1
|
Khessib T, Franc B, Yang E, Moradi F. Retroperitoneal Inflammation Detected on FDG PET/CT in Patient on Long-Term Immunotherapy. Clin Nucl Med 2023; 48:e165-e166. [PMID: 36728374 DOI: 10.1097/rlu.0000000000004513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT A 68-year-old man with a history of pulmonary adenocarcinoma on maintenance pembrolizumab presented for surveillance imaging. 18 F-FDG PET/CT demonstrated new ill-defined right retroperitoneal and presacral soft tissue stranding with associated FDG uptake suggestive of inflammation. Biopsy results revealed fibroadipose tissue with extensive lymphoplasmacytic inflammation concerning for immunotherapy-related toxicity. The patient was subsequently taken off pembrolizumab, which he had been on for approximately 3 years. Recognition of immunotherapy-related adverse effects and how they can manifest on 18 F-FDG PET/CT is important for prompt cessation of treatment.
Collapse
Affiliation(s)
- Tasnim Khessib
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
| | - Benjamin Franc
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
| | - Eric Yang
- Division of Surgical Pathology, Department of Pathology, Stanford Health Care, Palo Alto, CA
| | - Farshad Moradi
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
| |
Collapse
|
2
|
Levitte S, Yarani R, Ganguly A, Martin L, Gubatan J, Nadel HR, Franc B, Gugig R, Syed A, Goyal A, Park KT, Thakor AS. Case Series of Precision Delivery of Methylprednisolone in Pediatric Inflammatory Bowel Disease: Feasibility, Clinical Outcomes, and Identification of a Vasculitic Transcriptional Program. J Clin Med 2023; 12:jcm12062386. [PMID: 36983386 PMCID: PMC10053508 DOI: 10.3390/jcm12062386] [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: 01/24/2023] [Revised: 03/05/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Systemic steroid exposure, while useful for the treatment of acute flares in inflammatory bowel disease (IBD), is associated with an array of side effects that are particularly significant in children. Technical advancements have enabled locoregional intraarterial steroid delivery directly into specific segments of the gastrointestinal tract, thereby maximizing tissue concentration while limiting systemic exposure. We investigated the feasibility of intraarterial steroid administration into the bowel in a cohort of nine pediatric patients who had IBD. This treatment approach provided symptom relief in all patients, with sustained relief (>2 weeks) in seven out of nine; no serious adverse effects occurred in any patient. In addition, we identified patterns of vascular morphologic changes indicative of a vasculopathy within the mesenteric circulation of inflamed segments of the bowel in pediatric patients with Crohn's disease, which correlated with disease activity. An analysis of publicly available transcriptomic studies identified vasculitis-associated molecular pathways activated in the endothelial cells of patients with active Crohn's disease, suggesting a possible shared transcriptional program between vasculitis and IBD. Intraarterial corticosteroid treatment is safe and has the potential to be widely accepted as a locoregional approach for therapy delivery directly into the bowel; however, this approach still warrants further consideration as a short-term "bridge" between therapy transitions for symptomatic IBD patients with refractory disease, as part of a broader steroid-minimizing treatment strategy.
Collapse
Affiliation(s)
- Steven Levitte
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA 94304, USA
| | - Reza Yarani
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
| | - Abantika Ganguly
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
| | - Lynne Martin
- Department of Pediatric Radiology, Interventional Radiology, Stanford University, Palo Alto, CA 94304, USA
| | - John Gubatan
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA 94304, USA
| | - Helen R Nadel
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
- Department of Pediatric Radiology, Interventional Radiology, Stanford University, Palo Alto, CA 94304, USA
| | - Benjamin Franc
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
| | - Roberto Gugig
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA 94304, USA
| | - Ali Syed
- Department of Pediatric Radiology, Interventional Radiology, Stanford University, Palo Alto, CA 94304, USA
| | - Alka Goyal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA 94304, USA
| | - K T Park
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA 94304, USA
| | - Avnesh S Thakor
- Interventional Radiology Innovation at Stanford (IRIS), 3155 Porter Drive, Palo Alto, CA 94304, USA
- Department of Pediatric Radiology, Interventional Radiology, Stanford University, Palo Alto, CA 94304, USA
| |
Collapse
|
3
|
Raghavan K, Copeland TP, Rabow M, Ladenheim M, Marks A, Pantilat SZ, O'Riordan D, Seidenwurm D, Franc B. Palliative care and imaging utilisation for patients with cancer. BMJ Support Palliat Care 2022; 12:e813-e820. [PMID: 30826736 PMCID: PMC6773516 DOI: 10.1136/bmjspcare-2018-001572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 01/01/2019] [Accepted: 01/16/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This observational study explores the association between palliative care (PC) involvement and high-cost imaging utilisation for patients with cancer patients during the last 3 months of life. METHODS Adult patients with cancer who died between 1 January 2012 and 31 May 2015 were identified. Referral to PC, intensity of PC service use, and non-emergent oncological imaging utilisation were determined. Associations between PC utilisation and proportion of patients imaged and mean number of studies per patient (mean imaging intensity (MII)) were assessed for the last 3 months and the last month of life. Similar analyses were performed for randomly matched case-control pairs (n = 197). Finally, the association between intensity of PC involvement and imaging utilisation was assessed. RESULTS 3784 patients were included, with 3523 (93%) never referred to PC and 261 (7%) seen by PC, largely before the last month of life (61%). Similar proportions of patients with and without PC referral were imaged during the last 3 months, while a greater proportion of patients with PC referral were imaged in the last month of life. PC involvement was not associated with significantly different MII during either time frame. In the matched-pairs analysis, a greater proportion of patients previously referred to PC received imaging in the period between the first PC encounter and death, and in the last month of life. MII remained similar between PC and non-PC groups. Finally, intensity of PC services was similar for imaged and non-imaged patients in the final 3 months and 1 month of life. During these time periods, increased PC intensity was not associated with decreased MII. CONCLUSIONS PC involvement in end-of-life oncological care was not associated with decreased use of non-emergent, high-cost imaging. The role of advanced imaging in the PC setting requires further investigation.
Collapse
Affiliation(s)
- Kesav Raghavan
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Timothy P Copeland
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Michael Rabow
- Palliative Care Program, University of California San Francisco, San Francisco, California, USA
| | - Maya Ladenheim
- Palliative Care Program, University of California San Francisco, San Francisco, California, USA
| | - Angela Marks
- Palliative Care Program, University of California San Francisco, San Francisco, California, USA
| | - Steven Z Pantilat
- Palliative Care Program, University of California San Francisco, San Francisco, California, USA
| | - David O'Riordan
- Palliative Care Program, University of California San Francisco, San Francisco, California, USA
| | | | - Benjamin Franc
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
4
|
Iagaru A, Franc B. Disparities in PET Imaging of Prostate Cancer at a Tertiary Academic Medical Center. J Nucl Med 2021; 62:747-748. [PMID: 33127623 DOI: 10.2967/jnumed.120.258160] [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] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrei Iagaru
- Stanford University 300 Pasteur Dr., H-2200 Stanford, CA 94305 E-mail:
| | | |
Collapse
|
5
|
Beckford V, Fu C, Janneck J, Huynh T, Blecha J, Li X, Franc B, Vanbrocklin H. Immuno-PET imaging of human tumor necrosis factor alpha in a transgenic mouse model of rheumatoid arthritis. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30234-3] [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: 10/26/2022]
|
6
|
Lituiev DS, Trivedi H, Panahiazar M, Norgeot B, Seo Y, Franc B, Harnish R, Kawczynski M, Hadley D. Automatic Labeling of Special Diagnostic Mammography Views from Images and DICOM Headers. J Digit Imaging 2019; 32:228-233. [PMID: 30465142 PMCID: PMC6456464 DOI: 10.1007/s10278-018-0154-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Applying state-of-the-art machine learning techniques to medical images requires a thorough selection and normalization of input data. One of such steps in digital mammography screening for breast cancer is the labeling and removal of special diagnostic views, in which diagnostic tools or magnification are applied to assist in assessment of suspicious initial findings. As a common task in medical informatics is prediction of disease and its stage, these special diagnostic views, which are only enriched among the cohort of diseased cases, will bias machine learning disease predictions. In order to automate this process, here, we develop a machine learning pipeline that utilizes both DICOM headers and images to predict such views in an automatic manner, allowing for their removal and the generation of unbiased datasets. We achieve AUC of 99.72% in predicting special mammogram views when combining both types of models. Finally, we apply these models to clean up a dataset of about 772,000 images with expected sensitivity of 99.0%. The pipeline presented in this paper can be applied to other datasets to obtain high-quality image sets suitable to train algorithms for disease detection.
