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Trimboli P, Crescenzi A. Diagnosing medullary thyroid carcinoma is facilitated by measuring calcitonin in FNA washout fluids: Alea iacta est. Cancer Cytopathol 2024; 132:139. [PMID: 38324164 DOI: 10.1002/cncy.22797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
The prognosis for patients diagnosed with medullary thyroid carcinoma (MTC) varies significantly with the timing of detection: the earlier the diagnosis, the higher the likelihood of achieving a complete cure (or at least a better outcome). Ogmen et al. show that the routine measurement of calcitonin in serum could lead to an earlier MTC diagnosis.
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Affiliation(s)
- Pierpaolo Trimboli
- Servizio di Endocrinologia e Diabetologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Anna Crescenzi
- Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo Patologiche, Facoltà di Medicina e Odontoiatria, Università Sapienza, Rome, Italy
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De Leo S, D'Elia S, Grani G, Dondi F, Bertagna F, Puxeddu E, Morelli S, Piovesan A, Nervo A, Zatelli MC, Gagliardi I, Samà MT, Aimaretti G, Crocetti U, Massa M, Deandrea M, Retta F, Pagano L, Rossi M, Solaroli E, Pezzullo L, Chiofalo MG, Pontecorvi A, Lombardi CP, Antonelli A, Patrizio A, Messuti I, Magri F, Spiazzi G, Ceresini G, Bruno R, Sparano C, Centanni M, Crescenzi A, Tallini G, Marotta V, Madeo B, Mian C, Filetti S, Durante C, Fugazzola L. A Prospective Multicenter Study Examining the Relationship Between Thyroid Cancer Treatment Outcomes and the Presence of Autoimmune Thyroiditis. Thyroid 2023; 33:1318-1326. [PMID: 37725571 DOI: 10.1089/thy.2023.0052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Background: There is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data. Methods: We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339). We divided the groups according to the presence (AT) or absence (no autoimmune thyroiditis [noAT]) of associated AT. We used propensity score matching to compare the clinical features and outcomes between the two groups at 1-year follow-up. Results: We included data from 4233 DTC patients, including 3172 (75%) females. The American Thyroid Association (ATA) risk levels were as follows: 51% (2160/4233) low risk, 41.3% (1750/4233) intermediate risk, and 7.6% (323/4233) high risk. There were 1552 patients (36.7%) who had AT. Before propensity score matching, AT patients were significantly younger and had a smaller and bilateral tumor (p < 0.0001). Patients with AT more frequently fell into the low- and intermediate-risk categories, while the ATA high risk was more frequent among noAT patients (p = 0.004). After propensity score matching, patients with AT more frequently showed evidence of disease (structural/biochemical incomplete response) versus excellent/indeterminate response, compared with patients without AT (7.3% vs. 4.5%, p = 0.001), with an odds ratio of 1.86 ([confidence interval: 1.3-2.6], p = 0.0001). However, when considering only structural persistence as the outcome, no statistically significant differences were observed between patients with or without AT (3.4% vs. 2.7%, p = 0.35). The elevated risk associated with the ATA intermediate and high risk at diagnosis remained consistently statistically significant. Conclusions: In this large prospective series, biochemical persistence was more frequent, at 1-year follow-up, in AT patients. However, there was no significant association between the presence of AT and structural persistence of disease. These findings may be explained by the presence of a residual thyroid tissue.
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Affiliation(s)
- Simone De Leo
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Silvia D'Elia
- Department of Statistical Sciences and Sapienza University of Rome, Rome, Italy
| | - Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Dondi
- Nuclear Medicine Department, University of Brescia and ASST-Spedali Civili, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine Department, University of Brescia and ASST-Spedali Civili, Brescia, Italy
| | - Efisio Puxeddu
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Silvia Morelli
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alessandro Piovesan
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Alice Nervo
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maria Chiara Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Irene Gagliardi
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Teresa Samà
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Maggiore della Carità University Hospital, Novara, Italy
| | - Gianluca Aimaretti
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Maggiore della Carità University Hospital, Novara, Italy
| | - Umberto Crocetti
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Michela Massa
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maurilio Deandrea
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, Torino, Italy
| | - Francesca Retta
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, Torino, Italy
| | - Loredana Pagano
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Mattia Rossi
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Erica Solaroli
- Unit of Endocrinology, Department of Medicine, AUSL Bologna, Bologna, Italy
| | - Luciano Pezzullo
- Thyroid Oncological Surgery Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Maria Grazia Chiofalo
- Thyroid Oncological Surgery Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Alfredo Pontecorvi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Celestino Pio Lombardi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Division of Endocrine Surgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Armando Patrizio
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Ilaria Messuti
- Department of Endocrinology and Andrology, Humanitas Gradenigo, Turin, Italy
| | - Flavia Magri
- Unit of Internal Medicine and Endocrinology, Department of Internal Medicine and Therapeutics, University of Pavia and Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Giovanna Spiazzi
- Endocrinology and Diabetology Unit, Department of Medicine, Azienda Ospedaliera-Universitaria di Verona, Verona, Italy
| | - Graziano Ceresini
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Rocco Bruno
- Endocrine Unit, Tinchi Hospital-ASM, Matera, Italy
| | - Clotilde Sparano
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- UOC Endocrinologia, AUSL Latina, Latina, Italy
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Giovanni Tallini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Vincenzo Marotta
- UOC Clinica Endocrinologica e Diabetologica, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Bruno Madeo
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Policlinico di Modena, Ospedale Civile di Baggiovara, Modena, Italy
| | - Caterina Mian
- Unit of Endocrinology, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | | | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Fugazzola
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Bellantuono L, Tommasi R, Pantaleo E, Verri M, Amoroso N, Crucitti P, Di Gioacchino M, Longo F, Monaco A, Naciu AM, Palermo A, Taffon C, Tangaro S, Crescenzi A, Sodo A, Bellotti R. An eXplainable Artificial Intelligence analysis of Raman spectra for thyroid cancer diagnosis. Sci Rep 2023; 13:16590. [PMID: 37789191 PMCID: PMC10547772 DOI: 10.1038/s41598-023-43856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
Raman spectroscopy shows great potential as a diagnostic tool for thyroid cancer due to its ability to detect biochemical changes during cancer development. This technique is particularly valuable because it is non-invasive and label/dye-free. Compared to molecular tests, Raman spectroscopy analyses can more effectively discriminate malignant features, thus reducing unnecessary surgeries. However, one major hurdle to using Raman spectroscopy as a diagnostic tool is the identification of significant patterns and peaks. In this study, we propose a Machine Learning procedure to discriminate healthy/benign versus malignant nodules that produces interpretable results. We collect Raman spectra obtained from histological samples, select a set of peaks with a data-driven and label independent approach and train the algorithms with the relative prominence of the peaks in the selected set. The performance of the considered models, quantified by area under the Receiver Operating Characteristic curve, exceeds 0.9. To enhance the interpretability of the results, we employ eXplainable Artificial Intelligence and compute the contribution of each feature to the prediction of each sample.
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Affiliation(s)
- Loredana Bellantuono
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
| | - Raffaele Tommasi
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
| | - Ester Pantaleo
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Martina Verri
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
- Dipartimento di Scienze, Università degli Studi Roma Tre, 00146, Roma, Italy
| | - Nicola Amoroso
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | | | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Alfonso Monaco
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Chiara Taffon
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Sabina Tangaro
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Armida Sodo
- Dipartimento di Scienze, Università degli Studi Roma Tre, 00146, Roma, Italy
| | - Roberto Bellotti
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
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4
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Verri M, Scarpino S, Naciu AM, Lopez G, Tabacco G, Taffon C, Pilozzi E, Palermo A, Crescenzi A. Real-Time Evaluation of Thyroid Cytology Using New Digital Microscopy Allows for Sample Adequacy Assessment, Morphological Classification, and Supports Molecular Analysis. Cancers (Basel) 2023; 15:4215. [PMID: 37686491 PMCID: PMC10486817 DOI: 10.3390/cancers15174215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Thyroid cytological examination, a key tool in preoperative thyroid nodule evaluation, is specific and accurate; some drawbacks are due to inadequate or indeterminate cytological reports and there is a need for an innovative approach overcoming the limits of traditional cytological diagnostics. Fluorescence laser confocal microscopes (FCM) is a new optical technique for allowing immediate digital imaging of fresh unfixed tissues and real-time assessment of sample adequacy and diagnostic evaluation for small biopsies and cytological samples. Currently, there are no data about the use of FCMs in the field of thyroid nodular pathology. The aims of this study were to test FCM technology for evaluating the adequacy of FNA samples at the time of the procedure and to assess the level of concordance between FCM cytological evaluations, paired conventional cytology, and final surgical histology. The secondary aim was to define the integrity of nucleic acids after FCM evaluation through NGS molecular analysis. Sample adequacy was correctly stated. Comparing FCM evaluation with the final histology, all cases resulting in malignant or suspicious for malignancy at FCM, were confirmed to be carcinomas (PPV 100%). In conclusion, we describe a successful application of FCM in thyroid preoperative cytological evaluation, with advantages in immediate adequacy assessment and diagnostic information, while preserving cellular specimens for permanent morphology and molecular analysis, thus improving timely and accurate patient management.
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Affiliation(s)
- Martina Verri
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (C.T.); (A.C.)
| | - Stefania Scarpino
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University, Sant’Andrea University Hospital, 00189 Rome, Italy; (S.S.); (G.L.); (E.P.)
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (G.T.); (A.P.)
| | - Gianluca Lopez
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University, Sant’Andrea University Hospital, 00189 Rome, Italy; (S.S.); (G.L.); (E.P.)
| | - Gaia Tabacco
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (G.T.); (A.P.)
| | - Chiara Taffon
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (C.T.); (A.C.)
| | - Emanuela Pilozzi
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University, Sant’Andrea University Hospital, 00189 Rome, Italy; (S.S.); (G.L.); (E.P.)
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (G.T.); (A.P.)
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (C.T.); (A.C.)
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De Benedetto L, Moffa A, Baptista P, Di Giovanni S, Giorgi L, Verri M, Taffon C, Crescenzi A, Casale M. Potential Use of Vivascope for Real-Time Histological Evaluation in Endoscopic Laryngeal Surgery. J Pers Med 2023; 13:1252. [PMID: 37623502 PMCID: PMC10455566 DOI: 10.3390/jpm13081252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
We aimed to assess the feasibility of using confocal laser scanning microscopy (CLSM) for the real-time ex vivo examination of histological samples of laryngeal lesions and to evaluate the correlation between CLSM and definitive histological results. This preliminary study included eight consecutive patients with "suspected" laryngeal lesions who were candidates for endoscopic laryngeal surgery. The obtained samples were evaluated using CLSM and classified as "inadequate" or "adequate" (high- and low-grade dysplasia, in situ and invasive carcinoma, positive surgical margin, and inflammatory outbreaks). CLSM showed the macro image in all cases and generated a digital version. All the samples were defined as adequate during CLSM and confirmed at histopathology: low-grade dysplasia (n = 5), low- and high-grade dysplasia (n = 2), and high-grade dysplasia (n = 1). Four samples had an involved resection margin, and three samples revealed the presence of inflammatory outbreaks. CLSM can be applied to larynx pathology with excellent agreement with final histological results.
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Affiliation(s)
- Luigi De Benedetto
- Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Rome, Italy (M.C.)
| | - Antonio Moffa
- Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Rome, Italy (M.C.)
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Peter Baptista
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
- ENT Department, Al Zahra Private Hospital Dubai, Dubai 23614, United Arab Emirates
| | - Simone Di Giovanni
- Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Rome, Italy (M.C.)
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Lucrezia Giorgi
- Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Rome, Italy (M.C.)
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Martina Verri
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Chiara Taffon
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Manuele Casale
- Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Rome, Italy (M.C.)
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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Stigliano S, Crescenzi A, Marocchi G, Taffon C, Verri M, Di Matteo FM. A new tool for rapid evaluation of endoscopic ultrasound through the needle biopsy in pancreatic cystic neoplasm. Dig Liver Dis 2023; 55:1161-1163. [PMID: 37277287 DOI: 10.1016/j.dld.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 06/07/2023]
Affiliation(s)
- Serena Stigliano
- Operative Endoscopy department, Fondazione Policlinico Universitario Campus Bio-Medico, Rome Italy.
| | - Anna Crescenzi
- Unit of Endocrine organs and neuromuscular pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome Italy
| | - Gianmarco Marocchi
- Operative Endoscopy department, Fondazione Policlinico Universitario Campus Bio-Medico, Rome Italy
| | - Chiara Taffon
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome Italy
| | - Martina Verri
- Unit of Endocrine organs and neuromuscular pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome Italy
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7
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Cioce M, Fumagalli MR, Donzelli S, Goeman F, Canu V, Rutigliano D, Orlandi G, Sacconi A, Pulito C, Palcau AC, Fanciulli M, Morrone A, Diodoro MG, Caricato M, Crescenzi A, Verri M, Fazio VM, Zapperi S, Levrero M, Strano S, Grazi GL, La Porta C, Blandino G. Interrogating colorectal cancer metastasis to liver: a search for clinically viable compounds and mechanistic insights in colorectal cancer Patient Derived Organoids. J Exp Clin Cancer Res 2023; 42:170. [PMID: 37460938 DOI: 10.1186/s13046-023-02754-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Approximately 20-50% of patients presenting with localized colorectal cancer progress to stage IV metastatic disease (mCRC) following initial treatment and this is a major prognostic determinant. Here, we have interrogated a heterogeneous set of primary colorectal cancer (CRC), liver CRC metastases and adjacent liver tissue to identify molecular determinants of the colon to liver spreading. Screening Food and Drug Administration (FDA) approved drugs for their ability to interfere with an identified colon to liver metastasis signature may help filling an unmet therapeutic need. METHODS RNA sequencing of primary colorectal cancer specimens vs adjacent liver tissue vs synchronous and asynchronous liver metastases. Pathways enrichment analyses. The Library of Integrated Network-based Cellular Signatures (LINCS)-based and Connectivity Map (CMAP)-mediated identification of FDA-approved compounds capable to interfere with a 22 gene signature from primary CRC and liver metastases. Testing the identified compounds on CRC-Patient Derived Organoid (PDO) cultures. Microscopy and Fluorescence Activated Cell Sorting (FACS) based analysis of the treated PDOs. RESULTS We have found that liver metastases acquire features of the adjacent liver tissue while partially losing those of the primary tumors they derived from. We have identified a 22-gene signature differentially expressed among primary tumors and metastases and validated in public databases. A pharmacogenomic screening for FDA-approved compounds capable of interfering with this signature has been performed. We have validated some of the identified representative compounds in CRC-Patient Derived Organoid cultures (PDOs) and found that pentoxyfilline and, to a minor extent, dexketoprofen and desloratadine, can variably interfere with number, size and viability of the CRC -PDOs in a patient-specific way. We explored the pentoxifylline mechanism of action and found that pentoxifylline treatment attenuated the 5-FU elicited increase of ALDHhigh cells by attenuating the IL-6 mediated STAT3 (tyr705) phosphorylation. CONCLUSIONS Pentoxifylline synergizes with 5-Fluorouracil (5-FU) in attenuating organoid formation. It does so by interfering with an IL-6-STAT3 axis leading to the emergence of chemoresistant ALDHhigh cell subpopulations in 5-FU treated PDOs. A larger cohort of CRC-PDOs will be required to validate and expand on the findings of this proof-of-concept study.
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Affiliation(s)
- Mario Cioce
- Department of Medicine, Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Rome, Italy.
