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Fontana L, Sirchia SM, Pesenti C, Colpi GM, Miozzo MR. Non-invasive biomarkers for sperm retrieval in non-obstructive patients: a comprehensive review. Front Endocrinol (Lausanne) 2024; 15:1349000. [PMID: 38689732 PMCID: PMC11058837 DOI: 10.3389/fendo.2024.1349000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Recent advancements in reproductive medicine have guided novel strategies for addressing male infertility, particularly in cases of non-obstructive azoospermia (NOA). Two prominent invasive interventions, namely testicular sperm extraction (TESE) and microdissection TESE (micro-TESE), have emerged as key techniques to retrieve gametes for assisted reproduction technologies (ART). Both heterogeneity and complexity of NOA pose a multifaceted challenge to clinicians, as the invasiveness of these procedures and their unpredictable success underscore the need for more precise guidance. Seminal plasma can be aptly regarded as a liquid biopsy of the male reproductive tract, encompassing secretions from the testes, epididymides, seminal vesicles, bulbourethral glands, and prostate. This fluid harbors a variety of cell-free nucleic acids, microvesicles, proteins, and metabolites intricately linked to gonadal activity. However, despite numerous investigations exploring potential biomarkers from seminal fluid, their widespread inclusion into the clinical practice remains limited. This could be partially due to the complex interplay of diverse clinical and genetic factors inherent to NOA that likely contributes to the absence of definitive biomarkers for residual spermatogenesis. It is conceivable that the integration of clinical data with biomarkers could increase the potential in predicting surgical procedure outcomes and their choice in NOA cases. This comprehensive review addresses the challenge of sperm retrieval in NOA through non-invasive biomarkers. Moreover, we delve into promising perspectives, elucidating innovative approaches grounded in multi-omics methodologies, including genomics, transcriptomics and proteomics. These cutting-edge techniques, combined with the clinical and genetics features of patients, could improve the use of biomarkers in personalized medical approaches, patient counseling, and the decision-making continuum. Finally, Artificial intelligence (AI) holds significant potential in the realm of combining biomarkers and clinical data, also in the context of identifying non-invasive biomarkers for sperm retrieval.
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Affiliation(s)
- Laura Fontana
- Medical Genetics Unit, Aziende Socio Sanitarie Territoriali (ASST) Santi Paolo e Carlo, Milan, Italy
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia M. Sirchia
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Chiara Pesenti
- Medical Genetics Unit, Aziende Socio Sanitarie Territoriali (ASST) Santi Paolo e Carlo, Milan, Italy
| | - Giovanni Maria Colpi
- Next Fertility Procrea, International Center for Assisted Reproductive Technology, Lugano, Switzerland
| | - Monica R. Miozzo
- Medical Genetics Unit, Aziende Socio Sanitarie Territoriali (ASST) Santi Paolo e Carlo, Milan, Italy
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Velle A, Pesenti C, Grassi T, Beltrame L, Martini P, Jaconi M, Agostinis F, Calura E, Katsaros D, Borella F, Fruscio R, D'Incalci M, Marchini S, Romualdi C. A comprehensive investigation of histotype-specific microRNA and their variants in Stage I epithelial ovarian cancers. Int J Cancer 2023; 152:1989-2001. [PMID: 36541726 DOI: 10.1002/ijc.34408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
isomiRs, the sequence-variants of microRNA, are known to be tissue and cell type specific but their physiological role is largely unknown. In our study, we explored for the first time the expression of isomiRs across different Stage I epithelial ovarian cancer (EOC) histological subtypes, in order to shed new light on their biological role in tumor growth and progression. In a multicentric retrospective cohort of tumor biopsies (n = 215) we sequenced small RNAs finding 971 expressed miRNAs, 64% of which are isomiRs. Among them, 42 isomiRs showed a clear histotype specific pattern, confirming our previously identified miRNA markers (miR192/194 and miR30a-3p/5p for mucinous and clear cell subtypes, respectively) and uncovering new biomarkers for all the five subtypes. Using integrative models, we found that the 38% of these miRNA expression alterations is the result of copy number variations while the 17% of differential transcriptional activities. Our work represents the first attempt to characterize isomiRs expression in Stage I EOC within and across subtypes and to contextualize their alterations in the framework of the large genomic heterogeneity of this tumor.
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Affiliation(s)
- Angelo Velle
- Department of Biology, University of Padova, Padova, Italy
| | - Chiara Pesenti
- Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy.,Medical Genetics Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - Tommaso Grassi
- Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Luca Beltrame
- IRCCS Humanitas Research Hospital, Molecular Pharmacology Lab, Rozzano, Italy
| | - Paolo Martini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Marta Jaconi
- Department of Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | | | - Enrica Calura
- Department of Biology, University of Padova, Padova, Italy
| | - Dionyssios Katsaros
- Azienda Ospedaliero-Universitaria Città della Salute, Presidio S Anna and Department of Surgical Science, Gynecology, University of Torino, Torino, Italy
| | - Fulvio Borella
- Gynaecology and Obstetrics 1, Department of Surgical Sciences, St Anna Hospital and University of Torino, Turin, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Maurizio D'Incalci
- Cancer Pharmacology, IRCCS Humanitas Research Hospital, Italy.,Department of Biomedical Sciences, Humanitas University, Italy
| | - Sergio Marchini
- IRCCS Humanitas Research Hospital, Molecular Pharmacology Lab, Rozzano, Italy
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Tirelli C, Pesenti C, Miozzo M, Mondoni M, Fontana L, Centanni S. The Genetic and Epigenetic Footprint in Idiopathic Pulmonary Fibrosis and Familial Pulmonary Fibrosis: A State-of-the-Art Review. Diagnostics (Basel) 2022; 12:diagnostics12123107. [PMID: 36553114 PMCID: PMC9777399 DOI: 10.3390/diagnostics12123107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a rare disease of the lung with a largely unknown etiology and a poor prognosis. Intriguingly, forms of familial pulmonary fibrosis (FPF) have long been known and linked to specific genetic mutations. There is little evidence of the possible role of genetics in the etiology of sporadic IPF. We carried out a non-systematic, narrative literature review aimed at describing the main known genetic and epigenetic mechanisms that are involved in the pathogenesis and prognosis of IPF and FPF. In this review, we highlighted the mutations in classical genes associated with FPF, including those encoding for telomerases (TERT, TERC, PARN, RTEL1), which are also found in about 10-20% of cases of sporadic IPF. In addition to the Mendelian forms, mutations in the genes encoding for the surfactant proteins (SFTPC, SFTPA1, SFTPA2, ABCA3) and polymorphisms of genes for the mucin MUC5B and the Toll-interacting protein TOLLIP are other pathways favoring the fibrogenesis that have been thoroughly explored. Moreover, great attention has been paid to the main epigenetic alterations (DNA methylation, histone modification and non-coding RNA gene silencing) that are emerging to play a role in fibrogenesis. Finally, a gaze on the shared mechanisms between cancer and fibrogenesis, and future perspectives on the genetics of pulmonary fibrosis have been analyzed.
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Affiliation(s)
- Claudio Tirelli
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
- Correspondence:
| | - Chiara Pesenti
- Medical Genetics Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Monica Miozzo
- Medical Genetics Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Laura Fontana
- Medical Genetics Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
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Pesenti C, Beltrame L, Velle A, Fruscio R, Jaconi M, Borella F, Cribiù FM, Calura E, Venturini LV, Lenoci D, Agostinis F, Katsaros D, Panini N, Bianchi T, Landoni F, Miozzo M, D'Incalci M, Brenton JD, Romualdi C, Marchini S. Copy number alterations in stage I epithelial ovarian cancer highlight three genomic patterns associated with prognosis. Eur J Cancer 2022; 171:85-95. [PMID: 35714451 DOI: 10.1016/j.ejca.2022.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 02/03/2022] [Revised: 04/13/2022] [Accepted: 05/03/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Stage I epithelial ovarian cancer (EOC) encompasses five histologically different subtypes of tumors confined to the ovaries with a generally favorable prognosis. Despite the intrinsic heterogeneity, all stage I EOCs are treated with complete resection and adjuvant therapy in most of the cases. Owing to the lack of robust prognostic markers, this often leads to overtreatment. Therefore, a better molecular characterization of stage I EOCs could improve the assessment of the risk of relapse and the refinement of optimal treatment options. MATERIALS AND METHODS 205 stage I EOCs tumor biopsies with a median follow-up of eight years were gathered from two independent Italian tumor tissue collections, and the genome distribution of somatic copy number alterations (SCNAs) was investigated by shallow whole genome sequencing (sWGS) approach. RESULTS Despite the variability in SCNAs distribution both across and within the histotypes, we were able to define three common genomic instability patterns, namely stable, unstable, and highly unstable. These patterns were based on the percentage of the genome affected by SCNAs and on their length. The genomic instability pattern was strongly predictive of patients' prognosis also with multivariate models including currently used clinico-pathological variables. CONCLUSIONS The results obtained in this study support the idea that novel molecular markers, in this case genomic instability patterns, can anticipate the behavior of stage I EOC regardless of tumor subtype and provide valuable prognostic information. Thus, it might be propitious to extend the study of these genomic instability patterns to improve rational management of this disease.
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Affiliation(s)
- Chiara Pesenti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Angelo Velle
- Department of Biology, University of Padova, Padova, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marta Jaconi
- Department of Pathology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, San Anna Hospital, University of Torino, Torino, Italy
| | - Fulvia Milena Cribiù
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Enrica Calura
- Department of Biology, University of Padova, Padova, Italy
| | - Lara Veronica Venturini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Deborah Lenoci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Dionyssios Katsaros
- AOU City of Health, Dept of Surgical Sciences, Gynecology, St Anna Hospital and University of Torino, Torino, Italy
| | - Nicolò Panini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Tommaso Bianchi
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Monica Miozzo
- Department of Health Sciences, Medical Genetics, Università Degli Studi di Milano, Milano, Italy; Research Laboratories Coordination Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Maurizio D'Incalci
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
| | - James D Brenton
- Cancer Research UK Cambridge Research Institute, University of Cambridge, Cambridge, UK
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Conforti F, Pala L, Pagan E, Rocco EG, Bagnardi V, Montagna E, Peruzzotti G, De Pas T, Fumagalli C, Pileggi S, Pesenti C, Marchini S, Corso G, Marchio' C, Sapino A, Graffeo R, Collet L, Aftimos P, Sotiriou C, Piccart M, Gelber RD, Viale G, Colleoni M, Goldhirsch A. Biological and clinical features of triple negative Invasive Lobular Carcinomas of the breast. Clinical outcome and actionable molecular alterations. Breast 2021; 59:94-101. [PMID: 34217971 PMCID: PMC8261657 DOI: 10.1016/j.breast.2021.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/05/2021] [Accepted: 06/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background We report here for the first time, a comprehensive characterization of biological and clinical features of early-stage triple negative Invasive Lobular Carcinomas(TN-ILCs) Methods We analyzed all consecutive patients with early-stage TN-ILC operated at two reference cancer-centers between 1994 and 2012. Primary objective was to assess the invasive disease-free survival(iDFS). Co-primary objective was to assess biological features of TN-ILCs, including molecular intrinsic subtypes based on PAM-50 assay, expression of androgen receptor (AR) and mutational status of ERBB2-gene. Additionally, DNA mutational status of an independent cohort of 45 TN-ILCs from three databases were analyzed, to confirm mutations in ERBB2-gene and to identify other recurrently mutated genes. Results Among 4152 ILCs, 74(1.8%) were TN and were analyzed. The iDFS at 5 and 10 years of FUP were 50.4%(95%CI,38.0–61.6) and 37.2%(95%CI,25.5–48.8), respectively. The molecular subtype was defined through PAM50-classifier for 31 out of 74 TN-ILCs: 48% were Luminal-A(15/31), 3% luminal-B(1/31), 32% HER2-enriched (10/31), and only 16% basal-like(5/31). Luminal tumors expressed AR more frequently than non-luminal tumors (AR≥1% in 94% of luminal tumors versus 53% in non-luminal tumors; p-value = 0.001). 20% of TN-ILCs analyzed(7/35), harbored a pathogenetic and actionable mutation in the ERBB2-gene. Analysis of the independent cohort of 45 TN-ILCs from three different databases, confirmed similar percentage of pathogenetic and actionable mutations in ERBB2-gene(20%; 9/45). Among the top 10 molecular pathways significantly enriched for recurrently mutated genes in TN-ILCs(FDR<0.05), there were ErbB-signaling and DNA-damage-response pathways. Conclusions TN-ILCs are rare tumors with poor prognosis. Their specific biological features require newly defined targeted therapeutic strategies Triple-negative ILCs are distinct from both TN-IDCs and endocrine-responsive ILC. TN-ILCs are enriched for actionable mutations in ErbB2 gene and DNA Damage Response genes. The Luminal Androgen Receptor (LAR) is the most prevalent subtype in TN-ILCs.