Collapse
Affiliation(s)
- Dmytro S Lituiev
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Hari Trivedi
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Maryam Panahiazar
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Beau Norgeot
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St., San Francisco, CA, 94143-0946, USA
| | - Benjamin Franc
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St., San Francisco, CA, 94143-0946, USA
| | - Roy Harnish
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St., San Francisco, CA, 94143-0946, USA
| | - Michael Kawczynski
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Dexter Hadley
- Institute for Computational Health Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA.
| |
Collapse
|
7
|
Barcellos-Hoff M, Gonzalez-Junca A, Vera DB, VanBrocklin H, Franc B, Parry R. IMMU-12. TGFβ ACTIVATION BY RADIATION OPPOSES IMMUNE REJECTION OF INTRACRANIAL GL261. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.515] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - Benjamin Franc
- University of California, San Francisco, San Francisco, CA, USA
| | - Renate Parry
- Varian Medical Systems, Inc., Palo Alto, CA, USA
| |
Collapse
|
8
|
Shaikh F, Franc B, Allen E, Sala E, Awan O, Hendrata K, Halabi S, Mohiuddin S, Malik S, Hadley D, Shrestha R. Translational Radiomics: Defining the Strategy Pipeline and Considerations for Application-Part 2: From Clinical Implementation to Enterprise. J Am Coll Radiol 2018; 15:543-549. [PMID: 29366598 DOI: 10.1016/j.jacr.2017.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 12/18/2022]
Abstract
Enterprise imaging has channeled various technological innovations to the field of clinical radiology, ranging from advanced imaging equipment and postacquisition iterative reconstruction tools to image analysis and computer-aided detection tools. More recently, the advancement in the field of quantitative image analysis coupled with machine learning-based data analytics, classification, and integration has ushered in the era of radiomics, a paradigm shift that holds tremendous potential in clinical decision support as well as drug discovery. However, there are important issues to consider to incorporate radiomics into a clinically applicable system and a commercially viable solution. In this two-part series, we offer insights into the development of the translational pipeline for radiomics from methodology to clinical implementation (Part 1) and from that point to enterprise development (Part 2). In Part 2 of this two-part series, we study the components of the strategy pipeline, from clinical implementation to building enterprise solutions.
Collapse
Affiliation(s)
- Faiq Shaikh
- Institute of Computational Health Sciences, UCSF, San Francisco, California.
| | - Benjamin Franc
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California
| | | | - Evis Sala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Omer Awan
- Department of Radiology, Temple University, Philadelphia, Pennsylvania
| | | | - Safwan Halabi
- Department of Radiology, Stanford University, Palo Alto, California
| | - Sohaib Mohiuddin
- Department of Radiology, Division of Nuclear Medicine, University of Miami, Miami, Florida
| | - Sana Malik
- School of Social Welfare, Stony Brook University, New York, New York
| | - Dexter Hadley
- Institute of Computational Health Sciences, UCSF, San Francisco, California
| | | |
Collapse
|
9
|
Liu G, Huang SY, Franc B, Seo Y, Mitra D. Unsupervised Learning in PET Radiomics. IEEE Nucl Sci Symp Conf Rec (1997) 2017; 2017:10.1109/NSSMIC.2017.8532959. [PMID: 30631241 PMCID: PMC6324844 DOI: 10.1109/nssmic.2017.8532959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this study, we investigated large scale radoimics on 116 breast cancer patients. We are particularly interested in unsupervised learning to bicluster patients and features in order to associate such biclusters with the disease characteristics. The results show that radiomics features with wavelet features have a better biclustering ability. And 172 radiomics features have shown a better classification capability.
Collapse
Affiliation(s)
- G Liu
- School of Computing, Florida Institute of Technology, Melbourne, FL
| | - S-Y Huang
- Radiology Department, University of California San Francisco
| | - B Franc
- Radiology Department, University of California San Francisco
| | - Y Seo
- Radiology Department, University of California San Francisco
| | - D Mitra
- School of Computing, Florida Institute of Technology, Melbourne, FL
| |
Collapse
|
10
|
Zygourakis CC, Winkler E, Pitts L, Hannegan L, Franc B, Lawton MT. Clinical utility and cost analysis of routine postoperative head CT in elective aneurysm clippings. J Neurosurg 2017; 126:558-563. [DOI: 10.3171/2016.1.jns152242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Postoperative head CT scanning is performed routinely at the authors' institution on all neurosurgical patients after elective aneurysm clippings. The goal of this study was to determine how often these scans influence medical management and to quantify the associated imaging costs.
METHODS
The authors reviewed the medical records and accounting database of 304 patients who underwent elective (i.e., nonruptured) aneurysm clipping performed by 1 surgeon (M.T.L.) from 2010 to 2014 at the University of California, San Francisco. Specifically, the total number of postoperative head CT scans, radiographic findings, and the effect of these studies on patient management were determined. The authors obtained the total hospital costs for these patients, including the cost of imaging studies, from the hospital accounting database.
RESULTS
Overall, postoperative CT findings influenced clinical management in 3.6% of cases; specifically, they led to permissive hypertension in 4 patients for possible ischemia, administration of mannitol for edema and high-flow oxygen for pneumocephalus in 2 patients each, seizure prophylaxis in 1 patient, Plavix readjustment in 1 patient, and return to the operating room for an asymptomatic epidural hematoma evacuation in 1 patient. When patients were stratified on the basis of postoperative neurological examination, findings on CT scans altered management in 1.1%, 4.8%, and 9.0% of patients with no new neurological deficits, a nonfocal examination, and focal deficits, respectively. The mean total hospital cost for treating patients who undergo elective aneurysm clipping was $72,227 (± $53,966) (all values are US dollars), and the cost of obtaining a noncontrast head CT scan was $292. Neurologically intact patients required 99 head CT scans, at a cost of $28,908, to obtain 1 head CT scan that influenced medical management. In contrast, patients with a focal neurological deficit required only 11 head CT scans, at a cost of $3212, to obtain 1 head CT scan that changed clinical management.
CONCLUSIONS
Although there are no clear guidelines, the large number and high cost of CT scans needed to treat neurologically intact elective aneurysm patients suggest that careful neurological monitoring may be more clinically useful and a better use of hospital resources than routine postoperative CT.
Collapse
Affiliation(s)
| | | | | | | | - Benjamin Franc
- 2Radiology, University of California, San Francisco, California
| | | |
Collapse
|
11
|
Boulle F, Velthuis H, Koedam K, Steinbusch HW, van den Hove DLA, Kenis G, Gabriel C, Mocaer E, Franc B, Rognan D, Mongeau R, Lanfumey L. Behavioral and neurochemical characterization of TrkB-dependent mechanisms of agomelatine in glucocorticoid receptor-impaired mice. Eur Neuropsychopharmacol 2016; 26:65-77. [PMID: 26653128 DOI: 10.1016/j.euroneuro.2015.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/30/2015] [Accepted: 11/08/2015] [Indexed: 12/13/2022]
Abstract
Growing evidence indicates that impairment of the stress response, in particular the negative feedback regulation mechanism exerted by the hypothalamo-pituitary-adrenal (HPA) axis, might be responsible for the hippocampal atrophy observed in depressed patients. Antidepressants, possibly through the activation of BDNF signaling, may enhance neuroplasticity and restore normal hippocampal functions. In this context, glucocorticoid receptor-impaired (GR-i) mice-a transgenic mouse model of reduced GR-induced negative feedback regulation of the HPA axis-were used to investigate the role of BDNF/TrkB signaling in the behavioral and neurochemical effects of the new generation antidepressant drug, agomelatine. GR-i mice exhibited marked alterations in depressive-like and anxiety-like behaviors, together with a decreased cell proliferation and altered levels of neuroplastic and epigenetic markers in the hippocampus. GR-i mice and their wild-type littermates were treated for 21 days with vehicle, agomelatine (50mg/kg/day; i.p) or the TrkB inhibitor Ana-12 (0.5mg/kg/day, i.p) alone, or in combination with agomelatine. Chronic treatment with agomelatine resulted in antidepressant-like effects in GR-i mice and reversed the deficit in hippocampal cell proliferation and some of the alterations of mRNA plasticity markers in GR-i mice. Ana-12 blocked the effect of agomelatine on motor activity as well as its ability to restore a normal hippocampal cell proliferation and expression of neurotrophic factors. Altogether, our findings indicate that agomelatine requires TrkB signaling to reverse some of the molecular and behavioral alterations caused by HPA axis impairment.
Collapse
Affiliation(s)
- F Boulle
- Centre de Psychiatrie et Neurosciences, Inserm UMR 894, Paris, France; Université Paris Descartes, UMR S894, Paris, France; Department of Psychiatry and Neuropsychology, European Graduate School for Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - H Velthuis
- Centre de Psychiatrie et Neurosciences, Inserm UMR 894, Paris, France; Université Paris Descartes, UMR S894, Paris, France
| | - K Koedam
- Department of Psychiatry and Neuropsychology, European Graduate School for Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - H W Steinbusch
- Department of Psychiatry and Neuropsychology, European Graduate School for Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - D L A van den Hove
- Department of Psychiatry and Neuropsychology, European Graduate School for Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - G Kenis
- Department of Psychiatry and Neuropsychology, European Graduate School for Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - C Gabriel
- Institut de Recherche International Servier, Suresnes, France
| | - E Mocaer
- Institut de Recherche International Servier, Suresnes, France
| | - B Franc
- Centre de Psychiatrie et Neurosciences, Inserm UMR 894, Paris, France; Université Paris Descartes, UMR S894, Paris, France
| | - D Rognan
- Laboratoire d'Innovation Thérepeutique, UMR 7200 CNRS, Université de Strasbourg, Illkirch, France
| | - R Mongeau
- Centre de Psychiatrie et Neurosciences, Inserm UMR 894, Paris, France; Université Paris Descartes, UMR S894, Paris, France; EA4475, Pharmacology department, University Paris Descartes, Paris, France
| | - L Lanfumey
- Centre de Psychiatrie et Neurosciences, Inserm UMR 894, Paris, France; Université Paris Descartes, UMR S894, Paris, France.