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), Rome, Italy.
| | - Maria Rita Fumagalli
- Center for Complexity and Biosystems, Department of Environmental Science and Policy, University of Milan, Via Celoria 26, 20133, Milano, Italy
- CNR - Consiglio Nazionale Delle Ricerche, Biophysics Institute, Via De Marini 6, 16149, Genoa, Italy
| | - Sara Donzelli
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Frauke Goeman
- Department of Research, Diagnosis and Innovative Technologies, UOSD SAFU, Translational Research Area, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Valeria Canu
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Daniela Rutigliano
- Department of Medicine, Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Rome, Italy
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Giulia Orlandi
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Andrea Sacconi
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Pulito
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Alina Catalina Palcau
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Maurizio Fanciulli
- Department of Research, Diagnosis and Innovative Technologies, UOSD SAFU, Translational Research Area, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Maria Grazia Diodoro
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Caricato
- Colorectal Surgery Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Università Campus Bio-Medico, Rome, Italy
| | - Anna Crescenzi
- Department of Medicine, Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Rome, Italy
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Martina Verri
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Vito Michele Fazio
- Department of Medicine, Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Rome, Italy
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), Rome, Italy
| | - Stefano Zapperi
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Via Celoria 16, 20133, Milano, Italy
- Istituto Di Chimica Della Materia Condensata E Di Tecnologie Per L'Energia, CNR - Consiglio Nazionale Delle Ricerche, Via R. Cozzi 53, 20125, Milano, Italy
| | - Massimo Levrero
- Cancer Research Center of Lyon (CRCL), UMR Inserm, CNRS 5286 Mixte CLB, Université de Lyon, 1 (UCBL1), 69003, Lyon, France
| | - Sabrina Strano
- Department of Research, Diagnosis and Innovative Technologies, UOSD SAFU, Translational Research Area, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Gian Luca Grazi
- Department of Experimental and Clinical Medicine, Hepato-Biliary Pancreatic Surgery, University of Florence, Florence, Italy
| | - Caterina La Porta
- Center for Complexity and Biosystems, Department of Environmental Science and Policy, University of Milan, Via Celoria 26, 20133, Milano, Italy
- CNR - Consiglio Nazionale Delle Ricerche, Istituto Di Biofisica, Via Celoria 26, 20133, Milano, Italy
| | - Giovanni Blandino
- Translational Oncology Research Unit, Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy.
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Grani G, Gentili M, Siciliano F, Albano D, Zilioli V, Morelli S, Puxeddu E, Zatelli MC, Gagliardi I, Piovesan A, Nervo A, Crocetti U, Massa M, Samà MT, Mele C, Deandrea M, Fugazzola L, Puligheddu B, Antonelli A, Rossetto R, D'Amore A, Ceresini G, Castello R, Solaroli E, Centanni M, Monti S, Magri F, Bruno R, Sparano C, Pezzullo L, Crescenzi A, Mian C, Tumino D, Repaci A, Castagna MG, Triggiani V, Porcelli T, Meringolo D, Locati L, Spiazzi G, Di Dalmazi G, Anagnostopoulos A, Leonardi S, Filetti S, Durante C. A Data-Driven Approach to Refine Predictions of Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study. J Clin Endocrinol Metab 2023; 108:1921-1928. [PMID: 36795619 DOI: 10.1210/clinem/dgad075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
CONTEXT The risk stratification of patients with differentiated thyroid cancer (DTC) is crucial in clinical decision making. The most widely accepted method to assess risk of recurrent/persistent disease is described in the 2015 American Thyroid Association (ATA) guidelines. However, recent research has focused on the inclusion of novel features or questioned the relevance of currently included features. OBJECTIVE To develop a comprehensive data-driven model to predict persistent/recurrent disease that can capture all available features and determine the weight of predictors. METHODS In a prospective cohort study, using the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339), we selected consecutive cases with DTC and at least early follow-up data (n = 4773; median follow-up 26 months; interquartile range, 12-46 months) at 40 Italian clinical centers. A decision tree was built to assign a risk index to each patient. The model allowed us to investigate the impact of different variables in risk prediction. RESULTS By ATA risk estimation, 2492 patients (52.2%) were classified as low, 1873 (39.2%) as intermediate, and 408 as high risk. The decision tree model outperformed the ATA risk stratification system: the sensitivity of high-risk classification for structural disease increased from 37% to 49%, and the negative predictive value for low-risk patients increased by 3%. Feature importance was estimated. Several variables not included in the ATA system significantly impacted the prediction of disease persistence/recurrence: age, body mass index, tumor size, sex, family history of thyroid cancer, surgical approach, presurgical cytology, and circumstances of the diagnosis. CONCLUSION Current risk stratification systems may be complemented by the inclusion of other variables in order to improve the prediction of treatment response. A complete dataset allows for more precise patient clustering.
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Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Michele Gentili
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, 00185 Rome, Italy
| | - Federico Siciliano
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, 00185 Rome, Italy
| | - Domenico Albano
- Department of Nuclear Medicine, Università e ASST-Spedali Civili- Brescia, 25123 Brescia, Italy
| | - Valentina Zilioli
- Department of Nuclear Medicine, Università e ASST-Spedali Civili- Brescia, 25123 Brescia, Italy
| | - Silvia Morelli
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Efisio Puxeddu
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Maria Chiara Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Irene Gagliardi
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Alessandro Piovesan
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Alice Nervo
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Umberto Crocetti
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Michela Massa
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Maria Teresa Samà
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Chiara Mele
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Maurilio Deandrea
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, 10128 Torino, Italy
| | - Laura Fugazzola
- Department of Endocrinology and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Barbara Puligheddu
- Department of Endocrinology and Andrology, Humanitas Gradenigo, University of Turin, 10153 Turin, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Ruth Rossetto
- Department of Endocrinology and Metabolic Diseases, AO Città della Salute e della Scienza Turin, University of Turin, 10126 Turin, Italy
| | - Annamaria D'Amore
- Division of Endocrine Surgery, Department of Gastroenterologic, Endocrine-Metabolic and Nephro-Urologic sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Graziano Ceresini
- Department of Medicine and Surgery, University Hospital of Parma, 43121 Parma, Italy
| | - Roberto Castello
- Department of Medicine, Hospital and University of Verona, 37129 Verona, Italy
| | - Erica Solaroli
- Unit of Endocrinology, Department of Medicine, AUSL, 40124 Bologna, Italy
| | - Marco Centanni
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, and UOC Endocrinologia, AUSL Latina, 04100 Latina, Italy
| | - Salvatore Monti
- Endocrinology and Diabetes Unit, Azienda Ospedaliero-Universitaria Sant'Andrea, "Sapienza" University of Rome, 00189 Rome, Italy
| | - Flavia Magri
- Department of Internal Medicine and Therapeutics and Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, University of Pavia, 27100 Pavia, Italy
| | - Rocco Bruno
- Thyroid Unit, Tinchi Hospital-ASM Matera, 75100 Matera, Italy
| | - Clotilde Sparano
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Luciano Pezzullo
- Struttura Complessa Chirurgia Oncologica della Tiroide, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Caterina Mian
- Unit of Endocrinology, Department of Medicine-DIMED University of Padua, 35122 Padua, Italy
| | - Dario Tumino
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Andrea Repaci
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Maria Grazia Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "Aldo Moro" School of Medicine, 70121 Bari, Italy
| | - Tommaso Porcelli
- Department of Public Health, University of Naples "Federico II", 80138 Naples, Italy
| | | | - Laura Locati
- Translational Oncology Unit, IRCCS ICS Maugeri, 27100 Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Giovanna Spiazzi
- Endocrinology and Diabetology Unit, Department of Medicine, Azienda Ospedaliera-Universitaria di Verona, 37129 Verona, Italy
| | - Giulia Di Dalmazi
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Aris Anagnostopoulos
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Leonardi
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, 00185 Rome, Italy
| | - Sebastiano Filetti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
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9
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Crescenzi A, Baloch Z. Immunohistochemistry in the pathologic diagnosis and management of thyroid neoplasms. Front Endocrinol (Lausanne) 2023; 14:1198099. [PMID: 37324272 PMCID: PMC10266214 DOI: 10.3389/fendo.2023.1198099] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
The use of immunohistochemistry cannot be underestimated in the everyday practice of thyroid pathology. It has evolved over the years beyond the traditional confirmation of thyroid origin to molecular profiling and the prediction of clinical behavior. In addition, immunohistochemistry has served to implement changes in the current thyroid tumor classification scheme. It is prudent to perform a panel of immunostains, and the immunoprofile should be interpreted in light of the cytologic and architectural features. Immunohistochemistry can also be easily performed in the limited cellularity specimen preparation generated from thyroid fine-needle aspiration and core biopsy; however, it will require laboratory validation of immunostains specific to these preparations to avoid diagnostic pitfalls. This review discusses the application of immunohistochemistry in thyroid pathology with a focus on limited cellularity preparations.
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Affiliation(s)
- Anna Crescenzi
- Pathology, University Campus Bio-Medico of Rome, Fondazione Policlinico, Rome, Italy
| | - Zubair Baloch
- Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Perelman School of Medicine, Philadelphia, PA, United States
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10
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Porcelli F, Verri M, De Santis S, Crescenzi A, Bianchi A, Felici AC, Sotgiu G, Romano S, Orsini M. Considerations on chemical composition of psammoma bodies: Automated detection strategy by infrared microspectroscopy in ovarian and thyroid cancer tissues. Spectrochim Acta A Mol Biomol Spectrosc 2023; 298:122792. [PMID: 37156176 DOI: 10.1016/j.saa.2023.122792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/04/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
Ectopic calcifications are observed in many soft tissues and are associated with several diseases, including cancer. The mechanism of their formation and the correlation with disease progression are often unclear. Detailed knowledge of the chemical composition of these inorganic formations can be very helpful in better understanding their relationship with unhealthy tissue. In addition, information on microcalcifications can be very useful for early diagnosis and provide insight into prognosis. In this work the chemical composition of psammoma bodies (PBs) found in tissues of human ovarian serous tumors was examined. The analysis using Micro Fourier Transform Infrared Spectroscopy (micro-FTIR) revealed that these microcalcifications contain amorphous calcium carbonate phosphate. Moreover, some PB grains showed the presence of phospholipids. This interesting result corroborates the proposed formation mechanism reported in many studies according to which ovarian cancer cells switch to a calcifying phenotype by inducing the deposition of calcifications. In addition, other techniques as X-ray Fluorescence Spectroscopy (XRF), Inductively Coupled Plasma Optical Emission Spectroscopy(ICP-OES) and Scanning electron microscopy (SEM) with Energy Dispersive X-ray Spectroscopy (EDX) were performed on the PBs from ovary tissues to determine the elements present. The PBs found in ovarian serous cancer showed a composition comparable to PBs isolated from papillary thyroid. Based on the chemical similarity of IR spectra, using micro-FTIR spectroscopy combined with multivariate analysis, an automatic recognition method was constructed. With this prediction model it was possible to identify PBs microcalcifications in tissues of both ovarian cancers, regardless of tumor grade, and thyroid cancer with high sensitivity. Such approach could become a valuable tool for routine macrocalcification detection because it eliminates sample staining, and the subjectivity of conventional histopathological analysis.
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Affiliation(s)
- Francesco Porcelli
- Department of Industrial, Electronic and Mechanical Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy
| | - Martina Verri
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Serena De Santis
- Department of Industrial, Electronic and Mechanical Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | | | - Anna Candida Felici
- Basic and Applied Sciences for Engineering, Sapienza University, Via A. Scarpa 16, Rome, Italy
| | - Giovanni Sotgiu
- Department of Industrial, Electronic and Mechanical Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy
| | - Susanna Romano
- Department of Industrial, Electronic and Mechanical Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy
| | - Monica Orsini
- Department of Industrial, Electronic and Mechanical Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy.
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11
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Prata F, Anceschi U, Taffon C, Rossi SM, Verri M, Iannuzzi A, Ragusa A, Esperto F, Prata SM, Crescenzi A, Scarpa RM, Simone G, Papalia R. Real-Time Urethral and Ureteral Assessment during Radical Cystectomy Using Ex-Vivo Optical Imaging: A Novel Technique for the Evaluation of Fresh Unfixed Surgical Margins. Curr Oncol 2023; 30:3421-3431. [PMID: 36975472 PMCID: PMC10047830 DOI: 10.3390/curroncol30030259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Background: Our study aims to assess the feasibility and the reproducibility of fluorescent confocal microscopy (FCM) real-time assessment of urethral and ureteral margins during open radical cystectomy (ORC) for bladder cancer (BCa). Methods: From May 2020 to January 2022, 46 patients underwent ORC with intraoperative FCM evaluation. Each specimen was intraoperatively stained for histopathological analysis using FCM, analyzed as a frozen section (FSA), and sent for traditional H&E examination. Sensitivity, specificity, positive predictive value (PPV), and the negative predictive value (NPV) of FCM and FSA were assessed and compared with H&E for urethral and ureteral margins separately. Results: The agreement was evaluated through Cohen’s κ statistic. Urethral diagnostic agreement between FCM and FSA showed a κ = 0.776 (p < 0.001), while between FCM and H&E, the agreement was κ = 0.691 (p < 0.001). With regard to ureteral margins, an overall agreement of κ = 0.712 (p < 0.001) between FCM and FSA and of κ = 0.481 (p < 0.001) between FCM and H&E was found. Conclusions: FCM proved to be a safe, feasible, and reproducible method for the intraoperative assessment of urethral and ureteral margins during ORC. Compared to standard FSA, FCM showed adequate diagnostic performance in detecting urethral and ureteral malignant involvement.
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Affiliation(s)
- Francesco Prata
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Correspondence: ; Tel.: +39-3934373027; Fax: +39-06225411995
| | - Umberto Anceschi
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Chiara Taffon
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Silvia Maria Rossi
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Martina Verri
- Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Andrea Iannuzzi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Alberto Ragusa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Salvatore Mario Prata
- Simple Operating Unit of Lower Urinary Tract Surgery, SS. Trinità Hospital, 03039 Sora, Italy
| | - Anna Crescenzi
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Giuseppe Simone
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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12
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Stigliano S, Crescenzi A, Taffon C, Marocchi G, Di Matteo FM. Fluorescence confocal microscopy for rapid evaluation of EUS fine-needle biopsy in pancreatic solid lesions. VideoGIE 2023; 8:113-114. [PMID: 36935810 PMCID: PMC10020000 DOI: 10.1016/j.vgie.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Video 1EUS fine-needle biopsy of a pancreatic solid lesion evaluated with fluorescence confocal microscopy.
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Affiliation(s)
- Serena Stigliano
- Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, Rome, Italy
| | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, Rome, Italy
| | - Gianmarco Marocchi
- Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy
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13
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Papini E, Crescenzi A, D’Amore A, Deandrea M, De Benedictis A, Frasoldati A, Garberoglio R, Guglielmi R, Lombardi CP, Mauri G, Miceli RE, Puglisi S, Rago T, Salvatore D, Triggiani V, Van Doorne D, Mitrova Z, Saulle R, Vecchi S, Basile M, Scoppola A, Paoletta A, Persichetti A, Samperi I, Cozzi R, Grimaldi F, Boniardi M, Camaioni A, Elisei R, Guastamacchia E, Nati G, Novo T, Salvatori M, Spiezia S, Vallone G, Zini M, Attanasio R. Italian Guidelines for the Management of Non-Functioning Benign and Locally Symptomatic Thyroid Nodules. Endocr Metab Immune Disord Drug Targets 2023; 23:876-885. [PMID: 36722479 PMCID: PMC10245801 DOI: 10.2174/1871530323666230201104112] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 02/02/2023]
Abstract
AIM This guideline (GL) is aimed at providing a reference for the management of non-functioning, benign thyroid nodules causing local symptoms in adults outside of pregnancy. METHODS This GL has been developed following the methods described in the Manual of the National Guideline System. For each question, the panel appointed by Associazione Medici Endocrinology (AME) identified potentially relevant outcomes, which were then rated for their impact on therapeutic choices. Only outcomes classified as "critical" and "important" were considered in the systematic review of evidence and only those classified as "critical" were considered in the formulation of recommendations. RESULTS The present GL contains recommendations about the respective roles of surgery and minimally invasive treatments for the management of benign symptomatic thyroid nodules. We suggest hemithyroidectomy plus isthmectomy as the first-choice surgical treatment, provided that clinically significant disease is not present in the contralateral thyroid lobe. Total thyroidectomy should be considered for patients with clinically significant disease in the contralateral thyroid lobe. We suggest considering thermo-ablation as an alternative option to surgery for patients with a symptomatic, solid, benign, single, or dominant thyroid nodule. These recommendations apply to outpatients, either in primary care or when referred to specialists. CONCLUSION The present GL is directed to endocrinologists, surgeons, and interventional radiologists working in hospitals, in territorial services, or private practice, general practitioners, and patients. The available data suggest that the implementation of this GL recommendations will result in the progressive reduction of surgical procedures for benign thyroid nodular disease, with a decreased number of admissions to surgical departments for non-malignant conditions and more rapid access to patients with thyroid cancer. Importantly, a reduction of indirect costs due to long-term replacement therapy and the management of surgical complications may also be speculated.