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Affiliation(s)
- Fabio Conforti
- Division of Medical Oncology for Melanoma & Sarcoma, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Laura Pala
- Division of Medical Oncology for Melanoma & Sarcoma, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Elena Guerini Rocco
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milano, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Emilia Montagna
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Peruzzotti
- Division of Data Management, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Tommaso De Pas
- Division of Medical Oncology for Melanoma & Sarcoma, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Caterina Fumagalli
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Silvana Pileggi
- Department of Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Italy
| | - Chiara Pesenti
- Department of Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Italy
| | - Sergio Marchini
- Department of Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Italy
| | - Giovanni Corso
- Division of Senology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Caterina Marchio'
- Department of Medical Sciences, University of Torino, Turin, Italy; Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, TO, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Torino, Turin, Italy; Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, TO, Italy
| | - Rossella Graffeo
- High Risk Clinic, Oncological Genetics Service, Oncology Institute of Southern Switzerland, Ospedale Italiano, Lugano, Switzerland
| | - Laetitia Collet
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Aftimos
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Martine Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Richard D Gelber
- Department of Data Sciences, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health, Frontier Science & Technology Research Foundation, Boston, USA
| | - Giuseppe Viale
- Department of Pathology, IEO, European Institute of Oncology IRCCS & State University of Milan, Milan, Italy
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Pesenti C, Paracchini L, Marchette MD, Beltrame L, Bianchi T, Grassi T, Buda A, Landoni F, Ceppi L, Bosetti C, Paderno MC, Adorni M, Vicini D, Perego P, Leone BE, Marchini S, Fruscio R, D'Incalci M. Abstract LB-268: Detection of TP53 clonal mutations in PAP test collected up to six years prior to high-grade serous epithelial ovarian cancer diagnosis. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-lb-268] [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: 11/16/2022]
Abstract
Abstract
Background: The low five-years survival rate of High Grade Serous Epithelial Ovarian Cancer (HGS-EOC) is mainly related to late diagnosis. The anticipation of diagnosis constitutes a crucial step to increase the curability of this disease.
Aim: This study explores an innovative potential HGS-EOC screening approach exploiting PAP tests routinely executed for cervical cancer surveillance and the presence of TP53 clonal alterations in almost all HGS-EOCs. Indeed, it investigates the possibility to detect, in DNA purified from PAP tests collected by patients years before the diagnosis, the clonal pathogenic TP53 variant identified in the matched primary tumor biopsy.
Study Design: This retrospective and longitudinal study was conducted on 17 advanced HGS-EOC patients. Next Generation Sequencing (NGS) was used to identify TP53 clonal mutations in tumor tissue. The presence of these TP53 variants was then assessed by the droplet digital PCR (ddPCR) in DNA purified from all available patients' PAP tests executed up to almost six years before diagnosis.
Results: In each patient, one TP53 clonal somatic variant was identified by NGS in the primary tumor samples (Table 1). The presence of the TP53 variant was then investigated by ddPCR in matched Pap tests. In twelve out of 17 patients the TP53 variant was detectable in PAP tests collected within six months before diagnosis (T1) or earlier (T2, T3 and T4) (Table 1). For two patients (21561 and 21521) more PAP tests collected at different time before diagnosis (two/four and three/six years before diagnosis, respectively) were analyzed and the TP53 clonal variant was detected at all time points (Table 1).
Table 1:NGS and ddPCR resultsPatient IDTP53 mutationNGS tumor mutated %PAP test (months before surgery)T1(0-6)T2(7-24)T3(25-48)T4(≥49)Time intervalddPCR mutated %Time intervalddPCR mutated %Time intervalddPCR mutated %Time intervalddPCR mutated %21561c.818G>A65.010.20.24--250.21490.2621585c.817C>T40.94--11.30.21----21567c.281C>A71.9830.07------21587c.469G>T15.122ND------21586c.818G>A79.73--19.30.15----21569c.574C>T62.365.21.18------21624c.820G>T86.72----37.50.0465.3ND21570c.844C>T89.190.32.62------21627c.425_427del76.040.72.4------21640c.993+2T>G70.68--8ND----21507c.1025G>C91.23--9.20.06----21635c.844C>T66.241.3ND------21549c. 393_395del54.06----31.2ND65.3ND21521c. 722 C>G61.15----26.70.0567.30.0721654c.586 C>T49.354.70.09------21665c. 393_395del45.34----37.6ND--21683c.602 T>A33.42--18.50.06----ND Not Detected
Conclusion: This study demonstrates that non-invasive early molecular diagnosis of HGS-EOC is feasible through detection of TP53 clonal mutations in the DNA purified from PAP tests performed during cervical cancer screening. Further developments in highly sensitive molecular approaches could dramatically improve early diagnosis of HGS-EOC.
Citation Format: Chiara Pesenti, Lara Paracchini, Martina Delle Marchette, Luca Beltrame, Tommaso Bianchi, Tommaso Grassi, Alessandro Buda, Fabio Landoni, Lorenzo Ceppi, Cristina Bosetti, Maria Chiara Paderno, Marco Adorni, Debora Vicini, Patrizia Perego, Biagio Eugenio Leone, Sergio Marchini, Robert Fruscio, Maurizio D'Incalci. Detection of TP53 clonal mutations in PAP test collected up to six years prior to high-grade serous epithelial ovarian cancer diagnosis [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr LB-268.
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Affiliation(s)
- Chiara Pesenti
- 1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Lara Paracchini
- 1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Luca Beltrame
- 1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | | | | | - Fabio Landoni
- 2Università degli Studi Milano-Bicocca, Monza, Italy
| | | | | | | | - Marco Adorni
- 2Università degli Studi Milano-Bicocca, Monza, Italy
| | - Debora Vicini
- 2Università degli Studi Milano-Bicocca, Monza, Italy
| | | | | | - Sergio Marchini
- 1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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Paracchini L, Pesenti C, Delle Marchette M, Beltrame L, Bianchi T, Grassi T, Buda A, Landoni F, Ceppi L, Bosetti C, Paderno M, Adorni M, Vicini D, Perego P, Leone BE, D’Incalci M, Marchini S, Fruscio R. Detection of TP53 Clonal Variants in Papanicolaou Test Samples Collected up to 6 Years Prior to High-Grade Serous Epithelial Ovarian Cancer Diagnosis. JAMA Netw Open 2020; 3:e207566. [PMID: 32609349 PMCID: PMC7330718 DOI: 10.1001/jamanetworkopen.2020.7566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE The low 5-year survival rate of women with high-grade serous epithelial ovarian cancer (HGS-EOC) is related to its late diagnosis; thus, improvement in diagnosis constitutes a crucial step to increase the curability of this disease. OBJECTIVE To determine whether the presence of the clonal pathogenic TP53 variant detected in matched primary tumor biopsies can be identified in DNA purified from Papanicolaou test samples collected from women with HGS-EOC years before the diagnosis. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among a single-center cohort of women with histologically confirmed diagnosis of HGS-EOC recruited at San Gerardo Hospital, Monza, Italy, from October 15, 2015, to January 4, 2019. Serial dilutions of DNA derived from tumor samples and DNA extracted from healthy women's Papanicolaou test samples were analyzed to define the sensitivity and specificity of droplet digital polymerase chain reaction assays designed to detect the TP53 variants identified in tumors. All available brush-based Papanicolaou test slides performed up to 6 years before diagnosis were investigated at the Mario Negri Institute, Milano, Italy. Data were analyzed from October 2018 to December 2019. MAIN OUTCOMES AND MEASURES The presence of tumor pathogenic TP53 variants was assessed by the droplet digital polymerase chain reaction approach in DNA purified from Papanicolaou test samples obtained from the same patients before diagnosis during cervical cancer screenings. RESULTS Among 17 included patients (median [interquartile range] age at diagnosis, 60 [53-69] years), Papanicolaou tests withdrawn before diagnosis presented tumor-matched TP53 variants in 11 patients (64%). In 2 patients for whom longitudinal Papanicolaou tests were available, including 1 patient with Papanicolaou tests from 25 and 49 months before diagnosis and 1 patient with Papanicolaou tests from 27 and 68 months before diagnosis, the TP53 clonal variant was detected at all time points. CONCLUSIONS AND RELEVANCE These findings suggest that noninvasive early molecular diagnosis of HGS-EOC is potentially achievable through detection of TP53 clonal variants in the DNA purified from Papanicolaou tests performed during cervical cancer screening.
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Affiliation(s)
- Lara Paracchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Pesenti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Martina Delle Marchette
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Luca Beltrame
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Tommaso Bianchi
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Tommaso Grassi
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Ceppi
- Department of Obstetrics and Gynecology, Azienda Socio Sanitaria Territoriale -Monza, Desio Hospital, Desio, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Mariachiara Paderno
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marco Adorni
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Debora Vicini
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Patrizia Perego
- Department of Pathology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Biagio Eugenio Leone
- Department of Pathology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Maurizio D’Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Sergio Marchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
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8
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Conforti F, Pala L, Guerini Rocco E, Pagan E, Bagnardi V, Montagna E, Peruzzotti G, De Pas TM, Fumagalli C, Pileggi S, Pesenti C, Marchini S, Marchiò C, Sapino A, Gelber RD, Viale G, Colleoni M, Goldhirsch A. Biological and clinical features of early triple-negative invasive lobular carcinomas of the breast. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e12570] [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
e12570 Background: Hormone receptors and HER2 negative (triple negative, TN) invasive lobular carcinomas (ILCs) are very rare, accounting for 1-2% of all TN breast cancers (BCs). Methods: We extracted data from our prospectively collected institutional database on all consecutive patients (pts) with early stage TN ILC operated at the European Institute of Oncology (IEO) between June 1994 and December 2012. Invasive disease-free survival (iDFS) and cumulative incidence of distant metastases (CI-DM) were calculated. Biological features of these tumors, including molecular intrinsic subtypes based on PAM50 assay, expression of androgen receptor (AR) and mutational status of c-erbB2 gene were also evaluated. Additionally, NGS data of 45 TN ILCs were obtained from 3 large public databases, to confirm mutations in c-erbB2 gene and to identify other recurrently mutated genes. Results: Among 2952 ILCs treated at IEO, 44 (1.5%) were TN and were included in the analysis. All pts received adjuvant chemotherapy. The iDFS rates at 5 and 10 years of follow-up were 47.4% (95% CI, 31.1-62.0) and 29.5% (95% CI, 14.8-45.8), respectively. The corresponding CI-DM percentages were 17.6% (95% CI, 7.6-31.2) and 20.8% (95% CI, 9.5-35.1). The molecular intrinsic subtype was defined through PAM50 for 31 out of 44 TN ILCs: 48% were classified as luminal A, 3% luminal B, 32% HER2-enriched, and only 16% basal-like. The group of pts with luminal A or B tumors had a significantly better CI-DM as compared with pts with non-luminal tumors (i.e. HER2-enriched and basal-like; p=0.003). Luminal tumors expressed AR more frequently than non-luminal tumors (AR≥1% in 96% of luminal tumors versus 53% in non-luminal tumors; p=0.001), and at significantly higher levels (median percentage of AR-positive cells was 80% in luminal tumors versus 15% in non-luminal tumors; p=0.01). Higher AR expression was associated with significantly better iDFS in the whole cohort of TN ILCs (p=0.01), as well as in the group of luminal tumors (p=0.05). 27 TN ILCs of the IEO cohort were analyzed for mutations in c-erbB2 gene, and 9 (33%) harbored mutations. Analysis of the 3 public databases, confirmed c-erbB2 mutations in 9 out of 45 (20%) TN ILCs. All the c-erbB2 mutations found were previously reported to be pathogenetic in BCs and to predict response to neratinib. ErbB signaling and DNA damage response were among the top 10 pathways significantly enriched for mutated genes in TN ILCs. Conclusions: TN ILCs are rare tumors with dire prognosis. Their specific biological features require newly defined targeted therapeutic strategies.
