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Đokić S, Gazić B, Grčar Kuzmanov B, Blazina J, Miceska S, Čugura T, Grašič Kuhar C, Jeruc J. Clinical and Analytical Validation of Two Methods for Ki-67 Scoring in Formalin Fixed and Paraffin Embedded Tissue Sections of Early Breast Cancer. Cancers (Basel) 2024; 16:1405. [PMID: 38611083 PMCID: PMC11011015 DOI: 10.3390/cancers16071405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
Proliferation determined by Ki-67 immunohistochemistry has been proposed as a useful prognostic and predictive marker in breast cancer. However, the clinical validity of Ki-67 is questionable. In this study, Ki-67 was retrospectively evaluated by three pathologists using two methods: a visual assessment of the entire slide and a quantitative assessment of the tumour margin in 411 early-stage breast cancer patients with a median follow-up of 26.8 years. We found excellent agreement between the three pathologists for both methods. The risk of recurrence for Ki-67 was time-dependent, as the high proliferation group (Ki-67 ≥ 30%) had a higher risk of recurrence initially, but after 4.5 years the risk was higher in the low proliferation group. In estrogen receptor (ER)-positive patients, the intermediate Ki-67 group initially followed the high Ki-67 group, but eventually followed the low Ki-67 group. ER-positive pN0-1 patients with intermediate Ki-67 treated with endocrine therapy alone had a similar outcome to patients treated with chemotherapy. A cut-off value of 20% appeared to be most appropriate for distinguishing between the high and low Ki-67 groups. To summarize, a simple visual whole slide Ki-67 assessment turned out to be a reliable method for clinical decision-making in early breast cancer patients. We confirmed Ki-67 as an important prognostic and predictive biomarker.
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Affiliation(s)
- Snežana Đokić
- Department of Pathology, Institute of Oncology, 1000 Ljubljana, Slovenia; (S.Đ.); (B.G.)
- Faculty of Medicine Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Barbara Gazić
- Department of Pathology, Institute of Oncology, 1000 Ljubljana, Slovenia; (S.Đ.); (B.G.)
| | - Biljana Grčar Kuzmanov
- Department of Pathology, Institute of Oncology, 1000 Ljubljana, Slovenia; (S.Đ.); (B.G.)
| | - Jerca Blazina
- Department of Pathology, Institute of Oncology, 1000 Ljubljana, Slovenia; (S.Đ.); (B.G.)
| | - Simona Miceska
- Faculty of Medicine Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia;
- Department of Cytopathology, Institute of Oncology, 1000 Ljubljana, Slovenia
| | - Tanja Čugura
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Cvetka Grašič Kuhar
- Faculty of Medicine Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia;
- Department of Medical Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Jera Jeruc
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Avčin SL, Črepinšek K, Jenko Bizjan B, Šket R, Kovač J, Vrhovšek B, Blazina J, Blatnik O, Kordič R, Kitanovski L, Jazbec J, Debeljak M, Tesovnik T. Integrative Transcriptomic Profiling of the Wilms Tumor. Cancers (Basel) 2023; 15:3846. [PMID: 37568662 PMCID: PMC10416970 DOI: 10.3390/cancers15153846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Our study aimed to identify relevant transcriptomic biomarkers for the Wilms tumor, the most common pediatric kidney cancer, independent of the histological type and stage. Using next-generation sequencing, we analyzed the miRNA profiles of 74 kidney samples, which were divided into two independent groups: fresh frozen tissue and formalin-fixed paraffin-embedded tissue samples. Subsequent mRNA expression profiling and pathway analysis were performed to establish the interplay and potential involvement of miRNAs and mRNA in the Wilms tumor. Comparative analysis, irrespective of post-dissection tissue processing, revealed 41 differentially expressed miRNAs, with 27 miRNAs having decreased expression and 14 miRNAs having increased expression in the Wilms tumor tissue compared to healthy kidney tissue. Among global mRNA transcriptomic profile differences, cross-sectional analysis suggested a limited list of genes potentially regulated by differentially expressed miRNAs in the Wilms tumor. This study identified the comprehensive miRNA and mRNA profile of the Wilms tumor using next-generation sequencing and bioinformatics approach, providing better insights into the pathogenesis of the Wilms tumor. The identified Wilms tumor miRNAs have potential as biomarkers for the diagnosis and treatment of the Wilms tumor, regardless of histological subtype and disease stage.
