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Béchu C, Rullier A, Lesoin PE, Gaillot-Durand L, Trecourt A, Gosset P, Tilmant C. The carbon footprint of a surgical pathology laboratory in France. Am J Clin Pathol 2024:aqae022. [PMID: 38470223 DOI: 10.1093/ajcp/aqae022] [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: 12/12/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES The health sector contributes to climate disruption through greenhouse gas (GHG) emissions. It accounts for 8% to 10% of France's GHG emissions. Although the medical community has been alerted to the problem, more data are needed. This study aimed to determine the carbon footprint of a surgical pathology laboratory. METHODS The study was conducted in the surgical pathology laboratory at Saint Vincent hospital (Lille) in 2021. It represented 17,242 patient cases corresponding to 54,124 paraffin blocks. The 17 staff members performed cytology, immunohistochemistry, and in situ hybridization. The study included all inputs, capital equipment, freight, travel, energy consumption, and waste. Carbon emission factors were based on the French Agence De l'Environnement et de la Maîtrise de l'Energie database. RESULTS In 2021, the pathology laboratory's carbon footprint was 117 tons of CO2 equivalent (t CO2e), corresponding to 0.5% of Saint Vincent hospital's total emissions. The most significant emissions categories were inputs (60 t CO2e; 51%), freight associated with inputs (24 t CO2e; 20%), and travel (14 t CO2e; 12%). Waste and energy generated 10 t CO2e (9%) and 9 t CO2e (8%), respectively. CONCLUSIONS The pathology laboratory's carbon footprint was equivalent to the yearly carbon impact of 11 French inhabitants. This footprint is dominated by inputs and associated freight. This suggests an urgent need to develop ecodesign and self-sufficiency in our routine practices.
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Affiliation(s)
| | | | | | | | | | - Pierre Gosset
- Service d'ACP, Hôpital Saint Vincent de Paul, GHICL, Lille, France
| | - Cyprien Tilmant
- Service d'ACP, Hôpital Saint Vincent de Paul, GHICL, Lille, France
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São Julião GP, Fernández LM, Vailati BB, Habr-Gama A, Azevedo JM, Santiago IA, Parés O, Parvaiz A, Vendrely V, Rullier A, Rullier E, Denost Q, Perez RO. Local Regrowth and the Risk of Distant Metastases Among Patients Undergoing Watch-and-Wait for Rectal Cancer: What Is the Best Control Group? Multicenter Retrospective Study. Dis Colon Rectum 2024; 67:73-81. [PMID: 37493198 DOI: 10.1097/dcr.0000000000002930] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
BACKGROUND A proportion of rectal cancer patients who achieve a clinical complete response may develop local regrowth. Although salvage appears to provide appropriate local control, the risk of distant metastases is less known. OBJECTIVE To compare the risk of distant metastases between patients who achieve a clinical complete response (watch-and-wait strategy) and subsequent local regrowth and patients managed by surgery after chemoradiation. DESIGN Retrospective multicenter cohort study. SETTINGS This study used data of patients from 3 institutions who were treated between 1993 and 2019. PATIENTS Patients with initial clinical complete response (after neoadjuvant therapy) followed by local regrowth and patients with near-complete pathological response (≤10%) after straightforward surgery after chemoradiation were included. MAIN OUTCOME MEASURES Univariate and multivariate analyses were performed to identify risk factors for distant metastases. Kaplan-Meier curves were created (log-rank test) to compare survival outcomes. Analyses were performed using time zero as last day of radiation therapy or as date of salvage resection in the local regrowth group. RESULTS Twenty-one of 79 patients with local regrowth developed distant metastases, whereas only 10 of 74 after upfront total mesorectal excision following neoadjuvant chemoradiation therapy ( p = 0.04). Local regrowth and final pathology (ypT3-4) were the only independent risk factors associated with distant metastases. When using date of salvage resection as time zero, distant metastases-free survival rates were significantly inferior for patients with local regrowth (70% vs 86%; p = 0.01). LIMITATIONS Small number of patients, many neoadjuvant therapies, and selection bias. CONCLUSIONS Patients undergoing watch-and-wait strategy who develop local regrowth are at higher risk for development of distant metastases compared to patients with near-complete pathological response managed by upfront surgery after chemoradiation. See Video Abstract. NUEVO CRECIMIENTO LOCAL Y EL RIESGO DE METSTASIS A DISTANCIA ENTRE PACIENTES SOMETIDOS A OBSERVACIN Y ESPERA POR CNCER DE RECTO CUL ES EL MEJOR GRUPO DE CONTROL ESTUDIO RETROSPECTIVO MUTICNTRICO ANTECEDENTES:Una proporción de pacientes que logran una respuesta clínica completa pueden desarrollar un nuevo crecimiento local. Si bien el rescate parece proporcionar un control local apropiado, el riesgo de metástasis a distancia es menos conocido.OBJETIVO:Comparar el riesgo de metástasis a distancia entre los pacientes que logran una respuesta clínica completa (estrategia de observación y espera) y el nuevo crecimiento local posterior con los pacientes tratados con cirugía después de la quimiorradiación.DISEÑO:Estudio de cohorte multicéntrico retrospectivo.CONFIGURACIÓN:Este estudio utilizó datos de pacientes de 3 instituciones que fueron tratados entre 1993 y 2019.PACIENTES:Pacientes con respuesta clínica completa inicial (después de la terapia neoadyuvante) seguida de crecimiento local nuevo y pacientes con respuesta patológica casi completa (≤10 %) después de cirugía directa después de quimiorradiación.PRINCIPALES MEDIDAS DE RESULTADO:Se realizó un análisis univariante/multivariante para identificar los factores de riesgo de metástasis a distancia. Se crearon curvas de Kaplan-Meier (prueba de rango logarítmico) para comparar los resultados de supervivencia. El análisis se realizó utilizando el tiempo cero como último día de radioterapia (1) o como fecha de resección de rescate (2) en el grupo de recrecimiento local.RESULTADOS:Veintiuno de 79 pacientes con recrecimiento local desarrollaron metástasis a distancia, mientras que solo 10 de 74 después de una cirugía sencilla (p = 0,04). El recrecimiento local y la patología final (ypT3-4) fueron los únicos factores de riesgo independientes asociados con las metástasis a distancia. Cuando se utilizó la fecha de la resección de rescate como tiempo cero, las tasas de supervivencia sin metástasis a distancia fueron significativamente inferiores para los pacientes con recrecimiento local (70 frente a 86 %; p = 0,01).LIMITACIONES:Pequeño número de pacientes, muchas terapias neoadyuvantes, sesgo de selección.CONCLUSIONES:Los pacientes sometidos a observación y espera que desarrollan un nuevo crecimiento local tienen un mayor riesgo de desarrollar metástasis a distancia en comparación con los pacientes con una respuesta patológica casi completa manejados con cirugía por adelantado después de la quimiorradiación. (Traducción-Dr. Xavier Delgadillo ).
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Affiliation(s)
- Guilherme Pagin São Julião
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
- Department of Coloproctology, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Hospital Beneficencia Portuguesa, São Paulo, Brazil
| | | | - Bruna Borba Vailati
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
- Department of Coloproctology, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Hospital Beneficencia Portuguesa, São Paulo, Brazil
| | - Angelita Habr-Gama
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
- Department of Coloproctology, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Hospital Beneficencia Portuguesa, São Paulo, Brazil
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - José M Azevedo
- Colorectal Surgery Department, Champalimaud Foundation, Lisbon
| | | | - Oriol Parés
- Radiation Oncology Department, Champalimaud Foundation, Lisbon
| | - Amjad Parvaiz
- Colorectal Surgery Department, Champalimaud Foundation, Lisbon
| | - Véronique Vendrely
- Department of Radiotherapy, Haut-Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Anne Rullier
- Department of Pathology, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Eric Rullier
- Department of Colorectal Surgery, Haut-Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Quentin Denost
- Bordeaux Colorectal Institute, Tivoli Clinic, Bordeaux, France
| | - Rodrigo Oliva Perez
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
- Department of Coloproctology, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Hospital Beneficencia Portuguesa, São Paulo, Brazil
- Ludwig Institute for Cancer Research, São Paulo Branch, Brazil
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Trecourt A, Cottinet PJ, Donzel M, Favretto M, Bancel B, Decaussin-Petrucci M, Traverse-Glehen A, Devouassoux-Shisheboran M, Meyronet D, Belleannée G, Rullier A, Lê MQ, Rival G, Grinberg D, Tilmant C, Gaillot-Durand L. Carbon footprint evaluation of routine anatomic pathology practices using eco-audit: Current status and mitigation strategies. Ann Diagn Pathol 2023; 67:152210. [PMID: 37734347 DOI: 10.1016/j.anndiagpath.2023.152210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Alexis Trecourt
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon-Sud Charles Mérieux, UR 3738, CICLY, Lyon, France.
| | - Pierre-Jean Cottinet
- Université de Lyon, INSA-Lyon, Laboratoire de Génie Electrique et Férroélectricité (LGEF), EA682, F-69621 Villeurbanne, France
| | - Marie Donzel
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud, Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052, CNRS UMR 5286, Lyon, France
| | - Marion Favretto
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France
| | - Béatrice Bancel
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France
| | - Myriam Decaussin-Petrucci
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud, Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052, CNRS UMR 5286, Lyon, France
| | - Alexandra Traverse-Glehen
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud, Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052, CNRS UMR 5286, Lyon, France
| | - Mojgan Devouassoux-Shisheboran
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon-Est, CRCL, INSERM U1052, CNRS UMR 5286, Lyon, France
| | - David Meyronet
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon-Est, CRCL, INSERM U1052, CNRS UMR 5286, Lyon, France
| | | | - Anne Rullier
- CHU de Bordeaux, Hôpital Pellegrin, Service de Pathologie, Bordeaux, France
| | - Minh-Quyen Lê
- Université de Lyon, INSA-Lyon, Laboratoire de Génie Electrique et Férroélectricité (LGEF), EA682, F-69621 Villeurbanne, France
| | - Guilhem Rival
- Université de Lyon, INSA-Lyon, Laboratoire de Génie Electrique et Férroélectricité (LGEF), EA682, F-69621 Villeurbanne, France
| | - Daniel Grinberg
- Université de Lyon, INSA-Lyon, Laboratoire de Génie Electrique et Férroélectricité (LGEF), EA682, F-69621 Villeurbanne, France; Hospices Civils de Lyon, Hôpital cardiologique « Louis Pradel », Service de chirurgie cardiaque, Lyon, France
| | - Cyprien Tilmant
- Groupement des Hôpitaux de l'Institut Catholique de Lille, Service de Pathologie, Lille, France
| | - Lucie Gaillot-Durand
- Hospices Civils de Lyon, Service de Pathologie Multi-Site et Université Claude Bernard Lyon I, France
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Amintas S, Giraud N, Fernandez B, Dupin C, Denost Q, Garant A, Frulio N, Smith D, Rullier A, Rullier E, Vuong T, Dabernat S, Vendrely V. The Crying Need for a Better Response Assessment in Rectal Cancer. Curr Treat Options Oncol 2023; 24:1507-1523. [PMID: 37702885 PMCID: PMC10643426 DOI: 10.1007/s11864-023-01125-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 09/14/2023]
Abstract
OPINION STATEMENT Since total neoadjuvant treatment achieves almost 30% pathologic complete response, organ preservation has been increasingly debated for good responders after neoadjuvant treatment for patients diagnosed with rectal cancer. Two organ preservation strategies are available: a watch and wait strategy and a local excision strategy including patients with a near clinical complete response. A major issue is the selection of patients according to the initial tumor staging or the response assessment. Despite modern imaging improvement, identifying complete response remains challenging. A better selection could be possible by radiomics analyses, exploiting numerous image features to feed data characterization algorithms. The subsequent step is to include baseline and/or pre-therapeutic MRI, PET-CT, and CT radiomics added to the patients' clinicopathological data, inside machine learning (ML) prediction models, with predictive or prognostic purposes. These models could be further improved by the addition of new biomarkers such as circulating tumor biomarkers, molecular profiling, or pathological immune biomarkers.