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Affiliation(s)
- Fabio Conforti
- Division of Medical Oncology for Melanoma & Sarcoma, IEO, European Institute of Oncology IRCCS, Milan, Milan, Italy
| | - Laura Pala
- Division of Medical Oncology for Melanoma & Sarcoma, IEO, European Institute of Oncology IRCCS, Milan, Milano, Italy
| | - Elena Guerini Rocco
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, and Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy, Milan, Italy
| | - Emilia Montagna
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Peruzzotti
- Division of Data Management, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Tommaso Martino De Pas
- Division of Medical Oncology for Melanoma & Sarcoma, European Institute of Oncology, Milan, Italy
| | - Caterina Fumagalli
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Silvana Pileggi
- Departmentof Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Milano, Italy
| | - Chiara Pesenti
- Departmentof Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Milan, Italy
| | - Sergio Marchini
- Departmentof Oncology, Mario Negri Institute for Pharmacological Research, IRCCS, Milan, Italy
| | - Caterina Marchiò
- Department of Medical Sciences, University of Torino; Pathology Unit, Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino; Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Torino, Turin, Italy; Unit of Pathology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo (TO), Italy, Turin, Italy, Italy
| | - Richard D. Gelber
- Dana-Farber Cancer Institute, Harvard Medical School, Harvard TH Chan School of Public Health, and Frontier Science and Technology Research Foundation, Boston, MA
| | - Giuseppe Viale
- Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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9
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Fusco N, Lopez G, Corti C, Pesenti C, Colapietro P, Ercoli G, Gaudioso G, Faversani A, Gambini D, Despini L, Blundo C, Vaira V, Miozzo M, Ferrero S, Bosari S. Abstract P2-08-21: Mismatch repair protein loss is a prognostic and predictive biomarker in breast cancers regardless of microsatellite instability. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-21] [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: 11/16/2022]
Abstract
Abstract
Despite the approval of pembrolizumab in all tumors showing mismatch-repair (MMR) deficiency and/or microsatellite instability (MSI), there are currently no companion diagnostics for MMR status assessment in breast cancer. Here, we sought to define the diagnostic and prognostic role of MMR and MSI testing in breast cancer patients.
We subjected 444 breast cancers to MMR immunohistochemistry (IHC) and MSI analysis. Cases were classified as MMR-proficient (pMMR), MMR-deficient (dMMR), and MMR-heterogeneous (hMMR) based on the loss of immunoreactivity; MSI was defined by the instability in the five indicators recommended by the National Cancer Institute for endometrial and colorectal cancers. Correlation of MMR status with patients' survival was assessed using the Kaplan-Meier estimator.
In 75 patients (17%) the loss of MMR proteins was homogeneous, classified as dMMR, while 55 cases (12%) were hMMR. The prevalence of cancers with loss of the MMR proteins was homogeneous across ER+ breast cancers (15-19% for dMMR and 10-18% for hMMR tumors). The level of overlap between IHC and MSI analysis was 9% (p<0.0001). Among ER+/HER2- carcinomas, pMMR and hMMR patients displayed better survival rates (p=0.008). In chemo-treated ER-/HER2- breast cancers, the dMMR status was a marker of good prognosis (p<0.001).
Our study documents the clinical impact of MMR testing in a large series of breast cancers, using the most commonly adopted diagnostic tools and criteria. We show that MMR protein loss is a rather common event in breast cancer and has a remarkable degree of intra-tumor heterogeneity, therefore making the analysis of a small area of the tumor, or a small biopsy, of little clinical value. Our investigation supports the concept that MSI occurs rarely in breast cancer and demonstrate that this condition is restricted to a minority of tumors with MMR protein loss. These data suggest that MMR IHC and MSI analysis should not be considered as interchangeable tests in the diagnostic workup of breast carcinomas. Finally, our observations indicate that the complete loss of at least one of the MMR proteins assessed by IHC is able to identify high-risk ER+/HER2- breast cancers that can potentially benefit from pembrolizumab therapy, whereas first-line chemotherapy shows comparatively good results in dMMR ER-/HER2- breast cancers.
Citation Format: Fusco N, Lopez G, Corti C, Pesenti C, Colapietro P, Ercoli G, Gaudioso G, Faversani A, Gambini D, Despini L, Blundo C, Vaira V, Miozzo M, Ferrero S, Bosari S. Mismatch repair protein loss is a prognostic and predictive biomarker in breast cancers regardless of microsatellite instability [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-21.
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Affiliation(s)
- N Fusco
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - G Lopez
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - C Corti
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - C Pesenti
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - P Colapietro
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - G Ercoli
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - G Gaudioso
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - A Faversani
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - D Gambini
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - L Despini
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - C Blundo
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - V Vaira
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - M Miozzo
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - S Ferrero
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - S Bosari
- University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
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10
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Colombo C, Muzza M, Proverbio MC, Tosi D, Soranna D, Pesenti C, Rossi S, Cirello V, De Leo S, Fusco N, Miozzo M, Bulfamante G, Vicentini L, Ferrero S, Zambon A, Tabano S, Fugazzola L. Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability. Thyroid 2019; 29:237-251. [PMID: 30501571 DOI: 10.1089/thy.2018.0339] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The need to integrate the classification of cancer with information on the genetic pattern has emerged in recent years for several tumors. METHODS The genomic background of a large series of 208 papillary thyroid cancers (PTC) followed at a single center was analyzed by a custom MassARRAY genotyping platform, which allows the simultaneous detection of 19 common genetic alterations, including point mutations and fusions. RESULTS Of the PTCs investigated, 71% were found to have pathognomonic genetic findings, with BRAFV600E and TERT promoter mutations being the most frequent monoallelic alterations (42% and 23.5%, respectively), followed by RET/PTC fusions. In 19.2% of cases, two or more point mutations were found, and the co-occurrence of a fusion with one or more point mutation(s) was also observed. Coexisting BRAFV600E and TERT promoter mutations were detected in a subgroup of aggressive PTCs (12%). A correlation between several aggressive features and mutation density was found, regardless of the type of association (i.e., only point mutations, or point mutations and fusions). Importantly, Kaplan-Meier curves demonstrated that mutation density significantly correlated with a higher risk of persistent disease. In most cases, the evaluation of the allelic frequencies normalized for the cancer cell content indicated the presence of the monoallelic mutation in virtually all tumor cells. A minority of cases was found to harbor low allelic frequencies, consistent with the presence of the mutations in a small subset of cancer cells, thus indicating tumor heterogeneity. Consistently, the presence of coexisting genetic alterations with different allelic frequencies in some tumors suggests that PTC can be formed by clones/subclones with different mutational profiles. CONCLUSIONS A large mono-institutional series of PTCs was fully genotyped by means of a cost- and time-effective customized panel, revealing a strong impact of mutation density and genetic heterogeneity on the clinical features and on disease outcomes, indicating that an accurate risk stratification of thyroid cancer cannot rely on the analysis of a single genetic event. Finally, the heterogeneity found in some tumors warrants attention, since the occurrence of this phenomenon is likely to affect response to targeted therapies.
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Affiliation(s)
- Carla Colombo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marina Muzza
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 3 Endocrine Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Carla Proverbio
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Delfina Tosi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Chiara Pesenti
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Rossi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valentina Cirello
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Simone De Leo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicola Fusco
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaetano Bulfamante
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Leonardo Vicentini
- 10 Endocrine Surgery Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Ferrero
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Antonella Zambon
- 7 Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Silvia Tabano
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Fugazzola
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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11
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Azzollini J, Pesenti C, Pizzamiglio S, Fontana L, Guarino C, Peissel B, Plebani M, Tabano S, Sirchia SM, Colapietro P, Villa R, Paolini B, Verderio P, Miozzo M, Manoukian S. Constitutive BRCA1 Promoter Hypermethylation Can Be a Predisposing Event in Isolated Early-Onset Breast Cancer. Cancers (Basel) 2019; 11:cancers11010058. [PMID: 30634417 PMCID: PMC6356733 DOI: 10.3390/cancers11010058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022] Open
Abstract
Early age at onset of breast cancer (eoBC) is suggestive of an increased genetic risk. Although genetic testing is offered to all eoBC-affected women, in isolated cases the detection rate of pathogenic variants is <10%. This study aimed at assessing the role of constitutive promoter methylation at BC-associated loci as an underlying predisposing event in women with eoBC and negative family history. Promoter methylation at 12 loci was assessed by the MassARRAY technology in blood from 154 BRCA1/2 negative patients with eoBC and negative family history, and 60 healthy controls. Hypermethylation was determined, within each promoter, by comparing the patient’s mean methylation value with thresholds based on one-sided 95% bootstrap confidence interval of the controls’ mean. Three patients had hypermethylated results, two at BRCA1 and one at RAD51C. Analyses on tumor tissue from the patient exceeding the highest threshold at BRCA1 revealed a mean methylation >60% and loss of heterozygosity at chromosome 17q. The patient hypermethylated at RAD51C showed low methylation in the tumor sample, ruling out a role for methylation-induced silencing in tumor development. In isolated eoBC patients, BRCA1 constitutive promoter methylation may be a predisposing event. Further studies are required to define the impact of methylation changes occurring at BC-predisposing genes and their role in tumorigenesis.
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Affiliation(s)
- Jacopo Azzollini
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Chiara Pesenti
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Sara Pizzamiglio
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Laura Fontana
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Carmela Guarino
- Immunohematology & Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy.
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Maddalena Plebani
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Silvia Tabano
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Silvia Maria Sirchia
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, 20142 Milano, Italy.
| | - Patrizia Colapietro
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Roberta Villa
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Biagio Paolini
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Paolo Verderio
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Monica Miozzo
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
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12
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Fusco N, Lopez G, Corti C, Pesenti C, Colapietro P, Ercoli G, Gaudioso G, Faversani A, Gambini D, Michelotti A, Despini L, Blundo C, Vaira V, Miozzo M, Ferrero S, Bosari S. Mismatch Repair Protein Loss as a Prognostic and Predictive Biomarker in Breast Cancers Regardless of Microsatellite Instability. JNCI Cancer Spectr 2018; 2:pky056. [PMID: 31360876 PMCID: PMC6649738 DOI: 10.1093/jncics/pky056] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/20/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022] Open
Abstract
Background Breast cancers that harbor mismatch-repair (MMR) deficiency and/or microsatellite instability (MSI) might be sensitive to immune checkpoint blockade, but there are currently no specific guidelines for assessing MMR status in breast cancer. Here, we sought to define the clinical value of MMR immunohistochemistry (IHC) and MSI analysis in breast cancers. Methods We subjected 444 breast cancers to MMR IHC and MSI analysis. Cases were classified as MMR-proficient (pMMR), MMR-deficient (dMMR), and MMR-heterogeneous (hMMR) based on the loss of immunoreactivity; MSI was defined by instability in the five indicators recommended by the National Cancer Institute for endometrial and colorectal cancers. Correlation of MMR status with patients' survival was assessed using the Kaplan-Meier estimator. Statistical tests were two-sided. Results Loss of MMR proteins was homogeneous (dMMR) in 75 patients (17%) and heterogeneous (hMMR) in 55 (12%). Among luminal breast cancers, there were similar frequencies of dMMR and hMMR tumors. Overall, the rate of discrepancy between IHC and MSI analysis was high (91%). Women with Luminal B-like dMMR carcinomas (n = 44) showed shorter overall survival (median = 77 months, range = 0-115 months) than those with pMMR (n = 205) or hMMR (n = 35) tumors (median = 84 months, range = 0-127 months) (P = .008). On the contrary, patients with estrogen receptor-negative breast cancers treated with chemotherapy lived longer in cases of dMMR (n = 9) than pMMR (n = 33) or hMMR (n = 7) tumors, with 87 months of median survival (range = 73-123 months) for the former compared with 79 months (range = 8-113 months) for the latter two categories (P < .001). Conclusions Immunohistochemistry and MSI are not interchangeable tests in breast carcinomas. MMR protein loss is a more common event than MSI and shows intra-tumor heterogeneity. MMR IHC allows the identification of clinically relevant subclasses of breast cancer patients, provided that multiple areas of the tumor are analyzed.
