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Hruban L, Jouzova A, Janku P, Weinberger V, Seidlova D, Juren T, Senkyrik J, Kadlecova J, Hausnerova J, Jandakova E. Correction: Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture-case report. BMC Pregnancy Childbirth 2023; 23:533. [PMID: 37481529 PMCID: PMC10362739 DOI: 10.1186/s12884-023-05853-6] [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: 07/24/2023] Open
Affiliation(s)
- Lukas Hruban
- Department of Obstetrics and Gynecology, University Hospital Brno and Medical Faculty, Masaryk University, Jihlavská 20, Brno, 625 00, Czech Republic
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Anna Jouzova
- Department of Obstetrics and Gynecology, University Hospital Brno and Medical Faculty, Masaryk University, Jihlavská 20, Brno, 625 00, Czech Republic.
| | - Petr Janku
- Department of Obstetrics and Gynecology, University Hospital Brno and Medical Faculty, Masaryk University, Jihlavská 20, Brno, 625 00, Czech Republic
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Vit Weinberger
- Department of Obstetrics and Gynecology, University Hospital Brno and Medical Faculty, Masaryk University, Jihlavská 20, Brno, 625 00, Czech Republic
| | - Dagmar Seidlova
- Department of Anesthesiology and Intensive Care, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Tomas Juren
- Department of Neonatology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jan Senkyrik
- Department of Pediatric Radiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jana Kadlecova
- Department of Obstetrics and Gynecology, University Hospital Brno and Medical Faculty, Masaryk University, Jihlavská 20, Brno, 625 00, Czech Republic
| | - Jitka Hausnerova
- Department of Pathology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Eva Jandakova
- Department of Pathology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
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Holcakova J, Bartosik M, Anton M, Minar L, Hausnerova J, Bednarikova M, Weinberger V, Hrstka R. New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers. Cancers (Basel) 2021; 13:6339. [PMID: 34944963 PMCID: PMC8699592 DOI: 10.3390/cancers13246339] [Citation(s) in RCA: 3] [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: 09/23/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.
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Affiliation(s)
- Jitka Holcakova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic; (J.H.); (M.B.)
| | - Martin Bartosik
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic; (J.H.); (M.B.)
| | - Milan Anton
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (M.A.); (L.M.)
| | - Lubos Minar
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (M.A.); (L.M.)
| | - Jitka Hausnerova
- Department of Pathology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic;
| | - Marketa Bednarikova
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic;
| | - Vit Weinberger
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (M.A.); (L.M.)
| | - Roman Hrstka
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic; (J.H.); (M.B.)
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Bednarikova M, Vinklerova P, Gottwaldova J, Ovesna P, Hausnerova J, Minar L, Felsinger M, Valik D, Cermakova Z, Weinberger V. The Clinical Significance of DJ1 and L1CAM Serum Level Monitoring in Patients with Endometrial Cancer. J Clin Med 2021; 10:jcm10122640. [PMID: 34203959 PMCID: PMC8232635 DOI: 10.3390/jcm10122640] [Citation(s) in RCA: 7] [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: 05/02/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022] Open
Abstract
Circulating tumor markers are not routinely used in patients with endometrial cancer (EC). This pilot study evaluated the role of monitoring new biomarkers DJ1 and L1CAM, in correlation with CA125 and HE4, for the effects of anticancer treatment and preoperative management in EC patients. Serial serum levels of DJ1, L1CAM, CA125 and HE4 were collected in 65 enrolled patients. Serum DJ1, L1CAM, CA125 and HE4 levels were significantly higher at the time of diagnosis compared to those measured during follow-up (FU). In patients with recurrent disease, serum DJ1, CA125 and HE4 levels were significantly higher at the time of recurrence compared to levels in disease-free patients. Serum L1CAM levels were also higher in patients with recurrence but without reaching statistical significance. While DJ1 levels were not affected by any of the observed patient-related characteristics, L1CAM levels were significantly higher in patients with age ≥60 years who were overweight. At the time of EC diagnosis, DJ1 and L1CAM serum levels did not correlate with stage, histological type or risk of recurrence. This is a preliminary description of the potential of serial DJ1 and L1CAM serum level measurement for monitoring the effects of treatment in EC patients.