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Affiliation(s)
- Samuel Amintas
- Tumor Biology and Tumor Bank Laboratory, CHU Bordeaux, F-33600, Pessac, France.
- BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France.
| | - Nicolas Giraud
- Department of Radiation Oncology, CHU Bordeaux, F-33000, Bordeaux, France
| | | | - Charles Dupin
- BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France
- Department of Radiation Oncology, CHU Bordeaux, F-33000, Bordeaux, France
| | - Quentin Denost
- Bordeaux Colorectal Institute, F-33000, Bordeaux, France
| | - Aurelie Garant
- UT Southwestern Department of Radiation Oncology, Dallas, USA
| | - Nora Frulio
- Radiology Department, CHU Bordeaux, F-33600, Pessac, France
| | - Denis Smith
- Department of Digestive Oncology, CHU Bordeaux, F-33600, Pessac, France
| | - Anne Rullier
- Histology Department, CHU Bordeaux, F-33000, Bordeaux, France
| | - Eric Rullier
- BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France
- Surgery Department, CHU Bordeaux, F-33600, Pessac, France
| | - Te Vuong
- Department of Radiation Oncology, McGill University, Jewish General Hospital, Montreal, Canada
| | - Sandrine Dabernat
- BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France
- Biochemistry Department, CHU Bordeaux, F-33000, Bordeaux, France
| | - Véronique Vendrely
- BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France
- Department of Radiation Oncology, CHU Bordeaux, F-33000, Bordeaux, France
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Rivière P, Le Chevillier A, Rullier A, Marty M, Schurr E, Lapuyade B, Célerier B, Fernandez B, Bessissow T, Treton X, Uzzan M, Poullenot F, Berger A, Zerbib F, Laharie D. Deep ulcers are associated with increased C-reactive protein in active ulcerative colitis. Dig Liver Dis 2023; 55:1194-1200. [PMID: 37244790 DOI: 10.1016/j.dld.2023.05.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Increased C-reactive protein (CRP) is used to diagnose and predict response to treatment in acute severe ulcerative colitis (UC). AIMS To investigate the connection between CRP elevation and deep ulcers in UC. METHODS Patients with active UC were enrolled in a multicenter prospective cohort and a retrospective cohort of consecutive patients undergoing colectomy from 2012 to 2019. RESULTS Forty-one (9 (22%) with deep ulcers) patients were included in the prospective cohort: 4/5 (80%) patients with CRP > 100 mg/L, 2/10 (20%) patients with CRP between 30 and 100 mg/L and 3/26 (12%) patients with CRP < 30 mg/L had deep ulcers (p = 0.006). In the retrospective cohort [46 patients (31 (67%) with deep ulcers)], 14/14 (100%) patients with CRP > 100 mg/L, 11/17 (65%) patients with CRP between 30 and 100 mg/l and 6/15 (40%) patients with CRP < 30 mg/L had deep ulcers (p = 0.001). Positive predictive value of CRP > 100 mg/l for presence of deep ulcers was 80% and 100% in both cohorts, respectively. CONCLUSIONS CRP elevation is a robust surrogate marker for presence of deep ulcers in UC. Elevated CRP or presence of deep ulcers could influence the choice of medical therapy in acute severe UC.
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Affiliation(s)
- P Rivière
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France; Program in Infectious Diseases and Immunity in Global Health, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - A Le Chevillier
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France
| | - A Rullier
- CHU de Bordeaux, Hôpital Pellegrin, Pathology department - Université de Bordeaux, Bordeaux F-33000, France
| | - M Marty
- CHU de Bordeaux, Hôpital Haut-Lévêque, Pathology department - Université de Bordeaux, Bordeaux F-33000, France
| | - E Schurr
- Program in Infectious Diseases and Immunity in Global Health, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - B Lapuyade
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Radiology department - Université de Bordeaux, Bordeaux F-33000, France
| | - B Célerier
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Abdominal surgery department - Université de Bordeaux, Bordeaux F-33000, France
| | - B Fernandez
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Abdominal surgery department - Université de Bordeaux, Bordeaux F-33000, France
| | - T Bessissow
- Division of Gastroenterology and hepatology, McGill University Health Centre, Montreal, Canada
| | - X Treton
- Paris IBD Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, 25 bd Victor Hugo, Neuilly/Seine 92200, France
| | - M Uzzan
- Paris Est Créteil University UPEC, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Gastroenterology department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Créteil F-94010, France
| | - F Poullenot
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France
| | - A Berger
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France
| | - F Zerbib
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France
| | - D Laharie
- CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
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Gest C, Sena S, Dif L, Neaud V, Loesch R, Dugot-Senant N, Paysan L, Piquet L, Robbe T, Allain N, Dembele D, Guettier C, Bioulac-Sage P, Rullier A, Le Bail B, Grosset CF, Saltel F, Lagrée V, Colnot S, Moreau V. Antagonism between wild-type and mutant β-catenin controls hepatoblastoma differentiation via fascin-1. JHEP Rep 2023; 5:100691. [PMID: 37153687 PMCID: PMC10159820 DOI: 10.1016/j.jhepr.2023.100691] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 05/10/2023] Open
Abstract
Background & Aims β-catenin is a well-known effector of the Wnt pathway, and a key player in cadherin-mediated cell adhesion. Oncogenic mutations of β-catenin are very frequent in paediatric liver primary tumours. Those mutations are mostly heterozygous, which allows the co-expression of wild-type (WT) and mutated β-catenins in tumour cells. We investigated the interplay between WT and mutated β-catenins in liver tumour cells, and searched for new actors of the β-catenin pathway. Methods Using an RNAi strategy in β-catenin-mutated hepatoblastoma (HB) cells, we dissociated the structural and transcriptional activities of β-catenin, which are carried mainly by WT and mutated proteins, respectively. Their impact was characterised using transcriptomic and functional analyses. We studied mice that develop liver tumours upon activation of β-catenin in hepatocytes (APCKO and β-cateninΔexon3 mice). We used transcriptomic data from mouse and human HB specimens, and used immunohistochemistry to analyse samples. Results We highlighted an antagonistic role of WT and mutated β-catenins with regard to hepatocyte differentiation, as attested by alterations in the expression of hepatocyte markers and the formation of bile canaliculi. We characterised fascin-1 as a transcriptional target of mutated β-catenin involved in tumour cell differentiation. Using mouse models, we found that fascin-1 is highly expressed in undifferentiated tumours. Finally, we found that fascin-1 is a specific marker of primitive cells including embryonal and blastemal cells in human HBs. Conclusions Fascin-1 expression is linked to a loss of differentiation and polarity of hepatocytes. We present fascin-1 as a previously unrecognised factor in the modulation of hepatocyte differentiation associated with β-catenin pathway alteration in the liver, and as a new potential target in HB. Impact and implications The FSCN1 gene, encoding fascin-1, was reported to be a metastasis-related gene in various cancers. Herein, we uncover its expression in poor-prognosis hepatoblastomas, a paediatric liver cancer. We show that fascin-1 expression is driven by the mutated beta-catenin in liver tumour cells. We provide new insights on the impact of fascin-1 expression on tumour cell differentiation. We highlight fascin-1 as a marker of immature cells in mouse and human hepatoblastomas.
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Affiliation(s)
- Caroline Gest
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Sandra Sena
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Lydia Dif
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Véronique Neaud
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Robin Loesch
- INSERM, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers (CRC), Paris, France
| | | | - Lisa Paysan
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Léo Piquet
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Terezinha Robbe
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Nathalie Allain
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Doulaye Dembele
- IGBMC, CNRS UMR 7104 – INSERM U 1258 – Université de Strasbourg, Illkirch, France
| | - Catherine Guettier
- Department of Pathology, Bicêtre University Hospital, University of Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Anne Rullier
- Department of Pathology, University Bordeaux Hospital, Bordeaux, France
| | - Brigitte Le Bail
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
- Department of Pathology, University Bordeaux Hospital, Bordeaux, France
| | | | - Frédéric Saltel
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Valérie Lagrée
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
| | - Sabine Colnot
- INSERM, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers (CRC), Paris, France
| | - Violaine Moreau
- University of Bordeaux, INSERM, BRIC, U1312, Bordeaux, France
- Corresponding author. Address: 146 Rue Léo Saignat, F-33076, Bordeaux, France. Tel.: +33-5-57-57-12-72.
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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. Morbidité chirurgicale sévère après une chimioradiothérapie néoadjuvante en technique conformationnelle tridimensionnelle comparée à la modulation d’intensité pour l’adénocarcinome rectal localement évolué. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.016] [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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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. PO-1244 Severe surgical morbidity after chemoradiotherapy conformational-3D versus IMRT for rectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07695-7] [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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9
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Denost Q, Frison E, Salut C, Sitta R, Rullier A, Harji D, Maillou-Martinaud H, Rullier E, Smith D, Vendrely V. A phase III randomized trial evaluating chemotherapy followed by pelvic reirradiation versus chemotherapy alone as preoperative treatment for locally recurrent rectal cancer - GRECCAR 15 trial protocol. Colorectal Dis 2021; 23:1909-1918. [PMID: 33843133 DOI: 10.1111/codi.15670] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/14/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022]
Abstract
AIM Treatment strategies in locally recurrent rectal cancer (LRRC) are complex and need to be balanced against previous treatments received for the primary rectal cancer. Radiotherapy is an important component of treatment in LRRC. However, there is little high-quality evidence on the role of reirradiation in this cohort. Therefore, the aim of this trial is to assess the efficacy of neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone on the rate of curative surgery (R0) in previously irradiated patients with LRRC. METHOD GRECCAR 15 is a prospective, multicentre, open-label, outcome assessor-blinded, superiority randomized controlled phase III clinical trial comparing neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone in patients with LRRC previously irradiated for the primary cancer. Adult patients (>18 years old) with a histologically proven resectable LRRC, who have previously received pelvic radiotherapy for their primary rectal cancer at a dose of 25-50.4 Gy, and an Eastern Cooperative Oncology Group performance status of <2 will be eligible to participate. The pelvic reirradiation will consist of conformational intensity-modulated external irradiation, delivering a dose of 30.6 Gy with concomitant chemotherapy using capecitabine. The primary outcome of this trial is the R0 resection rate. Overall, GRECCAR 15 aims to recruit 186 patients to detect an absolute difference of 20% in the R0 resection rate with 80% power and 5% two-sided significance level. CONCLUSION The GRECCAR 15 trial is the first, definitive, phase III trial to investigate reirradiation in LRRC. The results of this trial will inform definitively the neoadjuvant treatment strategy in previously irradiated patients and assess whether there is any associated benefit of reirradiation in combination with induction chemotherapy in improving R0 resection rates.