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Affiliation(s)
- Nicola Fusco
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Corti
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Pesenti
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Colapietro
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giulia Ercoli
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriella Gaudioso
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Faversani
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences
| | | | - Anna Michelotti
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Division of Medical Oncology (DG, AM)
| | - Luca Despini
- Division of Breast Surgery, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Concetta Blundo
- Division of Breast Surgery, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences
| | - Silvano Bosari
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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13
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Parlangeli A, Pirola E, Caroli M, Pesenti C, Buonamassa S, Miozzo M, Rampini P. P01.064 Correlation with MGMT pyrosequencing-based methylation levels and overall survival in glioblastoma patients with gross total resection and concomitant chemio and radiotherapy. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.106] [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)
| | - E Pirola
- IRCCS Ca’ Granda Policlinico, Milan, Italy
| | - M Caroli
- IRCCS Ca’ Granda Policlinico, Milan, Italy
| | - C Pesenti
- IRCCS Ca’ Granda Policlinico, Milan, Italy
| | - S Buonamassa
- Quenn’s Hospital, BHR NHS Trust, Romford, United Kingdom
| | - M Miozzo
- IRCCS Ca’ Granda Policlinico, Milan, Italy
| | - P Rampini
- IRCCS Ca’ Granda Policlinico, Milan, Italy
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14
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Pesenti C, Muzza M, Colombo C, Proverbio MC, Farè C, Ferrero S, Miozzo M, Fugazzola L, Tabano S. MassARRAY-based simultaneous detection of hotspot somatic mutations and recurrent fusion genes in papillary thyroid carcinoma: the PTC-MA assay. Endocrine 2018; 61:36-41. [PMID: 29214440 PMCID: PMC5997117 DOI: 10.1007/s12020-017-1483-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/22/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE We exploited the MassARRAY (MA) genotyping platform to develop the "PTC-MA assay", which allows the simultaneous detection of 13 hotspot mutations, in the BRAF, KRAS, NRAS, HRAS, TERT, AKT1, PIK3CA, and EIF1AX genes, and six recurrent genetic rearrangements, involving the RET and TRK genes in papillary thyroid cancer (PTC). METHODS The assay was developed using DNA and cDNA from 12 frozen and 11 formalin-fixed paraffin embedded samples from 23 PTC cases, together with positive and negative controls. RESULTS The PTC-MA assay displays high sensitivity towards point mutations and gene rearrangements, detecting their presence at frequencies as low as 5%. Moreover, this technique allows quantification of the mutated alleles identified at each tested locus. CONCLUSIONS The PTC-MA assay is a novel MA test, which is able to detect fusion genes generated by genomic rearrangements concomitantly with the analysis of hotspot point mutations, thus allowing the evaluation of key diagnostic, prognostic, and therapeutic markers of PTC in a single experiment without any informatics analysis. As the assay is sensitive, robust, easily achievable, and affordable, it is suitable for the diagnostic practice. Finally, the PTC-MA assay can be easily implemented and updated by adding novel genetic markers, according to clinical requirements.
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Affiliation(s)
- Chiara Pesenti
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marina Muzza
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carla Colombo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Maria Carla Proverbio
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Claudia Farè
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Laura Fugazzola
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
- Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milano, Italy.
| | - Silvia Tabano
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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15
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Paganini L, Pesenti C, Milani D, Fontana L, Motta S, Sirchia SM, Scuvera G, Marchisio P, Esposito S, Cinnante CM, Tabano SM, Miozzo MR. A novel splice site variant in ITPR1
gene underlying recessive Gillespie syndrome. Am J Med Genet A 2018; 176:1427-1431. [DOI: 10.1002/ajmg.a.38704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/06/2018] [Accepted: 03/15/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Leda Paganini
- Division of Pathology; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
| | - Chiara Pesenti
- Division of Pathology; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
| | - Donatella Milani
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Laura Fontana
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
| | - Silvia Motta
- Division of Pathology; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
| | - Silvia Maria Sirchia
- Medical Genetics, Department of Health Sciences; Università degli Studi di Milano; Italy
| | - Giulietta Scuvera
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Paola Marchisio
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences; Università degli Studi di Perugia; Italy
| | - Claudia Maria Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Silvia Maria Tabano
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
| | - Monica Rosa Miozzo
- Division of Pathology; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
- Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Italy
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16
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Bonaparte E, Pesenti C, Fontana L, Falcone R, Paganini L, Marzorati A, Ferrero S, Nosotti M, Mendogni P, Bareggi C, Sirchia SM, Tabano S, Bosari S, Miozzo M. Molecular profiling of lung cancer specimens and liquid biopsies using MALDI-TOF mass spectrometry. Diagn Pathol 2018; 13:4. [PMID: 29368620 PMCID: PMC6389067 DOI: 10.1186/s13000-017-0683-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identification of predictive molecular alterations in lung adenocarcinoma is essential for accurate therapeutic decisions. Although several molecular approaches are available, a number of issues, including tumor heterogeneity, frequent material scarcity, and the large number of loci to be investigated, must be taken into account in selecting the most appropriate technique. MALDI-TOF mass spectrometry (MS), which allows multiplexed genotyping, has been adopted in routine diagnostics as a sensitive, reliable, fast, and cost-effective method. Our aim was to test the reliability of this approach in detecting targetable mutations in non-small cell lung cancer (NSCLC). In addition, we also analyzed low-quality samples, such as cytologic specimens, that often, are the unique source of starting material in lung cancer cases, to test the sensitivity of the system. METHODS We designed a MS-based assay for testing 158 mutations in the EGFR, KRAS, BRAF, ALK, PIK3CA, ERBB2, DDR2, AKT, and MEK1 genes and applied it to 92 NSCLC specimens and 13 liquid biopsies from another subset of NSCLC patients. We also tested the sensitivity of the method to distinguish low represented mutations using serial dilutions of mutated DNA. RESULTS Our panel is able to detect the most common NSCLC mutations and the frequency of the mutations observed in our cohort was comparable to literature data. The assay identifies mutated alleles at frequencies of 2.5-10%. In addition, we found that the amount of DNA template was irrelevant to efficiently uncover mutated alleles present at high frequency. However, when using less than 10 ng of DNA, the assay can detect mutations present in at least 10% of the alleles. Finally, using MS and a commercial kit for RT-PCR we tested liquid biopsy from 13 patients with identified mutations in cancers and detected the mutations in 4 (MS) and in 5 samples (RT-PCR). CONCLUSIONS MS is a powerful method for the routine predictive tests of lung cancer also using low quality and scant tissues. Finally, after appropriate validation and improvement, MS could represent a promising and cost-effective strategy for monitoring the presence and percentage of the mutations also in non-invasive sampling.
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Affiliation(s)
- Eleonora Bonaparte
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Chiara Pesenti
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Laura Fontana
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Rossella Falcone
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Leda Paganini
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Anna Marzorati
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Medical School, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Mario Nosotti
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Paolo Mendogni
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Claudia Bareggi
- Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Silvia Maria Sirchia
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, via Antonio di Rudini, 8 -20142, Milan, Italy
| | - Silvia Tabano
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy. .,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy.
| | - Silvano Bosari
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
| | - Monica Miozzo
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Via Francesco Sforza, 35 -20122, Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 -20122, Milan, Italy
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17
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Jaussent I, Beziat S, Pesenti C, Lopez R, Barateau L, Carlander B, Lucas G, Tafti M, Morin C, Billiard M, Dauvilliers Y. Measurement of narcolepsy symptoms: the narcolepsy severity scale. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.431] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Del Gobbo A, Morotti A, Colombo AE, Vaira V, Ercoli G, Pesenti C, Bonaparte E, Guerini-Rocco E, Di Cristofori A, Locatelli M, Palleschi A, Ferrero S. IMP3 expression in NSCLC brain metastases demonstrates its role as a prognostic factor in non-neuroendocrine phenotypes. Med Oncol 2017; 35:2. [DOI: 10.1007/s12032-017-1062-7] [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] [Received: 11/01/2017] [Accepted: 11/21/2017] [Indexed: 10/18/2022]
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19
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Roveda E, Montaruli A, Galasso L, Pesenti C, Bruno E, Pasanisi P, Cortellini M, Rampichini S, Erzegovesi S, Caumo A, Esposito F. Rest-activity circadian rhythm and sleep quality in patients with binge eating disorder. Chronobiol Int 2017; 35:198-207. [PMID: 29144185 DOI: 10.1080/07420528.2017.1392549] [Citation(s) in RCA: 25] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recent findings suggest that altered rest-activity circadian rhythms (RARs) are associated with a compromised health status. RARs abnormalities have been observed also in several pathological conditions, such as cardiovascular, neurological, and cancer diseases. Binge eating disorder (BED) is the most common eating disorder, with a prevalence of 3.5% in women and 2% in men. BED and its associate obesity and motor inactivity could induce RARs disruption and have negative consequences on health-related quality of life. However, the circadian RARs and sleep behavior in patients with BED has been so far assessed only by questionnaires. Therefore, the purpose of this study was to determine RARs and sleep parameters by actigraphy in patients with BED compared to a body mass index-matched control group (Ctrl). Sixteen participants (eight obese women with and eight obese women without BED diagnosis) were recruited to undergo 5-day monitoring period by actigraphy (MotionWatch 8®, CamNtech, Cambridge, UK) to evaluate RARs and sleep parameters. In order to determine the RARs, the actigraphic data were analyzed using the single cosinor method. The rhythmometric parameters of activity levels (MESOR, amplitude and acrophase) were then processed with the population mean cosinor. The Actiwatch Sleep Analysis Software (Cambridge Neurotecnology, Cambridge, UK) evaluated the sleep patterns. In each participant, we considered seven sleep parameters (sleep onset: S-on; sleep offset: S-off; sleep duration: SD; sleep latency: SL; movement and fragmentation index: MFI; immobility time: IT; sleep efficiency: SE) calculated over a period of five nights. The population mean cosinor applied to BED and Ctrl revealed the presence of a significant circadian rhythm in both groups (p < 0.001). The MESOR (170.0 vs 301.6 a.c., in BED and Ctrl, respectively; p < 0.01) and amplitude (157.66 vs 238.19 a.c., in BED and Ctrl, respectively p < 0.05) differed significantly between the two groups. Acrophase was not different between BED and Ctrl, as well as all sleep parameters. Both groups displayed a low level of sleep quality (SE 80.7% and 75.7% in BED and Ctrl, respectively). These data provided the first actigraphy-based evidence of RARs disruption and sleep behavior disorder in patients with BED. However, while sleep disorders could be reasonably ascribed to overweight/obesity and the related lower daily physical activity, RARs disruption in this pathology should be ascribed to factors other than reduced physical activity. The circadian timing approach can represent a novel potential tool in the treatment of patients with eating disorders. These data provide exploratory evidence of behavioral association in a small population of patients that, if confirmed in a wider number of subjects and across different populations, may lead to a revision and enhancement of interventions in BED patients.
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Affiliation(s)
- E Roveda
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - A Montaruli
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - L Galasso
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - C Pesenti
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - E Bruno
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy.,b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - P Pasanisi
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - M Cortellini
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - S Rampichini
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - S Erzegovesi
- c Department of Clinical Neuroscience , San Raffaele Scientific Institute , Milan , Italy
| | - A Caumo
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - F Esposito
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
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20
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Pesenti C, Paganini L, Fontana L, Veniani E, Runza L, Ferrero S, Bosari S, Menghi M, Marfia G, Caroli M, Silipigni R, Guerneri S, Tabano S, Miozzo M. Mass spectrometry-based assay for the molecular diagnosis of glioma: concomitant detection of chromosome 1p/19q codeletion, and IDH1, IDH2, and TERT mutation status. Oncotarget 2017; 8:57134-57148. [PMID: 28915660 PMCID: PMC5593631 DOI: 10.18632/oncotarget.19103] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/19/2017] [Indexed: 02/06/2023] Open
Abstract
The World Health Organization recently revised the diagnosis of glioma, to integrate molecular parameters, including IDH mutations and codeletion (loss of heterozygosity; LOH) of chromosome arms 1p/19q, into the definitions of adult glioma histological subtypes. Mutations in the TERT promoter may also be useful for glioma diagnosis and prognosis. The integration of molecular markers into routine diagnosis requires their rapid and reliable assessment. We propose a MassARRAY (MS)-based test that can identify 1p/19q codeletion using quantitative SNP genotyping and, simultaneously, characterize hotspot mutations in the IDH1, IDH2, and TERT genes in tumor DNA. We determined the reliability of the MS approach testing 50 gliomas and comparing the MS results with those obtained by standard methods, such as short tandem repeat genotyping, array comparative genomic hybridization (array-CGH) and Fluorescence In Situ Hybridization (FISH) for 1p/19q codeletion and Sanger sequencing for hotspots mutations. The results indicate that MS is suitable for the accurate, rapid, and cost-effective evaluation of chromosome deletions combined with hotspot mutation detection. This MS approach could be similarly exploited in evaluation of LOH in other situations of clinical and/or research importance.