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Affiliation(s)
- Enrico Papini
- Department of Endocrine and Metabolic Diseases, Ospedale Regina Apostolorum, Albano Laziale, Rome, Italy
| | - Anna Crescenzi
- Department of Endocrine Organs and Neuromuscolar Pathology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Annamaria D’Amore
- Endocrine Surgery Division, Agostino Gemelli School of Medicine, University Foundation Polyclinic, Rome, Italy
| | - Maurilio Deandrea
- Endocrinology and Center for Thyroid Diseases, Ospedale Mauriziano “Umberto I”, Turin, Italy
| | - Anna De Benedictis
- Quality Management - Clinical Direction, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Andrea Frasoldati
- Struttura Complessa di Endocrinologia, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Roberto Garberoglio
- Freelancer at Thyroid Multidisciplinary Center at Humanitas Cellin, Turin, Italy
| | - Rinaldo Guglielmi
- Department of Endocrine and Metabolic Diseases, Ospedale Regina Apostolorum, Albano Laziale, Rome, Italy
| | - Celestino Pio Lombardi
- Endocrine Surgery Division, Agostino Gemelli School of Medicine, University Foundation Polyclinic, Rome, Italy
| | - Giovanni Mauri
- Interventional Radiology, IRCCS European Institute of Oncology, Milan, Italy
| | | | - Soraya Puglisi
- Department of Clinical and Biological Sciences, Internal Medicine, AOU San Luigi di Orbassano, University of Turin, Turin, Italy
| | - Teresa Rago
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari, Bari, Italy
| | - Dominique Van Doorne
- Associazione Medici Endocrinologi, Relationship with Patients’ Associations, RomeItaly
| | - Zuzana Mitrova
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Simona Vecchi
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Michele Basile
- High School of Economy and Management of Health Systems, Catholic University of Sacred Heart, Rome, Italy
| | | | | | - Agnese Persichetti
- Department of Firefighters, Public Rescue and Civil Defense, Ministry of Interior, Rome, Italy
| | - Irene Samperi
- Department of Endocrinology, ASL Novara, Novara, Italy
| | - Renato Cozzi
- President of Associazione Medici Endocrinologi, Milan, Italy
| | - Franco Grimaldi
- Past-president of Associazione Medici Endocrinologi, Udine, Italy
| | - Marco Boniardi
- General Oncologic and Mini-invasive Surgery Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Edoardo Guastamacchia
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari, Bari, Italy
| | | | - Tommaso Novo
- Department of Endocrinology, Santa Maria Nuova Hospital, Turin, Italy
| | - Massimo Salvatori
- Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS and Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, Rome, Italy
| | - Stefano Spiezia
- Department of Endocrine and Ultrasound-Guided Surgery, Ospedale del Mare, Naples, Italy
| | | | - Michele Zini
- Struttura Complessa di Endocrinologia, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
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14
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Palermo A, Sodo A, Naciu AM, Di Gioacchino M, Paolucci A, di Masi A, Maggi D, Crucitti P, Longo F, Perrella E, Taffon C, Verri M, Ricci MA, Crescenzi A. Clinical Use of Raman Spectroscopy Improves Diagnostic Accuracy for Indeterminate Thyroid Nodules. J Clin Endocrinol Metab 2022; 107:3309-3319. [PMID: 36103268 DOI: 10.1210/clinem/dgac537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Molecular analysis of thyroid fine-needle aspiration (FNA) specimens is believed to improve the management of indeterminate nodules. Raman spectroscopy (RS) can differentiate benign and malignant thyroid lesions in surgically removed tissues, generating distinctive structural profiles. Herein, the diagnostic performance of RS was tested on FNA biopsies of thyroid gland. DESIGN Prospective, blinded, and single-center study. METHODS We enrolled 123 patients with indeterminate or more ominous cytologic diagnoses (TIR3A-low-risk indeterminate lesion, TIR3B-high-risk indeterminate lesion, TIR4-suspicious of malignancy, TIR5-malignant). All subjects were surgical candidates (defined by international guidelines) and submitted to FNA procedures for RS analysis. We compared RS data, cytologic findings, and final histologic assessments (as reference standard) using various statistical techniques. RESULTS The distribution of our study population was as follows: TIR3A:37, TIR3B:32, TIR4:16, and TIR5:38. In 30.9% of patients, histologic diagnoses were benign. For predicting thyroid malignancy in FNA samples, the overall specificity of RS was 86.8%, with 86.5% specificity in indeterminate cytologic categories. In patients with high-risk ultrasound categories, the specificity of RS increased to 87.5% for TIR3A, reaching 100% for TIR3B. Benign histologic diagnoses accounted for 72.9% of patients classified as TIR3A and 31.3% of those classified as TIR3B. Based on positive RS testing, unnecessary surgery was reduced to 7.4% overall (TIR3A-33.3%, TIR3B-6.7%). CONCLUSIONS This premier use of RS for thyroid cytology confirms its role as a valuable diagnostic tool and a valid alternative to molecular studies, capable of improving the management of indeterminate nodules and reducing unnecessary surgery.
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Affiliation(s)
- Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy
- Unit of Endocrinology and Diabetes, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Armida Sodo
- Dipartimento di Scienze, Università Roma Tre, Rome, Italy
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy
| | | | | | | | - Daria Maggi
- Unit of Endocrinology and Diabetes, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Eleonora Perrella
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Chiara Taffon
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Martina Verri
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Anna Crescenzi
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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15
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Palermo A, Sodo A, Naciu AM, Gioacchino MD, Paolucci A, Masi AD, Maggi D, Crucitti P, Longo F, Perrella E, Taffon C, Verri M, Ricci MA, Crescenzi A. PSAT379 Performance of a Raman Fingerprint in Thyroid Nodules with Indeterminate Cytology: A Prospective Blinded Monocentric Study. J Endocr Soc 2022. [PMCID: PMC9628681 DOI: 10.1210/jendso/bvac150.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Molecular analysis of thyroid fine-needle aspiration biopsy (FNA) was proposed to improve indeterminate nodules management. However, sensibility and specificity as well as the cost of molecular diagnostics require to be improved to increase their cost-effectiveness for medical practice setting. Raman spectroscopy (RS) demonstrated ability in separating benign from malignant thyroid lesions in surgically removed tissues, based on specific RS profile. This study aimed to investigate the diagnostic performance of RS on cytological samples obtained by thyroid FNA. Methods In this prospective, blinded monocentric study, we enrolled 123 patients with indeterminate or worse cytological diagnosis, candidate to surgery according to international guidelines, and submitted to RS analysis of FNA samples. Cytology specimens were evaluated in agreement to Italian Reporting System for Thyroid Cytology1 as follows: TIR1 (non-diagnostic), TIR1C (non-diagnostic-cystic), TIR 2 non-malignant/benign, TIR3A (low-risk indeterminate lesion), TIR3B (high-risk indeterminate lesion), TIR 4 (suspicious of malignancy), or TIR 5 (malignant). As previously published2, the two diagnostic subcategories referred to indeterminate nodules with low (TIR3A) and high risk (TIR3B) of malignancy, may be respectively compared to the class III and Class IV of The Bethesda System for Reporting Thyroid Cytopathology. We compared RS, cytology and final histology, as reference standard, using various statistical approaches. Findings: Our study population included 37 TIR3A, 32 TIR3B, 16 TIR4 and 38 TIR5; the 30.9% of patients had benign histological diagnosis after surgery. In particular, 72.9% of patients classified TIR3A and 31.3% TIR3B had benign histological diagnosis. RS analysis of FNA samples had overall specificity of 86.8% in predicting thyroid malignancy. In indeterminate cytological categories, RS specificity was 86.5%. In patients with TI-RADS score four or five, the specificity of RS increased to 87.5% for TIR3A and reached 100% in TIR3B.; if considering RS positive test, unnecessary surgery was reduced to 7.4% in the whole sample, 33.3% in TIR3A, and 6.7% in TIR 3B. Interpretation: We demonstrated for the first time that RS represents a valuable tool for thyroid cytology and a valid alternative to molecular analyses, able to improve management and reduce unnecessary surgery in indeterminate nodules. Funding: This study was supported by Ministero della Salute, through TIRAMA project (RF-2018-12366568). 1 J Endocrinol Invest. 2014;37(6): 593-599. doi: 10.1007/s40618-014-0062-0 2Cytopathology. 2021;32(6): 714-717. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
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16
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di Masi A, Sessa RL, Cerrato Y, Pastore G, Guantario B, Ambra R, Di Gioacchino M, Sodo A, Verri M, Crucitti P, Longo F, Naciu AM, Palermo A, Taffon C, Acconcia F, Bianchi F, Ascenzi P, Ricci MA, Crescenzi A. Unraveling the Effects of Carotenoids Accumulation in Human Papillary Thyroid Carcinoma. Antioxidants (Basel) 2022; 11:antiox11081463. [PMID: 36009182 PMCID: PMC9405418 DOI: 10.3390/antiox11081463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023] Open
Abstract
Among the thyroid cancers, papillary thyroid cancer (PTC) accounts for 90% of the cases. In addition to the necessity to identify new targets for PTC treatment, early diagnosis and management are highly demanded. Previous data indicated that the multivariate statistical analysis of the Raman spectra allows the discrimination of healthy tissues from PTC ones; this is characterized by bands typical of carotenoids. Here, we dissected the molecular effects of carotenoid accumulation in PTC patients by analyzing whether they were required to provide increased retinoic acid (RA) synthesis and signaling and/or to sustain antioxidant functions. HPLC analysis revealed the lack of a significant difference in the overall content of carotenoids. For this reason, we wondered whether the carotenoid accumulation in PTC patients could be related to vitamin A derivative retinoic acid (RA) biosynthesis and, consequently, the RA-related pathway activation. The transcriptomic analysis performed using a dedicated PCR array revealed a significant downregulation of RA-related pathways in PTCs, suggesting that the carotenoid accumulation in PTC could be related to a lower metabolic conversion into RA compared to that of healthy tissues. In addition, the gene expression profile of 474 PTC cases previously published in the framework of the Cancer Genome Atlas (TGCA) project was examined by hierarchical clustering and heatmap analyses. This metanalysis study indicated that the RA-related pathways resulted in being significantly downregulated in PTCs and being associated with the follicular variant of PTC (FV-PTC). To assess whether the possible fate of the carotenoids accumulated in PTCs is associated with the oxidative stress response, the expression of enzymes involved in ROS scavenging was checked. An increased oxidative stress status and a reduced antioxidant defense response were observed in PTCs compared to matched healthy thyroids; this was possibly associated with the prooxidant effects of high levels of carotenoids. Finally, the DepMap datasets were used to profile the levels of 225 metabolites in 12 thyroid cancer cell lines. The results obtained suggested that the high carotenoid content in PTCs correlates with tryptophan metabolism. This pilot provided novel possible markers and possible therapeutic targets for PTC diagnosis and therapy. For the future, a larger study including a higher number of PTC patients will be necessary to further validate the molecular data reported here.
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Affiliation(s)
- Alessandra di Masi
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
- Correspondence: ; Tel.: +39-06-57336363
| | - Rosario Luigi Sessa
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Ylenia Cerrato
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Gianni Pastore
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Barbara Guantario
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Roberto Ambra
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Michael Di Gioacchino
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Armida Sodo
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Martina Verri
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (P.C.); (F.L.)
| | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (P.C.); (F.L.)
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (A.P.)
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (A.P.)
| | - Chiara Taffon
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
| | - Filippo Acconcia
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Fabrizio Bianchi
- Cancer Biomarkers Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy;
| | - Paolo Ascenzi
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Maria Antonietta Ricci
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Anna Crescenzi
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
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17
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Donati M, Martinek P, Steiner P, Grossmann P, Vanecek T, Kastnerova L, Kolm I, Baneckova M, Donati P, Kletskaya I, Kalmykova A, Feit J, Blasch P, Szilagyi D, Baldi A, Persichetti P, Crescenzi A, Michal M, Kazakov DV. Novel insights into the BAP1-inactivated melanocytic tumor. Mod Pathol 2022; 35:664-675. [PMID: 34857909 DOI: 10.1038/s41379-021-00976-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022]
Abstract
BAP1-inactivated melanocytic tumor (BIMT) is a group of melanocytic neoplasms with epithelioid cell morphology molecularly characterized by the loss of function of BAP1, a tumor suppressor gene located on chromosome 3p21, and a mutually exclusive mitogenic driver mutation, more commonly BRAF. BIMTs can occur as a sporadic lesion or, less commonly, in the setting of an autosomal dominant cancer susceptibility syndrome caused by a BAP1 germline inactivating mutation. Owing to the frequent identification of remnants of a conventional nevus, BIMTs are currently classified within the group of combined melanocytic nevi. "Pure" lesions can also be observed. We studied 50 BIMTs from 36 patients. Most lesions were composed of epithelioid melanocytes of varying size and shapes, resulting extreme cytomorphological heterogeneity. Several distinctive morphological variants of multinucleated/giant cells were identified. Some hitherto underrecognized microscopic features, especially regarding nuclear characteristics included nuclear blebbing, nuclear budding, micronuclei, shadow nuclei, peculiar cytoplasmic projections (ant-bear cells) often containing micronuclei and cell-in-cell structures (entosis). In addition, there were mixed nests of conventional and BAP1-inactivated melanocytes and squeezed remnants of the original nevus. Of the 26 lesions studied, 24 yielded a BRAF mutation, while in the remaining two cases there was a RAF1 fusion. BAP1 biallelic and singe allele mutations were found in 4/22 and 16/24 neoplasms, respectively. In five patients, there was a BAP1 germline mutation. Six novel, previously unreported BAP1 mutations have been identified. BAP1 heterozygous loss was detected in 11/22 lesions. Fluorescence in situ hybridization for copy number changes revealed a related amplification of both RREB1 and MYC genes in one tumor, whereas the remaining 20 lesions studied were negative; no TERT-p mutation was found in 14 studied neoplasms. Tetraploidy was identified in 5/21 BIMTs. Of the 21 patients with available follow-up, only one child had a locoregional lymph node metastasis. Our results support a progression of BIMTs from a conventional BRAF mutated in which the original nevus is gradually replaced by epithelioid BAP1-inactivated melanocytes. Some features suggest more complex underlying pathophysiological events that need to be elucidated.
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Affiliation(s)
- Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy.,Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | | | | | | | | | - Liubov Kastnerova
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic.,Bioptical Laboratory, Pilsen, Czech Republic
| | - Isabel Kolm
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Martina Baneckova
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic.,Bioptical Laboratory, Pilsen, Czech Republic
| | | | - Irina Kletskaya
- Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
| | | | - Josef Feit
- Institute of Pathology, University of Ostrava, Ostrava, Czech Republic
| | - Petr Blasch
- Department of Pathology, Regional Hospital, Hranice, Czech Republic
| | - Diana Szilagyi
- Department of Pathology, Emergency Clinical County Hospital "Pius Brinzeu", Timisoara, Romania
| | - Alfonso Baldi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico di Roma University, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Michal Michal
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic.,Bioptical Laboratory, Pilsen, Czech Republic
| | - Dmitry V Kazakov
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic. .,Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
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18
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Rosina M, Ceci V, Turchi R, Chuan L, Borcherding N, Sciarretta F, Sánchez-Díaz M, Tortolici F, Karlinsey K, Chiurchiù V, Fuoco C, Giwa R, Field RL, Audano M, Arena S, Palma A, Riccio F, Shamsi F, Renzone G, Verri M, Crescenzi A, Rizza S, Faienza F, Filomeni G, Kooijman S, Rufini S, de Vries AAF, Scaloni A, Mitro N, Tseng YH, Hidalgo A, Zhou B, Brestoff JR, Aquilano K, Lettieri-Barbato D. Ejection of damaged mitochondria and their removal by macrophages ensure efficient thermogenesis in brown adipose tissue. Cell Metab 2022; 34:533-548.e12. [PMID: 35305295 PMCID: PMC9039922 DOI: 10.1016/j.cmet.2022.02.016] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/11/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023]
Abstract
Recent findings have demonstrated that mitochondria can be transferred between cells to control metabolic homeostasis. Although the mitochondria of brown adipocytes comprise a large component of the cell volume and undergo reorganization to sustain thermogenesis, it remains unclear whether an intercellular mitochondrial transfer occurs in brown adipose tissue (BAT) and regulates adaptive thermogenesis. Herein, we demonstrated that thermogenically stressed brown adipocytes release extracellular vesicles (EVs) that contain oxidatively damaged mitochondrial parts to avoid failure of the thermogenic program. When re-uptaken by parental brown adipocytes, mitochondria-derived EVs reduced peroxisome proliferator-activated receptor-γ signaling and the levels of mitochondrial proteins, including UCP1. Their removal via the phagocytic activity of BAT-resident macrophages is instrumental in preserving BAT physiology. Depletion of macrophages in vivo causes the abnormal accumulation of extracellular mitochondrial vesicles in BAT, impairing the thermogenic response to cold exposure. These findings reveal a homeostatic role of tissue-resident macrophages in the mitochondrial quality control of BAT.