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Affiliation(s)
- Quentin Denost
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU, Bordeaux, France
| | - Eric Frison
- Inserm, CIC1401-EC, Bordeaux, Service D'information Médicale, CHU, Bordeaux, France
| | - Cécile Salut
- Service de Radiologie, Hôpital Haut-Lévèque, CHU, Bordeaux, France
| | - Remy Sitta
- Inserm, CIC1401-EC, Bordeaux, Service D'information Médicale, CHU, Bordeaux, France
| | - Anne Rullier
- Service d'Anatomopathologie, Hôpital Pellegrin, CHU, Bordeaux, France
| | - Deena Harji
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU, Bordeaux, France
| | | | - Eric Rullier
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU, Bordeaux, France
| | - Denis Smith
- Service D'oncologie, Hôpital Haut-Lévèque, CHU, Bordeaux, France
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10
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Schollhammer R, Lepreux S, Barthe N, Vimont D, Rullier A, Sibon I, Berard X, Zhang A, Kimura Y, Fujita M, Innis RB, Zanotti-Fregonara P, Morgat C. In vitro and pilot in vivo imaging of 18 kDa translocator protein (TSPO) in inflammatory vascular disease. EJNMMI Res 2021; 11:45. [PMID: 33950298 PMCID: PMC8099943 DOI: 10.1186/s13550-021-00786-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/17/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Inflammatory vascular disease of the arteries, such as inflamed atheromatous plaques or arteritis, may cause aneurysms or ischemic strokes. In this context, using positron emission tomography (PET) to image inflammation may help select patients who would benefit from appropriate therapeutic interventions. This study sought to assess the usefulness of the 18 kDa translocator protein (TSPO) tracers [11C]-PBR28 and [18F]-PBR06 for imaging inflammatory vascular disease in vitro and in vivo. Immunohistochemistry for macrophage infiltration as well as autoradiography with [18F]-PBR06 were performed on eight paraffin-embedded, formalin-fixed atherosclerosis plaques prospectively collected after carotid endarterectomy of eight patients affected by ischemic stroke. Six different patients, one of whom was also included in the in vitro study, underwent PET imaging. Two patients with carotid stenosis associated with ischemic stroke were imaged with [18F]-PBR06 PET/CT, and four other patients (three with large vessel vasculitis and one with bilateral carotid stenosis but without stroke) were imaged with [11C]-PBR28. Results All in vitro sections showed specific binding of [18F]-PBR06, which co-localized with immunohistochemistry markers for inflammation. However, in vivo TSPO imaging with either [11C]-PBR28 or [18F]-PBR06 was negative in all participants. Conclusion Despite good uptake on surgical samples in vitro, [11C]-PBR28 and [18F]-PBR06 are not viable clinical tools for imaging inflammatory vascular disease. Trial registration: NCT02513589, registered 31 July 2015 and NCT00547976, registered 23 October 2007. https://clinicaltrials.gov.
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Affiliation(s)
- Romain Schollhammer
- Nuclear Medicine Department, University Hospital of Bordeaux, 33076, Bordeaux, France. .,University of Bordeaux, INCIA, UMR5287, 33400, Talence, France. .,CNRS, INCIA, UMR5287, 33400, Talence, France. .,Nuclear Medicine Department, University Hospital of Bordeaux, Place Amélie Raba Léon, 33000, Bordeaux, France.
| | | | | | - Delphine Vimont
- University of Bordeaux, INCIA, UMR5287, 33400, Talence, France.,CNRS, INCIA, UMR5287, 33400, Talence, France
| | - Anne Rullier
- Histologic Department, University Hospital of Bordeaux, 33076, Bordeaux, France
| | - Igor Sibon
- Neurology Department, University Hospital of Bordeaux, 33076, Bordeaux, France
| | - Xavier Berard
- Vascular Surgery Department, University Hospital of Bordeaux, 33076, Bordeaux, France
| | - Andrea Zhang
- Molecular Imaging Branch, NIMH, Bethesda, MD, USA
| | | | | | | | | | - Clément Morgat
- Nuclear Medicine Department, University Hospital of Bordeaux, 33076, Bordeaux, France.,University of Bordeaux, INCIA, UMR5287, 33400, Talence, France.,CNRS, INCIA, UMR5287, 33400, Talence, France
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11
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Denost Q, Assenat V, Vendrely V, Celerier B, Rullier A, Laurent C, Rullier E. Oncological strategy following R1 sphincter-saving resection in low rectal cancer after chemoradiotherapy. Eur J Surg Oncol 2021; 47:1683-1690. [PMID: 33610393 DOI: 10.1016/j.ejso.2021.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/07/2020] [Revised: 12/01/2020] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
AIM Sphincter-saving resection (SSR) for low rectal cancer remains challenging due to the high risk of positive resection margin (R1). Long-term outcomes and the dedicated oncological strategy are not well established in this situation. The aim of this study was to define the more appropriate strategy according to the patterns of recurrence. METHODS Between 1994 and 2014, patients treated by SSR for low rectal cancer with preoperative chemoradiotherapy were included. Three types of recurrences were defined: local (LR), distant (DR) and mixed (MR). Recurrences and survival after R0 and R1 resection were analysed by Kaplan-Meier and compared with the log-rang test. RESULTS Among 394 patients receiving SSR, 42 (10.6%) had R1 resection. Independent factors of R1 resection were EMVI (OR2.24,95%IC1.10-4.53,p = 0.025) and no tumor downstaging (OR8.41,95%IC2.50-8.32,p = 0.001). Both 5-year disease free and overall survival, and 5-year distant and local recurrence, were significantly worse after R1 resection. The overall recurrence after R1 resection was 57% (24/42), 7% had LR, 36% DR and 14% MR. Time to DR was shorter than time to LR (11.1 vs. 34.3) months. In all cases of MR, DR occurred before LR (12.1 vs. 34.3) months, meaning that after R1 resection, the first concern was DR. CONCLUSION R1 resection after SSR for low rectal cancer reflects a more aggressive and systemic disease. Prognosis depends on DR in about 90% of cases, suggesting that pelvic control should not be the priority in the oncological strategy after R1. Adjuvant systemic chemotherapy ought to be preferred to salvage abdominoperineal resection.
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Affiliation(s)
- Quentin Denost
- CHU Bordeaux, Colorectal Unit Magellan Centre, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux; Bordeaux, F-33076, France.
| | - Vincent Assenat
- CHU Bordeaux, Colorectal Unit Magellan Centre, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux; Bordeaux, F-33076, France
| | - Veronique Vendrely
- CHU Bordeaux, Department of Radiotherapy, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux, Bordeaux, F-33076, France
| | - Bertrand Celerier
- CHU Bordeaux, Colorectal Unit Magellan Centre, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux; Bordeaux, F-33076, France
| | - Anne Rullier
- CHU Bordeaux, Department of Pathology, Pellegrin Hospital, Bordeaux, F-33075, France; University of Bordeaux, Bordeaux, F-33076, France
| | - Christophe Laurent
- CHU Bordeaux, Colorectal Unit Magellan Centre, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux; Bordeaux, F-33076, France
| | - Eric Rullier
- CHU Bordeaux, Colorectal Unit Magellan Centre, Haut-Leveque Hospital, Pessac, F-33600; University of Bordeaux; Bordeaux, F-33076, France
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12
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Denost Q, Moreau JB, Vendrely V, Celerier B, Rullier A, Assenat V, Rullier E. Intersphincteric resection for low rectal cancer: the risk is functional rather than oncological. A 25-year experience from Bordeaux. Colorectal Dis 2020; 22:1603-1613. [PMID: 32649005 DOI: 10.1111/codi.15258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/13/2019] [Accepted: 04/03/2020] [Indexed: 02/07/2023]
Abstract
AIM There are few data evaluating the long-term outcomes of intersphincteric resection (ISR), especially the impact of inclusion of more juxtapositioned and intra-anal tumours on oncological and functional outcomes. We compared the oncological and functional results of patients treated by total mesorectal excision and ISR for low rectal cancer over a 25-year period. METHOD This is a retrospective study from a single institution evaluating results of ISR over three periods: 1990-1998, 1999-2006 and 2007-2014. Patients treated by partial or total ISR, with or without neoadjuvant chemoradiotherapy, for low rectal cancer (≤ 6 cm from the anal verge) were included. We compared postoperative morbidity, quality of surgery and oncological and functional outcomes in the time periods studied. RESULTS Of 813 patients operated on for low rectal cancer, 303 had ISR. Tumour stage did not differ; however, the distance of the tumour from the anorectal junction decreased from 1 to 0 cm (P < 0.001) and the distal resection margin shortened from 25 to 10 mm (P < 0.001) from 1990 to 2014. The postoperative morbidity and quality of surgery did not change significantly over time. The 5-year local recurrence (4.3% vs 5.9% vs 3.5%; P = 0.741) and disease-free survival (72% vs 71% vs 75%; P = 0.918) did not differ between the three time periods. Functional results improved during the last period; however, overall 42% of patients experienced major bowel dysfunction. CONCLUSION Pushing the envelope of sphincter-saving resection in ultra-low rectal cancer reaching or invading the anal sphincter did not compromise oncological and functional outcomes. The main limitation of the ISR procedure appears to be functional rather than oncological, suggesting that bowel rehabilitation programmes should be developed.
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Affiliation(s)
- Q Denost
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - J-B Moreau
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - V Vendrely
- Department of Radiotherapy, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - B Celerier
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - A Rullier
- Department of Pathology, CHU Bordeaux, Pellegrin Hospital, University of Bordeaux, Bordeaux, France
| | - V Assenat
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - E Rullier
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
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13
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Rullier E, Vendrely V, Asselineau J, Rouanet P, Tuech JJ, Valverde A, de Chaisemartin C, Rivoire M, Trilling B, Jafari M, Portier G, Meunier B, Sieleznieff I, Bertrand M, Marchal F, Dubois A, Pocard M, Rullier A, Smith D, Frulio N, Frison E, Denost Q. Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial. Lancet Gastroenterol Hepatol 2020; 5:465-474. [PMID: 32043980 DOI: 10.1016/s2468-1253(19)30410-8] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [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: 10/07/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND GRECCAR 2 was the first multicentre, randomised trial to compare local excision with total mesorectal excision in downstaged low rectal cancer. Encouraging oncological results were noted at 3 years' follow-up but needed to be corroborated with longer follow-up. In this study, we aimed to report the 5-year oncological outcomes, including local recurrence, metastatic disease, and survival. METHODS Patients age 18 years and older with T2T3 low rectal cancer, of maximum size 4 cm, who were clinically good responders after chemoradiotherapy (residual tumour ≤2 cm) were randomly assigned before surgery to either local excision or total mesorectal excision. Randomisation was centralised and not stratified and used permuted blocks of size eight. In the local excision group, a completion total mesorectal excision was performed if pathological tumour stage was ypT2-3. The primary objective of this study was to assess the 5-year oncological outcomes of local recurrence, metastatic disease, disease-free survival, overall survival, and cancer-specific mortality, which were the secondary endpoints of GRECCAR 2. We used Kaplan-Meier estimates and Cox modelling to estimate and compare recurrence and survival in modified intention-to-treat and as-treated populations. This trial was registered with ClinicalTrials.gov, number NCT00427375. FINDINGS Between March 1, 2007, and Sept 24, 2012, 148 patients who were good clinical responders were randomly assigned to treatment, three patients were excluded after randomisation (because they had metastatic disease, tumour >8 cm from anal verge, or withdrew consent), leaving 145 for analysis: 74 in the local excision group and 71 in the total mesorectal excision group. Median follow-up was 60 months (IQR 58-60) in the local excision group and 60 months (57-60) in the total mesorectal excision group. 23 patients died and five were lost to follow-up. In the local excision group, 26 had a completion total mesorectal excision for ypT2-3 tumour. In the modified intention-to-treat analysis, there was no difference between the local excision and total mesorectal excision groups in 5-year local recurrence (7% [95% CI 3-16] vs 7% [3-16]; adjusted hazard ratio [HR] 0·71 [95% CI 0·19-2·58]; p=0·60), metastatic disease (18% [CI 11-30] vs 19% [11-31]; 0·86 [0·36-2·06]; p=0·73), overall survival (84% [73-91] vs 82% [71-90]; 0·92 [0·38-2·22]; p=0·85), disease-free survival (70% [58-79] vs 72% [60-82]; 0·87 [0·44-1·72]; p=0·68), or cancer-specific mortality (7% [3-17] vs 10% [5-20]; 0·65 [0·17-2·49]; p=0·53). INTERPRETATION The 5-year results of this multicentre randomised trial corroborate the 3-year results, providing no evidence of difference in oncological outcomes between local excision and total mesorectal excision. Local excision can be proposed in selected patients having a small T2T3 low rectal cancer with a good clinical response after chemoradiotherapy. FUNDING National Cancer Institute of France.