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Affiliation(s)
- Chiara Pesenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Leda Paganini
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Fontana
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Veniani
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Letterio Runza
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvano Bosari
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giovanni Marfia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Manuela Caroli
- Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosamaria Silipigni
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvana Guerneri
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Tabano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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21
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Rawal CC, Riccardo S, Pesenti C, Ferrari M, Marini F, Pellicioli A. Reduced kinase activity of polo kinase Cdc5 affects chromosome stability and DNA damage response in S. cerevisiae. Cell Cycle 2016; 15:2906-2919. [PMID: 27565373 DOI: 10.1080/15384101.2016.1222338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Polo-like kinases (PLKs) control several aspects of eukaryotic cell division and DNA damage response. Remarkably, PLKs are overexpressed in several types of cancer, being therefore a marker of bad prognosis. As such, specific PLK kinase activity inhibitors are already used in clinical trials and the regulation of PLK activation is a relevant topic of cancer research. Phosphorylation of threonine residues in the T-loop of the kinase domain is pivotal for PLKs activation. Here, we show that T238A substitution in the T-loop reduces the kinase activity of Cdc5, the only PLK in Saccharomyces cerevisiae, with minor effect on cell growth in unperturbed conditions. However, the cdc5-T238A cells have increased rate of chromosome loss and gross chromosomal rearrangements, indicating altered genome stability. Moreover, the T238A mutation affects timely localization of Cdc5 to the spindle pole bodies and blocks cell cycle restart after one irreparable double-strand break. In cells responding to alkylating agent metylmethane sulfonate (MMS), the cdc5-T238A mutation reduces the phosphorylation of Mus81-Mms4 resolvase and exacerbates the MMS sensitivity of sgs1Δ cells that accumulate Holliday junctions. Of importance, the previously described checkpoint adaptation defective allele, cdc5-ad does not show reduced kinase activity, defective Mms4 phosphorylation and genetic interaction with sgs1Δ. Our data define the importance of regulating Cdc5 activity through T-loop phosphorylation to preserve genome integrity and respond to DNA damage.
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Affiliation(s)
- Chetan C Rawal
- a Department of Biosciences , University of Milan , Milano , Italy
| | - Sara Riccardo
- a Department of Biosciences , University of Milan , Milano , Italy
| | - Chiara Pesenti
- a Department of Biosciences , University of Milan , Milano , Italy.,b Department of Pathophysiology & Transplantation , Universitá degli Studi di Milano , Milan , Italy.,c Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Matteo Ferrari
- a Department of Biosciences , University of Milan , Milano , Italy
| | - Federica Marini
- a Department of Biosciences , University of Milan , Milano , Italy
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Fontana L, Tabano S, Bonaparte E, Marfia G, Pesenti C, Falcone R, Augello C, Carlessi N, Silipigni R, Guerneri S, Campanella R, Caroli M, Sirchia S, Bosari S, Miozzo M. MGMT-Methylated Alleles Are Distributed Heterogeneously Within Glioma Samples Irrespective of IDH Status and Chromosome 10q Deletion. J Neuropathol Exp Neurol 2016; 75:791-800. [PMID: 27346749 PMCID: PMC5409217 DOI: 10.1093/jnen/nlw052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Indexed: 01/01/2023] Open
Abstract
Several molecular markers drive diagnostic classification, prognostic stratification, and/or prediction of response to therapy in patients with gliomas. Among them, IDH gene mutations are valuable markers for defining subtypes and are strongly associated with epigenetic silencing of the methylguanine DNA methyltransferase (MGMT) gene. However, little is known about the percentage of MGMT-methylated alleles in IDH-mutated cells or the potential association between MGMT methylation and deletion of chromosome 10q, which encompasses the MGMT locus. Here, we quantitatively assessed MGMT methylation and IDH1 mutation in 208 primary glioma samples to explore possible differences associated with the IDH genotype. We also explored a potential association between MGMT methylation and loss of chromosome 10q. We observed that MGMT methylation was heterogeneously distributed within glioma samples irrespective of IDH status suggesting an incomplete overlap between IDH1-mutated and MGMT-methylated alleles and indicating a partial association between these 2 events. Moreover, loss of one MGMT allele did not affect the methylation level of the remaining allele. MGMT was methylated in about half of gliomas harboring a 10q deletion; in those cases, loss of heterozygosity might be considered a second hit leading to complete inactivation of MGMT and further contributing to tumor progression.
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Affiliation(s)
- Laura Fontana
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Silvia Tabano
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Eleonora Bonaparte
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Giovanni Marfia
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Chiara Pesenti
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Rossella Falcone
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Claudia Augello
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Nicole Carlessi
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Rosamaria Silipigni
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Silvana Guerneri
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Rolando Campanella
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Manuela Caroli
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Silvia Sirchia
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Silvano Bosari
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS)
| | - Monica Miozzo
- From the Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milan, Italy (LF, ST, EB, GM, CP, RF, CA, RC, SB, MM); Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (EB, CP, RF, NC, SB, MM); Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (GM, RC); Medical Genetics Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (RS, SG); Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy (MC); and Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy (SMS).
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Marfia G, Navone SE, Fanizzi C, Tabano S, Pesenti C, Abdel Hadi L, Franzini A, Caroli M, Miozzo M, Riboni L, Rampini P, Campanella R. Prognostic value of preoperative von Willebrand factor plasma levels in patients with Glioblastoma. Cancer Med 2016; 5:1783-90. [PMID: 27236861 PMCID: PMC4887291 DOI: 10.1002/cam4.747] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/24/2016] [Accepted: 04/02/2016] [Indexed: 11/26/2022] Open
Abstract
Circulating biomarker for malignant gliomas could improve both differential diagnosis and clinical management of brain tumor patients. Among all gliomas, glioblastoma (GBM) is considered the most hypervascularized tumor with activation of multiple proangiogenic signaling pathways that enhance tumor growth. To investigate whether preoperative antigen plasma level of von Willebrand Factor (VWF:Ag) might be possible marker for GBM onset, progression, and prognosis, we retrospectively examined 57 patients with histological diagnosis for GBM and 23 meningiomas (MNGs), benign intracranial expansive lesions, enrolled as controls. Blood samples were collected from all the patients before tumor resection. Plasma von Willebrand Factor (VWF):Ag levels were determined by using a latex particle‐enhanced immunoturbidimetric assay. The median levels of vWF:Ag were significantly higher in GBMs than in meningiomas (MNGs) (183 vs. 133 IU/dL, P = 0.01). The cumulative 1‐year survival was significantly shorter in patients with VWF:Ag levels >200 IU/dL than in those with levels <200 IU/dL and increased VWF levels were associated with a threefold higher risk of death in GBM patients. Our data suggest that VWF:Ag could be a circulating biomarker of disease malignancy, that could be considered, in association with other genetic and epigenetic factors, currently available in the GBM management. Future studies should investigate whether plasma VWF:Ag levels could also be used to monitor therapeutic effects and whether it may have a prognostic value.
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Affiliation(s)
- Giovanni Marfia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Stefania Elena Navone
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Claudia Fanizzi
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Silvia Tabano
- Division of Pathology, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Chiara Pesenti
- Division of Pathology, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Loubna Abdel Hadi
- Department of Medical Biotechnology and Translational Medicine, LITA-Segrate, University of Milan, via Fratelli Cervi, 93, MI Milan, Segrate, 20090, Italy
| | - Andrea Franzini
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Manuela Caroli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Monica Miozzo
- Division of Pathology, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Laura Riboni
- Department of Medical Biotechnology and Translational Medicine, LITA-Segrate, University of Milan, via Fratelli Cervi, 93, MI Milan, Segrate, 20090, Italy
| | - Paolo Rampini
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
| | - Rolando Campanella
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via F. Sforza, 35, Milan, 20122, Italy
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Araujo J, Bories E, Caillol F, Pesenti C, Guiramand J, Poizat FF, Monges G, Ries P, Raoul JL, Delpero JR, Giovannini M. Distant lymph node metastases in gastroesophageal junction adenocarcinoma: impact of endoscopic ultrasound-guided fine-needle aspiration. Endosc Ultrasound 2014. [PMID: 24949383 DOI: 10.4103/2303-9027.117660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Endoscopic ultrasound (EUS) is established as the most accurate technique for pre-operative locoregional staging of gastroesophageal junction (GEJ) adenocarcinoma, the purpose of the present study was to evaluate the distant lymph nodes (LNs) EUS-fine-needle aspiration (FNA) impact in therapeutic decision for patients with GEJ adenocarcinoma. MATERIALS AND METHODS Retrospective study was made, with cross-sectional, non-probabilistic analysis from prospectively collected database for all GEJ adenocarcinoma staging patients referred between January 2009 and August 2012 in Paoli-Calmette Institute in Marseille-France. RESULTS A total of 154 patients with GEJ adenocarcinoma were managed in our institution, of whom 113 (73.3%) had non-distant metastatic disease at computed tomography (CT) scan and underwent EUS for initial tumor staging prior to a treatment decision. On A total of 113 patients undergoing EUS, 8 (7%) patients underwent endoscopic resection and 6 (5.3%) underwent direct surgical resection. Of the remaining 99 patients (87.6%), 24 (21.2%) distant LN EUS-FNA were made. Seventeen LN had EUS malignant features, including 9 (52.9%) that were confirmed as malignant and underwent palliative treatment with chemotherapy. Ninety (79.6%) patients were treated with pre-operative neoadjuvant therapy and were revaluated after. 4 (4.4%) had metastatic disease at CT scan (underwent palliative treatment) and 65 (72.2%) underwent EUS restaging to treatment decision revaluation. Of these, twelve (18.4%) distant LN EUS-FNA were performed. Seven had LN EUS malignancy features, including 4 (57.1%) that were confirmed as malignant and underwent palliative treatment. The remaining 61 patients underwent surgery. As stated above, 21 patients (23.3%) did not undergo EUS restaging, including 10 (47.6%) that did not go to surgery because patient's age, poor general status and comorbidities, 6 (28.5%) had a loss of follow-up, 1 (4.7%) underwent to surgery due to chemotherapy collateral effects, 3 (14.2%) were still on pre-operative chemotherapy and 1 (4.7%) died for sepsis after mediastinal EUS-FNA, this was the only complication event evidenced. EUS-FNA changed clinical management in 54.2% of patients who met the criteria inclusion (distant LN with malignancies EUS features), which corresponds to 11.5% of patients with GEJ adenocarcinoma. CONCLUSION EUS-FNA was able to provide a different tumor staging and these differences were associated with treatment received. EUS-FNA had a significant impact on treatment decision.
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Affiliation(s)
- J Araujo
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - E Bories
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - F Caillol
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - C Pesenti
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J Guiramand
- Department of Surgery, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - F F Poizat
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - G Monges
- Department of Biopathology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - P Ries
- Department of Oncology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J L Raoul
- Department of Oncology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J R Delpero
- Department of Surgery, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - M Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
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Bories E, Caillol F, Pesenti C, Giovannini M. Short-term results after hepaticogastrostomy guided by echo-endoscopy: Monocentric retrospective study. Endosc Ultrasound 2014; 3:S14. [PMID: 26425513 PMCID: PMC4569911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Biliary drainage guided by echo-endoscopy (EUS) is a recent technique but expanding more and more in addition of retrograde and percutaneous approaches. METHODS Seventy-three hepaticogastrostomy (HG) were carried out from 2000 to 2013. After exclusion of patients included in a randomized prospective study, data from 60 patients were retrospectively analyzed in order to study the feasibility and early results of this technique. RESULTS During the study period, 60 patients (woman = 32; median age = 64 years [38-93]) were treated by HG. This technique was choose in the event of impossibility to reach the papilla, a failure of endoscopic retrograde cholangiopancreatography or to achieve drainage of the left hepatic biliary ducts in 35%, 15% and 50%, respectively. The biliary stricture was neoplasic in 85%. Sixty-four procedures were carried out: The technical success rate was 94%. Eighteen patients presented one or more adverse effects (28%) including: Infection (n = 14), pneumoperitoneum (n = 7), choleperitoneum/bilioma (n = 8), hemorrhage (n = 2), other (n = 2). Seven stents migration occurred (11%). The average duration of hospitalization was 9 days (0-61j). Three related deaths occurred, due to severe infection. During the period of the study, several types of stent were placed during the first procedure: Plastic stent (n = 12), one covered or uncovered metallic stent (n = 9), association of one uncovered metallic stent and one fully covered stent (SIS, n = 27), or one half covered metallic stent (n = 16). The rate of complications was respectively 33% (n = 4), 56% (n = 5), 26% (n = 7) and 13% (n = 2) according to the type of stent used. Three successive periods can thus be individualized according to the type of biliary stent used and the use of the CO2 insufflator [Table 1]. [Table: see text]. CONCLUSIONS Hepaticogastric anastomosis guided by echo-endoscopy is an effective, useful technique when the retrograde way is not possible or to drain selectively left intrahepatic biliary ducts. The morbidity rate is quite high but seems to decrease.
