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Gabanella F, Maftei D, Colizza A, Rullo E, Riminucci M, Pasqualucci E, Di Certo MG, Lattanzi R, Possenti R, Corsi A, Greco A, De Vincentiis M, Severini C, Ralli M. Reduced expression of secretogranin VGF in laryngeal squamous cell carcinoma. Oncol Lett 2024; 27:37. [PMID: 38108073 PMCID: PMC10722547 DOI: 10.3892/ol.2023.14170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/07/2023] [Indexed: 12/19/2023] Open
Abstract
Laryngeal cancer accounts for one-third of all head and neck tumors, with squamous cell carcinoma (SCC) being the most predominant type, followed by neuroendocrine tumors. Chromogranins, are commonly used as biomarkers for neuroendocrine tumors, including laryngeal cancer. It has been reported that secretogranin VGF, a member of the chromogranin family, can be also used as a significant biomarker for neuroendocrine tumors. However, the expression and role of VGF in laryngeal carcinomas have not been previously investigated. Therefore, the present study aimed to determine the expression levels of VGF in laryngeal SCC (LSCC). The present study collected tumor tissues, as well as serum samples, from a cohort of 15 patients with LSCC. The results of reverse transcription-quantitative PCR, western blot analysis and immunofluorescence assays showed that the selective VGF precursor was downregulated in patients with LSCC. Notably, in tumor tissue, the immunoreactivity for VGF was found in vimentin-positive cells, probably corresponding to T lymphocytes. The current preliminary study suggested that the reduced expression levels of VGF observed in tumor tissue and at the systemic level could sustain LSCC phenotype. Overall, VGF could be a potential biomarker for detecting neoplastic lesions with a higher risk of tumor invasiveness, even in non-neuroendocrine tumors.
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Affiliation(s)
- Francesca Gabanella
- CNR-Institute of Biochemistry and Cell Biology, Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Daniela Maftei
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, I-00185 Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Emma Rullo
- Department of Molecular Medicine, Sapienza University of Rome, I-00161 Rome, Italy
| | - Mara Riminucci
- Department of Molecular Medicine, Sapienza University of Rome, I-00161 Rome, Italy
| | - Elena Pasqualucci
- Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Maria Grazia Di Certo
- CNR-Institute of Biochemistry and Cell Biology, Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Roberta Lattanzi
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, I-00185 Rome, Italy
| | - Roberta Possenti
- Department of Systems Medicine, University of Rome Tor Vergata, I-00173 Rome, Italy
| | - Alessandro Corsi
- Department of Molecular Medicine, Sapienza University of Rome, I-00161 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Marco De Vincentiis
- Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Cinzia Severini
- CNR-Institute of Biochemistry and Cell Biology, Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, I-00161 Rome, Italy
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Mazzarella G, Picardi B, Rossi S, Del Monte SR, Muttillo EM, Rullo E, Gomes V, Muttillo IA. Solid-pseudopapillary tumor of the pancreas. An extrapancreatic loco-regional site and a review of the literature. Ann Ital Chir 2022; 11:S2239253X22037343. [PMID: 36412249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Solid pseudopapillary tumors (SPT) of the pancreas are rare, low malignancy and predominantly affect young women, but it may be locally aggressive. Pancreatic resection is the main treatment for SPTs. However, low malignancy SPT may give insidious extrapancreatic invasions. CASE REPORT A 20-year-old woman was admitted with non-specific abdominal pain and diarrhea. A 9-cm SPT of the pancreas was discovered with extra-pancreatic invasion of the left adrenal gland and the spleen, in close contact with the body-tail of the pancreas, proximal portion of the jejunum, splenic flexure of the colon and the gastric fundus, with no signs of infiltration. For the young patient, a pancreas-preserving tumor excision was performed, with en-bloc resection of the spleen and adrenal gland, lymphadenectomy of the splenic vessels (13 lymph-nodes) and pre-pancreatic lymph node dissection, with no need for distal pancreatectomy. The duration of the surgery was 145 min, with no transfusion. The woman's postoperative course was complicated by a splenic lodge abscess treated via CT-guided percutaneous drainage, and a left pleural effusion treated medically, with a hospital stay of 16 days. Histology confirmed the diagnosis of a 9- cm low-grade SPT of the pancreas. In a close follow-up, the patient was asymptomatic 21 months later, with no tumor recurrence and good health. CONCLUSIONS Low-grade SPT of the pancreas with extra-pancreatic invasion of loco-regional organs can be treated by a pancreas-preserving approach to avoid a pancreatectomy. Moreover, still few cases of extra-pancreatic SPT are reported in the literature and there is an urgent need for more relevant evidence. KEY WORDS Extrapancreatic, Frantz's tumor, Pancreas preserving, Pancreas, Pancreatic neoplasm, Solid pseudopapillary tumor, Solid pancreatic tumor.