| |
Collapse
|
12
|
Quach A, Ji L, Mishra V, Sznewajs A, Veatch J, Huberty J, Franc B, Sposto R, Groshen S, Wei D, Fitzgerald P, Maris JM, Yanik G, Hawkins RA, Villablanca JG, Matthay KK. Thyroid and hepatic function after high-dose 131 I-metaiodobenzylguanidine (131 I-MIBG) therapy for neuroblastoma. Pediatr Blood Cancer 2011; 56:191-201. [PMID: 20830775 PMCID: PMC3006009 DOI: 10.1002/pbc.22767] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [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: 04/29/2010] [Accepted: 07/01/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND (131) I-Metaiodobenzylguanidine ((131) I-MIBG) provides targeted radiotherapy for children with neuroblastoma, a malignancy of the sympathetic nervous system. Dissociated radioactive iodide may concentrate in the thyroid, and (131) I-MIBG is concentrated in the liver after (131) I-MIBG therapy. The aim of our study was to analyze the effects of (131) I-MIBG therapy on thyroid and liver function. PROCEDURE Pre- and post-therapy thyroid and liver functions were reviewed in a total of 194 neuroblastoma patients treated with (131) I-MIBG therapy. The cumulative incidence over time was estimated for both thyroid and liver toxicities. The relationship to cumulative dose/kg, number of treatments, time from treatment to follow-up, sex, and patient age was examined. RESULTS In patients who presented with Grade 0 or 1 thyroid toxicity at baseline, 12 ± 4% experienced onset of or worsening to Grade 2 hypothyroidism and one patient developed Grade 2 hyperthyroidism by 2 years after (131) I-MIBG therapy. At 2 years post-(131) I-MIBG therapy, 76 ± 4% patients experienced onset or worsening of hepatic toxicity to any grade, and 23 ± 5% experienced onset of or worsening to Grade 3 or 4 liver toxicity. Liver toxicity was usually transient asymptomatic transaminase elevation, frequently confounded by disease progression and other therapies. CONCLUSION The prophylactic regimen of potassium iodide and potassium perchlorate with (131) I-MIBG therapy resulted in a low rate of significant hypothyroidism. Liver abnormalities following (131) I-MIBG therapy were primarily reversible and did not result in late toxicity. (131) I-MIBG therapy is a promising treatment for children with relapsed neuroblastoma with a relatively low rate of symptomatic thyroid or hepatic dysfunction.
Collapse
Affiliation(s)
- Alekist Quach
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - Lingyun Ji
- Children’s Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles
| | - Vikash Mishra
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - Aimee Sznewajs
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - Janet Veatch
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - John Huberty
- Department of Radiology, Nuclear Medicine Program, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - Benjamin Franc
- Department of Radiology, Nuclear Medicine Program, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - Richard Sposto
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
,Children’s Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles
| | - Susan Groshen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Denice Wei
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Paul Fitzgerald
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | - John M. Maris
- Department of Pediatrics, Children’s Hospital of Philadelphia; University of Pennsylvania, Philadelphia, PA
| | - Gregory Yanik
- Department of Pediatrics, University of Michigan and Mott Children’s Hospital, Ann Arbor, MI
| | - Randall A. Hawkins
- Department of Radiology, Nuclear Medicine Program, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| | | | - Katherine K. Matthay
- Department of Pediatrics, University of California San Francisco and UCSF Children’s Hospital, San Francisco, CA
| |
Collapse
|
13
|
Jin L, Burniat A, Dumont JE, Miot F, Corvilain B, Franc B. Erratum: Human thyroid tumours, the puzzling lessons from E7 and RET/PTC3 transgenic mice. Br J Cancer 2009. [PMCID: PMC2661780 DOI: 10.1038/sj.bjc.6604991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
14
|
Abstract
Human rearranged RET/PTC3 (papillary thyroid carcinoma) proto-oncogene and high-risk human papillomavirus (HPV) type 16 E7 oncogene induces in the mouse a neoplastic transformation of thyroid follicular cells. We present a detailed immuno-histological study (170 mouse thyroids: RET/PTC3, E7, wild type, 2- to 10-month-old) with cell cycle proliferation and signalling pathway indicators. The characteristics of both models are different. There is an 'oncogene dependent' cellular signature, maintained at all studied ages in the E7 model, less in the RET/PTC3 model. During tumour development a large heterogeneity occurred in the Tg-RET/PTC3 model within a same tumour or within a same thyroid lobe. The Tg-E7 model was less heterogeneous, with a dominant goitrous pattern. The solid tumour already described in the RET/PTC3 models associated with cribriform patterns, suggested 'PTC spindle cell changes' as in humans PTC rather than the equivalent of the solid human PTC. Proliferation and apoptosis in the two thyroid models are related to the causal oncogene rather than reflect a general tumorigenic process. The thyroids of RET/PTC3 mice appeared as a partial and transient model of human PTCs, whereas the Tg-E7 mice do not belong to the usual PTC type.
Collapse
Affiliation(s)
- L Jin
- Institut de Recherche Interdisciplinaire (IRIBHM), Faculté de Médecine, Université Libre de Bruxelles (ULB), Campus Erasme, Route de Lennik 808, B 1070 Bruxelles, Belgique.
| | | | | | | | | | | |
Collapse
|
15
|
Roussi JH, Houbouyan LL, Alterescu R, Franc B, Goguel AF. ACQUIRED VON WILLEBRAND'S SYNDROME ASSOCIATED WITH HAIRY CELL LEUKAEMIA. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.1980.00503.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: 11/30/2022]
|
16
|
Rutherford GC, Franc B, O'Connor A. Nuclear medicine in the assessment of differentiated thyroid cancer. Clin Radiol 2008; 63:453-63. [DOI: 10.1016/j.crad.2007.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 07/31/2007] [Accepted: 08/06/2007] [Indexed: 11/27/2022]
|
17
|
Gillis A, Hwang A, Teo K, Bacharach S, Bucci M, Millender L, Schechter N, Quivey J, Franc B, Xia P. PET-CT for Head and Neck IMRT Planning: Target Delineation and Dose Escalation. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1636] [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: 11/29/2022]
|
18
|
Detours V, Delys L, Libert F, Weiss Solís D, Bogdanova T, Dumont JE, Franc B, Thomas G, Maenhaut C. Genome-wide gene expression profiling suggests distinct radiation susceptibilities in sporadic and post-Chernobyl papillary thyroid cancers. Br J Cancer 2007; 97:818-25. [PMID: 17712314 PMCID: PMC2360382 DOI: 10.1038/sj.bjc.6603938] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Papillary thyroid cancers (PTCs) incidence dramatically increased in the vicinity of Chernobyl. The cancer-initiating role of radiation elsewhere is debated. Therefore, we searched for a signature distinguishing radio-induced from sporadic cancers. Using microarrays, we compared the expression profiles of PTCs from the Chernobyl Tissue Bank (CTB, n=12) and from French patients with no history of exposure to ionising radiations (n=14). We also compared the transcriptional responses of human lymphocytes to the presumed aetiological agents initiating these tumours, γ-radiation and H2O2. On a global scale, the transcriptomes of CTB and French tumours are indistinguishable, and the transcriptional responses to γ-radiation and H2O2 are similar. On a finer scale, a 118 genes signature discriminated the γ-radiation and H2O2 responses. This signature could be used to classify the tumours as CTB or French with an error of 15–27%. Similar results were obtained with an independent signature of 13 genes involved in homologous recombination. Although sporadic and radio-induced PTCs represent the same disease, they are distinguishable with molecular signatures reflecting specific responses to γ-radiation and H2O2. These signatures in PTCs could reflect the susceptibility profiles of the patients, suggesting the feasibility of a radiation susceptibility test.
Collapse
Affiliation(s)
- V Detours
- Institute of Interdisciplinary Research, School of Medicine, Univertisté Libre de Bruxelles (ULB), Campus Erasme, CP602, route de Lennik 808, Brussels, Belgium.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Delys L, Detours V, Franc B, Thomas G, Bogdanova T, Tronko M, Libert F, Dumont JE, Maenhaut C. Gene expression and the biological phenotype of papillary thyroid carcinomas. Oncogene 2007; 26:7894-903. [PMID: 17621275 DOI: 10.1038/sj.onc.1210588] [Citation(s) in RCA: 62] [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: 11/08/2022]
Abstract
The purpose of this paper is to correlate the molecular phenotype of papillary thyroid carcinoma (PTC) to their biological pathology. We hybridized 26 PTC on microarrays and showed that nearly 44% of the transcriptome was regulated in these tumors. We then combined our data set with two published PTC microarray studies to produce a platform- and study-independent list of PTC-associated genes. We further confirmed the mRNA regulation of 15 genes from this list by quantitative reverse transcription-PCR. Analysis of this list with statistical tools led to several conclusions: (1) there is a change in cell population with an increased expression of genes involved in the immune response, reflecting lymphocyte infiltration in the tumor compared to the normal tissue. (2) The c-jun N-terminal kinase pathway is activated by overexpression of its components. (3) The activation of ERKK1/2 by genetic alterations is supplemented by activation of the epidermal growth factor but not of the insulin-like growth factor signaling pathway. (4) There is a downregulation of immediate early genes. (5) We observed an overexpression of many proteases in accordance with tumor remodeling, and suggested a probable role of S100 proteins and annexin A2 in this process. (6) Numerous overexpressed genes favor the hypothesis of a collective migration mode of tumor cells.