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Affiliation(s)
- E. Bories
- Institut Paoli Calmettes, Marseille, France
| | - F. Caillol
- Institut Paoli Calmettes, Marseille, France
| | - C. Pesenti
- Institut Paoli Calmettes, Marseille, France
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Reimão S, Francioni E, Bories E, Caillol F, Pesenti C, Giovannini M. Endoscopic ultrasonography-guided bi-lateral biliary drainage: A case series study. Endosc Ultrasound 2014; 3:S18. [PMID: 26425521 PMCID: PMC4569919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Biliary obstruction is preferentially managed by endoscopic retrograde cholangiopancreatography (ERCP). However, after ERCP failed, alternatives include percutaneous transhepatic drainage, surgery and more recently, endoscopic ultrasonography (EUS)-guided hepaticogastrostomy. The limitation of this technique is that the drainage is restricted to the left side. The aim of this study is to describe a new method of drainage of both hepatic ductal systems by hepaticogastrostomy in patients with hilar obstruction. RESULTS Nine prospectively patients were included, all with hilar obstruction (metastasis of a pancreatic adenocarcinoma n = 4, cholangiocarcinoma n = 1, gallbladder cancer n = 2 and metastasis from a pancreatic neuroendocrine tumor n = 2). A total of four patients had previously Whipple surgery and the others five had duodenal involvement by the tumor. The topography of the stenosis varied from Bismuth type 2 (n = 7) and hilar infiltration in the others two. All of them were submitted a three-step drainage. The first one consisted in a transgastric EUS-guided puncture of the left-side bile duct with a 19 gauge needle, insertion of a 0.0035 inch guide wire which was positioned at the right biliary tree crossing the bile bifurcation. After a dilatation with 6 Fr cystotome, a non-covered self-expandable metal stent was placed communicating the right and left biliary ducts. Finally, a second stent, partially covered, was inserted at the left biliary duct, with the distal part inside the previously stent and the proximal edge positioned at the stomach. Successful drainage was observed in seven patients, two of them presented abdominal pain during the first 72 h. One patient developed sepsis and death 7 days after the procedure and the other one had drainage failure. Jaundice was reduced significatively in seven patients and a chemotherapy was started in 6/7 patients. CONCLUSION This pilot study shows the feasibility of this new technique to drain the right biliary duct in patients with hilar obstruction, with few major complications rates.
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Affiliation(s)
- S. Reimão
- Institut Paoli-Calmettes, Marseille, France
| | | | - E Bories
- Institut Paoli-Calmettes, Marseille, France
| | - F. Caillol
- Institut Paoli-Calmettes, Marseille, France
| | - C. Pesenti
- Institut Paoli-Calmettes, Marseille, France
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Galasso D, Bories E, Caillol F, Forero Pineros EA, Pesenti C, Giovannini M. Feasibility of endoscopic ultrasound-guided hepaticogastrostomy in a patient with previous gastric banding. Endoscopy 2014; 45 Suppl 2 UCTN:E233-4. [PMID: 23945925 DOI: 10.1055/s-0033-1344322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- D Galasso
- A Gemelli Hospital, Digestive Endoscopy Unit, Rome, Italy.
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Araujo J, Bories E, Caillol F, Pesenti C, Guiramand J, Poizat FF, Monges G, Ries P, Raoul JL, Delpero JR, Giovannini M. Distant lymph node metastases in gastroesophageal junction adenocarcinoma: impact of endoscopic ultrasound-guided fine-needle aspiration. Endosc Ultrasound 2013; 2:148-52. [PMID: 24949383 PMCID: PMC4062258 DOI: 10.7178/eus.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/21/2013] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Endoscopic ultrasound (EUS) is established as the most accurate technique for pre-operative locoregional staging of gastroesophageal junction (GEJ) adenocarcinoma, the purpose of the present study was to evaluate the distant lymph nodes (LNs) EUS-fine-needle aspiration (FNA) impact in therapeutic decision for patients with GEJ adenocarcinoma. MATERIALS AND METHODS Retrospective study was made, with cross-sectional, non-probabilistic analysis from prospectively collected database for all GEJ adenocarcinoma staging patients referred between January 2009 and August 2012 in Paoli-Calmette Institute in Marseille-France. RESULTS A total of 154 patients with GEJ adenocarcinoma were managed in our institution, of whom 113 (73.3%) had non-distant metastatic disease at computed tomography (CT) scan and underwent EUS for initial tumor staging prior to a treatment decision. On A total of 113 patients undergoing EUS, 8 (7%) patients underwent endoscopic resection and 6 (5.3%) underwent direct surgical resection. Of the remaining 99 patients (87.6%), 24 (21.2%) distant LN EUS-FNA were made. Seventeen LN had EUS malignant features, including 9 (52.9%) that were confirmed as malignant and underwent palliative treatment with chemotherapy. Ninety (79.6%) patients were treated with pre-operative neoadjuvant therapy and were revaluated after. 4 (4.4%) had metastatic disease at CT scan (underwent palliative treatment) and 65 (72.2%) underwent EUS restaging to treatment decision revaluation. Of these, twelve (18.4%) distant LN EUS-FNA were performed. Seven had LN EUS malignancy features, including 4 (57.1%) that were confirmed as malignant and underwent palliative treatment. The remaining 61 patients underwent surgery. As stated above, 21 patients (23.3%) did not undergo EUS restaging, including 10 (47.6%) that did not go to surgery because patient's age, poor general status and comorbidities, 6 (28.5%) had a loss of follow-up, 1 (4.7%) underwent to surgery due to chemotherapy collateral effects, 3 (14.2%) were still on pre-operative chemotherapy and 1 (4.7%) died for sepsis after mediastinal EUS-FNA, this was the only complication event evidenced. EUS-FNA changed clinical management in 54.2% of patients who met the criteria inclusion (distant LN with malignancies EUS features), which corresponds to 11.5% of patients with GEJ adenocarcinoma. CONCLUSION EUS-FNA was able to provide a different tumor staging and these differences were associated with treatment received. EUS-FNA had a significant impact on treatment decision.
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Affiliation(s)
- J. Araujo
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - E. Bories
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - F. Caillol
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - C. Pesenti
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J. Guiramand
- Department of Surgery, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | | | - G. Monges
- Department of Biopathology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - P. Ries
- Department of Oncology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J. L. Raoul
- Department of Oncology, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - J. R. Delpero
- Department of Surgery, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
| | - M. Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite 13273, Marseille Cedex 9, France
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Farnault B, Bories E, De Chaisemartin C, Raoul JL, Lelong B, Poizat F, Pesenti C, Delpero JR, Giovannini M, Moureau-Zabotto L. Fiabilité de l’échoendoscopie dans l’évaluation de la réponse tumorale après chimioradiothérapie concomitante pour un cancer du rectum localement évolué. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.116] [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: 11/28/2022]
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Caillol F, Bories E, Pesenti C, Poizat F, Monges G, Guiramand J, Esterni B, Giovannini M. Radiofrequency ablation associated to mucosal resection in the oesophagus: experience in a single centre. Clin Res Hepatol Gastroenterol 2012; 36:371-7. [PMID: 22361442 DOI: 10.1016/j.clinre.2012.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/07/2011] [Accepted: 01/02/2012] [Indexed: 02/04/2023]
Abstract
UNLABELLED Endoscopic resection (EMR) and radiofrequency ablation (RFA) form part of the treatment of Barrett's oesophagus (BO), dysplasia, superficial adenocarcinoma (OAC) associated with BO. PATIENTS AND METHODS Between June 2008 and April 2011, 34 patients underwent treatment with RFA (HALO system(®)), in a tertiary centre. For the study, patients were divided into two groups. Group 1 (16 patients of average 60 years old; 14 men, two women) received EMR and RFA. Group 2 (18 patients averaging 59 years age; 14 men, four women) received RFA without EMR in the year preceding the RFA. RESULTS In group 1, high grade dysplasia (HGD) was eradicated in 12 cases (92%), low grade dysplasia (LGD) in three cases (100%). Complete response occurred in nine cases (56%), partial response in 100% of cases. Mean follow-up was 15 months. In group 2, HGD was eradicated in one patient (100%), LGD in three patients (64%). A complete response was achieved in eight patients, partial response in four cases (77%). Mean follow-up was 10 months. The complication rate for groups 1 and 2 was of 18% and 10% respectively. No complication prevented completion of treatment or continued monitoring. Recurrence was evaluated to 5% in both groups. CONCLUSION RFA associated with EMR is feasible, offering probably better results and a very important advantage: a more complete histology before follow-up. Our results show effective treatment of BO and associated dysplasia with a low rate of complication. Nevertheless, when new techniques of BO ablation are used, the need to obtain histology before treatment should not be forgotten.
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Affiliation(s)
- F Caillol
- Endoscopy unit, Paoli Calmette institute, 232, boulevard Ste-Marguerite, 13009 Marseille, France.
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Poizat F, Piera E, Giovannini M, Bories E, Pesenti C, Caillol F, Chetaille B, Xerri L, Monges G. Ponction sous écho-endoscopie avec une nouvelle aiguille 19G : résultats pour 29 biopsies. Ann Pathol 2011. [DOI: 10.1016/j.annpat.2011.09.073] [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: 11/16/2022]
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Giovannini M, Bories E, Monges G, Pesenti C, Caillol F, Delpero JR. Results of a phase I-II study on intraductal confocal microscopy (IDCM) in patients with common bile duct (CBD) stenosis. Surg Endosc 2011; 25:2247-53. [PMID: 21424206 DOI: 10.1007/s00464-010-1542-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Accepted: 11/16/2010] [Indexed: 12/17/2022]
Abstract
BACKGROUND Confocal endomicroscopy is an emergent technique and allows real optical biopsies in the gastrointestinal (GI) tract. The aim of this study was to evaluate a new intraductal confocal miniprobe in patients with a normal common bile duct (CBD) or with a suspicion of a malignant stenosis (cholangiocarcinoma). METHODS Thirty-seven patients (23 males) underwent endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stone removal (7 cases) or bile duct stenosis (30 cases). Intraductal confocal microscopy (IDCM) was performed during the ERCP using a probe-based confocal laser endomicroscopy (pCLE) technique. IDCM was done with the CholangioFlex probe with Cellvizio (Mauna Kea Technologies, Paris, France). The depth of penetration of theCholangioFlex probe was 40-70 μm and magnification was 400×. Images were reviewed by an experienced pathologist in GI disease and compared to ERCP findings, CBD biopsies performed during ERCP or EUS, and in 15 patients to the resected specimen (Wipple resection). RESULTS No complications related to the CholangioFlex insertion occurred after the ERCP. Good images were obtained in 33 patients. Final histology diagnosis was a normal CBD in 7 cases, 23 malignant stenoses (4 ampullary carcinomas, 13 cholangiocarcinomas, and 6 pancreatic cancer), and 7 inflammatory stenoses (4 chronic pancreatitis, 1 stenosis of hepaticojejunal anastomosis, 1 postcholecystectomy CBD stenosis, and 1 primary sclerosing cholangitis). IDCM of a normal CBD showed a thin black band (<20 μm), normal vessels (thin and regular), and no visible glands. IDCM of malignant strictures revealed irregular vessels with lack of contrast in the CBD wall, large black band (>20 μm), and an aggregate of irregular black cells (black clumps). These aspects were seen in all malignant stenoses and none were seen in benign or normal CBD. The presence of irregular vessels, large black bands, and black clumps seen with confocal laser microscopy enabled prediction of neoplasia with an accuracy rate of 86%, sensitivity of 83%, and specificity of 75%. The respective numbers for standard histopathology were 53, 65, and 53%. CONCLUSION This phase I-II study on IDCM showed that IDCM is feasible. This new technique will open a new door for optical biopsy of the CBD.
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Affiliation(s)
- M Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite, 13273, Marseilles cedex 9, France.