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Affiliation(s)
- Marco Rosina
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy; Neurology Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Veronica Ceci
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Riccardo Turchi
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Li Chuan
- Department of Immunology, School of Medicine, University of Connecticut, Farmington, CT 06030, USA
| | - Nicholas Borcherding
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | | | - María Sánchez-Díaz
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid 28029, Spain
| | - Flavia Tortolici
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Keaton Karlinsey
- Department of Immunology, School of Medicine, University of Connecticut, Farmington, CT 06030, USA
| | - Valerio Chiurchiù
- IRCCS, Fondazione Santa Lucia, 00179 Rome, Italy; Institute of Translational Pharmacology, Laboratory of Resolution of Neuroinflammation, National Research Council, 00133 Rome, Italy
| | - Claudia Fuoco
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Rocky Giwa
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Rachael L Field
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Matteo Audano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | - Simona Arena
- Proteomics, Metabolomics and Mass Spectrometry Laboratory, ISPAAM-National Research Council, Portici, 80055 Naples, Italy
| | - Alessandro Palma
- Department of Onco-Hematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
| | - Federica Riccio
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Farnaz Shamsi
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY 10010, USA
| | - Giovanni Renzone
- Proteomics, Metabolomics and Mass Spectrometry Laboratory, ISPAAM-National Research Council, Portici, 80055 Naples, Italy
| | - Martina Verri
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Salvatore Rizza
- Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | | | | | - Sander Kooijman
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Stefano Rufini
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Antoine A F de Vries
- Department of Cardiology, Laboratory of Experimental Cardiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Andrea Scaloni
- Proteomics, Metabolomics and Mass Spectrometry Laboratory, ISPAAM-National Research Council, Portici, 80055 Naples, Italy
| | - Nico Mitro
- Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | - Yu-Hua Tseng
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
| | - Andrés Hidalgo
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid 28029, Spain
| | - Beiyan Zhou
- Department of Immunology, School of Medicine, University of Connecticut, Farmington, CT 06030, USA; Institute for Systems Genomics, University of Connecticut, Farmington, CT 06030, USA
| | - Jonathan R Brestoff
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Katia Aquilano
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Daniele Lettieri-Barbato
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy; IRCCS, Fondazione Santa Lucia, 00179 Rome, Italy.
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Cesareo R, Tabacco G, Naciu AM, Crescenzi A, Bernardi S, Romanelli F, Deandrea M, Trimboli P, Palermo A, Castellana M. Long-term efficacy and safety of percutaneous ethanol injection (PEI) in cystic thyroid nodules: A systematic review and meta-analysis. Clin Endocrinol (Oxf) 2022; 96:97-106. [PMID: 34028855 DOI: 10.1111/cen.14530] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Percutaneous ethanol injection (PEI) is used for the treatment of benign cystic thyroid nodules. This systematic review and meta-analysis aimed to obtain strong evidence of its long-term efficacy and safety. METHODS PubMed, CENTRAL, Scopus and Web of Science databases were searched until November 2020 for studies reporting data on volume reduction rate (VRR), compressive symptoms and cosmetic concerns. Associated complications were assessed. A random-effects model was designed to pool the data. RESULTS Out of 385 papers, nine studies evaluating 1667 nodules were finally included. Overall, VRR at 6, 12, 24, 36, 60 and 120 months was 77%, 81%, 72%, 68%, 74% and 69%, respectively. Significant reductions in the compressive symptoms and cosmetic concerns were observed. No permanent complications were observed. CONCLUSIONS The present meta-analysis showed that PEI could significantly reduce the volume of benign cystic thyroid nodules. This reduction was already effective at 6 months post-treatment, and the effect was stable over time.
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Affiliation(s)
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Stella Bernardi
- Dipartimento di Scienze Mediche, Università degli Studi di Trieste, Trieste, Italy
- UO Medicina Clinica, Ospedale di Cattinara, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), Trieste, Italy
| | - Francesco Romanelli
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Maurilio Deandrea
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, Torino, Italy
| | - Pierpaolo Trimboli
- Clinic of Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Marco Castellana
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
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Citarella F, Vespasiani-Gentilucci U, Crescenzi A, Bianchi A, Virzì V, Tonini G. Liver involvement in the course of thymoma-associated multiorgan autoimmunity: The first histological description. Hepatobiliary Pancreat Dis Int 2022; 21:86-89. [PMID: 33637455 DOI: 10.1016/j.hbpd.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/19/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Fabrizio Citarella
- Department of Medical Oncology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy.
| | - Umberto Vespasiani-Gentilucci
- Area of Internal Medicine, Unit of Hepatology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy
| | - Anna Crescenzi
- Unit of Pathology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy
| | - Antonella Bianchi
- Unit of Pathology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy
| | - Vladimir Virzì
- Department of Medical Oncology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, Policlinico Universitario Campus Bio-Medico, via Alvaro del Portillo, Rome 00128, Italy
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21
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Trimboli P, Giannelli J, Marques B, Piccardo A, Crescenzi A, Deandrea M. Head-to-head comparison of FNA cytology vs. calcitonin measurement in FNA washout fluids (FNA-CT) to diagnose medullary thyroid carcinoma. A systematic review and meta-analysis. Endocrine 2022; 75:33-39. [PMID: 34606057 PMCID: PMC8763758 DOI: 10.1007/s12020-021-02892-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The sensitivity of cytology after fine needle aspiration (FNA-cytology) in detecting medullary thyroid carcinoma (MTC) is low. To overcome this problem, measuring calcitonin (CT) in washout fluid of FNA (FNA-CT) has been largely diffused and showed good performance. However, no evidence-based study exists comparing systematically the sensitivity of FNA-cytology and FNA-CT. This study aimed to systematically review the literature and collect data allowing a head-to-head comparison meta-analysis between FNA-cytology and FNA-CT in detecting MTC lesions. METHODS The online databases of PubMed/MEDLINE and Scopus were searched until June 2021. Original articles reporting the use of both FNA-cytology and FNA-CT in the same series of histologically proven MTC lesions were included They were extracted general features of each study, number of MTC lesions (nodule and neck lymph nodes), and true positive and false negatives of both FNA-cytology and FNA-CT. RESULTS Six studies were included. The sensitivity of FNA-cytology varied from 20% to 86% with a pooled value of 54% (95% CI 35-73%) and significant heterogeneity. The sensitivity of FNA-CT was higher than 95% in almost all studies with a pooled value of 98% (95% CI 96-100%) without heterogeneity. The sensitivity of FNA-CT was significantly higher than that of FNA-cytology. CONCLUSIONS FNA-CT is significantly more sensitive than FNA-cytology in detecting MTC. Accordingly, FNA-CT represents the standard method to use in patients with suspicious MTC lesions, combined with cytology.
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Affiliation(s)
- Pierpaolo Trimboli
- Servizio di Endocrinologia e Diabetologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - Jacopo Giannelli
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Turin, Turin, Italy
| | - Bernardo Marques
- Endocrinology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Arnoldo Piccardo
- Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera", Genoa, Italy
| | - Anna Crescenzi
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Maurilio Deandrea
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, Torino, Italy
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22
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Forleo R, Grani G, Alfò M, Zilioli V, Giubbini R, Zatelli MC, Gagliardi I, Piovesan A, Ragni A, Morelli S, Puxeddu E, Pagano L, Deandrea M, Ceresini G, Torlontano M, Puligheddu B, Antonelli A, Centanni M, Fugazzola L, Spiazzi G, Monti S, Rossetto R, Monzani F, Tallini G, Crescenzi A, Sparano C, Bruno R, Repaci A, Tumino D, Pezzullo L, Lombardi CP, Ferraro Petrillo U, Filetti S, Durante C, Castagna MG. Minimal Extrathyroidal Extension in Predicting 1-Year Outcomes: A Longitudinal Multicenter Study of Low-to-Intermediate-Risk Papillary Thyroid Carcinoma (ITCO#4). Thyroid 2021; 31:1814-1821. [PMID: 34541894 DOI: 10.1089/thy.2021.0248] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: The role of minimal extrathyroidal extension (mETE) as a risk factor for persistent papillary thyroid carcinoma (PTC) is still debated. The aims of this study were to assess the clinical impact of mETE as a predictor of worse initial treatment response in PTC patients and to verify the impact of radioiodine therapy after surgery in patients with mETE. Methods: We reviewed all records in the Italian Thyroid Cancer Observatory database and selected 2237 consecutive patients with PTC who satisfied the inclusion criteria (PTC with no lymph node metastases and at least 1 year of follow-up). For each case, we considered initial surgery, histological variant of PTC, tumor diameter, recurrence risk class according to the American Thyroid Association (ATA) risk stratification system, use of radioiodine therapy, and initial therapy response, as suggested by ATA guidelines. Results: At 1-year follow-up, 1831 patients (81.8%) had an excellent response, 296 (13.2%) had an indeterminate response, 55 (2.5%) had a biochemical incomplete response, and 55 (2.5%) had a structural incomplete response. Statistical analysis suggested that mETE (odds ratio [OR] 1.16, p = 0.65), tumor size >2 cm (OR 1.45, p = 0.34), aggressive PTC histology (OR 0.55, p = 0.15), and age at diagnosis (OR 0.90, p = 0.32) were not significant risk factors for a worse initial therapy response. When evaluating the combination of mETE, tumor size, and aggressive PTC histology, the presence of mETE with a >2 cm tumor was significantly associated with a worse outcome (OR 5.27 [95% confidence interval], p = 0.014). The role of radioiodine ablation in patients with mETE was also evaluated. When considering radioiodine treatment, propensity score-based matching was performed, and no significant differences were found between treated and nontreated patients (p = 0.24). Conclusions: This study failed to show the prognostic value of mETE in predicting initial therapy response in a large cohort of PTC patients without lymph node metastases. The study suggests that the combination of tumor diameter and mETE can be used as a reliable prognostic factor for persistence and could be easily applied in clinical practice to manage PTC patients with low-to-intermediate risk of recurrent/persistent disease.
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Affiliation(s)
- Raffaella Forleo
- Department of Medical, Surgical, and Neurological Sciences, University of Siena, Siena, Italy
| | - Giorgio Grani
- Department of Translational and Precision Medicine, and Sapienza University of Rome, Rome, Italy
| | - Marco Alfò
- Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Zilioli
- Chair and Nuclear Medicine Unit, University and Spedali Civili Hospital, Brescia, Italy
| | - Raffaele Giubbini
- Chair and Nuclear Medicine Unit, University and Spedali Civili Hospital, Brescia, Italy
| | - Maria Chiara Zatelli
- Department of Medical Sciences, Unit of Endocrinology, University of Ferrara, Ferrara, Italy
| | - Irene Gagliardi
- Department of Medical Sciences, Unit of Endocrinology, University of Ferrara, Ferrara, Italy
| | - Alessandro Piovesan
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Alberto Ragni
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Silvia Morelli
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Efisio Puxeddu
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Loredana Pagano
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Maurilio Deandrea
- UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano Torino, Torino, Italy
| | - Graziano Ceresini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Massimo Torlontano
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Barbara Puligheddu
- SCDU Endocrinology, Andrology and Metabolism, Humanitas Gradenigo Hospital, Turin, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Laura Fugazzola
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giovanna Spiazzi
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - Salvatore Monti
- Department of Endocrinology and Diabetes, Azienda Ospedaliero-Universitaria Sant'Andrea, Sapienza University of Rome, Roma, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Tallini
- Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Clotilde Sparano
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy
| | - Rocco Bruno
- Endocrinology Unit, Tinchi Hospital, Matera, Italy
| | - Andrea Repaci
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dario Tumino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luciano Pezzullo
- Struttura Complessa Chirurgia Oncologica della Tiroide, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
| | | | - Sebastiano Filetti
- Department of Translational and Precision Medicine, and Sapienza University of Rome, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, and Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Castagna
- Department of Medical, Surgical, and Neurological Sciences, University of Siena, Siena, Italy
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Garber JR, Papini E, Frasoldati A, Lupo MA, Harrell RM, Parangi S, Patkar V, Baloch ZW, Pessah-Pollack R, Hegedus L, Crescenzi A, Lubitz CC, Paschke R, Randolph GW, Guglielmi R, Lombardi CP, Gharib H. American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool. Endocr Metab Immune Disord Drug Targets 2021; 21:2104-2115. [DOI: 10.2174/187153032111211230225617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/09/2021] [Accepted: 06/03/2021] [Indexed: 11/22/2022]
Abstract
<P>Objective: The first edition of the American Association of Clinical Endocrinology/American College of
Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management
of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of
Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary
thyroid nodules task force was charged with developing a novel interactive electronic
algorithmic tool to evaluate thyroid nodules.
<P>
Methods: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice
guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary
diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool
development, its data requirements, and its basis for decision making. It provides links to the web-based
algorithmic tool and a tutorial.
<P>
Results: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses.
<P>
Conclusion: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular
marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be
used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to
create registries for solo practices, large multispecialty delivery systems, regional and national databases,
and research consortiums. Prospective studies are underway to validate TNAPP to determine how it
compares with other ultrasound-based classification systems and whether it can improve the care of
patients with clinically significant thyroid nodules while reducing the substantial burden incurred by
those who do not benefit from further evaluation and treatment.</P>
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Affiliation(s)
- Jeffrey R. Garber
- Endocrine Division, Harvard Vanguard Medical Associates, Boston, Massachusetts,United States
| | - Enrico Papini
- Endocrinology and Metabolism Department, Regina Apostolorum Hospital, Albano, Rome,Italy
| | - Andrea Frasoldati
- Metabolism and Nutrition Department, Santa Maria Nuova Hospital Scientific Institute for Research, Hospitalization and Healthcare, Reggio Emilia,Italy
| | - Mark A. Lupo
- Thyroid & Endocrine Center of Florida, Sarasota, Florida,United States
| | - R. Mack Harrell
- Memorial Center for Integrative Endocrine Surgery, Hollywood, Florida,United States
| | - Sareh Parangi
- Harvard Medical School, Boston, Massachusetts,United States
| | | | - Zubair W. Baloch
- Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania,United States
| | - Rachel Pessah-Pollack
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, New York,United States
| | | | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome,Italy
| | - Carrie C. Lubitz
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts,United States
| | - Ralf Paschke
- Cumming School of Medicine, University of Calgary, Calgary, Alberta,Canada
| | | | - Rinaldo Guglielmi
- Endocrinology and Metabolism Department, Regina Apostolorum Hospital, Albano, Rome,Italy
| | - Celestino P. Lombardi
- Endocrine Surgery Department, Policlinico Agostino Gemelli, Catholic University, Rome,Italy
| | - Hossein Gharib
- Mayo Clinic College of Medicine, Rochester, Minnesota,United States
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24
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De Santis S, Porcelli F, Sotgiu G, Crescenzi A, Ceccucci A, Verri M, Caricato M, Taffon C, Orsini M. Identification of remodeled collagen fibers in tumor stroma by FTIR Micro-spectroscopy: A new approach to recognize the colon carcinoma. Biochim Biophys Acta Mol Basis Dis 2021; 1868:166279. [PMID: 34600082 DOI: 10.1016/j.bbadis.2021.166279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/22/2022]
Abstract
The tumor stroma plays a pivotal role in colon cancer genesis and progression. It was observed that collagen fibers in the extracellular matrix (ECM) of cancer stroma, undergo a strong remodeling. These fibrous proteins result more aligned and compact than in physiological conditions, creating a microenvironment that favors cancer development. In this work, micro-FTIR spectroscopy was applied to investigate the chemical modifications in the tumor stroma. Using Fuzzy C-means clustering, mean spectra from diseased and normal stroma were compared and collagen was found to be responsible for the main differences between them. Specifically, the modified absorptions at 1203, 1238, 1284 cm-1 and 1338 cm-1 wavenumbers, were related to the amide III band and CH2 bending of side chains. These signals are sensitive to the interactions between the α-chains in the triple helices of collagen structure. This provided robust chemical evidence that in cancer ECM, collagen fibers are more parallelized, stiff and ordered than in normal tissue. Principal Component Analysis (PCA) applied to the spectra from malignant and normal stroma confirmed these findings. Using LDA (Linear Discriminant Analysis) classification, the absorptions 1203, 1238, 1284 and 1338 cm-1 were examined as spectral biomarkers, obtaining quite promising results. The use of a PCA-LDA prediction model on samples with moderate tumor degree further showed that the stroma chemical modifications are more indicative of malignancy compared to the epithelium. These preliminary findings have shown that micro-FTIR spectroscopy, focused on collagen signals, could become a promising tool for colon cancer diagnosis.