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Affiliation(s)
- Marketa Bednarikova
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic;
| | - Petra Vinklerova
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (P.V.); (L.M.); (M.F.)
| | - Jana Gottwaldova
- Department of Laboratory Medicine, Department of Laboratory Methods, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (J.G.); (D.V.); (Z.C.)
- Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, 602 00 Brno, Czech Republic
| | - Petra Ovesna
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czech Republic;
| | - Jitka Hausnerova
- Department of Pathology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic;
| | - Lubos Minar
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (P.V.); (L.M.); (M.F.)
| | - Michal Felsinger
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (P.V.); (L.M.); (M.F.)
| | - Dalibor Valik
- Department of Laboratory Medicine, Department of Laboratory Methods, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (J.G.); (D.V.); (Z.C.)
| | - Zdenka Cermakova
- Department of Laboratory Medicine, Department of Laboratory Methods, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (J.G.); (D.V.); (Z.C.)
- Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, 602 00 Brno, Czech Republic
| | - Vit Weinberger
- Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic; (P.V.); (L.M.); (M.F.)
- Correspondence:
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Vrede SW, van Weelden WJ, Visser NCM, Bulten J, van der Putten LJM, van de Vijver K, Santacana M, Colas E, Gil-Moreno A, Moiola CP, Mancebo G, Krakstad C, Trovik J, Haldorsen IS, Huvila J, Koskas M, Weinberger V, Bednarikova M, Hausnerova J, van der Wurff AA, Matias-Guiu X, Amant F, Snijders MPLM, Küsters-Vandevelde HVN, Reijnen C, Pijnenborg JMA. Immunohistochemical biomarkers are prognostic relevant in addition to the ESMO-ESGO-ESTRO risk classification in endometrial cancer. Gynecol Oncol 2021; 161:787-794. [PMID: 33858677 DOI: 10.1016/j.ygyno.2021.03.031] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/30/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Pre-operative immunohistochemical (IHC) biomarkers are not incorporated in endometrial cancer (EC) risk classification. We aim to investigate the added prognostic relevance of IHC biomarkers to the ESMO-ESGO-ESTRO risk classification and lymph node (LN) status in EC. METHODS Retrospective multicenter study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), analyzing pre-operative IHC expression of p53, L1 cell-adhesion molecule (L1CAM), estrogen receptor (ER) and progesterone receptor (PR), and relate to ESMO-ESGO-ESTRO risk groups, LN status and outcome. RESULTS A total of 763 EC patients were included with a median follow-up of 5.5-years. Abnormal IHC expression was present for p53 in 112 (14.7%), L1CAM in 79 (10.4%), ER- in 76 (10.0%), and PR- in 138 (18.1%) patients. Abnormal expression of p53/L1CAM/ER/PR was significantly related with higher risk classification groups, and combined associated with the worst outcome within the 'high and advanced/metastatic' risk group. In multivariate analysis p53-abn, ER/PR- and ESMO-ESGO-ESTRO 'high and advanced/metastatic' were independently associated with reduced disease-specific survival (DSS). Patients with abnormal IHC expression and lymph node metastasis (LNM) had the worst outcome. Patients with LNM and normal IHC expression had comparable outcome with patients without LNM and abnormal IHC expression. CONCLUSION The use of pre-operative IHC biomarkers has important prognostic relevance in addition to the ESMO-ESGO-ESTRO risk classification and in addition to LN status. For daily clinical practice, p53/L1CAM/ER/PR expression could serve as indicator for surgical staging and refine selective adjuvant treatment by incorporation into the ESMO-ESGO-ESTRO risk classification.