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Giovannini M, Bories E, Monges G, Pesenti C, Caillol F, Delpero JR. Results of a phase I-II study on intraductal confocal microscopy (IDCM) in patients with common bile duct (CBD) stenosis. Surg Endosc 2011. [PMID: 21424206 DOI: 10.1007/s00464-010-1542-8d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Confocal endomicroscopy is an emergent technique and allows real optical biopsies in the gastrointestinal (GI) tract. The aim of this study was to evaluate a new intraductal confocal miniprobe in patients with a normal common bile duct (CBD) or with a suspicion of a malignant stenosis (cholangiocarcinoma). METHODS Thirty-seven patients (23 males) underwent endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stone removal (7 cases) or bile duct stenosis (30 cases). Intraductal confocal microscopy (IDCM) was performed during the ERCP using a probe-based confocal laser endomicroscopy (pCLE) technique. IDCM was done with the CholangioFlex probe with Cellvizio (Mauna Kea Technologies, Paris, France). The depth of penetration of theCholangioFlex probe was 40-70 μm and magnification was 400×. Images were reviewed by an experienced pathologist in GI disease and compared to ERCP findings, CBD biopsies performed during ERCP or EUS, and in 15 patients to the resected specimen (Wipple resection). RESULTS No complications related to the CholangioFlex insertion occurred after the ERCP. Good images were obtained in 33 patients. Final histology diagnosis was a normal CBD in 7 cases, 23 malignant stenoses (4 ampullary carcinomas, 13 cholangiocarcinomas, and 6 pancreatic cancer), and 7 inflammatory stenoses (4 chronic pancreatitis, 1 stenosis of hepaticojejunal anastomosis, 1 postcholecystectomy CBD stenosis, and 1 primary sclerosing cholangitis). IDCM of a normal CBD showed a thin black band (<20 μm), normal vessels (thin and regular), and no visible glands. IDCM of malignant strictures revealed irregular vessels with lack of contrast in the CBD wall, large black band (>20 μm), and an aggregate of irregular black cells (black clumps). These aspects were seen in all malignant stenoses and none were seen in benign or normal CBD. The presence of irregular vessels, large black bands, and black clumps seen with confocal laser microscopy enabled prediction of neoplasia with an accuracy rate of 86%, sensitivity of 83%, and specificity of 75%. The respective numbers for standard histopathology were 53, 65, and 53%. CONCLUSION This phase I-II study on IDCM showed that IDCM is feasible. This new technique will open a new door for optical biopsy of the CBD.
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Affiliation(s)
- M Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite, 13273, Marseilles cedex 9, France.
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Moureau-Zabotto L, Viret F, Giovaninni M, Lelong B, Bories E, Delpero J, Pesenti C, Caillol F, de Chaisemartin C, Minsat M, Monges G, Sarran A, Resbeut M. Is neoadjuvant chemotherapy prior to radio-chemotherapy beneficial in T4 anal carcinoma? J Surg Oncol 2011; 104:66-71. [DOI: 10.1002/jso.21866] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 12/21/2010] [Indexed: 01/09/2023]
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Abstract
BACKGROUND AND STUDY AIMS Endoscopic retrograde cholangiopancreatography (ERCP) access to the biliary tract is sometimes impossible and percutaneous access has the disadvantages of increased morbidity and patient discomfort. We present our first results with an alternative technique: endoscopic ultrasonography (EUS)-guided transgastric biliary drainage. PATIENTS AND METHODS 11 patients (7 men, mean age 64 years) were referred for failed ERCP and biliary obstruction (malignancy n = 8, benign conditions n = 3). The retrograde approach via the papilla had been impossible due to surgical anatomy, duodenal stenosis, and hilar stricture with occlusion of the left side. EUS-guided drainage was done with endoscopic and fluoroscopic monitoring. After puncture of the left biliary duct a guide wire was inserted into it followed by tract dilation using a cystostome. A plastic or a metallic stent was placed through this gastrobiliary fistula for bile drainage. RESULTS EUS-guided left hepaticogastrostomy was successfully performed in 10/11 cases, with one failure of guide wire insertion after puncture. Plastic and covered metal stents were inserted in seven and three patients, respectively. Complications in the plastic stent group included one early occlusion requiring stent replacement, and one transient ileus. In the metallic stent group there was one bilioma and one cholangitis, due to stent shortening. Clinically, the stent was efficacious in all 10 cases; during a mean follow-up of 213 days (range 3-610), two patients presented with stent occlusion and one with stent migration, with successful endoscopic treatment in all. CONCLUSIONS EUS-guided hepaticogastrostomy is an efficient technique and could be a future alternative to percutaneous biliary drainage or palliative surgical drainage.
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Affiliation(s)
- E Bories
- Endoscopic Unit, Paoli-Calmettes Institute, Marseille, France.
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Lopes CV, Hela M, Pesenti C, Bories E, Caillol F, Monges G, Giovannini M. Circumferential endoscopic resection of Barrett's esophagus with high-grade dysplasia or early adenocarcinoma. Surg Endosc 2007; 21:820-4. [PMID: 17294308 DOI: 10.1007/s00464-006-9187-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [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: 09/19/2006] [Accepted: 11/24/2006] [Indexed: 12/28/2022]
Abstract
BACKGROUND Barrett's esophagus-related high-grade dysplasia or mucosal cancer can be treated by endoscopic mucosal resection (EMR), but the adjacent metaplastic epithelium remains at risk for developing further lesions. Our objective was to evaluate the results of the circumferential EMR in removing not only the neoplastic lesion but also the remaining Barrett's epithelium. METHODS Forty-one consecutive patients (mean age: 66 years) with Barrett's esophagus were submitted to 63 EMR sessions in one single-referral endoscopic unit. All patients had high-grade dysplasia, and cancer was detected in 23 of these cases, most of them classified as T1N0 (20 patients) by endosonography. Mucosectomy after saline submucosal injection was performed for the neoplastic lesions and, if necessary, the residual Barrett's epithelium was removed by the same technique one month later. RESULTS A retrospective evaluation showed that, during a mean follow-up of 31.6 months, Barrett's epithelium was completely replaced by squamous epithelium in 31 (75.6%) cases. There were 10 complications, all of which were managed endoscopically: 8 cases of bleeding and two perforations occurred in 9 (14.3%) patients. One patient developed an esophageal stricture. Barrett's epithelium recurred in 10 (24.4%) patients and recurrent or metachronous early cancer was detected in 5 (12.2%), all but one of which were treated again by EMR; the fifth patient was referred to surgery. Argon plasma coagulation was used in 6 cases to treat Barrett's epithelium, and two patients received concomitant chemoradiotherapy as adjuvant therapy. CONCLUSIONS Circumferential EMR provides an effective endoscopic approach to the management of Barrett's esophagus-related high-grade dysplasia and mucosal cancer. Additional studies are necessary to evaluate the long-term results.
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Affiliation(s)
- C V Lopes
- Endoscopy Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite, 13273, Marseille, Cedex 9, France
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Lorenzi B, Pesenti C, Bories E, Caillol F, Economou M, Giovannini M. Small-bowel obstruction due to a migrated cystogastric endoprosthesis: report of a case. Endoscopy 2007; 39 Suppl 1:E307. [PMID: 17957629 DOI: 10.1055/s-2007-967016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- B Lorenzi
- Dept. of Endoscopy, Paoli-Calmettes Institute, Marseilles, France
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Giovannini M, Bories E, Pesenti C, Moutardier V, Lelong B, Delpéro JR. Three-dimensional endorectal ultrasound using a new freehand software program: results in 35 patients with rectal cancer. Endoscopy 2006; 38:339-43. [PMID: 16680631 DOI: 10.1055/s-2005-870412] [Citation(s) in RCA: 36] [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: 12/23/2022]
Abstract
BACKGROUND AND STUDY AIMS This paper describes experience in the staging of rectal cancer using a new software program for three-dimensional endoscopic ultrasonography (EUS) that works without electromagnetic sensors and can be used even with electronic radial or linear rectal probes. MATERIALS AND METHODS From May 2003 to March 2004, 35 three-dimensional endorectal ultrasound (ERUS) examinations were carried out using this program. The indication for ERUS was local staging of rectal cancer in all cases. The three-dimensional software imaging program forms part of a new ultrasound scanning system (Hitachi 6500 or 8000) and allows reconstruction of the two-dimensional EUS images in six different scans. RESULTS Thirty-five rectal cancers were assessed using two-dimensional and three-dimensional EUS. Using two-dimensional imaging, it was not possible to assess precisely the degree of involvement of the mesorectum (more or less than 50%). No differences were evident with three-dimensional EUS for superficial tumors (T1 and T2N0), but in six of 15 patients classified as having T3N0 lesions, three-dimensional EUS revealed malignant lymph nodes, a finding that was confirmed surgically in five of the six cases. Three-dimensional EUS also made it possible to assess the degree of infiltration of the mesorectum precisely in all cases, demonstrating complete invasion of the mesorectum in eight cases. These findings were confirmed in all cases by the surgical data. Two-dimensional EUS correctly assessed 25 of the 35 rectal tumors (71.4%) in relation to the T and N classifications, and three-dimensional EUS increased this figure to 31 correct evaluations out of 35 (88.6%). CONCLUSION Three-dimensional ERUS is easy to carry out using this new software program. There is no need for an external sensor mounted at the tip of the probe, and manipulation of the rectal probe is facilitated. Three-dimensional ERUS can be carried out using linear and radial electronic probes with the same ultrasound equipment. Three-dimensional ERUS allows more precise staging of lesions and better definition of the mesorectal margins, and this has a direct impact on therapeutic decision-making in patients with rectal cancer.
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Affiliation(s)
- M Giovannini
- Endoscopy Unit, Paoli-Calmettes Institute, Marseilles, France.
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Giovannini M, Hookey LC, Bories E, Pesenti C, Monges G, Delpero JR. Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients. Endoscopy 2006; 38:344-8. [PMID: 16680632 DOI: 10.1055/s-2006-925158] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.2] [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: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS It is well known that some diseases, such as cancer, lead to changes in the hardness of tissue. Sonoelastography, a technique that allows the elasticity of tissue to be assessed during ultrasound examination, provides the ultrasonographer with important additional information that can be used for diagnosis. The aim of this study was to evaluate the ability of endoscopic ultrasound elastography to differentiate between benign and malignant pancreatic masses and lymph nodes. PATIENTS AND METHODS During a 12-month period, 49 patients underwent endoscopic ultrasound (EUS) examinations with elastography, conducted by a single endoscopist. Twenty-four patients underwent evaluation of a pancreatic mass (mean diameter 24.7 +/- 11.1 mm) and 25 underwent evaluation of 31 lymph nodes. The mean diameter of the lymph nodes was 19.7 +/- 8.6 mm, and they were found in the cervical area (n = 3), mediastinum (n = 17), celiac arterial trunk region (n = 5), and aortocaval region (n = 6). RESULTS The sonoelastography images of pancreatic masses were interpreted as benign in four cases and malignant in 20. The sensitivity and specificity of sonoelastography in the diagnosis of malignant lesions were 100% and 67%, respectively. The sonoelastography images of the lymph nodes were interpreted as showing malignancy in 22 cases, benign conditions in seven, and indeterminate status in two. The sensitivity and specificity of sonoelastography for evaluating malignant lymph-node invasion were 100% and 50%, respectively. CONCLUSIONS EUS elastography is potentially capable of further defining the tissue characteristics of benign and malignant lesions but specifity has to be improved. It can be used to guide biopsy sampling for diagnosis.
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Affiliation(s)
- M Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France.
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Bories E, Pesenti C, Monges G, Lelong B, Moutardier V, Delpero JR, Giovannini M. Endoscopic mucosal resection for advanced sessile adenoma and early-stage colorectal carcinoma. Endoscopy 2006; 38:231-5. [PMID: 16528648 DOI: 10.1055/s-2005-921206] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [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: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS The aim of this study was to evaluate the efficacy and outcomes of treatment by endoscopic mucosal resection (EMR) of patients with high-grade dysplasia (HGD) or carcinoma. PATIENTS AND METHODS Between January 1995 and January 2002, 50 patients (35 men, 15 women) were treated by EMR for 52 sessile polyps. The median size of the polyps was 27.5 mm (range 10-60). The "lift and cut" EMR technique was used. If the lesion was poorly differentiated or infiltrated the muscularis mucosae to more than 1000 microm, the patient was referred for colectomy. In the other cases, follow-up was proposed. RESULTS Complications occurred in 9.6 % of cases and were always treated conservatively. The rate of endoscopically complete resection was judged to be 98.1 %. Argon plasma coagulation was applied to the margins of the lesion in 21.6 % of cases. Histological examination showed 38 HGDs and 14 carcinomas. Seven patients had a lesion reaching the deep or lateral margin; four were referred for surgery; two patients for whom surgery would have been high risk were followed up, and both developed local recurrence; and one patient was followed up, without recurrence, because infiltration was less than 1000 microm. A total of 43 patients were followed up after complete excision. Two patients died during follow-up; neither death could be reliably attributed to colorectal carcinoma. Seven patients were lost during the follow-up. For 34 patients, information from a mean follow-up of 17.3 months (6 - 57) was available and recurrence was observed in five cases (15 %). CONCLUSIONS EMR appears to be a safe and efficient treatment of HGD and early colorectal cancer. However, correct analysis of submucosal infiltration is essential to assess the completeness of the resection.
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Affiliation(s)
- E Bories
- Endoscopic Unit, Paoli-Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille Cedex 09, France.