Collapse
Affiliation(s)
- L Delys
- Institute of Interdisciplinary Research, School of Medicine, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Seo Y, Hashimoto T, Nuki Y, Hasegawa B, Franc B. SU-EE-A4-03: Contrast-Enhanced MicroCT Imaging of Rodent Brain. Med Phys 2007. [DOI: 10.1118/1.2760353] [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: 11/07/2022] Open
|
21
|
Affiliation(s)
- Steven W Hetts
- Department of Radiology, University of California, San Francisco, CA 94143-0628, USA.
| | | | | | | |
Collapse
|
22
|
Falk MS, Truitt AK, Coakley FV, Kashani-Sabet M, Hawkins RA, Franc B. Interpretation, accuracy and management implications of FDG PET/CT in cutaneous malignant melanoma. Nucl Med Commun 2007; 28:273-80. [PMID: 17325590 DOI: 10.1097/mnm.0b013e3280708ecf] [Citation(s) in RCA: 26] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the accuracy of different interpretative approaches and to evaluate the management implications of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in cutaneous malignant melanoma. METHODS We retrospectively identified 60 consecutive patients who underwent 76 PET/CT scans for cutaneous malignant melanoma. PET/CT reports were classified as positive, negative, or equivocal for regional and distant disease. Scan indication (staging, restaging, surveillance, or therapeutic monitoring), tumour stage, presence or absence of regional or distant disease, and post-scan management changes were determined by review of all available medical records. Maximum standardized uptake values (SUV(max)) of all findings were noted. Diagnostic accuracy of PET/CT was compared using either a high or low threshold interpretation (i.e. subtle, but indeterminate findings coded negative or positive, respectively). The frequency of management changes was compared between patient subgroups (stratified by tumour stage or indication). RESULTS Using a high threshold interpretative approach, the overall accuracy of PET/CT for disease was 72.4% (55/76), which was significantly (P<0.05) greater than the accuracy of 53.9% (41/76) seen when using a low threshold approach. Per scan accuracy by staging site was 92.1% (70/76) for regional and 76.3% (58/76) for distant disease. PET/CT changed management in 21 of 76 studies (27.6%). When stratified by stage and indication, management changes occurred in all patient subgroups, except for stage I patients (0 of 5). CONCLUSION When interpreted with a high threshold approach, PET/CT demonstrates high accuracy for the diagnosis of both regional and distant disease in cutaneous malignant melanoma and frequently changes management in patients with stage II-IV disease referred for a variety of indications.
Collapse
Affiliation(s)
- Matthew S Falk
- Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628, USA
| | | | | | | | | | | |
Collapse
|
23
|
Colonna M, Guizard AV, Schvartz C, Velten M, Raverdy N, Molinie F, Delafosse P, Franc B, Grosclaude P. A time trend analysis of papillary and follicular cancers as a function of tumour size: a study of data from six cancer registries in France (1983-2000). Eur J Cancer 2007; 43:891-900. [PMID: 17289376 DOI: 10.1016/j.ejca.2006.11.024] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 11/21/2006] [Accepted: 11/27/2006] [Indexed: 02/03/2023]
Abstract
The incidence of thyroid cancers, and in particular the papillary forms, has been increasing sharply for many years in Western countries. However, the factors explaining this increase have not been clearly established. Some studies mention the effects of radioactive fallout, particularly after the accident in Chernobyl. Another probable cause is related to progress in medical practice, and particularly in diagnosis. In this article, we describe time trends in the incidence of papillary and follicular cancers, taking into account the size of the tumour at the time of diagnosis. The analysis was carried out on cases from six French cancer registries for the period 1983-2000. Anatomopathological reports concerning 3381 cancer cases were systematically recoded and centralised, following ICDO-3 rules. Over the whole period, the annual percent change of the incidence of papillary cancers was +8.13% and +8.98%, respectively in men and in women. For micropapillary carcinomas (< or = 10 mm), this increase was respectively +12.05% and +12.85%. There is no significant effect of period apart from micropapillary carcinomas in women. However, a birth cohort effect exists for some groups. This effect corresponds to an acceleration in the risk for people born after the 1930s. For the most recent period (1998-2000), half the cases of papillary cancer were micropapillary carcinomas, and for one third of these, the tumour was < or = 5 mm. Our description of a time trend of incidence as a function of tumour size supports the hypothesis of the role of medical practice in a context of high prevalence. Obviously, these findings do not exclude the possible role of other factors.
Collapse
Affiliation(s)
- M Colonna
- FRANCIM, French Cancer Registries Network, Faculté de Médecine, 37 allée Jules Guesdes, 31073 Toulouse Cedex, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Hetts SW, Hilchey SD, Wilson R, Franc B. Case 110. Radiology 2006. [DOI: 10.1148/radiol.2413040426] [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: 11/11/2022]
|
25
|
Barrier A, Roser F, Boëlle PY, Franc B, Tse C, Brault D, Lacaine F, Houry S, Callard P, Penna C, Debuire B, Flahault A, Dudoit S, Lemoine A. Prognosis of stage II colon cancer by non-neoplastic mucosa gene expression profiling. Oncogene 2006; 26:2642-8. [PMID: 17043639 DOI: 10.1038/sj.onc.1210060] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [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: 11/09/2022]
Abstract
We have assessed the possibility to build a prognosis predictor (PP), based on non-neoplastic mucosa microarray gene expression measures, for stage II colon cancer patients. Non-neoplastic colonic mucosa mRNA samples from 24 patients (10 with a metachronous metastasis, 14 with no recurrence) were profiled using the Affymetrix HGU133A GeneChip. Patients were repeatedly and randomly divided into 1000 training sets (TSs) of size 16 and validation sets (VS) of size 8. For each TS/VS split, a 70-gene PP, identified on the TS by selecting the 70 most differentially expressed genes and applying diagonal linear discriminant analysis, was used to predict the prognoses of VS patients. Mean prognosis prediction performances of the 70-gene PP were 81.8% for accuracy, 73.0% for sensitivity and 87.1% for specificity. Informative genes suggested branching signal-transduction pathways with possible extensive networks between individual pathways. They also included genes coding for proteins involved in immune surveillance. In conclusion, our study suggests that one can build an accurate PP for stage II colon cancer patients, based on non-neoplastic mucosa microarray gene expression measures.
Collapse
Affiliation(s)
- A Barrier
- Service de Chirurgie Digestive, Hôpital Tenon, AP-HP, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Matthay KK, Quach A, Huberty J, Franc B, Groshen S, Shusterman S, Veatch J, Brophy P, Yanik G, Maris J. 131I-Metaiodobenzylguanidine ( 131I-MIBG) double infusion with autologous stem cell transplant for neuroblastoma: A New Approaches to Neuroblastoma Therapy (NANT) study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.9011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9011 Background: 131I-MIBG provides targeted radiotherapy with >30% response in refractory neuroblastoma, but the activity infused is limited by radiation safety and hematologic toxicity. The goal was to determine the maximum tolerated dose of 131I-MIBG in two consecutive infusions at a 2-week interval, supported by autologous stem cell transplant (ASCT) 2 weeks after the second dose. Methods: The 131I-MIBG was escalated in a 3+3 Phase I trial design, with levels calculated by total red marrow radiation index (RMI) from the double infusion. The first infusion of 131I-MIBG was 12, 15, 18 and 21 mCi/kg for levels 1, 2, 3 and 4 respectively. Using detailed dosimetry, the second infusion was adjusted to achieve the target RMI, except at Level 4, where the second infusion was capped at 21 mCi/kg. Results: Twenty-one patients were enrolled at Level 1–4, with 18 evaluable for toxicity. Median age at enrollment was 7 years, all were heavily pretreated, including 12 with prior high dose therapy and ASCT, and 12 patients had bone marrow tumor. Cumulative 131I-MIBG given to achieve the target RMI ranged from 18 mci/kg to 49 mCi/kg. RMI delivered per mCi of MIBG decreased in 15/19 patients by mean of 0.21 cGy/mCi with the second infusion. Hematologic toxicity was acceptable, with median time to ANC>500 after ASCT of 13 (4–27) days. Platelet transfusion was required in 15/18 patients, with median time to platelet independence of 18 (6–47) days after ASCT. There were no non-hematologic toxicities above grade 2 attributed to therapy, though 9 patients had grade 1–2 elevations of transaminase, and 1 had grade 2 hypothyroidism. Responses in 17 evaluable patients included 1 PR, 4 MR, 6 SD, and 6 PD. Eleven patients are alive at median of 361 days (46–483); 5 died of PD and 1 of unrelated toxicity. Conclusion: The lack of toxicity with this approach allowed dramatic dose intensification of 131I-MIBG, with minimal toxicity and the possibility of improved response. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
- K. K. Matthay
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - A. Quach
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - J. Huberty
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - B. Franc
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - S. Groshen
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - S. Shusterman
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - J. Veatch
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - P. Brophy
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - G. Yanik
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| | - J. Maris
- University of California San Francisco, San Francisco, CA; University of Southern California, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Children’s Hospital of Philadelphia, Philadelphia, PA; C.S. Mott Children’s Hospital, Ann Arbor, MI
| |
Collapse
|
27
|
Matthay KK, Tan JC, Villablanca JG, Yanik GA, Veatch J, Franc B, Twomey E, Horn B, Reynolds CP, Groshen S, Seeger RC, Maris JM. Phase I dose escalation of iodine-131-metaiodobenzylguanidine with myeloablative chemotherapy and autologous stem-cell transplantation in refractory neuroblastoma: a new approaches to Neuroblastoma Therapy Consortium Study. J Clin Oncol 2006; 24:500-6. [PMID: 16421427 DOI: 10.1200/jco.2005.03.6400] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the maximum-tolerated dose (MTD) and toxicity of iodine-131-metaiodobenzylguanidine ((131)I-MIBG) with carboplatin, etoposide, melphalan (CEM) and autologous stem-cell transplantation (ASCT) in refractory neuroblastoma. PATIENTS AND METHODS Twenty-four children with primary refractory neuroblastoma and no prior ASCT were entered; 22 were assessable for toxicity and response. (131)I-MIBG was administered on day -21, CEM was administered on days -7 to -4, and ASCT was performed on day 0, followed by 13-cis-retinoic acid. (131)I-MIBG was escalated in groups of three to six patients, stratified by corrected glomerular filtration rate (GFR). RESULTS The MTD for patients with normal GFR (> or = 100 mL/min/1.73 m2) was 131I-MIBG 12 mCi/kg, carboplatin 1,500 mg/m2, etoposide 1,200 mg/m2, and melphalan 210 mg/m2. In the low-GFR cohort, at the initial dose level using 12 mCi/kg of 131I-MIBG and reduced chemotherapy, one in six patients had dose limiting toxicity (DLT), including veno-occlusive disease (VOD). Three more patients in this group had grade 3 or 4 hepatotoxicity, and two had VOD, without meeting DLT criteria. There was only one death as a result of toxicity among all 24 patients. All assessable patients engrafted, with median time for neutrophils > or = 500/microL of 10 days and median time for platelets > or = 20,000/microL of 26 days. Six of 22 assessable patients had complete or partial response, and 15 patients had mixed response or stable disease. The estimated probability of event-free survival and survival from the day of MIBG infusion for all patients at 3 years was 0.31 +/- 0.10 and 0.58 +/- 0.10, respectively. CONCLUSION 131I-MIBG with myeloablative chemotherapy is feasible and effective for patients with neuroblastoma exhibiting de novo resistance to chemotherapy.