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Affiliation(s)
- S W Vrede
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands; Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands.
| | - W J van Weelden
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
| | - N C M Visser
- Department of Pathology, Stichting PAMM, Eindhoven, the Netherlands; Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | - J Bulten
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | - L J M van der Putten
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
| | - K van de Vijver
- Department of Pathology, Ghent University Hospital, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - M Santacana
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - E Colas
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, Barcelona, Spain
| | - A Gil-Moreno
- Gynecological Department, Vall Hebron University Hospital, CIBERONC, Barcelona, Spain; Pathology Department, Vall Hebron University Hospital, CIBERONC, Barcelona, Spain
| | - C P Moiola
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, Barcelona, Spain
| | - G Mancebo
- Department of Obstetrics and Gynaecology, Hospital del Mar, PSMAR, Barcelona, Spain
| | - C Krakstad
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J Trovik
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - I S Haldorsen
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - J Huvila
- Department of Pathology, University of Turku, Turku, Finland
| | - M Koskas
- Department of Obstetrics and Gynaecology Department, Bichat-Claude Bernard Hospital, Paris, France
| | - V Weinberger
- Department of Obstetrics and Gynaecology, University Hospital in Brno and Masaryk University, Brno, Czech Republic
| | - M Bednarikova
- Department of Internal Medicine, Hematology and Oncology, University Hospital in Brno and Masaryk University, Brno, Czech Republic
| | - J Hausnerova
- Department of Pathology, University Hospital in Brno and Masaryk University, Brno, Czech Republic
| | - A A van der Wurff
- Department of Pathology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - X Matias-Guiu
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - F Amant
- Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynaecologic Oncology, Netherlands Cancer Institute and Amsterdam Medical Centers, Amsterdam, the Netherlands
| | | | - M P L M Snijders
- Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | | | - C Reijnen
- Department of Radiation Oncology, Radboud university medical center, Nijmegen, the Netherlands
| | - J M A Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
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5
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van Weelden WJ, Reijnen C, Küsters-Vandevelde HVN, Bulten J, Bult P, Leung S, Visser NCM, Santacana M, Bronsert P, Hirschfeld M, Colas E, Gil-Moreno A, Reques A, Mancebo G, Huvila J, Koskas M, Weinberger V, Bednarikova M, Hausnerova J, Snijders MPLM, Matias-Guiu X, Amant F. The cutoff for estrogen and progesterone receptor expression in endometrial cancer revisited: a European Network for Individualized Treatment of Endometrial Cancer collaboration study. Hum Pathol 2020; 109:80-91. [PMID: 33338506 DOI: 10.1016/j.humpath.2020.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/22/2022]
Abstract
There is no consensus on the cutoff for positivity of estrogen receptor (ER) and progesterone receptor (PR) in endometrial cancer (EC). Therefore, we determined the cutoff value for ER and PR expression with the strongest prognostic impact on the outcome. Immunohistochemical expression of ER and PR was scored as a percentage of positive EC cell nuclei. Cutoff values were related to disease-specific survival (DSS) and disease-free survival (DFS) using sensitivity, specificity, and multivariable regression analysis. The results were validated in an independent cohort. The study cohort (n = 527) included 82% of grade 1-2 and 18% of grade 3 EC. Specificity for DSS and DFS was highest for the cutoff values of 1-30%. Sensitivity was highest for the cutoff values of 80-90%. ER and PR expression were independent markers for DSS at cutoff values of 10% and 80%. Consequently, three subgroups with distinct clinical outcomes were identified: 0-10% of ER/PR expression with, unfavorable outcome (5-year DSS = 75.9-83.3%); 20-80% of ER/PR expression with, intermediate outcome (5-year DSS = 93.0-93.9%); and 90-100% of ER/PR expression with, favorable outcome (5-year DSS = 97.8-100%). The association between ER/PR subgroups and outcomes was confirmed in the validation cohort (n = 265). We propose classification of ER and PR expression based on a high-risk (0-10%), intermediate-risk (20-80%), and low-risk (90-100%) group.