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Affiliation(s)
- Serena De Santis
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy.
| | - Francesco Porcelli
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Giovanni Sotgiu
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Anita Ceccucci
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Martina Verri
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Marco Caricato
- Colorectal surgery Unit, University Campus Bio-Medico of Rome, Italy
| | - Chiara Taffon
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Monica Orsini
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
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25
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Stigliano S, Crescenzi A, Taffon C, Covotta F, Hassan C, Antonelli G, Verri M, Biasutto D, Scarpa RM, Di Matteo FM. Role of fluorescence confocal microscopy for rapid evaluation of EUS fine-needle biopsy sampling in pancreatic solid lesions. Gastrointest Endosc 2021; 94:562-568.e1. [PMID: 33798539 DOI: 10.1016/j.gie.2021.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/21/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS EUS fine-needle biopsy (EUS-FNB) sampling is the standard procedure for diagnosis of pancreatic lesions. Fluorescence confocal microscopy (FCM) allows imaging of tissues in the fresh state, requiring minimal preparation without damage or loss of tissue. Until now, no data exist on FCM in the field of microhistologic specimens. We aimed to assess the diagnostic performance of FCM in predicting histologic adequacy of EUS-FNB samples in pancreatic solid lesions and to assess the agreement between FCM evaluation and final histology. METHODS In this single-center prospective study on consecutive patients with pancreatic lesions receiving EUS-FNB, the obtained samples have been evaluated at FCM and classified as "inadequate" or "adequate" (benign, suspicious, or malignant). The kappa test was used to quantify agreement. The diagnostic accuracy of FCM was assessed. A P < .05 was considered to be statistically significant. RESULTS From April 2020 to September 2020, 81 patients were enrolled. In all cases FCM showed the macro image of the sample and created a digital image. Of the samples, 92.6% was defined as adequate at the FCM evaluation and confirmed at histopathology. Histologic diagnoses were 8% benign, 17.3% atypical/suspicious, and 74.7% malignant with satisfactory agreement with the FCM evaluation (Cohen's κ coefficient, .95; 95% confidence interval [CI], .89-1.01; P = .001). The sensitivity of the FCM evaluation was 100% (95% CI, 95%-100%), specificity 66.7% (95% CI, 22.3%-95.7%), accuracy 97% (95% CI, 90.7%-99.7%), positive predictive value 97% (95% CI, 91.8%-99%), and negative predictive value 100%. CONCLUSIONS FCM represents a new technique successfully applicable to microhistologic specimens. It provides fast information about sample adequacy in small specimens with good agreement in the final histology.
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Affiliation(s)
- Serena Stigliano
- Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, Rome, Italy
| | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, Rome, Italy
| | - Francesco Covotta
- Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy
| | - Cesare Hassan
- Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | | | - Martina Verri
- Pathology Unit, Campus Bio-Medico University Hospital, Rome, Italy
| | - Dario Biasutto
- Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy
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26
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Maddaloni E, Briganti SI, Crescenzi A, Beretta Anguissola G, Perrella E, Taffon C, Palermo A, Manfrini S, Pozzilli P, Lauria Pantano A. Usefulness of Color Doppler Ultrasonography in the Risk Stratification of Thyroid Nodules. Eur Thyroid J 2021; 10:339-344. [PMID: 34395306 PMCID: PMC8314784 DOI: 10.1159/000509325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/10/2020] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Thyroid ultrasound (US) is crucial for clinical decision in the management of thyroid nodules. In this cross-sectional study, we aimed to test if the evaluation of thyroid nodules' vascularization could improve the risk stratification ability of the American College of Radiology (ACR) TI-RADS classification system. METHODS A total of 873 thyroid nodules undergoing fine-needle aspiration were classified according to ACR TI-RADS US classification. Three types of vascularization were identified: type 0, no vascular signals; type 1, peripheral vascular signals; type 2, peripheral and intralesional vascular signals. Cytology specimens were evaluated conforming to the Italian Reporting System for Thyroid Cytology, and TIR3b, TIR4, and TIR5 were defined as high risk for malignancy. Odds ratios (ORs) with 95% confidence intervals (CI) and the areas under the receiver operating characteristic curves (ROC-AUC) for high-risk cytology categories were calculated. RESULTS The 3 vascular patterns were differently distributed within the cytology categories: 52.4% of TIR1c, 15.9% of TIR2, 5.9% of TIR3a, 6.7% of TIR3b, 12.5% of TIR4, and 28.9% of TIR5 nodules had no vascular signals (p < 0.001). Nodule vascularity alone was not associated with a higher risk of malignant cytology (OR [95% CI] 0.75 [0.43-1.32], p = 0.32), without differences between peripheral (OR [95% CI] 0.65 [0.35-1.20]) and intranodular (OR [95% CI] 0.88 [0.48-1.62]) vascularization (p = 0.22). The ROC-AUC (95% CI) for the diagnosis of malignant cytology was similar when considering TI-RADS classification alone (0.736 [0.684-0.786]) and when considering TI-RADS classification plus the presence/absence of vascular signals (0.736 [0.683-0.789], p value for differences between the ROC-AUCs: 0.91). Among TR1, TR2, and TR3 TI-RADS classes, no nodules without vascular signals showed a malignant cytology, allowing the identification of nodules with benign cytology with 100% specificity within these US classes. CONCLUSIONS Color Doppler study of thyroid nodules does not improve the risk stratification ability of the ACR TI-RADS US classification system.
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Affiliation(s)
- Ernesto Maddaloni
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- *Ernesto Maddaloni, MD, PhD, Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, IT–00161 Rome (Italy),
| | - Silvia Irina Briganti
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | | | | | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Andrea Palermo
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Silvia Manfrini
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Pozzilli
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Angelo Lauria Pantano
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
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27
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Crescenzi A, Palermo A, Trimboli P. Cancer prevalence in the subcategories of the indeterminate class III (AUS/FLUS) of the Bethesda system for thyroid cytology: a meta-analysis. J Endocrinol Invest 2021; 44:1343-1351. [PMID: 33590467 DOI: 10.1007/s40618-021-01526-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/01/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE The indeterminate cytologic report represents a major challenge in the field of thyroid nodule. The indeterminate class III of the Bethesda classification system (i.e., AUS/FLUS) includes a heterogeneous group of subcategories characterized by doubtful nuclear and/or architectural atypia. The study aim was to conduct a systematic review and meta-analysis to evaluate the rate of malignancy in each subcategory of Bethesda III. METHODS PubMed, CENTRAL, and Scopus databases were searched until April 2020. Original articles reporting data on the subcategories of Bethesda III were included. The histological diagnosis was the reference standard to classify true/false negative and true/false positive cases. RESULTS The pooled cancer prevalence in each subcategory of Bethesda III was estimated using a random-effects model. Twenty-three papers with 4241 nodules were included. Overall, 1163 (27.4%) were malignant. The cancer rate observed in the subcategories ranged from 15%, in "Hürthle cell aspirates with low risk pattern", to 44%, in "Focal cytologic atypia". CONCLUSIONS The overall cancer rate found in the Bethesda III ranged more largely than that originally estimated (10-30%) and varied among any scenarios. These evidence-based data represent a reference for the clinical management of these patients.
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Affiliation(s)
- A Crescenzi
- Unit of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - A Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - P Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland.
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
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Garber JR, Papini E, Frasoldati A, Lupo MA, Harrell RM, Parangi S, Patkar V, Baloch ZW, Pessah-Pollack R, Hegedus L, Crescenzi A, Lubitz CC, Paschke R, Randolph GW, Guglielmi R, Lombardi CP, Gharib H. American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool. Endocr Pract 2021; 27:649-660. [PMID: 34090820 DOI: 10.1016/j.eprac.2021.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. METHODS The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. RESULTS TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. CONCLUSION TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.
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Affiliation(s)
- Jeffrey R Garber
- Endocrine Division, Harvard Vanguard Medical Associates, Boston, Massachusetts; Division of Endocrinology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Enrico Papini
- Endocrinology and Metabolism Department, Regina Apostolorum Hospital, Albano, Rome, Italy
| | - Andrea Frasoldati
- Metabolism and Nutrition Department, Santa Maria Nuova Hospital Scientific Institute for Research, Hospitalization and Healthcare, Reggio Emilia, Italy
| | - Mark A Lupo
- Thyroid & Endocrine Center of Florida, Sarasota, Florida; Florida State University College of Medicine, Sarasota, Florida
| | - R Mack Harrell
- Memorial Center for Integrative Endocrine Surgery, Hollywood, Florida
| | - Sareh Parangi
- Harvard Medical School, Boston, Massachusetts; Newton-Wellesley Hospital, Newton, Massachusetts; Department of Endocrine Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Zubair W Baloch
- Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rachel Pessah-Pollack
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, New York
| | - Laszlo Hegedus
- University of Southern Denmark, Odense, Denmark; Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Carrie C Lubitz
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Ralf Paschke
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gregory W Randolph
- Harvard Medical School, Boston, Massachusetts; Thyroid/Parathyroid Endocrine Surgical Division, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Endocrine Surgical Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Rinaldo Guglielmi
- Endocrinology and Metabolism Department, Regina Apostolorum Hospital, Albano, Rome, Italy
| | - Celestino P Lombardi
- Endocrine Surgery Department, Policlinico Agostino Gemelli, Catholic University, Rome, Italy
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29
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Esperto F, Prata F, Civitella A, Tuzzolo P, Romei L, Crimi V, Cacciatore L, Taffon C, Crescenzi A, Scarpa R, Papalia R. Real time urethral and ureteral assessment during radical cystectomy using ex vivo optical imaging. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Cesareo R, Manfrini S, Pasqualini V, Ambrogi C, Sanson G, Gallo A, Pozzilli P, Pedone C, Crescenzi A, Palermo A. Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study). J Clin Endocrinol Metab 2021; 106:1692-1701. [PMID: 33608728 DOI: 10.1210/clinem/dgab102] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Indexed: 12/14/2022]
Abstract
CONTEXT Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign nonfunctioning thyroid nodules (BNTNs). OBJECTIVE To compare the efficacy and safety of both treatments at 12-month follow-up in patients with solid or predominantly solid BNTN. METHODS This was a single-center, 12-month, randomized, superiority, open-label, parallel-group trial conducted in an outpatient clinic. Sixty patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems were randomly assigned (1:1 ratio) to receive either a single session of RFA or LA. Twenty-9 patients per group completed the study. The main outcome measures were VRR and proportion of nodules with more than 50% reduction (technical success rate). RESULTS At 12 months, VRR was 70.9 ± 16.9% and 60.0 ± 19.0% in the RFA and LA groups, respectively (P = .024). This effect was confirmed in the linear regression model that was adjusted for age, sex, nodule baseline volume, and proportion of cellular components (RFA treatment: β = .390; P = .009). No significant between-group difference was observed in the technical success rate at 12 months after treatment. A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3 ± 0.8, P < .001; and LA: 4.6 ± 2.1 and 1.6 ± 0.8, respectively, P < .001) and cosmetic (RFA: 3.4 ± 0.6 and 1.3 ± 0.5, P < .001; and LA: 3.4 ± 0.5 and 1.4 ± 0.6, P < .001) scores although the between-group differences were not significant. CONCLUSION RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.
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Affiliation(s)
- Roberto Cesareo
- Unit of metabolic diseases, "S. M. Goretti" Hospital, Latina, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | | | - Cesare Ambrogi
- Department of Radiology, "S. M. Goretti" Hospital, Latina, Italy
| | - Gianfranco Sanson
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Andrea Gallo
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Claudio Pedone
- Geriatric Unit, Campus Bio-Medico University, Rome, Italy
| | - Anna Crescenzi
- Unit of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
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31
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Grani G, Zatelli MC, Alfò M, Montesano T, Torlontano M, Morelli S, Deandrea M, Antonelli A, Francese C, Ceresini G, Orlandi F, Maniglia CA, Bruno R, Monti S, Santaguida MG, Repaci A, Tallini G, Fugazzola L, Monzani F, Giubbini R, Rossetto R, Mian C, Crescenzi A, Tumino D, Pagano L, Pezzullo L, Lombardi CP, Arvat E, Petrone L, Castagna MG, Spiazzi G, Salvatore D, Meringolo D, Solaroli E, Monari F, Magri F, Triggiani V, Castello R, Piazza C, Rossi R, Ferraro Petrillo U, Filetti S, Durante C. Real-World Performance of the American Thyroid Association Risk Estimates in Predicting 1-Year Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study of 2000 Patients. Thyroid 2021; 31:264-271. [PMID: 32475305 DOI: 10.1089/thy.2020.0272] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: One of the most widely used risk stratification systems for estimating individual patients' risk of persistent or recurrent differentiated thyroid cancer (DTC) is the American Thyroid Association (ATA) guidelines. The 2015 ATA version, which has increased the number of patients considered at low or intermediate risk, has been validated in several retrospective, single-center studies. The aims of this study were to evaluate the real-world performance of the 2015 ATA risk stratification system in predicting the response to treatment 12 months after the initial treatment and to determine the extent to which this performance is affected by the treatment center in which it is used. Methods: A prospective cohort of DTC patients collected by the Italian Thyroid Cancer Observatory web-based database was analyzed. We reviewed all records present in the database and selected consecutive cases that satisfied inclusion criteria: (i) histological diagnosis of DTC, with the exclusion of noninvasive follicular thyroid neoplasm with papillary-like nuclear features; (ii) complete data of the initial treatment and pathological features; and (iii) results of 1-year follow-up visit (6-18 months after the initial treatment), including all data needed to classify the estimated response to treatment. Results: The final cohort was composed of 2071 patients from 40 centers. The ATA risk of persistent/recurrent disease was classified as low in 1109 patients (53.6%), intermediate in 796 (38.4%), and high in 166 (8.0%). Structural incomplete responses were documented in only 86 (4.2%) patients: 1.5% in the low-risk, 5.7% in the intermediate-risk, and 14.5% in the high-risk group. The baseline ATA risk class proved to be a significant predictor of structural persistent disease, both for intermediate-risk (odds ratio [OR] 4.67; 95% confidence interval [CI] 2.59-8.43) and high-risk groups (OR 16.48; CI 7.87-34.5). Individual center did not significantly influence the prediction of the 1-year disease status. Conclusions: The ATA risk stratification system is a reliable predictor of short-term outcomes in patients with DTC in real-world clinical settings characterized by center heterogeneity in terms of size, location, level of care, local management strategies, and resource availability.
