A G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - T Davidson
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - S Ochs
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - K L Currie
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - A Petrella
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - A Finelli
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON
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Abd El-Maqsoud NMR, Osman NAA, Abd El-Hamid AMA, Fath El-Bab TK, Galal EM. Golgi Phosphoprotein-3 and Y-Box-Binding Protein-1 Are Novel Markers Correlating With Poor Prognosis in Prostate Cancer. Clin Genitourin Cancer 2015; 14:e143-52. [PMID: 26794392 DOI: 10.1016/j.clgc.2015.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/13/2015] [Accepted: 12/16/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prostate cancer is a common and aggressive cancer among men. Despite advances in treatment, the mechanisms involved in progression are still unclear. New prognostic markers are needed to better design patient-specific therapeutic regimens. MATERIALS AND METHODS The present study included 120 patients: 76 with prostate carcinoma, 12 with low-grade prostate intraepithelial lesions, 12 with high-grade prostate intraepithelial lesions, and 20 with benign prostatic hyperplasia. Immunohistochemical study was performed for Golgi phosphoprotein-3 (GOLPH3) and Y-box-binding protein-1 (YB-1) analysis. The correlation with clinicopathologic data and overall survival was analyzed. RESULTS Both GOLPH3 and YB-1 showed increased expression from benign to malignant tumors. In prostate carcinoma, cytoplasmic GOLPH3 was associated with Gleason score, tumor stage, and androgen receptor status (P = .034, P < .001, and P = .008, respectively). Nuclear YB-1 expression was associated with Gleason score and androgen receptor status (P = .018 and P = .024, respectively). Cytoplasmic YB-1 expression was associated with Gleason score, tumor stage, and androgen receptor status (P = .008, P = .027, and P < .001, respectively). A high Gleason score (P = .004), high tumor stage (P < .001), and androgen receptor-independent cancer (P = .006) were the only detected adverse prognostic clinicopathologic factors. Moderate to intense GOLPH3 and high nuclear and cytoplasmic YB-1 expression correlated with shorter overall survival (P < .001, P = .020, and P < .001, respectively). On multivariate analysis, moderate to intense GOLPH3 expression was the only predictor of overall survival (P = .025). CONCLUSION High GOLPH3 and nuclear/cytoplasmic YB-1 expression correlated with a poor prognosis in patients with prostate cancer. Both markers could be promising targets for new treatment strategies.
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Affiliation(s)
| | - Nisreen A A Osman
- Department of Pathology, Faculty of Medicine, Minia University, Minia, Egypt
| | | | | | - Ehab M Galal
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
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Budd WT, Seashols-Williams SJ, Clark GC, Weaver D, Calvert V, Petricoin E, Dragoescu EA, O’Hanlon K, Zehner ZE. Dual Action of miR-125b As a Tumor Suppressor and OncomiR-22 Promotes Prostate Cancer Tumorigenesis. PLoS One 2015; 10:e0142373. [PMID: 26544868 PMCID: PMC4636224 DOI: 10.1371/journal.pone.0142373] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/21/2015] [Indexed: 12/21/2022] Open
Abstract
MicroRNAs (miRs) are a novel class of small RNA molecules, the dysregulation of which can contribute to cancer. A combinatorial approach was used to identify miRs that promote prostate cancer progression in a unique set of prostate cancer cell lines, which originate from the parental p69 cell line and extend to a highly tumorigenic/metastatic M12 subline. Together, these cell lines are thought to mimic prostate cancer progression in vivo. Previous network analysis and miR arrays suggested that the loss of hsa-miR-125b together with the overexpression of hsa-miR-22 could contribute to prostate tumorigenesis. The dysregulation of these two miRs was confirmed in human prostate tumor samples as compared to adjacent benign glandular epithelium collected through laser capture microdissection from radical prostatectomies. In fact, alterations in hsa-miR-125b expression appeared to be an early event in tumorigenesis. Reverse phase microarray proteomic analysis revealed ErbB2/3 and downstream members of the PI3K/AKT and MAPK/ERK pathways as well as PTEN to be protein targets differentially expressed in the M12 tumor cell compared to its parental p69 cell. Relevant luciferase+3’-UTR expression studies confirmed a direct interaction between hsa-miR-125b and ErbB2 and between hsa-miR-22 and PTEN. Restoration of hsa-miR-125b or inhibition of hsa-miR-22 expression via an antagomiR resulted in an alteration of M12 tumor cell behavior in vitro. Thus, the dual action of hsa-miR-125b as a tumor suppressor and hsa-miR-22 as an oncomiR contributed to prostate tumorigenesis by modulations in PI3K/AKT and MAPK/ERK signaling pathways, key pathways known to influence prostate cancer progression.
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Affiliation(s)
- William T. Budd
- Department of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Sarah J. Seashols-Williams
- Department of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Gene C. Clark
- Department of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Danielle Weaver
- Center for the Study of Biological Complexity, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Valerie Calvert
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, Virginia, United States of America
| | - Emanuel Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, Virginia, United States of America
| | - Ema A. Dragoescu
- Department of Pathology, VCU Medical Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Katherine O’Hanlon
- American International Biotechnology, Richmond, Virginia, United States of America
| | - Zendra E. Zehner
- Department of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
- * E-mail:
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