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Rullo E, Pecorella I, Pernazza A, Carletti R, Tornese A, Larghi Laureiro Z. Ciliated Cells in Renal Calyx mucosa: Metaplastic Change or Developmental Abnormality? Immunohistochemical Study of one Case and Review of the Literature. Int J Surg Pathol 2022:10668969221117988. [PMID: 35946108 DOI: 10.1177/10668969221117988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ciliated epithelial cells have been rarely observed in urothelium lined mucosa. Only extremely rare reports in the literature have described this phenomenon and no cases have been described in other sites than the male urethra. Herein, we illustrate the finding of ciliated pseudostratified columnar cells in the renal calyx mucosa adjacent to an area of urothelial invasive carcinoma in an 82 year-old man with previous history of nephrolithiasis. The ciliated cells covered a linear extension of 0.5 cm: they were positive for keratin 7 and keratin 8/18 and negative for keratin 20. Alcian blue staining was positive in some vacuoles in the apical cytoplasm of the same cells whereas PAS (Periodic Acid-Schiff) staining was negative. GATA3 resulted negative in ciliated cells except for a layer in the basal portion of the epithelium, just above the basal membrane. The actual prevalence of ciliated epithelia in the urinary tract is not well documented and the current knowledge on the subject is limited to electron scanning microscopy studies. The significance of this phenomenon remains unknown: it could be either a developmental abnormality or more probably a metaplastic change. Associated urolithiasis, which has been described in both a previous report and in the present one, could hypothetically represent a possible trigger for this unusual cell change. However, this hypothesis needs to be confirmed through further investigation.
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Affiliation(s)
- Emma Rullo
- Department of Radiological, Oncological and Pathological Sciences, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Irene Pecorella
- Department of Radiological, Oncological and Pathological Sciences, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Angelina Pernazza
- Department of Radiological, Oncological and Pathological Sciences, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Raffaella Carletti
- Department of Radiological, Oncological and Pathological Sciences, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Andrea Tornese
- Department of Radiological, Oncological and Pathological Sciences, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Zoe Larghi Laureiro
- Department of General Surgery and Organs Transplantation, 9311Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Triaca V, Fico E, Rosso P, Ralli M, Corsi A, Severini C, Crevenna A, Agostinelli E, Rullo E, Riminucci M, Colizza A, Polimeni A, Greco A, Tirassa P. Pilot Investigation on p75ICD Expression in Laryngeal Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14112622. [PMID: 35681602 PMCID: PMC9179539 DOI: 10.3390/cancers14112622] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
We investigated the p75 Neurotrophin Receptor (p75NTR) expression and cleavage product p75NTR Intracellular Domain (p75ICD) as potential oncogenic and metastatic markers in human Laryngeal Squamous Cell Carcinoma (LSCC). p75NTR is highly expressed in Cancer Stem Cells (CSCs) of the laryngeal epithelia and it has been proposed as a marker for stemness, cell migration, and chemo-resistance in different squamous carcinomas. To investigate the clinical significance of p75NTR cleavage products in solid tumors, full-length and cleaved p75NTR expression was analyzed in laryngeal primary tumors from different-stage LSCC patients, diagnosed at the Policlinico Umberto I Hospital. Molecular and histological techniques were used to detect the expressions of p75NTR and p75ICD, and ATP Binding Cassette Subfamily G Member 2 (ABCG2), a CSC marker. We found regulated p75NTR cleavage during squamous epithelial tumor progression and tissue invasion. Our preliminary investigation suggests p75ICD expression and localization as possible features of tumorigenesis and metastaticity. Its co-localization with ABCG2 in squamous cells in the parenchyma invaded by the tumor formation allows us to hypothesize p75NTR and p75ICD roles in tumor invasion and CSC spreading in LSCC patients. These data might represent a starting point for a comprehensive analysis of p75NTR cleavage and of its clinical relevance as a potential molecular LSCC signature, possibly helping diagnosis, and improving prognosis and personalized therapy.