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Affiliation(s)
- Eric Rullier
- Department of Colorectal Surgery, Haut-Lévèque Hospital, CHU Bordeaux, France.
| | | | - Julien Asselineau
- INSERM CIC1401-EC, Bordeaux, France; CHU Bordeaux, Service d'information médicale, Bordeaux, France
| | - Philippe Rouanet
- Département de Chirurgie Oncologique, ICM Val d'Aurelle, Montpellier, France
| | | | - Alain Valverde
- Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | | | - Michel Rivoire
- Département de Chirurgie Oncologique, Centre Léon Bérard, Lyon, France
| | - Bertrand Trilling
- Service de Chirurgie Digestive, Hôpital A. Michallon, La Tronche, France
| | - Mehrdad Jafari
- Département de Chirurgie Oncologique, Centre Oscar Lambret, Lille, France
| | | | - Bernard Meunier
- Service de Chirurgie Viscérale, CHU Pontchaillou, Rennes, France
| | | | - Martin Bertrand
- Département de Chirurgie Digestive et de Cancérologie Digestive, Hôpital Universitaire Carémeau, Nimes, France
| | - Frédéric Marchal
- Département de Chirurgie Oncologique, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France
| | - Anne Dubois
- Service de Chirurgie Générale et Digestive, Hôtel Dieu, Clermont-Ferrand, France
| | - Marc Pocard
- Département Médico-Chirurgical de Pathologie Digestive, Hôpital Lariboisière, Paris, France
| | - Anne Rullier
- Service d'Anatomopathologie, Hôpital Pellegrin, Bordeaux, CHU Bordeaux, France
| | - Denis Smith
- Service d'Oncologie médicale, Haut-Lévèque Hospital, CHU Bordeaux, France
| | - Nora Frulio
- Service de Radiologie, Haut-Lévèque Hospital, CHU Bordeaux, France
| | - Eric Frison
- INSERM CIC1401-EC, Bordeaux, France; CHU Bordeaux, Service d'information médicale, Bordeaux, France
| | - Quentin Denost
- Department of Colorectal Surgery, Haut-Lévèque Hospital, CHU Bordeaux, France
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14
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Amico S, Fouquet C, Rullier A, Lévy M, Vergier B, Fraitag S, Léauté-Labrèze C. Hémangiomatose infantile compliquée de saignements intra-tumoraux. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.288] [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: 10/25/2022]
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15
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Kambouchner M, Emile JF, Copin MC, Coulomb-Lherminé A, Sabourin JC, Della Valle V, Sileo C, Ducou Le Pointe H, Bégueret H, Galmiche L, Lambilliotte A, Paraf F, Piche M, Piguet C, Rullier A, Secq V, Serre I, Bernaudin JF, Donadieu J. Childhood pulmonary Langerhans cell histiocytosis: a comprehensive clinical-histopathological and BRAF V600E mutation study from the French national cohort. Hum Pathol 2019; 89:51-61. [PMID: 31054893 DOI: 10.1016/j.humpath.2019.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/04/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/08/2023]
Abstract
Childhood pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease. Its pulmonary histopathology, according to comprehensive clinical-radiological findings and BRAFV600E mutation status, has not yet been thoroughly documented. From the 167 childhood PLCH cases entered in the French National Histiocytosis Registry (1983-2016), we retrieved lung biopsies from a consecutive retrospective series of 17 patients, diagnosed when they were 2 weeks to 16 years old (median, 9.4 years), and report the clinical and histopathological findings herein. Histological analyses of biopsies (16 surgical and 1 postmortem) found the following features, alone or associated: Langerhans cell (LC) nodules with cavitation (9/17), cysts (14/17), fibrotic scars (2/17), peribronchiolar topographic distribution of the lesions (10/17), and accessory changes, like stretch emphysema (7/17). Those characteristics closely resemble those describing adult PLCH. However, unusual findings observed were 2 large nodules and a diffuse interstitial LC infiltrate. BRAFV600E mutation was detected in 4 of 12 samples tested, notably in the 3 with unusual features. In conclusion, childhood PLCH mostly shares the common histology features already described in adult PLCH, regardless of age. Because smoking is considered the major trigger in PLCH pathogenesis, the findings based on this series suggest other inducers of bronchiolar LC recruitment, especially in very young patients.
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Affiliation(s)
- Marianne Kambouchner
- Pathology Department, APHP, Centre Hospitalier Universitaire (CHU) Avicenne, 93000 Bobigny, France.
| | - Jean-François Emile
- Pathology Department, APHP, CHU Ambroise-Paré, 92104 Boulogne-Billancourt, France
| | | | | | | | | | - Chiara Sileo
- Radiology Department, APHP, CHU Armand-Trousseau, 75012 Paris, France
| | | | - Hugues Bégueret
- Pathology Department, CHU de Bordeaux Haut-Lévêque, 33600 Pessac, France
| | - Louise Galmiche
- Pathology Department, APHP, CHU Necker-Enfants Malades, 75015 Paris, France
| | - Anne Lambilliotte
- Pediatric Hemato-Oncology Department, CHU Jeanne-de-Flandre, 59120 Lille, France
| | - François Paraf
- Pathology Department, CHU Dupuytren, 87000 Limoges, France
| | | | | | - Anne Rullier
- Pathology Department, CHU de Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Véronique Secq
- Pathology Department, CHU La Timone, 13385 Marseille, France
| | - Isabelle Serre
- Pathology Department, CHU Gui-de-Chauliac, 34295 Montpellier, France
| | | | - Jean Donadieu
- Pediatric Hemato-Oncology Department and French Referent Centre for Histiocytoses, APHP, CHU Armand-Trousseau, 75012 Paris, France
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16
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Dilly-Feldis M, Aladjidi N, Refait JK, Parrens M, Ducassou S, Rullier A. Expression of PD-1/PD-L1 in children's classical Hodgkin lymphomas. Pediatr Blood Cancer 2019; 66:e27571. [PMID: 30637917 DOI: 10.1002/pbc.27571] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 08/23/2018] [Revised: 11/09/2018] [Accepted: 11/10/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although a prognosis of recurrent or refractory childhood Hodgkin lymphoma (HL) is associated with poor outcomes despite intensive therapy, the immune checkpoint inhibitors PD-1/PD-L1 appear to be therapeutic alternatives for advanced adult cases. However, these pharmacotherapies are yet to be studied in a pediatric population. PROCEDURE The present study measured the expression of PD-1/PD-L1 in diagnostic samples of children with classical HL, according to the disease course. This study included two groups of patients treated at the Department of Pediatric Oncology, Bordeaux University Hospital-a group of cured or in-remission cases and a group of relapsed or refractory cases. Immunohistochemical analyses of anti-PD-1 and anti-PD-L1 (clone 28-8, companion test for nivolumab) were performed on baseline and follow-up biopsies. RESULTS Of the 42 included patients, 31 were cured or in remission and 11 were categorized as relapsed or refractory. At the time of diagnosis, PD-1 expression was low (1-3% of intratumoral lymphocytes labeled) in <20% of cases, whereas PD-L1 was expressed by tumor cells in all cases, and strongly (≥50%) in most cases. There were no significant differences in the expression levels of the two checkpoint molecules between the groups. Initial biopsies showed strong expression of PD-L1, whereas expression of PD-1 was rare. CONCLUSIONS The identical labeling profiles of the cured and relapsed/refractory patients suggest that comparable responses to inhibitors of the PD1/PDL1 immunological checkpoints could be expected in patients undergoing first-, second-, or third-line therapy.
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Affiliation(s)
- Marie Dilly-Feldis
- Pediatrics Oncology Department, Children's Hospital of Bordeaux University Hospital, Bordeaux, France
| | - Nathalie Aladjidi
- Pediatrics Oncology Department, Children's Hospital of Bordeaux University Hospital, Bordeaux, France
| | - John K Refait
- Department of Nuclear Medicine, Haut-Lévêque Southern Group of Bordeaux University Hospital, Pessac, France
| | - Marie Parrens
- Department of Pathology, Haut-Lévêque Hospital, Southern Hospital Group, Bordeaux University Hospital, Pessac, France
| | - Stéphane Ducassou
- Pediatrics Oncology Department, Children's Hospital of Bordeaux University Hospital, Bordeaux, France
| | - Anne Rullier
- Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Bordeaux, France
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17
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Thicoïpé A, Laharie D, Smith D, Chabrun E, Rullier A, Poullenot F, Rullier E, Denost Q. Oncological outcomes of IBD-associated versus sporadic colorectal cancer in modern era: a matched case-control study. Int J Colorectal Dis 2018; 33:963-966. [PMID: 29675590 DOI: 10.1007/s00384-018-3049-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Accepted: 04/04/2018] [Indexed: 02/04/2023]
Abstract
AIM Inflammatory bowel diseases (IBD) are associated with an increased risk for colorectal cancer (CRC). However and despite significant advances in the management of IBD and CRC, the prognosis of IBD-related CRC (IBD-CRC) remains controversial. The aim of the present case-control study was to compare the prognosis of IBD-CRC to sporadic CRC. METHODS Consecutive patients operated for IBD-CRC from 2004 to 2014 were recruited and matched with sporadic CRC (ratio 3:1) from the same center. Matching was performed on gender, tumor stage, and location and period of surgery. Endpoints were postoperative morbidity (Dindo-Clavien III-V), quality of surgery, and long-term oncological outcomes. RESULTS Among 1498 CRC patients operated during the study period, 21 patients were identified with IBD-CRC and matched to 63 patients with sporadic CRC (S-CRC). Patients with IBD-CRC were significantly younger (p < 0.001), had multifocal lesions more frequently (p = 0.04), and undergone abdominoperineal excision and coloproctectomy more often (p = 0.001). Postoperative morbidity was not significantly different between the two groups (25 vs. 14%; p = 0.309), as well as the rate of R0 resection (86 vs. 95%; p = 0.162). Five-year disease-free and overall survival were 71 and 81% in patients with IBD-CRC and 69% (p = 0.801) and 78% (p = 0.845) in those with S-CRC, respectively. CONCLUSION In a case-control study of patients operated for CRC within the last decade, the prognosis of cancer associated with IBD is similar to sporadic cancer.
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Affiliation(s)
- Antoine Thicoïpé
- CHU of Bordeaux, Colorectal Unit, Department of Surgery, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - David Laharie
- CHU of Bordeaux, Department of Gastroenterology, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - Denis Smith
- CHU of Bordeaux, Department of Oncology, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - Edouard Chabrun
- CHU of Bordeaux, Department of Gastroenterology, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - Anne Rullier
- CHU of Bordeaux, Department of Pathology, Pellegrin Hospital, University of Bordeaux, Bordeaux, France
| | - Florian Poullenot
- CHU of Bordeaux, Department of Gastroenterology, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - Eric Rullier
- CHU of Bordeaux, Colorectal Unit, Department of Surgery, Magellan Hospital, University of Bordeaux, Bordeaux, France
| | - Quentin Denost
- CHU of Bordeaux, Colorectal Unit, Department of Surgery, Magellan Hospital, University of Bordeaux, Bordeaux, France.