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Affiliation(s)
- Willem Jan van Weelden
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525, GA, Nijmegen, the Netherlands.
| | - Casper Reijnen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525, GA, Nijmegen, the Netherlands; Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, 6532, SZ, the Netherlands
| | | | - Johan Bulten
- Department of Pathology, Radboud University Medical Center, Nijmegen, 6525, GA, the Netherlands
| | - Peter Bult
- Department of Pathology, Radboud University Medical Center, Nijmegen, 6525, GA, the Netherlands
| | - Samuel Leung
- Genetic Pathology Evaluation Center, Vancouver General Hospital, Vancouver, BC V5Z 1M9, British Columbia, Canada
| | - Nicole C M Visser
- Foundation Laboratory for Pathology and Medical Microbiology (PAMM), 5623 EJ, Eindhoven, the Netherlands
| | - Maria Santacana
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, 25198, Lleida, Spain
| | - Peter Bronsert
- Institute of Pathology, University Medical Center, 79106, Freiburg, Germany
| | - Marc Hirschfeld
- Department of Obstetrics and Gynecology, University Medical Center, 79106, Freiburg, Germany; Institute of Veterinary Medicine, Georg-August-University, 37073, Goettingen, Germany
| | - Eva Colas
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035, Barcelona, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, CIBERONC, 08035, Barcelona, Spain; Gynecological Department, Vall Hebron University Hospital, CIBERONC, 08035, Barcelona, Spain
| | - Armando Reques
- Pathology Department, Vall Hebron University Hospital, CIBERONC, 08035, Barcelona, Spain
| | - Gemma Mancebo
- Department of Obstetrics and Gynecology, Hospital del Mar, PSMAR, 08003, Barcelona, Spain
| | - Jutta Huvila
- Department of Pathology, University of Turku, 20500, Turku, Finland
| | - Martin Koskas
- Obstetrics and Gynecology Department, Bichat-Claude Bernard Hospital, 75018, Paris, France
| | - Vit Weinberger
- Department of Gynecology and Obstetrics, Faculty of Medicine, Masaryk University, 62500, Brno, Czech Republic
| | - Marketa Bednarikova
- Department of Internal Medicine, Oncology and Hematology, Faculty of Medicine, Masaryk University, 62500, Brno, Czech Republic
| | - Jitka Hausnerova
- Institute of Pathology, Faculty of Medicine, Masaryk University, 62500, Brno, Czech Republic
| | - Marc P L M Snijders
- Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, 6532, SZ, the Netherlands
| | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, 25198, Lleida, Spain
| | - Frédéric Amant
- Department of Oncology, KU Leuven, 3000, Leuven, Belgium; Center for Gynaecologic Oncology, Netherlands Cancer Institute and Amsterdam University Medical Center, 1066, CX, Amsterdam, the Netherlands
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6
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Visser NCM, van der Putten LJM, van Egerschot A, Van de Vijver KK, Santacana M, Bronsert P, Hirschfeld M, Colas E, Gil-Moreno A, Garcia A, Mancebo G, Alameda F, Krakstad C, Tangen IL, Huvila J, Schrauwen S, Koskas M, Walker F, Weinberger V, Minar L, Hausnerova J, Snijders MPLM, van den Berg-van Erp S, Matias-Guiu X, Trovik J, Amant F, Massuger LFAG, Bulten J, Pijnenborg JMA. Addition of IMP3 to L1CAM for discrimination between low- and high-grade endometrial carcinomas: a European Network for Individualised Treatment of Endometrial Cancer collaboration study. Hum Pathol 2019; 89:90-98. [PMID: 31054899 DOI: 10.1016/j.humpath.2019.04.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 12/20/2022]
Abstract