Collapse
Affiliation(s)
- Katherine K Matthay
- Department of Pediatrics, University of California, San Francisco, School of Medicine, and UCSF Children's Hospital, San Francisco, CA 94143-0106, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Detours V, Wattel S, Venet D, Hutsebaut N, Bogdanova T, Tronko MD, Dumont JE, Franc B, Thomas G, Maenhaut C. Absence of a specific radiation signature in post-Chernobyl thyroid cancers. Br J Cancer 2005; 92:1545-52. [PMID: 15812549 PMCID: PMC2362019 DOI: 10.1038/sj.bjc.6602521] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Thyroid cancers have been the main medical consequence of the Chernobyl accident. On the basis of their pathological features and of the fact that a large proportion of them demonstrate RET-PTC translocations, these cancers are considered as similar to classical sporadic papillary carcinomas, although molecular alterations differ between both tumours. We analysed gene expression in post-Chernobyl cancers, sporadic papillary carcinomas and compared to autonomous adenomas used as controls. Unsupervised clustering of these data did not distinguish between the cancers, but separates both cancers from adenomas. No gene signature separating sporadic from post-Chernobyl PTC (chPTC) could be found using supervised and unsupervised classification methods although such a signature is demonstrated for cancers and adenomas. Furthermore, we demonstrate that pooled RNA from sporadic and chPTC are as strongly correlated as two independent sporadic PTC pools, one from Europe, one from the US involving patients not exposed to Chernobyl radiations. This result relies on cDNA and Affymetrix microarrays. Thus, platform-specific artifacts are controlled for. Our findings suggest the absence of a radiation fingerprint in the chPTC and support the concept that post-Chernobyl cancer data, for which the cancer-causing event and its date are known, are a unique source of information to study naturally occurring papillary carcinomas.
Collapse
Affiliation(s)
- V Detours
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
| | - S Wattel
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
| | - D Venet
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
| | - N Hutsebaut
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
| | - T Bogdanova
- Institute of Endocrinology and Metabolism, 04114 Kiev, Ukraine
| | - M D Tronko
- Institute of Endocrinology and Metabolism, 04114 Kiev, Ukraine
| | - J E Dumont
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
| | - B Franc
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital A Paré (AP-HP), Université de Versailles, St Quentin en Yvelines, France
| | - G Thomas
- South West Wales Cancer Institute/Swansea Clinical School, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, UK
| | - C Maenhaut
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium
- Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Campus Erasme, route de Lennik 808, B-1070 Brussels, Belgium. E-mail:
| |
Collapse
|
29
|
Matthay KK, Yanik G, Tan J, Huberty J, Franc B, Villablanca JG, Reynolds CP, Groshen S, Seeger RC, Maris J. 131I-MIBG with myeloablative chemotherapy for neuroblastoma: A New Approaches to Neuroblastoma Therapy (NANT) phase I study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8505] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. K. Matthay
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - G. Yanik
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - J. Tan
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - J. Huberty
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - B. Franc
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - J. G. Villablanca
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - C. P. Reynolds
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - S. Groshen
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - R. C. Seeger
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| | - J. Maris
- Univ of CA, San Francisco, San Francisco, CA; Univ of Michigan, Ann Arbor, MI; Univ of Southern CA, Los Angeles, CA; Univ of Pennsylvania, Philadelphia, PA
| |
Collapse
|
30
|
Affiliation(s)
- Benjamin Franc
- Department of Radiology, Division of Nuclear Medicine, Stanford University School of Medicine, Palo Alto, California 94122, USA.
| | | | | | | |
Collapse
|
31
|
Sznajder M, Chaussade V, Zimmermann U, Sei JF, Bendersky N, Franc B, Saiag P. [The cost of Mohs micrographic surgery for basal cell carcinoma. The Ambroise Paré hospital's experience (Boulogne, France)]. Ann Dermatol Venereol 2004; 131:150-6. [PMID: 15026741 DOI: 10.1016/s0151-9638(04)93562-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 11/30/2022]
Abstract
OBJECTIVE Mohs'micrographic surgery is generally considered as the best procedure for the treatment of difficult basal cell carcinomas. It is supposed to be costly, but an economic evaluation, with a cost-outcome analysis, is necessary to estimate the actual contribution of this procedure in skin cancer treatment, in comparison with the reference procedure, i.e. traditional surgical excision. Our aim was to evaluate the actual cost of Mohs'surgery applied on basal cell carcinoma treatment in France. METHODS The charts of 97 patients treated by Mohs'surgery between january 1997 and july 2001 in a teaching hospital near Paris (Ambroise Paré hospital, Boulogne), where Mohs'surgery is exclusively performed in France, were reviewed. Direct costs were derived from resource utilization of staff and material required for Mohs'surgery, estimated by a micro-costing method. Indirect costs and total costs were then calculated. RESULTS When adding surgery and pathology facility costs, mean direct and total costs per basal cell carcinoma were 776.0 (range: 538.4-1273.9), and 1014.6 Euros (range: 777-1512.4), respectively. When including costs of diagnosis, the average total cost per procedure was 1084.3 Euros. DISCUSSION These costs appear higher than those obtained with other methods of valuation of hospital costs used in France, but they are slightly lower than those found in the literature. The next stage will be to estimate, in the same way, the cost of traditional surgical excision for the same type of lesions, and to calculate the incremental cost-effectiveness ratio between the two procedures, with rate of recurrence at five years as the effectiveness outcome.
Collapse
Affiliation(s)
- M Sznajder
- Service de Santé Publique et d'Information Médicale, Hôpital Ambroise Paré, Assistance Publique-hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, Boulogne
| | | | | | | | | | | | | |
Collapse
|
32
|
Karoui M, Tresallet C, Julie C, Zimmermann U, Staroz F, Brams A, Muti C, Boulard C, Robreau AM, Puy H, Malafosse R, Penna C, Pruvot FR, Thiery JP, Boileau C, Rougier P, Nordlinger B, Radvanyi F, Franc B, Hofmann-Radvanyi H. Loss of heterozygosity on 10q and mutational status of PTEN and BMPR1A in colorectal primary tumours and metastases. Br J Cancer 2004; 90:1230-4. [PMID: 15026806 PMCID: PMC2409663 DOI: 10.1038/sj.bjc.6601687] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the possible role of chromosome 10q losses in colorectal cancer metastasis by carrying out an allelic imbalance study on a series of microsatellite instability-negative (MSI−) primary tumours (n=32) and metastases (n=36) from 49 patients. Our results demonstrate that 10q allelic losses are associated with a significant proportion (25%) of MSI− colorectal tumours, but are not involved in the metastatic process. PTEN and BMPR1A, two genes located in the common deleted region, were screened for mutations in samples with loss of heterozygosity. The absence or low frequency of mutations indicates that the inactivation of these genes by deletion of one allele and mutation of the other one plays only a minor role in MSI− tumours.