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Giuly E, Pesenti C, Pernoud N, Bories E, Francon D. Embolie gazeuse : une complication rare de la cholangiopancréatographie rétrograde endoscopique. ACTA ACUST UNITED AC 2005; 24:1400-3. [PMID: 16226421 DOI: 10.1016/j.annfar.2005.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2005] [Accepted: 06/15/2005] [Indexed: 11/22/2022]
Abstract
We report the case of a 60-year-old-woman with a myeloma who was hospitalized with a cholestasis. An endoscopic retrograde cholangiopancreatography was scheduled under general anaesthesia with oral intubation. As the biliary prothesis was placed an air embolism happened. The symptomatic treatment allowed a complete recovery. This complication is rare. The pathophysiology is not well known, we discuss the possible mechanisms.
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Affiliation(s)
- E Giuly
- Département d'anesthésie-réanimation, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13273 Marseille cedex 9, France
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D'Journo XB, Moutardier V, Turrini O, Guiramand J, Lelong B, Pesenti C, Monges G, Giovannini M, Delpero JR. Gastric duplication in an adult mimicking mucinous cystadenoma of the pancreas. J Clin Pathol 2004; 57:1215-8. [PMID: 15509688 PMCID: PMC1770488 DOI: 10.1136/jcp.2004.019091] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [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: 12/23/2022]
Abstract
Gastric duplication cyst (GDC) in an adult can have several clinical presentations. A review of the literature showed previously reported cases of GDC presenting as pancreatic pseudocyst or with greatly raised concentrations of carbohydrate antigen 19-9 (CA 19-9). It is often difficult to discriminate GDC from pancreatic cystic tumour, in particular pancreatic mucinous cystadenoma, in which concentrations of carcinoembryonic antigen and CA 19-9 are classically raised. This report describes an adult case of GDC mimicking a mucinous cystadenoma of the pancreas. This is the first report of a simultaneous increase in carcinoembryonic antigen and CA 19-9 in GDC in the absence of malignancy. Although few cases of carcinoma arising from a GDC having been reported, the production of oncofetal antigens raises the problem of a precancerous condition in long standing intestinal duplications. In this situation surgical resection must be performed.
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Affiliation(s)
- X B D'Journo
- Department of Surgical Oncology, Institut Paoli-Calmettes, 232 Boulevard de Sainte Marguerite, 13009 Marseille, France.
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Giovannini M, Bories E, Pesenti C, Moutardier V, Monges G, Danisi C, Lelong B, Delpero JR. Circumferential endoscopic mucosal resection in Barrett's esophagus with high-grade intraepithelial neoplasia or mucosal cancer. Preliminary results in 21 patients. Endoscopy 2004; 36:782-7. [PMID: 15326573 DOI: 10.1055/s-2004-825813] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIMS Treatment by endoscopic mucosal resection (EMR) has been established for early lesions in Barrett's esophagus. However, the remaining Barrett's esophagus epithelium remains at risk of developing further lesions. The aim of this study was to evaluate the efficacy of circumferential endoscopic mucosectomy (circumferential EMR)s in removing not only the index lesion (high-grade intraepithelial neoplasia (HGIN) or mucosal cancer), but also the remaining Barrett's esophagus epithelium. PATIENTS AND METHODS A total of 21 patients were included in the study (11 men, 10 women), who had Barrett's esophagus and either HGIN (n = 12) or mucosal cancer (n = 9). Of the patients, 17/21 were at high surgical risk and five had refused surgery. On the basis of preprocedure endosonography their lesions were classified as T1N0 (n = 19) or T0N0 (n = 2). The lesions and the Barrett's esophagus epithelium were removed by polypectomy after submucosal injection of 10-15 ml of saline; a double-channel endoscope was used in 15/21 cases. Circumferential EMR was performed in two sessions, the lesion and the surrounding half of the circumferential Barrett's esophagus mucosa being removed in the first session. In order to prevent the formation of esophageal stenosis, the second half of the Barrett's esophagus mucosa was resected 1 month later. RESULTS Complications occurred in 4/21 patients (19 %), consisting of bleeding which was successfully managed by endoscopic hemostasis in all cases. No strictures were observed during follow-up (mean duration 18 months) and endoscopic resection was considered complete in 18/21 patients (86 %). For three patients, histological examination showed incomplete removal of tumor: one of these underwent surgery; two received chemoradiotherapy, and showed no evidence of residual tumor at 18 months' and 24 months' follow-up, respectively. Two patients in whom resection was initially classified as complete later presented with local recurrence and were treated again by EMR. Barrett's esophagus mucosa was completely replaced by squamous cell epithelium in 15/20 patients (75 %). CONCLUSIONS Circumferential EMR is a noninvasive treatment of Barrett's esophagus with HGIN or mucosal cancer, with a low complication rate and good short-term clinical efficacy. Further studies should focus on long-term results and on technical improvements.
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Affiliation(s)
- M Giovannini
- Endoscopic Unit, Institut Paoli-Calmettes, 232 Boulevard St-Marguerite, 13273 Marseilles Cedex 9, France
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Affiliation(s)
- C Pesenti
- Department of Endoscopy, Paoli Calmettes Institute, Marseille, France
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45
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Giovannini M, Dotti M, Bories E, Moutardier V, Pesenti C, Danisi C, Delpero JR. Hepaticogastrostomy by echo-endoscopy as a palliative treatment in a patient with metastatic biliary obstruction. Endoscopy 2003; 35:1076-8. [PMID: 14648424 DOI: 10.1055/s-2003-44596] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.9] [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: 02/07/2023]
Abstract
A palliative hepaticogastrostomy was performed under endoscopic ultrasound guidance in a patient with inoperable hepatic hilar obstruction, creating an anastomosis between the dilated left hepatic duct and the stomach, to relieve symptoms of cholangitis and to allow biliary drainage. This therapeutic procedure was used as an alternative method of drainage of the biliary tree because endoscopic retrograde cholangiopancreatography was not possible and because the percutaneous metallic stent which had been inserted earlier had become occluded (probably by tumor overgrowth). It was a two-step procedure. In the first step a hepatic duct was punctured through the gastric wall with placement of a plastic stent, which created a fistula between them. In a second step a covered, metallic, self-expandable stent was substituted for the plastic stent to maintain the anastomosis and to improve patency over the medium term. The patient's fever was relieved and the bilirubin level fell; the patient remained asymptomatic at the five-months-follow-up.
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Affiliation(s)
- M Giovannini
- Endoscopic Unit, Paoli-Calmettes Institute, Marseille, France.
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Abstract
BACKGROUND AND STUDY AIMS The purpose of this study was to evaluate the clinical efficacy of endosonographically guided transrectal aspiration and drainage by plastic stent of deep pelvic abscesses, using a therapeutic echo endoscope device. PATIENTS AND METHODS Between September 2000 and June 2001, 12 patients (nine men, three women, mean age 67 years) were treated for a perirectal or a pelvic abscess using an endoscopic ultrasound (EUS) technique. The drainage of these fluid collections was performed under EUS guidance, using therapeutic EUS scopes with a large working channel. RESULTS No major complication occurred during this study. Transrectal stent insertion succeeded in nine patients. In three patients, only aspiration was possible. Among the nine patients in whom a stent was successfully introduced into the fluid collection, complete drainage without relapse was achieved in eight patients (mean follow-up 10.6 months, range 6-14 months). The stent was removed endoscopically after 3 to 6 months. Drainage was incomplete in one patient (with a large abscess, diameter > 8 cm), who subsequently underwent surgical drainage. However, two out of the three patients in whom aspiration alone was performed developed a recurrence of the abscess and required surgical treatment. CONCLUSION EUS-guided drainage of deep pelvic abscesses could offer an alternative treatment to surgery in the management of these postoperative complications.
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Affiliation(s)
- M Giovannini
- Oncology Unit 1 and Endoscopic Department, Paoli-Calmettes Institute, 232 Boulevard Sainte-Marguerite BP 156, 13273 Marseille Cedex 9, France.
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Dubois E, Pesenti C, Mauget-Faÿsse M. [Value and practice of in-home "low-vision" rehabilitation in Rhone-Alp region of France]. J Fr Ophtalmol 2002; 25:1057-60. [PMID: 12527831] [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: 02/28/2023]
Abstract
INTRODUCTION To demonstrate the interest of patient's home orthoptist deplacement to realize an in-home low-vision rehabilitation and encourage orthoptists to integrate this task in their usual work methods. PATIENTS AND METHODS Eighty-five consecutive patients coming from a private ophthalmic rehabilitation Center and needing low-vision rehabilitation, were studied. The exercises used at patient's home were usually the same as those used in the rehabilitation Center. The choice in the organization of rehabilitation was always function of patient general health, people vicinity, and social context. RESULTS Among the 85 patients, 60 (70.6%) were rehabilitated only in the ophthalmic Center, 11 (12.9%) could have a low-vision rehabilitation only thanks to the organization of the home's patient rehabilitation and 14 (16.5%) were both rehabilitated at the ophthalmic Center and, in the patient's home, some training was necessary too. The reasons for in-home low-vision rehabilitation were mainly represented by isolation problems, mobilisation physical capacities, but also, home installation conditions making difficult to realize the orthoptist recommendations. DISCUSSION Besides some disadvantages: time-consuming, badly paid, decrease of efficiency in familiar environment, advantages are easily objected: ergonomy, training on optic systems, and psychological comfort. CONCLUSION In-home low-vision rehabilitation is represented by the necessity of correctly taking care of each patient. It is an answer to a social demand and must be an integral part of low-vision orthoptist work.
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Affiliation(s)
- E Dubois
- Centre Ophtalmologique Rabelais, 12-14, rue Rabelais, 69003 Lyon, France
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Ambrosi P, Arnone A, Bravo P, Bruché L, De Cristofaro A, Francardi V, Frigerio M, Gatti E, Germinara GS, Panzeri W, Pennacchio F, Pesenti C, Rotundo G, Roversi PF, Salvadori C, Viani F, Zanda M. Stereoselective synthesis of trifluoro- and monofluoro-analogues of frontalin and evaluation of their biological activity. J Org Chem 2001; 66:8336-43. [PMID: 11735511 DOI: 10.1021/jo0055640] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/30/2022]
Abstract
The stereoselective synthesis of both enantiomers of trifluoro frontalin (-)-(1S,5R)- and (+)-(1R,5S)-8, as well as of diastereomeric monofluoro frontalines (-)-(1R,2R,5R)-18 and (-)-(1R,2S,5R)-20, analogues of the bioactive component of the aggregation pheromone of the Scolytidae insect family, has been accomplished starting from (-)-(1R)- and (+)-(1S)-menthyl (S)-toluene-4-sulfinate as a source of chirality and methyl trifluoroacetate or fluoroacetate, respectively, as sources of fluorine. The C-1 stereocenters were installed via stereoselective epoxidation of beta-sulfinyl ketones 2 and 13 with diazomethane. The bicyclic core was obtained by totally stereocontrolled and chemoselective tandem Wacker oxidation/intramolecular ketalization of the intermediate unsatured sulfinyl diols 5, 15, and 19. Axially fluorinated (-)-20 elicited a strong electroantennographic response in laboratory tests on females of Dendroctonus micans, whereas equatorially fluorinated (-)-18 and the trifluoroanalogue (-)-8 showed modest responses. Field trials using (-)-20 were not indicative owing to the locally scarce population of D. micans, but it showed some attractiveness for other Coleoptera families.
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Affiliation(s)
- P Ambrosi
- CNR, Centro di Studio sulle Sostanze Organiche Naturali, via Mancinelli 7, I-20131 Milano, Italy
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Giovannini M, Moutardier V, Pesenti C, Bories E, Lelong B, Delpero JR. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy 2001; 33:898-900. [PMID: 11571690 DOI: 10.1055/s-2001-17324] [Citation(s) in RCA: 441] [Impact Index Per Article: 19.2] [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: 12/12/2022]
Abstract
Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound (EUS) and EUS-guided puncture of the common bile duct (CBD). A 56-year-old man with obstructive jaundice was referred for EUS and endoscopic retrograde cholangiopancreatography (ERCP) because a computed tomography (CT) scan had shown a pancreatic mass in the head of the pancreas and a dilated CBD. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic EUS scope (FG 38X Pentax), the CBD was punctured with a 5-F needle-knife under EUS guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the CBD. The EUS scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The CBD was drained properly. No complication occurred.
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Affiliation(s)
- M Giovannini
- Endoscopy Unit, Paoli-Calmettes Institute, Marseilles, France.
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Pesenti C, Bravo P, Corradi E, Frigerio M, Meille SV, Panzeri W, Viani F, Zanda M. Synthesis of (+)- and (-)-statine via chiral sulfoxide chemistry. J Org Chem 2001; 66:5637-40. [PMID: 11485499 DOI: 10.1021/jo010383z] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Pesenti
- Dipartimento di Chimica del Politecnico di Milano, via Mancinelli 7, I-20131 Milano, Italy
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