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Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Pathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Zatelli
- Section of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Marco Alfò
- Department of Statistical Sciences, Pathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Teresa Montesano
- Department of Radiological, Pathological, Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Torlontano
- Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Silvia Morelli
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Maurilio Deandrea
- Division of Endocrinology, Diabetology, and Metabolism, Mauriziano Umberto I Hospital, Turin, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Cecilia Francese
- Division of Endocrinology, Clinica Salus di Battipaglia, Salerno, Italy
| | - Graziano Ceresini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Orlandi
- Division of Endocrinology and Metabolism, Department of Oncology, Humanitas-Gradenigo Hospital, University of Turin, Turin, Italy
| | | | - Rocco Bruno
- Unit of Endocrinology, Tinchi-Pisticci Hospital, Matera, Italy
| | - Salvatore Monti
- Department of Endocrinology, AOU Sant'Andrea, Sapienza Università di Roma, Rome, Italy
| | | | - Andrea Repaci
- Endocrinology, Pathology and Radiotherapy Units, University of Bologna Medical Center, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Giovanni Tallini
- Endocrinology, Pathology and Radiotherapy Units, University of Bologna Medical Center, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Laura Fugazzola
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan and Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Giubbini
- Nuclear Medicine Unit, Spedali Civili Università degli Studi di Brescia, Brescia, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine-DIMED, University Hospital of Padua, Padua, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Dario Tumino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Loredana Pagano
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Luciano Pezzullo
- Struttura Complessa Chirurgia Oncologica della Tiroide, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
| | - Emanuela Arvat
- Oncological Endocrinology Unit, Department of Medical Sciences, Molinette Hospital, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Luisa Petrone
- Endocrinology Unit, Careggi University Hospital, Florence, Italy
| | - Maria Grazia Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Giovanna Spiazzi
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - Domenico Salvatore
- Department of Public Health, University of Naples "Federico II," Naples, Italy
| | | | - Erica Solaroli
- Endocrinology Unit, Medical Department, AUSL Bologna Maggiore-Bellaria Hospital, Bologna, Italy
| | - Fabio Monari
- Endocrinology, Pathology and Radiotherapy Units, University of Bologna Medical Center, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Flavia Magri
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Department of Internal Medicine, Istituti Clinici Scientifici Maugeri IRCCS, and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Bari, Italy
| | - Roberto Castello
- Division of General Medicine, University Hospital of Verona, Verona, Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy
| | - Roberta Rossi
- Endocrine Unit, Azienda Ospedaliero Universitaria S. Anna, Ferrara, Italy
| | - Umberto Ferraro Petrillo
- Department of Statistical Sciences, Pathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Sebastiano Filetti
- Department of Translational and Precision Medicine, Pathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Pathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
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Naciu AM, Verri M, Crescenzi A, Taffon C, Longo F, Frasca L, Tabacco G, Monte L, Palermo A, Crucitti P, Cesareo R. Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth. Endocrinol Diabetes Metab Case Rep 2021; 2021:EDM200184. [PMID: 33522492 PMCID: PMC7849458 DOI: 10.1530/edm-20-0184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/07/2021] [Indexed: 12/04/2022] Open
Abstract
SUMMARY We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect. LEARNING POINTS HVPTC is an aggressive variant of PTC, usually associated with radioactive iodine refractoriness, and a higher mortality rate compared to classic PTC. However, there is a marked individual variability in this association. HVPTC usually appears as small unifocal lesion but a multinodular goiter presentation may occur. The present case highlights that despite of the histology, our patient achieved a high ablation success rate after radioactive iodine therapy.
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Affiliation(s)
- Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Martina Verri
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Anna Crescenzi
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Chiara Taffon
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Filippo Longo
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Luca Frasca
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Lavinia Monte
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Pierfilippo Crucitti
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Roberto Cesareo
- Unit of Metabolic Diseases, ‘S.M. Goretti’ Hospital, Latina, Italy
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Sodo A, Verri M, Palermo A, Naciu AM, Sponziello M, Durante C, Di Gioacchino M, Paolucci A, di Masi A, Longo F, Crucitti P, Taffon C, Ricci MA, Crescenzi A. Raman Spectroscopy Discloses Altered Molecular Profile in Thyroid Adenomas. Diagnostics (Basel) 2020; 11:diagnostics11010043. [PMID: 33383892 PMCID: PMC7823803 DOI: 10.3390/diagnostics11010043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant thyroid nodules based on their molecular fingerprint; anyway, some histologically proved follicular adenomas were clustered as having a characteristic profile of malignant lesions. In this study, we analyzed five follicular thyroid adenomas with a malignant spectroscopic profile compared to five follicular adenomas with a benign Raman spectrum in order to assess possible molecular differences between the two groups. Morphological, immunohistochemical, and molecular analyses evidenced expression of malignancy-associated proteins in four out of five malignant clustered adenomas. The remaining malignant clustered adenoma showed a TSHR mutation previously associated with autonomously functioning follicular carcinomas. In conclusion, thyroid follicular adenomas are a group of morphologically benign neoplasms that may have altered the mutational or expression profile; cases of adenomas with altered immunophenotype are recognized as showing a profile associated with malignancy by Raman spectroscopy. This correlation warrants a more extensive evaluation and suggests a potential predictive value of spectroscopic assessment in recognizing characteristics associated with tumor progression in follicular thyroid neoplasms.
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Affiliation(s)
- Armida Sodo
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Martina Verri
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy; (A.P.); (A.M.N.)
| | - Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy; (A.P.); (A.M.N.)
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (M.S.); (C.D.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (M.S.); (C.D.)
| | - Michael Di Gioacchino
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Alessio Paolucci
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Alessandra di Masi
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Filippo Longo
- Unit of Thoracic Surgery, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (F.L.); (P.C.)
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (F.L.); (P.C.)
| | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
| | - Maria Antonietta Ricci
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
- Correspondence: ; Tel.: +39-06-225411106
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Castiello G, Mallio CA, Altamura C, Marano M, Crescenzi A, Beomonte Zobel B, Quattrocchi CC, Di Lazzaro V. Bilateral MCP Infarct Due to Vertebral Giant Cell Arteritis. J Stroke Cerebrovasc Dis 2020; 30:105430. [PMID: 33160128 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/17/2020] [Accepted: 10/25/2020] [Indexed: 11/26/2022] Open
Abstract
We present the case of an 83-year-old woman with an isolated bilateral middle cerebellar peduncles stroke caused by complete occlusion of the right vertebral artery and focal occlusion of the left vertebral artery due to giant cell arteritis. The diagnosis was achieved by integrating MRI, ultrasound study, laboratory data and subsequent pathology analysis after biopsy of the temporal artery.
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Affiliation(s)
- Gennaro Castiello
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Claudia Altamura
- Neurology Department, Headache and Neurosonology Unit, Università Campus Bio-Medico di Roma, Italy
| | - Massimo Marano
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, Università Campus Bio-Medico di Roma, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Di Lazzaro
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
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Girolami I, Pantanowitz L, Mete O, Brunelli M, Marletta S, Colato C, Trimboli P, Crescenzi A, Bongiovanni M, Barbareschi M, Eccher A. Programmed Death-Ligand 1 (PD-L1) Is a Potential Biomarker of Disease-Free Survival in Papillary Thyroid Carcinoma: a Systematic Review and Meta-Analysis of PD-L1 Immunoexpression in Follicular Epithelial Derived Thyroid Carcinoma. Endocr Pathol 2020; 31:291-300. [PMID: 32468210 DOI: 10.1007/s12022-020-09630-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The expression of programmed death-ligand 1 (PD-L1) is an established prerequisite for the administration of checkpoint inhibitor therapy and is of prognostic value in several cancer types. Data concerning the potential effect of PD-L1 on the prognosis of thyroid carcinoma are limited. Therefore, this study aimed to provide a systematic review of the published data on this topic. The literature was reviewed to gather and quantify evidence on the prognostic role of PD-L1 in follicular epithelial derived thyroid carcinomas and determine its association with clinicopathological parameters. A meta-analysis was performed using the DerSimonian-Laird random-effects model. The quality of studies was evaluated with the Newcastle-Ottawa Scale and a modified GRADE approach used to rate the quality of evidence. Out of 445 papers, 18 were included and 15 provided adequate data for meta-analysis. The quality of evidence ranged from low to high. PD-L1 expression was significantly associated with a reduced disease-free survival (DFS) (RR 1.63, CI 1.04-2.56, p = 0.03, I2 68%, τ2 0.19 and HR 1.90, CI 1.33-2.70, p< 0.001, I2 0%, τ2 0.00); however, no association was found with the overall survival (OS). Furthermore, a significant association was found with respect to underlying chronic lymphocytic thyroiditis and BRAFV600E mutation status in papillary thyroid carcinomas. In the subgroup analysis, the association of PD-L1 and DFS remained strong in papillary thyroid carcinoma when compared with dedifferentiated thyroid carcinomas (anaplastic and poorly differentiated thyroid carcinomas) that failed to demonstrate a significant association with respect to PD-L1. These findings underscore the role of PD-L1 immunohistochemistry as a potential prognostic biomarker of disease recurrence in patients with papillary thyroid carcinoma.
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MESH Headings
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/metabolism
- Adenocarcinoma, Follicular/mortality
- Adenocarcinoma, Follicular/therapy
- Adult
- Aged
- Aged, 80 and over
- B7-H1 Antigen/analysis
- B7-H1 Antigen/metabolism
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/metabolism
- Disease-Free Survival
- Female
- Humans
- Immunohistochemistry
- Male
- Middle Aged
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/mortality
- Prognosis
- Thyroid Cancer, Papillary/diagnosis
- Thyroid Cancer, Papillary/metabolism
- Thyroid Cancer, Papillary/mortality
- Thyroid Cancer, Papillary/therapy
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/metabolism
- Thyroid Neoplasms/mortality
- Thyroid Neoplasms/therapy
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Affiliation(s)
- Ilaria Girolami
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy
| | - Liron Pantanowitz
- Department of Pathology, UPMC Shadyside Hospital, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ozgur Mete
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Matteo Brunelli
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy
| | - Stefano Marletta
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy
| | - Chiara Colato
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy
| | - Pierpaolo Trimboli
- Clinic for Nuclear Medicine and Competence Centre for Thyroid Disease, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Anna Crescenzi
- Section of Pathology, University Hospital Campus Bio Medico, Rome, Italy
| | | | | | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy.
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Crescenzi A, Trimboli P, Basolo F, Frasoldati A, Orlandi F, Palombini L, Papini E, Pontecorvi A, Vitti P, Zini M, Nardi F, Fadda G. Exploring the Inter-observer Agreement Among the Members of the Italian Consensus for the Classification and Reporting of Thyroid Cytology. Endocr Pathol 2020; 31:301-306. [PMID: 32621106 DOI: 10.1007/s12022-020-09636-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Classification schemes for reporting thyroid cytology of fine needle aspiration (FNA) of thyroid nodules are largely used in clinical practice, but the level of inter-observer agreement among cytopathologists is poorly acknowledged. The present study aimed to explore the inter-observer agreement among the experienced authors of the 2014 Italian Consensus for Classification and Reporting of Thyroid Cytology (ICCRTC). A stratified randomization was performed in order to obtain a sample homogeneously distributed and representative of all ICCRTC classes. Four high-experience raters were randomly selected among the extensors of the Italian consensus. They independently reviewed 60 FNA samples blindly of the initial cytological report and clinical features. Their overall agreement was evaluated according to Fleiss' kappa. The overall inter-observer agreement was moderate (κ 0.46). Specifically, a good agreement was found when the samples were consistent for malignancy (TIR5) or were not adequate for diagnosis (TIR1) (κ 0.67 and κ 0.73, respectively). A moderate agreement was present for suspicious-for-malignant category (TIR4), and a fair agreement was recorded in the two intermediate ones (TIR3A and TIR3B) (κ 0.36 and κ 0.35, respectively). For clinical purposes, the agreement was good (κ 0.74) in differentiating cases with surgical indication (TIR4/TIR5) from those in which surgery is not essential or requires limited extension (TIR3B/TIR3A/TIR2). In conclusion, the present study confirms the reliability of ICCRTC. These data represent a reference for cytopathologists using this system and are useful for the practice of clinicians and surgeons.
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Affiliation(s)
- Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Pierpaolo Trimboli
- Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500, Bellinzona, Switzerland.
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - Fulvio Basolo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Andrea Frasoldati
- Endocrinology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Fabio Orlandi
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Enrico Papini
- Endocrinology and Metabolism Unit, Regina Apostolorum Hospital, Albano Laziale, Italy
| | - Alfredo Pontecorvi
- Università Cattolica Del Sacro Cuore Agostino Gemelli, University Hospital, Rome, Italy
| | - Paolo Vitti
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Zini
- Endocrinology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Nardi
- Former Professor in Pathology, Sapienza University of Rome, Rome, Italy
| | - Guido Fadda
- Department of Pathology and Cytopathology - Catholic University, "Agostino Gemelli" Hospital IRCCS, Rome, Italy
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De Santis S, Sotgiu G, Crescenzi A, Taffon C, Felici AC, Orsini M. On the chemical composition of psammoma bodies microcalcifications in thyroid cancer tissues. J Pharm Biomed Anal 2020; 190:113534. [PMID: 32841781 DOI: 10.1016/j.jpba.2020.113534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
Recently the knowledge of chemical composition of pathological mineralizations is an important topic extensively studied because it could give more in-depth information to understand pathologies themselves and to improve prevention methods. In this work, psammoma bodies (PBs) microcalcifications in thyroid cancer tissue are investigated by different and complementary analytical methods as: micro-Fourier transformed spectroscopy, X-ray fluorescence spectroscopy, Inductively Coupled plasma Optical Emission Spectroscopy (ICP-OES) and scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy imaging (EDX). For the first time the micro-FTIR analysis of the only inorganic phase isolated from PBs was reported. Signals of the recorded spectrum showed that the main component of the calcifications is the amorphous carbonated calcium phosphate, and the IR spectrum of thyroid PBs is strongly consistent with that of PBs in human ovarian tumors. The XRF and the ICP analysis detected also the presence of iron ad zinc in thyroid PBs. These results are validated by scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy imaging (EDX) carried out on tissue samples of the papillary thyroid carcinoma. By these analytical methods magnesium and sodium were detected within PBs while the presence of iron was confirmed by the Perls test. Summarizing the results of applied analytical methods, the main detected elements within the thyroid psammoma bodies are Ca, P, Mg, Na, Fe and Zn. Magnesium and sodium are found in malignant breast cancer microcalcifications, thus they seem correlated to neoplastic transformation. The Fe and Zn elements could give information about the origin of these pathological microcalcifications.
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Affiliation(s)
- Serena De Santis
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma Italy.
| | - Giovanni Sotgiu
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome Italy
| | - Chiara Taffon
- Pathology Unit, University Hospital Campus Bio-Medico, Rome Italy
| | - Anna Candita Felici
- Basic and Applied Sciences for Engineering, Sapienza University, Via A. Scarpa 16, Roma Italy
| | - Monica Orsini
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma Italy
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38
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Cesareo R, Pacella CM, Pasqualini V, Campagna G, Iozzino M, Gallo A, Lauria Pantano A, Cianni R, Pedone C, Pozzilli P, Taffon C, Crescenzi A, Manfrini S, Palermo A. Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial). Thyroid 2020; 30:847-856. [PMID: 32056501 DOI: 10.1089/thy.2019.0660] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: No direct prospective studies comparing laser ablation (LA) and radiofrequency ablation (RFA) for debulking benign non-functioning thyroid nodules (BNTNs) exist. We aimed at comparing the efficacy and safety of both techniques in patients with solid or predominantly solid BNTN. Methods: This six-month, single-use, randomized, open-label, parallel trial compared the following primary endpoints between the RFA and LA groups six months after treatment: (i) nodule volume reduction expressed as a percentage of nodule volume at baseline; (ii) proportion of nodules with more than 50% reduction (successful rate). We enrolled subjects with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems or patients without symptoms who experienced a volume increase >20% in one year. Nodules underwent core needle biopsy for diagnosis. Patients were randomly assigned (1:1) to receive LA or RFA. Safety was assessed in all randomly assigned participants. Results: Sixty patients were randomly assigned to receive either RFA or LA (1:1) between January 2016 and November 2018. Both groups were similar in basal nodule volume, thyroid function, histology, symptoms/cosmetic score, and procedure time. At six months, the nodule volume reduction was 64.3% (95% confidence interval, CI 57.5-71.2) in the RFA group and 53.2% ([CI 47.2-95.2]; p = 0.02) in the LA group. This effect was also confirmed in the linear regression model adjusted for age, baseline volume, and proportion of cellular component (LA vs. RFA percent change Delta = -12.8, p = 0.02). No significant difference was observed in success rate six months after treatment (RFA vs. LA: 86.7% vs. 66.7%, p = 0.13) or in thyrotropin level between the groups. Although improved, no significant difference was observed between RFA and LA for compressive symptoms (RFA: 2.13 vs. 3.9, p < 0 · 001; LA: 2.4 vs. 3.87, p < 0.001) and cosmetic score (RFA: 1.65 vs. 2.2, p < 0.001; LA: 1.85 vs. 2.2, p < 0.001). The adverse event rates (local pain, dysphonia, thyrotoxicosis, fever, hematoma) were 37% (n = 11) and 43% (n = 13) for RFA and LA, respectively, with no requirement for hospitalization. Conclusion: Although the success rate was similar in the RFA and LA groups, RFA achieved a significantly larger nodule volume reduction at six months.