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18
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Hooks KB, Audoux J, Fazli H, Lesjean S, Ernault T, Dugot-Senant N, Leste-Lasserre T, Hagedorn M, Rousseau B, Danet C, Branchereau S, Brugières L, Taque S, Guettier C, Fabre M, Rullier A, Buendia MA, Commes T, Grosset CF, Raymond AA. New insights into diagnosis and therapeutic options for proliferative hepatoblastoma. Hepatology 2018; 68:89-102. [PMID: 29152775 DOI: 10.1002/hep.29672] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 07/25/2017] [Revised: 10/10/2017] [Accepted: 11/15/2017] [Indexed: 12/30/2022]
Abstract
UNLABELLED Surgery and cisplatin-based treatment of hepatoblastoma (HB) currently guarantee the survival of 70%-80% of patients. However, some important challenges remain in diagnosing high-risk tumors and identifying relevant targetable pathways offering new therapeutic avenues. Previously, two molecular subclasses of HB tumors have been described, C1 and C2, with C2 being the subgroup with the poorest prognosis, a more advanced tumor stage, and the worst overall survival rate. An associated 16-gene signature to discriminate the two tumoral subgroups was proposed, but it has not been transferred into clinical routine. To address these issues, we performed RNA sequencing of 25 tumors and matched normal liver samples from patients. The transcript profiling separated HB into three distinct subgroups named C1, C2A, and C2B, identifiable by a concise four-gene signature: hydroxysteroid 17-beta dehydrogenase 6, integrin alpha 6, topoisomerase 2-alpha, and vimentin, with topoisomerase 2-alpha being characteristic for the proliferative C2A tumors. Differential expression of these genes was confirmed by quantitative RT-PCR on an expanded cohort and by immunohistochemistry. We also revealed significant overexpression of genes involved in the Fanconi anemia (FA) pathway in the C2A subgroup. We then investigated the ability of several described FA inhibitors to block growth of HB cells in vitro and in vivo. We demonstrated that bortezomib, a Food and Drug Administration-approved proteasome inhibitor, strongly impairs the proliferation and survival of HB cell lines in vitro, blocks FA pathway-associated double-strand DNA repair, and significantly impedes HB growth in vivo. CONCLUSION The highly proliferating C2A subtype is characterized by topoisomerase 2-alpha gene up-regulation and FA pathway activation, and the HB therapeutic arsenal could include bortezomib for the treatment of patients with the most aggressive tumors. (Hepatology 2018;68:89-102).
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Affiliation(s)
- Katarzyna B Hooks
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
| | - Jérôme Audoux
- Institut de Médecine Régénératrice et de Biothérapie, Inserm U1183, CHU Montpellier.,Institut de Biologie Computationnelle, Université Montpellier, Montpellier, France
| | - Helena Fazli
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
| | - Sarah Lesjean
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
| | - Tony Ernault
- Physiopathologie et traitement des maladies du foie, Inserm, UMR1193, Hôpital Paul-Brousse, Hepatobiliary Centre.,Université Paris Saclay, Villejuif, France
| | | | | | - Martin Hagedorn
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
| | | | | | | | | | | | | | | | - Anne Rullier
- Hôpital Universitaire de Bordeaux, Bordeaux, France
| | - Marie-Annick Buendia
- Physiopathologie et traitement des maladies du foie, Inserm, UMR1193, Hôpital Paul-Brousse, Hepatobiliary Centre.,Université Paris Saclay, Villejuif, France
| | - Thérèse Commes
- Institut de Médecine Régénératrice et de Biothérapie, Inserm U1183, CHU Montpellier.,Institut de Biologie Computationnelle, Université Montpellier, Montpellier, France
| | - Christophe F Grosset
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
| | - Anne-Aurélie Raymond
- Univ. Bordeaux, Inserm, GREF, U1053.,Univ. Bordeaux, Inserm, BMGIC, U1035, Bordeaux, France
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19
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Karoui M, Rullier A, Mariette C, Maillard E, Bardier A, Poizat F, Luciani A, Sarran A, Legoux JL, De Chaisemartin C, Lecaille C, Bouche O, Mauvais F, Brunetti F, Prudhomme M, Seitz JF, Lepage C, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 plus cetuximab versus immediate surgery for high-risk stage II and III colon cancers: A phase II multicentre randomised controlled trial (PRODIGE 22). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Rullier E, Rouanet P, Tuech JJ, Valverde A, Lelong B, Rivoire M, Faucheron JL, Jafari M, Portier G, Meunier B, Sileznieff I, Prudhomme M, Marchal F, Pocard M, Pezet D, Rullier A, Vendrely V, Denost Q, Asselineau J, Doussau A. Organ preservation for rectal cancer (GRECCAR 2): a prospective, randomised, open-label, multicentre, phase 3 trial. Lancet 2017; 390:469-479. [PMID: 28601342 DOI: 10.1016/s0140-6736(17)31056-5] [Citation(s) in RCA: 212] [Impact Index Per Article: 30.3] [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: 02/02/2017] [Revised: 02/28/2017] [Accepted: 03/07/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. METHODS We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer. Patients aged 18 years and older with stage T2T3 lower rectal carcinoma, of maximum size 4 cm, who had a good clinical response to neoadjuvant chemoradiotherapy (residual tumour ≤2 cm) were centrally randomly assigned by the surgeon before surgery to either local excision or total mesorectal excision surgery. Randomisation, which was done via the internet, was not stratified and used permuted blocks of size eight. In the local excision group, a completion total mesorectal excision was required if tumour stage was ypT2-3. The primary endpoint was a composite outcome of death, recurrence, morbidity, and side-effects at 2 years after surgery, to show superiority of local excision over total mesorectal excision in the modified intention-to-treat (ITT) population (expected proportions of patients having at least one event were 25% vs 60% for superiority). This trial was registered with ClinicalTrials.gov, number NCT00427375. FINDINGS From March 1, 2007, to Sept 24, 2012, 186 patients received chemoradiotherapy and were enrolled in the study. 148 good clinical responders were randomly assigned to treatment, three were excluded (because they had metastatic disease, tumour >8 cm from anal verge, and withdrew consent), and 145 were analysed: 74 in the local excision group and 71 in the total mesorectal excision group. In the local excision group, 26 patients had a completion total mesorectal excision. At 2 years in the modified ITT population, one or more events from the composite primary outcome occurred in 41 (56%) of 73 patients in the local excision group and 33 (48%) of 69 in the total mesorectal excision group (odds ratio 1·33, 95% CI 0·62-2·86; p=0·43). In the modified ITT analysis, there was no difference between the groups in all components of the composite outcome, and superiority was not shown for local excision over total mesorectal excision. INTERPRETATION We failed to show superiority of local excision over total mesorectal excision, because many patients in the local excision group received a completion total mesorectal excision that probably increased morbidity and side-effects, and compromised the potential advantages of local excision. Better patient selection to avoid unnecessary completion total mesorectal excision could improve the strategy. FUNDING National Cancer Institute of France, Sanofi, Roche Pharma.
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Affiliation(s)
- Eric Rullier
- Department of Colorectal Surgery, Haut-Lévèque Hospital, Pessac, CHU Bordeaux, France.
| | - Philippe Rouanet
- Département de Chirurgie Oncologique, ICM Val d'Aurelle, Montpellier, France
| | | | - Alain Valverde
- Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Bernard Lelong
- Département de Chirurgie Oncologique, Institut Paoli Calmette, Marseille, France
| | - Michel Rivoire
- Département de Chirurgie Oncologique, Centre Léon Bérard, Lyon, France
| | | | - Mehrdad Jafari
- Département de Chirurgie Oncologique, Centre Oscar Lambret, Lille, France
| | | | - Bernard Meunier
- Service de Chirurgie Viscérale, CHU Pontchaillou, Rennes, France
| | - Igor Sileznieff
- Service de Chirurgie Digestive, CHU Timone, Marseille, France
| | - Michel Prudhomme
- Département de Chirurgie Digestive et de Cancérologie Digestive, Hôpital Universitaire Carémeau, Nimes, France
| | - Frédéric Marchal
- Département de Chirurgie Oncologique, Institut de Cancérologie de Lorraine, CRAN, UMR 7039, Université de Lorraine, CNRS, Vandoeuvre les Nancy, France
| | - Marc Pocard
- Département Médico-Chirurgical de Pathologie Digestive, Hôpital Lariboisière, Paris, France
| | - Denis Pezet
- Service de Chirurgie Générale et Digestive, Hôtel Dieu, Clermont-Ferrand, France
| | - Anne Rullier
- Service d'Anatomopathologie, Hôpital Pellegrin, Bordeaux, CHU Bordeaux, France
| | - Véronique Vendrely
- Service de Radiothérapie, Haut-Lévèque Hospital, Pessac, CHU Bordeaux, France
| | - Quentin Denost
- Department of Colorectal Surgery, Haut-Lévèque Hospital, Pessac, CHU Bordeaux, France
| | - Julien Asselineau
- Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique du CHU de Bordeaux, Université Bordeaux, Bordeaux, France
| | - Adélaïde Doussau
- Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique du CHU de Bordeaux, Université Bordeaux, Bordeaux, France
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21
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Indersie E, Lesjean S, Hooks KB, Sagliocco F, Ernault T, Cairo S, Merched-Sauvage M, Rullier A, Le Bail B, Taque S, Grotzer M, Branchereau S, Guettier C, Fabre M, Brugières L, Hagedorn M, Buendia MA, Grosset CF. MicroRNA therapy inhibits hepatoblastoma growth in vivo by targeting β-catenin and Wnt signaling. Hepatol Commun 2017; 1:168-183. [PMID: 29404451 PMCID: PMC5721429 DOI: 10.1002/hep4.1029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/24/2017] [Accepted: 02/27/2017] [Indexed: 01/03/2023] Open
Abstract
Hepatoblastoma (HBL) is the most common pediatric liver cancer. In this malignant neoplasm, beta-catenin protein accumulates and increases Wnt signaling due to recurrent activating mutations in the catenin-beta 1 (CTNNB1) gene. Therefore, beta-catenin is a key therapeutic target in HBL. However, controlling beta-catenin production with therapeutic molecules has been challenging. New biological studies could provide alternative therapeutic solutions for the treatment of HBL, especially for advanced tumors and metastatic disease. In this study, we identified microRNAs (miRNAs) that target beta-catenin and block HBL cell proliferation in vitro and tumor growth in vivo. Using our dual-fluorescence-FunREG system, we screened a library of 1,712 miRNA mimics and selected candidates inhibiting CTNNB1 expression through interaction with its untranslated regions. After validating the regulatory effect of nine miRNAs on beta-catenin in HBL cells, we measured their expression in patient samples. Let-7i-3p, miR-449b-3p, miR-624-5p, and miR-885-5p were decreased in tumors compared to normal livers. Moreover, they inhibited HBL cell growth and Wnt signaling activity in vitro partly through beta-catenin down-regulation. Additionally, miR-624-5p induced cell senescence in vitro, blocked experimental HBL growth in vivo, and directly targeted the beta-catenin 3'-untranslated region. Conclusion: Our results shed light on how beta-catenin-regulating miRNAs control HBL progression through Wnt signaling inactivation. In particular, miR-624-5p may constitute a promising candidate for miRNA replacement therapy for HBL patients. (Hepatology Communications 2017;1:168-183).