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Affiliation(s)
- Viviana Triaca
- Institute of Biochemistry and Cell Biology, National Research Council (CNR), International Campus A. Buzzati-Traverso, Monterotondo Scalo, 00015 Rome, Italy
- Correspondence: (V.T.); (P.T.)
| | - Elena Fico
- Department of Sense Organs, Institute of Biochemistry and Cell Biology, National Research Council (CNR), University of Rome La Sapienza, 00185 Rome, Italy; (E.F.); (P.R.); (C.S.)
| | - Pamela Rosso
- Department of Sense Organs, Institute of Biochemistry and Cell Biology, National Research Council (CNR), University of Rome La Sapienza, 00185 Rome, Italy; (E.F.); (P.R.); (C.S.)
| | - Massimo Ralli
- Department of Sense Organs, University of Rome La Sapienza, 00185 Rome, Italy; (M.R.); (E.A.); (A.C.); (A.G.)
| | - Alessandro Corsi
- Department of Molecular Medicine, University of Rome La Sapienza, 00185 Rome, Italy; (A.C.); (E.R.); (M.R.)
| | - Cinzia Severini
- Department of Sense Organs, Institute of Biochemistry and Cell Biology, National Research Council (CNR), University of Rome La Sapienza, 00185 Rome, Italy; (E.F.); (P.R.); (C.S.)
| | - Alvaro Crevenna
- Epigenetics and Neurobiology Unit, EMBL Rome, International Campus A. Buzzati-Traverso, Monterotondo Scalo, 00015 Rome, Italy;
| | - Enzo Agostinelli
- Department of Sense Organs, University of Rome La Sapienza, 00185 Rome, Italy; (M.R.); (E.A.); (A.C.); (A.G.)
| | - Emma Rullo
- Department of Molecular Medicine, University of Rome La Sapienza, 00185 Rome, Italy; (A.C.); (E.R.); (M.R.)
| | - Mara Riminucci
- Department of Molecular Medicine, University of Rome La Sapienza, 00185 Rome, Italy; (A.C.); (E.R.); (M.R.)
| | - Andrea Colizza
- Department of Sense Organs, University of Rome La Sapienza, 00185 Rome, Italy; (M.R.); (E.A.); (A.C.); (A.G.)
| | - Antonella Polimeni
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00185 Rome, Italy;
| | - Antonio Greco
- Department of Sense Organs, University of Rome La Sapienza, 00185 Rome, Italy; (M.R.); (E.A.); (A.C.); (A.G.)
| | - Paola Tirassa
- Department of Sense Organs, Institute of Biochemistry and Cell Biology, National Research Council (CNR), University of Rome La Sapienza, 00185 Rome, Italy; (E.F.); (P.R.); (C.S.)
- Correspondence: (V.T.); (P.T.)
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5
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Zizzari IG, Di Filippo A, Botticelli A, Strigari L, Pernazza A, Rullo E, Pignataro MG, Ugolini A, Scirocchi F, Di Pietro FR, Rossi E, Gelibter A, Schinzari G, D'Amati G, Rughetti A, Marchetti P, Nuti M, Napoletano C. Circulating CD137+ T Cells Correlate with Improved Response to Anti-PD1 Immunotherapy in Patients with Cancer. Clin Cancer Res 2022; 28:1027-1037. [PMID: 34980602 PMCID: PMC9377756 DOI: 10.1158/1078-0432.ccr-21-2918] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/09/2021] [Accepted: 12/28/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE CD137 molecule is expressed by activated lymphocytes, and in patients with cancer identifies the tumor-reactive T cells. In solid tumors, high levels of circulating CD137+ T cells are associated with the clinical response and the disease-free status. Here, we examined the role of the CD137+ T cells in the improvement of patients' selection for immunotherapy treatment. EXPERIMENTAL DESIGN Peripheral blood mononuclear cells derived from 109 patients with metastatic cancer (66 patients for the identification cohort and 43 for the validation cohort) were analyzed for the expression of CD3, CD4, CD8, CD137, and PD1 molecules before the beginning of anti-PD1 therapy. Twenty healthy donors were used as control. The soluble form of CD137 (sCD137) was also analyzed. The CD137+ T cell subsets and the sCD137 were correlated with the clinicopathologic characteristics. The distribution of CD137+ T cells was also examined in different tumor settings. RESULTS The percentage of CD137+ T cells was higher in healthy donors and in those patients with a better clinical status (performance status = 0-1, n°metastasis≤2) and these high levels were ascribed to the CD8+CD137+ T cell population. The high frequency of CD137+ and CD8+CD137+ T cells resulted as a prognostic factor of overall survival (OS) and progression-free survival (PFS), respectively, and were confirmed in the validation cohort. High levels of CD3+CD137+PD1+ lymphocytes were associated with a low number of metastasis and longer survival. Instead, the high concentration of the immunosuppressive sCD137 in the serum is associated with a lower PFS and OS. In tumor bed, patients with a complete response showed a high percentage of CD137+ and CD8+ T cells. CONCLUSIONS We propose the CD137+ T subset as an immune biomarker to define the wellness status of the immune system for successful anticancer immunotherapy.