Discrimination between low- and high-grade endometrial carcinomas (ECs) is clinically relevant but can be challenging for pathologists, with moderate interobserver agreement. Insulin-like growth factor-II mRNA-binding protein 3 (IMP3) is an oncofoetal protein that is associated with nonendometrioid endometrial carcinomas but has been limited studied in endometrioid carcinomas. The aim of this study is to investigate the diagnostic and prognostic value of IMP3 in the discrimination between low- and high-grade ECs and its added value to L1CAM. IMP3 and L1CAM expression was assessed in tumors from 378 patients treated for EC at 1 of 9 participating European Network for Individualised Treatment of Endometrial Cancer centers. IMP3 was expressed in 24.6% of the tumors. In general, IMP3 was more homogeneously expressed than L1CAM. IMP3 expression was significantly associated with advanced stage, nonendometrioid histology, grade 3 tumors, deep myometrial invasion, lymphovascular space invasion, distant recurrences, overall mortality, and disease-related mortality. Simultaneous absence of IMP3 and L1CAM expression showed the highest accuracy for identifying low-grade carcinomas (area under the curve 0.766), whereas simultaneous expression of IMP3 and L1CAM was strongly associated with high-grade carcinomas (odds ratio 19.7; 95% confidence interval 9.2-42.2). Even within endometrioid carcinomas, this combination remained superior to IMP3 and L1CAM alone (odds ratio 8.6; 95% confidence interval 3.4-21.9). In conclusion, IMP3 has good diagnostic value and together with L1CAM represents the optimal combination of diagnostic markers for discrimination between low- and high-grade ECs compared to IMP3 and L1CAM alone. Because of the homogenous expression of IMP3, this marker might be valuable in preoperative biopsies when compared to the more patchy L1CAM expression.
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Affiliation(s)
- Nicole C M Visser
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, 6500HB, Nijmegen, the Netherlands.
| | - Louis J M van der Putten
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Alex van Egerschot
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | | | - Maria Santacana
- Department of Pathology and Molecular Genetics and Oncological Pathology Group, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, 25198, Lleida, Spain
| | - Peter Bronsert
- Institute for Surgical Pathology, Medical Centre-University of Freiburg, 79085, Freiburg, Germany; Comprehensive Cancer Centre Freiburg, Medical Centre-University of Freiburg, 79106, Freiburg, Germany; Faculty of Medicine, University of Freiburg, 79085, Freiburg, Germany
| | - Marc Hirschfeld
- Department of Obstetrics and Gynaecology, University Medical Centre Freiburg, 79106, Freiburg, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), 69120, Heidelberg, Germany
| | - Eva Colas
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, CIBERONC, 08193, Barcelona, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynaecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, CIBERONC, 08193, Barcelona, Spain; Gynecological Department, Vall Hebron University Hospital, CIBERONC, 8035, Barcelona, Spain
| | - Angel Garcia
- Pathology Department, Vall Hebron University Hospital, 8035, Barcelona, Spain
| | - Gemma Mancebo
- Department of Obstetrics and Gynaecology, Hospital del Mar, 8003, Barcelona, Spain
| | - Francesc Alameda
- Department of Pathology, Hospital del Mar, 8003, Barcelona, Spain
| | - Camilla Krakstad
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Ingvild L Tangen
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Jutta Huvila
- Department of Pathology, University of Turku, 20500, Turku, Finland
| | - Stefanie Schrauwen
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, 3000, Leuven, Belgium
| | - Martin Koskas
- Obstetrics and Gynaecology Department, Bichat-Claude Bernard Hospital, 75877, Paris, France
| | - Francine Walker
- Pathology Department, Bichat-Claude Bernard Hospital, 75877, Paris, France
| | - Vit Weinberger
- Department of Obstetrics and Gynaecology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Lubos Minar
- Department of Obstetrics and Gynaecology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Jitka Hausnerova