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Affiliation(s)
- Emilie Indersie
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Sarah Lesjean
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Katarzyna B Hooks
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Francis Sagliocco
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Tony Ernault
- INSERM, UMR 1193, Paul-Brousse Hospital, Hepatobiliary Centre F-94800 Villejuif France.,Univ. Paris Saclay F-94800 Villejuif France
| | - Stefano Cairo
- XenTechEvry France.,Laboratory for Technologies of Advanced Therapies, Department of Morphology, Surgery and Experimental Medicine University of Ferrara Italy
| | | | | | | | | | - Michael Grotzer
- SIOPEL (International Childhood Liver Tumours Strategy Group) Liver Tumor and Tissue Banking Program University Children's Hospital Zürich Switzerland
| | | | | | | | | | - Martin Hagedorn
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
| | - Marie-Annick Buendia
- INSERM, UMR 1193, Paul-Brousse Hospital, Hepatobiliary Centre F-94800 Villejuif France.,Univ. Paris Saclay F-94800 Villejuif France
| | - Christophe F Grosset
- Univ. Bordeaux, Inserm, GREF, U1053, 33076 Bordeaux France.,Univ. Bordeaux, Inserm, BMGIC, U1035, 33076 Bordeaux France
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22
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Ménard S, Laharie D, Asensio C, Vidal-Martinez T, Candalh C, Rullier A, Zerbib F, Mégraud F, Matysiak-Budnik T, Heyman M. Bifidobacterium breve and Streptococcus thermophilus Secretion Products Enhance T Helper 1 Immune Response and Intestinal Barrier in Mice. Exp Biol Med (Maywood) 2016; 230:749-56. [PMID: 16246902 DOI: 10.1177/153537020523001008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 11/17/2022] Open
Abstract
Lactic acid bacteria or their secretion products can modulate immune responses differently in normal and inflammatory conditions. This comparative study analyzes the effect of oral administration of living lactic acid bacteria, or their conditioned media, on the epithelial and immune functions of colitis-prone C57BL/6 IL-10-deficient mice. Mice were untreated (control) or infected with Helicobacter hepaticus with or without oral treatment with living bacteria, Bifidobacterium breve C50 and Streptococcus thermophilus 065 (LB), or their culture-conditioned media (CM). Histology, cytokine mRNA, electrical resistance, and barrier capacity of colonic samples as well as cytokine secretion by mesenteric lymph node (MLN) cells were studied. Helicobacter hepaticus mice developed only mild colitis, which was not modified in LB or CM groups. In the CM (but not the LB) group, the colonic barrier was reinforced as compared to the other groups, as evidenced by decreased horseradish peroxidase (HRP) transcytosis and mannitol fluxes and increased electrical resistance. In MLN, the percentage of CD4+ and CD8+ T cells secreting IFNγ was significantly higher in CM (2.06% and 1.98%, respectively) mice than in H. hepaticus (1–1% and 0.47%, P < 0.05) or control mice. In addition, the nonspecific stimulation of IFNγ, TNFΑ, and IL-12 secretion by MLN cells was significantly higher in the CM group as compared to the other groups. In the absence of severe colitis, Bifidobacterium breve C50- and Streptococcus thermophilus 065-conditioned media can reinforce intestinal barrier capacity and stimulate Th1 immune response, highlighting the involvement of lactic acid bacteria–derived components in host defense.
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Affiliation(s)
- Sandrine Ménard
- INSERM EMI 0212, Faculté Cochin Necker, 156 rue de Vaugirard, 75730 Paris, France
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23
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Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, Le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer 2015; 15:511. [PMID: 26156156 PMCID: PMC4497499 DOI: 10.1186/s12885-015-1507-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 10/19/2014] [Accepted: 06/19/2015] [Indexed: 02/08/2023] Open
Abstract
Background In patients with high risk stage II and stage III colon cancer (CC), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 20 to 30 % of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for these CCs and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery. Methods/Design PRODIGE 22 - ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy and feasibility of two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4 + Cetuximab) in a peri-operative strategy in patients with bulky CCs. Patients with CC deemed as high risk T3, T4 and/or N2 on initial abdominopelvic CT scan are randomized to either colectomy and adjuvant chemotherapy (control arm), or 4 cycles of neoadjuvant chemotherapy with FOLFOX-4 (for RAS mutated patients). In RAS wild-type patients a third arm testing FOLFOX+ cetuximab has been added prior to colectomy. Patients in the neoadjuvant chemotherapy arms will receive postoperative treatment for 4 months (8 cycles) to complete their therapeutic schedule. The primary endpoint of the study is the histological Tumor Regression Grade (TRG) as defined by Ryan. The secondary endpoints are: treatment strategy safety (toxicity, primary tumor related complications under chemotherapy, peri-operative morbidity), disease-free and recurrence free survivals at 3 years, quality of life, carcinologic quality and completeness of the surgery, initial radiological staging and radiological response to neoadjuvant chemotherapy, and the correlation between histopathological and radiological response. Taking into account a 50 % prevalence of CC without RAS mutation, accrual of 165 patients is needed for this Phase II trial. Trial Registration NCT01675999 (ClinicalTrials.gov)
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Affiliation(s)
- Mehdi Karoui
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, University Institute of Cancerology (Paris VI), Pierre & Marie Curie University (Paris VI), 47-83 Boulevard de l'Hôpital, 75013, Paris, France. .,FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Anne Rullier
- Department of Pathology, Pellegrin University Hospital, Bordeaux, France.
| | - Alain Luciani
- Assistance Publique-Hôpitaux de Paris, Department of Radiology, Henri Mondor University Hospital, Paris XII university, Créteil, France.
| | - Franck Bonnetain
- Department of Medical Oncology and public health, Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France.
| | - Marie-Luce Auriault
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Antony Sarran
- Department of Radiology, Institut Paoli Calmettes, Marseille, France.
| | - Geneviève Monges
- Department of Pathology, Institut Paoli Calmettes, Marseille, France.
| | - Hervé Trillaud
- Department of Radiology, St André University Hospital, Bordeaux, France.
| | - Karine Le Malicot
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Karen Leroy
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Iradj Sobhani
- Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Henri Mondor University Hospital, Créteil, France.
| | - Armelle Bardier
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Pitié-Salpêtrière University Hospital, Paris, France.
| | - Marie Moreau
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Isabelle Brindel
- Assistance Publique-Hôpitaux de Paris, Département de la Recherche Clinique et du Développement (DRCD), Paris, France.
| | | | - Julien Taieb
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France. .,Assistance Publique-Hôpitaux de Paris, Department of Digestive Oncology, European Georges Pompidou - Paris Descartes University, Paris, France.
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Savel H, Bonnabau H, Rullier A, Raymond AA, Raimbault M, Dupuy JW, Claverol S, Bonneu M, Perez P, Thiébaut R. Approche protéomique par « label-free » des peptides associés à la réponse à la radio chimiothérapie préopératoire du cancer du rectum localement avancé (étude PROTEORECTUM). Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.071] [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: 11/27/2022] Open
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25
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Rullier A. [Pathology of gallbladder and extrahepatic bile ducts. Case 5. Clear cell vesicular adenocarcinoma, pT1bNx stage (TNM, 7th edition)]. Ann Pathol 2014; 34:296-308. [PMID: 25132441 DOI: 10.1016/j.annpat.2014.06.009] [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] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Anne Rullier
- Service de pathologie, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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26
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Rullier A. [Pathology of gallbladder and extrahepatic bile ducts. Case 4. Sclerosing lymphoplasmacytic cholecystitis]. Ann Pathol 2014; 34:288-95. [PMID: 25132440 DOI: 10.1016/j.annpat.2014.06.003] [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] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Anne Rullier
- Service de pathologie, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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Savel H, Raimbault M, Rullier A, Raymond AA, Bonnabau H, Dupuy JW, Claverol S, Bonneu M, Perez P, Thiébaut R. Approche protéomique par le label-free des peptides associés à la réponse à la radiochimiothérapie préopératoire du cancer du rectum localement avancé (étude PROTEORECTUM). Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.046] [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: 11/26/2022] Open
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Elbes D, Denost Q, Laurent C, Trillaud H, Rullier A, Quesson B. Pre-clinical study of in vivo magnetic resonance-guided bubble-enhanced heating in pig liver. Ultrasound Med Biol 2013; 39:1388-1397. [PMID: 23562012 DOI: 10.1016/j.ultrasmedbio.2013.01.014] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 01/16/2013] [Accepted: 01/21/2013] [Indexed: 06/02/2023]
Abstract
Bubble-enhanced heating (BEH) can be exploited to increase heating efficiency in treatment of liver tumors with non-invasive high-intensity focused ultrasound (HIFU). The objectives of this study were: (i) to demonstrate the feasibility of increasing the heating efficiency of sonication exploiting BEH in pig liver in vivo using a clinical platform; (ii) to determine the acoustic threshold for such effects with real-time, motion-compensated magnetic resonance-guided thermometry; and (iii) to compare the heating patterns and thermal lesion characteristics resulting from continuous sonication and sonication including a burst pulse. The threshold acoustic power for generation of BEH in pig liver in vivo was determined using sonication of 0.5-s duration ("burst pulse") under real-time magnetic resonance thermometry. In a second step, experimental sonication composed of a burst pulse followed by continuous sonication (14.5 s) was compared with conventional sonication (15 s) of identical energy (1.8 kJ). Modification of the heating pattern at the targeted region located at a liver depth between 20 and 25 mm required 600-800 acoustic watts. The experimental group exhibited near-spherical heating with 40% mean enhancement of the maximal temperature rise as compared with the conventional sonication group, a mean shift of 7 ± 3.3 mm toward the transducer and reduction of the post-focal temperature increase. Magnetic resonance thermometry can be exploited to control acoustic BEH in vivo in the liver. By use of experimental sonication, more efficient heating can be achieved while protecting tissues located beyond the focal point.
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Affiliation(s)
- Delphine Elbes
- Centre de Recherche Cardio-Thoracique, Université de Bordeaux, Bordeaux, France.
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Chetty R, Gill P, Bateman AC, Driman DK, Govender D, Bateman AR, Chua YJ, Greywoode G, Hemmings C, Imat I, Jaynes E, Lee CS, Locketz M, Rowsell C, Rullier A, Serra S, Szentgyorgyi E, Vajpeyi R, Delaney D, Wang LM. Pathological grading of regression: an International Study Group perspective. J Clin Pathol 2012; 65:865-6. [DOI: 10.1136/jclinpath-2012-201054] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Callens C, Baleydier F, Lengline E, Ben Abdelali R, Petit A, Villarese P, Cieslak A, Minard-Colin V, Rullier A, Moreau A, Baruchel A, Schmitt C, Asnafi V, Bertrand Y, Macintyre E. Clinical impact of NOTCH1 and/or FBXW7 mutations, FLASH deletion, and TCR status in pediatric T-cell lymphoblastic lymphoma. J Clin Oncol 2012; 30:1966-73. [PMID: 22547598 DOI: 10.1200/jco.2011.39.7661] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Pediatric T-cell lymphoblastic lymphomas (T-LBL) are commonly treated on T-cell acute lymphoblastic leukemia (T-ALL) -derived protocols. Therapeutic stratification based on response to the prephase treatment and on minimal residual disease assessment is well established in T-ALL but is not easy to extrapolate to T-LBL. The identification of molecular prognostic markers at diagnosis in T-LBL could provide an alternative for early therapeutic stratification. Our study determines the frequency and prognostic value of NOTCH1/FBXW7 mutations (N/F(mut)), FLASH deletion at chromosome 6q, and TCR rearrangements in a prospective cohort of pediatric T-LBL. PATIENTS AND METHODS Pathologic samples were obtained at diagnosis for 54 patients treated according to the EuroLB02 protocol in France. N/F(mut) were identified by direct sequencing and allelic dosage was used to detect FLASH and TCRγ deletions, which were interpreted in conjunction with TCRγ, TCRβ, and TCRδ rearrangements. RESULTS N/F(mut) were found in 55% of T-LBL patients, in whom they were associated with improved event-free survival (P < .01) and overall survival (P < .01). FLASH monoallelic deletions were observed in 18% of patients; they were predominantly N/F wild-type (six of nine) and tended to be of inferior prognosis (P = .09). Absence of biallelic TCRγ deletion (ABD) was seen in 7%, all of which were N/F(mut) and identified a poor prognosis group (P = .02). On multivariate analysis of N/F(mut), TCRγ ABD, and FLASH deletion, only N/F(mut) was an independent factor for good prognosis. CONCLUSION Mutational status of NOTCH1/FBXW7 represents a promising marker for early therapeutic stratification in pediatric T-LBL.