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Affiliation(s)
- Ilaria Grazia Zizzari
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Alessandra Di Filippo
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Botticelli
- Division of Oncology, Department of Radiological, Oncological and Pathological Science, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | - Lidia Strigari
- Medical Physics Unit, “S. Orsola-Malpighi” Hospital, Bologna, Italy
| | - Angelina Pernazza
- Department of Radiology, Oncology and Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Emma Rullo
- Department of Radiology, Oncology and Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Radiology, Oncology and Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Alessio Ugolini
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy.,Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Fabio Scirocchi
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Francesca Romana Di Pietro
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Ernesto Rossi
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alain Gelibter
- Division of Oncology, Department of Radiological, Oncological and Pathological Science, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | - Giovanni Schinzari
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Medical Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia D'Amati
- Department of Radiology, Oncology and Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Aurelia Rughetti
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Marchetti
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,AOU Policlinico Umberto I, Rome, Italy
| | - Marianna Nuti
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Napoletano
- Laboratory of Tumor Immunology and Cell Therapies, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy.,Corresponding Author: Chiara Napoletano, Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, Rome 00161, Italy. Phone: 3906-4997-3025; E-mail:
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6
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Pernazza A, Mancini M, Rullo E, Bassi M, De Giacomo T, Rocca CD, d'Amati G. Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen. Virchows Arch 2020; 477:743-748. [PMID: 32356025 PMCID: PMC7192563 DOI: 10.1007/s00428-020-02829-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [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: 04/02/2020] [Revised: 04/11/2020] [Accepted: 04/26/2020] [Indexed: 02/07/2023]
Abstract
Despite the current pandemic season, reports on pathologic features of coronavirus disease 19 (Covid-19) are exceedingly rare at the present time. Here we describe the pathologic features of early lung involvement by Covid-19 in a surgical sample resected for carcinoma from a patient who developed SARS-CoV-2 infection soon after surgery. The main histologic findings observed were pneumocyte damage, alveolar hemorrhages with clustering of macrophages, prominent and diffuse neutrophilic margination within septal vessels, and interstitial inflammatory infiltrates, mainly represented by CD8+ T lymphocytes. These features are similar to those previously described in SARS-CoV-1 infection. Subtle histologic changes suggestive pulmonary involvement by Covid-19 may be accidentally encountered in routine pathology practice, especially when extensive sampling is performed for histology. These findings should be carefully interpreted in light of the clinical context of the patient and could prompt a pharyngeal swab PCR test to rule out the possibility of SARS-CoV-2 infection in asymptomatic patients.
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Affiliation(s)
- Angelina Pernazza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, 04100, Latina, Italy
| | - Massimiliano Mancini
- Division of Morphologic and Molecular S. Andrea Hospital, Sapienza, University of Rome, 00189, Rome, Italy
| | - Emma Rullo
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Massimiliano Bassi
- Department of General and Specialistic Surgery "P. Stefanini", Sapienza, University of Rome, 00161, Rome, Italy
| | - Tiziano De Giacomo
- Department of General and Specialistic Surgery "P. Stefanini", Sapienza, University of Rome, 00161, Rome, Italy
| | - Carlo Della Rocca
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, 04100, Latina, Italy
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy.
