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Coughlin R, Della-Giustina D, Tsyrulnik A, Bod J, Brennan-Wydra E, Ray J, Duke J, Chandler I, Wong A, Goldflam K. 278 Identifying High Performer Residents in Emergency Medicine Training. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chiu K, Chambers J, Chandler I, Osborne M. P-250 Clinical Impact and Cost Implication of Routine MMR Protein Immunohistochemistry in High Risk Dukes B Colon Cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.247] [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: 11/13/2022] Open
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Tucker D, Sarsfield P, Chandler I, Kerr P. One cancer destroys another: short report of a myeloid sarcoma causing ischaemic necrosis of an adenocarcinoma. J Clin Pathol 2013; 67:70-1. [PMID: 23922355 DOI: 10.1136/jclinpath-2012-201185] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We present a highly unusual case and histological images of a patient who underwent complete resection of a perforated caecal adenocarcinoma caused by angiodestruction of the proximal vasculature by a distinct acute myeloid infiltrate. Both tumours were removed in their entirety at one visit to theatre and the patient remains well and in remission 18 months later.
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Affiliation(s)
- D Tucker
- Department of Haematology, Derriford Hospital, , Plymouth, UK
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Gilbert DC, Chandler I, Summersgill B, McIntyre A, Missiaglia E, Goddard NC, Huddart RA, Shipley J. Genomic gain and over expression of CCL2 correlate with vascular invasion in stage I non-seminomatous testicular germ-cell tumours. ACTA ACUST UNITED AC 2011; 34:e114-21; discussion e121. [DOI: 10.1111/j.1365-2605.2011.01161.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Gilbert DC, Chandler I, McIntyre A, Goddard NC, Gabe R, Huddart RA, Shipley J. Clinical and biological significance of CXCL12 and CXCR4 expression in adult testes and germ cell tumours of adults and adolescents. J Pathol 2009; 217:94-102. [PMID: 18839394 DOI: 10.1002/path.2436] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Interaction between the chemokine CXCL12 (SDF1) and the G-protein coupled receptor CXCR4 is responsible for the maintenance of adult stem cell niches and is known to play an important role in utero in the migration of primordial germ cells. We demonstrate expression of CXCL12 by Sertoli cells and confirm CXCR4 expression by the germ cell population of the adult human testes. CXCR4 is also known to mediate organ-specific patterns of metastases in a range of common cancers. We identify consistent expression of CXCR4 mRNA and protein in testicular germ cell tumours (TGCT) that accounts for their patterns of relapse in sites of known CXCL12 expression. Extragonadal primary germ cell tumours express CXCR4 and their sites of occurrence are coincident with areas of known CXCL12 expression in utero. We show that CXCL12 stimulates the invasive migration of a TGCT cell line in vitro in a CXCR4-dependent fashion and activates ERK. Furthermore, we demonstrate that expression of CXCL12 in stage I non-seminomas is significantly associated with organ-confined disease post-orchidectomy and reduced risk of relapse (p = 0.003). This may be through the loss of CXCL12 gradients that might otherwise attract cells away from the primary tumour. We propose CXCL12 expression as a potential predictor of subsequent relapse that could lead to avoiding unnecessary treatment and associated late toxicities. Our observations support a role for CXCL12/CXCR4 in the adult germ cell population and demonstrate pathological function in germ cell tumour development and metastasis that may have clinical utility.
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Affiliation(s)
- D C Gilbert
- Molecular Cytogenetics, Section of Molecular Carcinogenesis, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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Webb E, Broderick P, Chandler I, Lubbe S, Penegar S, Tomlinson IPM, Houlston RS. Comprehensive analysis of common mitochondrial DNA variants and colorectal cancer risk. Br J Cancer 2008; 99:2088-93. [PMID: 19050702 PMCID: PMC2607223 DOI: 10.1038/sj.bjc.6604805] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Several lines of evidence implicate mitochondrial dysfunction in the development of cancer. To test the hypothesis that common mtDNA variation influences the risk of colorectal cancer (CRC), we genotyped 132 tagging mtDNA variants in a sample of 2854 CRC cases and 2822 controls. The variants examined capture approximately 80% of mtDNA common variation (excluding the hypervariable D-loop). We first tested for single marker associations; the strongest association detected was with A5657G (P=0.06). Overall the distribution of association P-values was consistent with a null distribution. Next, we classified individuals into the nine common European haplogroups and compared their distribution in cases and controls. This analysis also provided no evidence of an association between mitochondrial variation and CRC risk. In conclusion, our results provide little evidence that mitochondrial genetic background plays a role in modifying an individual's risk of developing CRC.