- Department of Pathology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Marc P L M Snijders
- Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, 6500, GS, Nijmegen, the Netherlands
| | | | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics and Oncological Pathology Group, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLLEIDA, CIBERONC, 25198, Lleida, Spain
| | - Jone Trovik
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021, Bergen, Norway; Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, 5021, Bergen, Norway
| | - Frédéric Amant
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, 3000, Leuven, Belgium; Department of Gynaecologic Oncology, Centre Gynaecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute and Amsterdam University Medical Centres, Academic Medical Centre, 1105, AZ, Amsterdam, the Netherlands
| | - Leon F A G Massuger
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Johan Bulten
- Department of Pathology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6500HB, Nijmegen, the Netherlands
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7
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Weinberger V, Bednarikova M, Hausnerova J, Ovesna P, Vinklerova P, Minar L, Felsinger M, Jandakova E, Cihalova M, Zikan M. A Novel Approach to Preoperative Risk Stratification in Endometrial Cancer: The Added Value of Immunohistochemical Markers. Front Oncol 2019; 9:265. [PMID: 31032226 PMCID: PMC6473394 DOI: 10.3389/fonc.2019.00265] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/07/2018] [Accepted: 03/22/2019] [Indexed: 12/21/2022] Open
Abstract
Background: The current model used to preoperatively stratify endometrial cancer (EC) patients into low- and high-risk groups is based on histotype, grade, and imaging method and is not optimal. Our study aims to prove whether a new model incorporating immunohistochemical markers, L1CAM, ER, PR, p53, obtained from preoperative biopsy could help refine stratification and thus the choice of adequate surgical extent and appropriate adjuvant treatment. Materials and Methods: The following data were prospectively collected from patients operated for EC from January 2016 through August 2018: age, pre- and post-operative histology, grade, lymphovascular space invasion, L1CAM, ER, PR, p53, imaging parameters obtained from ultrasound, CT chest/abdomen, final FIGO stage, and current decision model (based on histology, grade, imaging method). Results: In total, 132 patients were enrolled. The current model revealed 48% sensitivity and 89% specificity for high-risk group determination. In myometrial invasion >50%, lower levels of ER (p = 0.024), PR (0.048), and higher levels of L1CAM (p = 0.001) were observed; in cervical involvement a higher expression of L1CAM (p = 0.001), lower PR (p = 0.014); in tumors with positive LVSI, higher L1CAM (p = 0.014); in cases with positive LN, lower expression of ER/PR (p < 0.001), higher L1CAM (p = 0.002) and frequent mutation of p53 (p = 0.008). Cut-offs for determination of high-risk tumors were established: ER <78% (p = 0.001), PR <88% (p = 0.008), and L1CAM ≥4% (p < 0.001). The positive predictive values (PPV) for ER, PR, and L1CAM were 87% (60.8–96.5%), 63% (52.1–72.8%), 83% (70.5–90.8%); the negative predictive values (NPV) for each marker were as follows: 59% (54.5–63.4%), 65% (55.6–74.0%), and 77% (67.3–84.2%). Mutation of p53 revealed PPV 94% (67.4–99.1%) and NPV 61% (56.1–66.3%). When immunohistochemical markers were included into the current diagnostic model, sensitivity improved (48.4 vs. 75.8%, p < 0.001). PPV was similar for both methods, while NPV (i.e., the probability of extremely low risk in negative test cases) was improved (66 vs. 78.9%, p < 0.001). Conclusion: We proved superiority of new proposed model using immunohistochemical markers over standard clinical practice and that new proposed model increases accuracy of prognosis prediction. We propose wider implementation and validation of the proposed model.