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7
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Cozzolino A, Pozza C, Pofi R, Sbardella E, Faggiano A, Isidori AM, Giannetta E, Pernazza A, Rullo E, Ascoli V, Lenzi A, Gianfrilli D. Predictors of malignancy in high-risk indeterminate (TIR3B) cytopathology thyroid nodules. J Endocrinol Invest 2020; 43:1115-1123. [PMID: 32100197 DOI: 10.1007/s40618-020-01200-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/22/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The classification of indeterminate cytopathology at thyroid fine-needle-aspiration (FNA) has been updated to reduce the number of unnecessary surgery; the 2014 Italian classification introduced the low-risk (TIR3A) and high-risk (TIR3B) subcategories. Aim of this study was to identify the ultrasonographic (US), clinical and cytological predictors of malignancy among TIR3B nodules from a single institution. METHODS A prospective observational study including 1844 patients who underwent thyroid FNA from June 2014 to January 2019. Ultrasonographic, clinical and cytological features were recorded. All TIR3B diagnoses were referred to surgery. According to final histology, patients were divided into thyroid cancer (TC) or benign nodules. Chi-square test, or Fisher exact test when appropriate, were used to compare groups and logistic regression analyses were used to determine independent predictors of malignancy. RESULTS Of 1844 FNAs, 96 (5.2%) were TIR3B. Histology report was available in 65. Among them, 25 (38.5%) were TC. Predictors of TC were nodule size < 20 mm [Odds Ratio (OR) = 5.88, 95% CI 1.91-18.11, p = 0.002], absence or weak intralesional flow [OR = 0.3, 95% CI 0.09-0.77, p = 0.015], microcalcifications [OR = 6.5, 95% CI 1.90-21.93, p = 0.003] at US; nuclear inclusions [OR = 25.3, 95% CI 1.34-476.07, p = 0.031] and chromatin clearing [OR = 3.7, 95% CI 1.27-10.99, p = 0.017] at cytopathology. Patients aged < 55 years had a significantly higher risk of TC [OR = 9.7, 95% CI 2.79-34.07, p < 0.001]. In multivariate analysis, age < 55 and nodule size < 20 mm resulted as independent risk factors. CONCLUSIONS Patients < 55 years receiving a diagnosis TIR3B on nodules < 20 mm, with microcalcifications, showing specific nuclear atypia at cytopathology are more likely to have TC. Combining US, cytological and clinical features could help determining which patients with a TIR3B diagnosis should be referred to surgery.
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Affiliation(s)
- A Cozzolino
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - C Pozza
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - R Pofi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - E Sbardella
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - A Faggiano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - E Giannetta
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - A Pernazza
- Department of Radiology, Oncology and Pathological Science, "Sapienza" University of Rome, Rome, Italy
| | - E Rullo
- Department of Radiology, Oncology and Pathological Science, "Sapienza" University of Rome, Rome, Italy
| | - V Ascoli
- Department of Radiology, Oncology and Pathological Science, "Sapienza" University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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8
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Proietti I, Di Fraia M, Michelini S, Colapietra D, Rullo E, Porta N, Petrozza V, Skroza N, Potenza C. Black and Pink: Single Lesion or Double Diagnosis? Dermatol Pract Concept 2019; 10:e2020025. [PMID: 31921512 DOI: 10.5826/dpc.1001a25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 10/31/2022] Open
Affiliation(s)
- Ilaria Proietti
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - Marco Di Fraia
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - Simone Michelini
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - Daniela Colapietra
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - Emma Rullo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Natale Porta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Vincenzo Petrozza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina, Italy
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Rullo E, Minelli G, Bosco D, Nardi F, Grani G, Durante C, Ascoli V. Indeterminate thyroid nodules (TIR3A/TIR3B) according to the new Italian reporting system for thyroid cytology: A cytomorphological study. Cytopathology 2019; 30:475-484. [PMID: 31112332 DOI: 10.1111/cyt.12732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/16/2019] [Accepted: 05/08/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The Italian reporting system for thyroid cytology classifies indeterminate lesions as TIR3A (low risk) or TIR3B (high risk) and is meant to provide practical guidance rather than a detailed consideration of morphological features. We aimed to assess which cytological features have the most diagnostic value and whether they are effective in classifying nodules as either TIR3A or TIR3B and in predicting histological outcomes. METHODS Thyroid fine-needle aspirates from 111 indeterminate nodules were reviewed blinded to clinical information, TIR3A/TIR3B classification, and histology in order to assess which cytological features (pooled into artefacts, smear background, architectural and nuclear atypia, and oncocytes) differentiate TIR3A from TIR3B, and benign from malignant histological outcomes. RESULTS Of the cytological features examined, those specific for TIR3B included high cellularity, nuclear atypia, oncocyte predominance and transgressing vessels. Features specific for TIR3A included artefacts, low cellularity and oncocyte sparseness. Other features, such as microfollicules/trabeculae, were non-specific. Due to the different distributions of these features, three TIR3B subgroups were identifiable: follicular lesions with oncocytic changes, pure follicular lesions, and follicular lesions with nuclear atypia, whereas no subgroups were identifiable in TIR3A. Nuclear atypia was a significant indicator of malignancy, whereas oncocyte predominance was not a reliable predictor of malignancy. High cellularity and microfollicules/trabeculae were not indicative of any histological outcome. CONCLUSIONS The majority of the assessed features were good predictors of histological outcomes. The TIR3A category included undefined nodules due to the absence of characterising features, whereas the TIR3B category included nodules with a greater number of distinguishing features.