Collapse
Affiliation(s)
- M Karoui
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
- Service de Chirurgie Digestive et de Transplantation, Hôpital Claude Huriez, CHRU de Lille, 59037 Lille Cedex, France
| | - C Tresallet
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
- Service de Chirurgie Digestive, Hôpital Pitié-Salpêtrière, AP-HP, 75651 Paris Cedex 13, France
| | - C Julie
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - U Zimmermann
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - F Staroz
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - A Brams
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
| | - C Muti
- Service de Génétique, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne Cedex, France
| | - C Boulard
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
| | - A-M Robreau
- Laboratoire de Biochimie, Hôpital Louis Mourier, AP-HP, 92701 Colombes Cedex, France
| | - H Puy
- Laboratoire de Biochimie, Hôpital Louis Mourier, AP-HP, 92701 Colombes Cedex, France
- Laboratoire de Biochimie et de Génétique Moléculaire, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 9 Avenue Charles de Gaulle, 92104 Boulogne Cedex, France
| | - R Malafosse
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - C Penna
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - F-R Pruvot
- Service de Chirurgie Digestive et de Transplantation, Hôpital Claude Huriez, CHRU de Lille, 59037 Lille Cedex, France
| | - J P Thiery
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
| | - C Boileau
- Laboratoire de Biochimie et de Génétique Moléculaire, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 9 Avenue Charles de Gaulle, 92104 Boulogne Cedex, France
| | - P Rougier
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - B Nordlinger
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - F Radvanyi
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
| | - B Franc
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 92104 Boulogne Cedex, France
| | - H Hofmann-Radvanyi
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France
- Laboratoire de Biochimie et de Génétique Moléculaire, Hôpital Ambroise Paré, AP-HP, Université Versailles-Saint Quentin en Yvelines, 9 Avenue Charles de Gaulle, 92104 Boulogne Cedex, France
- UMR 144, CNRS-Institut Curie, 75248 Paris Cedex 05, France. E-mail:
| |
Collapse
|
33
|
Abstract
OBJECTIVE Although angiogenic proteins have been identified as positive modulators of myocardial revascularization following acute myocardial infarction, little if anything is known regarding the role that antiangiogenic proteins have in myocardial revascularization. We explored the temporospatial distribution of endothelial-monocyte activating polypeptide (EMAP) II to determine whether antiangiogenic proteins have a role in the repair of myocardial tissue following infarction. METHODS A rat model of myocardial infarction was utilized to examine EMAP II distribution (in situ hybridization) and protein expression (Western analysis) over a 6-week period. RESULTS At baseline, EMAP II protein and mRNA are minimally expressed with transcription products localizing predominately to the perivascular stroma region in the normal rat myocardium. Six hours following myocardial infarction, EMAP II changes its distribution from the perivascular stroma to an invading inflammatory cell population. This is associated with a 2-fold (P < 0.0009) increase in EMAP II protein and its transcription primarily localized to the infarct region. EMAP II protein expression remains elevated throughout the weeks following the infarction with transcription limited to the infarct region and a notable decrease in EMAP II transcription products noted in the viable vasculature surrounding the infarct zone. Six weeks following myocardial infarction, EMAP II protein is elevated above control, changes its location of transcription from the inflammatory cell population to that of the fibroblasts located in the relative avascular scar tissue, and has resumed its perivascular stromal distribution in the viable periinfarct tissue. CONCLUSIONS Thus, the temporospatial distribution of this antiangiogenic protein suggests that negative vascular modulators may have a function in the revascularization process following acute myocardial infarction.
Collapse
Affiliation(s)
- Jess L Thompson
- Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | | | | | | | | | | |
Collapse
|
34
|
Sei JF, Tchakerian A, Zimmermann U, Clerici T, Chaussade V, Franc B, Saiag P. Dermatofibrosarcome de Darier Ferrand : traitement par chirurgie micrographique de Mohs avec inclusion en paraffine. Ann Dermatol Venereol 2004; 131:158-60. [PMID: 15026742 DOI: 10.1016/s0151-9638(04)93563-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [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: 11/26/2022]
Abstract
INTRODUCTION Dermatofibrosarcoma protuberans is a tumor of intermediate malignancy characterized by its aggressive local growth due to pseudopodium-like outgrowths and marked propensity to recur after surgical excision. To achieve complete cure with conventional surgery, surgical margins up to 5 cm are required, leading to wide scars. Mohs' micrographic surgery is used for the removal of certain malignant tumors, both ensuring complete excision by examination of all margins as well as minimizing normal tissue loss. However, differentiating minimal residual tumor from normal skin can be difficult on the frozen sections used in Mohs' micrographic surgery. Our aim was to develop a procedure of Mohs' micrographic surgery in conjunction with rush formalin-fixed, paraffin-embedded tangential sections. PATIENTS AND METHODS Ten consecutive cases have been prospectively treated since 1998. Under local anesthesia, the tumor was first excised including lateral margin of 1 cm and a deep margin including the underlying muscle aponevrosis. A 2 to 3 mm thick horizontal section of the surgical bed was then removed, rush formalin-fixed, paraffin-embedded, tangentially sectioned, hematin-eosin stained, and eventually stained with an anti-CD34 monoclonal antibody. While waiting for pathology results, the surgical bed was not definitively closed. If excision was incomplete, an oriented complementary excision was performed. RESULTS Excision was complete after the first stage in 7 patients and incomplete only deeply in 3. Lateral surgical margins were reduced to 1.3 cm in all patients, facilitating wound closure: direct suture (5 patients), controlled wound healing (3 patients) or flap coverage (2 patients). No recurrence has been observed after a mean follow-up of 26 months. DISCUSSION The use of Mohs' micrographic surgery in conjunction with rush formalin-fixed, paraffin-embedded tangential sections reduce surgical margins in dermatofibrosarcoma protuberans. This procedure would be interesting in difficult sites, such as the genitalia, the breast, or the periarticular regions. Other cases, and longer follow-up are however necessary to validate this promising technique.
Collapse
Affiliation(s)
- J-F Sei
- Service de Dermatologie, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, CHU Paris-Ile de France Ouest, Université de Versailles-Saint Quentin en Yvelines, Boulogne
| | | | | | | | | | | | | |
Collapse
|
35
|
Sei JF, Chaussade V, Zimmermann U, Tchakerian A, Clerici T, Franc B, Saiag P. Historique, principes, analyse critique de l’efficacité et indications de la chirurgie micrographique de Mohs. Ann Dermatol Venereol 2004; 131:173-82. [PMID: 15026745 DOI: 10.1016/s0151-9638(04)93566-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To systematically review the literature for studies reporting on the role of Mohs' micrographic (MMS) surgery in the treatment of skin tumors. To show how it is performed in France. DESIGN We reviewed with a quality grid all studies indexed in MEDLINE before 2003/01/01 and published in English or French. Data were extracted by two independent reviewers. MAIN OUTCOME MEASURES Quality of clinical studies, recurrence rates, number of patients lost to follow-up. RESULTS No randomized study was found among the 493 references found. Studies of lower quality, on procedures similar to MMS, or previous systematic reviews were therefore selected. In tumors such as basal (BCC) or spinous (SCC) cell carcinoma, microcystic adnexal carcinoma, dermatofibrosarcoma protuberans, and Merkel cell carcinoma, MMS commonly induced lower recurrence rates than figures reported for conventional treatments and/or reduced surgical margins. Studies on melanoma were of low quality. CONCLUSIONS Although no evidence-based guidelines could be developed, MMS should be used mainly for larger, morphea, micronodular or infiltrative-type, or recurrent BCCs located in danger zones, but also (sometimes with a slightly modified procedure) in microcystic adnexal carcinomas, dermatofibrosarcoma protuberans, Merkel cell carcinoma, and in aggressive forms of SCC. Randomized, controlled studies should be performed.
Collapse
Affiliation(s)
- J-F Sei
- Service de Dermatologie, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, CHU Paris-Ile de France Ouest, Université de Versailles-Saint Quentin en Yvelines, Boulogne
| | | | | | | | | | | | | |
Collapse
|
36
|
Franc B, Valenty M, Galakhin K, Kovalchuk E, Kulagenko V, Puchkou A, Sidorov Y, Tirmarche M. Histological validation of diagnoses of thyroid cancer among adults in the registries of Belarus and the Ukraine. Br J Cancer 2004; 89:2098-103. [PMID: 14647144 PMCID: PMC2376855 DOI: 10.1038/sj.bjc.6601395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In order to evaluate the diagnostic reliability of the thyroid cancers listed in adult registries from the Ukraine and Belarus, a histological review was organised of 327 randomly selected thyroid carcinoma cases diagnosed between 1980 and 1999. A final diagnosis was reached at a 5-day consensus conference by six pathologists who met around a multiheaded microscope. The study concluded with a comparison between the final diagnosis and the initial diagnosis. The pathologists agreed with the initial diagnosis of malignancy in 286 cases (88%). A final diagnosis of papillary, follicular or medullary thyroid carcinoma was reached in 86, 4, and 6% of the cases respectively. In 2.8% of the cases reviewed, diagnostic discrepancies persisted. The percentage of agreement between the final diagnosis and the initial diagnosis was 93%, with a weighted κ-statistic of 0.61 (confidence interval 95% (CI95%): [0.45–0.77]). In all, 89% of the 286 confirmed cancer cases were in agreement for the type of cancer, with a κ-statistic of 0.56 (CI95%: [0.43–0.69]). The level of agreement differed according to cancer categories, with concordance rates of 94, 40 and 33% for papillary, follicular and medullary thyroid carcinomas respectively. The low prevalence of follicular thyroid carcinomas in the adult population studied calls for further exploration. The discrepancies and classification difficulties encountered were analysed.
Collapse
Affiliation(s)
- B Franc
- Service Anatomie et Cytologie Pathologiques, Hôpital Ambroise Paré, 92100 Boulogne, France.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Gérard AC, Daumerie C, Mestdagh C, Gohy S, De Burbure C, Costagliola S, Miot F, Nollevaux MC, Denef JF, Rahier J, Franc B, De Vijlder JJM, Colin IM, Many MC. Correlation between the loss of thyroglobulin iodination and the expression of thyroid-specific proteins involved in iodine metabolism in thyroid carcinomas. J Clin Endocrinol Metab 2003; 88:4977-83. [PMID: 14557483 DOI: 10.1210/jc.2003-030586] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [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: 02/12/2023]
Abstract
Progress in biotechnology has provided useful tools for tracing proteins involved in thyroid hormone synthesis in vivo. Mono- or polyclonal antibodies are now available to detect on histological sections the Na(+)/I(-) symporter (NIS) at the basolateral pole of the cell, the putative iodide channel (pendrin) at the apical plasma membrane, thyroperoxidase (TPO), and members of the NADPH-oxidase family, thyroid oxidase 1 and 2 (ThOXs), part of the H(2)O(2)-generating system. The aim of this study was to correlate thyroglobulin (Tg) iodination with the presence of these proteins. Tg, T(4)-containing Tg, NIS, pendrin, TPO, ThOXs, and TSH receptor (TSHr) were detected by immunohistochemistry on tissue sections of normal thyroids and various benign and malignant thyroid disorders. Tg was present in all cases. T(4)-containing Tg was found in the adenomas, except in Hurthle cell adenomas. It was never detected in carcinomas. NIS was reduced in all types of carcinomas, whereas it was detected in noncancerous tissues. Pendrin was not expressed in carcinomas, except in follicular carcinomas, where weak staining persisted. TPO expression was present in insular, follicular carcinomas and in follicular variants of papillary carcinomas, but in a reduced percentage of cells. It was below the level of detection in papillary carcinomas. The H(2)O(2)-generating system, ThOXs, was found in all carcinomas and was even increased in papillary carcinomas. Its staining was apical in normal thyroids, whereas it was cytoplasmic in carcinomas. The TSHr was expressed in all cases, but the intensity of the staining was decreased in insular carcinomas. In conclusion, our work shows that all types of carcinomas lose the capacity to synthesize T(4)-rich, iodinated Tg. In follicular carcinomas, this might be due to a defect in iodide transport at the basolateral pole of the cell. In papillary carcinomas, this defect seems to be coupled to an altered apical transport of iodide and probably TPO activity. The TSHr persists in virtually all cases.