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Affiliation(s)
- Vit Weinberger
- Department of Gynecology and Obstetrics, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Marketa Bednarikova
- Department of Internal Medicine - Hematology and Oncology, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Jitka Hausnerova
- Department of Pathology, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Petra Ovesna
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czechia
| | - Petra Vinklerova
- Department of Gynecology and Obstetrics, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Lubos Minar
- Department of Gynecology and Obstetrics, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Michal Felsinger
- Department of Gynecology and Obstetrics, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Eva Jandakova
- Department of Pathology, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Marta Cihalova
- Department of Pathology, University Hospital in Brno and Masaryk University, Brno, Czechia
| | - Michal Zikan
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
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8
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Smardova J, Liskova K, Ravcukova B, Malcikova J, Hausnerova J, Svitakova M, Hrabalkova R, Zlamalikova L, Stano-Kozubik K, Blahakova I, Speldova J, Jarkovsky J, Smarda J. Complex analysis of the p53 tumor suppressor in lung carcinoma. Oncol Rep 2015; 35:1859-67. [PMID: 26718964 DOI: 10.3892/or.2015.4533] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/10/2015] [Indexed: 11/05/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide. The p53 tumor suppressor is a transcription factor controlling expression of its target genes in response to various stress stimuli. Mutations of the TP53 gene occur very frequently in lung carcinomas and they play an important role in both oncogenic transformation of lung epithelial cells and lung carcinoma progression. We determined the TP53 status in 42 samples of squamous cell lung carcinoma (SQCC) and 56 samples of lung adenocarcinoma (AC) by the functional analysis FASAY and its variant called split assay. Altogether, we detected 64 TP53 mutations in 63 patients and analyzed them by cDNA and gDNA sequencing. The TP53 mutations were found in 76.2% (32/42) of SQCC cases, and 55.4% (31/56) of ACs. Immunoblotting revealed the p53 protein accumulation in 18 samples (42.9%) among SQCC cases and 19 samples (33.9%) among AC cases. Using fluorescence in situ hybridization we detected loss of the TP53-specific 17p13.3 locus in 23 from 41 analyzed SQCC samples (56.1%) and in 20 from 54 analyzed AC samples (37.0%). We did not find any statistically significant differences in overall and disease-free survival in relation to TP53 status.
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Affiliation(s)
- Jana Smardova
- Department of Pathology, University Hospital, Brno, Czech Republic
| | | | - Barbora Ravcukova
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
| | - Jitka Malcikova
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Jitka Hausnerova
- Department of Pathology, University Hospital, Brno, Czech Republic
| | - Miluse Svitakova
- Department of Pathology, University Hospital, Brno, Czech Republic
| | | | | | - Katerina Stano-Kozubik
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Ivona Blahakova
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Jana Speldova
- Department of Respiratory Diseases and TB, University Hospital, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Smarda
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
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9
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Vychytilova-Faltejskova P, Kiss I, Klusova S, Hlavsa J, Prochazka V, Kala Z, Mazanec J, Hausnerova J, Kren L, Hermanova M, Lenz J, Karasek P, Vyzula R, Slaby O. MiR-21, miR-34a, miR-198 and miR-217 as diagnostic and prognostic biomarkers for chronic pancreatitis and pancreatic ductal adenocarcinoma. Diagn Pathol 2015; 10:38. [PMID: 25908274 PMCID: PMC4407796 DOI: 10.1186/s13000-015-0272-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [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: 12/21/2014] [Accepted: 04/15/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma is an aggressive malignancy with late presentation, metastatic potential and very poor prognosis. Therefore, there is an urgent need for novel diagnostic and prognostic biomarkers. MicroRNAs are small non-coding RNAs that post-transcriptionally regulate gene expression. Altered expression of microRNAs has been reported in wide range of malignancies, including pancreatic ductal adenocarcinoma. The aim of this study was to analyze the expression of selected microRNAs in normal pancreas, chronic pancreatitis and pancreatic ductal adenocarcinoma tissues and evaluate their diagnostic and prognostic potential. FINDINGS Using quantitative real-time PCR, expression levels of 4 microRNAs were examined in 74 tumor tissues, 18 tissues of chronic pancreatitis and 9 adjacent normal tissues and correlated with clinicopathological features of patients. Expression levels of miR-21, miR-34a and miR-198 were significantly higher, whereas levels of miR-217 were significantly lower in pancreatic ductal adenocarcinomas compared to healthy tissues and tissues of chronic pancreatitis. Moreover, increased expression of miR-21 and miR-198 was significantly associated with shorter disease free survival and overall survival. CONCLUSIONS Our data suggest that altered expression of examined microRNAs is related to neoplastic transformation and progression of the disease and these microRNAs could serve as diagnostic and prognostic biomarkers for pancreatic ductal adenocarcinoma. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1373952531543898.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Pancreatic Ductal/diagnosis
- Carcinoma, Pancreatic Ductal/genetics
- Carcinoma, Pancreatic Ductal/pathology
- Female
- Gene Expression Regulation, Neoplastic/genetics
- Humans
- Male
- MicroRNAs/genetics
- Middle Aged
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/genetics
- Pancreatic Neoplasms/pathology
- Pancreatitis, Chronic/diagnosis
- Pancreatitis, Chronic/genetics
- Pancreatitis, Chronic/pathology
- Prognosis
- Pancreatic Neoplasms
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Affiliation(s)
- Petra Vychytilova-Faltejskova
- Molecular Oncology II - Solid Cancers, Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic.
| | - Igor Kiss
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic.
| | - Sona Klusova
- Molecular Oncology II - Solid Cancers, Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
| | - Jan Hlavsa
- Department of Surgery, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Vladimir Prochazka
- Department of Surgery, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Zdenek Kala
- Department of Surgery, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Jan Mazanec
- Department of Pathology, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Jitka Hausnerova
- Department of Pathology, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Leos Kren
- Department of Pathology, Institutions shared with the Faculty Hospital Brno, Brno, Czech Republic.
| | - Marketa Hermanova
- First Department of Pathological Anatomy, Institutions shared with St. Anne's Faculty Hospital, Brno, Czech Republic.
| | - Jiri Lenz
- First Department of Pathological Anatomy, Institutions shared with St. Anne's Faculty Hospital, Brno, Czech Republic.
| | - Petr Karasek
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic.
| | - Rostislav Vyzula
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic.
| | - Ondrej Slaby
- Molecular Oncology II - Solid Cancers, Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic.
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10
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Robesova B, Bajerova M, Hausnerova J, Skrickova J, Tomiskova M, Dvorakova D. Identification of atypical ATRNL1 insertion to EML4-ALK fusion gene in NSCLC. Lung Cancer 2015; 87:318-20. [PMID: 25601488 DOI: 10.1016/j.lungcan.2015.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 11/28/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 01/18/2023]
Abstract
We herein present a rare case of an EML4-ALK positive patient. A 61-year-old man was diagnosed with locoregional non-small cell lung cancer (NSCLC). No EGFR mutations were detected, and therefore the ALK rearrangement was evaluated using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) and the reverse transcription PCR (RT-PCR) method for EML4-ALK. All methods showed a positive result and, therefore, the patient was treated with crizotinib with a good therapeutic response. However, a detailed RT-PCR analysis and sequencing revealed an unexpected 138 bp insertion of attractin-like 1 (ATRNL1) gene into the EML4-ALK fusion gene. In our case, the positive therapeutic response suggests that ATRNL1 insertion does not affect EML4-ALK's sensitivity to crizotinib. This case shows great EML4-ALK heterogeneity and also that basic detection methods (IHC, FISH) cannot fully specify ALK rearrangement but in many cases a full specification seems to be important for an effective TKI indication, and sequencing ALK variants might contribute to optimized patient selection.
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Affiliation(s)
- Blanka Robesova
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic.
| | - Monika Bajerova
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Jitka Hausnerova
- Department of Pathology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Jana Skrickova
- Department of Respiratory Diseases and Tuberculosis, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Marcela Tomiskova
- Department of Respiratory Diseases and Tuberculosis, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Dana Dvorakova
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
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