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Affiliation(s)
- Emma Rullo
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giada Minelli
- Unit of Statistics, National Institute of Public Health (Istituto Superiore di Sanità), Rome, Italy
| | - Daniela Bosco
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Nardi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giorgio Grani
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Cosimo Durante
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
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Rullo E, Minelli G, Bosco D, Nardi F, Ascoli V. Evaluation of the Italian cytological subclassification of thyroid indeterminate nodules into TIR-3A and TIR-3B: a retrospective study of 290 cases with histological correlation from a single institution. J Endocrinol Invest 2018; 41:531-538. [PMID: 28948534 DOI: 10.1007/s40618-017-0763-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/13/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE The Italian consensus to classify thyroid cytology has provided a standardized reporting scheme, including the subdivision of indeterminate for malignancy TIR-3 category into TIR-3A (low-risk) and TIR-3B (high-risk). We aimed to present our experience on this subclassification by evaluating risks of malignancy and the validity in sorting nodules with dissimilar risks. Another aim was to compare our performance against the Bethesda system. METHODS Fine-needle aspirates of 290 TIR-3 that underwent thyroid surgery at our hospital (2008-2013) were reviewed and divided into TIR-3A or TIR-3B, and AUS/FLUS or FN/SFN. Cytological diagnoses were then correlated to histology. Results were evaluated using univariate analysis. RESULTS The subclassification into TIR-3A and TIR-3B differentiated hyperplastic nodules (p = 0.000) but not adenomas (p = 0.090). Rates of malignancy were significantly different between TIR-3A (10.2%) and TIR-3B (43.8%); TIR-3B malignancies were often papillary carcinomas (83%). TIR-3A/TIR-3B accounted for high sensitivity (84.5%; CI 79.7-88.4%), accuracy (64.1%; CI 58.6-69.6%) and NPV (89.8%; CI 85.6-93.0%) as opposed to modest specificity (55.8%; CI 49.9-61.6%) and PPV (43.8%; CI 38.1-49.8%). The rate of malignancy in AUS-FLUS was higher than in TIR-3A (p = 0.007), whereas it was not different between FN/SFN and TIR-3B (p = 0.337). Sensitivity of the Bethesda system was significantly lower respect to the Italian system. CONCLUSIONS The study supports the Italian consensus showing a different risk of malignancy for TIR-3A as compared to TIR-3B. TIR-3A/TIR-3B subclassification is valid to sort out benign nodules (high NPV) and malignancies (high sensitivity) but not adenomas (modest specificity, low PPV). In our experience, sensitivity is the main difference between Italian and Bethesda systems.
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Affiliation(s)
- E Rullo
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Università Sapienza, Viale Regina Elena, 324, 00161, Rome, Italy
| | - G Minelli
- Unità di Statistica, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - D Bosco
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Università Sapienza, Viale Regina Elena, 324, 00161, Rome, Italy
| | - F Nardi
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Università Sapienza, Viale Regina Elena, 324, 00161, Rome, Italy
| | - V Ascoli
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Università Sapienza, Viale Regina Elena, 324, 00161, Rome, Italy.
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Cozzi I, Oprescu FA, Rullo E, Ascoli V. Loss of BRCA1-associated protein 1 (BAP1) expression is useful in diagnostic cytopathology of malignant mesothelioma in effusions. Diagn Cytopathol 2017; 46:9-14. [DOI: 10.1002/dc.23837] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/20/2017] [Accepted: 09/27/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Ilaria Cozzi
- Department of Radiological, Oncological and Anatomo-Pathological Sciences; Sapienza University; Viale Regina, Rome 324-00161 Italy
| | - Florina Anca Oprescu
- Department of Radiological, Oncological and Anatomo-Pathological Sciences; Sapienza University; Viale Regina, Rome 324-00161 Italy
| | - Emma Rullo
- Department of Radiological, Oncological and Anatomo-Pathological Sciences; Sapienza University; Viale Regina, Rome 324-00161 Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences; Sapienza University; Viale Regina, Rome 324-00161 Italy
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