Collapse
Affiliation(s)
- A-C Gérard
- Histology, Université Catholique de Louvain Medical School, B-1070 Brussels, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Franc B, Carlisle MR, Segall G. Oral administration of F-18 FDG to evaluate a single pulmonary nodule by positron emission tomography in a patient with poor intravenous access. Clin Nucl Med 2003; 28:541-4. [PMID: 12819404 DOI: 10.1097/00003072-200307000-00001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/27/2022]
Abstract
F-18 fluorodeoxyglucose (FDG) is typically administered intravenously for positron emission tomography. The authors present a case of oral administration of FDG for evaluation of a pulmonary nodule and review the limited literature on this subject. Oral administration of FDG is a useful alternative to intravenous administration in patients with difficult intravenous access when the alimentary tract is not involved in the clinical diagnosis.
Collapse
Affiliation(s)
- Benjamin Franc
- Nuclear Medicine Service, Veterans Affairs Health System, Palo Alto and Division of Nuclear Medicine, Stanford Hospitals and Clinics, California, USA
| | | | | |
Collapse
|
39
|
Franc B, Goris M. Low uptake of Tc-99m tetrofosmin in lung cancer: a case report. Clin Nucl Med 2002; 27:698-700. [PMID: 12352109 DOI: 10.1097/00003072-200210000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Technetium-99m tetrofosmin has been used as a tumor-imaging agent in cases of lung cancer. The authors present a case showing a lung tumor that concentrated Tl-201 distinctly more than Tc-99m tetrofosmin during a dual-isotope cardiac examination. A brief review of the literature is provided and possible explanations for this difference in tracer uptake are discussed.
Collapse
Affiliation(s)
- Benjamin Franc
- Department of Radiology, Division of Nuclear Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 943905-5281, USA.
| | | |
Collapse
|
40
|
Helal BO, Merlet P, Toubert ME, Franc B, Schvartz C, Gauthier-Koelesnikov H, Prigent A, Syrota A. Clinical impact of (18)F-FDG PET in thyroid carcinoma patients with elevated thyroglobulin levels and negative (131)I scanning results after therapy. J Nucl Med 2001; 42:1464-9. [PMID: 11585858] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
UNLABELLED 18F-FDG PET has been shown to effectively detect differentiated thyroid carcinoma (DTC) metastases with impaired iodine-trapping ability. This article evaluates the potential contribution of FDG PET in the follow-up of patients with differentiated thyroid carcinoma, elevated thyroglobulin (Tg) levels, and negative whole-body scan results obtained after high doses of (131)I. METHODS We prospectively assessed the ability of FDG to detect metastases in 37 DTC patients who had undergone total thyroidectomy and radioactive ablation and presented with persistent disease, as assessed from elevated Tg levels and negative results of whole-body scans performed after therapeutic doses of (131)I. Additional conventional imaging procedures were performed to detect residual disease, and the patients were divided into 2 groups: group 1, with positive conventional imaging findings (n = 10), and group 2, with negative conventional imaging findings (n = 27). RESULTS FDG PET showed positive findings in 28 patients and accurately localized tumor sites in 89% of them. In group 1, FDG PET confirmed 17 of 18 previously known tumor sites and detected 11 additional sites. In group 2, FDG PET findings were positive in 19 of 27 patients with no previously detected metastases. PET was effective for both low- and high-stage tumors. The FDG data led to a change in the clinical management of 29 of 37 patients with further surgical resection in 23 patients, 14 of whom achieved disease-free status, and external radiation therapy in 4 patients. CONCLUSION FDG PET is able to detect metastases undetected by (131)I posttherapy whole-body scanning in patients with elevated Tg levels. It should be proposed as a first-line investigation in patients with persistent disease but negative findings on (131)I whole-body scans after treatment.
Collapse
Affiliation(s)
- B O Helal
- Service de Médecine Nucléaire, Hôpital Antoine Béclère, AP-HP, 157 rue de la Porte de Trivaux, 92141 Clamart CEDEX, France
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Oxyphilic tumors (oncocytomas or Hürthle cell tumors) form a rare subgroup of thyroid tumors characterized by cells containing abundant mitochondria. The relationship between the mitochondrial proliferation and the pathogenesis of these tumors is unknown. We have assessed the expression of the mitochondrial ND2 and ND5 (subunits of the nicotinamide adenine dinucleotide dehydrogenase complex) genes and the nuclear UCP2 (uncoupling protein 2) gene in 22 oxyphilic thyroid tumors and matched controls. The consumption of oxygen in mitochondria from tumors was determined by polarography. ATP assays were used to explore the mitochondrial respiratory chain activity and the oxidative phosphorylation coupling in seven fresh thyroid tumors and controls. Adenosine triphosphate synthesis was significantly lower in all the tumors, compared with controls, suggesting that a coupling defect in oxidative phosphorylation may be a cause of mitochondrial hyperplasia in oxyphilic thyroid tumors.
Collapse
Affiliation(s)
- F Savagner
- Inserm EMI-U 00-18, Laboratoire de Biochimie et Biologie Moléculaire, 4rue Larrey, F-49033 Angers cedex 01, France.
| | | | | | | | | | | |
Collapse
|
42
|
Karoui M, Hofmann-Radvanyi H, Zimmermann U, Couvelard A, Degott C, Faridoni-Laurens L, Ahomadegbe JC, Gazzeri S, Brambilla E, Clerici T, Charbonnier P, Tresallet C, Mitry E, Penna C, Rougier P, Boileau C, Thiery JP, Nordlinger B, Franc B, Radvanyi F. No evidence of somatic FGFR3 mutation in various types of carcinoma. Oncogene 2001; 20:5059-61. [PMID: 11526491 DOI: 10.1038/sj.onc.1204651] [Citation(s) in RCA: 35] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2001] [Revised: 04/18/2001] [Accepted: 05/23/2001] [Indexed: 11/09/2022]
Abstract
Germline specific point mutations in the gene encoding fibroblast growth factor receptor 3 (FGFR3) are associated with autosomal dominant human skeletal dysplasia and craniosynostosis syndromes. Mutations identical to the germinal activating mutations found in severe skeletal dysplasias have been identified in certain types of cancer: at low frequency in multiple myeloma and cervix carcinoma and at high frequency in bladder carcinoma. We analysed, by SSCP and sequencing, the prevalence of FGFR3 mutations in 116 primary tumours of various types (upper aerodigestive tract, oesophagus, stomach, lung and skin). The regions analysed encompassed all FGFR3 point mutations previously described in severe skeletal dysplasia and cancers. No mutations were detected in the tumour types examined, suggesting that FGFR3 mutations are restricted to a few tumour types, the evidence to date suggesting that they are very specific to bladder carcinomas.
Collapse
Affiliation(s)
- M Karoui
- Fédération des Spécialités Digestives, Hôpital Ambroise Paré, Université Paris V, 92104 Boulogne Cedex, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Bièche I, Franc B, Vidaud D, Vidaud M, Lidereau R. Analyses of MYC, ERBB2, and CCND1 genes in benign and malignant thyroid follicular cell tumors by real-time polymerase chain reaction. Thyroid 2001; 11:147-52. [PMID: 11288983 DOI: 10.1089/105072501300042802] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [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: 11/13/2022]
Abstract
The roles of the MYC, ERBB2, and CCND1 genes in thyroid carcinogenesis are poorly known. We used real-time quantitative polymerase chain reaction (PCR) assays based on fluorescent TaqMan methodology to quantify MYC, ERBB2, and CCND1 gene amplification and expression in 24 benign tumors (adenomas and goiter nodules) and 12 carcinomas (9 papillary, 2 follicular, and 1 anaplastic) of the thyroid. Real-time PCR is a recently developed method for nucleic acid quantification in homogeneous solutions, and has the potential to become a reference in terms of performance, accuracy, sensitivity, wide dynamic range, excellent interlaboratory agreement, and high throughput capacity, while avoiding the need for tedious post-PCR processing. Overexpression (>5 standard deviations above mean for normal thyroid tissues) of the ERBB2 and CCND1 genes was observed (3.2- to 5.2-fold and 3.8- to 8.4-fold, respectively) in 5 (14%) and 13 (36%) of 36 neoplastic thyroid RNA samples, respectively. Overexpression of the CCND1 gene was observed in both the benign and malignant thyroid tumors, whereas the ERBB2 gene was mainly overexpressed in malignant thyroid tumors. None of the neoplastic thyroid samples overexpressed MYC. No MYC, ERBB2, or CCND1 gene amplification was identified. These results suggest that the CCND1 gene plays an early role and the ERBB2 gene a later role in thyroid tumorigenesis.