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Lapeyrere N, Mathoulin-Pélissier S, Merlio JP, Rullier A, Belleannée G, LeBail B, Hostein I, Soubeyran I. Prise en charge d’une analyse KRAS : processus et délais. Ann Pathol 2012; 32:81-90. [DOI: 10.1016/j.annpat.2012.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 12/09/2011] [Accepted: 02/01/2012] [Indexed: 10/28/2022]
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Chetty R, Gill P, Govender D, Bateman A, Chang HJ, Driman D, Duthie F, Gomez M, Jaynes E, Lee CS, Locketz M, Mescoli C, Rowsell C, Rullier A, Serra S, Shepherd N, Szentgyorgyi E, Vajpeyi R, Wang LM. A multi-centre pathologist survey on pathological processing and regression grading of colorectal cancer resection specimens treated by neoadjuvant chemoradiation. Virchows Arch 2012; 460:151-5. [PMID: 22241181 DOI: 10.1007/s00428-012-1193-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 12/12/2011] [Accepted: 01/03/2012] [Indexed: 12/13/2022]
Abstract
To ascertain the approach and degree of consensus of pathologists in the handling and regression grading of colorectal cancer resection specimens treated with neoadjuvant chemoradiation, a ten-part questionnaire was circulated to 18 gastrointestinal pathologists in eight countries. The questions were specific and addressed pertinent issues related to colorectal cancer with neoadjuvant chemoradiation. There is a lack of consensus on how to handle the specimen, number of sections taken, correlation with pre- and post-operative radiological imaging, and especially, regression grading schema employed. Consensus in the form of guidelines is required so that the pathological assessment of these specimens will provide clinically relevant information for patient management, irrespective of location.
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Affiliation(s)
- Runjan Chetty
- Department of Cellular Pathology, John Radcliffe Hospital and University of Oxford, Oxford, UK.
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Bibeau F, Rullier A, Jourdan MF, Frugier H, Palasse J, Leaha C, Gudin de Vallerin A, Rivière B, Bodin X, Perrault V, Cantos C, Lavaill R, Boissière-Michot F, Azria D, Colombo PE, Rouanet P, Rullier E, Panis Y, Guedj N. [Locally advanced rectal cancer management: which role for the pathologist in 2011?]. Ann Pathol 2011; 31:433-41. [PMID: 22172116 DOI: 10.1016/j.annpat.2011.10.010] [Citation(s) in RCA: 7] [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: 07/12/2011] [Accepted: 10/15/2011] [Indexed: 01/16/2023]
Abstract
Locally advanced rectal cancers mainly correspond to lieberkünhien adenocarcinomas and are defined by T3-T4 lesions with or without regional metastatic lymph nodes. Such tumors benefit from neoadjuvant treatment combining chemotherapy and radiotherapy, followed by surgery with total mesorectum excision. Such a strategy can decrease the rate of local relapse and lead to an easier complementary surgery. The pathologist plays an important role in the management of locally advanced rectal cancer. Indeed, he is involved in the gross examination of the mesorectum excision quality and in the exhaustive sampling of the most informative areas. He also has to perform a precise histopathological analysis, including the determination of the circumferential margin or clearance and the evaluation of tumor regression. All these parameters are major prognostic factors which have to be clearly included in the pathology report. Moreover, the next challenge for the pathologist will be to determine and validate new prognostic and predictive markers, notably by using pre-therapeutic biopsies. The goal of this mini-review is to emphasize the pathologist's role in the different steps of the management of locally advanced rectal cancers and to underline its implication in the determination of potential biomarkers of aggressiveness and response.
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Affiliation(s)
- Frédéric Bibeau
- Service de pathologie, CRLC Val-d'Aurelle, Montpellier, France.
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Rullier A, Gourgou-Bourgade S, Bibeau F, Chassagne C, Hennequin C, Étienne PL, Leroux A, Bérylle J, Conroy T, Gerard JP. Facteurs prédictifs de marge circonférentielle envahie après radiochimiothérapie pour cancer du rectum : résultats de l’essai français randomisé ACCORD12/0405 PRODIGE 2. Ann Pathol 2011. [DOI: 10.1016/j.annpat.2011.09.016] [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: 10/15/2022]
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Quesson B, Laurent C, Maclair G, de Senneville BD, Mougenot C, Ries M, Carteret T, Rullier A, Moonen CTW. Real-time volumetric MRI thermometry of focused ultrasound ablation in vivo: a feasibility study in pig liver and kidney. NMR Biomed 2011; 24:145-153. [PMID: 21344531 DOI: 10.1002/nbm.1563] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 05/28/2023]
Abstract
MR thermometry offers the possibility to precisely guide high-intensity focused ultrasound (HIFU) for the noninvasive treatment of kidney and liver tumours. The objectives of this study were to demonstrate therapy guidance by motion-compensated, rapid and volumetric MR temperature monitoring and to evaluate the feasibility of MR-guided HIFU ablation in these organs. Fourteen HIFU sonications were performed in the kidney and liver of five pigs under general anaesthesia using an MR-compatible Philips HIFU platform prototype. HIFU sonication power and duration were varied. Volumetric MR thermometry was performed continuously at 1.5 T using the proton resonance frequency shift method employing a multi-slice, single-shot, echo-planar imaging sequence with an update frequency of 2.5 Hz. Motion-related suceptibility artefacts were compensated for using multi-baseline reference images acquired prior to sonication. At the end of the experiment, the animals were sacrificed for macroscopic and microscopic examinations of the kidney, liver and skin. The standard deviation of the temperature measured prior to heating in the sonicated area was approximately 1 °C in kidney and liver, and 2.5 °C near the skin. The maximum temperature rise was 30 °C for a sonication of 1.2 MHz in the liver over 15 s at 300 W. The thermal dose reached the lethal threshold (240 CEM(43) ) in two of six cases in the kidney and four of eight cases in the liver, but remained below this value in skin regions in the beam path. These findings were in agreement with histological analysis. Volumetric thermometry allows real-time monitoring of the temperature at the target location in liver and kidney, as well as in surrounding tissues. Thermal ablation was more difficult to achieve in renal than in hepatic tissue even using higher acoustic energy, probably because of a more efficient heat evacuation in the kidney by perfusion.
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Affiliation(s)
- Bruno Quesson
- Laboratoire d'Imagerie Moleculaire et Fonctionnelle, UMR 5231 CNRS/Université Victor Segalen Bordeaux 2, Bordeaux, France.
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Grise F, Bidaud-Meynard A, Dugot-Senant N, Rullier A, Bioulac-Sage P, Zucman-Rossi J, Rosenbaum J, Moreau V. R36: Sous-expression de Rnd3/RhoE dans le carcinome hépatocellulaire : implication dans l’invasion des hépatocytes tumoraux. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)30953-x] [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: 10/23/2022]
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Rullier A, Coindre JM, Sassoust G, Bioulac-Sage P, Lepreux S. Myopéricytome artériel : à propos d’un cas. Ann Pathol 2010; 30:325-7. [DOI: 10.1016/j.annpat.2010.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 05/10/2010] [Accepted: 05/11/2010] [Indexed: 10/19/2022]
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Gilbert M, Firah N, Aladjidi N, Verité C, Ansoborlo S, Rullier A, Micheau M, Moreau J, Perel Y. P428 - L’association aplasie médullaire - hépatite. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70822-8] [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: 10/19/2022]
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Lavrand F, Notz A, Bouty A, Bessou P, Rullier A, Lamireau T. P249 - Fetus in Fetu : une étiologie rare de tumeur chez l’enfant. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70647-3] [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: 11/15/2022]
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Abstract
AIM: To study the protein C activation system in human liver myofibroblasts, and the effects of activated protein C (APC) on these cells.
METHODS: Human liver myofibroblasts were obtained by outgrowth. Expression of protease activated receptor 1 (PAR-1), endothelial protein C receptor (EPCR) and thrombomodulin (TM) was analyzed by flow cytometry. Extracellular signal-regulated kinase (ERK)1/2 activation was assessed by Western blotting using anti-phospho-ERK antibodies. Collagen synthesis was studied with real-time reverse transcription-polymerase chain reaction (RT-PCR). Activation of protein C was studied by incubating liver myofibroblasts with zymogen protein C in the presence of thrombin and detecting the generation of APC with a colorimetric assay using a peptide substrate.
RESULTS: Primary cultures of human liver myofibroblasts expressed EPCR on their surface, together with PAR-1 and TM. This receptor system was functional since exposure of myofibroblasts to APC induced ERK1/2 phosphorylation in a dose- and time-dependent manner. Furthermore, APC significantly upregulated the expression of collagen mRNA, as shown by real-time RT-PCR. Collagen upregulation was controlled through the ERK pathway as it was inhibited when using the mitogen-activated protein/extracellular signal-regulated kinase kinase inhibitor PD98059. Finally, using a cell-based colorimetric assay, we showed that intact myofibroblasts converted protein C into APC in the presence of thrombin.
CONCLUSION: These data suggest that APC is a new modulator of liver myofibroblast activity and contributes to the pathophysiology of chronic liver diseases.
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Bioulac-Sage P, Laumonier H, Couchy G, Le Bail B, Sa Cunha A, Rullier A, Laurent C, Blanc JF, Cubel G, Trillaud H, Zucman-Rossi J, Balabaud C, Saric J. Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience. Hepatology 2009; 50:481-9. [PMID: 19585623 DOI: 10.1002/hep.22995] [Citation(s) in RCA: 282] [Impact Index Per Article: 18.8] [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: 12/11/2022]
Abstract
UNLABELLED We took advantage of the reported genotype/phenotype classification to analyze our surgical series of hepatocellular adenoma (HCA). The series without specific known etiologies included 128 cases (116 women). The number of nodules varies from single, <5, and >or=5 in 78, 38, and 12 cases, respectively. The resection was complete in 95 cases. We identified 46 HNF1alpha-inactivated HCAs (44 women), 63 inflammatory HCAs (IHCA, 53 women) of which nine were also beta-catenin-activated, and seven beta-catenin-activated HCAs (all women); six additional cases had no known phenotypic marker and six others could not be phenotypically analyzed. Twenty-three of 128 HCAs showed bleeding. No differences were observed in solitary or multiple tumors in terms of hemorrhagic manifestations between groups. In contrast, differences were observed between the two main groups. Steatosis (tumor), microadenomas (resected specimen), and additional benign nodules were more frequently observed in HNF1alpha-inactivated HCAs (P < 0.01) than in IHCAs. Body mass index > 25, peliosis (tumor), and steatosis in background liver were more frequent in IHCA (P < 0.01). After complete resection, new HCAs in the centimetric range were more frequently found during follow-up (>1 year) in HNF1alpha-inactivated HCA. After incomplete resection (HCA left in nonresected liver), the majority of HCA remained stable in the two main groups and even sometimes regressed. Six patients of 128 developed hepatocellular carcinoma (HCC) (all were beta-catenin-activated, whether inflammatory or not). CONCLUSION There were noticeable clinical differences between HNF1alpha-inactivated HCA and IHCA; there was no increased risk of bleeding or HCC related to the number of HCAs; beta-catenin-activated HCAs are at higher risk of HCC. As a consequence, we believe that management of HCA needs to be adapted to the phenotype of these tumors.
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Affiliation(s)
- Paulette Bioulac-Sage
- Service d'Anatomie Pathologique, Hôpital Pellegrin, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France.