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Affiliation(s)
- E Webb
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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Abstract
BACKGROUND In the abdominoperineal excision (APE) specimen 'surgical wasting' has been described, where the least amount of tissue covers the rectum. This is associated with high positive margin rates. The aim of this study was to locate the site of surgical wasting, namely the least amount of tissue excised at APE. METHODS Distances from the anal verge to the distal and proximal edges of the sphincter, puborectalis and levator muscles were measured in 12 patients using morphological features on magnetic resonance images. Distances from the mucularis propria to the outer surface of the pelvic muscles and the outer edge of the specimen were measured on axial images. The height from the anal verge at which axial measurements of tissue were minimal was determined. RESULTS The presence of a surgical waist between 35 and 42 mm above the anal verge, corresponding to the puborectalis, was confirmed. A smaller amount of perirectal tissue was resected at this level than at other heights (P < 0.001). CONCLUSION Because less tissue is excised at the puborectalis, careful dissection along the levator plane is necessary, especially if tumour is present. More radical excision of the levators and puborectalis may be of benefit in such patients.
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Affiliation(s)
- G Salerno
- Pelican Cancer Foundation, North Hampshire Hospital, Basingstoke, London, UK
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Chandler I, Houlston RS. Interobserver agreement in grading of colorectal cancers-findings from a nationwide web-based survey of histopathologists. Histopathology 2008; 52:494-9. [PMID: 18315602 DOI: 10.1111/j.1365-2559.2008.02976.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Tumour grade represents a gestalt of all molecular changes in malignancy, reflecting aggressiveness and has been shown to add prognostic information independent of stage for many malignancies, including colorectal cancer. Despite the grade of colorectal cancer being reported routinely in the UK, there is paucity of data on the level of agreement between histopathologists and hence the value of this metric in clinical practice. The aim was to estimate the degree of inter-observer variation in grading by conducting a nationwide web-based survey of histopathologists. METHODS AND RESULTS Individuals were asked to grade a series of 20 tumours. Data from 104 pathologists surveyed indicates that agreement using both two and three grade systems is at best fair. CONCLUSION Given that for the foreseeable future the histopathological criteria of stage and grade will still provide the mainstay of prognostication and therefore clinical decision-making, efforts should be made to improve grading criteria and standardize use of the low- and high-grade categories.
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Affiliation(s)
- I Chandler
- Department of Cellular Pathology, St George's Hospital, London, and Section of Cancer Genetics, Institute of Cancer Research, Sutton, UK.
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Penegar S, Wood W, Lubbe S, Chandler I, Broderick P, Papaemmanuil E, Sellick G, Gray R, Peto J, Houlston R. National study of colorectal cancer genetics. Br J Cancer 2007; 97:1305-9. [PMID: 17895893 PMCID: PMC2360468 DOI: 10.1038/sj.bjc.6603997] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Revised: 08/24/2007] [Accepted: 08/29/2007] [Indexed: 11/08/2022] Open
Abstract
Approximately, a third of all colorectal cancer (CRC) is due to inherited susceptibility. However, high-risk mutations in APC, the mismatch repair (MMR) genes, MUTYH/MYH, SMAD4, ALK3 and STK11/LKB1 are rare and account for <5% of cases. Much of the remaining variation in genetic risk is likely to be explained by combinations of more common gene variants that modestly increase risk. Reliable identification of such 'low penetrance' alleles would provide insight into the aetiology of CRC and might highlight potential therapeutic and preventative interventions. In 2003, the National Study of Colorectal Cancer Genetics (NSCCG) was established with the aim of collecting DNA and clinicopathological data from 20,000 CRC cases and a series of spouse/partner controls, thereby creating a unique resource for identifying low-penetrance CRC susceptibility alleles. The National Cancer Research Network (NCRN) adopted NSCCG onto its portfolio of trials and 148 centres in the United Kingdom (UK) are now actively participating. Over 8,700 cases and 2,185 controls have so far been entered into NSCCG. Our experience in developing NSCCG serves to illustrate how world-class DNA databases for genetic analyses can be rapidly developed in the United Kingdom.