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Affiliation(s)
- Simona Lucija Avčin
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Klementina Črepinšek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Robert Šket
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Jernej Kovač
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Blaž Vrhovšek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Jerca Blazina
- Department of Pathology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Olga Blatnik
- Department of Pathology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Robert Kordič
- Department of Pediatric Surgery, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Lidija Kitanovski
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Janez Jazbec
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Maruša Debeljak
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Tine Tesovnik
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
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Strauss RG, Levy GJ, Sotelo-Avila C, Albanese MA, Hume H, Schloz L, Blazina J, Werner A, Barrasso C, Blanchette V. National survey of neonatal transfusion practices: II. Blood component therapy. Pediatrics 1993; 91:530-6. [PMID: 8382782] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Neonatal transfusion practices during 1989 of 452 institutions involved in transfusing infants were surveyed by questionnaire. Most respondents (77%) transfused fresh frozen plasma appropriately (ie, primarily to treat coagulation disorders). However, 11% stated that their most frequent use of fresh frozen plasma was solely to treat hypovolemia, a practice generally not recommended. Seventy-eight percent of respondents transfused platelets to treat bleeding infants with blood platelet counts of less than 50 x 10(9)/L; 84% gave platelets to sick, premature neonates with counts of less than 50 x 10(9)/L whether or not bleeding was evident. Only 35% of respondents transfused granulocytes for neonatal sepsis; most institutions used buffy coats isolated from units of blood--a product readily available, but of questionable efficacy when compared with leukapheresis granulocytes. Ninety-three percent of respondents provided blood components with low risk of transmitting cytomegalovirus: components from seronegative donors were used by 84%, leukocyte-reduced products by 6%, and a combination by 10%. Thirteen percent of respondents gave gamma-irradiated blood components to all and 46% gave them to some neonates to prevent graft vs host disease. Forty-one percent did not routinely irradiate. Ten percent of respondents used leukocyte reduction instead of gamma irradiation to prevent graft vs host disease, a practice currently not advocated. Thus, national transfusion practices for neonates are variable, controversial, and, occasionally, other than those usually recommended. Additional research and educational efforts are needed to ensure optimal transfusion therapy.
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Affiliation(s)
- R G Strauss
- Department of Pathology, University of Iowa College of Medicine, Iowa City
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Levy GJ, Strauss RG, Hume H, Schloz L, Albanese MA, Blazina J, Werner A, Sotelo-Avila C, Barrasso C, Blanchette V. National survey of neonatal transfusion practices: I. Red blood cell therapy. Pediatrics 1993; 91:523-9. [PMID: 8441554] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Neonatal blood component transfusion practices during 1989 were surveyed via a questionnaire developed by the Pediatric Hemotherapy Committee of the American Association of Blood Banks. Of 1790 questionnaires mailed, 452 were selected to form the database for this analysis because they were from institutions in which neonates were transfused. Nearly all institutions contained intensive care units directed by neonatologists and were involved in the management of high-risk infants. Results from institutions serving as the primary pediatric teaching hospital of a medical school were compared with those with no medical school affiliation. Thirty-six percent of primary pediatric teaching hospitals and 52% of hospitals with no medical school affiliation performed pretransfusion testing in excess of that required, resulting in additional blood loss in neonates. Sixty-six percent of primary pediatric teaching hospitals used fresh frozen plasma to adjust the hematocrit of red blood cell concentrates prior to transfusion (a practice increasing donor exposure), compared with only 29% of hospitals with no medical school affiliation. The usual indication for small-volume red blood cell transfusions in severely ill neonates was to maintain a desired hematocrit level, whereas for stable infants, red blood cell transfusions were given to treat symptomatic anemia, rather than to maintain a predetermined hematocrit. As found in 1985, neonatal transfusion practices in 1989 were variable. However, improvements have occurred since 1985 to suggest that further research and educational efforts may serve to promote even better neonatal transfusion therapy.
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Affiliation(s)
- G J Levy
- Louisiana Blood Center, Shreveport
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Strohm P, O'Shaughnessy R, Moore J, Blazina J, Kennedy M. Determining the significance of anti-Kl in hemolytic disease of the newborn (HDN). Immunohematology 1991; 7:40-2. [PMID: 15946019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Anti-K1 is capable of causing severe hemolytic disease of the newborn (HDN), but few cases are seen due to the low frequency of the antigen. A total of 1,215 pregnancies from 1962 to 1989 were reviewed. There were 404 non-anti-D clinically significant antibodies, of which 103 (25%) were anti-K1. Anti-K1 was detected in nine of the women at delivery, of whom two had antigen-positive infants who were clinically unaffected. Antigen typing was done on 64 of the 85 fathers. Forty-seven were K - 1 and 17 were K1,2; 21 were unavailable. Antibody titers were done on the mothers in the latter two groups. Women with titers <32 were followed by titration studies; all delivered clinically unaffected infants, four of whom were K:1. Women with titers >32 had amniocentesis performed for optical density values (AOD450) or, after November 1987, were offered an alternative test, cordocentesis, to type the fetus and to do hemoglobins if the fetus was antigen-positive. Two women had severely affected infants requiring multiple intrauterine transfusions starting at 20-23 weeks. Six others delivered antigen-positive infants who did not require transfusions, although all had positive direct antiglobulin tests (DAB). We conclude that titration studies are reliable tools to evaluate anti-K1 sensitization when the titer is <32. Cordocentesis can detect antigen-negative fetuses, which then reduces the need for titrations and amniocentesis.
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Affiliation(s)
- P Strohm
- Southside Medical Center, Western Reserve Care System, 345 Oak Hill Avenue, Youngstown, OH 44501, USA
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