Collapse
Affiliation(s)
- I Bièche
- Laboratoire d' Oncogénétique-INSERM E0017, Centre René Huguenin, St-Cloud, France.
| | | | | | | | | |
Collapse
|
44
|
Abstract
Medullary carcinoma of the thyroid (MTC) is a rare tumour derived from thyroid C cells with serum calcitonin as a specific and sensitive marker. MTC is inherited in 25% of cases, with an autosomal dominant transmission, age-related penetrance and variable expressivity. MTC is an obligatory component of multiple endocrine neoplasia type 2 (MEN2), which comprises three well defined syndromes: MEN2A, which may be associated with pheochromocytoma and/or hyperparathyroidism; the much rarer MEN2B, which occurs early and is accompanied by developmental abnormalities; while in contrast, familial MTC (FMTC) is not associated with any endocrinopathy. The RET proto-oncogene is the causative gene of the MEN2 syndromes and mutations in this gene are found in >90% of inherited cases, allowing easier and more reliable family screening than pentagastrin stimulation tests. Nevertheless, the correlation between the genotype and the different clinical phenotypes is not perfect. The prognosis of MTC depends on its staging at presentation, and the early appearance of cervical lymph node metastases emphasizes the need for extensive surgery, although many patients still do not normalize calcitonin levels post-operatively, and they remain a challenge for the further management.
Collapse
Affiliation(s)
- E Modigliani
- Groupe d'étude des tumeurs à calcitonine, Centre médical Europe, 75311 Paris, Cedex 09, France
| | | | | |
Collapse
|
45
|
Heymann MF, Joubert M, Nemeth J, Franc B, Visset J, Hamy A, le Borgne J, le Neel JC, Murat A, Cordel S, le Bodic MF. Prognostic and immunohistochemical validation of the capella classification of pancreatic neuroendocrine tumours: an analysis of 82 sporadic cases. Histopathology 2000; 36:421-32. [PMID: 10792483 DOI: 10.1046/j.1365-2559.2000.00892.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [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: 11/20/2022]
Abstract
AIMS To study the clinical outcome of 82 cases of pancreatic neuroendocrine tumours classified according to the recent histological and prognostic classification of Capella. METHODS AND RESULTS Eighty-two surgical cases of pancreatic neuroendocrine tumours were examined histologically with immunohistochemical staining of paraffin sections using streptavidin-biotin complex and application of antibodies against chromogranin A and 10 hormonal peptides. Classification in four groups correlated with long follow-up and outcome of these cases. Histological examination showed 30 group I, four group II, 41 group III and seven group IV tumours. Twenty-one (70%) of group I tumours were insulinomas, whereas 25% of group III tumours were glucagonomas and 25% were unclassified. Most group IV tumours were unclassified, showing no immunohistochemical staining with any of the 10 hormonal peptides tested. Outcome was clearly correlated with tumour group. Among the 14 patients who died of the disease, four had group IV and 10 group III tumours. Thus, unclassified asymptomatic tumours without immunohistochemical staining had a poorer prognosis than asymptomatic tumours with staining. CONCLUSION This study validates the Capella classification as easy to apply and useful in predicting clinical outcome.
Collapse
Affiliation(s)
- M F Heymann
- Department of Pathology, University Hospital, Paris Lariboisière, Nantes, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Deleu S, Allory Y, Radulescu A, Pirson I, Carrasco N, Corvilain B, Salmon I, Franc B, Dumont JE, Van Sande J, Maenhaut C. Characterization of autonomous thyroid adenoma: metabolism, gene expression, and pathology. Thyroid 2000; 10:131-40. [PMID: 10718549 DOI: 10.1089/thy.2000.10.131] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fifty-one in vivo characterized autonomous single adenomas have been studied for functional parameters in vitro, for gene and protein expression and for pathology, and have been systematically compared to the corresponding extratumoral quiescent tissue. The adenomas were characterized by a high level of iodide trapping that corresponds to a high level of Na+ /iodide symporter gene expression, a high thyroperoxidase mRNA and protein content, and a low H2O2 generation. This explains the iodide metabolism characteristics demonstrated before, ie, the main cause of the "hot" character of the adenomas is their increased iodide transport. The adenomas spontaneously secreted higher amounts of thyroid hormone than the quiescent tissue and in agreement with previous in vivo data, this secretion could be further enhanced by thyrotropin (TSH). Inositol uptake was also increased but there was no spontaneous increase of the generation of inositol phosphates and this metabolism could be further activated by TSH. These positive responses to TSH are in agreement with the properties of TSH-stimulated thyroid cells in vitro and in vivo. They are compatible with the characteristics of mutated TSH receptors whose constitutive activation accounts for the majority of autonomous thyroid adenomas in Europe. The number of cycling cells, as evaluated by MIB-1 immunolabeling was low but increased in comparison with the corresponding quiescent tissue or normal tissue. The cycling cells are observed mainly at the periphery; there was very little apoptosis. Both findings account for the slow growth of these established adenomas. On the other hand, by thyroperoxidase immunohistochemistry, the whole lesion appeared hyperfunctional, which demonstrates a dissociation of mitogenic and functional stimulations. Thyroglobulin, TSH receptor, and E-cadherin mRNA accumulations were not modified in a consistent way, which confirms the near-constitutive expression of the corresponding genes in normal differentiated tissue. On the contrary, early immediate genes expressions (c-myc, NGF1B, egr 1, genes of the fos and jun families) were decreased. This may be explained by the proliferative heterogeneity of the lesion and the previously described short, biphasic expression of these genes when induced by mitogenic agents. All the characteristics of the autonomous adenomas can therefore be explained by the effect of the known activating mutations of genes coding for proteins of the TSH cyclic adenosine monophosphate (cAMP) cascade, all cells being functionally activated while only those at the periphery multiply. The reason of this heterogeneity is unknown.
Collapse
Affiliation(s)
- S Deleu
- IRIBHN, Free University of Brussels, Brussels, Belgium
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Gosset P, Lecomte-Houcke M, Duhamel A, Labat-Moleur F, Patey M, Floquet J, Viennet G, Berger-Dutrieux N, Caillou B, Franc B. [112 cases of sporadic and genetically determined pheochromocytoma: a comparative pathologic study]. Ann Pathol 1999; 19:480-6. [PMID: 10617804] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The aim of this study was to compare 64 genetically determined pheochromocytomas (PH) (49 MEN IIa, 3 MEN IIb, 6 Von Recklinghausen diseases, 1 von Hippel-Lindau disease, 5 familial pheochromocytomas) and 48 sporadic PH. Genetically determined PH were more often observed among men and more frequently bilateral and multicentric than sporadic PH. Sporadic tumors had more often adrenal capsular invasion, necrosis and pseudocysts. Genetically determined PH were more differentiated with an insular pattern, hyaline globules and a higher percentage of polyhedric cells. Sporadic tumors were less differentiated with more frequently a diffuse pattern and small cells. Adrenal medullar hyperplasia was significantly associated with genetically determined PH. Adrenal cortical hyperplasia was not associated with a particular type of PH. The PS100 and chromogranin immunodetection was equivalent in both groups.
Collapse
Affiliation(s)
- P Gosset
- Groupe d'Etude des Tumeurs Endocrines à Calcitonine (GETC), Faculté de Médecine de Lille
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Bataille N, Franc B. [Extemporaneous pathologic examinations in breast and thyroid diseases. Working group put together by ANAES. National Agency for Accreditation and Evaluation of Health]. Ann Pathol 1999; 19:344-72. [PMID: 10544775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
49
|
Guyétant S, Dupre F, Bigorgne JC, Franc B, Dutrieux-Berger N, Lecomte-Houcke M, Patey M, Caillou B, Viennet G, Guerin O, Saint-Andre JP. Medullary thyroid microcarcinoma: a clinicopathologic retrospective study of 38 patients with no prior familial disease. Hum Pathol 1999; 30:957-63. [PMID: 10452509 DOI: 10.1016/s0046-8177(99)90250-2] [Citation(s) in RCA: 37] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thirty-eight patients (25 women, 13 men; mean age, 57.8 [32 to 91]) showing one or more medullary thyroid microcarcinomas (ie, < 1 cm), with no prior MEN II or medullary thyroid carcinoma history in their family, were reviewed. Follow-up was available for 29 patients (mean, 53.6 months [1 to 147]). 21 patients (72.4%) are alive and free of disease, four patients (13.8%) died during follow-up without disease, 2 patients are alive with disease (local recurrence and persistent hypercalcitoninemia) after 80 and 99 months, respectively, and 2 patients died of disease after 24 and 46 months. Most tumors were incidental pathological findings (19 of 38) or were discovered by systematic blood calcitonin measurement for a nodular thyroid disease (15 of 38). Only the four patients who had an unfavorable outcome were symptomatic cases (palpable micro-MTC, diarrhea, cervical lymph node metastasis and pulmonary metastatic disease). The two patients with metastatic disease at diagnosis died during follow-up. In univariate analysis, a symptomatic medullary thyroid carcinoma was a strong predictor of an unfavourable outcome (p < .00008), as were the preoperative calcitonin level (P = .007) and an elevated postoperative calcitonin level (P = .004). Among 30 histopathological criteria, only the presence of amyloid correlated with an unfavorable outcome (P = .018).
Collapse
Affiliation(s)
- S Guyétant
- Department of Pathology, Médecine C, Centre Hospitalier Universitaire, Angers, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Franc B, Bellocq JP. [Extemporaneous anatomo-pathologic examination of breast and thyroid diseases]. Presse Med 1999; 28:973. [PMID: 10366936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
|