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Affiliation(s)
- S Penegar
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - W Wood
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - S Lubbe
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - I Chandler
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
- Department of Cellular Pathology, St George's Hospital, London, SW17 0QT, UK
| | - P Broderick
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - E Papaemmanuil
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - G Sellick
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - R Gray
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - J Peto
- Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Cancer Research, Surrey, UK
| | - R Houlston
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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Popat S, Chen Z, Zhao D, Pan H, Hearle N, Chandler I, Shao Y, Aherne W, Houlston R. A prospective, blinded analysis of thymidylate synthase and p53 expression as prognostic markers in the adjuvant treatment of colorectal cancer. Ann Oncol 2006; 17:1810-7. [PMID: 16971666 DOI: 10.1093/annonc/mdl301] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [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: 01/10/2023] Open
Abstract
BACKGROUND Despite previous studies, uncertainty has persisted about the role of thymidylate synthase (TS) and p53 status as markers of prognosis in colorectal cancer (CRC). PATIENTS AND METHODS A total of 967 patients accrued to a large adjuvant trial in CRC were included in a prospectively planned molecular substudy, and of them, 59% had rectal cancer and about 90% received adjuvant chemotherapy (either systemically or randomly allocated to intraportal 5-fluorouracil infusion or both). TS and p53 status were determined, blinded to any clinical data, by immunohistochemistry using a validated polyclonal antibody or the DO-7 clone, respectively, and their relationships with overall survival were examined. RESULTS High TS expression was observed in 58% and overexpression of p53 in 60% of tumours. TS expression correlated with tumour stage, and p53 overexpression, with rectal cancers. There was no evidence that either marker was significantly associated with survival by either univariate (TS hazard ratio (HR) = 0.94, 95% CI 0.76-1.18 and P = 0.6 and p53 HR = 0.98, 95% CI 0.78-1.23 and P = 0.9) or multivariate analyses (TS HR = 0.99, 95% CI 0.79-1.25 and P = 0.9 and p53 HR = 0.98, 95% CI 0.78-1.23 and P = 0.8). CONCLUSIONS Neither TS nor p53 expression has significant prognostic value in the adjuvant setting of CRC.
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Affiliation(s)
- S Popat
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, UK.
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Sharp CD, Fowler M, Jackson TH, Houghton J, Warren A, Nanda A, Chandler I, Cappell B, Long A, Minagar A, Alexander JS. Human neuroepithelial cells express NMDA receptors. BMC Neurosci 2003; 4:28. [PMID: 14614784 PMCID: PMC293342 DOI: 10.1186/1471-2202-4-28] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2003] [Accepted: 11/13/2003] [Indexed: 11/16/2022] Open
Abstract
L-glutamate, an excitatory neurotransmitter, binds to both ionotropic and metabotropic glutamate receptors. In certain parts of the brain the BBB contains two normally impermeable barriers: 1) cerebral endothelial barrier and 2) cerebral epithelial barrier. Human cerebral endothelial cells express NMDA receptors; however, to date, human cerebral epithelial cells (neuroepithelial cells) have not been shown to express NMDA receptor message or protein. In this study, human hypothalamic sections were examined for NMDA receptors (NMDAR) expression via immunohistochemistry and murine neuroepithelial cell line (V1) were examined for NMDAR via RT-PCR and Western analysis. We found that human cerebral epithelium express protein and cultured mouse neuroepithelial cells express both mRNA and protein for the NMDA receptor. These findings may have important consequences for neuroepithelial responses during excitotoxicity and in disease.
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Affiliation(s)
- Christopher D Sharp
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - M Fowler
- Department of Pathology, LSU Health Sciences Center, Shreveport, LA, USA
| | - TH Jackson
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - J Houghton
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - A Warren
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - A Nanda
- Department of Neurosurgery, LSU Health Sciences Center, Shreveport, LA, USA
| | - I Chandler
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - B Cappell
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - A Long
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
| | - A Minagar
- Department of Neurology, LSU Health Sciences Center, Shreveport, LA, USA
| | - JS Alexander
- Department of Molecular and Cellular Physiology, LSU Health Sciences Center, Shreveport, LA, USA
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