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Affiliation(s)
- Roberto Cesareo
- Unit of Metabolic Diseases, "S.M. Goretti" Hospital, Latina, Italy
| | - Claudio Maurizio Pacella
- Department of Diagnostic Imaging and Interventional Radiology, Regina Apostolorum Hospital, Albano Laziale, Italy
| | | | - Giuseppe Campagna
- Department of Internal Medicine, "S.M. Goretti" Hospital, Latina, Italy
| | - Mario Iozzino
- Department of Diagnostic Imaging and Interventional Radiology, Regina Apostolorum Hospital, Albano Laziale, Italy
| | - Andrea Gallo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Roberto Cianni
- Department of Interventional Radiology, S. Camillo Hospital, Rome, Italy
| | - Claudio Pedone
- Geriatric Unit, Campus Bio-Medico University, Rome, Italy
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Chiara Taffon
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
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39
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Scarpino S, Taccogna S, Pepe G, Papini E, D'Angelo M, Cascone F, Nicoletti D, Guglielmi R, Palermo A, Trombetta M, Rainer A, Taffon C, Crescenzi A. Morphological and Molecular Assessment in Thyroid Cytology Using Cell-Capturing Scaffolds. Horm Metab Res 2020; 52:803-808. [PMID: 32392586 DOI: 10.1055/a-1157-6419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The increased frequency of thyroid nodules is paralleled by the rise of thyroid cancer diagnosis. To define the nature of most thyroid nodules, fine needle aspiration (FNA) followed by cytological evaluation is considered the method of choice. About 20% of FNA biopsies on thyroid nodules, however, show indeterminate cytological features and may require diagnostic surgery. Several immunocytochemical and molecular markers have been proposed to improve classification of thyroid nodules, but these tests require adequate cell amount and cytological paraffin inclusion. Polymeric matrices were recently proposed for the collection of cells for diagnostic purposes. In this study, we evaluated the diagnostic use of a new matrix (CytoMatrix). Morphological, molecular and immunohistochemical investigations were carried out on 23 FNA samples included in CytoMatrix and compared with data obtained from the definitive histology of surgical samples. Our results showed that CytoMatrix is suitable to capture and preserve the cellularity of the samples harvested by FNA and that its paraffin sections mimic the morphology of those obtained from real histological tissue. Immunohistochemistry on CytoMatrix samples was consistent with the immunophenotypical profile of the corresponding histological surgical specimens. Mutational analysis of the BRAF (V600E) gene performed on CytoMatrix inclusions and paired surgical tissue matched in all but one cases while matrix immunohistochemistry identified 91.6% of BRAF mutated samples. In conclusion, we suggest that CytoMatrix could be a reliable tool to overcome the current limits of traditional collection methods for the study of thyroid cytology, thereby improving their reliability for a conclusive diagnostic interpretation.
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Affiliation(s)
- Stefania Scarpino
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Albano Laziale (RM), Italy
| | - Silvia Taccogna
- Pathology Unit, Regina Apostolorum Hospital, Albano Laziale (RM), Italy
| | - Giuseppina Pepe
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Albano Laziale (RM), Italy
| | - Enrico Papini
- Endocrinology and Metabolism Unit, Regina Apostolorum Hospital, Albano Laziale (RM), Italy
| | - Martina D'Angelo
- Pathology Unit, Regina Apostolorum Hospital, Albano Laziale (RM), Italy
| | - Federica Cascone
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Daniele Nicoletti
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Rinaldo Guglielmi
- Endocrinology and Metabolism Unit, Regina Apostolorum Hospital, Albano Laziale (RM), Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Marcella Trombetta
- Department of Engineering, University Campus Bio-Medico of Rome, Rome, Italy
| | - Alberto Rainer
- Department of Engineering, University Campus Bio-Medico of Rome, Rome, Italy
| | - Chiara Taffon
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy
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40
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Cesareo R, Pacella CM, Pasqualini V, Campagna G, Iozzino M, Gallo A, Pantano AL, Cianni R, Pedone C, Pozzilli P, Taffon C, Crescenzi A, manfrini S, Palermo A. OR18-07 Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomised, Parallel, Open-Label, Trial (Lara Trial). J Endocr Soc 2020. [PMCID: PMC7207726 DOI: 10.1210/jendso/bvaa046.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
ABSTRACT Background: Up to now, there are no direct prospective studies comparing Laser (LA) and radiofrequency ablation (RFA). We aimed to compare, in a head- to-head clinical trial, the efficacy and safety of both techniques in a population affected by solid or predominantly solid benign non-functioning thyroid nodules (BNTN). Methods. LARA is a six-month, single-use, randomized, superiority, open-label, parallel trial. We enrolled subjects with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems or patients without symptoms who experienced a volume increase >20% in one year. Nodules underwent core needle biopsy (CNB) to evaluate the histological architecture. Patients were randomly assigned (1:1) to receive treatment with either LA or RFA. The primary endpoint was to evaluate the difference in nodule volume reduction between the RF and the LA group at six months. Moreover, we aimed to assess the differences between groups in the rate of nodules with greater than 50% base volume reduction (successful rate) at six months after treatment. ClinicalTrials.gov: number NCT02714946. Findings: From January 2016 to November 2018, 60 patients were randomly assigned (30 participants per group). In the whole study population, the average volume of nodules was 25 ml. The two groups were similar in terms of basal nodule volume, thyroid function, histology, symptoms/cosmetic score and procedure time. At six months, participants in the RFA group showed a reduction volume of 64·3% (95% CI: 57·5% - 71·2%) compared to 53·2% (95% CI: 47·2% - 59·2%) in the LA group (p= 0·015) and this difference was also confirmed in a linear regression model adjusted for age, baseline volume and proportion of cellular component (Laser vs. RFA percent change Delta= -12·8, P=0·018).We have not recorded any significant difference in terms of successful rate at six months after treatment between the two groups (86·7% in the RFA vs 66·7% in the LA, p=0·127). At six months, both symptoms and cosmetic scores improved (compressive symptom score: 2·13 vs 3·9 for RFA, p < 0·001; 2·4 vs. 3·87 for LA, p < 0·001; cosmetic score: 1·65 vs 2·2 for RFA p <0·001, 1·85 vs 2·2 for LA p <0·001) without any statistically significant difference between the two groups. No statistical difference between the two groups was detected at six months as regards the TSH level. High rate of cellularity negatively affects the volume reduction in RFA group (r coefficient -0·41, p=0·034) while histological features did not affect the efficacy of the LA. The adverse event rates were 37% and 43% for RFA and LA, respectively, with no requirement for hospitalization. Interpretation: Both techniques are very effective in reducing the volume of thyroid nodules. RFA appears to be more effective than LA, but both techniques showed no difference in terms of success rate six months after treatment. The safety of the two techniques is very satisfactory.
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41
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Palermo A, Napolitano A, Maggi D, Naciu AM, Tabacco G, Manfrini S, Crescenzi A, Taffon C, Pantano F, Vincenzi B, Tonini G, Santini D. Regression of Papillary Thyroid Cancer during Nivolumab for Renal Cell Cancer. Eur Thyroid J 2020; 9:157-161. [PMID: 32523892 PMCID: PMC7265713 DOI: 10.1159/000506107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/21/2020] [Indexed: 12/17/2022] Open
Abstract
Immune checkpoint inhibitors have been recently approved for cancer treatment. Nivolumab is a monoclonal antibody specific for programmed cell death-1 (PD-1) that modulates T-cell response. It was initially used for the treatment of malignant melanoma and then approved in other cancers, such as non-small cell lung cancer and clear cell renal cell carcinoma (ccRCC). So far, the activity of nivolumab in patients with thyroid malignancies has been reported in a single case of anaplastic thyroid cancer. Here, we report the case of a patient with ccRCC who developed a papillary thyroid carcinoma (PTC) under first-line sunitinib treatment. During nivolumab, the second-line treatment for ccRCC, we unexpectedly observed a complete regression of PTC.
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Affiliation(s)
- Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
- *Andrea Palermo, Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Via Alvaro del Portillo 200, IT–00128 Rome (Italy),
| | - Andrea Napolitano
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Daria Maggi
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Anna Crescenzi
- Department of Anatomic Pathology, Campus Bio-Medico University, Rome, Italy
| | - Chiara Taffon
- Department of Anatomic Pathology, Campus Bio-Medico University, Rome, Italy
| | - Francesco Pantano
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Bruno Vincenzi
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Guiseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
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42
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Zancla A, De Santis S, Sotgiu G, Taffon C, Crescenzi A, Orsini M. Micro-FTIR spectroscopy as robust tool for psammoma bodies detection in papillary thyroid carcinoma. Spectrochim Acta A Mol Biomol Spectrosc 2020; 229:117984. [PMID: 31887679 DOI: 10.1016/j.saa.2019.117984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
The presence of psammoma bodies (PBs), concentric lamellated calcified structures, in thyroid tissues is considered a reliable diagnostic marker for Papillary thyroid carcinoma (PTC) and has been correlated to aggressive tumour behaviours such as multifocality and lymph node metastasis. Fourier transform infrared (FTIR) microspectroscopy already proved to be a powerful tool for biological tissues study thanks to its ability to spatially resolve information on the chemical composition of the analysed samples. FTIR maps were collected from thyroid tumour resections and analysed by multivariate unsupervised Principal Component Analysis (PCA) and Clustering (K-means and fuzzy c-means clustering) techniques. The resulting spectral images were compared to the corresponding hematoxylin-eosin stained tissue section which provided histopathological validation. The 850-1100 cm-1 spectral range was the most reliable for detection of PBs and the characteristic bands of carboapatite, present in this region, were correctly identified by the multivariate techniques. These findings disclose the possibility to use a combination of FTIR microspectroscopy and multivariate spectral processing as objective and robust tools for automated PBs recognition and consequently for PTC early diagnosis.
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Affiliation(s)
- Andrea Zancla
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Serena De Santis
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Giovanni Sotgiu
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy
| | - Chiara Taffon
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Anna Crescenzi
- Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy
| | - Monica Orsini
- Department of Engineering, Roma Tre University, via Vito Volterra 62, Roma, Italy.
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43
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di Masi A, Leboffe L, Sodo A, Tabacco G, Cesareo R, Sbroscia M, Giovannoni I, Taffon C, Crucitti P, Longo F, Manfrini S, Ricci MA, Ascenzi P, Crescenzi A, Palermo A. Metabolic profile of human parathyroid adenoma. Endocrine 2020; 67:699-707. [PMID: 31786773 DOI: 10.1007/s12020-019-02146-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Recently, it has been demonstrated that Raman spectroscopy is able to differentiate between healthy parathyroid tissues and parathyroid adenoma based on the basis of a specific molecular fingerprint. However, to our knowledge, no previous studies have been performed to evaluate the metabolic profile of parathyroid adenoma. Therefore, we designed a proof of concept study aimed to investigate the glucose/fatty acid metabolisms, in addition to the mitochondrial changes, in solitary parathyroid adenoma and in healthy parathyroid glands. METHODS Nine females with primary hyperparathyroidism due to a solitary parathyroid adenoma and formal surgical indication for parathyroidectomy have been enrolled. At the time of surgery, the removed specimens were immediately submitted unfixed and a tissue slice of about 0.5 cm in diameter was obtained from the nodular lesion. The expression of selected metabolic enzymes and proteins has been evaluated by western blot analysis, using human parathyroid whole tissue lysates as control. RESULTS Data obtained highlighted an increase, compared with the healthy group, of: (i) the glucose uptake by the GLUT-1 receptor and its phosphorylation by hexokinase II (HXKII); (ii) the expression of 3-phosphoglycerate dehydrogenase (3-PGDH) and glucose-6-phosphate dehydrogenase (G6PD); (iii) lipids biosynthesis; and (iv) cytochrome c expression. CONCLUSIONS Our findings highlight for the first time the parathyroid adenoma metabolic hallmarks that could represent potential molecular targets usable for the development of new pharmacological treatments, allowing to reduce surgical parathyroidectomy.
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Affiliation(s)
| | - Loris Leboffe
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Armida Sodo
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
| | - Roberto Cesareo
- Unit of Metabolic Diseases, Department of Internal Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Marco Sbroscia
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | | | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, Roma, Italy
| | | | - Filippo Longo
- Unit of Neck and Chest Surgery, Campus Bio-Medico University, Roma, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
| | | | - Paolo Ascenzi
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, Roma, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
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44
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Marano M, Todisco A, Motolese F, Quattrocchi CC, Crescenzi A, Cirillo G, Di Lazzaro V. Choreo-Athetosis and Ataxia as Leading Features in a Case of Erdheim-Chester Disease. Mov Disord Clin Pract 2020; 7:215-217. [PMID: 32071944 PMCID: PMC7011650 DOI: 10.1002/mdc3.12891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/16/2019] [Accepted: 12/22/2019] [Indexed: 11/06/2022] Open
Abstract
View Supplementary Video 1
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Affiliation(s)
- Massimo Marano
- Neurology, Neurophysiology and Neurobiology Unit, Department of MedicineUniversity Campus Bio‐MedicoRomeItaly
| | - Antonio Todisco
- Neurology, Neurophysiology and Neurobiology Unit, Department of MedicineUniversity Campus Bio‐MedicoRomeItaly
| | - Francesco Motolese
- Neurology, Neurophysiology and Neurobiology Unit, Department of MedicineUniversity Campus Bio‐MedicoRomeItaly
| | | | | | - Giovanni Cirillo
- Division of Human Anatomy–Neuronal Networks Morphology Lab, Department of Mental, Physical Health and Preventive MedicineUniversity of Campania “Luigi Vanvitelli,”NaplesItaly
| | - Vincenzo Di Lazzaro
- Neurology, Neurophysiology and Neurobiology Unit, Department of MedicineUniversity Campus Bio‐MedicoRomeItaly
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45
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Donati M, Zelano G, Coppola R, Cinelli E, Verri M, Persichetti P, Perrella E, Devirgiliis V, Calvieri S, Crescenzi A, Panasiti V. Personalized and targeted mutational analysis of multiple second primary melanomas under kinase inhibitors. Ital J Dermatol Venerol 2019. [PMID: 31804055 DOI: 10.23736/s0392-0488.19.06516-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Second primary melanomas (SPMs) are new developed primary melanomas occurring in a subset of patients affected by BRAF-mutated metastatic melanoma during treatment with BRAF-inhibitors. A drug-induced paradoxical activation of mitogen-activated protein kinase (MAPK) signaling pathway in BRAF-wild type/RAS-mutated cells have been proposed as a possible molecular mechanism but data on the mutational status of SPMs are lacking. In order to better understand genetic alterations affecting the biological mechanism of SPMs, we performed a personalized and targeted next-generation sequencing analysis of a patient affected by metastatic melanoma who developed multiple SPMs during treatment with encorafenib (LGX818). METHODS Using a cancer panel of 50 genes for solid tumors enriched with a custom panel of 10 genes specifically involved in melanoma pathogenesis, we analyzed the primary melanoma, two SPMs, one benign compound nevus and the normal DNA extracted from blood lymphocytes of the patient. RESULTS We identified HRAS Q61 somatic mutation in one SPM developed in a pre-existing nevus. In the primary melanoma, besides the BRAF mutation, we identified the clinically actionable IDH1 R132C somatic mutation. Both SPMs were BRAF wild type. The patient harbors the recently recognized pathogenetic germline variant KDR Q472. We observed that mutations detected in tumor samples involving genes related to melanoma pathogenesis (TP53, PIK3CA, FGFR3, ATF1, KIT, HRAS and MAP2K2) were present in heterozygosis in the germline status of the patient. CONCLUSIONS Our results support the paradoxical mechanism of MAPK pathway for SPMs under BRAF inhibitors. Moreover, they suggest that targeted mutational assessment based on matching somatic and germline analysis represent a promising approach to detect the neoplastic landscape of the tumor and to identify most accurate treatment in metastatic melanoma patient.