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Bioulac-Sage P, Laumonier H, Rullier A, Cubel G, Laurent C, Zucman-Rossi J, Balabaud C. Over-expression of glutamine synthetase in focal nodular hyperplasia: a novel easy diagnostic tool in surgical pathology. Liver Int 2009; 29:459-65. [PMID: 18803590 DOI: 10.1111/j.1478-3231.2008.01849.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Glutamine synthetase (GS) is a useful marker in tumour liver pathology, including hepatocellular adenomas and nodules in cirrhosis. We investigated the use of GS as a marker in various clinical situations, in which FNH diagnosis had been firmly established to determine its contribution to diagnosis. METHODS Seventy-nine cases of resected FNH, all on normal (or occasionally steatotic) livers, were retrieved from our collection. The control group was composed of hepatocellular adenomas and well-differentiated hepatocellular carcinoma. The following stains: H&E, Masson's trichrome, Gordon-Sweet, PAS, perls and immunostains: CK7 and 19, and GS were carried out. FNH was diagnosed based on traditional pathological techniques. In case of uncertainty, particularly with hepatocellular adenoma, additional immunostainings including liver fatty acid-binding protein, serum amyloid A and beta-catenin were performed. RESULTS Glutamine synthetase immunostaining was similar in all FNH cases. Positive GS staining of hepatocytic cytoplasms formed large areas, anastomosed in a 'map-like' pattern, often surrounding hepatic veins, whereas GS was not expressed in hepatocytes close to fibrotic bands containing arteries and ductules. In comparison, hepatocellular adenoma staining was completely different, even in cases of fibrotic bands due to tumour remodelling related to necrosis or haemorrhage. In hepatocellular adenomas or well-differentiated hepatocellular carcinoma presenting beta-catenin mutation, GS was positive but with a completely different pattern that appeared diffuse and not 'map-like'. CONCLUSION Regardless of the FNH size or steatotic content, GS produced a similar and characteristic pattern and consequently represents a good marker for easily identifying resected FNH from other hepatocellular nodules.
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Laumonier H, Rullier A, Saric J, Balabaud C, Bioulac-Sage P. Unexpected discovery of 2 cases of hepatocyte nuclear factor 1α-mutated infracentimetric adenomatosis. World J Gastroenterol 2008; 14:4830-3. [PMID: 18720549 PMCID: PMC2739350 DOI: 10.3748/wjg.14.4830] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We present 2 cases of hepatocyte nuclear factor 1α (HNF1α)-mutated adenomatosis, discovered for reasons unrelated to this disease, and identified using immunohistochemical methods. These new tools may further our understanding of the link between adenomas/adenomatosis subtypes and their complications, and their association with other abnormalities.
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Rullier A, Gillibert-Duplantier J, Costet P, Cubel G, Haurie V, Petibois C, Taras D, Dugot-Senant N, Deleris G, Bioulac-Sage P, Rosenbaum J. Protease-activated receptor 1 knockout reduces experimentally induced liver fibrosis. Am J Physiol Gastrointest Liver Physiol 2008; 294:G226-35. [PMID: 17962354 DOI: 10.1152/ajpgi.00444.2007] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [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: 01/31/2023]
Abstract
Thrombin inhibition protects against liver fibrosis. However, it is not known whether the thrombin profibrogenic effect is due to effects on blood coagulation or to signaling via protease-activated receptors (PARs). We took advantage of the lack of blood coagulation defects in PAR-1-knockout mice. Acute carbon tetrachloride (CCl(4)) toxicity was similar in wild-type (WT), PAR-1(-/-), and PAR-1(+/-) mice as judged by aminotransferase levels, area of liver necrosis, and liver peroxidation measured by Fourier-transformed infrared spectroscopy. Fifteen mice/group received CCl(4) or its solvent for 6 wk (300 microl/kg, 3 times a week). Fibrosis area was increased 10-fold by CCl(4) treatment in WT mice. PAR-1 deficiency protected against fibrosis, with 36% and 56% decrease in PAR-1(+/-) and PAR-1(-/-) mice, respectively (P < 0.001). Similar results were obtained for area of activated fibrogenic cells (64% and 79% decrease in PAR-1(+/-) and PAR-1(-/-) mice, respectively, P < 0.001). These findings were corroborated by measurements of type I collagen, matrix metalloproteinase-2, and PDGF-beta receptor mRNA levels. There was also a significant decrease in T lymphocyte infiltration in PAR-1-deficient mice. Altogether, these results suggest that thrombin profibrogenic effects are independent of effects on blood coagulation and are instead due to direct effects on fibrogenic cells and possibly on T lymphocytes.
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Affiliation(s)
- Anne Rullier
- INSERM U889, Université Victor Segalen Bordeaux 2, 146, Rue Léo Saignat, 33076 Bordeaux, France
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Jarry J, Biscay D, Lepront D, Rullier A, Midy D. Spontaneous intramural haematoma of the sigmoid colon causing acute intestinal obstruction in a haemophiliac: report of a case. Haemophilia 2007; 14:383-4. [PMID: 18179573 DOI: 10.1111/j.1365-2516.2007.01627.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Delage B, Rullier A, Capdepont M, Rullier E, Cassand P. The effect of body weight on altered expression of nuclear receptors and cyclooxygenase-2 in human colorectal cancers. Nutr J 2007; 6:20. [PMID: 17767717 PMCID: PMC2018695 DOI: 10.1186/1475-2891-6-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 09/03/2007] [Indexed: 12/13/2022] Open
Abstract
Background Epidemiological studies on risk factors for colorectal cancer (CRC) have mainly focused on diet, and being overweight is now recognized to contribute significantly to CRC risk. Overweight and obesity are defined as an excess of adipose tissue mass and are associated with disorders in lipid metabolism. Peroxisome proliferator-activated receptors (PPARs) and retinoid-activated receptors (RARs and RXRs) are important modulators of lipid metabolism and cellular homeostasis. Alterations in expression and activity of these ligand-activated transcription factors might be involved in obesity-associated diseases, which include CRC. Cyclooxygenase-2 (COX-2) also plays a critical role in lipid metabolism and alterations in COX-2 expression have already been associated with unfavourable clinical outcomes in epithelial tumors. The objective of this study is to examine the hypothesis questioning the relationship between alterations in the expression of nuclear receptors and COX-2 and the weight status among male subjects with CRC. Method The mRNA expression of the different nuclear receptor subtypes and of COX-2 was measured in 20 resected samples of CRC and paired non-tumor tissues. The association between expression patterns and weight status defined as a body mass index (BMI) was statistically analyzed. Results No changes were observed in PPARγ mRNA expression while the expression of PPARδ, retinoid-activated receptors and COX-2 were significantly increased in cancer tissues compared to normal colon mucosa (P ≤ 0.001). The weight status appeared to be an independent factor, although we detected an increased level of COX-2 expression in the normal mucosa from overweight patients (BMI ≥ 25) compared to subjects with healthy BMI (P = 0.002). Conclusion Our findings show that alterations in the pattern of nuclear receptor expression observed in CRC do not appear to be correlated with patient weight status. However, the analysis of COX-2 expression in normal colon mucosa from subjects with a high BMI suggests that COX-2 deregulation might be driven by excess weight during the colon carcinogenesis process.
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Affiliation(s)
- Barbara Delage
- Laboratoire Alimentation et Cancerogenese Colique, Unite de Nutrition et Signalisation Cellulaire, Universite Bordeaux1, France
| | - Anne Rullier
- Departement de Pathologie, Hopital Pellegrin, Bordeaux, France
| | - Maylis Capdepont
- Departement de Chirurgie Digestive, Hopital Saint-André, Bordeaux, France
| | - Eric Rullier
- Departement de Chirurgie Digestive, Hopital Saint-André, Bordeaux, France
| | - Pierrette Cassand
- Laboratoire Alimentation et Cancerogenese Colique, Unite de Nutrition et Signalisation Cellulaire, Universite Bordeaux1, France
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Bioulac-Sage P, Rebouissou S, Thomas C, Blanc JF, Saric J, Sa Cunha A, Rullier A, Cubel G, Couchy G, Imbeaud S, Balabaud C, Zucman-Rossi J. Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry. Hepatology 2007; 46:740-8. [PMID: 17663417 DOI: 10.1002/hep.21743] [Citation(s) in RCA: 460] [Impact Index Per Article: 27.1] [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] [Indexed: 12/13/2022]
Abstract
UNLABELLED Hepatocellular adenomas (HCA) with activated beta-catenin present a high risk of malignant transformation. To permit robust routine diagnosis to allow for HCA subtype classification, we searched new useful markers. We analyzed the expression of candidate genes by quantitative reverse transcription polymerase chain reaction QRT-PCR followed by immunohistochemistry to validate their specificity and sensitivity according to hepatocyte nuclear factor 1 alpha (HNF1alpha) and beta-catenin mutations as well as inflammatory phenotype. Quantitative RT-PCR showed that FABP1 (liver fatty acid binding protein) and UGT2B7 were downregulated in HNF1alpha-inactivated HCA (P <or= 0.0002); GLUL (glutamine synthetase) and GPR49 overexpression were associated with beta-catenin-activating mutations (P <or= 0.0005), and SAA2 (serum amyloid A2) and CRP (C-reactive protein) were upregulated in inflammatory HCA (P = 0.0001). Immunohistochemistry validation confirmed that the absence of liver-fatty acid binding protein (L-FABP) expression rightly indicated HNF1alpha mutation (100% sensitivity and specificity), the combination of glutamine synthetase overexpression and nuclear beta-catenin staining were excellent predictors of beta-catenin-activating mutation (85% sensitivity, 100% specificity), and SAA hepatocytic staining was ideal to classify inflammatory HCA (91% sensitivity and specificity). Finally, a series of 93 HCA was unambiguously classified using our 4 validated immunohistochemical markers. Importantly, new associations were revealed for inflammatory HCA defined by SAA staining with frequent hemorrhages (P = 0.003), telangiectatic phenotype (P < 0.001), high body mass index, and alcohol intake (P <or= 0.04). Previously described associations were confirmed and in particular the significant association between beta-catenin-activated HCA and hepatocellular carcinomas (HCC) at diagnosis or during follow-up (P < 10(-5)). CONCLUSION We refined HCA classification and its phenotypic correlations, providing a routine test to classify hepatocellular adenomas using simple and robust immunohistochemistry.
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Rullier A, Laurent C. [Recommendations for clinical practice. Therapeutic choices for rectal cancer. What quality criteria are important for surgical excision of rectal cancer?]. Gastroenterol Clin Biol 2007; 31 Spec No 1:1S34-51, 1S91-5. [PMID: 17569476] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Taras D, Blanc JF, Rullier A, Dugot-Senant N, Laurendeau I, Vidaud M, Rosenbaum J. Pravastatin reduces lung metastasis of rat hepatocellular carcinoma via a coordinated decrease of MMP expression and activity. J Hepatol 2007; 46:69-76. [PMID: 16935385 DOI: 10.1016/j.jhep.2006.06.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [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: 03/02/2006] [Revised: 05/10/2006] [Accepted: 06/05/2006] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Statins have beneficial effects in early pre-clinical models of hepatocellular carcinoma (HCC). Our aim was to test the efficacy of pravastatin on the progression of established HCC in rat, and to study its mechanisms. METHODS HCC was induced with diethylnitrosamine and N-nitrosomorpholine. After 14 weeks, all rats developed HCC and then received pravastatin or its solvent for 10 weeks (10 rats/group). RESULTS Liver tumor mass was lower in pravastatin group (PG) than control group (CG), as estimated from the number of liver tumors (p<0.004) and the liver weight/body weight ratio (p<0.04). Every CG rat surviving at 24 weeks (4/4) had lung metastasis, against only 5/8 in PG. Moreover, the percentage of lung surface occupied by metastasis was 10-fold smaller in PG than CG (p<0.016). Pravastatin decreased liver matrix metalloproteinase (MMP)-9 activity and mostly suppressed MMP-2 activation (p<0.004), likely because it decreased expression of MMP-14 and tissue inhibitor of matrix metalloproteinases-2 (p<0.01), required for MMP-2 activation. CONCLUSIONS Pravastatin reduces progression and limits metastatic diffusion of established HCC. This could be linked to the decreased MMP activity. These results, obtained in a very aggressive HCC model, further suggest the potential benefit of statins in human HCC.
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