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Affiliation(s)
- Michele Donati
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Giovanni Zelano
- Institute of Human Anatomy and Cell Biology, Sacred Heart Catholic University, Rome, Italy
| | - Rosa Coppola
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy -
| | - Eleonora Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Martina Verri
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
| | | | - Valeria Devirgiliis
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
| | - Stefano Calvieri
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Vincenzo Panasiti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
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46
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Donati M, Zelano G, Coppola R, Cinelli E, Verri M, Persichetti P, Perrella E, Devirgiliis V, Calvieri S, Crescenzi A, Panasiti V. Personalized and targeted mutational analysis of multiple second primary melanomas under kinase inhibitors. Ital J Dermatol Venerol 2019; 156:593-598. [PMID: 31804055 DOI: 10.23736/s2784-8671.19.06516-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Second primary melanomas (SPMs) are new developed primary melanomas occurring in a subset of patients affected by BRAF-mutated metastatic melanoma during treatment with BRAF-inhibitors. A drug-induced paradoxical activation of mitogen-activated protein kinase (MAPK) signaling pathway in BRAF-wild type/RAS-mutated cells have been proposed as a possible molecular mechanism but data on the mutational status of SPMs are lacking. In order to better understand genetic alterations affecting the biological mechanism of SPMs, we performed a personalized and targeted next-generation sequencing analysis of a patient affected by metastatic melanoma who developed multiple SPMs during treatment with encorafenib (LGX818). METHODS Using a cancer panel of 50 genes for solid tumors enriched with a custom panel of 10 genes specifically involved in melanoma pathogenesis, we analyzed the primary melanoma, two SPMs, one benign compound nevus and the normal DNA extracted from blood lymphocytes of the patient. RESULTS We identified HRAS Q61 somatic mutation in one SPM developed in a pre-existing nevus. In the primary melanoma, besides the BRAF mutation, we identified the clinically actionable IDH1 R132C somatic mutation. Both SPMs were BRAF wild type. The patient harbors the recently recognized pathogenetic germline variant KDR Q472. We observed that mutations detected in tumor samples involving genes related to melanoma pathogenesis (TP53, PIK3CA, FGFR3, ATF1, KIT, HRAS and MAP2K2) were present in heterozygosis in the germline status of the patient. CONCLUSIONS Our results support the paradoxical mechanism of MAPK pathway for SPMs under BRAF inhibitors. Moreover, they suggest that targeted mutational assessment based on matching somatic and germline analysis represent a promising approach to detect the neoplastic landscape of the tumor and to identify most accurate treatment in metastatic melanoma patient.
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Affiliation(s)
- Michele Donati
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Giovanni Zelano
- Institute of Human Anatomy and Cell Biology, Sacred Heart Catholic University, Rome, Italy
| | - Rosa Coppola
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy -
| | - Eleonora Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Martina Verri
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
| | | | - Valeria Devirgiliis
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
| | - Stefano Calvieri
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, Campus Bio-Medico University, Rome, Italy
| | - Vincenzo Panasiti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Rome, Italy
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47
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Trimboli P, Palermo A, Deandrea M, Piccardo A, Campennì A, Valabrega S, Grani G, Santolamazza G, Bottoni G, Barnabei A, Ramundo V, Lauretta R, Monte L, Ferrarazzo G, Paone G, Crosetto C, Ruggeri RM, Baldari S, Chiefari A, Vottari S, Giarnieri E, Perrella E, Limone P, Durante C, Giovanella L, Appetecchia M, Crescenzi A. Prognosis of patients with differentiated thyroid carcinomas having a preoperative cytological report of indeterminate at low or high risk. A multicenter study. Endocrine 2019; 66:557-562. [PMID: 31313225 DOI: 10.1007/s12020-019-02013-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Italian cytology system for thyroid fine-needle aspiration (FNA) includes indeterminate lesions at low- (Tir 3A) and high-risk (Tir 3B). The present retrospective multicenter study was undertaken to compare the histological type of cancers and disease-free survival in these two groups. METHODS Eight institutions participated. Thyroid cancer patients diagnosed and followed-up after Tir 3A or Tir 3B were reviewed. Histological diagnosis was adopted as the gold standard. Patients were defined with cancer recurrence or no evidence of disease. Disease-free survival (DFS) was calculated. A non-parametric statistical analysis was used. DFS was estimated by Kaplan-Meier method and Hazard Ratio (HR) defined the slope of curves. RESULTS Two hundred and nine patients (median DFS 24 months) were enrolled and a 6.3% of these recurred. Tir 3B group had higher age (p = 0.014), larger cancer size (p = 0.0002), shorter DFS (p = 0.003), higher number of aggressive cancers (p = 0.006), and relapse frequency double than Tir 3A. At survival curves analysis, Tir 3B group had HR of 2.37 with respect to Tir 3A. At Cox's proportional hazard regression analysis histology was the only significant predictor of relapse. CONCLUSIONS While patients with thyroid FNA of Tir 3B should be addressed to surgery due to high likelihood of more aggressive cancer, a diagnostic surgery could be avoided in patients with Tir 3A if concurrent unsuspicious clinical features are found.
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Affiliation(s)
- Pierpaolo Trimboli
- Department of Nuclear Medicine and Thyroid Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
| | - Andrea Palermo
- Units of Endocrinology and Diabetes, Department of Medicine, University Hospital Campus Bio Medico, Rome, Italy
| | - Maurilio Deandrea
- Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital, Turin, Italy
| | | | - Alfredo Campennì
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Stefano Valabrega
- Department of Medical and Surgical Sciences, Ospedale S. Andrea, Sapienza University, Rome, Italy
| | - Giorgio Grani
- Department of Traslational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giuliano Santolamazza
- Department of Medical and Surgical Sciences, Ospedale S. Andrea, Sapienza University, Rome, Italy
| | | | - Agnese Barnabei
- Oncological Endocrinology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Valeria Ramundo
- Department of Traslational and Precision Medicine, Sapienza University, Rome, Italy
| | - Rosa Lauretta
- Oncological Endocrinology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Lavinia Monte
- Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital, Turin, Italy
| | | | - Gaetano Paone
- Department of Nuclear Medicine and Thyroid Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Cecilia Crosetto
- Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital, Turin, Italy
| | - Rosaria Maddalena Ruggeri
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, "G. Martino" University Hospital, University of Messina, Messina, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Alfonsina Chiefari
- Oncological Endocrinology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Sebastiano Vottari
- Oncological Endocrinology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Giarnieri
- Departments of Clinical and Molecular Medicine, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Eleonora Perrella
- Section of Pathology, University Hospital Campus Bio Medico, Rome, Italy
| | - Paolo Limone
- Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital, Turin, Italy
| | - Cosimo Durante
- Department of Traslational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luca Giovanella
- Department of Nuclear Medicine and Thyroid Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Marialuisa Appetecchia
- Oncological Endocrinology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Anna Crescenzi
- Section of Pathology, University Hospital Campus Bio Medico, Rome, Italy
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Vicari M, Guidobaldi L, Perrella E, Bianchi A, Ferrari S, Martucci M, Petitti T, Rabitti C, Crescenzi A. Morphometric analysis of atypical glandular cells correctly classifies normal, reactive, and atypical cells in cervical smears. Diagn Cytopathol 2019; 48:10-16. [DOI: 10.1002/dc.24320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/29/2019] [Accepted: 09/06/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Marco Vicari
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
| | - Leo Guidobaldi
- Cytodiagnostic Service, Microbiology and Virology Unit“Sandro Pertini” Hospital Rome Italy
| | - Eleonora Perrella
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
| | - Antonella Bianchi
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
| | - Simona Ferrari
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
| | | | - Tommasangelo Petitti
- Hygiene, Public Health and statistics Research UnitCampus Bio‐Medico University Rome Italy
| | - Carla Rabitti
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
| | - Anna Crescenzi
- Pathology UnitUniversity Hospital Campus Bio‐Medico of Rome Rome Italy
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Bruschini S, di Martino S, Pisanu ME, Fattore L, De Vitis C, Laquintana V, Buglioni S, Tabbì E, Cerri A, Visca P, Alessandrini G, Facciolo F, Napoli C, Trombetta M, Santoro A, Crescenzi A, Ciliberto G, Mancini R. CytoMatrix for a reliable and simple characterization of lung cancer stem cells from malignant pleural effusions. J Cell Physiol 2019; 235:1877-1887. [PMID: 31397494 PMCID: PMC6916247 DOI: 10.1002/jcp.29121] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/17/2019] [Indexed: 12/14/2022]
Abstract
Cancer stem cells (CSCs) are a subpopulation with the properties of extensive self‐renewal, capability to generate differentiated cancer cells and resistance to therapies. We have previously shown that malignant pleural effusions (MPEs) from patients with non‐small‐cell lung cancer (NSCLC) represent a valuable source of cancer cells that can be grown as three‐dimensional (3D) spheroids enriched for stem‐like features, which depend on the activation of the Yes‐associated protein‐transcriptional coactivator with PDZ‐binding motif (YAP‐TAZ)/Wnt‐βcatenin/stearoyl‐CoA desaturase 1 (SCD1) axis. Here, we describe a novel support, called CytoMatrix, for the characterization of limited amounts of cancer cells isolated from MPEs of patients with NSCLC. Our results show that this synthetic matrix allows an easy and fast characterization of several epithelial cellular markers. The use of CytoMatrix to study CSCs subpopulation confirms that SCD1 protein expression is enhanced in 3D spheroids when compared with 2D adherent cell cultures. YAP/TAZ nuclear‐cytoplasmic distribution analysed by CytoMatrix in 3D spheroids is highly heterogeneous and faithfully reproduces what is observed in tumour biopsies. Our results confirm and extend the robustness of our workflow for the isolation and phenotypic characterization of primary cancer cells derived from the lung MPEs and underscore the role of SCD1.
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Affiliation(s)
- Sara Bruschini
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Simona di Martino
- Phatology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Elena Pisanu
- High Resolution NMR Unit, Core Facilities, Istituto Superiore di Sanità, Rome, Italy
| | - Luigi Fattore
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Simonetta Buglioni
- Phatology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Eugenio Tabbì
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Andrea Cerri
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Visca
- Phatology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Marcella Trombetta
- Tissue Engineering and Chemistry for Engineering Lab, Department of Engineering, University Campus Bio-Medico, Rome, Italy
| | | | - Anna Crescenzi
- Section of Pathology, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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50
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Papini E, Pacella CM, Solbiati LA, Achille G, Barbaro D, Bernardi S, Cantisani V, Cesareo R, Chiti A, Cozzaglio L, Crescenzi A, De Cobelli F, Deandrea M, Fugazzola L, Gambelunghe G, Garberoglio R, Giugliano G, Luzi L, Negro R, Persani L, Raggiunti B, Sardanelli F, Seregni E, Sollini M, Spiezia S, Stacul F, Van Doorne D, Sconfienza LM, Mauri G. Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group. Int J Hyperthermia 2019; 36:376-382. [PMID: 30909759 DOI: 10.1080/02656736.2019.1575482] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Benign thyroid nodules are a common clinical occurrence and usually do not require treatment unless symptomatic. During the last years, ultrasound-guided minimally invasive treatments (MIT) gained an increasing role in the management of nodules causing local symptoms. In February 2018, the Italian MIT Thyroid Group was founded to create a permanent cooperation between Italian and international physicians dedicated to clinical research and assistance on MIT for thyroid nodules. The group drafted this list of statements based on literature review and consensus opinion of interdisciplinary experts to facilitate the diffusion and the appropriate use of MIT of thyroid nodules in clinical practice. (#1) Predominantly cystic/cystic symptomatic nodules should first undergo US-guided aspiration; ethanol injection should be performed if relapsing (level of evidence [LoE]: ethanol is superior to simple aspiration = 2); (#2) In symptomatic cystic nodules, thermal ablation is an option when symptoms persist after ethanol ablation (LoE = 4); (#3) Double cytological benignity confirmation is needed before thermal ablation (LoE = 2); (#4) Single cytological sample is adequate in ultrasound low risk (EU-TIRADS ≤3) and in autonomously functioning nodules (LoE = 2); (#5) Thermal ablation may be proposed as first-line treatment for solid, symptomatic, nonfunctioning, benign nodules (LoE = 2); (#6) Thermal ablation may be used for dominant lesions in nonfunctioning multinodular goiter in patients refusing/not eligible for surgery (LoE = 5); (#7) Clinical and ultrasound follow-up is appropriate after thermal ablation (LoE = 2); (#8) Nodule re-treatment can be considered when symptoms relapse or partially resolve (LoE = 2); (#9) In case of nodule regrowth, a new cytological assessment is suggested before second ablation (LoE = 5); (#10) Thermal ablation is an option for autonomously functioning nodules in patients refusing/not eligible for radioiodine or surgery (LoE = 2); (#11) Small autonomously functioning nodules can be treated with thermal ablation when thyroid tissue sparing is a priority and ≥80% nodule volume ablation is expected (LoE = 3).
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Affiliation(s)
- Enrico Papini
- a Dipartimento di Endocrinologia , Ospedale Regina Apostolorum , Albano Laziale , Italy
| | - Claudio Maurizio Pacella
- b Dipartimento di Imaging Diagnostico e Radiologia Interventistica , Ospedale Regina Apostolorum , Albano Laziale , Italy
| | - Luigi Alessandro Solbiati
- c Humanitas University, Pieve Emanuele , Milan , Italy.,d Humanitas Clinical and Research Center IRCCS , Rozzano , Italy
| | - Gaetano Achille
- e Unità Operativa ORL, IRCCS Oncologico "Giovanni Paolo II" , Bari , Italy
| | - Daniele Barbaro
- f U.O. Endocrinologia ASL Nordovest Toscana , Toscana , Italy
| | - Stella Bernardi
- g Azienda Sanitaria Universitaria Integrata Trieste , Trieste , Italy.,h Università degli Studi di Trieste , Trieste , Italy
| | - Vito Cantisani
- i Policlinico Umberto I, Università Sapienza , Roma , Italy
| | - Roberto Cesareo
- j Thyroid and metabolic bone diseases center, Ospedale Santa Maria Goretti , Latina , Italy
| | - Arturo Chiti
- c Humanitas University, Pieve Emanuele , Milan , Italy.,d Humanitas Clinical and Research Center IRCCS , Rozzano , Italy
| | - Luca Cozzaglio
- d Humanitas Clinical and Research Center IRCCS , Rozzano , Italy
| | - Anna Crescenzi
- k UOC Anatomia Patologica, Policlinico Universitario Campus Bio-Medico , Roma , Italy
| | | | | | - Laura Fugazzola
- n Istituto Auxologico Italiano IRCCS , Milano , Italy.,o Università degli Studi di Milano , Milano , Italy
| | | | - Roberto Garberoglio
- q Ospedale Città della Salute Torino, Dipartimento Universitario di Endocrinologia e Malattie Metaboliche , Torino , Italy
| | - Gioacchino Giugliano
- r Department of Head and Neck , Istituto Europeo di Oncologia, IRCCS , Milano , Italy
| | - Livio Luzi
- o Università degli Studi di Milano , Milano , Italy.,s IRCCS Policlinico San Donato, UOC Endocrinologia e Malattie Metaboliche , San Donato Milanese , Italy
| | | | - Luca Persani
- n Istituto Auxologico Italiano IRCCS , Milano , Italy.,o Università degli Studi di Milano , Milano , Italy
| | | | - Francesco Sardanelli
- o Università degli Studi di Milano , Milano , Italy.,v IRCCS Policlinico San Donato , San Donato Milanese , Italy
| | - Ettore Seregni
- w Fondazione IRCCS Istituto Nazionale dei Tumori , Milano , Italy
| | | | - Stefano Spiezia
- x Unità Operativa di Chirurgia Endocrina ed Ecoguidata , Ospedale del Mare, ASL Napoli1 centro , Napoli , Italy
| | - Fulvio Stacul
- g Azienda Sanitaria Universitaria Integrata Trieste , Trieste , Italy
| | | | - Luca Maria Sconfienza
- o Università degli Studi di Milano , Milano , Italy.,z IRCCS Istituto Ortopedico Galeazzi , Milano , Italy
| | - Giovanni Mauri
- aa Division of Interventional Radiology , IEO, European Institute of Oncology IRCCS , Milan , Italy
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